Billeder på siden
PDF
ePub

the avoidance of the filth which accumulates visibly upon the surface of the body, but includes the avoidance of inhaling and swallowing foul matter circulating in the air or in the soil.

Among the hygienic measures of the ancients to which Dr. Thomas would have us return are the biblically inculcated law of washing the hands before eating and the circumcision of male infants. The latter he regards as "one of the greatest hygienic customs of the world."

We cite these as illustrations of what the encouragement of cleanliness may accomplish. Dr. Thomas recommends the creation of a government department with a secretary of health, the dissemination of knowledge in sanitary matters by medical societies, a professorship of hygiene in every large university, the more thorough text book teaching of the subject in every school, and a greater interest of the physician in offering instruction to his clientele in matters relating to the prevention of disease. These propositions cannot fail to meet the approval of all progressive men, lay as well as professional.

A TARDY RECOGNITION.

With their usual fairness and desire to advance the best interests of medical science, the Paris Academy of Medicine has made "The Cold-bath Treatment of Typhoid Fever" the subject of the essay for the Prix Louis for 1892. Aside from the enormous import of the subject, the prize of 5,000 francs will doubtless bring out a full competition.

A glance at the history of the cold-bath treatment of typhoid fever reveals the fact that from the time of Hippocrates to recent times, the method has frequently been the subject of enthusiastic commendation by eminent and trustworthy men. Hufeland's prize, which was won by Dr. Froelich, the physician of the Austrian Court, may be referred to as an illustration. But it was not until Ernst Brand, of Stettin, published his work in 1861, that the method received a modern scientific interpretation, together with ample clinical demonstration.

Its introduction into France forms an interesting episode in medical history. How good may come of evil was never more strikingly illustrated than by the fact that while thousands of patriotic Frenchmen were slain on the battlefield and in hospitals during the Franco-Prussian war, the seed was sown in the prison hospitals at Stettin whose fruit has been the great saving of life of Frenchmen who have suffered since that time from typhoid fever. Dr. Francois Glénard, a highly gifted and scientific man, who was a prisoner of war, observed the phenomenal success of Brand's treatment in typhoid fever, and carried with him to Lyons, his place of residence, the conviction

which made him the champion of the treatment in all France. It is not singular that this German method was not favorably received at a time when the patriotic and suffering people of France were writhing under the infliction of defeat and loss of territory which was dear to their hearts. To overcome opposition which was deeply tinged by the sentiment of hatred thus engendered required the courage of the strongest conviction.

Having acted as Brand's assistant in the prison hospitals at Stettin, and being en rapport with the daily work and achievements of the great master, he had an opportunity three years later to illustrate the teaching of the latter, in an epidemic which furnished the Red Cross Hospital with 51 cases, of which only one died. The method became so popular by this public demonstration of its value that Lyons became the great centre of this treatment.

Only a few years ago Dujardin-Beaumetz opposed the bath treatment so energetically in the Paris Academie de Medicine, and obtained its approval of his views so thoroughly, that the Lyons fraternity regarded it as incumbent upon themselves to inaugurate a personal defense. A memorial was drawn up and signed by twenty-two out of the twenty-four hospital physicians and teachers of Lyons, containing the following declaration :

"The hospital physicians of Lyons declare themselves partisans of the method of Brand in the treatment of typhoid fever, convinced that the method, systematically applied from the inception of the disease, will considerably reduce the mortality. They testify that they employ it in their own families, in their hospital service and in private practice."

The cultured and earnest Glénard presented the memorial to the Academy, meeting great opposition. But time has brought its sweet revenge. The work of Tripier and Bouveret, which has been translated into German-an account of its great clinical value and minute attention to details-has won the French profession over to the German method.

To

Slowly but surely the prejudice engendered by sentiment, laudable in itself, has been overcome. day the French Academie is considering a number of essays sent in for the Prix Louis, which is to be given. to the best dissertation on the subject of "Bathing in Typhoid Fever"-a subject which aroused the greatest antagonism in the same body a few years ago. May we not hope that the well-known frankness and courtesy of the French will in the future render justice to the man whose misfortune it was once in their eyes to be born a German, but who, with the generosity and kindness born of humanitywhich ever shines in its most resplendent light in the ranks of medicine-restored the enemies of his country back to life and health by a treatment which was destined to bear such noble fruit in civil life after the

strife and animosity of war had become a thing of the past?

All honor to the French physicians, who, by this tardy recognition, testify not only to the glowing nationalism which ever animates their hearts, but also to the fairness and humane spirit for which they have long been noted.

All honor, too, to Ernst Brand, who, amid good and evil report, amid the praises of friends and detraction of enemies, stood unmoved, pointing steadfastly to the unerring tests of clinical experience, and calmly pursuing the defense of his method by the only crucial argument-indisputable facts and figures.

Annotations.

The Germicidal Properties of Milk. -Dr. Freudenreich, after a series of experiments on the action of raw milk on bacteria, has come to the conclusion that it possesses remarkable germicidal properties. He claims that the bacillus of cholera in fresh cow's milk dies in an hour; the bacillus of typhoid fever in twenty-four hours, while other germs die at the end of varying periods. He further found that milk exposed to a temperature of 131° F. loses this germicidal property, as does also milk that is four or five days old.

These experiments will set the physicians to thinking very seriously on the advisability of sterilizing milk for infants' food or food of adults. We were

just congratulating ourselves on the fact that a means of preventing the introduction of disease into the human body through milk, had been discovered in sterilization. According to Dr. Freudenreich, one might conclude, at first thought, that we were mistaken in our expectations and confidence, and that raw milk is, after all, preferable for human consumption. While this view of the case seems reasonable, yet, in our judgment, it should not obtain; for the experiments in question do not indicate that the sterilization of milk should not still continue, and be considered a great source of protection against the germs which may be found in this fluid. In fact, the object of the artificial sterilization of milk is, first, to deprive the milk of its fermentive properties-that is, to destroy the microorganisms that cause it to ferment; and secondly, to destroy the microbes of disease that may accidentally be in them. The first object named is the chief one.

Whatever Dr. Freudenreich may find concerning the microbicide powers of milk upon disease germs, it is evident that raw milk is not a destroyer of all germs which produce irritant or septic poisons. It is only sufficient to let milk stand, and allow all kinds of germs that may, to live at the expense of it, to prove this to any one. Consequently, this sterilization is

needed to destroy those organisms which milk in its raw condition is unable to destroy, and these are certainly the most common, as well as the most dangerous, of the germs of milk, particularly in infant foods. It is not so much to destroy the germs of typhoid fever, or tuberculosis, or any other disease, that sterilization is recommended, but to destroy germs which cause the transformation of the various substances composing the milk, and create nefarious products. Granted that raw milk is a bactericide of certain disease germs, this does not militate against its sterilization for the other deleterious organisms which it does. not destroy. If, for instance, the bacillus of cholera. dies in an hour in fresh cow's milk, and the death of the bacillus of typhoid fever occurs at the end of twenty-four hours, artificial sterilization can hasten this destruction, and kill these germs within a few minutes. So, from a practical standpoint, no matter what may be the germicidal property in the milk, it does not follow that one is warranted to depend on it alone for the sterilization of milk.

The demonstration of the experimentalist named has a great scientific value. Showing, as it does, the microbe killing power of this composition, this experiment proves, or at least indicates, that milk, for a certain time, contains the properties of certain other vital fluids of the body, such as blood-serum, and it also suggests that probably the transmission of certain disease germs from animals to man through raw milk as generally utilized, is, in a measure, prevented by its natural powers. We cannot see that the discovery should in any sense be taken as an indication of a safeguard against individual diseases produced by milk ferments, particularly the various and numerous maladies of the alimentary canal. We would not even consider it a sufficient safeguard against the transmission of such gerras as those of typhoid fever, or other pathogenic germs of a similar nature, because frequently milk is drunk very fresh, several hours before the time which it would require to kill them.Bacteriological World.

Meat-Making in the United States.Meat (Prof. Atwood, in the Century for November) is a manufactured product for which a large amount of raw material is required. The manufacture of meat is a process of transforming the vegetable protein, fats and carbohydrates of grass and grain into the animal protein and fat of beef, pork and mutton. The same principle applies in the production of milk, eggs and other animal foods. In the most economical. feeding of animals it takes a number of pounds of hay or corn to make a pound of beef or pork. In other words, let the farmer make animal protein and fat from vegetable materials in the best way he can, and still he must consume a large quantity of soil product to produce a small amount of animal food. Hence

animal foods are costlier than vegetable. This is the simple explanation of the fact that in most parts of the world meat is the food of only the well-to-do, while the poor live almost entirely on vegetable food. Thus ordinary people in Europe eat but little meat, and in India and China they have none at all. It is hard enough for them to get the nutriment they need in vegetable forms. Meats they can not afford.

But meat-making in the United States to-day is far more wasteful than it need be, on account of the excessive fatness of our meats. This comes about very naturally. We have a great excess of soil product in the valleys of the Ohio and the Mississippi and on the ranches of the West. At present the pork maker and the ranchman convert a large portion of this into very fat meat. The pork producers of the great corngrowing States select the breeds of swine which, as they say, "will take the most corn to market," and have thus got into the way of growing animals that are little else than masses of fat. The beef growers of the Western ranches, and those in the East as well, produce excessively fat meat. Part of the fat is trimmed out of the meat by the butcher, part is left on our plates at the table to go to the soap man or garbage barrel, and part is eaten. Unfortunately very many of us eat much more fat, both in meat and butter, than is needed for nourishment, and thus do injury to our health.--New York Med. Times.

Sulphuring or or Bleaching of Dried Fruit. From an article upon this subject by Dr. Smith (Canada Lancet, Dec., 1891) we learn that it is about fifteen years since the sulphuring or bleaching of dried fruit began. At first only the uniform light color was sought, as in apples, pears, etc., but for some years past nearly all the large evaporating establishments have "sulphured" all kinds of fruits and some vegetables, and now much of the California sun-dried fruit for market is also treated in the same manner. The light color, especially of apples, early attracted unthinking consumers and commercial men, thus materially increasing the price of such fruit. That caused the practice to spread even to those who disapproved of it. The expense and trouble were very slight. Fruit so treated is said to dry more readily, consequently all now prefer to do it. While the apparent change is only in color, there is a loss of the natural fruit flavor, even by the most careful sulphuring. Unfortunately, some people do not notice the difference, but careful comparison shows it, as is admitted by the manufacturers of such fruit. Later investigations have proved the presence of sulphate of zinc, "white vitriol," in all samples of fruit where zinc-surfaced trays were used while drying. Interested parties have charged the German prohibition of American evaporated apples to rival trade opposition, but there is no German fruit to com

pete with them. The real cause was the finding of zinc poison in considerable quantity.-Maryland Med. Journal.

Abortive Treatment of Pneumonia.Moliner says that, having regard to the microbic origin of pneumonia, it is reasonable to suppose that the disease can be aborted by treatment which can arrest the local evolution of the pathogenic culture. On account of the rapid development of the pneumonic infection such treatment can be advantageously applied only within the first forty-eight hours of the

illness. The well known fact that cultures lose their

activity and virulence under the influence of a low temperature suggests local refrigeration of the lung by the application of ice to the affected part and by the inhalation of cold air as a rational method of treatment. Clinical evidence in support of this is afforded by Lees' statistics. An essential adjuvant to the treatment by cold is pulmonary antisepsis secured by inhalations of "balsamic essences;" and in combination with these oxygen, which is antagonistic to the pneumococcus, acts as a powerful antiseptic. As acid substances are also antagonistic to the pneumococcus, it must necessarily be of advantage that the exudations, the inspired air, and all that surrounds the micro-organism should be as acid as possible.

On these grounds Moliner proposes the following "specific abortive" method of treatment for pneu. monia within forty-eight hours of its onset; (1) The application of ice to the spot where the physical signs indicate commencing pneumonia; (2) frequently repeated or almost continuous inhalations of cold air, oxygenated to the extent of one-third and saturated with balsamic essences; (3) rectal injections of sulphuretted hydrogen, sprays of acetic or lactic acid, perhaps injections of hydrofluoric acid, and alcohol in small doses.-British Medical Journal, February,

1892.

Diet in Rheumatism.-Dr. James Frauenfelter gives the following as the best in his experi

ence:

In the early stages of the disease it is not difficult as a rule, to restrict the patient to a suitable diet, as the difficulty usually is to get them to take enough nourishment, but during convalescence, and when the appetite begins to return, then it is difficult to make a patient believe that a good supply of butcher's meat. will retard his progress toward recovery. But as a matter of fact, those of us who have had much experience with rheumatism know that a return to solid food, and more especially the giving of meat too soon, is most likely to be followed by a relapse, because in acute rheumatism the system is loaded with waste products, the result of imperfect assimilation, and the digestive functions are seriously impaired. So long therefore, as the symptoms are acute, small quantities

of milk, with some alkaline water, such as soda or lime water, should form the main part of the diet; besides these a little beef tea, chicken tea or mutton broth may be added. As the temperature falls and the acute symptoms subside, vegetable soups, bread and other starchy foods may be gradually added to the list; gruels, malted foods, arrow root, rice, the yolk of an egg beaten up with milk, and a small quantity of brandy. As convalescence progresses, fish, oysters, and chicken may be allowed once daily. The above line of diet should be adhered to strictly until all symptoms of rheumatism have entirely disappeared. As a rule ales, wines and the stronger alcoholic liquids are objectionable, except where the action of the heart is feeble, or in the latter stage of the disease.-Medical and Surgical Reporter.

Lysol, a New Antiseptic.-Dr. Vondergoltz says since October, 1890, he has used lysol as a disinfectant in all cases of emergency or operation with excellent results.

The field of operation is to be prepared by washing it with a 5 per cent. lysol solution.

He employs a 5 per cent. lysol gauze, and in small pieces uses it for sponging. The gauze is prepared by boiling for three hours in a 5 per cent. solution of lysol and then drying in an oven.

For emergency cases, as in obstetrics, he has used, with the most satisfactory results, pure cotton dipped for about twenty minutes in a hot 2 per cent. solution of lysol and wrung out.

Its deodorizing power is striking. The smell of a putrid vaginal discharge, caused by an inoperable carcinoma cervicis, ceased after an irrigation of thirty minutes with a one-half per cent. solution.

There was no irritation of the tissues except slight burning sensation for ten minutes after the use of a one-half to 2 per cent. solution.-Am. J. Obstet.. Feb., 1892.

Amenorrhoea of Schoolgirls.-Dr. T. A. Reamy in discussing the amenorrhoea of anæmia, common to schoolgirls, says: (1) She must leave school, and must not even study at home. (2) She must spend several hours each day in the In winter open air, either walking or riding. she must, of course, be warmly clad; but must wear no sheepskins or other chest-protecting pads. Standing in the open air, she must be induced to breath

Lysol is obtained by dissolving in fat and saponifying with the aid of alcohol the fraction of tar oil which boils between 190° and 200° C. It is a brown, oily-looking, clear liquid, with a feebly creosote-like odor. It forms clear mixtures at once, in every proportion and all temperatures, with water. It possesses the properties of a saponaceous solution in addition to its germicidal power. While as valuable as bichloride of mercury, it is without any toxic property-a point deeply with the mouth closed; this should be done

to be considered when it is used in cavities, and especially in gynecology and obstetrics. In the latter, and especially in emergency cases, lysol is of the highest value.

In an experience with lysol in more than two hundred cases it has given perfect satisfaction.

In the preparation of material for ligature and suture Dr. Vondergoltz boils the silk wound on glass spools for three hours in a 5 per cent. solution of lysol, so as to be ready shortly before the fixed hour of the operation. For emergency cases he boils the silk in the same way, then puts it in 2 per cent. lysolalcohol till needed. These methods are quick, simple, safe and reliable.

The instruments-after being assured that the nickel-plating is perfect-are washed with a brush in hot pearline water, then washed with a brush in a 5 per cent. solution of lysol, (hot) and after that put in a hot one-half per cent. solution ready for use.

The hands and forearms of the operator and of his assistants must first be rubbed with pure lysol and then washed with a brush in a 1 per cent. hot solution. Just before operating, the hands are to be dipped again in a basin containing a one-third per cent. lysol solution. In this solution the hands and instruments are always dipped if soiled in any way during the operation. This last low percentage prevents the slipperiness against which so many argue.

for at least fifteen or twenty minutes, and be repeated at least twice a day. Nothing that can be done will more rapidly improve the character of her blood. (3) She must sponge her extremities and body each morning on arising from bed. The water must be of the temperature of the room, and she must practice friction freely with an ordinary towel. (4) She must drink plenty of milk and eat plenty of beefsteak. (5) She must take small doses of iron, combined with some bitter tonic, three times a day. Improvement may be somewhat slow, but if this course is faithfully carried out a perfect cure will result, and her education may then be finished.

If this course or its equivalent be not followed, ́these cases will go from bad to worse, and finally die of pulmonary tuberculosis. Arch. Gyn. Obs. and Ped.

The Japanese Hot Box in Inflammations of the Eye.-Dr. Julian J. Chisolm, of Baltimore (Annals of Ophthalm. and Otology, January, 1892), writes as follows in regard to this method of applying heat: Hot cloths are so soothing in relief of eye pains that I determined to experiment with this hot box from Japan. Its size made it a little awkward for eye work, but I found it nevertheless very efficient. It is now one of my most trusted agents for the relief of pain in many eye diseases, such as iritis, scleritis, corneal ulcers and glaucoma. My method of

application is as follows: After inserting the lighted fuse and the box has become warm, I envelop the box in the folds of a handkerchief, and by the ends of the handkerchief secure it to the head. A little loose cotton applied over the closed eye fills up the socket and allows the heat to be transmitted directly to the painful organ. The handkerchief protects the face from the edges of the hot box. Once applied it needs no renewal for two or three hours.

In many cases the relief of pain is magical. In old persons I have avoided the necessity of removing painful eyes lost by glaucoma by the use of this hot box. Previous to its application the disease had resisted both iridectomy and medication local and general.

The Japanese hot boxes and cartridges can be found at all Japanese stores and are also kept by many druggists. They commend themselves for their convenience, simplicity, economy, cleanliness and efficiency as an application for the relief of pain. I find in them the most valuable method of applying dry a remedial agent.-College and Clinical

heat as Record.

Absorption of Proteids.-R. Neumister has made a large number of researches on this subject, which are conveniently grouped in the Zeitsch f. Biologie, 1891, xxvii, p. 309. It is well known that some proteids when introduced directly into the bloodstream are excreted as foreign bodies, while others are not so excreted. Neumister finds that those proteids which, when injected into the blood of dogs, are not excreted by the urine as foreign bodies, but are assimilated, are such proteids as those which, when introduced into the stomach, can pass from the stomach and intestine via the absorptive channels without undergoing change by the digestive processes. They are syntonin and albuminate—that is, alkali-albumen from egg albumen-muscle syntonin, phyto-vitellin from the seeds of the gourd, and pure serum albumen. Those proteids, however, which do not pass into the blood without undergoing change in the process of absorption, are excreted as foreign bodies; for example, normal egg albumen, casein, hæmoglobin, albumoses peptone.-British Medical Journal.

Hygiene in the Barber Shop.-The fundamental principles of hygiene underlie all progress of refined tastes. It is not much to say that we live in one of the most important sanitary periods of the world. We know some of the beneficial agencies, based upon scientific knowledge, by which health is preserved.

Materson observes : "Men live longer and faster than formerly. A man, in these days of steam and electricity, may do more, see more, know more, and if wise, enjoy more than generations of his ancestors.

But he must learn to understand and obey the laws of sanitary science."

As an instance of our carelessness, observe with what indifference we allow the barber and hair dresser to wander over our faces and heads, with hands still reeking and hot from our predecessor in the chair— comb, brush and puff yet warm from the tonsorial manipulations. No wonder that baldness so soon supervenes on our civilized craniums. Admitted that many of the proprietors of tonsorial shops take pains. to keep things clean and what they deem wholesome; that their patrons find no fault; but that it is indifference from habit; and they have not the slightest idea of the danger-never give it a thought, they are too anxious to spring forward when "next" is called! Let it here be stated that asepsis is not enough, but antiseptic means to cleanse and disinfect the armamentarium of the barbers are imperatively demanded to avoid danger from the propagation of disease, transmitted by comb, brush and razor, such as eczema of ear and face, herpes, acne mentagra, cyosis, etc.

Buckley found, in 1,000 cases of skin disease, 8 per cent. of barber's itch transmitted by foul razors or other barber's paraphernalia.

No, cleanliness in this matter is not enough. Disinfection with the proper germicides should never be neglected.

"Mais, au fond, c'est une affaire de toilette privée." But it is also a duty of the sanitarian to hang out the danger signal.-Texas Sanitarian.

Poisonous American Apples.-The Horticultural Times of London has demanded of the Board of Trade that the importation of American apples be forbidden, because apple trees in America are sprayed with Paris green, to protect the fruit against the coddling moth. It has been shown, however, that but one pound of Paris green is used to one hundred done while the apples are very small, and that the and fifty gallons of water, and that the spraying is amount of poison which could possibly remain on ripe apples is practically nothing.-Boston Medical and Surgical Journal.

The Dietetic Treatment of Oxaluria.Dr. A. Winckler, of Wurzburg, states that in the vast majority of cases oxaluria is due to a dietary rich in oxalic acid. For this reason the following foods and beverages are strictly to be prohibited: Cocoa, chocolate, tea, chicory coffee, rye bread, beans, turnips, spinach, rhubarb, salads and fruits. In patients with an oxalic acid diathesis, in whom the oxaluria is attributable to morbid alterations of the chemical processes of digestion in consequence of fermentation of the ingesta, the consumption of sugary and starchy foods must be restricted, as well as effervescent drinks, such as seltzer water, beer, champagne and sour wines. The following foods may be permitted: All

« ForrigeFortsæt »