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ORIGINAL COMMUNICATIONS members of the chemical section of the
American Association for the Advancement Short stories on the treatment of diseases and experience with of Science that they adopted a reform in
new remedies are solicited from the profession for this department; also difficult cases for diagnosis and treat- spelling, which has brought many common
terms out of the limbo of confusion. This Articles accepted must be contributed to this journal only.
The editors are not responsible for views expressed by was by the simple expedient of dropping contributors.
the final "e" wherever phonetically useCopy must be received on or before the twelfth of the month
for publication in the next month. Unused manuscript less ; that is, when it does not render the
cannot be returned. Certainly it is excellent discipline for an author to feel that he must
preceding vowel long. This brings the say all he has to say in the fewest possible words, or his reader pronunciation of chlorin,” “iodin," is sure to skip them; and in the plainest possible words, or his
“chlorid ” and “bromid ” in accord with reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want
the spelling. It has been said by some downright facts at present more than anything else.-RUSKIN.
that the omission of the final "e" is indeRECORD,
pendent of the effect on the pronunciation,
and that iodin would be so-spelled even if Spelling Reform in Chemistry.
pronounced so as to rhyme with " confine."
regard this as a most objectionable view. BY HENRY LEFFMANN, M. D., PHILADELPHIA.
Spelling.reform should be true reform; if it Editor MEDICAL WORLD:-Our British is merely a change from one bad system to ancestors wrote “tung,” and it was not another, it has no basis. The American until the Norman clerks, who came over and British Philologic Societies, which with the Conqueror, had bewitcht the initiated these reforms, were actuated by language, that "tongue became the a desire to reform the incongruities of approved spelling. English has never English spelling and not simply to shorten recovered from the mixing of languages, words. and to-day it stands as an object of deris- One of the fiercest contentions in regard to ion among civilized nations for the eccen- the reform in the spelling of chemic terms tricities of spelling and pronunciation has been concerning the dropping of the With that bumptiousness that is apt to be final “e” in such names as “quinin” and born of success, many intelligent persons strychnin.” Some English chemists have in the English-speaking countries glory in almost shed tears over this change. It these peculiarities, and oppose or even
has been said that the final "e" is needed abuse those who would simplify the system. to show “basic" quality. There are sev. It is true that the discordance between eral objections to this argument. In the spelling and pronunciation is due in part first place,“ basic" is a term no longer to changes in the latter. Shakespearean
Shakespearean exact. It may serve as a mere adjective, scholars tell us that the first Hamlet but it cannot be defined with precision. pronounced the “1” in “would” and Secondly, the so-called basic bodies show "could.” The final "e," now generally different degrees of activity, and it is diffisilent, was once in full use.
cult to say when the silent letter should be It is not, however, spelling in general, retained and when dropt. The most seribut certain changes in the spelling of ous objection to the argument is, that the scientific terms that I wish to discuss. nomenclature in chemistry is not intended Chemistry is a science requiring a large to show properties or qualities, but structure. number of special terms, and in the last In organic chemistry, the whole effort at quarter-century the demand has practically present is to secure a nomenclature which exceeded the supply. Moreover, the shall indicate the structural relations of nomenclature dates from a very early the bodies. In only one series is an experiod, when the prevailing theories were ception made to this rule. The enzyms or highly erroneous; in fact, from about a non-organized ferments end in "ase." century ago, when the vast advances in These bodies are, however, quite peculiar the science were not foreseen. During the in their nature, and their structural relapast twenty-five years, chernists have been tions are wholly unknown. It is permistrying, without success, to define with sible, therefore, to distinguish them by a exactness such inherited terms as
termination indicating a special property. "base "and "metal," and to find system- The importance of the dependence of proatic names for the legion of organic deriv- nunciation on spelling is shown by the fact atives.
that the final "e" is retained in one series I deem it a fortunate circumstance that of compounds, the hydrocarbons homothe spirit of reform stirred so deeply the logous with C,Hz. The body commonly of age.
called acetylene is systematically termed water, contaminated by sewage, or air ethine, and the last syllable rhymes with reeking with the emanations from filth in "vine.'' This method of spelling and the cellar, alleys, back-yard, gutter or pronunciation is part of a system which cesspool. If these sources of malignancy includes ethane and ethene, the change in are removed, the remedies ordinarily efthe long vowel of the last syllable indicat- fective will prove so again. And of these, ing a change in the amount of hydrogen none is so efficient as calcium sulfid. by two atoms, ethane, C,H,; ethene, C,H, ; I have given it to adults in doses of one ethine, C.H. Unless we preserve the long grain seven times a day, with no bad efvowel sound in each of these cases, the fect. Others have given this quantity and final "e" is phonetically useless and more to children two years of age, and should be dropt. In the reformed system,
In the reformed system, pronounce it practically harmless in any the syllable "ine" will indicate a hydro- doses. I would urge its use in the dose of carbon of the ethine series, and it is just half to one grain every hour, to children such exactness and suggestiveness of two years old, in diphtheria, continued nomenclature that chemists are seeking. until the danger is evidently past.
In regard to the substitution of “f” for Besides this, the sequels of diphtheria, “ph," in sulfur, it may be said that those such as heart failure, other forms of parwho think that etymology justifies the older alysis, etc., would be much less frequent spelling, are wrong. Our true “ph” comes if strychnin were given thruout the attack from the Greek, but sulphur is not a Greek as a preventive. I prefer the arseniate, in word. Neither it nor phantom deserves doses of half a milligram every one to the “ph,” but should etymologically have three hours, to a child two to four years the letter f."
I have so frequently urged the impor
tance of thoro local treatment, frequently Calcium Sulfid and lodid-Phthisis-Morphin
and efficiently applied, that I shall assume Habit.
that every reader of The World knows Editor MEDICAL WORLD :-During the my views on this subject, and thus I will last year my attention has been attracted not repeat them. to the use of two comparatively new rem- Is membranous croup the same thing as edies — calcium sulfid and iodid. The laryngeal diphtheria ? The trend of opinformer has been before the profession for a ion has been in that direction for some long time, but only recently have its re- years, since the strong presentation of the markable properties begun to be appreci- case by Morell Mackenzie. Very wisely, ated. Ringer recommended it in doses of the health authorities of most cities direct one-tenth grain. Brunton described it as that all cases of both shall be reported as a dangerous drug, sulfudric acid reducing diphtheria, to be on the safe side. hemoglobin and being with difficulty re- clincical study and bacteriologic investiga. placed by oxygen. Dyspnea is the evi- tion alike point to the probability that dence of its full or rather toxic action, some cases of croup are not diphtheritic. and it causes death by asphyxia. How And in some of these typical croup cases, much would be required to produce this calcium sulfid has failed completely. Howeffect I do not know, but much larger ever, it is in just these that the iodized doses than those mentioned may be given calcium has succeeded best. This subwith impunity. It comes very near being stance is not the chemical known as cala specific for gonorrhea, especially in such cium iodid, but a product known commerconstitutional infections as gonorrheal cially as brown iodid of lime. Given in rheumatism.
doses of gr. } every five minutes, it reIt won a reputation in diphtheria, even lieves the symptoms of croup and induces in the inefficient doses, but failed in ma- resolution in a way that seems little short lignant epidemics. Since these are invari- of marvelous. But in : e diphtheria, it ably dependent upon gross defects in the has no perceptible effect whatever. hygienic conditions of the affected locality, It has been a year since I described in it scarcely seems to be our duty to look for this journal a treatment of pulmonary cona remedy for a condition so easily obviated sumption, from which I was obtaining by well-known and accessible means. It such effects as warranted me in recomdoes not seem the part of common sense mending it to my brethren. In brief, it to hunt for specifics for such a condition, consisted in the use of calcium sulfocarboand let the poisoning go on by impure late as an intestinal antiseptic, iodoform to relieve cough and keep the lymphatic the month. The remedy was well borno circulation clear, possibly affecting the by the stomach.
by the stomach. In doses of 60 grains a diseased lung-tissues favorably at the same day the urine blackened, and it was found time, and nuclêin to create an artificial expedient to drop the drug for a few days leukocytosis. I have employed this sys- and then resume in doses of 30 grains tem now for another year, and have that daily. That patient is now taking creomuch more reason to trust it. No tuber. gote carbonate for a month, for comparison. culous patient has died. Some have gained It has been a long time since I wrote in steadily, others have apparently recovered, my WORLD articles anything about the the bacilli having disappeared from their morphin habit, but I still receive letters sputa and the physical signs indicating referring to those I wrote a year or more cicatrization.
ago. Experience brings a certain improveThe only alteration the year has seen in ment in methods, or in the application of my plan is that I have used the nuclein in them, and this is seen in the lessening of much larger doses, giving ten minims once the patient's suffering. In a case just disto three times daily. The reason for using charged, the patient ceased to take morphin nuclein constitutes one of the most inter- in less than a week, took no other narcotic esting chapters of modern physiologic re- as a substitute, never missed a meal, slept search. The white blood cell was an ele- at least four hours every night, and did ment of unknown importance, until not suffer a particle of pain, aching, burnMetschnikoft's celebrated observations ing or other distress. It was a youth who were made public. Previous to this, our evidently had been persuaded by his physiologies talked of the white cells friends to undertake the treatment, and changing into red cells, or vice versa. Fol- he had very little if any real desire to quit lowing Metschnikoft's investigations came the use of the drug. Those who have the study of leukocytosis, which was found treated these cases know how difficult to be present in nearly every disease of in- they are. He had no need for the drug, fectious nature, the most notable exception but yet he wanted it, not to relieve sufferbeing tuberculosis. But tuberculosis is a ing, but to make him feel good. Nevernotable exception, in that it alone of the theless, in ten days he was so well over it infectious diseases is non-protective and that he was allowed to go out alone, and not self-limited. Is the leukocytosis the did not abuse his liberty. cause of the self-limitation ?
If so, may
Will the cure be permanent? It will we not utilize Vaughan and Aulde's no depend on the happenings of the next six less remarkable discovery, that the admin- months. If his neuralgia returns, and the istration of nucleinic acid increases the doctor into whose hands he falls uses mornumber and activity of the leukocytes ? phin to relieve it, he will probably relapse,
This is the problem we are trying to as he has no idea of suffering pain. But work out. And as my contribution to it he goes for six months' rest to Colorado, I have to say that the administration of where the climate will restore his red blood nuclein in tuberculosis is followed by a cells and the hygienic conditions will be surprising improvement, enough to explain nearly ideal. the enthusiastic claim of a colleag, that Dr. L. S. Cooms, on page 77, asks some nuclein is "the active principle of life." rather singular questions. No, it is not a
Now this is all new, too new for any mixture of anything but simply the result detailed statements as to results. I am of experience. Some cases of morning giving you a glimpse into the laboratory, diarrhea are benefited by these minute of a process not yet fully elaborated, but doses; others are not. Metrorrhagia is still inchoate. Try the idea if you will, also benefited by the alkaloid hydrastin, but do not hold me too strictly to account (not the resin), in small doses, and it is if the completion of these studies leads us good practice to give just enough to accomto widely different conclusions. If you plish your object, and stop at that. succeed, you will have the satisfaction to Otherwise you miss your object by your be among the first to enter the field ; if clumsiness in handling your weapons. you fail, your consumptives will be no Take pilocarpin in the treatment of the worse off, to say the least.
night-sweats of phthisis, for instance. If Guaiamar is one of the newest creasote you give just enough to restore the normal derivatives. I have given it to one tuber- tenacity of the skin, the leakage, which is culous girl for one month. The bacilli were passive, will be checkt. If you give an notably decreast in number at the end of overdose you will cause a warm,
perspiration. Five grains of zinc sulfo- does not contain the germ; others assert carbolate is a very moderate dose, if the that it does. Some claim that the disease salt is pure.
If it disagrees with a few is directly transmissible to healthy perpersons they have abnormally sensitive sons by contact; others assert that certain stomachs. If it disagrees with everyone preparatory conditions are essential. It you have a poor specimen of the drug, cannot, therefore, be out of place for possibly with some free carbolic acid in it. another to enter testimony derived thru I have often given ten and sometimes the legitimate channels of observation and twenty-grain doses with impunity, and so experiment. Assuming the right and have many others. It is sometimes worth privilege to be heard, I shall proceed as while to try a new idea before concluding briefly as possible to put down the concluthat because it has not occurred in one's sions formed from personal observation own experience it must be a mistake. and experiment and designate wbatever is
But these questions are after all unim- quoted from others. portant. I offer a solution of Dr. Richards' In the first place let me ask: Can we problem : Why do dogs howl? I would recognize a tuberculosis without the “basuggest that it is because they have not cillus tuberculosus” of Koch? There enough fleas to keep them properly em- certainly are cases of phthisis in which the ployed. WILLIAM F. Waugh, M. D. bacilli are entirely wanting. They cannot Ravenswood, Chicago.
be distinguisht from cases of the true
tuberculous type, except that they are Tuberculosis.
usually attended by more intense symp. Editor MEDICAL WORLD : Altho for toms and run a rapid course to a fatal years a reader of THE WORLD, I have not end. I have met with a goodly number until now sought access to its columns. of cases in which no bacilli could be found And now I ask for space to put before the in any excreta from the body, from the reader, whoever he may be, a few thoughts very beginning of the disease to its fatal upon that thread bare subject :-Pulmonary end. Every possible method to find them Tuberculosis. The views herein expresst failed. Therefore I must record myself as are the ultimate product of years of close a believer in the existence of a non-tuber. study, observation and experiment. culous phthisis.
The greatest minds do not always enun- The fact that such cases are not at all ciate the greatest truths; for some impor- uncommon, necessitates the adoption of tant things are withheld sometimes from one of two opinions: We must either the great and wise, and given to those recognize a non-tuberculous phthisis, or who occupy a more modest position. As we must cease to recognize the bacillus of conclusions arrived at depend somewhat Koch as a pathogenic organism. The forupon the nature of experiments made, the mer proposition will promptly appeal to place and surroundings, as well as the any close observer. mental peculiarities of the experimenter, But in the present light the bacillus it is well not to accept too readily the cannot fail to hold its etiologic place. dogma of one or two, while the accumula- The relation of the bacillus to tuberculous ted testimony of the rank and file has not disease is unquestionable, and if evidence yet been given. We should be receptive were necessary, the one fact that the toward the truth; but he who would gradual destruction of the bacillus is inknow the truth must find it for himself. variably attended by a gradual return of For to receive and adopt that which is health would be sufficient. given out by another is not receiving The bacillus tuberculosis, like anything truth until it has been tested and proven and everything else in Nature, possesses by the recipient himself. So long as wide an individuality which renders it a separdifferences of opinion exist between au- ate and distinct entity. It is a true thorities of equal eminence touching any parasite, therefore its home is within a one thing the essential truth is not estab- living organism. When expelled from its lisht. And the field is still open for selective abode its life is very brief, unless even far lesser lights to put in a word. it is quickly provided with an artificial
In regard to tuberculosis there seems to medium which will furnish the conditions be a wide divergence of opinion upon some necessary to its existence-warmth, moistimportant points. Some regard all cases ure and protection from light. Its disof phthisis as tuberculous; some do not. tribution embraces the human race and Some declare that the breath of the patient certain species of lower animals. In its
selective abode it manifests remarkable doubtful. Possibly it may occur under vitality. Taken into the systems of exceptionally favorable conditions, but in healthy persons with food, the bacilli may all of my observations there has not been pass thru the alimentary canal and out of a case that could be so regarded. Recent the body with the excreta without produc- writers express opposing of views on this ing any lesion whatever.
point. Some, while supporting the inhalaSome able authorities deny the possibil- tion theory, state clearly that the bacillus ity of the germ passing thru the stomach is rapidly destroyed by exposure to dayowing to the hydrochloric acid of the gas- light. tric juice. It is doubtful if the acid in the Sternberg, quoting the words of Koch, stomach is in sufficient strength to have at Berlin, in 1892, said that the sputum of any effect upon a germ of such great vital- a consumptive expectorated upon the ity. Furthermore the transit might be ground or sidewalk, and exposed to direct made at a time when the gastric fluids sunlight, is disinfected in from a few minwere temporarily deficient in acid.
utes to several hours, according to the However they get there, they linger in thickness of the layer; that diffuse daythe colon. I have found them in the con- light destroys the bacillus in seven hours; tents of the colons of several robust, healthy that sputa exposed to daylight is disinmen. This shows that we take them in fected long before it is dry enuf to be with food. It is not probable that any pickt up by the wind as dust. person is at all times free from them. This statement has not been disproven, But altho commonly present in the diges- and if it be true, the expectorations of a tive tract, they are perfectly innocuous consumptive when out of doors are en. except under conditions to be mentioned tirely harmless. later.
Experiments made to determine the When favorable conditions arise, the presence of bacilli in the air have not system is invaded by way of the digest- been successful ; only a very few were ive tract, in a very large majority of cases. found in the air of a consumptive ward of The mesenteric glands and the liver are a hospital. Sweeping down the walls of a the seat of the primary lesion. Recent consumptive ward is charged with giving writers state that “tuberculosis of the the disease to one of the workers; but liver is always secondary to tuberculosis in this cannot be verified. One experimenter other organs.
In this I do not concur. sprays pure culture into a cage of dogs, The intractable gastric catarrh, which so and one of the men engaged at the work commonly precedes the pulmonary symp. afterward developt the disease. These toms, is very probably due to the invasion
cases are put down as inhalation infection. of abdominal organs. Postmortem ap- There is not a particle of evidence that pearances may not indicate an early in- either of these cases were infected at that vasion of the liver; yet we should remem- time and place. ber the migratory character of the para- Some cases are recorded as transmitted site, and also the fact that disease in one from husband to wife, or wife to husband, organ may become stationary when a more but there is nothing to support the statevital one has become involved.
ment. If these were a transmission of the Therefore, when the patient dies of pul. disease of a direct nature, what are we to monary disease, one, two, or perhaps five say of the thousands of cases in which one years from the inception, the fact that the partner dies of the disease and the rerecent lesions obscure the early ones, gives maining one never contracts it? What of the impression that the disease had but the fond mother, who hovers lovingly over recently invaded that organ, while, in re- a son or daughter dying of consumption, ality, it was first invaded, becoming latent ministers to every want, denying herself as the lung disease advanced, and proba- the much-needed rest, staying with the bly aroused again late in the disease when sick night and day, often, in the fervency the entire glandular system was becom- of affection, pressing a warm kiss to the ing rapidly involved.
lips of the loved one, often after death? If we consider the high percentage of And did that mother contract the disease? deaths from tuberculous diseases among No! Do you say such cases are rare? I artificially-fed infants, we will recognize answer, "No! They are as common as the food as the medium, and the digestive day." tract as the channel of invasion.
The theory of tuberculous infection, Invasion by inhalation is extremely after exhausting the consecutive skill and