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ORIGINAL COMMUNICATIONS preparations, is a mountebank and a beast

of prey. He well deserves the ostracism Short stories on the treatment of diseases and experience with of all decent people, medical or not. Four

new remedies are solicited from the profession for this department; also difficult cases for diagnosis and treat- fifths of our worst quacks have hanging in

ment. Articles accepted must be contributed to this journal only.

their offices diplomas from reputable mediThe editors are not responsible for views expressed by cal colleges. Their turpitude depends upon

contributors. Copy must be received on or before the twelfth of the month

vulgar gall, not upon method of medicafor publication in the next month. Unused manuscript tion. They sin more against the dignity cannot be returned.

of a learned profession than against the Certainly it is excellent discipline for an author to feel that he must

say all he has to say in the fewest possible words, or his reader laity, excepting that they are practised is sure to skip them; and in the plainest possible words, or his reader will certainly misunderstand then. Generally, also, a

robbers almost to a man. Let us not de. downright fact may be told in a plain way; and we want nounce the adherents of one ideaistic sysdownright facts at present more than anything else. -RUSKIN.

tems as quacks, but as visionaries, scioCOMPARE. RECORD, lists, etc.

A criticism of the college methods of Therapeutic Philosophy.

the regular school will seem a brazen thing

in so obscure a personage as myself, but it No. 3.

is certain that such criticism is justified. Editor MEDICAL WORLD :-It is proper The fault I shall call attention to is com. to take a glance at medical ethics before ing to be recognized by many of the more proceeding to the discussion of errors and thoughtful of the dominant school, as it abuses. Happily, the straight-laced ma- has been so recognized by the membership jesterialism of the ethical past of medi- of protestant schools for a long time. cine is fast disappearing. Still there are What I refer to, is the comparatively small many who are too free with the use of the amount of attention the teachers in the word quack. If there were a scientific regular school give to therapeutics. No and inflexible therapeutics, then this sys- end of time and labor are given to etioltem, by the force of its evident rightness, ogy, pathology and diagnosis, while the would be the legitimate one. Any devia- study of drug action—the heart of medition from this would constitute doubtless cine—is made next to incidental. The quackery. But there is no such system, clinical value of all the rest of medicine is so that it is difficult to make charlatanism as one to ten compared with that of a depend upon therapeutic methods. The knowledge of drug spheres, with their difficulty is increast by the fact that the associated symptom-schemes. To cure a mortuary lists of differing schools do not patient, we must give the right drug, and help us out in the matter. Let us be fair whether we do this or not must always about it; we may call Christian Science a depend upon our knowledge of two things: humbug (which I believe it is as a sys- symtomatology and drug action. We may tem), but can we call it quackery ? Unless affect a “ proper" scorn for the empiric, they lose a greater proportion of patients but it is an implacable fact that he bears than do drug doctors, we cannot call them to us the relation of master to slave. Raquacks. Realizing how much malmedica- tional empiricism constitutes nearly the tion there necessarily is, and remember whole of the healing art, whatever may ing that the patients of Christian Scientists be its relation to medical institutionalism. escape all this, is it not probable that they We laugh at the symptomic elaborateness can show as creditable totals as we? This, of homeopathy, but are forced to acknowl. which may be true now, won't be true in edge that if they are excessive in this, that the future, because the legitimate physi- is better than negligence in it. It seems cian will add to all the psychologic benefits a pity, but it is notable that the developof christian science, doubtless drug benefits, ment of no trustworthy drug has resulted instead of subtracting from them, as is now from scientific suggestion. The regular done in a majority of cases by over or school is battling bravely and enthusiwrong drugging. It is a little humiliating astically with bacteriologic relationships, to concede the fairness of the foregoing but unless natural analogies stultify themargument, but I believe that every un- selves, the ultimate result will be a splendid prejudiced and hard thinker will do it. structure of ornamental knowledge-only

Quackery, in my judgment, depends this. The veil between time and eternity almost wholly upon business methods. is not more impenetrable than is that The doctor who spreads himself showily between scientific prevision and the specific hru the lay press, and who handles secret electivity of an untried drug. There is

surculity of

arthodoxy

THE MEDIOAL WORLD.

225

but one way to establish remedial virtue can an editor afford to publish an article in any agent, and that is by countless which adversely criticises, however justly, provings.

any preparation, the advertisement of In this connection, there is a self-sug. which he carries? Happily, I don't think gested rule which some may not have THE WORLD advertises a single preparation noticed. It is this: Generally, the efficacy which I cannot more or less endorse. of a drug in a particular condition is not To bring into startling relief the tissueestablisht as long as it does well for some feeding fallacy, I will consider the subject doctors but not for others; it must be- of anemia. Now, doctor, does not the have the same for all. For instance, the mere term, anemia,' start in you a ferproper use of a reliable preparation of ruginous trend of thought? Certainly it phytolacca in threatened mammary abscess does, unless you have a very independent always prevents the trouble. It will do and exacting method of logic. Anemia, this for any doctor on earth whose symp- iron—what ruthless iconoclast shall attomotologic acuteness is equal to the tempt to sever this twain, which have discriminative strain (!) in the case. The clung together thru all the historic past! niche for phytolacca in the therapeutic Well, the investigating spirit of the age is temple has, therefore, been hewn out. It going to do it. Within a year I have read is curative in all glandular troubles, and a two or three articles upon this subject, specific for "gathered breasts," if given written by prominent regular physicians, before pus has deyelopt.

in which iron was very considerably given I have discust, far from exhaustively, the go.by. They did not make war upon the abuse : hypermedication. I propose, this time-honored agent, but such allusions now, to call attention to a very compre- as they made to it were not caressive. hensive error, which holds a prominent They were a little gingerly about it, but place in the therapeutics of all systems they did go so far as to express a doubt as which employ drugs. This error is that to whether the good qualities imputed to it fallacy out of which has been evolved the were equal to the bad ones which actually idea of tissue-feeding. The theory is so do belong to it. Altho the tip of the white plausible and fascinating upon the surface feather fluttered thru their dare-deviltry, that only the most wary have not, to a the motif and bent of their utterances greater or lesser extent, been entrapt by showed which way the wind medical is it. It is classical and blue-blooded to the setting. very uttermost degree, so that you might, But anemia. The word is a misnomer, under its ægis, girdle the earth with funer- for anemia is not a disease—it is the effect als, and still maintain the smugness of of disease. I will not waste space in a 6 eminent respectability.” It is astound- description of the various varieties of ing that this ankle-deep philosophy should anemia, included among which are oligehave controlled the medical world for mia,oligocythemia, or aglobulism, hypalbuages, and that it still does so to a great minosis, etc. The causes of the different extent. That its necessarily negative or anemias are numerous and complex. I harmful results did not work its extinction shall consider, principally, the commoner centuries ago constitutes a scathing satire variety which, under a strained pathoupon the obduracy of preterism, and the logic courtesy, is called idiopathic aneservility of orthodoxy. This half-baked mia. This is the form of anemia which philosophy, so far from losing vitality, has has been ironed thru all the dim ages since at last crystallized into a new medical sys. Hippocrates, and which has ever transtem, but this will be discust later.

muted the process into the sinister echoIt is impossible to fairly treat this sub- irony. You will infer from this that I do ject without, not in a mean sense however, not advocate iron in anemia. I do not. I stepping upon somebody's toes. This is will present my objections as plainly and because it cannot be so treated without clearly as I can. seeming to disparage preparations which There is a family consisting of seven or honest and conscientious men make to eight persons. They all sit at the same sell. But, think over it-must we sup- table and eat the same food. One of them press free discussion because it might hurt falls into the condition known as anemia. the sale of Hood's Sarsaparilla, for in- What is the cause of this? We know it is stance? Don't you know there are scores not a lack of iron in the food, else they of " legitimate" drug preparations which would all become anemic. But can are no better than it? On the other hand, give the patient iron under any other theory

we

than that he does not get enuf of it in his use of spending months in curing anemia food? And in giving it, don't we assume thru the round-about and tedious route of to be better histogenetic caterers than the prima viæ when we can do it in a few Nature is? And if the monstrous conceit minutes by hypodermic injections ? We could be realized, and we could thus arti. obtain a drop of the anemic's blood, and ficially feed the blood, why should the by examining it, we ascertain just what system ever again become reconciled to element is lacking. All that is left to do Nature's preparation of iron ?

then is to inject a proper amount of the Having excluded iron-lack in the food "shy" elements, and presto, the patient as a cause of anemia, a class of physicians is cured! I submit that this idiocy is will, under the irresistible stress of common rigorous and unshakable logic, with refersense, admit that a form of malassimilation ence to the tissue-feeding idea. is at the bottom of the trouble; but, under Now all this is not to say that some pressure of orthodox impulses, they give ferric preparations are not more or less iron just the same. Altho they will not good, but they are good in spite of the iron admit it to themselves, they actually they contain. More next month. reason as follows, if they reason at all : Cleves, 0. W. C. COOPER, M.D. " The ultimate condition of the assimilat- [These rather bold expressions by Dr. ing apparatus is such that it can not ap- Cooper inspires me to make a personal propriate iron, therefore I shall give the confession-let us always be willing to patient-iron!"

confess for the good of the profession and We have all of us read the scholarly for the sake of truth. The lawyers have papers of medical doctrinaires in which this saying: "A lawyer who pleads his successive laboratory examinations of the own case has a fool for a client." So it blood were made during the adminis. might be said that the physician who tration of some favorite iron preparation. treats his own case has a fool for a patient There would be a steady increase in the or shall we say, has a fool for a physinumber of red globules until the normal cian? Last fall I occasionally had those proportion was reacht. It is certain that symptoms of malaria best described as “ a most of these reports are perfectly accu- feeling of general cussedness.” I took rate and trustworthy. But if these ex- anti-malarial treatment, and felt well perimenters will surround the patient with again. In a few weeks the symptoms rethe same hygienic improvements, the same turned, and I again took treatment and psychologic influences, and give him, was well. After this comedy was repeated say the tincture of the muriate of iron- several times I began to resolve to watch conceded to be the best of all iron prepa- for the septennial return and ward it off; rations-giving this minus the iron, they but in time I found that the return was at will note a much more rapid improvement. irregular intervals. Then I tried regular It is not the iron that does the work, but and daily dosings with antiperiodics, but the elements associated with it. Hydro- the depression came anyway. By this chloric acid is a positive remedy in several time spring was approaching, and while I forms of defective assimilation. The iron had all along been “making a hand," my can do nothing but harm unless it is a state of health was not satisfactory. I remedy for malassimilation. But we know that began to doubt my diagnosis. I then went it damages the stomach and bowels and to my scientific friend, Dr. Judson Daultimately, therefore, the assimilative pro- land, to see if he could find any malarial cess. No one claims that iron directly im- “jiggers" in my blood. I was surprised proves the assimilative function. What and somewhat disappointed to learn that kind of physical logic, then, would inhere none were present. To be a patient of in a fact which should depend upon the Dr. Daland means business. I immedieasy assimilation of the enemy of assimilation ? ately gave up all further attempts at self It is understood, of course, that the iron treatment, and devoted my efforts to being of our food is assimilable, and is only a good and obedient patient and that barred out by a pathologic condition. It always pays). He made further blood is not an enemy of ferric election.

examinations and found the percentage of If a lack of hemoglobin, or what-not, con- hemoglobin much too low. Then he made stitutes a disease, and to directly supply a thoro physical examination, then close that lack (as by tissue-feeding, so-called) questioning as to diet, hours of work, rest, is to eure that disease, what a soft snap

etc. I inadvertently mentioned a baked we can have of it, anyhow. What is the apple-dumpling with cream (of which I am very fond), for dessert the day before, and then than at any other time. I have on all pastries were at once forbidden. And several occasions advised childless couples as for cream : “Yes, I take a great deal to cohabit at this time, and pregnancy reof cream; I drink my coffee half hot sulted. What effect does intercourse cream; cream has always agreed with me; during menstruation have on the female ? it builds me up and sustains me.” “But, Sometimes a headache follows, but as this Doctor, you are not digesting it. Let me is a common thing at the wind-up of mensee your tongue. I notice, also, that your struation, it is doubtful if it is caused by breath is heavy. Avoid all fats for the the intercourse. Women are more amopresent, and take milk instead of cream rous during menstruation, and some have with your oat meal, coffee, etc.” When the sexual orgasm then and at no other we discust hours of rest, he said : “Now time. The menstrual flow may be inI am going to hit you hard. Nine continu- creast by anything that arouses sexual ous hours in bed ! and one hour of complete feeling, such as toying with the genitals or rest and relaxation, with massage, in the the breast, by the free use of rich foods middle of the day.” My urine was anal- and stimulants, hot baths or hot tea of yzed, and every inquiry made in the direc- sassafras, tho that comes under the catetion of: “What is your system doing, and gory of drugs. The most effective emmenhow is it doing it?" I was ordered to agogues are potassium permanganate and drink more water, and directed concerning other preparations of manganese, sanguiphysical exercise. Medicine? Yes. First

Medicine? Yes. First narin in frigidity, iron in amenia, colchià bitter tonic, and later a digestant was cin in plethora, gold and platinum in added. I had taken ferruginous hematics obesity. during the winter, but to little or no pur- I cannot agree with Dr. Landes (page pose. Calling to mind the diminisht per 194) when he blames the medical profescentage of hemoglobin in my blood, one sion for the spread of morphinism. The day I ventured to suggest iron. (And this cause lies deeper-in the conditions of is the reason I am telling this story.) The our modern civilization, As long as men Doctor said, “No, Doctor, I not only think will wreck their health in the mad race it would do you no good, but in your pres- for riches that they cannot enjoy when ent condition, I think it would do you they have won them, there will be the harm.” Thus, among the masters in medi- tendency to look to such drugs for temcine, cold scientific analysis, with a view porary stimulation, for holding physical to discover the abnormal in order to reestab- ailments in abeyance, or for a solace to lish the normal, is superseding the easy their disappointment. Among the hunand routine prescribing of iron, iron, iron. dreds of cases I have treated in the last I rapidly recovered my usual health.- ten years there are scarcely any that could ED.)

justly charge their habit to the doctor, tho

some were ready enuf to saddle him with Notes and Comments.-Summer Diseases of

the wrong they had done themselves. Children.

Dr. Stearns' letter (page 196) is most Editor MEDICAL WORLD :-Dr. Cottew suggestive, but it opens the door to fruit(page 191, May WORLD) certainly had less discussion. Do but suggest the prenerve to give gr. 1-30 of atropin to a vention of venereal diseases by state reguchild six months old ; and in spite of the lation of prostitution, the only possible favorable results, I would not care to re- way, and Theology steps in to say to Hypeat his experience. But I have given giene, “ Thou shalt not.” And as Theolpretty nearly a relative dose of strychnin. ogy has not as yet devised a practical Except in emergencies it is better to give means of protecting the inexperience of the small doses very frequently until ef- youth, the perpetrator of a sexual sin is fect, as all danger of over-dosing is there- ruined, body and soul, and allowed to go by prevented.

abroad in the community, a standing In Dr. Hill's case (page 192) the patient danger to everyone he approaches, for the had disease of the arteries far beyond the very insufficient reason that he ought not affected limb. Assuredly the operation to have done it. This is not much consowas justifiable, and the patient was given lation to the innocent victim, but such the only chance for his life.

considerations have little weight with the “A Doctor's Wife," on page 193, asks people who construct their ideals of what if conception can occur doing menstruation. men ought to be, and then send them to Not only so, but it is more likely to occur Gehenna because the clothes don't fit.

But I must quit, or the small remains of them_a Tennesseean-the pulse almost my hair that the ladies left when I tackled imperceptible, the extremities cold. the child avoidance question will be in once gave him a hypodermic injection of danger.

hyoscyamin, gr. 1-50, glonoin gr. 1-50, On page 200 “ Central California” asks and cocain gr. 1-8. In a very short time advice. The salient points in his case he showed the physiologic effects of the are, the evidences of abdominal decompo- mydriatic, when I gave him a whiff of sition, gas-formation, etc., and auto-tox- chloroform, about five to ten drops. This emia, as shown by the pains at points not settled the paroxysm, affected simultaneously in any affection But my next case was a caution! A unless it be multiple neuritis. Pruritus is woman who had taken morphin for renal frequently an indication of uricemia. This colic, and was decidedly of the opinion that is as far as one can go safely without the drug was harmless, or at least that its a physical examination, but the location use was unobjectionable. She had had of the pains in the back and their per- better health than before she used it, had sistence under good treatment, would gained flesh," etc., etc. To those of us arouse in my mind the suspicion of cancer who are familiar with the drug-habits, such somewhere in the abdominal cavity. talk is evidence of an advanced stage of Meanwhile the only treatment indicated the malady, when the mentality of the by the symptoms given is: Empty the in- victim is affected by the drug. However, testinal canal by repeated doses of some she was put upon the usual treatment, the mild saline laxative and hot colonic flush- morphin withdrawn in two days, with very ings; keep him on an exclusive diet of little suffering, when she suddenly began milk and fruit juices, and give enuf sul- to writhe and groan, declaring that she focarbolates to keep his alimentary canal had her renal colic! There were none of aseptic; also a dose of pilocarpin enuf to the symptoms usual in such attacks, but make him sweat freely, repeated when she averred that this was the way they al. ever the itching is noticed. My only case ways commenced with her. I therefore in which pilocarpin failed to relieve itch- gave her the same combination as the preing was that of poor Imgard, which turned ceding case. The most markt effect mani. out to be cancer of the liver. Mustard fested was dryness of the mouth, with debaths give complete relief when the pruri- lirium of active type. She claimed that tus is due to urticaria or prickly heat, and the pain was still intense, but smelling the in other forms of cutaneous disease. In cork of the chloroform bottle sent her off, cancer of the liver there is the same and she displayed the greatest energy in tendency to find ease in lying on the endeavoring to secure the chloroform bottle, stomach as in cancer of the stomach, a condition totally impossible to a person but not so generally.

in the agonies of renal colic. In eight A gentleman came to me recently for the hours the delirium subsided, and after a morphin habit. He had contracted this ter moderate hypodermic of pilocarpin she rible disease in seeking relief from the pangs slept about six hours, and awaked sane of spasm of the gall bladder. He had had and cured of her desire for the drug. the gall bladder opened, over 100 calculi My object in describing these cases is to removed and the viscus stitched to his call attention to the vast superiority of the side. Since then he had been baving new remedies for the relief of pain. Too frightful spasms in the gall bladder, the many physicians associate the idea of pain last requiring twenty-four hours' suffering, with that of morphin, so that the one follows six grains of morphin and six ounces of the other as a matter of course. chloroform to relieve. Evidently this was for the severer forms of pain morpbin in

case demanding something stronger any dose is inefficient. It cannot compare than morphin to meet the indication ; but with spirits of chloroform for colics, cramps when I suggested this he denied the exis- and other gastro-intestinal pains, while for tence of any such agent. He was not the agonies of renal and hepatic calculi, familiar with the resources of modern and the major neuralgias, the potent commedicine. The morphin was taken off, bination above named is far and away the process requiring three days, without more effectual. And who that has atany special suffering; then the spasm ap- tempted with morphin to suppress the pain peared in all its vehemence. The pain of confined pus, or of a testicle swelling was so intense that the man could not under adhesive strapping, does not redden speak—and he was as gritty as they make with shame as he recalls the experience!

And yet

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