« ForrigeFortsett »
cious. Says he could breathe deeply, but cannot bear the pain ; besides, deep breathing excites cough. His pulse is strong, full, and bounding, 100 to 120 per minute. Now, doctors, what shall I call this case? I call it pneumonia.
At this stage of the game I am not afraid of morphin ; if there is nausea I give apomorphin; if not, I give morphin with atropin. If I give the apomorphin the stomach is empty in a few minutes. If pain or stitch in side continues, I give a hypodermic of sulf. morphin. This gives perfect ease with deep breathing. At this stage I am not afraid of acetanilid. I generally carry a preparation made as follows:
of ammonia, one or both. Even when so used, the effect of acetanilid should not be pusht to cyanosis. We trust that our good brother will take these remarks in the spirit in which they are offered. We wish, also, to suggest to him the desirability of keeping a record of all cases. It is only in this way that one can get the full benefit of his own experience; and without it he cannot give his experience to others.-ED.]
M.-Triturate thoroiu' si:::..äā Zss
Acetanilid .............. 33
Bromo seltzer, ...
Follow the hypodermic with a dose of the above mixture. In from 20 to 60 minutes the patient begins to complain, “Oh, I am so hot !” A few minutes later a colliquativ sweat seis in. Your patient is now comfortable. For an hour or two hours he may perspire so freely as to wet his clothing and sheets. When he ceases sweating I have his sheets and clothing changed. He may have a light chill in from two to four hours after the perspiration sets in ; but if he does not turn blue (cyanosis) followed by high temperature, your treatment is safe. He may have a slight rigor, a scarcely appreciable cyanosis and very little rise of fever; do not fear this. In four hours from first dose of mixture, give another small dose of same.
[We present the above portion of a long and frank article from an honest and respected Missouri brother in order to point out the danger of his practise. Perhaps he does not know that the activ ingredient of bromo-seltzer is acetanilid. When he knows this he will realize that his acetanilid mixture is too strong, particularly as it is without any tonic or stimulant of any kind-neither caffein nor ammonia, which are the drugs usually used to counteract the depressing effects of acetanilid. It is no wonder that his patients become cyanosed, and suffer from drenching sweats. Acetanilid should not be given to such a dangerous degree. It is thought by the most careful and conservativ practicians that such a dangerous depressant should not be used at all in any stage of pneumonia, even in the first stage in plethoric subjects. If it is used at all, it certainly should not be combined with a secret proprietary which is itself heavily charged with acetanilid. An acetanilid mixture should contain something to counteract the depression usually caused by the acetanilid, and the most popular drugs for this purpose are caffein and carbonate
Quinin Hydrochlorate Hypodermically in
Pneumonia. Editor MEDICAL WORLD :-After reading your editorial in November WORLD, page 440, Í at once purchased 30 grains of quinin hydrochlorate, and made a 2 oz. solution, enuf for four injections, and labeled it, with the idea that I would have it ready and would use it on the first case of pneumonia that I had. I did not have to wait long. A few mornings ago I was called to see a woman about 50 years of age, weight nearly 200 lbs. She had a chill at i a.m., had severe pain in her side, respirations were 36, coughing a good deal, and had a very anxious expression. I pronounced it pneumonia, and gave her one large dose of quinin, thinking to follow out Dr. Galbraith's treatment. This was 7.30 a.m. I called again at 5 p.m. and found her vomiting. She had not been able to keep the quinin down. Her fever was 10212°, pulse roo, the expectoration was markedly rusty, showing that my diagnosis was right. Her inability to keep the medicin down brought to mind the solution of quinin hydrochlorate which I had ready. I went home, got my solution and my antitoxin syringe, and injected a trifle more than a quarter-about 9 grains. Next morning her temperature was 9972°, pulse 94, expectoration still rusty ; 5 p.m., temperature 9972°, pulse 88. Next morning, temperature 996°, pulse 84; 5 p.m., temperature 997°, pulse 72, sputum clearing. The next morning, the third day of the disease, her temperature was normal, and pulse 72, and her sputum clear.
Now! Should I wait 8 or 10 years until I can report 50 to 200 cases ? I say, no. Let every one report to THE WORLD right away, and inside of a year we will have a treatment for pneumonia that will reduce the mortality. I would like to have other reports of the injection treatment.
Albany, N. Y. GEO. T. MOSTON, M.D.
Barium chlorid is of value in infectious diseases in which the circulation is weakened by central vasomotor paralysis, rather than by primary weakness of the heart. The drug acts chiefly by increasing the blood pressure thru the influence it exerts upon the vaso-motors. The results in pneumonia are particularly good. This is a drug which has been too greatly neglected in the search for more quickly acting preparations.
Treat Bill Perkins, Not Pneumonia. low tension; intermittent pulse with cyanosis ; Editor MEDICAL WORLD:-Rarely do two i. e., relaxation of the vessels—dilatation. physicians use the same therapeutic methods in Digitalis is a very slow acting remedy, and is the treatment of pneumonia. Dr. Bogart, therefore not a remedy to be depended on in page 484, and Dr. Kemper, page 485, Decem- an emergency, being absorbed slowly, and ber WORLD, treat pneumonia in about the same requiring from 12 or 14 to 36 hours in order way. This is the eclectic method of treating to get the characteristic effect of the drug. the disease.
Nitroglycerin is indicated by a high tension Dr. Whitman, page 483, treats his patients pulse; i. e., it relaxes the capillaries and in an entirely different manner. He uses arterioles. Its action is opposed to digitalis. homeopathic remedies in low dilution. Now, In pneumonia we have an obstruction in the the question arises in the mind of the layman, lungs, requiring the heart to perform an extra how can pneumonia be treated scientifically in amount of work, plus septicemia, from absorpsuch diverse ways? If Bill Perkins is sick, and tion of toxins. The nerve centers are prohis sickness is named pneumonia, shall we foundly deprest by the toxic poisoning. The treat pneumonia or Bill Perkins ? The scien- physiological heart remedy would be strychnin tific therapeutist will answer, treat the condi- or capsicum or both; and for the septic condition that you find, regardless of any arbitrary tion, an antiseptic which would be eliminated name which may be applied to it. Fit your largely by the lungs. Creasote carbonate is drugs as therapeutic measures to Bill Perkins one of the new remedies of this nature. The and his condition as you visit him from time older practicians used the iodids of potassium to time, and change your drugs or other treat- or ammonium. ment as Bill Perkins' condition changes. It The older physicians used the jacket poulgoes without saying, that the close observing tice. An old physician who had years of physician will see that the conditions of the experience told me that he had many times patient, Bill Perkins, require different treat witnest the beneficial effect of the jacket ment during the first, second, and third stages poultice, the solidified lung softening, and of pneumonia ; therefore, Bill Perkins must be resolution commencing in from 12 to 24 hours treated, and incidentally his pneumonia. after the application of the poultice. In my
Dr. Bogart gives a mixture of veratrum viride own case the hot poultice felt very grateful, gtt. V-x, bryonia gtt. viij-x, and asclepias tub. and relieved the pain and discomfort, yet I 3 ss-3j, in water Ziv. The specific medicins realize that the poultice would kill a patient of the above represent i grain of the crude with feeble circulation thru the lungs. drug to the minim. The specific indication for Dr. Reed uses hot water bottles around the veratrum v. is a full bounding pulse-i, e., body and ice over the lungs and head. This sthenic condition. Indication for bryonia: treatment might do in selected cases. I should pain or stitch in the side, worse on movement; select a patient whose power of reaction is that is, infiimmation of serous membranes. first class.
Dr. Kemper uses aconite instead of veratrum Then again, the treatment of a pneumonia v. This is the remedy for asthenic inflamma- patient in the high altitude of Colorado might tion, indicated by the frequent small pulse; differ from that of a patient in a low altitude, but it should be remembered that neither Brethren, “Let us have the conclusion of the veratrum nor aconite should be given when whole matter :” Study your patients, study your there is a weak pulse.
materia medica, and fit your treatment to the Dr. Whitman uses aconite in the first stage, individual patient. Bill Perkins may have followed by bryonia. In the second stage, pneumonia on Wednesday, and he may have phosforus.
pneumonia on the following Sunday, but his Phosforus is indicated by a sensation of weight condition may require diametrically opposit on the chest, frothy or blood streakt sputa. treatment; therefore, there is no treatment for
Sulfur is indicated in delayed resolution, or pneumonia. Bill Perkins must be treated. pus formation.
Ipswich, Mass. WM. H. RUSSELL, M.D. Dr. Whitman says: “Let the heart alone." This pre-supposes that the patient has been
Never attempt to reduce a Colles' fracture without under treatment from the beginning. If the administering an anesthetic. Nearly all cases of deheart is failing, and the physician not called
formity following such fractures are due to failure to
properly break up the impaction before attempting to until the lung is solidified, what heart remedies secure alignment and apposition of the fragments. should be given ? The modern text-book Short anesthesia gives ample time to do the adjusting mentions among the prominent remedies
thoroly and completely, and with all opportunity for
satisfying oneself as to the accuracy of his work. which influence the heart, digitalis and nitro Once a Colles' fracture is properly reduced, it is very glycerin.
easily retained in position, and any difficulty in retain
ing the apposition should at once arouse suspicion that The indications for digitalis are: a pulse of the fracture is not properly reduced.
Homeopathy and “Regular" Medicin Com- given without comment, to show the WORLD pared in the Treatment of Pneumonia.
family that there is a better way. THE WORLD:- In an editorial, page 433, Paris, Texas. G. F. THORNHILL, M.D. on Pneumonia, you say :
[Homeopaths treat the patient, and not the "Altho the disease has been known for so long, and
disease-- that is, they treat symptomatically. despite the familiarity of every physician with its When all doctors treat the patient ill with pneumanifestations, it has, as yet, defied the efforts of clinicians and bacteriologists. We are apparently
monia rather than pneumonia, the results will little nearer its mastery than we were decades ago, be better. -ED. and it is certain that our therapeutics, in this connection, must be conceded to be purely empirical, or at best only symptomatic. * *. Indeed, when
“ Brains " vs. “ Mud” in Chest Cases. knowledge of the profession is summed up, the result Editor MEDICAL WORLD:-I believe the use is very unsatisfactory. We have absolutely no drug or method in which we can place any reliance in its
of the glycerinized clay poultice by physicians power to influence favorably, either the septic condi is more from fashion or habit than from a fixt tion or the process in the lungs.”
belief in its therapeutic value. I have never The following is clipt from the Dallas (Texas) used it on my own person except as a dressing
for boils; the boils did not improve. The ap“Chicago, III., Jan. 28th. Drug treatment is useless plication was unsatisfactory, and a poultice of in cases of pneumonia. The medical profession, so far as medicins are concerned, can be of no assistance
linseed was substituted with markt benefit. I in the fight against this disease. The sooner the pro
have sometimes prescribed glycerinized clay fession will acknowledge this to the public, and set to for my patients, but have never been able to work to discover some specific to save pneumonia
satisfy myself that it was superior to any old patients, the better for all concerned. This startling statement by Dr. Arthur D. Regan, who stands high poultice of domestic manufacture. I should, in the profession, has stirred up the members of the
perhaps, make an exception that in inflamed Chicago Medical Society at their meeting. Several physicians sprang to their feet to protest against the
and tender joints an application of the glycerarraignment. All had to admit, however, that there is inized clay has given better results than any no definit remedy known, and they based their protests solely on the contention that they might influence
other external treatment. the patient favorably by easing him somewhat, and by
In colds, congestion of lungs, pneumonia, the moral effect of their presence.”
etc., an application of hot glycerin or camHere's what homeopathic authorities say. phorated oil to the chest and covered with a Fisher's Diseases of Children, page 663 : cotton jacket or pad of light material will gen
" If there be a disease in which the results of the erally prove useful, and may well be employed. homeopathic treatment as compared with the old
The strongest claims for lhe glycerinized clay school treatment are satisfactory, that disease is pneumonia. Osler is responsible for the statement that are that it depletes the tissues, is a protectiv, pneumonia is a sell-limited disease, and runs its and does not have to be renewed often. course, uninfluenced in any way by medicin. It can neither be aborted, nor cut short by any known means
I have never been able to satisfy myself to at our command. This statement is so exactly in what extent it depletes, if, indeed, it does so to variance with the testiniony of homeopathic physicians anvanpreciable extent It is evident that the whose word is considered equally as reliable with that of Osler, or any other old school authority, that we are
evaporation is greater than the extraction of justified in making the statement that homeopathy is moisture from the tissues, or the poultice far superior as a system of medicin, in this as in many
X would not dry at all. Some of its ,disadvan
would not dry at all. Some of its disadvan. other diseases in which the helplessness of the old school is freely acknowledged. For the clinical tages are that it is sticky, dirty, ard nasty, and course of pneumonia clearly shows that many, even is removed only with great difficulty before it severe cases, that seem to threaten disastrously, may terminate favorably, and it is a fact, that the ordinary
dries; ard when dry it crumbles ard gets scatcase of pneumonia can be modified and abbreviated in tered over the bed and floor. It is too comalmost every instance if proper medication be applied pact and too thoroly excludes the air from the early. Just why this disease should be abandoned to its unrestricted and natural course is not understood.”
skin. Its tendency is to sodden and debilitate Raue, Special Pathology, page 383, says:
rather than give the desired stimulation to the
tissues. “The mean or average time which it takes pneu
The poultice is too heavy. A case monia to run its course, if it is not interfered with by
seen recently will illustrate : A child aged 2 medicin, is as above stated, twenty.five days. But this years, ill with pneumonia, 52 respirations per average may, by judicious treatment, be considerably shortened, for pneumonia can be arrested in each of
minute, lying on its back, with a half pound of ils stages."
glycerinized clay spread over its chest ; poulJousset, Practise of Medicin, page 786 : tice to be renewed as soon as it would peel off. “ The various treatments disturb this natural course This was the fifth day of the disease, and the and increase or diminish the duration of the disease.” poultice had been on from the start. Now,
Arndt, Practise of Medicin, page 1007: suppose we do a litile figuring. The little “* * * the indicated remedy, selected upon home. baby's chest muscles were lifting 26 pounds of opathic principles, does, nevertheless, cut short, and
dead weight every minute ; 1,560 pounds per
dead weight every minute. Tebo pounds per modify the course of pneumonia, reduce the gravity of the complications, and materially lessen the death
hour, and 37,440 pounds per day-as much as
an able bodied man will move with a scoopThis comparison of ideas of both schools is shovel in a working day. Allowing the posi
tion and respiration to have been the same, dur- size and shape of the piece of metal ; it was ing the five days of its sickness the chest muscles 178 in. long, 5/8 in. wide, and it in. thick, of the sick baby had lifted 187,200 pounds of and nearly regular in shape. -Ed.] poultice. The attending physician now askt for counsel, for, as he expresst it, he “feared the child would not have strength enuf to pull
Carbolic Acid and Salt. thru."
Editor MEDICAL WORLD :-In regard to the It looks sometimes, as, if doctors would use report of Dr. Wilson, in October WORLD, on more “braips" and less “ mud” in the treat the administration of salt as an antidote in ment of chest cases, it would be vastly to the carbolic acid poisoning: Shoemaker quotes in advantage of everybody interested.
his materia medica, Sheurlen and Bechmen, Scio, Ohio. E. E. TOPE, M.D. who publisht a few years ago the results of
their experiments, proving that the germicidal The Swallowing of Foreign Bodies. action of carbolic acid is decidedly increast Editor MEDICAL WORLD:-A couple of by the addition of sodium chlorid. A soluweeks ago I was hastily called to see a little tion of 1 percent of carbolic acid in 24 percent boy not quite three years old because he had of common salt gives better results than 6 perswallowed a piece of lead. His grandmother cent carbolic acid in water; so it appears that is raising the little fellow, as his mother died the doctor was doing just what he ought not to two years ago. She is a very sensible lady, have done. Sulfate of soda or magnesia is a and has followed nursing a great deal, and so safe and prompt remedy; also vinegar. her statements can positivly be relied upon. Is the doctor certain that his patient As has always been my custom in such cases, swallowed an ounce of pure acid ? for such an I advised a let alone policy. I believe that amount would be immediately fatal in 95 peremetics or purgativs are a positiv harm in such cent of cases. Let us all be careful in our cases. When the object swallowed is sharp, a reports of cases, adding to the honor of the diet of potatoes and slippery elm will at least profession and The MEDICAL WORLD. do no harm. I advised her to watch the stools Brooklyn, N. Y.
J. H. TRENT. carefully, and to report at once any acute abdominal pains. In just two weeks to a day the little fellow
Care of Hypodermic Needles. passed the lead, or soldering metal, which it THE MEDICAL WORLD:-Speaking of the really is. Its weight is two ounces.
sterilization of hypodermatic needles, Dr. My view as to its long journey is that the Alexander gives us some good hints; but let weight had the effect of drawing the bowels me tell you how I do it. I could never see down, and thus it had to virtually travel up the use of the short attempt to cleanse the hill most of the time. It don't seem possible part for injection, as we know that it takes a that so small a child could pass such a large thoro washing in order to make the place steril, object into the stomach, but the weight must and who has the time to prepare the part when have been an activ factor; then it had to pass the every second counts against the patient; and pylorus; this is not very large, particularly in time is usually one of the things that we are a child ; then came the ileo.cecal valve. The trying to save when we give a hypodermatic wonder is that it did not fall into the cecum injection. I always have that old stand-by, and give rise to operativ symptoms.
carbolic acid, at hand, and I simply dip the When an open safety pin will safely pass needle into it (95 percent), and inject into the thru a child, most anything else can do so if arm or wherever it happens that I want it. let alone and Nature given a fair chance. The Afterwards I simply dip it in the acid again, little fellow suffered very little indeed. About and I am ready the next time, even tho I am twenty years ago I reported to THE WORLD caught with no other antiseptics, as we all are the case of a child swallowing a lot of small at times. Even tho a minute globule of the glass tubing, such as was used those days in acid remains on the needle at the time of inthe nursing bottles. I had only been in prac. jection, it does no harm. I use the P. D. tise a couple of years and was at a loss what needle, and with twelve hundred and fifty best to do; but I recalled what one of the (1250) injections I have never had an abscess; professors often would tell the boys : “when in and the patients do not complain of it hurting doubt, do nothing that can possibly do any as much. As to the care of the needle, suffice harm." I therefore did not prescribe a thing, it to say that one lasts me from 400 to 500 and in due course of time the child safely times, and that regardless as to the period of passed seventy-four sharp pieces of glass. time that it takes to amount to that many.
Bellingham, Wash. L. R. MARKLEY, M.D. That is long enuf for any needle to last any [The doctor inclosed a drawing showing the way, so why all that idle washing that cannot
be other than incomplete? Maybe this is not
Treatment for Epilepsy. new to the family; if not, throw it aside. Editor MEDICAL WORLD :-Doctor Noxon
Bayard, Fla. Geo. D. KENNEDY, M.D. asks for treatment for epilepsy. The best An Enterprising Osteopath.-Question of
treatment I ever used was a teaspoonful of Consultation.
fluid extract of passion flower and a teaspoonEditor MEDICAL WORLD:-We have in our
ful of fluid extract of black cohosh, every three town a man who is a gentleman, straightforward
hours, together with some good cathartic. and honorable in every respect, and a man of
Search for the cause while giving the above good intellect. He has practised osteopathy
treatment, and remove by surgery if necessary. here several years, and since locating here has
No drug habit is formed by the use of above studied medicin, taking his required number of
remedies. Miss M-, age 33 years, had suf
fered since 6 years old-frequently 15 to 20 terms and graduating in a medical college of good standing, stood the State Board examina
seizures in 24 hours. After five weeks of tion and received his state certificate and
above treatment, a decided improvement. registered same.
Treatment continued, and after two months Now he announces to the medical profession
she would sometimes be free from attack as and to the public that he is practising medicin
much as three weeks. and using osteopathy as an adjunct only, the
Dallas, Texas. S. D. BULLINGTON, M.D.; same as we would use electricity, hot air, etc.,
Lost Manhood. as adjuncts. Now, the question we wish your opinion
Dear DOCTOR TAYLOR:—The young man and the opinion of the readers of THE WORLD
sat by the window. Who shall say why? He on is this : Are we, as physicians, keeping
was a very young man. The fuzless innocence within the bounds of medical ethics when we
of his superior labium was a sleepless incubus consult with this man? Is it our duty to con
to him. This is not exceptional. He did not sult with him ? Of course, consultations to be
lack in nativ aplombness, and he was prostrictly on a medical basis, and nothing what
nouncedly chic. Still he was of a good famever in the osteopathic line.
ily and had a golf record. In an idle moment We inclose his announcement and card,
he pickt up a newspaper-a religious hebdomclipt from one of our papers, that you may
adal. Without any particular reason, his eyes see it.
fell upon the picture of a very sincere and Would like to hear from the Editor and
plausible looking gentleman. Connected with readers of The WORLD on this question.
the picture was printed matter. This printed W. P. WATSON, M.D.,
matter held a revelation for the young man. J. A. FERGUSON, M.D.
It was all about lost manhood, and it was the Dyersburg, Tenn.“
most frightfully convincing stuff he had ever [We congratulate the osteopath on his enter
read. After reading, and re-reading it, and prise. We would like to see physicians be
nervously studying it, he became convinced come as enterprising in regard to osteopathy
that he was a total wreck; or at least that he that is, take it up as a study as this osteopath
soon would be, unless he put himself under the took up medicin, and master it. We see no
care of this eminent physician. The physician reason why you should not consult with this
was eminent, for, with halting diffidence, he
had admitted it in his ad. But the young gentleman. You would consult with any other na man or woman who has attended medical col
man shrank from making a confession to the lege in the regular way, and passed the State
governor" (his father), and therefore where Board examination. Then why not consult
would the money come from wherewith to rewith this man ? His card in the paper is
munerate this medical philanthropist? He modest-as much so as any card could be. I
was full of red blood, micturin, concupiscence, am surprised that he does not mention osteop
etc. His virilic safety valve had been in athy in his card ; but he doesn't.-Ed.]
proper physiological evidence for some time.
Under the lurid glare of this learned doctor's Dr. J. M. Luttrell, of Mineral Wells, Tex., flaming periods, nature's innocent assertivness gives tr. iodin comp., 5 drops in plenty of was metamorphosed into the prodromata of water, every three hours, as his chief treatment knock-kneed imbecility or screeching insanity. in typhoid fever. It acts as an intestinal anti- The young man was scared gray, almost. septic.
To intensify his anguish, the charmed vision He wants to know what has been the exper- of Etta, his sweetheart, floated into his mindience of readers of the "regular" school with Etta whose melific towardness had saturated Lloyd's specific tinctures. He also wants to his soul with saccharin dreamery. What would know the best motor-bicycle for durability and she do if she knew he was on the verge of imlow cost of running.
potency, which would be quickly followed by