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tract, are nearly absent. It would seem that, peptonoids of the Arlington Company, or the under these circumstances, common
panopepton of the Fairchild's, given at interwould teach the avoidance of food during the vals of three or four hours. continuance of the sever, unless it had been Now, let us consider the case of Senator predigested. But, of all foods that the prac- Hanna. I have taken this case under considtician should hesitate to force into the disabled eration from no wish to accuse anyone of digestiv tract of the typhoid patient, milk un- neglect or wrong doing, but simply because, by digested is the worst.
the daily bulletins of the Associated Press, the Once more: “Although typhoid fever is entire nation was made acquainted with the essentially a system disease, its characteristic progress of the case, the daily variations in the lesion is the intestinal ulcer, which should, as condition of the patient, and some glimpses at far as possible, be kept at rest. Milk, which the treatment. But I have especially chosen has heretofore been regarded as the only proper this because it illustrates, as I look at it, the exclusiv food, is, as a recent writer, Dr. Inglis, disastrous results of feeding milk to a typhoid says, 'not a liquid, but a deceptiv solid,' patient. capable of filling the small intestins with dense The majority of practicians is guided by indigestible curds, which irritate the ulcerated authority and precedent, and follow the dictum bowel, and, in addition, ferment and cause of men like Professor Osler, who advises the gaseous distension."
use of milk in these cases. Now, typhoid fever is a conservativ process ; It seems to me, however, not difficult, in it naturally tends to recovery. I believe that following the record in this case, to see how, Professor Osler is on record that, in typhoid left step by step, day by day, taking a case of entirely without medical treatment, 75 percent mild fever by the acknowledgment of the at. of them would recover, and 85 percent would tending physicians, the administration of milk get well with very little medical attention. My played havoc with the vitality of the sufferer, experience and observation, after mature re- culminating in the chill, which banisht alí flection, teach me that this estimate is even too hope. low; that under intelligent nursing, without We get the first intelligible report on Febmedical aid, 90 percent of them would con- ruary 5, which, it seems, was the fifteenth day valesce favorably. That the results do not of the fever, the first symptoms having shown vary under the many different forms of treat- themselves on January 22. We find a mornment attests the truth of this statement, the ing temperature of 100°, and an evening temonly advantage being, under the strict Brand perature of 102.2°. The pulse was regular at method, where the intensity of the fever is 80. The doctors report no complications, and always greatly modified, and the mortality this seems to be the case thruout the course of very close to zero. I have seen cases of the fever. Surely this record justified the typhoid fever protracted three and four months physicians in claiming that it was a mild case. by the use of milk, while others have finally A man in the fifteenth day of typhoid fever succumbed under its continued administration. who has a regular pulse counting 80 to the The idea that typhoid patients would starve, or minute is certainly in very good condition. that they would lose strength to the danger But there is one ominous remark in this report, point without food, is contrary to experience to which the attention should be called.. and common sense. The absence of the high has been having milk for several days. temperature, the dry tongue, and other dis- The reports for the two following days are tressing concomitants of the milk-fed patient, not important, except that we begin to get the decided shortening of the period of fever, some intimation of the irritability of the enable the patient to convalesce with com- stomach which naturally follows the ingestion parativly little loss of strength or weight, and of milk. On the eighth we find the fever with no troublesome sequelae.
accelerated, being 103° in the forenoon, but But leaving aside all appeals to common dropping a degree in the latter part of the day. sense, how dare our hospitals, and prominent The pulse has increast, being 92 in the afterpracticians, many of whom guide the opinions noon, and we still find that the irritability of of the majority of physicians, continue to feed the stomach continues. How much mischief milk to typhoid patients, and render a mor- has been done to the gastric and intestinal tality record of 15 percent, when Dr. Brand tract we do not learn ; but, as later we are told has shown that under the no feeding practise that the patient is now retaining his nourishthe legitimate mortality is 1 percent?
ment better, we may form some idea. On the Before going further, let me say that there tenth the fever is decidedly less, being 100 8° may be cases in which, owing to the prejudices at noon, and a little lower later in the day; of the family, it is impossible to carry out the but the pulse has increast and the stomach still above advice. In this case you have the liquid rebels, tho Professor Osler reports that “all
the vital organs are working well except the Dysmenorrhea.-Coal Tar Remedies. stomach." On the eleventh the temperature Editor MEDICAL WORLD:-In reply to M.D., remains uniform at 102.2° during the greater regarding dysmenorrhea, page 167, April issue
, part of the day, but the pulse has reacht 100 will
that he will have trouble in such cases. at noon, the temperature running up later to The ordinary remedies and analgesics will 104°, the pulse following it to 112. While
most likely be useless. The Editor has recomagain affirming that there are no complications, mended gelsemium, which is good if used in the attendants are alarmed at this sudden very large doses, but he has suggested the comchange, tho attributing it to an imaginary bination of belladonna with it, which is its crisis. Here I think that they are mistaken; physiological antidote, and would neutralize, that the sudden increase of fever, reaching if not otherwise more seriously interfere with 105° that night, was due to septic infection its action. from the undigested and putrid casein in the Now Doctor, give the lady three 5 gr. capcolon. The attendants seem to have thought sules of quinin ; tell her to take one at 4 a.m., so, for we now find them giving saline trans
6 a.m. and 8 a.m., accompanying each with a fusions to “neutralize the poison in the blood." half cup of very hot water, the morning that Still there are no complications, and the vital she expects the trouble. Tell her that the pain organs are all right. But the milk diet still
will not come ; and I miss my guess if it does. continues. The temperature drops to 101.9°, Now I don't want you or anyone else that may but the pulse climbs up a little to 108. Whether succeed under such circumstances to laud this the chill, which occurred at 2 p. m. on the as a cure for dysmenorrhea, for it is not. It is twelfth, was the second I cannot gather from a cure for anything that is periodical, from a the report, but on the thirteenth at 9 a. m. we toothache to a pain in the big toe. I straightfind the temperature 104.9°, and the pulse 120, ened up the worst case of gastralgia I ever saw the same continuing with but small variation with these capsules as here recommended, as till the last.
soon as I had discovered that the exacerbation When we consider the sudden rise of fever came at 2 p.m. every day-i. e., as soon as I after a severe chill occurring on the twenty- recognized its periodicity, when all pain relievesecond day of a mild case of typhoid fever-a ing remedies had failed, as well as any other man who cannot read septic infection in that, treatment I had used. A month is a long time is blind.
(28 days) to consider as periodical, but the 9 The following remarks of Dr. McLane Ham
o'clock business gives me confidence. I conilton may serve to elucidate this point:
trol a great many cases of ordinary dysmenor“ That the lower bowel is the seat of infec. rhea with stramonium. I see gelsemium tion appears to be very well establisht by the recommended in the Eclectic Med. Jour., Janexperiments of Baumann, who found that when
uary, 1904, in doses starting at 4 teaspoonful a fistula was made in the portion which included every hour and increasing to a teaspoonful, in the lower portion of the small intestin, there tetanus. was disappearance of the ethereal sulfates of The Doctor says it is not a poison, and that the urin; but that, when the intestinal con- no bad signs are ever manifest until spasm has tents were allowed to pass thru the lower been subdued. natural outlet, the putrefactiv products were There is one good reason for keeping up the largely increast, and their presence was again price of all coal tar preparations which should detected in this fluid. . When we con- not be over-lookt, and that is that the doctor sider that the proteids have passed undigested who buys acetanilid by the pound is a dangerthru the small intestins and have accumulated ous man in a community. He may not know below, where they lie infolded in a congested it, but let him look over the list of his deaths and feeble gut, it is not difficult to appreciate in the last year or two. I don't mean immedthe fact that they form a rich field for bacterial iately after its use, but will say that terminated attack, with the resultant introduction into the fatally, or died a few months later from heart system of an amount of toxic material sufficient trouble. The fatality of wars is not in it with to produce a most serious change. this remedy. It suppresses pain and fever by The alcoholic extracts of fecal matter, ac- force, the same as you would subdue an antag. cording to Bouchard, are more toxic than or- onist by choking him with your hand. It is dinary putrid matter; so it will be appreciated quick and seemingly efficient, but beware, how readily the various alkaloids of the feces Nature asks for the removal of the cause, and may be introduced in such quantities as to do aid to strengthen the heart; then the heart can much mischief.”
do its work easily and will work slower and with The application of these observations to the
ease, and the temperature will be reduced. I case under consideration is obvious.
don't know it to be a fact, but I venture to say Meriden, Conn.
N. NICKERSON. that the late Senator Hanna had plenty of coal tar preparations. In substantiation of this, I Pemphigus Acutus Contagiosa. will call your attention to the evenness of his DEAR DOCTOR TAYLOR :-I am greatly intemperature at 102°, and of the weakness of his terested in a communication from J. D. Groom, heart, and tendency to such a high range at the M.D., of Maxton, N. C., appearing in April last. You may not want to publish this last WORLD, pages 158 and 159, entitled “ Diag. part; in case you do not I will ask, why? nosis Wanted for Epidemic Eruptiv Disease.”
I would like to know a sure remedy, outside During the past winter the village of Medina, the use of a shot-gun, for the alcohol habit. in the western part of this state, has been passPittsburg, Pa.
E. H. Moore, M.D. ing thru an epidemic which has been called [We think you are wrong in your guess that "mild smallpox” by some, including, I becoal tar antipyretics were given to Senator lieve, the health authorities. This diagnosis Hanna. Remember that his age, corpulency has been disputed by several competent men ; and a suspicious condition of the kidneys, were however, quarantine was maintained, and propall against him.
erly so, if there was any doubt as to the identity As to the reason why" an editor does or of the disease. One of my clients was emdoes not publish a communication, or certain ployed in Medina until December, 1903, when parts of a communication, is entirely a matter he returned (whether he evaded quarantine or of judgment as to whether or not it will be of not, I do not know), and within two weeks he interest and value to his readers. This is my presented all the symptoms of a mild “grip,” standard, and I suppose it is the standard of which he did not think needed any treatment. every other editor. According to that standard, He noticed three or four red spots on his neck. I decided to publish the above as written ; how- His wife was confined late in December, and ever, leaving it to every reader to decide for ten days later was taken with high fever, headhimself as to its value. In deciding on the ache, pain in back, and complete anorexia. In admission of communications, perhaps all my my absence she was attended by another physierrors, if any, are on the side of generosity. I cian, therefore, this one week's history is much prefer to err on that side, if at all, for 1 second-hand. The doctor diagnosed the conwant these pages to faithfully reflect the rank dition as “grip”; but on the fourth day, on and file of the profession as it is, its mental account of an eruption, he changed it to grasp, state of progress, etc., and its opinions, chickenpox; and later said he did not know resulting from its vast experience and observa- what "it" was. A week after the onset I retion.-Ed.]
turned and saw the case. Mrs. F. was then
covered with a vesicular eruption, discrete in Smallpox or Chickenpox?
character, and scattered all over the entire inEditor MEDICAL World: - I note in the tegument. The vesicles were situated on a April WORLD, pages 158 and 159, an article by hard, reddened base ; they were about marDr. J. D. Groom, on supposed smallpox of a row fat pea sized and showed no umbilication. mild type which offers difficulties in points of There was little itching, but much burning diagnosis. There have been a number of sim- pain. General condition was unsatisfactory; ilar cases in this neighborhood, diagnosed tongue heavily coated (yellowish-white); smallpox and rigidly quarantined. I think
bowels constipated; partial anuria. Urin five families in all. I was called to one of these dark, with specific gravity of 1,034; no sugar, families some three weeks ago and pronounced but a trace of albumin ; acidity high. Temthe disease chickenpox; and to confirm my perature 103°; pulse 105; was able to take opinion I vaccinated four of the children. The only a little liquid food ; lactation absolutely vaccination was successful in all four of the nil; baby artificially fed. Within the next cases. This I regard as a confirmation of my twenty-four hours the vesicles became disdiagnosis. What have the WORLD readers to tended with serum, tending to turbidity, and say? Will vaccination settle the question ? the temperature fell to almost normal ; pulse Can anyone who has had smallpox be success- came down to 80, bowels moved copiously, fully vaccinated ? Let us hear from you. Mr. urin became profuse and, of course, lighter in Editor what have you to say ?
color and gravity, and there was a desire for Lexington, Ohio. H. H. SMITH, M.D. food. Next day contents of vesicles increast
[We suppose that you vaccinated after re- in turbidity and rapidly became pustules, dried covery from the suspected disease in those four down, and crusting took place. At no time cases, tho you do no say so. Vaccination after was there any umbilication or reticulation. an attack of smallpox would not be successful. The woman convalesced without other notable - ED.]
symptom. The skin cleared up gradually, Terebene in five-drop doses dropt on a lump of leaving smooth red spots where the pustule and sugar makes a cheap and efficient expectorant, espe
its areola had been, but in no instance was cially valuable in bronchitis of the aged.
there any pitting.
The two weeks' old infant presented, in due exert any influence for good. It did not. The time, all the mother's symptoms, but in a eruption and accompanying phenomena were milder form. In the child only three papules milder the younger the victim; in the elderly appeared, and they did not pass beyond the they were the most serious, but in no case was papular stage. By January 20 the mother's there a fatal issue nor any extreme prostration, milk reappeared, and the baby accepted it with and convalescence was always rapid. An interjoy, and both rapidly regained health.
esting point, it seems to me, is the apparently These cases were the starting point for a progressiv attenuation of the poison in each small spread of the disease to, perhaps, twelve succeeding case, evidenced by the mildness of other persons, male and female, ranging in age the later invasions. from this infant to eighty years, in my In conclusion, I believe that this disease was practise, while there were three cases from the brought to us by our soldiers and sailors from same source attended by other physicians. the tropics—from our insular possessions; and Last week three new cases were referred to me, that much of the socalled smallpox and severe but they are only the shadow of the earlier epidemic chickenpox is nothing more nor less ones, symptoms and all the phenomena being than acute pemphigus, contagious in character; in every way extremely mild. I believe they therefore, much of the fear, expense, and are the final struggle of the morbific agent, trouble caused by this supposed variola has whatever it is.
been needless; but great care must be exerThe winter here promist, in December last, cised not to err on the wrong side, and every to be exceptionally hard financially and meteor- precaution should be observed until the diagologically (and it was); therefore, I felt it my nosis is certain. T. HAVEN Ross, M.D. duty to make absolutely sure whether or not Cato, N. Y. this was variola. If it were, quarantine would P. S.-I learned today that the physician be essential, and that would kill what little who saw Mrs. F. said "it" was smallpox, after business there was in this section, and many my diagnosis was announced.-R. individuals would suffer hardship, possibly hunger and starvation. If it were not variola, Proposed Cure for the Secret Nostrum a little precaution would prevent its spreading
Vendors. much, and every industry need not be paralyzed Dr. C. F. TAYLOR.-Dear Doctor: I have by the stigma of quarantine for smallpox. been reading your journal for sixteen years, After most painstaking study of Mrs. F.'s case and I don't hesitate to say that I believe you in every bearing, and observation of the happy to be one of the ablest champions of the rights effect of appropriate remedies in her treatment of the people that we have in our country toat the end of the first week, I became thoroly day. Therefore, I come to you for aid in a convinced that I had neither variola nor vari- cause that should interest every leading man cella to deal with. My final diagnosis was of our profession. To come at once to the pemphigus acutus contagiosa, based upon my subject of this letter, I have succeeded in interobservation of that eruption on sailors from esting our congressman, Hon. E. Y. Webb, in the tropics coming under my care years ago. a bill to lessen the secret nostrum evil. My I have as yet seen no reason to alter my opinion idea is to pass a bill requiring the manufacturers on that point. In this disease, while there are of all proprietary medicins to print in plain small, hard bodies to be felt under the skin, language the formula of the contents of every we do not get that “buried bird-shot” feel package put on the market. Congressman so characteristic in variola. The individual Webb askt me to draft a bill embodying my lesions are not so small as those of variola, nor ideas. I don't feel capable of doing this, as I do we meet with a secondary fever, as in the am not a lawyer. As a representativ of this latter disease. Smallpox and chickenpox are county in the last Legislature of North Caro. self-limited pathological entities, not to be lina, I drafted several bills of a local character, aborted by any line of treatment, while this but in a matter of so much importance as this affection seems to be favorably influenced by I want the aid of wiser and better informed early and vigorous measures.
men. Therefore, I come to you and appeal to in my experience, is never confluent, and there you to interest yourself in this matter. I want is no umbilication nor reticulation, nor is you to get up a bill that you think will best there any distinctiv odor connected therewith. suit the case and send it to me; or send it diSome of these distinctions apply as well to rect to Mr. Webb. I also want you, if you varicella and vaccinia. Furthermore, vaccina- can endorse this move, to present the case to tion has no influence on the disease under dis- readers of THE WORLD, and urge each one to cussion. Some of my cases had been vac- write his representativ in Congress in behalf cinated and some had not. I vaccinated two of the measure. Now, Dr. Taylor, if you will after the onset, to ascertain whether it would aid in this matter I will greatly appreciate the
favor to me, and if the bill should become a Their obscene and disgusting advertisements law, it will bring untold benefits to our com- fill the columns of every paper that comes into mon country.
H. Q. ALEXANDER. our families. By ingenious and persistent Matthews, N. C.
advertising they excite the passions, stimulate [The above letter is an able presentation of
he prejudice, arouse the hopes and expectathe matter. I have taken the liberty of chang- tions of a too confiding public, and thus deing in the above the expression “patent med
fraud the people in more ways than by taking icin evil” to secret nostrum evil; for patent
their money without giving value received. medicins are not secret; anything that is pat
Now I ask every reader of these lines to write ented cannot be secret, for the process of ob
at once to his Representativ in Congress and taining a patent involves revealing the secret. urge him to co-operate with Mr. Webb in putAny one can go or send to the Patent Office at
ting thru this much needed legislation. The Washington, and for five cents get a copy of
Bill has not yet been introduced, but is under. any patent, and he can then publish it if he
preparation. If you would like to make any wishes to do so. Peruna, for example, is not
suggestions about the matter of this Bill, don't patented. The name is trade markt, or copy
hesitate to write to Mr. Webb at once and give righted, and the composition and process are
ideas. Of course a bill of this kind kept secret. So with antikamnia and many
will meet with tremendous opposition, but let other proprietaries, but in the case of anti
the medical fraternity and all the friends of kamnia and other analgesics with fanciful (copy- humanity rally to the support of the measure, righted) names, we know that the chief in- and it will eventually prevail. Thanking the gredient is acetanilid. Also, in the following
Editor for his kindness, I am, clause: "A bill requiring the manufacturers
Yours for better conditions, of all secret nostrums to print in plain language
Matthews, N. C. H. Q. ALEXANDER. the formula,” etc., I changed secret nos
Tetanus from Flea Bites. trums" to proprietary medicins, for if such a law were in operation there would be no secret Editor MEDICAL WORLD:--Thru your valnostrums.
uable journal, I wish to call the attention of I wrote the Doctor to get a copy of the Hep
those concerned to a rather mysterious case burn Pure Food Bill, now before Congress, and which I was recently called to treat. Man, consider adding his suggestion as an amend- married, age 30, strong and robust. On ment to said bill; or if not, to study said bill. arriving I soon saw that he had tetanus. Of as a model, as much thought and talent have course I began to make inquiries to ascertain been spent upon it. I understand that Ger- some etiological factor of the disease, thinking many has a law embodying Dr. Alexander's surely I would get a detailed account of a preproposition, and that it works very satisfac- vious injury ; but to my ultimate astonishment, torily, but is a thorn in the side of the would- I could get no trace of a traumatic injury. be secret nostrum vendors.-ED.]
But the man had tetanus—no mistake. Ι I
could have treated him probably as well then Later :
as to have studied the etiology for hours; but I Editor MEDICAL WORLD:-I desire sufficient was “bent” on ascertaining how he got that space in your most excellent journal to call the germ. So I proceeded to remove his gown. attention of the World readers to the fact that I found that the skin had been feasted upon by Hon. E. Y. Webb, Congressman from North many insects, and I inquired about it. His Carolina, has in preparation a Bill to regulate wife remarkt : “ Doctor, that is where fleas bit the manufacture of proprietary medicins, or him. He was hauling manure from the gin any other secret medicinal compound. This house (old house gin) for several days, and Bill will require all such manufacturers to label was always complaining about the fleas biting every package with the formula or ingredients him, and they nearly kill him (would most of of the same, and if such package contains us brethren); so a few days later he began to, opium, chloral, cocain or alcohol, then such complain of soreness in his neck, could hardly label shall state the quantity of each of these swallow, and this morning his jaws were lockt." drugs contained in a given quantity.
Now doctors, that's the way she told me Now every man who has practised medicin about it. for any length of time knows full well that secret Evidently there was no puncture in the skin medicins are one of the the greatest curses in- more than those put there by the bills of those flicted on the American people today. Hun- Pleas. Gentlemen, could it be possible that dreds of lives are sacrificed by their use, mil- the tetanus germ could have gotten there thru lions of dollars are annually mulcted from the those Aea bites ? And if that be true, Louispeople, and thousands of drunkards and opium iana would as well exhibit at the 1904 Fair habitues are made every year.
some of her varieties of dangerous germ carry