« PreviousContinue »
No abuse is too severe for simulation. passionate desires, many couples, of whom Nauseous doses, severe cathartics, threats one or both are consumptiv, coax pregof cauterization if recovery does uot ense nancy. within a certain time, are often efficient. While it is true that in many instances In true hysteria no study and thought is Nature suspends the dread doom for the too deep
sake of the unborn child until after de
livery, it is also true that frequently before Treatment of Bualons.
the accouchement two lives pay the penMach more can be done for this painful alty demanded of ignorance and lust since affection than most textbooks mention or the world began, and that even if the physicians practise. In the early stages, "great white scourge” be temporarily before the bony structures have become checkt, the penalty is soon demanded with deformed, the soft parts may be brought interest compounded—and what does that to their normal healthy condition, and mean? shortened life for the mother, and even extensiv osseous change may be a defectiv child thrown upon the mercy of remedied without operation. I shoe with its friends and the charity and expense of a straight inside border and rounded toes, the state. which will be roomy enuf to give free play It is now an establisht fact that neither to the foot, is a necessity. The deformed father nor mother can transmit tuberculosis toes may be drawn inward by passing a to their children ; but that, tuberculosis strap of adhesiv plaster between the first existing in either parent in activ or latent and second toes, around the phalanges of form, the offspring have an acquired tenthe first and then carrying it along the dency toward the disease; hence, those inner border of the foot and around the predisposed to tuberculosis before marriage heel to the center of the outer side, where should not marry, and those who are marit is held in place by circular bandages ried should avoid conception. “Labor is around the foot. Cotton wool pledgets are generally rapid and easy in the phthisical, worn between the first two toes. Pockets but does not fail, nevertheless, to augment may be made for the first toe and for the the weakness of constitution, vitally imheel, and then attacht by a strip of elastic paired, and to increase the congestiv dyspalong the inner side of the foot. Metal nea on the part of the lungs" (Gaillard). sole plates and “bunion springs” are of Even if the wife, who is predisposed to service in many cases, and may be ob- tuberculosis by reason of heredity, has tained from any instrument dealer. If the never developt the disease, may we not case has not passed beyond the primary assume that the repeated miscarriages, stages of effusion and thickening, it may be labors, and lactations would exert a strain treated by repeated applications of mild which must aggravate Nature in a certain blistering agents, like tincture of iodin, fly period? The sword is two edged, for it blisters, or nitrat) of silver (a dram to the strikes both mother and child; it cuts on ounce). A wet dressing of lead water and both upward and downward stroke, for it laudanum makes one of the best agents to destroys lives and burdens the state. reduce inflammation and relieve pain. Relief from legislation seems well nigh Frequent hot foot baths aid any of the hopeless. Let the WORLD family do what treatments greatly.
they can to discourage the marriage of If the case fails to yield to warmth, con- any who have the tubercular diathesis. stant elevation of the foot and the above the doctor may often speak when the measures, operation may be considered. father and mother and pastor cannot. The confinement incidental to the opera- Gentle, professional, friendly, advice may tion is its worst objection, as it is gener- do much to help both individuals and hually successful if properly done.
manity. Every practician must know his
duty, and if it were but done, the plague The Influence of Pregnancy on Tuberculosis. would almost vanish, unaided by bacteri.
Most of the laity, and not a few physi- ology, provided hygienic principles are cians, believe that pregnancy has a bene- absorbed with moral and sexual suggesficial effect on the tuberculous mother. tions. Consumptive are
Never neglect to auscult the beart, examin the healthy persons. Hence, encouraged by
mouth for foreign bodies, and place the patient the “fooī” advice of the physician, and in the dorsal decubitus before starting an anesstimulated and aggravated by their own thetic.
Just a Reminder for You.
ORIGINAL COMMUNICATIONS Our forms close on the 12th of each month;
Short stories on the treatment of diseases and experience with that is, if you want an article publisht or a
new remedies are solicited from the profession for this query answered in the December issue, you must department; also difficult cases for diagnosis and treat get it in our hands before the 12th of November. Many are disappointed because of tardiness or
Articles accepted must be contributed to this journal only.
The editors are not responsible for views expressed by forgetfulness of this rule, and many valuable
contributors. articles are either held over a month or are en- Copy must be received on or before the twelfth of the month tirely unavailable. We must now get into
for publication in the next month. Unused manuscript
cannot be returned. winter work. Recall your successes and failures
Certainly is excellent discipline for an author to feel that he mud of last winter and report tersely. What was say all he has to say in the fewest possible words, or his reada your proportion of deaths in lobar pneumonia is sure to skip them; and in the plainest possible words, or Me and how many cases did you have? How do you
reader will certainly misunderstand then. Generally, also, a
doronright fact may be told in a plain way; and we want “ break up" an incipient cold ?-do not give a doronrighe facts at present more than anything else.-RUSKIN. long article on this; just give your prescriptions
READ. REFLECT. and directions in a few lines. Do you poultice the chest of a child in pneumonia ? and if so, Experience With Diphtheria Antitoxin. why, and what do you use ? What is your Editor MEDICAL WORLD:-In October favorit counter irritant ? Have you lookt up
WORLD, page 427, Dr. O'Ready wants to the new remedies for coughs and colds which have come out in the last few years ? or are you
know the truth about diphtheria anti. following the rut your grandfathers tripped in ? toxin; and as I have had considerable The man who is satisfied to take unquestioned experience with it, I will offer a reply, what is told him by those who consider them. which will not be based on scientific selves authority will never advance himself, his research, but on experience with it. profession, or the world. You must not only study, but you must work, and you ought to
I left college an ardent supporter of write if you wish to derive'the fullest possible diphtheria antitoxin, because our profesbenefit from your endeavors. Do not attempt to sor of diseases of children, Dr. J. H. Tayteach that about which you yourself know noth- lor, of Indianapolis, found it to be the ing, for it is well said that "You can not help best treatment for diphtheria. I soon another higher than you stand yourself.” Do
located in a small town in Southern Indi. not forget what you learned thru the summer and fall, but store it away and digest it well so
ana, where I bought the practise (?) of that you may give it to THE WORLD in condenst Dr. J. W., who in course of conversation and assimilable form next spring. The right told me of his cases of diphtheria, and thing in the wrong place is pathetic as well as remarkt that they were of the most malig. ludicrous. Now for the winter: keep THE nant form, and that he had lost a great WORLD warm with interesting and valuable articles.
many cases. I askt if he used antitoxin.
He answered: “No! Well, I used it on Black-list in Rock Island and Moline, Illinois. a few cases, but they all died, so I quit
The physicians of Moline held another meeting, Septem- using it.” I soon learned by report that ber 9, to complete their plans for the compiling of a black. most of his cases did die. One layman list. Nearly all present submitted lists of people considered dead-beats, and the others are to hand in their lists soon. remarkt that when Dr. J. W. diagnosed These names will be arranged in proper form and each physician in Moline and Rock Island will be furnisht a
diphtheria, they always sent the measurecopy.
ments to the undertaker. This is good work. Whoever renders a valu
I saw no cases of diphtheria until the able service should be faithfully rewarded for it;
next winter, when a case developt in a but some people think that doctors are an exception to this rule. Wonder if they think that doc boy four years old in the practise of tors can live on air ? If they think so, or if they another doctor, who would no; use antiare in the habit of neglecting or evading doctors' toxin, or allow it to be used if he could bills, they should speedily be convinced of their prevent, by telling of its “deleterious error. In this connection, what shall we say of effects," and “horrible results," etc. the doctor who neglects to pay his subscription However, as the case continued to grow to medical journals that are rendering extremely valuable service to bim? Shall we “black-list" worse, this doctor was discharged and Dr. doctors that get in arrears, and neglect every
M. L. Arthur was called. I saw the case bill or letter sent to them ? Can medical jour with him. We advised antitoxin. Fam. nalists "live on air” and pay the printer ily objected on the grounds that it was besides? Let us all live square, whether laymen,
" either kill or cure," left child in bad doctors, or medical journalists.
condition, etc. However, seeing that it Don't neglect your bed-ridden patients. In
was the only chance, they agreed, and sist upon frequent change of posture, clean 1,000 units were injected one afternoon lidens, alcohol baths, massage and a nutritious
with the happy result of noticeable diet.
improvement in child's condition next made recovery
morning. In forty-eight hours membrane lowing its use, I have never seen any. was gone, temperature normal and child Have used it several times to immunize
children in the same family, without the Altho I did not keep an accurate record slightest ill effect. Have never seen diphof my cases, I recall that diphtheria was theria develop in a child that had an quite prevalent, and that I treated quite a immunizing injection. Have also used number of cases in the three years I antitoxin with good effects late in scarlet remained there, in all of which I used fever, when throat symptoms were alarm1,000 units of diphtheria antitoxin just as ing. Of course these cases were compli- . soon as the diagnosis was made, and with- cated by the Klebs-Loeffler bacillus. out exception in from twelve to forty-eight Other treatments may be as good so far hours the membrane was gone, tempera- as the ultimate result, saving life, is conture normal,
normal, and recovery followed. cerned, yet so far as I know, none of them Some may say, as has been said, that the will shorten the course of the disease as disease had lost its virulence; was not in much as diphtheria antitoxin, which is such malignant form, etc. Possibly that quite a desideratum. is true, but let me report two cases that Hazleton, Ind. H. M. ARTHUR. occurred in the practise of the aforesaid doctor.
Experience Both With and Without AntiCase 1: A child eighteen months old,
toxin. developt diphtheria and was treated for Editor MEDICAL WORLD :-The paper two weeks; then developt suppurativ by James O'Ready, M.D., in the October parotiditis which was lanced, which
WORLD suggests the following: remained a fistulous opening until death, My experience of about forty years, about two months later, of post diphther. thirty-five of which have been spent in itic paralysis.
this city, has led me to believe that the Case 2: A young man, age 19, attending Doctor's treatment is most excellent. In town school, came into our office one the New York Medical Record, for March morning with burning fever and sore 18, 1876, was publisht a paper by Dr. C.
Dr. M. L. Arthur made the diag: E. Billington, giving a treatment which nosis of diphtheria. I saw the case and he claimed to have found most remarkconfirmed the diagnosis. Dr. Arthur ably successful. At that time I was at sea advised antitoxin. Young man declined, in regard to the treatment of that dread saying that he would go home and let
disease, having lost three cases in one “Uncle Doc." treat the case, which he family which I attended with a consultant did, for five days, until he was a corpse. from St. Louis. Since that time I have And when a few days later his father came followed substantially the Billington treatinto our office, with his eyes filled with ment with such modifications as each case tears, and remarkt, “Oh, if he had only might require; and with such success that let you use the antitoxin,” I could hardly when antitoxin was introduced to the prorefrain from saying what was uppermost fession I could say with truth that the in my mind: he would be alive and well Billington treatment gave a larger pertoday.
centage of cures than was claimed for In my opinion, antitoxin bears the same
antitoxin. And yet I adopted antitoxin relation to the toxin of diphtheria that in connection with the Billington treatwater does to fire; when the two are
ment as soon as I had an opportunity after brought in contact the water overcomes
it came upon the market. the fire, renders it inert, but cannot repair When called to a case I wrote three the damage done. So the antitoxin ren
prescriptions : ders the toxin inert, but cannot repair the
B damage done to the cells. And as we use
No. 1.-Tinct. ferri muriatis... water early to prevent damage, so we
. Zij Glycerinae ........
Ziiss should use antitoxin early to prevent
Ziss damage to the cells.
M. Sig. - Teaspoonful every hour. In no caso have I had to repeat the No. 2.- Potassae chloratis
.388 injection, which should be done in twenty
Ziv four hours if there is no improvement, or
M. Sig.-Teaspoonful every hour.
No. 3.- Acidi carbolici if the spreading of membrane has not
Ziv stopt. As to the reported bad results fol
M. Sig.-Spray throat every hour.
Directioned to keep up the medicins day successful in some very bad cases, even and night without fail.
when the membrane had invaded the Of course, in particular cases I used larynx. In my early cases, twenty-five other means, such as chlorin water, pe- years ago, I used alcohol as a stimulant in roxid of hydrogen, alcohol, etc., locally, accordance with the advice of Dr. Chapbut the use of the three prescriptions was man, of the Long Island College Hospital; never stopt. For some years I have not but of late years I never use whisky or used the chlorate of potash prescription brandy, as I could never see that they did (No. 2) and find the results just as good. the slightest good. I could give experiNow I use the same treatment in conjunc- ence to show that paralysis and urticaria tion with antitoxin, with this difference: follow cases in which antitoxin has not I do not give nearly as much medicin, been used; but I once treated two cases and I allow the patient to sleep one or two in the same family, one with antitoxin, or more hours at night without awakening the other without, and both had urticaria. him to give medicin.
Webster Grove Sta., St. Louis, Mo. B. J. BRISTOL. The point I want to emphasize is this : Under the Billington treatment alone Mostly Theories, and Those Not Well ) cases required from four to five weeks
Founded. sometimes before the last patch of mem- Editor MEDICAL WORLD :-If it pleases brane disappeared, while under the use of you, will you kindly publish the following antitoxin the membrane would begin to inquiries that some of your subscribers melt away by the second or third day, may answer them ? and would disappear entirely within one 1. Has horse serum, previous to its week.
being incorporated with its keeper (carOne case I will relate: The patient had bolic acid, etc.), been used in order to been sick a week when I was called in. prove that it is “it" (the serum pure) Saw E. T., a girl of nine years, at 10 p.m. that cures diphtheria ? Others and I have Faaces completely covered with thick, used “phenic acid " alone in this disease, firm, yellow membrane, the uvula as and our cures have been as effectual as large as my finger, a hard inelastic with the antitoxin of the market. mass completely filling the opening of 2. Since one of our “good” men has the fauces. She could not sleep, as she proved recently that sanitary measures would immediately choke on losing con- have worked better in one of our largest sciousness. It being Sunday night, I cities to prevent smallpox than vaccinacould not get antitoxin until 3 a.m. of the tion, would it not be advisable to stop com3d, when I injected 1,000 units—all I pulsory vaccination and give hygiene a could get. In twelve hours I injected test in each and every locality of our land 1,500 units, and the next day 1,500 more. where smallpox breaks out? It was at this last injection that the father, 3. Where can we find a "reasonable" despairing of ber life, begged of me not to reason to make surgically aseptic a local worry her any more and to let her die in area where we inject“ polluted” matter? peace. Suffice it to say that, at my last 4. Since our best authorities of today visit on the 8th, just six days from the tell us that micro-organisms have no effect beginning of treatment, there was not the
upon our economy until the latter is smallest shred of membrane to be seen, weakened to the point where the former and I dismist the case.
have their deadly influence set free, is our Now, cases similar to this, many of therapeutic adjunct in correspondence with which I had before the advent of anti- the above theory? What would result if toxin, required from three to four or five instead all sorts of antipyretics and antiweeks before the last patch disappeared; septics we generally use we tried to and during all this time there was anxiety, strengthen the backbone (vitality) of the as occasionally I would find on my morn. patient? ing visit that, instead of receding, the 5. Our physiologists of this century membrane was advancing; and then I teach us that life is the result of the activinstituted more vigorous treatment. ity of the cells. But where does the
I have had the good fortune never to “ force" lie that puts the cells into activhave lost a case in which I have used ity? And when that “force " is at fault, autitoxin ; and I must say that with the are all the cells deranged? or but one Billington treatment alone I have been organ "? Are we (in disease) to treat the organ diseased as an ultimate? or the ature? We take exception to what is " force"
as a cause of disease ? Can we called the danger point. Then, if we must reestablish equilibrium by removing the not stop heat, can we not take it away"effect?" or by restoring the force into when it reaches the danger point-by stimits normal agency? Now, do our thera- ulating mechanically the sweat centers ? peutics aim at the organ or at the Can we not increase the number of white " force" ? Is it the “patient” or the corpuscles by stimulating the lymphatic organ " that is sick?
system, thus aiding nature in killing the 6. Since in mostly all skin diseases we germs and removing their products ? see an effort of nature to throw out any 11. Is serumtherapy based upon the deadly element present in the economy, " contraria
similia" principle ? will any one give a scientific reason for
R. DEL MAs, Ph.D., M.D. using external adjuncts to dry up the Centreville, Minn. (Marquis of Villena.)? “ abnormal” excretions ?
[Marquis, give us your experience, not 7. Our drugs have been physiologically in general, but specifically, by a recital of tried upon the healthy cells to know of a number of cases, with phenic acid injectheir virtues, be they chemical or mechan. tions in diphtheria. As noted in our Ocical; and have been tried "singly ;' but tober issue, pages 414 and 427, the value do we have laboratory experiments to of diphtheritic antitoxin is now beyond demonstrate the action of mixtures" question. See the latest editions of works as a whole upon the healthy and the sick, by our highest authorities. This concluand of single remedies when incorporated sion was reacht by extensive bed-side exwith half a dozen or more? Are we merely perience on the part of many observers. empirical in our practise ? Is this medical You cannot controvert a conclusion so age one of facts or one of delusions? Is reacht, by vague generalities nor by polypharmacy a science ?
theories. Send us your actual experience 8. We beg to set here a corollary to and the facts brought out by the same, but Question 4: Since we admit that contagion touch a little more lightly on theory. The develops only in those predisposed to it, way in which antitoxins act is well known that is, in those whose vitality is lowered, to all who have studied this subject, and in whom primarily there is disorder, has been given many times in these pages. derangement (not pathological yet), the In regard to sanitary measures vs. vacgerm development must be "a result and cination, you doubtless refer to the experinot a cause. And, while the primary ence of Cleveland. Early in September I (disorder) and secondary (malnutrition, met a prominent city official of Cleveland either general or local) conditions con- and his wife. Upon inquiring how the tinue, is it possible to kill off the germi. children were they told me they were all at cidal influence ? Must we not say that home, having recently been vaccinated ; susceptibility is the etiological factor in that smallpox was already on the increase, infectious diseases, and bacteria the
and bacteria the threatening a worse visitation than ever sequelae ? Now, are
treat the this winter, and that vaccination was being patient, his state of disorder and malnu- done very extensivly. trition, in order to cure him? or shall we Space is given to the above article in simply direct our attention to the mi- order to illustrate a certain class of theocrobes ?
rists. The writer is not a typical WORLD 9. Since after the death of the body bac- reader. The ideal doctor is one who teria develop subsequently to the forma- studies carefully the recognized authorition of an alkaloidal ptomain poison, has ties; and while keeping ever in touch with any of our brethren proven the reverse to them, also reaches out into the so-called be true during life?
“irregular” fields of medical thought. So 10. Is not pure blood the best germicidal much for studying. And when he reaches agent on earth ? Is it good policy to bring the bed-side, he will do all in his power, down the temperature in fevers when the all in his knowledge thus gained by wide germs are present since, as Abbott says, and unprejudiced study, to cure his patient, bacteria will grow and develop most favor- It must be recognized that the “highest ably when the temperature is slightly authorities” are honest men, with large above the normal, and become inactive as experience and ample opportunities for soon as the thermometer registers three, observation, and they are as anxious as four or five degrees above normal temper- anybody else to cure patients. They have