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JANUARY, 1906)

Our Monthly Talk

39

OUR MONTHLY TALK.

Thus" Talk" without the medical part may be passed among lay friends, or given to the editor of the local paper to copy from.

I suppose I am expected to continue these “Talks ;' but, really, there isn't the occasion for them that there used to be; so whenever you get tired of them, say so, and I will quit. When I began these talks, over ten years ago, we had hard times all over the country. I claimed that something must be wrong when hard times exist in a country so productiv as ours, a country with such boundless re

such boundless resources, and peopled with the most energetic, industrious and ingenious people in the world. I urged that doctors should take a special interest in the prosperity of the masses of the people, for their work is with all classes, and their living must always come from the masses of the people. I urged that it was highly proper and very important that doctors should take an interest in economic, sociologic and political subjects, and that a medical magazine was a highly proper medium thru which the medical profession should be reacht upon such subjects. This idea was then an innovation, and many subscribers "kickt." I knew I was right-I knew that a doctor should be a complete man, and that something more than his scientific interests should be represented in his professional literature; so I kept on, tho many subscriptions were stopt, and many a "sassy” letter was received. I patiently took up each such letter, and returned argument and good feeling for the “sass," and reason won in most cases. After several years the tide began to turn, and we won more new readers than we lost because of the “Talks"; and now our subscription list is many fold what it was before these “ Talks" were begun. In the meantime, other medical magazines have burst the old traditional bounds, and it is now no curiosity to see articles in other medical magazines dealing with matters of great interest to physicians, but not medical nor scientific

Much that I said in these “ Talks" ten years ago was considered radical ; now a much greater radicalism pervades the whole country. In fact, some classed me then as among the “dangerous classes": but now, while I have not changed, I find myself very conservativ. If I had said, ten years ago, that the great insurance companies, which were then prating very loudly about honest money," “ national honor,'' etc., were themselves honeycombed with graft and fraud, I would have been considered crazy. The idea that the guardians of the widow's and orphan's dependence were anything but the soul of honor and integrity would have seemed absurd. Yet we all know the revelations that have been made recently. Start. ling? Yes; so much so that nothing, hardly, would startle us now. After those who have been intrusted with the most sacred trusts have been found guilty of grafting-not satisfied with immense salaries, many of them double and more than double the salary of the President of the Republic-we may expect almost any. thing.

I was the first journalist to boldly throw the light into dark places and show up things as they are; not only in these “Talks,” but in other departments of The World I have thrown the light upon fraud and chicanery in various forms until it has faded away like the poisonous mists before the rising sun. Now, literature of all kinds: books, magazines and newspapers have caught the spirit, and what a showing up there has been ! Neither thief nor fraudulent pretender is now safe-but honest people are safer. Men of great wealth used to address colleges, Y. M. C. A's, etc., and advise tireless industry, getting up earl the morning, etc., to the young men, as tho that was the way they made their great wealth. They don't make such speeches any more. The halo surrounding men of great wealth is being pierced; and what do we find? Verily, we find that our gods have feet of clay! We find that other people made the wealth, and that the magnate just pulled it in, by means of some unfair, usually dishonest, and frequently illegal, advantage which he managed to get. With these things known, as they are getting to be known, it is with ill grace that these men can address Sunday-schools. As revelations unfold from day to day, it is becoming difficult

to reconcile great wealth with respectability. This thing of being apparently a Christian and a gentleman on Sunday and a pirate the rest of the week will not always be tolerated. Those who have read Lawson's frenzied finance" articles in Everybody's Magazine during the past year and more will understand what I mean Also those who have read the Standard Oil and Rockefeller articles in McClure's Magazine will understand what I mean. And those who have been reading anything at all cannot have escaped the marvelous revelations that have been going on.

Literature, particularly magazine literature, is doing more now to serve the public good than ever before. We used to think that those who were rich were correspondingly powerful, and we were afraid to utter a word of criticism. But when we journalists realized that all wealth comes from the people, and we reach the people, we realized that we were reaching the source of all great fortunes. To make it specific in one instance in my own case, when I realized that the source of Dr. Lawrence's great wealth was the profession, I knew that I could safely show physicians how Dr. Lawrence had been “faking” the profession thru the Medical Brief all these years; and it caused a reform of Dr. Lawrence's management of the Brief. “Old Doc," with his boosting of Dr. Lawrence's proprietaries, subsided; and other objectionable features of the Brief were removed. The profession's eyes have been opened. I haven't access to the general public, but the medical profession is a large public, and it is ani important part of the general public. As further examples of periodic literature serving the interests of the public, witness the exposures of the proprietary nostrum business by the Ladies' Home Journal and Collier's Weekly. Preachers and W. C. T. U. women can no longer innocently get on peruna drunks. The article in Collier's for Dec. 2, entitled “The Subtil Poisons" is a notable piece of literature. Acetanilid mixtures head the list of these poisons, the leading ones being "orangeine," antikamina and Bromo-Selt2 âÒ►ņģēņēmētiņ2 /2/§Â2Ò2ÂòÂ?2 2/2/2/2/2/2 ÒâÒâ§âÒâēò►Ż2 222ūtiņ2–2 the secrets-are being found out and being given boldly to the public.

In politics the old conservatism is giving way to what, ten years ago, would have been considered the rankest radicalism. Imagin how the proposition to give the railroad rate-making power to the Interstate Commerce Commission would have imprest the conservativ elements ten years ago, I mean the corporation magnates, presidents of insurance companies, bankers, etc. Just a few weeks ago, as I was leaving the private office of a prominent banker, a distinguisht looking gentleman came in and I couldn't help hearing the first few words of the interview. They were these: “Roosevelt's idea of taking the rate-making power from the railroads won't do." But now the railroad interests have given up in advance, and rate legislation to suit the President is a foregone conclusion. The people are beginning to demand their own; and with a champion like President Roosevelt to press the people's claims, they are likely to get niore of “their own" than they ever got before.

To revert again to the magazines: They are voicing the thoughts and feelings of the people more than ever before in the history of literature; they are divining the needs and wishes of the people better than they ever did. In war times they and the newspapers have always fanned the flame of patriotism ; but in times of peace the people have seldom had a champion till now. “Napoleons of finance" and “captains of industry” have heretofore received adulations unstinted, and have been given all the credit of advancing civilization, and nearly all the profits; but now the people are beginning to "sit up and take notice"; and when they do that, you can be sure that “something will be doing." before very long. For example, something was “ doing” in the last election, Perhaps the most notable single thing was the election of Jerome as prosecuting attorney for the City of New York, with all the parties against him. This was distinctly a people's victory. But to revert to the magazines: Everybody's for January came to-day, and I notice a scroll on the outside cover bearing three paragraphs, each beginning with “Resolved.” I notice indication of the driver. Look at the picture of Russia and Norway: Russia burning and bleeding ; Norway peaceful, prosperous and happy. Russia in the throes of a bloody revolution, which will continue nobody knows how long, and nobody knows what the result will be ; Norway got thru with her revolution in a few months, peacefully and intelligently, and now the new regime is going along smoothly and satisfactorily. Norway used the Referendum.

may be separated from THE WORLD by cutting this leaf on this line. " Talk"

Ignorance and oppression=Burning and bleeding Russia.

Education, freedom and the Referendum=Peaceful and happy Norway.

that the first one is headed “My Country." Why should not our country-the good of, and service to our country-come first, in peace as well as in war? The next is “My Neighbors"; and last (properly) comes “Myself." As I read them I saw that they were intended as New Year's resolutions. They are different from the usual New Year's resolutions, which concern the quitting of smoking, or some other personal habit. In these resolutions there is not only a regeneration of the individual, but a consecration of the individual to the public good. This is as it should be, for no nation can be great without such consecra. tion. Those who pile up private wealth mountain high for selfish gratification, make a great display, keep extensiv establishments in city, mountain and at the seashore, sail private yachts, live abroad much of the time, and neglect voting and every other civic duty, don't do the country any good. For a people to be great, it must be great collectivly as well as individually. These New Year's resolutions sound this note-that of public as well as private duty. I have not opened the magazine yet, but as I read the Resolutions I resolved to give them to you, so I had a clerk to copy them carefully, for the printer, and-here they .are :

***** MY COUNTRY. Resolved, to become a Soldier in the Army of the Common Good; never to suffer graft in silence, nor endure the acquaintance of grafters; to enforce the Square Deal, and in all my relations with politics and government to remember that I am first of all an American Citizen.

MY NEIGHBORS. Resolved, to lend my Neighbor in need a helping hand; to be kind; to judge tolerantly; to be patient with affliction or misunderstanding; to extend to others the degree of courtesy and consideration I require them to accord me.

MYSELF. Resolved, to play fair ; to speak true; to hold sacred my pledge, my friendships, and my obligations; not to ask another to do aught I dare not or would not do myself-above all, ever to keep well in mind that wealth is no coroliary of worth and success no evidence of character. Witness my hand and seal

(Signed)

Throws Partyism to the Winds. Dr. J. A. Park, of Westminster, O., writes: “I believe you are doing a great work toward getting people to think. You have repeatedly pointed out certain wrongs and referred your readers to both old parties for proof. I was the most radical republican till this fall, when I voted for candidates on three tickets. I henceforth throw partyism to the four winds, and will be an American citizen and vote for what I think is the best for the common people and the country at large. Inclosed find 25c. for which send me your book on Direct

Every One Can Be a Patriot. MR. C. F. TAYLOR-My Dear Sir: I inclose fifty cents postage for two copies of "Politics in_New Zealand.” Kindly mail one copy to Sam. W. Funk, Pipestone, Minn., and one copy to Hubert Piesinger, LeSueur Center, Minn., and I will write them to accept with my compliments, and to read and get friends to order from you direct.

The work is a good one, and if every voter in our country could have a copy and would read and digest it, there would be no danger in the future of scandals in great corporations or Government departments.

I have spread this book as best I could. Being a traveling man, I have some opportunity to help the good work along; lately, however, I did not have my own copy, and had a friend. Mr. Wentworth, order for friends. I left mine with a high school debating team in my travels, and it has not yet been returned. Unless I get it soon I shall order another copy for myself to show my friends; or, if I feel able, will order the large book you advertise.

Some I pay for myself; others are perfectly willing to pay. I first ordered the book on the advice of Mr. Bryan, in the Commoner. Since then many of my friends have done likewise. Spring Valley, Minn.

C. F. ROHDE. [This man is as good a patriot as George Washington was, to the extent of his opportunities and abilities. Any country that has such citizens is safeprovided it has enuf of them. Don't you think our country ought to have more like this? Can't you be one? It don't require much time or money; but it does require a real interest in the welfare of the country, and a real desire to promote it. Have you these qualifications of a patriot ?-C. F. T.]

How do you like them? Can you sign them? Can you write a better set of resolutions? If so, let us have them.

“ Conservatism never made an invention, wrote a poem, painted a picture, nor breathed a prayer that rose above the roof."

Ignorance and Oppression Do Not Pay. Ignorance doesn't pay. Oppression doesn't pay. We have all been horrified by the news from Russia for weeks past. The latest bulletin from St. Petersburg today (December 20) is that “civil war is raging in the adjoining provinces. It is estimated that 1,300 palatial residences have been burned, at a loss of $100,000,000." This reminds us of the awful destruction of life and property during the French revolution. The French revolution had a basis of ignorance and oppression, as has the Russian revolution of today. The ignorant peasantry, enraged by oppression, pillage and burn the mansions of the hated oppressors. Compare this with the recent peaceful revolution in Scandinavia. Norway withdrew from Sweden, and elected a new King, starting a new dynasty, without confusion, or loss, of life or property. How was this possible ? Because ignorance and oppression do not exist in Scandinavia, and because the Referendum was used to get the enlightened sentiment of the people Norway. In this respect they are farther ahead than we. We can't have a referendum vote on any question. Our statesmen never think of referring questions to a direct vote of our people. Why? One reason is, that our people don't demand it-they don't seem to know their rights-and they don't know their power-like a horse in harness, responding to every

Dr. J. M. Gunning, of Harrington, Wash., writes: “Inclosed find P. O. order to keep my standing good in tbe Order of the Blessed. Also $1 for four copies of Politics in New Zealand.' for distribution among my friends, I have the larger work and prize it bighly."

If you wish never to be nervous, live with reason; have a purpose in life, and live for it; play joyously; strive not for the unattainable; never regret the unalterable; be not annoyed by trifles; aim to attain neither great knowledge nor great riches, but unlim

le of

ed common sense; be not self-centered, but love the good, and thy neighbor as thyself."-Patrick.

ited

Circulation : January, 1906, 35,521.

THE MEDICAL WORLD

The knowledge that a man can use is the only real knowledge; the only knowledge that has life and growth in it and converts itself into practical power. The rest hangs likc

dust about the brain, or dries like raindrops of the stones.-FROUDE.

The Medical World

C. F. TAYLOR, M.D., Editor

A. L. RUSSELL, M.D., Assistant Editor PUBLISHT BY THE MEDICAL WORLD Co. Entered at the Philadelphia Post-Office as Second-Class Matter, SUBSCRIPTION RATES: To any part of the United States,

Canada, and Mexico, ONE DOLLAR per year, or FOUR YEARS for THREB DOLLARS ; to England and the British Colonies, Five SHILLINGS Sıx PENCE per year; to other foreign counories in the Postal Union, the equivalent of gs. 6d. Postage free. Single copies, TEN CENTS. These rates are due in

advance. HOW TO REMIT: For their own protection we advise that

our patrons remit in a safe way, such as by postal money order, express order, check, draft, or registered mail, Currency sent by ordinary mail usually reaches its destination safely, but

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the end of the month. Notify as promptly of any change of address, mentioning both old

and new addresses. you want your subscription stopt at expiration of the time paid for, kindly notify us, as in the absence of such notice we will anderstand that it is the subscriber's pleasure that the subscrip

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"THE MEDICAL WORLD" 1920 Chestnut Street

Philadelphia, Pa.

Language is a crowth rather than a creation. The growtb of par vocabulary is seen in the vast increase in the size of our diction. aries during the past century. This growth is not only in amount, but among other elements of growth the written forms of words are becoming simpler and more uniform. For example, compare Eng. lish spelling of a centary or two centuries ago with that of to-day! It is our duty to encourage and advance the movement toward simple, uniform and rational spelling. See the recommendations of the Philological Society of London, and of the American Philo. logical Association, and list of amended spellings, publisht in the Century Dictionary (following the letter z) and also in the Standard Dictionary, Webster's Dictionary, and other authoritativ works on language. The tendency is to drop silent letters in some of the most flagrant instances, as ugh from though, etc., change ed tot in most places where so pronounced (where it does not affect the preceding sound), etc.

The National Educational Association, consisting of ten thous. and teachers, recommends the following:

"At a meeting of the Board of Directors of the National Educa. donal Association held in Washington, D. C., July 7, 1898, the action of the Department of Superintendence was approved, and the list of words with simplified spelling adopted for use in all pub ications of the National Educational Association as follows: cho (though);

program (programme); altho (although);

catalog (catalogue); thoro (thorough):

prolog (prologue); thorofare (thoroughfare); decalog (decalogue); thru (through);

demagog (demagogue); shraout (throughout);

pedagog (pedagogue). “You are invited to extend notice of this action and to join la securing the general adoption of the suggested amendments. IRVING SHEPARD, Secretary,"

We feel it a duty to recognize the above tendency, and to adopa it in a reasonable degree. We are also disposed to add enne

ngh) to the above list, and to conservativly adopt the follow ing rule recommended by the American Philological Association :

Drop final "e" in such words as “ definite," "infinite," favorite,” etc., when the preceding vowel is short, Thus, spell "opposit," “ preterit,” “hypocrit," " requisit," etc. When the preceding vowel is long, as in “polite," “ finite,"

** unite," etc., retain present forms unchanged. We simply wish to do our duty in aiding to simplify and rados alize our universal instrument-language.

VOL. XXIV.

FEBRUARY, 1906.

No. 2

Scarlet Fever. Confessed ignorance is always a source of chagrin and embarrassment to intelligent men, and yet this is the attitude every honest practician must assume when confronted with a case of scarlet fever. Our almost absolute lack of knowledge regarding the exciting factor renders any clear conception of the processes going on inside the body of the patient well-nigh impossible. We have no idea why the incubation period varies so greatly in different cases and in different epidemics; nor can we tell why some patients quickly succumb, while others, seemingly less rugged and presenting symp

toms more alarming, recover promptly and without untoward incident.

This deplorable condition has produced an unfortunate disposition to treat (?) cases of this disease strictly upon the "expectant” plan. In other words, because we know so little about the disease, we are to do nothing! Such a position is indefensible. A disease easily acknowledged the most fatal of all the exanthemata, demands not apathy nor lethargy, but the most careful attention and the highest skill to which any physician may attain. The life of the patient, often, depends upon the tact and energy with which the practician meets sudden compli

cations; and no physician, however gifted, considered a source of danger if it remains is competent to engage these exacerbations above 102 degrees F. The severe sore unless he has kept constant and conscien throat may be relieved by the application of tious supervision of the case from its in- the ice bag externally, and swabbing or cipiency.

spraying internally with chlorate of potash; Two routine treatments have been pre- but this drug should not be given in medisented, both claiming brilliant results, yet cins which are swallowed, on account of its neither has been accepted with any unanim irritating action on the kidneys. It is of ity by the profession at large. The first, great importance that a “good” rash apthe salicylate treatment, originated in pear; sudden disappearance of the rash, or Europe; the second, the chloral treatment, an imperfect development of the rash, early had birth in America. In the first, 2 grains in the course of the disease, is always a of salicylate of sodium are given in suit- symptom of grave import. The best method able menstruum every two hours thru the of treating this complication is to place the day and every three hours during the night; child in a hot pack, with cold water applied this is kept up from the incipiency of the to the head and neck (if the head is very disease until several days have elapsed after hot), while the body is wrapt in the steamdefervescence. In the second, 2 grains of ing blankets. In a short time this treatment chloral, in a suitable vehicle, are given every generally results in a perfect development two to four hours. The European plan of the rash, with a drop in the fever, and would not appear dangerous, but Hare be- frequently a disappearance of the delirium. lieves that the chloral treatment is not best Nothnagel uses a bath at 68 degrees F., for most cases "unless the nervous symp- whenever the rectal temperature reaches toms are very markt."

104 degrees F. One feature of treatment, to which no Some clinicians regard the itching and objection can be urged, and to which every burning of the skin as an important factor practician should devote his attention, is to in inducing heightened fever thru the nerprovide a plentiful supply of pure water vous irritation, and claim to have induced thruout the case. This water, for manifesta fall in the temperature and an improvereasons, should contain as little solid matter ment in the general condition by anointing as possible. In fact, distilled water is the the entire body at regular intervals with best, since the main object to be secured is vaselin, carbolized oil, benzoinated lard, or the thoro flushing of the kidneys with as plain fresh lard. little demand as possible upon their vitality. It is highly important that convalescence Hare suggests the use of Poland water, or should be prolonged. A confinement in bed if it can not be obtained, the employment for four weeks is insisted upon by some of of Vichy; or, in want of both, the use of the our best clinicians, and their results as regranulated Vichy salt obtainable from all gards appearance of nephritis are a comlarge distributing drug houses. If the latter plete justification of their plan. be used, it is added to distilled water as It is not our intention to attempt a résumé needed, just before drinking. But pure of the disease in all its protean manifestawater is better than Vichy or any water tions, nor yet to outline the treatment of all carrying salts or other solids in any form. the various complications, for these can be

Beyond this, the practician can only main found in any modern text-book. What we tain ceaseless vigilance. Any organ in the wish to emphasize is that sleepless vigilance body may suddenly present a serious com is necessary in every case; that the man plication. The kidney, brain, ear, heart, who "believes in doing nothing" should lung, and eye are the ones which cause the never attempt the conduct of a case of greatest concern; yet hyperpyrexia and an scarlet fever; that the proper kind of drinkgina must frequently be reckoned with. ing water is one of the most important facHigh fever is met best in just the same tors in handling every case; that cool spongmanner as that universally employed in ing, at about 68 degrees F., is the very best other diseases, yet the popular prejudice method of combating high fever; and that against “driving the rash in” deters many while there is no danger of “driving the from this method. Acetanilid and anti rash in" by such bathing, there is great pyrin may be used, but collapse is likely to danger whenever the rash fades in the early occur if the high temperature require large days of the disease; and that finally, many dosage. The temperature, in itself, is to be a case succumbs from late nephritis that

probably would have escaped it if the convalescence had been properly managed. And don't forget the anointing. It is a little thing, it can do no harm, and in many cases it apparently does much good; and it prevents the flying of flakes in desquamation. Lard is as good as anything.

Hygienic Management. Altho the recorded periods of incubation range from less than one day to over 20 days, and the absolute advantages of isolation when undoubted contact has probably taken place between the infected and the non-infected children are considered, such action is the closest approximation we can make to safety. The ill child is to be removed to a separate room as soon as the diagnosis is made, and if this room is on another floor above those occupied by the family, all the better. Once the isolation is made, to be of any value it must be kept

by nurse, doctor, and every member of the family. Not one particle of anything animate or inanimate should be permitted to pass outwards from the portal of that room without thoro disinfection. The mother, if one there be, is the most difficult party to reckon or reason with; and her position is hard. If she be a true woman, she will not remain away from the sick child, especially if danger threaten imminently. Perhaps she has an infant; or perhaps she feels that she can not abandon other young children absolutely for the required time. In most instances, she will insist upon dividing her attention between the child suffering with scarlet fever and the rest of the family. If this is permitted, there is no use in restricting unlimited intercourse between all members of the family and with any part of the house. To be sure, a complete bath in bichlorid solution, including the hair, and a complete change of all clothing, would be considered safe; yet this is not practicable when it would require performance several times a day. Among the intelligent and well-to-do, such precautions, under the care of a trained nurse, could be imagined as being accomplisht; but among the poor and ignorant, such a condition could never be attained nor maintained. Among the poor, the family must be practically abandoned to their fate, and the welfare of the public protected by an absolute house quarantine.

Where the selected room permits of any adjustment, arrangements for perfect ventilation are to be made; in fact, a continu

ous current of air thru the room, the bed being protected by screens from draughts, is the best plan. The temperature of the room should be kept at 60 degrees F.; no warmer. The bedclothing should be light. The mouth, nose, and throat should be frequently sprayed with an antiseptic solution. If a membrane appear in the throat, consider it diphtheritic until the presence of the Klebs-Loeffler bacillus has been excluded by three bacteriological examinations made on separate days. Peroxid of hydrogen swabbing every hour is the best treatment.

The food should be fluid or semi-fluid; the various cereals, well cookt, are perhaps the best form of nourishment. It is to be remembered that a great drain will be made on the vitality of the patient, and we can not know how long this is to continue, hence we must make an effort to replace a certain proportion of the great amount of albumin lost by the tissues. An excess of food is, of course, to be guarded against. A daily bath at 68 degrees F. is beneficial; it keeps the skin in good condition. If anointing is employed, the addition of soap to the bath is essential. No more than five minutes should be consumed in the bath, and every effort to prevent exertion on the part of the patient is to be made.

If subnormal temperature and markt stupor develop, the head and the neck are to be doucht with cold water while the patient is in a warm bath; this may be repeated in two hours, if necessary. If convulsions are present, the warm bath may be prolonged to fifteen minutes, and the cold douche given at the expiration of that period.

* * * Sometimes in hyperpyrexia the skin is cold; and such a condition denotes considerable weakness. Hypodermic injections of ether, every half hour, followed by hypodermic injections of camphorated oil, every ten hours, are the best measures to combat this condition. The hot bath, at 104 degrees F., is employed by some practicians for a period of ten minutes under such conditions. If high fever is present, both internally and peripherally, prompt cool sponging is imperativ. Leichtenstern, who has had extended experience in the treatment of scarlet fever, and who is enthusiastic in the use of the cold water, says: "My statistics justify me in the conclusion that the cold water treatment of scarlet fever markedly diminishes the tendency to

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