prejudice and heroic medication-such as large doses of aspirin and all the other coal-tar derivatives and keep his patients in bed for from ten days to two or three weeks, he will cure all his grip-patients or lose not more than 2 or 3 percent of them. J. E. CALLAWAY. Chillicothe, Mo. All depends upon what is meant by "heroic" treatment. Certainly, the management of influenza, as we observed the course of this disease during the last few months, requires energetic and definite treatment, besides great care in the prevention of complications and sequels. Doctor Callaway's treatment, conforming, as it does, to the "indications", as understood by eclectic physicians, as these indications present themselves, undoubtedly is excellent. However, other physicians likewise have been successful in the treatment of their grip-patients, and that by employing remedies and doses that Doctor Callaway probably would criticize as "heroic." We confess to having had during the first one or two days of the disease, a predilection for acetylsalicylic acid, although we are in the habit of guarding the heart, while administering this remedy, with cactin or monobromated camphor. The administration of iodized calcium and of calcium sulphide, both to full effect, may be considered heroic, yet, the practice is clearly indicated and has been productive of good results. Furthermore, the leukopenia, which is characteristic of this form of influenza, is logically combated with nuclein solution, given hypodermically. In general, the treatment of influenza has to be largely symptomatic, that is to say, controlling fever and pain, supporting the heart and the nutrition, relieving the cough, and preventing pulmonary congestion. Lastly, the patients have to be put on some efficient tonic, in order to overcome the weakness following the severe fever-attack. THE INFLUENZA SCOURGE It is 2 o'clock in the night and I am up from a relapse of this "flu" unable to sleep, because of my great nervousness and because one of my twin daughters is now down with this disease. If "war is hell", what is this influenza? And, putting the two together, then, it is what? Doctor, we are just now up against some of the great questions of the age. In our extremity, what shall we do? Nearly all my old-home doctors are dead or dying or sick with this dread disease, including my brother, Dr. A. R. Nason, at Tomnolen, Mississippi. It is awful! Yet, the American is marvelous and we are winning an unprecedented victory over a most atrocious foe. We have struggled so long and so many have had to die of as unconquerable [?-ED.] a disease as the Germans are as foes, before we can enjoy health. We, here, are losing every case of pneumonia, no matter what the treatment that is tried. People are dying without medical attention, because they can not get a doctor, and when they do get one of us, of what good are we? I say, really, of what good are we? Calomel has done more for me than any one thing, save, perhaps, echinacea. What are you doing in Chicago? If you know of anything that will save a poor doctor and his family, tell us of it-yes, wire me immediately. Excuse my poor writing-I am sick. My head is in a whirl, and, when it hits you the second time, there is some boom to it, 1 assure you. I happen to know authoritatively that one night last week 350 died in 5 wards in your own city of Chicago, while next-day's Chicago Tribune named only 250 deaths for the entire city. Darling, Miss. A. L. NASON. That terrible scourge, the "flu", has passed over us. At one time, I was the only doctor able to be up. One came down with the disease early and was abed. Another, in an adjoining county, visited a son ill with pneumonia, and the third doctor was away at the deathbed of his only son, who died at college. Our valley is 15 to 20 miles wide, and, to say that I was kept on the move does not express it. Besides, I had to cross the mountain and do work in another valley, seeing 34 families a day and having from 1 to 8 cases in each house. I had 5 down with pneumonia and lost them all. You never can make me believe that whisky will not cure pneumonia. Iodized calcium did good service, too: the temperature will fall, from 105, to 103 degrees in ten minutes, and then your whisky comes in. Many, many deaths have occurred; never the like of it has been seen in these parts. At present, now and then a new case comes on, but, I think, we are about over with it. For the pains and fever, I use 5 grains of acctylsalicylic acid and 3 grains of quinine sulphate every three hours. I kept the bowels open with calomel, podophyllin, and bilein. I was so tired out that I barely could get up when down. I hope that you escaped an attack. I, myself and my daughter, fortunately, escaped. I kept her close at home. Three-fifths of the victims have sore throat. I used gargle-tablets, composed of sodium salicylate, sodium bicarbonate, and boric acid, 3 grains of each to a glass of water. I ordered gargling every hour. W. S. CLINE. Woodstock, Va. [We print these two letters out of many that were received, as they are characteristic of frequent appeals for assistance that have come to this office. In numerous parts of the country, the members of the medical profession, already overworked on account of the many medical men now being in the service, were, literally, swamped by work; moreover, the epidemic proved so severe in some regions as to be truly a terrible visitation. Whether it is that in our part of the country the disease was less virulent or that we had taken early and prompt precautions, we are grateful, being able to say that we have passed through the epidemic at relatively slight cost. To be sure, there were some deaths in the families of some of our coworkers, but, not many. Most of the patients recovered promptly and returned to their wonted occupations after only brief periods of illness. jections being given to all who would submit to it. In this manner, we are certain that many, who otherwise might have yielded to the infection, preserved their health, while in those few who, nevertheless, became ill, the disease appeared in a very mild form. As to the treatment of the actual disease itself, we have repeatedly expressed our views and refer to the various articles printed in the October, November and December issues of this journal. Of course, we hope that the epidemic may die out speedily all over the country. yet, we must keep in mind that it is likely to recrudesce here and there all through the winter, and, in accordance with the results of epidemiological studies, we are led to believe that an aftermath of the epidemic may possibly make its appearance coming in February or March. For this reason, it behooves all of us to be on our guard and to treat every ordinary "cold" and winter-catarrh energetically and, indeed, as though it were a case of the justly dreaded "influenza".-ED.] TOXIC SYMPTOMS IN INFECTIOUS When in a case of influenza I have a diarrhea, I take it as conservative on the part of nature. Certainly, the elimination of toxins in that way is conservative, for, such patients usually have lower temperature than those without diarrhea. So, I don't treat the diarrhea per se, but take it as an indication for removing the cause, not of the diarrhea alone, but of all the symptoms of influenza as well. See? Now, here is a case of severe night sweats, day sweats too, for that matter. I believe this condition also to be conservative. But, what is, in phthisis, the under In an epidemic like this one of influenza, lying occasion for this increased perspira it is advisable for everybody, no matter how well or "fit" he may feel, to take proper precautions against contracting the disease, inasmuch as it virtually is impossible to escape being exposed to the infection. We have insisted upon a general and careful disinfection of the upper air-passages (nose and throat), by means of a mild antiseptic solution. As soon as the Rosenow influenza-pneumonia bacterin became available, it was freely administered in prophylactic doses, a course of three in tion which should be removed or obviated rather than the sweating itself. This is for publication or not as you please; perhaps it's merely "a foolish Query No. ........", but, I want an answer, and want it d bad. Lincolnville, Maine. ELMER F. GOULD. [We quite and fully agree with you in assuming that diarrhea, fever and night sweats are symptoms of toxemia and evi dences of the attempts on the part of nature to counteract the foreign injurious substances (the infectious bacteria) that have invaded the body, and to remove them as well as the products of their harmful action upon the tissue cells. Whenever something foreign to the organism invades the body, the attempt is made to remove it. Thus, for instance, if a sliver is lodged under the skin, there is an accumulation of white blood cells, then, of pus cells, which loosen the firmly lodged sliver in its bed and tend to remove it outside of the body in the direction of the least resistance. When bacteria invade the organism, mainly through the upper air passages, they also are removed by the production of bronchial and nasal secretions. However, if they find lodgement in the mucous membrane and have succeeded in giving rise to inflammatory manifestations, these in themselves are evidences of the organic resist ance. In this manner fever may appear, and it has often been claimed, as long ago as the days of Sydenham, even before him, that fever is a defensive provision of the organism against injurious outside influences that have entered the body. Fever, though, is due likewise to the development of bacterial and other toxins and represents the endeavor of the organism to form substances that neutralize and disintegrate the toxins-namely, antitoxins, or immune substances. These toxins do not only give rise to fever but may cause various other symptoms, notably diarrhea; and here we come to the question in point. Diarrhea is to be viewed as a reaction on the part of the organism, either to remove irritating substances from the intestinal tract or to eliminate toxic and other noxious elements from the blood. It has been shown that bacteria and their products are eliminated in part through the intestines, in part through the kidneys, and in part, of course, through such anatomical lesions, for instance, tuberculous ulcerations in the lungs and elsewhere, as their action has caused. Undoubtedly, the diarrhea that is often observed in infectious diseases, including influenza, is truly a conservative provision; conservative in so far as it tends to eliminate harmful substances and thereby relieve the body. It should, therefore, not be suppressed by treatment but should be managed in such a manner that the body does not get weakened unduly by the excessive peristaltic function and does not lose too much of intestinal contents that otherwise might be of use. In the case of night sweats, likewise, we have to consider the underlying causes. Night sweats, like diarrhea, are best treated by removing the cause, that is to say, by detoxicating the body rather than by suppressing either night sweats or diarrhea, these being simply disease manifestations and not disease in themselves. In both instances, in diarrhea as well as in night sweats, it has been observed quite correctly that the fever temperature is lower when these symptoms of intoxication are well established. Also, if the symptoms do not become excessive in severity, they usually will be followed by increased well being and by a diminution in the severity of other disease manifestations.-ED.] THE FLU When your back is broke and your eyes are blurred, And your shin bones knock and your tongue is furred, And your tonsils squeak and your hair gets dry, And you're doggone sure you're going to die, But you're skeered you won't and afraid you will Just drag to bed and have your chill, You've got the flu. When your toes curl up and your belt goes flat, And you're twice as mean as a Thomas cat, When your lattice aches and your head's a-buzz, And nothing is as it ever was, You've got the flu. What is it like, this Spanish flu? And fills your craw with moans and groans, And sometimes, may be, you get well, Some call it flu, I call it HELL. ANONYMUS. DOCTOR WAUGH Doctor Waugh was one of nature's noblemen, and to say that I was shocked beyond expression when a recent number of CLINICAL MEDICINE announced his demise puts it mildly indeed. Then it was that his careful words of encouragement and advice, when my daughter-who was the wife of Senator H. W. Grout, of Waterloo, Iowa, was dying of pernicious anemia, and also his tender words of sympathy after her passing at a Colorado sanatorium, came back to me with great force. It means something for a man of our departed friend's caliber and innumerable responsibilities thrust upon him to write letters of sympathy in connection with his medical advice; and, if true nobility of character, honesty of purpose and pure simplicity ever were harmoniously blended it was in the life of Doctor William Francis Waugh. I have a letter of more than usual interest written from his winter home in Texas that I shall treasure as one of my choicest possessions. Few men ever live to leave behind them such a enviable record as has Doctor Waugh. I am truly grateful for the beautiful portrait of him so kindly enclosed with the journal by the publishers. Blaine, Ill. C. M. H. W. CONCERNING HOMEOPATHY I am a homeopath. If that be treason, make the most of it. I am always interested in the things said in CLINICAL MEDICINE anent homeopathy. But, I am even more interested in the relief of suffering and the cure of disease, and that is why I take the magazine. Much that Hahnemann said has been disproved by modern research, but, I often wonder whether the fundamental principles he enunciated are not even more generally recognized now than they ever were in the past. It seems to me that the movement of medical theory among all medical men is increasingly in the direction of "similia similibus curantur". That sounds pretty strong, even to me. This movement, surely, is not appreciated; nevertheless, it may be very real. No one would cry "Anathema" if I should say: "The oldest and best-known example of artificial immunity to disease is vaccination against smallpox, in which by inoculating with an attenuated and harmless form of smallpox (sic!) the vital forces are put on guard and immunity to the real smallpox is established." Or, again, if I should remark that "it has been found that the normal animal body responds to the injection of very small amounts of certain bacterial toxins by the formation of antitoxins that are essentially antidotes to their respective poisons". No one would sit up and take notice. Phylacogens and active immunity are scientific facts. Also, they are homeopathic. Chickenpox, which is not smallpox, leaves something in the body, a phylacogen, that activates the defenders of the body against smallpox infection, which is very similar. An animal product from outside the body puts the body on its guard. This animal product in a healthy body, when in excess, produces symptoms similar to those that in its attenuate form it cures. "This immunity corresponds precisely to the specific character of the vaccination." This is as far as most of my good readers have gone. Come on, boys don't hang back! Guess! Make a good, broad guess, that possibly not only an animal product, but, vegetable and mineral substances as well, that in excess will produce certain symptoms in a well person, will rouse the prophylactic powers of the body to contend with a disease exhibiting those symptoms. The dose should be small enough so as not to overcome the guards, yet, large enough so that it will activate them. A. L. KENNAN. Hillard, Fla. [The contention, that the modern concepts of immunology and the modern methods of immunization are "homeopathic" in their basis, by no means is new, having been advanced by many writers in homeopathic journals and substantiated especially ably by the learned editor of The Hahnemannian Monthly, Dr. G. Harlan Wells. So far, we are quite willing to agree with Doctor Kennan. However, if he reasons, by analogy, that possibly "not only animal products, but, vegetable and mineral substances as well, that in excess will produce certain symptoms in a well person, will arouse the prophylactic power of the body to contend with a disease exhibiting these symptoms," then an unconditional acceptance of his proposition is more difficult. It has to be kept in mind, though, that bacterial substances are not animal, but, in all probability vegetable in nature, the bacteria having been classed with the schizomycetes and other forms of lowest plantlife; while only the protozoa, such as those responsible for the spirilloses, also the plasmodium of malaria and a few others are "animal" organisms. It remains, then, to be inquired into whether higher forms of vegetable substances, such as those making up the vegetable drugs in common use, act upon the organism in the same manner. Since our views of immunity are based largely upon the side-chain theory, according to which substances can be absorbed into the organism if there are present certain specific receptors that are attuned, as it were, to the substances introduced parenterally, it would have to be determined whether the organism possesses receptors "attuned", to, say, digitalis substances or to strychnine or to cocaine, atropine, morphine, and so on. It has been denied that such is the case. At any rate, there is not sufficient information available to determine the question. As to the further assertion, that mineral substances in minute doses may give rise to the same sort of immunity as do lower vegetable substances, that does seem extremely unlikely basically. The question raised by Doctor Kennan is largely speculative and would have to be investigated very carefully before any definite and positive information could be gained concerning it.-ED.] THE ETYMOLOGY OF PIU-PIU The nickname piou-piou (current spelling, piu) is, by French lexicographers, defined as a foot-soldier. However, slang words, arising, as they do, out of the lower strata of a people, are lawless excrescences to which the rules controlling the language can not be applied; while, moreover, the French tongue is peculiarly given to strange mutations of the sounds of speech. Note, for example, peau, pronounced po, is a contraction of Latin pellis, or eau, pronounced oh, is Latin aqua, or, clou, pronounced cloo is Latin clavis. So, then, suppose we take a look at pion, the French equivalent of our "pawn" (at chess), but, which originally is a regular designation for a foot-soldier. However, the original spelling, as also its pronunciation, was peon. But, peon now is the Spanish name for a man held in servitude because of a debt, although normally it means the same as in French. Now consider that our English "pawn" is precisely the same as "peon"; also, that, in chess, the German designation for this is bauer, meaning "farmer". This English word "pawn" formerly was written "paune" and "poun" (vowels sounded as in German), since in Old French it also had the form of "poon". Now to the point. Peon is directly derived from the Latin pes (pedis), French pied, and related to which are, Greek pous, German fuss, English foot. Consequently, peon and pion and pionnier are precisely the same as English "pedestrian"-man on foot, that is, an infantrist. This, of course, does not explain the transformation of pion into piou, unless, as said before, we allow for popular corruption, such as always plays a role in spoken language and of which we today have painful examples galore. At any rate, when one has, for years, followed up the most astounding permutations encountered in etymology, he is ready to accept almost anything half-plausible. Next, we find the word "pioneer" taken from the French, and it means, first, also a foot-soldier, then, modernly, a soldier detailed to prepare the way for the army, and thus, secondarily, one who prepares the wilderness for settlement. Connecting with what was said in the first paragraph, the following digression from the text possibly may be permitted by the Editor, for the purpose of demonstrating the peculiar vicissitudes to which the elements of the Indo-European languages are subject. I have chosen the word water - which, by the way, we here discover to be one of the very oldest elements of this family of human speech. English, water:-O. Fries. wetir, OHG. wazzer, G. wasser, Swed. vat, Dan. vand, Gath. watdh, Russ. voda (cf. vodka), Gr. |