Imagini ale paginilor
[blocks in formation]

He becomes so intent in trying to discover Here, according to argument made, the a specific for pneumonia, or " in relieving remedy of “ first value” is one which acts the extraneous deposit" that he fails to re- on no particular organ and excites no vislieve the patient. He is somewhat like the ible excretions, but which in some mystesurgeon who saved the tumor but lost the rious way improves the nutrition of the patient.

body! Add to this a febrifuge mixture, It it were possible to so forcibly impress and there you are—" snug as a bug in a one fact upon the minds of all physicians rug." No mere routine" about that! that they would at once accept it and I am convinced that, as a general rule, utilize it as a guide n the treatment of causes of disease produce pathologic effects disease, thousands of precious lives would primarily thru their influence on garglibe spared which otherwise will be sacri- onic nerve centers, either directly or inficed because of slavery to time honored directly (reflexly); either as simple irriauthority. It is this : There are no spe- tants producing spasmodic symptoms; or, cifics for diseases as ordina ily classified, but acting more profoundly, they depress the there are specifics for pathologic conditions ; functional activity of organs presided over symptoms and signs are the recognizable manifes- by ganglionic centers. I must differ with tations of pathologic conditions, and should be Dr. B. when he says we want remedies accepted as the principal guide in the selection of which act on the peripheral nerves in the remedies.

lungs. We want remedies which act on Seldom should two cases of pneumonia nerve centers, to counteract the influences or typhoid fever receive identical treat. of causes of disease. ment. It should not be forgotten that Fortunately, we have remedies which, under any treatment or with no treatment with unfailing regularity, produce their at all, a certain percentage of almost any most markt effect upon local areas, which disease will recover. If some prominent are presided over by distinct ganglionic man comes forward with statistics to show centers. In addition to their local action, that a larger percentage of cases of pneu- many of them also prodnce a greater or monia recover when they have been packt less general effect thru their influence on in ice than when their vital centers are the general vaso-motor centers. more or less paralyzed with morphin, ver- In treating pneumonia or any other disatrum or coal tar antipyretics, do not at ease, the condition of important vital once jump to the conclusion that there is organs should never be overlookt. Examno better treatment and abuse those who ine the tongue. This is dry and contracted publish higher percentages of recoveries (manifesting irritation of sympathetic cenunder other methods.

ters) warns us not to burden the stomach Dr. B. considers alteratives as of first with drugs which increase the irritation, value in treating pneumonia. Brunton like quinin, morphin, strychnin, etc. ; if says that an alterative medicine is one that it is broad and fabby, showing want of improves the nutrition of the body without ex- innervation, it tells as plainly as words erting any very perceptible action on indi- can tell that active nerve stimulants, be. vidual organs. Dunglison says that an fore contraindicated, are now demanded. alterative is an agent capable of producing Let us observe the general condition of the a salutary change in disease, but without pneumonia patient. exciting any sensible evacuation.

Here we have a person whose system is Here is a patient who will either be charged with extraneous matter, germs, dead or on the highway to recovery within ptomains, urea, etc. ; his skin and other ten days. There is engorgement of the excretory organs have ceased to perform pulmonary vessels due to profound de- their wonted function. The cardiac and pression of the vaso-motor centers which vaso-motor centers are so depresst that should control their caliber. He is breath- local engorgements and inflammations ening rapidly, his lips are livid, bis skin is sue. Is it not possible that in this time hot and dry. The pulse is rapid, bowels of extremity we can find remedies more constipated, urine scanty; digestion, nu- important than those which act on no partrition and elimination almost at a stand. ticular organs and produce no visible exstill and the circulatory and respiratory cretions? The remedies to be employed organs struggling under the depressing in pneumonia should be mainly those influence of the virus of disease in addition which have a gentle stimulating or sedato the accumulating products of tissue tive effect. (If you strengthen the heart's metamorphosis.

action, you quiet it.) Depressants are


contraindicated. Very few persons are even to using it pure. I also pin a napkin burdened with a surplus of vital energy. moistened with turpentine near the chin,

A few words concerning the use of aco- that the patient may inhale its odor with nite and veratrum : There is a right and a every

breath. Raw cotton should be wrong way to use them. Whisky is gen- tackt to a cloth and kept applied to the erally regarded as a stimulant, but you whole chest surface. can paralyze (temporarily) the strongest Strict attention must be paid to the

with it. Nitroglycerin is recom- comfort of the patient, and to the heart mended as a heart stimulant, but it does and kidneys. Give one-half to two grains not require much of it to quiet the heart of quinin every four to six hours, after for all time.

suitable nourishment. I cannot emphaIn small doses, five drops of Lloyd's size too strongly the vast importance of specific medicine to four ounces of water, sufficient rest. The patient should sleep teaspoonful every fifteen minutes to one or at least eight hours of each twenty-four. two hours, depending on the urgency of With this treatment fully carried out, I the case, aconite is a most reliable cardiac believe there will be but few fatalities in stimulant tonic, at the same time toning pneumonia. Edwin L. SWIFT, M. D. up the capillaries, and exercising a kindly Hamden, Conn. influence on the digestive and excretory organs when the tongue and skin are dry

Comments on Colds, Fevers, etc. and secretion and excretion diminished; Editor MEDICAL WORLD :- Apropos the restoring the functional activity of the cir- treatment of colds, why not give the cold calatory digestive and excretory organs. plunge bath a trial, if the patient's vital

In summing up, I will say, that the rem- powers justify it? In baptismal immeredy or remedies indicated by the symp- sions many people go into the water at altoms should be given, regardless of the most freezing temperature, regardless of name of the disease. If the tongue is dry the fact that they may be suffering from and contracted, quinin, strychnin, etc., colds, sore throats, etc. The ever-obserywill do harm, rather than good. If thé ing man of medicine expects his service patient's head is hot, face flusht, etc, opi- will be required the next day, but lo! the ates will place his life in greater danger. cold is cured! What are we to in fer from

In the stage of engorgement, some of this ? the following remedies will be indicated : The typhoid fever subject has been so Aconite, veratrum, gelsemium, jaborandi, thoroly discusst that it would seem there is asclepias, bryonia, ipecac, lobelia. In the “nothin' to say further.” I do not think stage of hepatization, potash bichromate the profession can endorse Dr. McRae s ammonia muriate, ipecac, lobelia, tartar routine of administering sufficient acetanemetic, etc.

ilid to keep the skin moist. While I use Specific diagnosis and specific medica- the drug occasionally in typhoid, and often tion afford the most rational guides in in pains and neuralgias of the sthenic type, the treatment of pneumonia or any other yet I have seen too many collapses from disease.

0. C. MASTIN, M. D. the use of the drug to prescribe it indisEwing, Neb.

criminately, especially for a continued

period. Doubtless it has a damaging acTreatment of the Average Case of Pneumonia. tion upon the ozoning function of the blood

Editor MEDICAL WORLD :-As the treat which may not be made manifest for ment of pneumonia is under discussion in months or years later. Nervous people THE MEDICAL WORLD, I desire to give, in in particular seem to have an idiosyncrasy part, my treatment for nearly all cases, against the coal-tar preparations. croupous or bronchial. If the attack is The central idea in the treatment of tyvery violent, bleed at once, taking blood phoid fever is, I think, to prevent sepsis. enough to cause a soft pulse. Then give Calomel meets this indication better than calomel in quarter-grain doses every hour any drug thoroly tried thus far. I have until the bowels are emptied. If patient treated many cases with no other drug. can tolerate it, apply spirits of turpentine It is needless to state that careful attenand alcohol, equal parts, every hour, to tion to nourishment, nursing, etc., were nearly the whole of the chest, front, sides rigidly enforced. I have one suggestion to and back, until the skin reddens, and then make which I have not seen in print. often enough to keep it red, increasing, if After the premonitory nervous symptoms need be, the proportion of turpentine, have abated and the patient is started out on the proper line of treatment, blow out stomach never refusing it. And that the light at night and let the patient sleep. strychnia arsenite is superior to whisky as Coddling and over kindness in sitting up a general stimulant in such cases. kills many typhoid patients.

I have learned much, unlearned much, “ Antiseptic obstetrics is all right, but and come to the old conclusion that the the most probable period of infection is not wire physician will individualize his cases during delivery but a few days after. As and treat them accordingly. I am in a matter of fact a large percentage of de- hearty sympathy with all you have to liveries are made under any thing but offer in Monthly Talks. aseptic conditions, particularly among the Unionville, Ct.

E. M. RIPLEY. poor and ignorant. I recently attended a primipara in a little hovel where only

To Abort a Cold. dirt, rags and equalor prevailed—not a

Editor MEDICAL WORLD:-- If colds are clean towel or cloth to be had. The treated in time they can always be arrested mother, an old crone who claimed to be a

in twenty-four or forty-eight hours. mid-wife, said she “ dassent 'tend on one

one, even those with chronic nasal catarrh, of her own folks because it was agin the need ever have a cold beyond the congestlaw." How such foolish notions gain cre

ive stage. The following is my remedy: dence among the laity I am unable to say.

e de Give an anti-bilious pill if the bowels are Notwithstanding these microbic hot-beds,

slow or tongue coated. At same time most of these cases make uneventful re

gargle the throat well (head well thrown coveries. But the practice of asepsis and back), with two teaspoonfuls of the followcleanliness among this class, aside from a bacteriologic stand-point, is a good object the mixture, taking no water within twenty

ing, without water, and then slowly swallow lesson toward wholesome, sanitary living mintes afterwards. if nothing else. W. T. MARRS, M.D. Jewett, II.

P. D. pain killer

oz. ij Things Learned About Typhoid fever.

Paregoric .

oz. ij

Wine of tar. Editor MEDICAL WORLD :-I have been

oz. j much interested in the various opinions of

Spt. camphor treatment of typhoid fever. I have re

Ess. peppermint cently had an interesting case in my own

Tr. benzoin compound . oz. j

Honey family, my son, taken sick at Camp Haven,

oz. vj

Mix.a member of the First Connecticut Volun. teers. To-day, November 29, marks the

At the same time snuff well back into beginning of the eleventh week of the the nose, three or four times a day, the disease, tho I am happy to state that he is following powder : convalescing. I learned many things in R connection with the case, and among them

Thymol the following:

Sodium chlorid That I could not break the fever with Pulv. hydrastis

3 ij the dosimetric trinity, tho I tried hard for

Sodium borati a week, and pusht it until the digitalin Ammonii carb affected the heart. That the triad of sul- 01. gaultheria

gtt. vj focarbolates would render the bowels anti

This never fails if taken before the stage septic by giving 90 grains daily, but they of secretion. J. W. SANDERS, M. D. would not stay the fever. That guaiacol Dover. applied to the skin, in 20-drop doses, would drop the temperature from 104 3.5 Typhoid fever, Homeopathic Treatment.-A

Protest. to 99 in two hours, followed by a chill and collapse. That guaiacol carbonate, in 60- Editor MEDICAL WORLD : - From the grain doses daily,would surely destroy the number of "sure cures" given in the typhoid germ, whatever it may be, and scores of different treatments by so many that the fever surely disappeared under writers for THE WORLD within the last its administration. That milk could not year, one might be led to the conclusion be tolerated by the stomach, peptonized or that just any old thing would abort or not; brandy, ditto. That bovinine, in cure typhoid fever. The article teaspoonful- and-a-half doses every two which strikes me a knockout blow right hours for weeks, was very acceptable, the over the cardiac plexus, is one on page 480

[ocr errors]
[ocr errors]



gr. vj grs. XX

gr. xx


[ocr errors]
[ocr errors]

of the November WORLD, under the above supply are largely independent of one heading

another, each house on the farm and many Now, I do not object to "A. E. M." in the villages and small towns having its having his own peculiar treatment, for it own well, while rain water is often used. is about as rational as the hundred other The wind, I believe, has much to do “sure cures,” but I do object to his calling with this general distribution of the germs. it homeopathic. To prescribe homeopath- Bacteria cling to dust particles and may ically, is to give a single remedy, which, be carried by the wind to places where when given to a healthy person in poison- conditions favor development and multiplious doses, or when given in continuous cation. Residents on the prairie are quite small doses till morbid symptoms appear, familiar with the long distances to which will produce symptoms exactly similar to dust may be carried by the high winds, the totality of the symptoms presented by and the agriculturist recognizes this as one the patient for whom we wish to prescribe of the most active agents in distributing homeopathically. Nothing else is or can the seeds of noxious weeds. be a homeopathic prescription.

That this agency of wind is also at work If A. E. M. has for ten years found in mountainous regions, the following every case of typhoid fever presenting a incident will show. Early this year there totality of symptoms similar to those pro- was a fall of dirty, yellow-colored snow at duced by rhus tox, baptisia, muriatic acid, Engadi in Switzerland. When the snow nux vomica, bryonia, hydrastis, calomel, was boiled and allowed to settle, there bismuth subnitrate and podophyllum, then was a thick deposit of mud which was his treatment was homeopathic, otherwise found to contain iron in combination with his article presents homeopathy in a false other minerals-a particular combination light. It is just such practice as this in characteristic of certain iron ores in Hunthe name of homeopathy which brings our gary, hundreds of miles away. The dust school into disrepute.

had been swept up from the plains and W. E. ALUMBAUGH, M. D. carried in the higher currents of the Vacaville, Cal.

atmosphere till intercepted by the falling

What happened to the iron ore Wind as a Factor in Spreading Infection. might also happen to typhoid and other

Editor MEDICAL WORLD:-There in one germs, which retain their vitality for some point in regard to the spreading of disease time, even when subjected to drying. . to which attention may be called. In They could be carried along with the dust rural districts, especially in the prairie particles into open wells, into vessels consections of the country, the physician is taining water, milk, butter and so on; into often puzzled to account for the origin of stagnant sloughs, and be deposited on the many isolated cases of say typhoid fever roofs of houses, thence to be washed by occurring apparently without connection the next rainfall into the cisterns. In this with each other or with pre-existing cases. manner many epidemics and isolated cases Now that the bacterial nature of the may be accounted for. infection in typhoid has been satisfactorily There are two points of practical imporestablisht, we can no longer fall back on tance to be deduced from the above. The insanitary conditions as being the source first concerns the management of the of the outbreak of this disease. These individual case of typhoid. The physician can only be regarded as accessory and con- directs the attendant to disinfect excretatributory causes. The drinking water is, of feces, urine and sputa—but as the thoro course, the favorite, but by no means the disinfection of a typhoid stool is a matter only, medium of introduction into the requiring time and trouble and is very system ; milk, butter and other articles of disagreeable, it is safe to say that it is diet being also vehicles for the contagion. never completely done. Indeed there is

The real problem is how do the germs often great carelessness in the disposal of get into the food and water? The usual typhoid excreta, and sometimes they are explanation is that of soaking into the thrown out on the surface, whence they wells, but in many cases this explanation may be carried by water into the wells, does not apply. It explains the presence but more likely on the plains, after becomof the organic matter, but very seldom the ing partially dried, to be swept with the presence of the germs. Typhoid is as dust to neighboring farms. In rural disgenerally diffused in rural as in urban tricts all typhoid stools should be buried communities, and yet the sources of water in a hole, away from the water supply,



[ocr errors]


to : TEE MEDICAL WORLD. the bottom of the hole being first covered ganate, and degree of dilution, given per with a liberal quantity of lime or other rectum, resulting in recovery, and how disinfectant; or, they should be burned. long the doctor was obliged to apply

The second point concerns the public digital pressure over the anus; or, more health authorities, and has to do with the important, how soon were the beneficial water closets in use on the railway trains. effects noticed ? These are, for the most part, open chutes As a rule, we obtain more prompt and down which the excreta are projected to certain effects from drugs administered the railway track. Many people with hypodermically, but if Dr. Sanders' expeambulatory typhoid, and patients in vari- rience should prove to be correct, I would ous stages of the disease, en route to offer the following explanation: hospitals or home, use these closets, and (1) Opium, in its various forms, taken thus typhoid stools are spread along the per mouth or rectum, reaches the portal railway, ready for distribution by the circulation and thence the liver, from wind all over the neighboring country. which absorption gradually takes place. The same thing might happen were

If now we follow with potassium permancholera ever to obtain a footing on this ganate by the mouth or rectum, it will continent; but apart from the specific travel the same route and directly antag. danger in such cases, the method is un- onize the opium (changed into dioxymorhygienic and offensive. It should not be phin) either in the gastro-intestinal tract, difficult to attach a box below the chute portal circulation, or liver. If, on the and adopt some modification of the earth other hand, the potassium permanganate closet, the excreta being removed and is given hypodermically, it is improbable burned at divisional points along the line. that it will have any effect whatever on

R. S. THORNTON, M. B., C. M. the morphin still situated in the above Deloraine, Man., Canada.

named anatomic localities.

(2) Opium or morphin, after having Potassium Permanganate as an Antidote for

reacht the general circulation and the Opium-Typhoid fever,

tissues, either primarily, thru hypodermic Editor MEDICAL World :-I like The administration, or secondarily, thru the WORLD, and so will anybody who can mouth or rectum, is eliminated to a large bring his views above preconceived preju- extent (between 40 and 50 per cent.), as dices--your method of arrangement, taking has been shown by Fauber, thru the feces. up of different subjects according to their It is not only excreted by the intestinal " season,” many of the original commu- tract, but also to a considerable amount nications, the quiz department, formulas, by the stomach, as proven by Prof. Hitzig. and above all, your editorials and current Undoubtedly the kidneys also eliminate a medical thought departments.

large share of the drug, but the final esI think The World is, particularly for cape from the body, to my mind, occurs “ beginners”, one of our most valuable only after repeated reabsorption, and it is medical journals. I believe in keeping the this at least which we very likely can prepractical in view; but, while we are con- vent by repeated doses of potassium percise, we should not lose sight of, or omit manganate by mouth and rectum, thus important points, the omission of which reaching the gastro-intestinal tract, portal will leave an "unclearness” or doubt in the circulation, liver and even kidneys more mind of those unfamiliar with the idea or or less directly. Administered by these experience to be conveyed.

routes it will, in addition, after reaching For instance, on page 488, November the general circulation, have the same World, Dr. Sanders gives his experience effect as when given hypodermically-if with potassium permanganate in opium any effect it has at this stage. I hope to poisoning. There are two points which I arrive at some definite conclusion on some would liked to have seen brought out, and of the cases which will come under my upon which I wish Dr. Sanders would care during my senior medical service. In give us further information:

either case, the drug ought to be given in (1) As to the amount of potassium per- free doses, and to my mind, well diluted. manganate, and degree of dilution, given If I should employ it hypodermically I hypodermically in both cases - without would use one or two pints of normal salt effect-and the amount of morphin given solution as a vehicle and give it as an “into the child?

fusion." (2) The amount of potassium perman- It may, perhaps, interest some of THE

« ÎnapoiContinuați »