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growth. It would be too much to expect The treatment of pneumonia has been that the enormous increment of power discussed at length but at present the imthrust upon those directing its policies and portant and interesting experimental work activities should be entirely free from a being carried on in efforts to combat this modicum of errors and mistakes. Things infection by means of the injection of have been done that are certainly open to leucocytic extract, is occupying a promgrave criticism, but when one reviews the

inent place in the field of progressive medienormous work and progress of the past cine. five years, and comprehends the unlimited

The principle of the treatment is power placed in the hands of a few men,

based upon the clinical fact that the presthe predominating sentiment is bound to

ence of a large number of white cells in be one of admiration. There may be—as

pneumonia is a good prognostic indication, has been said inherent evils in the system that the leucocyte as a consequence plays a of organization. There may and

most important role in the resistance to the doubtedly has been much abuse of power. infection. But there has been progress and a pro

Since the action between tissue fluids fessional uplift that means everything to

containing antibacterial substances, and the American physician. As we look,

tissue cells, is the important detail in protherefore, with just eyes on the actual

tection against any infection, the supremachievements of the past few years we

acy of one or the other in the process, would stultify our sense of fairness if we

depends upon the type of invading organfailed to express a sincere note of appre

ism and its virulence. Unless the pneuciation. We are glad to see the criticisms

monic infection is too overwhelming or that some of our contemporaries are mak

virulent, the essential element in the ing—though we do deplore the per

progress of the disease is the leucocyte. sonalities and vituperation. But knowledge of the ability and character of

The fact that the pneumonia infection is

not confined to the lungs but frequently inthe American physician leaves no doubt in our minds as to the ultimate future of an

vades the general circulation, led to the beorganization which can already boast of

lief that it was a local manifestation of a over thirty thousand American doctors. It general disease—and it was constantly obmay have storms and strife galore, it may

served that a stimulation of leucocytes alsuffer from the sins of omission and com

ways followed and continued with the mission of some of its officers, but as true

progress of the lesion. as the needle to the pole, the great Ameri

Believing that the phagocytic power of can Medical Association itself is going on the white cells of pneumonia patients was to successes that are only limited by the

less than that of the normal individual, needs of the American people. And not the

Hiss extracted these substances, and used least of its achievemen.s will be the aid and them in a diffusible form thus supplying impetus it will be able to give to the evolu

material to the infected organism, which tion of a national department of health. would aid its phagocytic action in protec

our

to

tion against the poison elaborated by the tality is given as 1275%. Fatal cases were bacteria.

in young children with broncho-pneuLaboratory experimentation upon ani- monia, and in adults of advanced age or mals showed that susceptibility and im- with cardiac complications. munity to pneumococcus infection were Insufficient cases have been observed be measured by the

the degree of as yet, to determine final conclusions as to phagocytic power of the white cells of the the therapeutic value of the leucocytic exanimal employed. Pneumococci from the tract; but reports show that no harm reblood of a pneumonia patient were injected sulted to the patient in any instance; that intraperitoneally in animals by the Wright in many cases the disease was apparently capillary pipette method. Since the peri- shortened—with improvement in most of toneal cavity of the animal exerts destruc- them; that in the severe cases recovery tive power upon certain numbers of pneu- was hastened and the toxaemia diminished; mococci, and the end results of a pneu- and that in the entire series a lower mormococci inoculation depend upon the bac- tality resulted. tericidal and phagocytic power of the ani- Granted that this treatment may be inmal, it was found that the reaction pro- efficient owing to the need of more exact duced a general peritonitis in a few hours, knowledge of the infection of pneumonia, and, although phagocytosis was slight, the and the workings of the organism in propneumococci gradually disappeared with tective effort; it still seems to promise no process suggesting lysis taking place. much which will be of decided therapeutic As a result of these intraperitoneal inocu- value. Among other important factors, it lations, it was found by Hiss and others

seems that the time of injection of the exthat the severity of the disease was modified tract, and the dosage used will be conand that the lesions were more localized. siderations of no small consequence in the

Only a small number of pneumonia cases final deductions. in man is thus far spoken of by Floyd and Certainly good results have been obLucas (in the Journal of Medical Re- tained and reports from more extended search)-in which the leucocytic extract series of cases will undoubtedly show that was used. An aqueous extraction of leu- much in the treatment of pneumonia: incocytes of rabbits, obtained from pleural fections can be done by the injection of the excitation, was injected into the subcu- leucocytic extract. taneous tissues of the buttocks, thigh, or back of the pneumonia patient with result- The increasing cost of meat is bound ing improvement, especially as to the symp- to have consequences which physicians toms due to the toxemia; and with no must anticipate, for to be forewarned is to immediate or subsequent harmful effects. be forearmed. We are interested in the In small children amounts ranging from causes because they show that the phe5 to 10 c.c. were used twice a day, while nomenon is biologically inevitable and will in severe cases 15 to 20 c.c. were injected continue for some time to come.

The inthree or four times in twenty-four hours. creasing amount of gold taken from mines The effect depends upon the day of the dis- makes that metal cheaper, so that the dolease that the serum is used.

The mor

lar buys less and less every year—but that affects the prices of all things proportion- huge numbers about to be accurately reately. The unit of exchange is merely be- ported by the census. There are a few coming smaller. Nevertheless a greater

who maintain that such increase of populaincreased production of some other things tion brings more harm than good and that has reduced their price even measured by it would be well for public health to keep the smaller unit, but in the case of meat down our numbers so that there would the amounts have not increased at the same be enough meat to go round. rate as the demand. A short while ago when land was free, meat was produced in such amounts that the poorest laborer

The movement to stop all immigration could afford it three times a day. The

must be considered by physicians. Surely conditions attracted a flood of immigrants

the medical facts elicited from the present from lands So overcrowded that the vast

investigations should help to decide the proportion of the poor could not afford proper course. The phenomenon is just meat once a month, and the movement will

being discovered though it is very old. Percontinue until there is no attraction—that haps we are on the verge of a change in is, until it is as difficult to get meat here

our national diet in which meat forms a as it is in Europe. So we can expect the decreasing part. Already we are talking price of meat to rise until it is beyond the

of importing both meat and wheat as we means of the poor and an occasional food

may not produce enough for home confor the middle classes.

sumption—let alone exportation. This will

do no harm--we will merely pay foreign The results of a non-meat diet are not

farmers for food instead of our own. Yet, necessarily bad, if there is plenty of nitro

there does not seem to be any doubt that gen of other forms—fish, eggs, milk prod

we are on the way to a crowded condition ucts, and the nitrogenous grains—so we

in which there will be as much undernutrineed not worry over imaginary ills, but the

tion as in Europe and as little meat in the trouble evidently will be the difficulty of

dietaries—whether for good or ill remains getting even these foods. America has al

to be seen. The effect upon school chilways been more or less free of the diseases

dren must be studied, and a determination of under-nutrition, which have afflicted the

made as to whether the percentage of depoor of Europe, but there now seems to be

fectives will increase. an end of this desirable state, and we must hereafter be on the lookout for them. Moreover our meat diet is generally recog- The spread of tuberculosis in the best nized as causing a magnificent development

climates is being unjustly laid to the doors of the native born children of immigrants of the sanitariums therein established, for who are undersized from underfeeding, it has been proved over and over again The intellectual accomplishments of these that such an institution almost invariably new types have astounded the world, for causes a great reduction in the morbidity they have far surpassed their ancestors. and mortality of the surrounding populaOur increasing density of population is tion, by reason of the educational effect in therefore not an unmixed blessing, and we methods of prevention and cure.

There should moderate our enthusiasm over the have been disquieting reports of the apWith every

pearance of tuberculosis at places adver- uated in a climate which has been widely tised as climatically curative, as for in- advertised as God's own for the cure and stance among the Mexicans of the south- prevention of the disease. west and American families in mountain thing in their favor as to climate and resorts of the east, but in every case as far hygiene they have been infected by their as we know the sanitariums have nothing patients, and their sad plight conveys the to do with it. Patients go to the place not lesson that there is great danger from confor skilled treatment but for the climate tact with any infection. It was only a few solely. They take board and bed with poor years ago that we thought typhoid a very families whom they promptly infect safe disease to nurse, but we are now apthrough criminal carelessness. Sanitariums palled at the enormous number of contact prevent this very thing. Perhaps we too cases and have reversed our teaching to the can prevent this new disaster from becom- end that nurses be guarded with extreme ing worse, by emphasizing the limitations precautions. Similarly, though to a less of climate and the vital necessity of skilled extent of course, we must warn all those management. Patients must be warned in contact with the tuberculous. Perhaps not to expect a cure from climate alone, in- the two cases we mention had become reckdeed they should be told that they might less from the proverbial contempt of get worse if not under proper care and that dangers daily encountered, or have been in the meantime they might carry the in- grossly careless, but even so they show fection to others. The whole wretched that the occupation is not as safe as we bebusiness shows that we have all been de- lieved. ceived as to the preventive value of certain climates, for there are increasing reports

The post-office fight against quacks of cases originating where we thought it

seems to be progressing with commendable impossible. Indeed, there is a beginning industry. Every now and then we hear of suspicion that the very abnormal conditions

some of them being refused the use of the of these places may even reduce one's re

mails, so that in time it may be difficult to sistance.

swindle sick people this way. At the same The danger of nursing the tuberculous time, it makes one heart-sick to think of in sanitariums has heretofore been con- the low level of intelligence of the victims, sidered so slight as to be negligible, indeed which makes this form of crime possible. one of the commonplace remarks in defense Child-like faith in advertised remedies of these institutions is to the effect that seems born in us and exposure of the they are the safest places in the world on frauds has no effect whatever on most peoaccount of the great care exercised to de- ple. They run to the next as eagerly as to stroy all bacilli escaping from the patients. the last. The only thing to do is to proAs usual with all such unqualified medical tect the poor fools like the children they opinions, a very false impression has been A paternal government seems desconveyed, for we have recently learned of tined to be our fate and our boasted two female nurses who have contracted democracy a sham. We wonder whether pulmonary tuberculosis in a sanitarium sit- it will ever be possible to exclude fraudulent medical advertisements from the lay press. duction is quickly becoming amply sufThe best papers have succeeded, but the ficient to replace the starches, though of vast majority are in a deplorable con- course such a change in physique is not a dition.

are.

matter for a day, but a slow change requiring millenniums. Nevertheless, there is

a danger which has already been recogThe successful use of trypsin and amy- nized. When starches are eaten, the sugar lopsin in round celled sarcoma is report

is slowly produced and always exists in ed by Capt. F. W. Lambelle, R. A. M. C.,

very weak solutions, but when sugar is in the March number of the Journal of the

eaten, particularly the absorbable varieties, Royal Army Medical Corps.

The case

it is apt to be in strong solution more or was that of a man in whom the tumor re

less harmful. Very strong solutions of all curred after operation and became so ex

the sugars seem to be used in nature as tensive as to prevent further interference.

well as in our kitchens, as antiseptics to The enzymes were then tried with the re

preserve other foods, for they are very inmarkable result of sloughing of the masses

jurious to living tissue. It is now said and an apparent cure in a few months. The

that sugar eaters suffer unduly from incase is remarkable in view of the prac

flammations of the intestinal tract and liver. tically unanimous professional verdict in We have called attention to this fact before, America that this form of treatment is and it seems important enough to repeat, powerless. It is quite evident that the whole

now that sugar diet is receiving high matter must now be reopened for even if praise which will doubtless lead many to one in a hundred are cured it is well worth

indulge unduly. while. A spontaneous cure may have occurred but it is so unlikely that we must

The false reasoning of anti-vivisectiongive credence to the case, particularly as

ists is well illustrated in a letter published the result followed the treatment

by S. W. Cleghorn in the January Ameripromptly.

can Magazine. There is the usual false

assumption that animals experimented The increasing consumption of sugar upon are in continual severe suffering in is at last receiving the attention of physi- the subsequent diseases or conditions proologists in many parts of the world, and duced, but the chief statement is to the efthe general opinion seems to be favorable fect that while vivisection may be useful, to this change in habits because it is eco- it is cruel and though it may help turn us nomical to relieve the digestive apparatus out strong and healthy, exercise and saniof part of its labor of digesting starches. tation would do it better. This opinion The change has been so recent that there calmly ignores the fact that almost every is not yet time to tell what harm if any bit of sanitation is based on prior experican result. The possible atrophy of the ments broadly classed as vivisection, and it tissues, which produce the starch-hydrating unconsciously concedes their necessity. To enzymes need not worry us. Indeed it stop them now, means that there shall be no would not be disastrous if we entirely lost future advances in sanitation and that the our power to digest starch, for sugar pro- problems of prevention and cure shall re

SO

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