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profound learning of a thousand years safe to deny the name of infection to such without any definite result, gets a foothold cases. only upon the discovery of the bacillus. When King Bacillus ascended the throne
But does a specific bacillus establish the and all the medical men bowed low, they theory of infection ? And if so, are not began at once to unlearn some things by all diseases infectious that are character- which in former times they were wont to ized by a particular germ ?
place great store.. Prominent among Furthermore, if tuberculosis were truly them was the tuberculous diathesis. At infectious, does it not reflect discredit one time it was a feature seen at a glance ; upon the profession for not having settled now it cannot be seen at all. Still, this the question a hundred years ago thru same diathesis is as patent to-day as at clinical evidences alone? Very little con- any previous time, and its import is just cern need be fostered in regard to infec- the same. Osler quotes Fagge as saying tion so long as the clinical evidence is that “these appearances denote nothing defirient. Those who were first to con- more than delicacy of constitution, incomceive the theory were no doubt honest and plete growth and imperfect development. ” sincere, but those who took it up and In the name of Heaven, what more could enlarged upon and promulgated it with be added and not have tuberculosis itself? energy were those who can hear the jingle I have never yet seen a case of conof coin afar, and in their dreams have sumption that did not present one or more bright visions of glory and of gold to come. of these diathetic peculiarities. Biggs
These are they who sound the cry of (Wood's Hand-Book) says that a suscepinfection. The awful danger of living,- tibility to the action of the tubercle bacil. danger in the theater, the church, rail- lus may be inherited. He could not base road train, cabs and street cars! Danger that very truthful statement on any other anywhere if there be a case of consump- foundation than the diathetic appearances, tion within ten miles.
which attract attention at once, and which These are they whose real purpose lies we invariably see tending toward the concealed beneath an assumption of phil- vortex. anthropy.' These are they who would A perfect organism could not, nor would tear the helpless sufferers from the embrace not, get sick.
not, get sick. But the liability to disease of family and friends and consign them to is proportionate to the degree of departure imprisonment for life, because they are from the standard of physical perfection ; the victims of a fatal malady. These are and the form of disease is determined by they who seek to so drape the public mind the direction of that departure. Disease with the black mantle of fear that legal is man's implacable foe, and the active enactments may be easily secured to en- elements, the micro-monsters, like so many force the diabolic scheme of isolation-a murderous bandits, lie ambusht along our scheme that means millions from the pathway, each awaiting opportunity to public treasury, and easy and profitable strike the fatal blow. “ The great, white employment for a host of political place- death,” tuberculosis, holds relentless and hunters. It also means deep despair and untiring vigil at every point of vantage. rapid death of all who are thus incarcer- The dairy, the meat-market, the grocery, ated.
provision booths and fruit-stands-in fact, Experiments made to determine the wherever food products are found, there infectivity of the disease have been so is a spot that supplies the conditions foreign to the manner of our contact with necessary to the life of the bacillus: that it that they become of no practical value in is, warmth, moisture and protection from the consideration of human tuberculosis. light.
Injections of pure culture would make Disease germs are all about us, and we anybody sick. The dog does not contract take them into the system every day. tuberculosis from his tuberculous master, But we are not at once afllicted, possibly but enough of the virus may be injected never, because we all possess in varying under his skin to overcome the vital resist degree that divine physical endowment, ance. But the human contact is not by which, for the want of a better name, we the injection of pure culture. We are not call tissue resistance. This is a congenital swallowing a red-hot poker to find out if attribute. It can never be acquired, but it will burn.
is easily lost. While this property holds Infection not recognizable by clinical the balance of power, disease is completely experience is very doubtful; in fact, it is excluded. No malady can ever trespass
upon our physical domain until etiologic wholesale contamination could not fail factors outweigh the resistant forces. to leave behind deep-rooted, constitutional
of tuberculosis Osler very truly says: defects. "Next to the germ a vulnerability of A poison so virulent and indestructible tissue, however brought about, whether as syphilis could not fail to fix the imprint congenital or acquired, is the most impor- of its vicious nature upon the cell structtant factor in the etiology of the disease." ure of its victims, to be transmitted under
Bartholow says: “The infective ma- various modifying influences in the conterial must fall into a properly prepared tinuity of race to the remotest times. organism."
May not this be the reason why the tuIf these declarations are true, tuber- bercle-bacillus finds such delightful pabuculosis is no more infectious than any lum in the human lung? other disease. For, if a dozen healthy As to the treatment of true tubercular persons are simultaneously exposed to disease of the lungs, much of the medicaconditions that depress the vital energies tion of the past has been worse than useto an extent that drives them to a sick less. Codliver oil, which for so long a bed, and during that period of exposure time has maintained such an exalted but are all taking into the system a dozen false reputation, is unquestionably not forms of disease germs, each one will be only useless, but positively injurious. affected by the disease his system is best Space will not admit of details, but to fitted to receive.
put it in short, this oil appropriates all the Why is this? Simply individuality of oxygen taken in by the diseased lungs, constitution. Diverse similitude is God's leaving nothing to act upon food. When first law. While one man may seem like it has reacht the finish of its chemical all other men, yet a vast difference exists changes, it has yielded to the diseased in constitution as well as mental percep- body nothing but its equivalent of heattion. For this reason the tissue resistance units. Thus we see the strange anomaly differs, or, to speak learnedly, the “locus of attempting to extinguish a fire while minoris resistentiæ" is different in each in- constantly adding fuel. Administering dividual.
codliver oil to increase the body temperaNo individual on earth can by any ture, already too high, and the use of means develop tuberculosis in the absence antipyretics to bring the temperature of the special conditions essential to the down, is a therapeutic antagonism which action of the bacillus.
cannot fail to do harm. Is it not true that some special systemic Of all the hypophosphites, the malts condition must precede the ingress of any and the millions of other things at one disease? And if so, by what line of reas- time or another acquiring prominence, oning or assembly of evidence does tuber- nothing more can be said than that the culosis stand as a contagion ?
patient goes steadily on down to the But where shall we look for the cause grave. of such systemic state? Of all chronic It was not until the discovery of the and fatal maladies there are none toward bacillus by Koch that any rational conwhich there can be seen such widespread cept of treatment began to dawn upon tendency. And does not this fact sug- Of the many cures that have been gest a possible cause in the remote past? made, there are none to the credit of old May not this tendency be the lineal legacy methods, nor to any method except such of a diseased and depraved remote an
as aimed at the destruction of the cestry? Dr. John Mason Good, in his bacillus. lectures at Oxford, upon the Dark Ages, Germicidal treatment, properly conquotes Sanger (History of Prostitution) ducted, is capable of affecting many cures. as saying: “The soldiers returning from If to such treatment be added suitable the Crusades were saturated with syphilis climatic change and the best possible contracted from the native women of that hygienic and social environments, it is country. From them it spread with fear- safe to count on 75 per cent. of all cases ful rapidity all over Europe. It invaded as curable. In support of the germicidal all classes, from king to peasant, clergy method, one only needs to look at the included. Thousands upon thousands work of Ingraham of Binghamton, Carcrowded the hospitals or died in secret roll of New York, and a host of others and went reeking to the grave."
less prominent who are quietly working Such were our remote progenitors. Such along this line, and, without display or
ostentation, are performing a wonderful Later in the day I visited him at his home work, as hundreds can testify.
and gave him a more careful examination. But the grandest opportunity is offered The heart-beat was rapid, very weak and to the sanitariums. It is in these institu- muffled. I outlined an increased area of tions that every facility can be had and dulness over region of heart and diagnosed employed. A sanitarium located in the
a pericardial effusion. best atmosphere possible, and fully equipt I was particularly struck with the pecufor the work, can accomplish much more liar dingy, dirty appearance of his face than treatment anywhere else, provided a and hands. They were like those of a truly scientific germicidal course of treat- person who had just come from a day's ment be pursued. An institution such as work in a smoky railroad shop. The dark the Loomis Sanitarium at Liberty, N. Y., hue extended down onto the neck and up enjoys a grand and glorious opportunity. to the hair. Beneath the hair and over the Its location is surpassingly fitted for the body the skin was fair. In the axillae and work, and I presume there is nothing inguinal regions and around nipples there wanting in its equipment. With the was a slight darkening. grand facilities, cottage system, beautiful At the end of a week the precordial dullocation, good air and liberal provision, ness disappeared, the temperature was if a truly scientific germicidal treatment normal and the pulse, though still very were adopted there the results would be weak, was only slightly accelerated. But wonderful to behold.
instead of improving he continued steadily E. P. ILIFF, M. D. to lose ground. The respiratory murmur 472 Broad Street, Newark, N. J.
was so weak as hardly to be heard, yet on
forced inspiration it was clear and distinct Report of a Case of Addison's Disease.
over the whole of both lungs. Obstinate Editor MEDICAL WORLD: -Permit me constipation and cold extremities were to present the following case for considera- present during the whole course of the tion: J. B., male, American, single, aged disease. 41; height, 5 feet 7 inches; weight, 175 Wandering pains in various parts of the pounds ; fair skin, dark brown hair, blue body and sometimes muscular soreness eyes—an employe in the railroad yards. were complained of, but the weak heart Never had any sickness except severe ty- and the general prostration were the promphoid fever 12 years ago. Ever since this
inent symptoms. sickness had been a little “short-winded” The urine was examined and found when running or in other violent exer- normal. cise.
Repeated examinations of lungs and During October and November he called heart failed to locate any disease to acat my office several times for relief of neu- count for his condition. My attention ralgic pains. At one time it was a severe again turned to the peculiar discoloration supra-orbital neuralgia, at another inter- and I made the diagnosis of Addison's costal, again in left shoulder. Tempera- disease. ture was normal, pulse not strong but reg- A day or two later he began to improve. ular. He was sleeping well, and his appe. His appetite, which had been fairly good tite was fairly good; complexion dingy, all the time, increast; eyes clear. He said he was losing his am- strength and by Christmas was able to sit bition; thought he got tired easily for the up and even walk around the house. past year or two. At is time he was I now hoped I was mistaken in my riding two miles, morning and night, on diagnosis. December 28 I was called in bicycle, and doing general work in rail- the night. He had been around the room road yards.
during the day but shortly after retiring The morning of December 3 he called at had been suddenly attackt with dyspnea. office on his way to work feeling unusually The attack only lasted 10 or 15 minutes, bad. A few days before had been moving but left him much prostrated. From this a heavy weight when he became suddenly time on he steadily lost ground. His approstrated and breathless. Had to lie petite failed, nausea and vomiting began down for several hours. Since then had and continued to the end. only been able to do very light work.
Nearly every day, and sometimes many I found a slight elevation of tempera- times a day he had short attacks of inture and a pulse so rapid and feeble that I tense dyspnea. The attacks of dyspnea
once ordered him home and to bed. did not depend on exertion but came at
intervals without apparent cause. The the change causing complete destruction heart grew weaker, the temperature be- of all glandular structure. came subnormal.
Theo. F. Johnson, M. D. The nausea and vomiting did not appear National City, Cal. to depend on taking food.
His treatment had from the start been largely tonics-digitalis, strychnia, sulfate
Scarlet Fever and its Treatment. of strychnia arseniate and other remedies Editor MEDICAL WORLD :-As the March of a like character. Salines and enemas World is in part to be devoted to scarlet were given to keep the bowels clear. fever, I will tell what I have found to be Several other physicians saw the case with good treatment. me; none felt like making a positive
Acid salicylic .
grs. xx On January 8, Dr. William A. Edwards
Acetanilid saw him and suggested disease of thyroid
M. Div. chts. No. x, one every three gland. He was put on thyroid extract.
hours. Whether due to, or simply coincident with the administration of the thyroid extract,
R the attacks of dyspnea ceased, to return
3 ss only once, shortly before death. The nau
Syr. lactucarium sea and vomiting continued, and he stead
Aq cinnamoni. ily declined till death came to his relief
M. Give teaspoonful in water every two His mind was clear
to four hours. January 17, 1899. until within a few hours of his death.
Have treated 10 cases, and all recovered. I performed the autopsy three hours af- (They do in some epidemics.) Locally, ter death. Drs. Magee, McConkey and to throats I prescribe a spray or gargle, Fly were present. Body was fairly well with a saturated solution of oil of cinnamon nourisht. The thyroid gland was exam- in water, adding 3 grains of boric acid to the ined and found normal.
ounce. The thoracic organs were all found nor- As syrup of lactucarium is costly and mal excepting very extensive old pleuritic not always attainable, I sometimes change adhesions involving both lungs, probably and double up the above formulas as foldating back to his sickness 12 years before lows: and sufficient to account for his being
R "short-winded.'' A few small calcare
grs. XXXV ous deposits were found at base of left
grs. XX lung. An examination of abdominal organs
Tinct. passiflora incarnata showed stomach, bowels, liver, pancreas
Aqua cinnamoni . .... zij and kidneys normal. Spleen was some- M. Shake. Give teaspoonful every two, what enlarged and quite friable. The
three or four hours, as required. suprarenal bodies were enlarged, firm and somewhat modulated. Each weighed four The results are, less fever, patients are drams, or more than double the average drowsy, and sleep quietly. The disease normal weight, which, as given by Gray, runs its course without complications. is one to two drams. On cutting thru My opinion of above treatment is: The them longitudinally a small cavity was ob- salicylic acid and chloral are antiseptic. served, but it was apparently empty, tho Chloral and passion flower analgesic and it may have been a cyst with fluid. Ma- hypnotic, and the acetanilid comp. anticroscopically the cut surface had the ap- thermic. “Shot-gun," sure enuf; but there pearance of a fibroid growth, and was is no restless tossing, no extra work on smooth and homogeneous. On one of the heart, no nephritis or dropsy. And you do glands the knife grated on what seemed to not have to disturb the patient so often to be a cretaceous granule, otherwise the two give medicines. Dr. W. K. HARRIS. were counterparts of each other. Micro- McLoud, Oklahoma. scopically nothing was seen but a typical fibrous stroma. There was nothing to "The January World is especially valuable on account of suggest tuberculous or cancerous degenera
its free criticisms and discussions. It is good, pot bigoted,
admitting all schools to it columns. Yet a little more tion.
critical spice added to its editorial articles would suit many
of us, even tho an occasional contributor would be hit." It was evidently a fibroid degeneration, GEO. OSBORNE, Valley, Neb.
Quinin Rash Simulating Initial Stages of bad both seen a good many cases of that Smallpox.
disease here. Editor MEDICAL WORLD:-Since the be- Still, I did not want to go to the comginning of winter I have been constantly pany's pest-house until I knew, beyond all exposed to smallpox, treating one or possible chance of mistake, that I was in more
at a time almost continu- for smallpox. ously.
So soon as the macules had appeared, I At the beginning of this month (Janu- had stopt all medicine. We waited for ary, 1899), as assistant surgeon for the the secondary fever and vesicular stage of Mexican Central Railroad, I was stationed the eruption, but neither came. In fact, at Jimulco, one of the road's surgical sta- before the end of the next two days, there tions. On the first day of the month I was less itching and the eruption seemed had a chill, followed by fever, and within to be receding, especially on my forehead. the following two days there developt
Within four days from the appearance of pain and constriction in the lower lobe of the papules they had entirely disappeared, my left lung; there was also slight rusty and the only reminder I had of the trouble sputum. I diagnosed my case as lobar was a good crop of scabs where I had pneumonia. On the third day I was un- scratched the skin off. able to leave my bed. I then telegraft to Until this time I had taken but little the chief surgeon of the road to send quinin since my twelfth year, but when. another doctor to take charge of the sta- ever I had taken a little, it had invariably tion. The doctor had 300 miles to
caused the disagreeable itching and ting. travel to reach me. When he arrived he ling in my extremities, mentioned before, found me delirious. Before that, in the which was much aggravated by cold water, preceding 24 hours, I had taken three or by touching any cold substance. seven-grain capsules of quinin sulfate and So soon as I would discontinue taking three doses of the following:
quinin, the disagreeable symptoms would R
promptly disappear. I have tried it time Quiniae sulf.)
and again, always with the same result. Ferri redact. . āā gr. )
In this last instance, however, I felt
that I had to take quinin, idiosyncrasy or Acid arsenosi
. aā gr. zo Strychnin sulf.
no idiosyncrasy, but I have since decided
that quinin is no friend of mine. The next morning I was conscious, ex
W. F. HOLSTEEN, M.D., pectorating freely, breathing easily, very
Assistant Surgeon Ferrocarril, Central Mexicano. little rise of temperature, and felt pretty Aguascalientes, Mexico. well generally, except that in all of my extremities-feet, hands, ears, etc.--there was an extremely painful itching and ting- The Question of Vaccination. Hypothetic ling sensation. I rubbed my forehead a
Medicine. little with the palm of my hand, and Editor MEDICAL WORLD:We have a coarse, red macules, slightly raised above smallpox scare in our vicinity, and as we the level of the surrounding skin, ap- have had no dissertation on that topic for peared. Within ten hours the itching a long time, I would like to ask the many and macules had progressed down my face, members of the World family to express neck, chest, and then to every part of my some opinions on the value of vaccination, body's visible surface. I, of course, independent from the commercial value to scratched; I could not have refrained the physician. The newspapers stated from scratching had my life depended that one physician in Omaha cleared $600 upon it. LE - 1x
from vaccination alone. The Gleaner, The next stage was the appearance
of January, '99, copied an article on small papules, several developing from "Holy Hypothesis." each macule.
The great discoveries of Pasteur, Koch, My case began to look very much like Virchow and many others are flowers and smallpox. At the end of the second day, fruits of innumerable hypotheses, conafter the appearance of the macules, there ceived in enthusiasm, controlled by indewas not an inch of skin free from papules. fatigable patience, abandoned for others, The itching continued intense. The doc- when shown to be uncontrolled by facts. tor, who had come to take my place, and Löffler's bacillus is found often in healthy I, both thought I had smallpox-and we throats is therefore not a cause of diph