Billeder på siden

ture and partial subsidence of the more alarming symptoms. The water plan was continued, and the fever rapidly yielded. In twenty days from the first, convalescence was so pronounced that the patient was discharged. Convalescence, in this case, seemed to be more rapid than ordinarily observed in typhoid fever patients with such threatening symptoms. This is the first case in my professional career of thirty-four years that I have treated without medicine.

Experiment 2nd.-Dr. C. S. Webb, my associate, visited Mr. Y., of Virginia, recently moved to this city, who seemed to have a mild attack of malarial fever, but instead of yielding promptly to the usual treatment of such a case, the remission became less marked, and in a week the temperature range morning and evening indicated fever.

I suggested to him to try the warm water flushing of the bowels and copious draughts of cold water. He used by enema nearly a gallon of warm water at 10 o'clock A. M., and directed him to drink a glass of cold water every half hour during the day. I visited him the next day, when he said he felt that he had drunk a barrel of water, and would never want any more. The following day he could hardly find vessels in his room sufficient to hold the urine he passed during the night, but he said he felt stronger and better -and this was true.

The flushing and draughts of cold water were kept up for a few days, and the patient continued rapidly to improve. He was soon entirely well and went on a visit to his home in Virginia.

Experiment 3.-Was called to visit Mrs. C, age over seventy, with a marked case of typhoid fever— temperature ranging from 1024 A. M., to 104° P. M. Began at once the warm water flushings, morning and evening; and after the latter, gave half pint of milk and half pint of warm water by enema, which was allowed to remain. Although the patient lay in a comatose condition for several days, and was threatened with heart failure, she rallied under the treatment, and in two days was convalescent. She was allowed all the water she could drink, and a tablespoonful of whiskey in milk every three hours when she could be induced to take it. Beef extract was given by the rectum at intervals between flushings.


Experiment 4.-Mamie J., age 5 years, was found on, my first visit to have a typical case of typhoid fever. Her older sister was taken on the same day of the same month with a similar attack over a year ago. Flushing the bowels was begun at once, and copious draughts of cold water (not iced) were frequently given during the day. In twenty-four hours, she had free perspiration and diuresis; the temperature was reduced, and never again reached so high a mark; the treatment was kept up daily. Mamie's convales

cence began in twelve days, while that of her older sister under the usual treatment, did not begin for thirty days.-Dr. Roy, Atlanta Medical Journal.

The Old-Time Faith-Cures.-Since the year 1844, when A. Gauthier reported his "Recherches historiques sur l'Exercice de la Médecine dans les Temples," a number of studies have been made of sacerdotal medicine among the ancient Greeks. One of the latest of these is by M. Diehl ("Excursions Archéologiques en Grèe, 1891 "). These works throw an interesting light upon the practice of medicine in olden times, but they particularly show its close resemblance to the faith-cures of to-day. The temples of Esculapius began to take a prominent part in the social and medical life of the Greeks at about the time of the Trojan War, and they lasted as institutions until 400 A. D. The faith-cures of old, therefore, officially endured for about one thousand years. The temples of Esculapius were usually small and modest structures. Like the doctor of to-day, they did not secure great gifts of gold; their reputation was among the poor. They were placed in some salubrious spot and had attached a corps of priests and attendants. The sick came and were placed on couches in the interior, where, after visitation from the priest, they made their vows and went to sleep. It was expected that the god would visit them in their dreams and either heal them or reveal a way for so doing. If a cure resulted the patient deposited some gift, and caused a tablet to be erected describing his disease and its cure, and rendering appropriate thanks to the deity. These gifts and inscriptions remained to ornament the temple and inspire hope and confidence in the hearts of new-comers. Some gave propitiatory offerings, i. e., paid before they were cured. But this seems to have been rather unusual. The ancient Greek was of a frugal mind and only paid for what he got. Archeologists have collected many of the curious votive tablets from these old faith-cure establishments. A Lacedemonian lady had the dropsy. Her mother consulted the god at the temple of Epidaurus, and dreamed that she saw him descend, cut off the head of her daughter, then hold up the trunk until all the water ran out. She woke up, went home, and found her daughter well. Another tablet describes the dream of a patient who suffered from cancer of the stomach. The god removed the cancer by a neat and painless laparotomy, and the patient awoke and was cured! If it could only be done that way now! Naturally the priests became somewhat skilful in the practical and real part of medicine. They saw that their patients received healing drugs and followed hygienic ways of living. It was from some of these practical physicians that Hippocrates learned what little he knew of medical art,

expunging from it priestly mysticism and quackery.

As time passed and the ancient religion became more of a conscious deception and means of gain the temples of Esculapius degenerated. They were sometimes started as a business venture by dishonest men, who worked them "for all they were worth," just as is done nowadays. Again, specialism entered the field. The oracle at Delphos, in order to enlarge its revenues, entered the field; the priests of Diana, at Ephesus, made a specialty of the eyes, and those of the temples of Venus looked after certain kinds of tumors. In order to help along the business later, a great deal of trickery was introduced; finally, human credulity could be taxed no farther, and the temples were abandoned.

In the early days, when conducted by honest priests, the temples of Esculapius no doubt did much service. They were the sanitaria and consulting centres of the people. Their decline and fall was inevitable as Christianity grew, but it was hastened by the gross abuses of the system.-Medical


Salt Baths in Phthisis.-The experiments of a Russian physician, Dr. Belicheff, in Tehondmonsky's clinical laboratory were as follows: Ten patients in various stages of pulmonary phthisis were selected and careful records made of temperature, pulse rate, number of respirations, blood pressure (pneumonmetric), lung capacity, inspiratory and expiratory power (dynamometric), muscular strength, morning and evening bodily weight, appetite, expectoration, cutano-pulmonary waste, and cutaneous sensibility. The food was the usual hospital fare. Each experiment lasted twelve days, divided into three periods of four days each. During the first four days, careful records and tests were noted before any baths were given. Then followed a period of four days, during which each patient had a daily bath lasting half an hour, in water heated to one hundred degrees and containing one part of salt to every hundred parts of water. Records and tests were also kept during the bath period, and the four days following. The conclusions reached by the twelve days' experiment are these:

I. During the bath period and the four days following, morning temperature is slightly elevated. Vesperal temperature is unchanged during the period of baths, and is slightly elevated during the post thermal period. Immediately after the bath proper, there is a fall in temperature.

II. Pulse rate is diminished during the bath period. In the third period, it is slightly accelerated. III. Blood pressure is raised in the second and third periods.

IV. Pulmonary capacity is augmented, especially so the days following the bath period.

V. The power of inspiration and expiration increases with the increase of pulmonary capacity. VI. Muscular force in the hands is increased. VII. There is a gain in morning and evening bodily weight during the bath period, and a gain also during the post thermal period, though less pronounced. VIII. Appetite improves during the bath period. Daily expectoration is lessened. Cutano-pulmonary waste is increased. Cutaneous sensibility is increased.





There is improvement in the general condition, and sleep is calmer and more profound.-Wratch.

Cracked Ice for Invalids.—One more thing there is that nurses apparently do not know, says a writer, and that is the value of cracked ice in cases where a prolonged drink of any fluid is next to an impossibility. Finely cracked ice, administered in a teaspoonful of champagne or brandy, has been the rallying point for many a sinking patient. Or the ice alone, finely crushed so that it simply melts away in in the mouth, trickling down the throat rather than being swallowed as a draught, is a most useful stimulant. The writer in the Philadelphia Ledger will never forget the look of amazement in Alice Foster's face when she was shown the ice-shaving machine at the Pennsylvania Hospital soon after her arrival there, and when an informal visit to that good old hospital gave an opportunity for conference over many points in nursing.

That ice should ever be needed in such quantities. and portions as to require a machine for shaving it was a novelty to her. In common with her countrymen generally she had the true English horror of ice-water, but the use of ice itself is quite a different matter from deluging the stomach with a cold fluid. The melted ice is not of the ice water temperature when it is swallowed. People who take cracked ice get the stimulus of ice upon the nerves of the mouth and tongue, and not the flooding by water of the feeble throat and stomach. Did not one ingenious nurse, at the time a matron, in the University Hospital, some years ago, actually feed a patient, who revolted at the mere thought of food and was starving in his exhaustion, by deftly sprinkling pounded ice over the bits of broiled chicken that she had prepared to tempt his taste?

It was the novelty and the sparkling ice that carried the day. The man tasted, enjoyed, and ate it all. Each country adds its contribution-according to climate and physical peculiarities-to the science of nursing. It has been said that no one in England can imagine the depths of weakness into which

American patients may suddenly go and may be pulled up and out of, because the English climate is not so exhausting in its demands. The uses of cracked ice in cholera cases are familiar to some. It is possible that with hot water bags at the feet, hot mush poultices on the stomach, and a constant diet of cracked ice, no further treatment may be needed to complete a cure. Nursing skill counts for much, and every woman should have as much knowledge of it as will be sufficient to keep patients from sliding down hill until the proper officials arrive.-Exchange.

Lavage.-Dr. W. S. Fenwick states (Practitioner) that at the present day every imaginable symptom that can in any way be connected with the digestive organs is immediately considered as an indication for the use of lavage, and not only are chlorosis, atonic dyspepsia, and the gastric crises of ataxia subjected to this treatment, but even cases of reflex vomiting are supposed by some to necessitate the employment of the douche. But it is obvious that in those cases where the treatment fails to do good it is extremely likely to do harm, since as Leube pointed out, it has the effect of removing those products of digestion whose manufacture has caused the stomach a considerable amount of labor. He cannot see how washing out the organ in a case where the normal amount of secretion proves insufficient can possibly increase its digestive powers; or the lavage of the stomach prevent the occurrence of symptoms which are wholly dependent on organic disease in another organ re motely situated. In one case of tabes dorsalis, accompanied by exceedingly severe gastric crises, he had the stomach washed out every day for some weeks and the state of digestion carefully watched; but beyond the fact that the symptoms of the disease grew steadily worse, he could detect no material alteration in the condition of the patient. In like manner, the few cases of atonic dyspepsia and chlorosis which he had treated by lavage have, without exception, proved exceedingly rebellious and only improved when subjected to the more ordinary course of medical treatment. Lavage is an invaluable remedy in gastric disease, but its indiscriminate employment in every case of disorder of digestion will prove a curse rather than a benefit, and will eventually discredit the procedure.

The Local Examination of Unmarried Women.-Commenting favorably on the excellent article of Dr. Coe (Medical and Surgical Reporter), the editor of Gaillard's Medical Journal says: "In the discussion of a recent able paper of Dr. A. Jacobus on amenorrhea, before the Northwestern Medical and Surgical Society, the consensus of opinion seemed to be that local treatment was un

[ocr errors]

availing in most cases, and several able observers inveighed against the too common practice of vaginal examination of young girls. The writer's personal observation may serve to enforce this view. He has occasion to treat a large number of young lady teachers. Recently two of these have consulted him who have been treated by lady physicians.' It appears from their statement that many of their friends have been subjected like themselves to tri-weekly applications of tampons, iodine, pessaries, etc. In both cases there was no organic disease requiring local treatment. One had become a utero-maniac, whose chief symptom was vomiting and loss of appetite. Placing her under strict surveillance in the hospital, and giving her daily cold ablutions, with tonics and absolute abstention from local treatment, restored the stomach. She gained flesh and went to work. But her utero-mania had been so firmly established that she applied at a dispensary, where the young gynecologists treated her anteflexure secundem artem (?) The other case was found to be suffering from constipative: anæmia and neurasthenia. Being a woman of great will power she has abandoned all thought of local treatment, and is now gaining health and strength under the rain bath, and daily ablutions, aloes and mast pills and good diet. It is our duty to save these young girls the mortification and annoyance, and absolute injury of a vaginal examination unless found absolutely necessary, after failure of other treatment. To our colleagues of the gentler sex this duty is quite as imperative, and their attention to it is the more necessary, since they may regard the moral effect less pronounced, and many of them deem themselves specially adapted to this class of practice among young women."-Medical Record.

Vegetarian Diet.-Dujardin-Beaumetz claimsthat this diet thoroughly subserves alimentation of ther oganism; the best proof of which is furnished by the poor peasants, who do not eat meat, yet they are strong and healthy. This diet is of therapeutic importance in certain diseases. A vegetable diet limits to a minimum the production of toxines, such as neurin, muscarin, etc. It is indicated by insufficient functional activity of the kidneys and alimentary canal, indeed, in all similar conditions where an accumulation of ptomaines in the blood might prove dangerous. It is also indicated in putrid diarrhoea. In diseases of the stomach, a vegetable diet is especially indicated, as the intestines are principally employed in its digestion, thus affording the stomach considerable rest. In the uric acid diathesis, this diet is also recommended.

Dietetic Value of Pineapple Juice.-Some time ago the late Dr. V. Marcano, of Venezuela,

noted (Med. Age) that pineapple juice contained a proteid digesting substance. Recently, Prof. R_H. Chittenden, assisted by Messrs. E. P. Joslin and F. S. Meara, have investigated the matter fully, and announce facts which are likely to give to the succulent pineapple a prominent place in dietetics.

Pineapple juice is an acid fluid of specific gravity of 1.043. An ordinary pineapple yields 600 to 800 cubic centimetres of it. The proteid-digesting power is quite remarkable in its intensity. Three ounces of the juice will dissolve ten or fifteen grains of dried albumen in four hours. The action takes place in acid, neutral, or even alkaline media, thus resembling trypsin more than pepsin. It acts best in neutral solutions. The pineapple juice contains also a milkcurdling ferment.- Weekly Medical Review.

The Knee Jerk in Health.-Is very seldom absent. If the tests be made with care, the jerk can be obtained in nearly all cases. The use of a hammer instead of the hand, or, locking the person's hands together, as recommended by Jendrassik, will elicit it when the ordinary plan might fail. I have made two hundred tests in perfectly healthy men whom I was examining for life insurance. I did not find it wanting in one. In two it appeared deficient, but was increased at once by holding the hands together. Now it is here I make the distinction between health and disease. When the loss is due to disease I have never found any of the plans cause an increase. the other hand, as just stated, when the jerk is deficient, and there is no disease, placing the hands together and making strong voluntary effort at once. causes a perceptible increase.-Dr. Ferguson in Med. Record.


Selection of Change of Climate for Invalids.--It is necessary to study each case from the standpoint of the individual as well as from the standpoint of the disease, and select the future place from actual knowledge, either derived from personal experience after a thorough investigation, or from that of others who know. When the location is decided upon, it is the best plan to write to a prominent physician of the place, giving him a history of the case, the diagnosis, the stage of the affection, the patient's temperament, his or her financial condition, and be advised by the local physician as to the probabilities of success at his resort. Let him secure the necessary accommodations, take entire charge of the patient on his or her arrival; be sure that there is impressed upon the sick one the necessity of following out the instructions of the local doctor, who, from a large experience, should be conversant with all the features of such cases, and who should not be hampered by conflicting instructions from the home physi

cian. Then the possibilities of success are increased to the maximum.-- University Medical Magazine.

Pineapple Juice.-Some time ago the late Dr. V. Marcano, of Venezuela, noted that pineapple juice contained a proteid digesting substance. No careful study of this fact was, however, made by him. Recently, Professor R. H. Chittenden, assisted by Messrs. E. P. Joslin and F. S. Meara, have investigated the matter fully, and announce facts which are likely to give to the succulent pineapple a prominent place in dietetics.

Pineapple juice is an acid fluid of specific gravity of 1.043. An ordinary pineapple yields 600 to 800 cubic centimetres of it. The proteid-digesting power is quite remarkable in its intensity. Three ounces of the juice will dissolve ten or fifteen grains of dried albumin in four hours. The action takes place in acid, neutral, or even in alkaline media, thus resembling trypsin more than pepsin. It acts best in neutral solutions. The pineapple juice contains also a milkcurdling ferment. Professor Chittenden does not seem to be aware that a well-known meat powder is prepared, or is said to be prepared, with the help of pineapple juice.-Med. Record.

Drink and the Death Rate.-The relation of drink consumption to the death rate formed the subject of a communication recently made to the Manchester Medico-Ethical Association by Mr. Meacham, district medical officer. The reporter recorded it as his experience of thirty years of work among all classes of the people, that a very large percentage of disease is directly attributable to the influence of alcohol. In the congested parts of the city this was especially the case, and he urged on the Association the duty that rested on it, of doing all that lay in its power to aid the Corporation of Manchester in the efforts that were being made to promote temperance principles among the masses. Mr. Meacham attributed 21 per cent. of the pauperism met with to the hereditary influences resulting from drink excesses. He had compared the children of drunkards with those of temperate parents, and found that the latter possessed vast advantages over the former in respect to healthfulness and freedom from disease.-Med. Press and Circular.

[merged small][graphic]

The Medical Calendar.


Red Bilberry in Rheumatism.-At the suggestion of the Russian Medical Council, T. T. Hermann tried the effect of the red bilberry (Vaccinium Vitis Idee, L.; Russ., brüsknika), which is extensively used by the Russian peasantry as a remedy for rheumatism. He used it in the form of a decoction or diffusion of one part of the fresh herb, with roots, to 8 parts of the colature (from two to three tumblerfuls being given daily) in an obstinate case of chronic articular rheumatism in which all the usual methods of treatment had failed. A striking improvement followed in a few weeks, while in two months the patient, an old man, was practically cured. S. P. Smirnoff, of Cronstadt (Meditzinskia Pribavlenïa K'Morskom Sbornik, December, 1891, p. 429) next tried the substance in nine patients (sailors and soldiers aged from 22 to 27), of whom six were suffering from acute, and three from chronic, articular rheumatism. In all of them the red bilberry treatment was commenced after all ordinary means (including salicylate of soda, iodide of sodium or potassium, hot baths, local application of tincture of iodine, turpentine oil, belladonna, mercurial or iodide of potassium ointment, etc.) had proved quite inefficacious. The remedy was used in the form of a decoction, prepared from one or two ounces of fresh stems, with leaves and roots, in six ounces of water; this amount being given daily in divided doses. The duration of the treatment varied from one week to three months. Of the nine patients, seven were cured, while in the remaining two the remedy failed (in one after a week's course, in the other after three months). In all the cases a slight increase of the daily quantity of urine was observed, while in the patients in whom catarrhal diarrhoea was present, the latter quickly ceased under the influence of the decoction. Smirnoff sums up as follows:

with a local application of anodynes and counterirritants. The decoction forms a cinnamon-brown, somewhat turbid fluid, with a slightly bitter and astringent taste, and a neutral reaction. As the author's analysis has shown, the decoction contains vaccinine, tannic acid, extractive, proteid and mucoid substances, Vaccinine, (discovered by Claassen in 1865) is a glucoside occurring in the form of white minute acicular crystals, which are easily soluble in water, but much less so in ether, and almost insoluble in alcohol. Contrary to Maisch's assertions, the glucoside is not identical with arbutin, for the latter is soluble in alcohol, and gives a green reaction with perchloride of iron; while vaccinine, when treated with the salt, assumes a cherry red color.-British Medical Journal.

Wine Drinking at Dinners. It is an undoubted fact that the serving of many and heavy wines at large dinners is gradually becoming a thing of the past, writes George W. Childs in the January Ladies' Home Journal. Of course, I do not mean that wines are no longer served, for they are and always will be, so long as civilized men consider them a feature of dinners. But I do mean that of the varieties of wine there are fewer, of the quantities less, and of the qualities lighter, than was the custom ten years ago. Were I preparing for a large dinner for men-which is always from the nature of things more heavily wined than an ordinary "mixed" dinner-I should not think it in the least degree necessary to order anything like the same amount or assortment of wines that would have been imperative a few years ago. And in extenuation of the statement that the qualities of the wines served are becoming lighter, the simple fact that at the average English dinner table port wine has been almost entirely superseded by claret, may be cited. It is also becoming a very ordinary thing at English dinners to meet prominent men who do not drink wines of any kind, and in our country this is becoming more and more a fact. Of course, a dinner must have fluids; the best of solids require some liquids with which to relish them,

1. The results obtained by him must be regarded and a dinner would be but wasted energy and material as exceedingly favorable.

2. The red bilberry treatment deserves a further extensive trial.

3. The method is extremely simple, convenient, harmless and cheap (in Russia the red bilberry is one of the commonest of plants).

4. It is advisable to continue the use of the decoction for some time after complete disappearance of all symptoms; since in one case, which had been cured in five weeks, a relapse occurred three and a half months later.

5. It is useful to combine the internal treatment

without them. But I think it is no longer imperative to serve wines, or at least we can serve with them some other beverage which will be of equal pleasure to the constantly increasing set of people who find that wining and dining together is rather too heavy a combination for their comfort.

ollowing Typhoid Fever.—It ular belief in England that a man id fever in his youth is incapable en. Why he should be sterile is

« ForrigeFortsæt »