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PATHOLOGY OF TYPHOID FEVER.
Levi S. Long, M. D., St. Joseph, Mo. BE anatomio lesions of typhoid fever are invariably present and are
characteristio. They consist in changes in Peyer's patches, solitary glands and the mesenteric glands, and may be divided into three stages:
1st. Stage of infiltration or swelling due to excessive proliferation of the cellular elements, and infiltration which also involves the surrounding mucous membrane. Peyer's patches become pale, thickened, hardened and elevated above the mucous membrane. The changes may affect only three or four of the glands, or the entire number.
2d. Stage of necrosis, softening or sloughing of the diseased struo. ture. The exudate may be absorbed, or it may undergo necrotic changes and be discharged, leaving an oval ulcer with an irregular margin, having for its base the submucous muscular or peritoneal coat of the intestine. These changes take place in the second or third week of the disease.
3d. Stage of ulceration, in which the separation of the sloughing and necrotic areas are complete, leaving ulcers of various sizes at the site of Peyer's patches and solitary glands. This process belongs usually to the fourth week. The mesenteric glands and spleen undergo changes similar to those in Peyer's patches, namely, infiltration, enlargement and softening, but seldom if ever rupture or ulcerate.
The spleen usually begins to enlarge in the middle of the first week, tbe enlargement reaching its height at the end of the second week. The mucous membrane of the entire intestinal tract is the seat of catarrhal changes, and a similar condition is present in the respiratory tract. The beart, liver and kidneys are affected with parenchymatous or granular changes.
It is still a disputed question whether the typhoid bacillus is the cause of typhoid fever or a typhotoxin originated from them (Tyson). The typhoid bacillus or bacillus typhosus was discovered by Eberth in the intestine of a case of the disease in 1880.
The bacillus is a short red-like bacterium, whose length is three mi. cromillimeters, and whose breadth is one micromillimeter-about onetbird the size of a blood disc. The end is rounded with at times a dark glistening body as a terminus. The bacillus stains readily saturate with a watery solution of metblene blue. Cultures can be made on the tenth day, or later, from the discharges. It thrives in ordinary temperature. Its death point is given 159 deg. F. (69 deg. C.); remaining vital for three months in distilled water. In upper layers of soil they are vital six months. Cold bas no effect on them. They have lived on linen from sixty to seventy days, and on buckskin eighty-five days. Bouillon cultures in vacuum lived 207 days. In a closet they had vitality at the end of 228 days. One-tenth to two-tenths per cent solution of carbolic acid has no effect on them; 0.5 of one per cent of corrosive sublimate solution are fatal to the bacillus. Billings demonstrated 98 per cent dead in two hours and total unnihilation in three to six bouis.
THE DOCTOR IN LOVE.*
Chris. M. Sampson, M. D., St. Joseph, Mo. DESCRIPTON of the doctor in love without a description of the disease would be incomplete, inacourate and unscientific. That being the case, before we can describe the siok man we must an
alyze his complaint.
Love.-An acute, febrile, contagious affection, characterized by delusions, ballucinations, and other manifestations of mental aberration.
Pathology.-The heart is usually muoh enlarged, and is found on the right side. The brain, and occasionally other organs, are found intensely congested with blood, and the gall-bladder is apt to be hypertrophied.
Etiology.-Authorities are hopelessly divided over the cause of this malady.
Bacteriology.-Not definitely settled, but the weight of opinion, backed by experience, would seem to point to the bacillus oscularis as being the specific cause in most every instance.
Incubation.- Period of incubation depends on too many factors to be subject to any set rule, but in most cases is very short. The disease may occur instantly.
Diagnosis.—This is easy-in fact is usually made by friends or relatives before the victim suspects anything wrong. Prognosis is good, un.. less a "Pair o' Docks” get the infection from the same source, when complications are sure to arise and may lead to a fatal termination.
Treatment.—The treatment should be strictly expectant as any active interference is sure to aggravate the malady. From such a description it is evident that the disease is a most serious one. Yet in not one of our vaunted "up-to-dute''medical schools is it even mentioned in the curriculum, much less taught in the class-room as it should be. The poor young doctor is turned out from the protecting walls of his college with his brain full of such unimportant things as medicine and surgery, and a more or Jess complete knowledge of the other 260 diseases which the human form divine is heir to, and is left in total ignorance of the most awful dis. ease in the whole category. He is not even given a bint as to the prophylaxis.
The consequence is that he has not been at large very long, bas not attended very many more or less public gatherings where women lowed, until some one of them makes up her mind that she always did like the title of "doctor," and that with the proper care and training this particlar specimen of the genus M. D. might be combed down and polished up into a presentable man.
Having once made up ber mind, the remainder is easy, and she proceeds. to do it. Sbe has inherited the art from thousands of her feminine ancestor,each one of whom had reduced the art more nearly to an exact science.
* Response to a toast at the annual banquet of the Buchanan County Medical Society.
In addition she has been coached from the cradle for her part, and she now has it letter perfect. The only thing that would disappoint her would be for her victim to give in without a struggle.
In the face of all these facts it is apparent the poor medic has not the ghost of a show. One would think that any one who saw as much of the seamy side of woman as a doctor, would be on his guard, but the very opposite seems to prevail.
In a few days or weeks she has sucoeeded in getting him going her way, in fact bas bim stampeded. She can take him when everything is coming his way, and he feels that the world is almost his for keeps, and in less than five minutes she can make him so blue that a wiggle-stick would be pale in comparison. She can take him when everything has gone wrong, when he has lost his best case and most of the others have forsaken him; when bis rent and all other bills are long overdue, wben tbe publisbed per capita circulation of $33.69 seems the work of a dope artist, when all other misfortunes that ever befell him seem trivial compared to his present state, and in half a minute she can make him so cheerful, proud aud vain that Lucifer would yield bim the palm without a word. She can at her fanoy put him at ease or on his knees. With a sentence she can send him up to the very dome of the seventh heaven, or down to the least obilly corner of the ultimate bades. With a look she can make him fight a spouting gatling gun or run from a sick poodle. With a touch she can make bim think that the most active live wire he ever innocently picked up was a circumstance not worth mentioning, or, that he has blundered into a cold storage plant. And with a tear-well, if he is made of the stuff of wbiob doctors should be made-with a tear she can make a "plumb fool" out of him in less than no time.
In a word, the doctor in love at the present day is a hopeless case. He deserves our profoundest sympathy-sometimes. Let us drink to his health. “May he live long and prosper.
Let thy day be to thy night
ACONITINE FOR NAUSEA - ACONITINE: AN INTERESTING SKIN
REACTION FOLLOWING ITS USE.
W. C. Abbott, M. D. Chicago. CORRESPONDENT inquires if aconitine can produce an eruption, the particular patient in question baving taken three granules every two hours for a few doses during a period of high fever
and then "breaking out all over.” Our answer naturally is 'no," but the fact is an eruption did follow. Correspondence develops the fact that this patient was extremely autotoxemio, with a densely loaded colon; therefore the experience, as curious and unusual as it is, is perfectly logical, corresponding exactly with the physiological action of the remedy.
Aconitine dilates all capillaries, acting strongly upon the organs of elimination, especially the skin. In the presence of autotoxemia nature would thus be stimulated to make an extra effort to eliminate by that chappel, the unusual demand producing the eruption mentioned.
That cur deduction is correct is evidenced by the fact that a thorough saline evacuation of the bowels and disinfection of the same with the sul. phocarbolates disposed of the eruption in forty-eight hours. The incident is mentioned that it may be fixed in the minds of many users of aconitine and other capillary.dilating remedies as a not impossible outcome in some instances.
We would also call your attention to the value of aconitine in pausea for stomach irritation. This drug is directly sedative to the end filaments of all peripberal nerves (those of the alimentary capal belong to this class). Try it after the stomach has been emptied, but always in granule form or in concentrated solution for local effect and note results. It will surprise you.
A clear comprehension of the physiological action of drugs will solve many a problem for the dootor, enabling him to apply his remedies with much greater precision. The use of the active principles making this easy.
Aconitine is a great (a truly great) remedy. It soope is broad; its applications are legion. If you know it, know it better; if you don't, or only think you do get to business and you'll be glad you did.
SPEECH is the obief revelation of the mind, the visible form that it takes. As the thought, so the speech. To better one's life in the way of simplicity, one must set a watch on bis lips and his pen. Let the word be as genuine as the thought, as artless, as valid; Think justly, speak frankly.-Charles Wagner.
By HOMER CLARK BENNETT, M.D., Lima, Ohio. In the busy world around us,
As we see it day by day, While we hurry on, unmindful
Of the beauties by the way ; There are those who in the turmoil
Of the busy strife for gain, Pass by gems of greatest value,
Which they long have sought in vain While they search with greatest ardor.
Looking high, and far, and wide, They o'erlook the thing they're seeking,
And go onward in their pride, Till some humbler, meeker brother,
Trav'ling o'er the selfsame track, Finds the gem, on which the other,
Passing by, had turned his back. Thus we see that those deluded,
That the good, beyond is found, And pursuing this, neglecting
All the better things around ; Oft may miss it, while another,
No phantasmal goal in mind, Ever watchful, finds the jewel,
And this benefits mankind. Like the children in the story,
Gath'ring lillies on the pond, Always hoping, ever seeking,
For still prettier ones beyond ; Put off plucking till the boatman,
Rowed the craft back to the land, And the darkness coming on them,
Found them each with empty hand. So may we be prone to wander,
And neglect our chances thus, Till the opportune time passes,
Never to return to us; Then let us be up and doing,
Gather flowers while we may, Do our best now, and remember,
We're not coming back this way.
The man who won the hurdle race,
I'll mention here, my son,
If he hadn't tried to run.
As all of us now grant,
Had he stopped to say, "I can't."