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Then, the amount and kind of food water Fehling's or Trommer's test, and must be regulated, so that the over-workt, you get no reaction. Now, if you are a poisoned and starved excretory organs smoker, you can get plenty of ptyalin in may not be injured. The mode of cook- your saliva with which to convert all the ing, too, has to be considered. Wasn't starch into glucose, in another quantity of it Fothergill who said, “Frying is a form starch water. The iodin will then give of cooking invented by the devil to reach no reaction, but the copper test will, peoples' souls thru their stomachs ?' showing that the starch has been con
There are four proximate principles of verted into sugar, in which condition only which our food mainly consists; viz.: is it available as food. Starch, as such, Water, starch, albumin and fat.
is insoluble, but sugar is readily so; hence 1. Water should be sufficient in amount we sometimes examine the feces with the to liquefy the solids we eat, to effect solu- microscope for starch grains. tion of the soluble portion, to favor ab. There is no flesh-forming property to sorption, and to favor elimination. It starch or sugar, but it is used in some should be chemically correct, i.e., free manner in the economy in tissue-metabolfrom organic or inorganic poison; it ism, and possibly its reduction to the simshould hold in solution a small quantity of pler forms of carbon dioxid and water is salines—table salt added to rain water will attended by the evolveinent of energy. do. The popular idea that “manufact- Latent activity may be produced at the ured ice is bad because it contains too moment of change and stored away in the much ammonia" is incorrect. The am- sympathetic system, to be available for monia does not get into the ice. The future draft. danger lies in the very purity of the 3. Albumin in one shape or another is water. Anemia has developt after the an important constituent of all organic prolonged use of very pure water. Most substances. When it has served its purof us have experienced discomfort after pose in the animal economy it appears in drinking pure water. A young lady died in part as urea or some mode of the urates. New York City from its use. A reference This substance (urea) is the antecedent of to the subject of dialysis will afford a par- the ammonia in stale urine. tial explanation.
Sometimes, as in typhoid states, we can, Water may sometimes be medicated by holding a stopper wet with muriatic with advantage to meet certain indica- acid in the breath of the patient (so that tions. In 1877-8 I learnt from natives in the fumes may mix with the expired air), Hindoostan that sulfuric acid in drinking observe a white cloud of muriate of amwater would keep away the cholera, and monia NH4HCl. this circumstance has since been con- I had a patient with pneumonia. His firmed. Three or four years later, Robert kidneys were previously unsound, and he Koch (of tuberculin fame) explained the became drowsy from uremic coma. I put reason. He announced that the water of him inter alia on ammonium benzoate, which the victims drank was always alka- with some improvement, including a reline in reaction, and that the coma storation of normal acidity of his urine bacillus could only proliferate in such (glycocol + benzoic acid = hippuric acid). medium. This circumstance affords a key A relative wanted another physician who to the successful treatment of typhoid said “we must stimulate him-give him fever also, since this disease resembles whisky and carbonate of ammonia." I cholera in its pathology and in its symp- retired in favor of the other physician. tomatology-only longer drawn out. Patient died within another thirty-six
The germs of neither can be killed by hours. The family declare that the new any acidulated water we may drink ; but, medicin killed him. Mineral acids in that if we thoroly acidulate the alimentary case might have done some good, especicanal, we deprive these germs of the ally the nitro-muriatic, which contains power of proliferating-of producing the free chlorin which decomposes water, harmful spores, and they die in about coming muriatic acid and liberating nas. eight or ten days.
cent oxygen, besides arresting free am2. Starch: Chemical tests: Suspend monia in its passage thru this series of some starch in water; apply a drop of changes. tinct. iodin and you get the dark blue Pepsin transforms albumin into peptone iodid of starch (starch is the antidote to in an acid medium, but papoid and fresh iodin): apply to another portion of starch pineapple juice will produce peptones in
dependently of the acid condition. I II. The second system in our scavenger sometime get the nurse to steep fresh beef business is that of the urinary organs. in fresh pineapple juice; this makes a At this stage of the review of our work very palatable peptone. Fresh pineapple of school days, it will be well to examine juice also digests and dissolves the false some samples of urine. Suppose we have membrane of diphtheria. It contains also (1) an unusually pale urine, in large quan. a stimulating ethereal principle.
tity (according to twenty-four hours' measConditionally, meats are objectionable, urement), of low density-anywhere bemore or less, in warm weather, owing to tween 1002 and 1012, reaction neutral, and the creatin and other irritating principles giving negative results to tests for albumin they contain. Cheese is a concentrated and glucose: that suggests polyuria, or and unirritating albuminate, but it is hard diabetes insipidus. Or (2) we have a to digest, and in a weak stomach it may urine also of low sp. gr., but decidedly form acid albumins with corresponding heavier than the preceding specimen, say gastralgia or pyrosis. A little cheese eaten 1015: that would suggest albumin, and after dinner seems to aid digestion : for that the kidney is the seat of the trouble. “cheese is the little elf that digests all, Heat slowly in a test-tube (or spoon, if except itself."
the former be not available); a white pre4. Fat is not absorbed as such, but is cipitate is either phosphates or albumin. first emulsified by the bile, and then Add a drop of vinegar; if the precipitate saponified with the aid of part of the pan- dissolves, it is phosphates; if it becomes creatic and intestinal secretions, in which more pronounced and separates into floccondition only is it absorbable. The fat culi, it is albumin. Or (3) the urine is of is split up into glycerin and fatty acids; high specific gravity-above 1025; it is the latter combine with bile and other usually pale in color and large in amount: alkalies to form soaps or absorbable salts. glycosuria or diabetes mellitus is indicated. Its mission seems to be connected with tis- If we should discover that the glycosuria sue metabolism and the production of ani. is due to ingestion of too much sugar, or mal heat.
that the liver is the source of the trouble Albumin may undergo fatty degenera- (in which case we are justified in assuming tion, as in the case of the transformation that the case is probably curable), it is of leucocytes into pus-cells. Adipocere is common to call it glycosuria ; if, on the formed by the albumins of a dead body other hand, due to a lesion about the undergoing fatty degeneration, and the calamus scriptorius of the fourth ventricle resulting fats furnishing stearic, margaric of the brain, it is called diabetes mellitus. and oleic acids to combine with ammonia Fill a test-tube with the urine, add some and metallic bases; privation of atmos- fresh yeast, invert the tube containing the pheric air is essential to this series of urine and yeast in a dish containing more changes.
urine, and leave in a warm place twelve to There must be a relationship between twenty-four hours. Any displacement of the kind and amount of food we eat, and the urine, any lowering of the column, is the amount of work performed. The fol- due to evolution of carbon dioxid, which, lowing table from McKendrick shows the along with alcohol, is formed from the quantity in avoirdupois ounces of the dif- sugar by the yeast. We may also apply ferent materials of dry food required under the copper tests of Fehling or Trommer different circumstances :
(taking great care not to mistake a precipitate of peptone for glucose), the picrie
acid test of Johnston, the bismuth and "NATURE OF FOOD. MATTER, FAT, HYDRATES, SALTS. TOTAL.
potash test of Boettger, the potash test of with mod'te exercise, / 4.21
Moore, or the phenylhydrazin test. Active artisan,
Our ally the pharmacist is the proper Hard-working laborer, 5.64
man to do this part of the work; but, as a
rule, his analysis is unreliable, and he “Add to each of these sixty to eighty wants a larger fee than we can afford to ounces of water, either alone or as part of pay, or than our patients can pay us. the food. Ordinarily, a healthy adult When we find a capable, trustworthy, and may perform a fair amount of labor with reasonable man we ought by all means to twenty-eight or thirty ounces of dry, encourage him by employing him to do the nutritious food, food, and seventy
work; but, unfortunately, when we have water."
found such an one, he has already prob
Bare subsistence diet, 2.33
11.69 18 96
ably begun to lay his tracks for a medical combining an agreeable antiseptic like oil education, whence he elbows his way into of eucalyptus with our ammonia and water the ranks of the medical profession, there vapors, to be constantly inhaled by the to persuade his former customers that he patient from a bronchitis kettle over a coal can supply them with “something just as oil stove placed near the bed. good” in the shape of treatment, so that IV. The skin is the fourth organ of we are again reduced to the necessity of elimination in our lesson. Normally it performing our own urinalysis.
secretes sebaceous matter, and excretes There is a very convenient“physicians' 1000 to 2000 grammes of sweat and about pocket reagent case" gotten up by Messrs. four grammes of carbon dioxid in twentyParke, Davis & Co. of Detroit, containing four hours, besides such substances as a new adaptation of an old method of as- sulfur (from albumins), aromatics which certaining specific gravity of fluids by may have been ingested (like garlic), urea, glass balls of different density, the lighter etc. ones being above and the heavier below in In diseased conditions the perspiration a tube. All balls of lighter density than has a peculiar odor. The subjects of the urine in the tube float, and the densest mania, and especially those of melancholia one that rises indicates the sp. gr. of the and dementia in its earlier stages exhale a urine. This is the most convenient, prac- peculiar odor. The source of this odor tical, and perfect arrangement I have yet is perhaps the materies morbi which
There is also a booklet of instruc- demoralizes the nerve cells. The liver is tions and a complete set of tests in the also, perhaps, in some way concerned, as shape of tablets. With this beautiful little
With this beautiful little deep percussion over the right hypochonarrangement all the ordinary tests may be drium often elicits tenderness in those made, both qualitatively and quantita- charged with unsound mind. tively.
The importance of the bath cannot be III. Our third system of elimination is over-estimated, both in health so-called, that of the lungs. About 900 grammes of and in disease. carbon dioxid are eliminated in twenty- In hyperpyrexia the fashionable antipyfour hours, which is food for plants; they retics depress high temperature only in generously separate, by means of the proportion to the amount of cutaneous acchlorophyl in their leaves, the carbon from tivity induced, and, sometimes too, in proit, and give oxygen back to the atmosphere portion to the amount of nervous and vasfor us to respire. An increase in the num- cular depression. The cold bath has done ber or depth of respirations favors the harm by deflecting nerve and vascular elimination of CO2. Vegetable food and currents towards internal organs, but there muscular activity favor it. It is diminisht is usually no objection to warm sponging, during sleep.
gradually cooling the water. In bronchial catarrh and in pneumonia, A remarkable case of pneumonia I saw elimination is interrupted. These condi. with my friend Dr. Hume of Frankfort, tions seldom occur in warm weather, hence showed a temperature of 104°F, rapidly we imitate nature and make an artificial rose to 107°, and began to cool only when summer temperature in the sick room. cold water was injected into the rectum. The se- or rather ex-cretion is probably Patient eventually recovered after inbaltoo viscid to be moved by the cilia lining ing over 70 gallons of oxygen gas. the bronchial tubes, so that we make an Louisville, Ky.
ROBERT WALLACE. atmosphere of steam around the bed. There is perhaps an engorged venous-sys
Sulphonal Habit. tem with distended right heart calling for Editor MEDICAL WORLD :-I recently met stimulations; ammonia vapor in the steam a case of sulphonal habit. A girl of twenty is not only a stimulant of circulation and years had been taking the drug over respiration, but it is also a solvent of eighteen months, it having been given her by mucus. There has probably been some de- a physician during an attack of typhoid gree of leucocytosis, and pus-cells may be fever to relieve nervousness and procure found in the bronchial excretion; ammonia sleep. As she convalesced, she continued will dissolve the pus. Septicemia may its use until she could not do without it. complicate our case, and the stomach may When I saw her, about two weeks ago, she be in such a condition as to obstruct medi- was taking about ten grains six to eight caments via that channel. It is more ra- times in twenty-four hours. Her supply tional to anticipate this complication by became exhausted one night, and the next morning she collapst, as she said, for lost only a few pounds in weight and are the want of it. She was pale, pulse very on the street feeling about as usual in one weak; said she had the feeling as of worms week after the fever has left. I never had crawling under the skin all over her body, hemorrhage from nose or bowels if I saw even to the ends of the fingers.
the case in time. Of course, if seen after I want to ask if any of the World fam- ten days or two weeks have elapst, I have ily have met a similar case, and to ask to combat the conditions somewhat differ. suggestions as to treatment.
ently, tho in the main they are treated as HORACE WARDNER, M.D. above. I never purge.
I give sweet milk La Porte, Ind.
or buttermilk, as they prefer, and it
agrees. Study the patient and don't treat Treatment of Typhoid Fever.
the name of the disease. Editor MEDICAL WORLD:- In the treat
J. S. McILHANY, M.D. ment of typhoid fever there is a golden Everett, Wash. mean. In all forms of treatment, any extreme is a fad, and all fads die out in time. The method I have tried with suc
Constitutionality of State Medical Laws. cess avoids all extremes, and yet all cases
Editor MEDICAL WORLD :-I read your are not treated exactly alike. The patient, proposal for a National medical law with in a given case, must be studied as much deep interest, but am not sure such a law as the disease. If seen as soon as the is necessary. Before me is the Declaration fever begins, and a diagnosis can be made of Independence, and it says: “We hold with certainty, I give a calomel laxative these truths to be self-evident: that all of } to 1.10 of a grain every hour until men are created equal; that they are enthere is a copious but gentle evacuation. dowed by their Creator with certain Then I give a grain, more or less, of cal- inalienable rights; that among these are cium sulfid three or four times a day and life, liberty and the pursuit of happiness." the sulfo-carbolates alternately. I never Now I turn to Article 4, Section 1, of the use any antifebrifuge but sponging in cold United States Constitution: “Full faith or tepid water, according to the individual and credit shall be given in each state to and range of fever, which produces a the public acts, records and judicial prostimulating, followed by a soothing sensa- ceedings of every other state; and the tion. I also give a 2 to 3 per cent. solu- Congress may by general laws prescribe tion of chloroform every one-half to one the manner in which such acts, records hour while awake, and keep it up until and proceedings shall be proved and the the fever begins to decline, and then I stop effect thereof." it. For food I give any soluble substances Recently it has been sought, in the exthat the patient likes, especially the acid uberant desire of medical boards of health. phosphates in water ad libitum, ice-cream to create themselves into courts of final or any other frozen preparation as pre- jurisdiction, sitting on the acts of medical ferred; soups, baked apples and cookt men within their state jurisdiction. On fruits, with skins removed, etc. Raw appeal, at least two state Supreme courts apple scrapt is often very appetizing, and have declared such powers assumed under the acid furnisht helps to keep the bowels state laws ultra vires and unconstitutional; moving normally. I also give strychnin, and the men whose licenses were can. 1-40 to 1.60 gr. t. i. d. all thru the dis- celed, were, by order of the courts, reease; it stimulates all the organs and func- stored to practice. tions, as bowels, kidneys and appetite. Now we come back to state jurisdiction ; Later I give digitalin if the heart seems there can be no doubt but that each state weak. The chloroform and acid phosphate has a right to protect its citizens from is especially agreeable to the patient, and ignorant charlatans under its police pow. I often prescribe them in solution together. ers. But has a state legislature the right I never have constipation or diarrhea in to meet a citizen at its borders who has in consequence. For tympanitis, if bad, I an honorable and legitimate way prepared give a few pills of salol and turpentine on himself for the profession of medicin by abdomen.
graduation out of the best colleges, or one My greatest trouble with this treatment of them, and say, "you cannot pursue life. is to keep the patients from eating too liberty and happiness in this state, no much, or such as I interdict. They are matter what your qualifications may be, paler when allowed to get up, but have until you are examined and past upon by
our State Board of Health.” This is now
Quiz Column, practically the law of eight or ten states
Questions are solicited for this column. Communications in our so-called free Republic. Does such not accompanied by the proper name and address of the
writer (not necessarily for publication) will not be a law infringe on Article 4 ? or does it noticed not? "Full faith and credit shall be The great number of requests for private answers, for the in
formation and benefit of the writer, makes it necessary given in each state to the public acts, for us to charge a fee for the time required. This fee will records, and judicial proceedings of every
be from one to five dollars, according to the amount of
research and writing required. other state." The public acts and records of the state of Illinois prove most con
Premature Emission. clusively that I have the inalienable right Editor MEDICAL WORLD :—Will you and to pursue the practice of medicin in this the readers of THE WORLD tell me what state. I can “live” only by my profes- course of treatment to pursue in the folsion and the practice thereof, as that is lowing cases? my legal calling; but the “Liberty” to First. A young married man, complains do so is denied me in Minnesota, and I am
of sexual weakness. Says he cannot gratify debarred of the “ happiness" guaranteed his wife's sexual passions because emisby the Constitution of the United States, sions are premature, occurring in a few the liberty and the right to live, by the seconds after introduction. Erections are medical act of Minnesota. Just what fairly good, and he is capable of intersubtle legal reasoning a learned lawyer course from three to four times per week. would employ to prove such an act consti- His general health is fairly good, tho he tutional, the lay mind is at a loss to un- suffers somewhat from gastric catarrh. derstand ; but to the lay mind all medical Sleeps well and does not have nocturnal acts that are for any other purpose than
seminal emissions when wife is away for a the protection of life and limb are wholly week or two. Penis small and cold. Uremischievous, exclusive and not within the thra not excessively tender. Never masmeaning of either the declaration of inde- turbated to excess, but has indulged in pendence or Article 4, section 1, of our sexual intercourse on an average of three constitution. My proposition is to carry times a week since his marriage, two years a test case to the supreme court of the ago. Only a few times previous to that. United States, and if it is then found that What can be done to render his sexual states have such medical police powers, powers and organs normal? then let us appeal under article 4, section
Second. A young man, age 25, single, 1, for a declaration of both Houses that is engaged to be married in the course of the practice of medicin is of right on pro
a month. Complains that he suffers from duction of public acts and records in any nocturnal seminal emissions, and in sexual state, the inherent right of every citizen intercourse emission takes place on introwherever our flag floats, and we have duction. Erections are vigorous, but orjurisdiction. If the Editor of THE MEDI- gans are small and end of penis cold. Has CAL World and its readers are prepared never had intercourse “more than a dozen to respond to the sentiments of this letter times,”' tho he masturbated from sixteen to and believe with me that such laws are eighteen on an average of three or four unconstitutional, a subscription of $1.00 times a week, and from eighteen to his presforwarded to the Editor would be ample ent age on an average of once a week. He to test a case and settle this burning ex- has no stricture, but was operated on for clusion question.
one six years ago.
General health below S. EDWARD McCULLY, M. D. par, but is fairly strong. He dreads his 73 Twenty-second St., Chicago, Ill.
wedding night and wishes relief. [We believe that every state has a con
Please give me your opinion of these stitutional right to determine the standard cases. I can't find satisfactory treatment in to be required of those who practice medi. my text-books, and am doubtful whether cin within its borders. Therefore we de- tonics or sedatives are indicated. What cline to “hold stakes” for the above- effect would electricity have ? Can an abmentioned purpose. At the same time we normally small penis be enlarged ? Tue favor a National enactment, creating a
World is my most valued of five journals. National Board of Medical Examiners, or
For practical information for general more than one if necessary, a certificate practitioners I have not seen its equal. from which to give the bearer a right to
"SUBSCRIBER.” practice medicin anywhere under the juris [These cases need disciplin, and not medidiction of the United States.-Ed.]
cin. As a placebo, and as a help in in.