Croup and Diphtheria-Systemic Gonorrhea

Organotherapy-Replies.

Editor MEDICAL WORLD:-When the late Sir Morell Mackenzie announced his belief in the identity of membranous croup and and laryngeal diphtheria this conclusion was accepted by me because it harmonized with my individual experience. Out of fifty-four cases of croup and diphtheria occurring in my practise, the two maladies had developt simultaneously, typical croup and typical diphtheria in the same family at the same time, or unmistakable diphtheria infection following croup. One of these cases was in the only child in a neighborhood, a girl of seven, typical membranous croup; and she recovered with laryngeal paraly sis of diphtheritic type. I therefore feel warranted in accepting Mackenzie's acute observations that croup is simply laryngeal diphtheria, and that the reason paralysis does not follow croup is that none of the patients live long enuf to reach the paralytic stage.

But no matter how extensiv is any doctor's experience, he must beware of basing his conclusions upon his own observations exclusivly. He must be always ready to compare and correct them with and by the observations of others.

And I have come to the conclusion that while many cases of membranous croup are really diphtheritic, there are others which are not due to this or any other known micro-organism, but are simply the most acute and violent manifestations of the inflammatory process. This conclusion is This conclusion is based on some observations of my own and numerous reports from others as to the effects of the two calcium salts, the sulphide and the iodide, when used in these cases. When the former is pusht to

full saturation, a grain given every half, one or two hours until the breath smells like a rotten egg, it exerts a powerful control over true diphtheritic processes, a control that cannot be gainsaid or misunderstood by those who have witnest it. Calcium iodide has no apparent effect whatever in these cases, but in others which I believe to be purely inflammatory non-diphtheritic, membranous croup, the reverse is true, the sulphide having no special effect, while the iodide given in doses of gr. every five to ten minutes, subdues the attack in a way that seems little short of marvellous to those who have exhausted the older treatments fruitlessly.

In this instance, in speaking of calcium iodide, I do not refer to the pure chemical salt going by that name, but to the socalled brown iodide of lime, or better, iodized calcium. This is a loose combination of iodine and lime, some of the former remaining free. It must be kept from air and light or the free iodine escapes or combines, and the preparation is inert. Used when activ it has a wonderful control over laryngeal inflammations. I have received many letters from experienced old practitioners, telling me of the surprising subsidence of the croup when this remedy has been given.

This has led me to employ iodized lime in the catarrhal affections of children, generally coryza, pharyngitis, laryngitis and bronchitis. A few grains dissolved in a glass of water, a teaspoonful every five minutes, will often break up a "cold," and dissipate the hyperemia 'before it has really gotten a start. And while the child, if hypercritical, may complain of the "sponge-taste a little, she is not at all apt to prefer castor oil, syrup of ipecac or boneset tea. A few grains of aromatic sugar cover even this slight taste.

Sometimes we get a run of cases of one sort. At present I have under observation three cases of paralysis agitans, two of 16 years' duration, one of 8 years. One of the former has for years taken morphin as a palliativ, the other hyoscin; and the condition of the latter, in general health, intelligence and capacity to enjoy life, as well as in respect to the progress of the malady, is notably the better. The third case developt out of many years suffering with rheumatism, which still afflicts her. Query: How much improvement will we get from quelling the rheumatism?

Already, under the use of strontium iodide the rheumatism is better and the shaking has notably lessened.

Another query: Could the gonococcus be responsible for this malady? My observations on the so-called gonorrheal rheumatism and some other maladies associated with systemic gonococcal infection, have led me to look with deep suspicion on this little Beelzebub. I am strongly suspicious that the gonococcus is responsible for very much more disease than is as yet credited to him. The dependence on him of very many cases of pelvic disease in women, for which the surgeon's aid is invoked, is now acknowledged. The future may show his agency in the production of much "rheumatism," myalgia, neuralgia, myelitis, and among others this paralysis agitans. For it may be laid down as an axiom that for every disease-process there is an exciting cause, and that that cause is either living or dead. In other words, its action is either vital or chemical, including under the latter head affections caused by the presence of substances acting merely as material, as "matter out of place," following the definition of dirt. For many affections the action of the unknown materies morbi of syphilis is determined or inferred. For many others the physician of the twentieth century will look to toxic substances generated in the alimentary canal or elsewhere, or to matter that the eliminants fail to remove from the body. It is safe to say that auto-toxemia will become a very common expression, and that the excretory function of the kidney will be closely scrutinized. And I believe that the gonococcus will be found very many times where his presence is not now suspected. What other known microorganism penetrates so far, keeps on reproducing his kind, and kicks up such a deuce of a row wherever he goes, as this one? Fortunately, in this case we are ready for him. We most devoutly pray that he will be found at the bottom of many such ailments, for we can then use our knowledge to help restrain our lusty young clients within the bounds of chastity; and we have in the sulfides, detectivs we can send anywhere thruout the body to arrest the culprits.

If there are any two subjects upon which more men are ready to theorize than determination of sex and maternal impressions, the writer would like to know of them.

On page 476, December WORLD, Dr. Allen promulgates a theory on the former, without adducing any proof whatever as to its correctness. If there were no proof beyond mere surmise, such theories would be pardonable. But all investigations on this subject seem to point to the general law, that the sex least likely to survive is reproduced, and thus the balance of the sexes is fairly maintained. The slight excess in females may be credited to the greater liability of males to death by accident, which heredity could not take into account.

On the next page Dr. Brunner likewise jumps at conclusions in regard to the causes of two cases of spina bifida, neither of which can rank above bad guesses. How could rubbing the washboard against the mother's belly affect the spine of the fetus floating in the amniotic sac? There is a good, safe ground for the doctor when asked to explain the causes of these and similar phenomena-a world of wisdom is embodied in the magic formula: "I don't know!"

Now as to Dr. Goodman's disbelief in organotherapy: You cannot dispose of a question of fact by alluding to its inherent absurdity or unlikelihood. The most absurd notions have proved true-vide, vaccination. The question is not, is organotherapy absurd, but, is it true? The idea is very ancient. It underlies cannibalism, as savages usually believe that in devouring the bodies of slain enemies they possess themselves of their virtues. The idea undoubtedly survives in the Lord's Supper. Further, most savages believe that partaking of the flesh of animals imparts their qualities. Our Indian tribes ate bears' flesh to become strong, deers' to become swift, foxes' to become sly, etc. But the actual use of thyroid, testicular, adrenal, splenic and other extracts has proved that each of these substances does in fact exercise upon the user an effect to be predicated from the function of the living gland; and that these extracts do not, as was once held, act merely as so much nitrogen, oxygen, e*, or as albumin, gelatin, etc Le пе activ principle be vital fme or independent organism as the leucocyte is deemed, or simply chemical, the activity is unmistakable. I have given testicular extract in many cases of impotence from defectiv testicular secretion and found it effectiv. In fact, I look upon this as the

surest and safest of aphrodisiacs in such

cases.

As to brain-eating, I cannot say; but the effects of blood are far superior to its properties as a nutrient alone. Cooking destroys living elements and ferments, but may not alter chemically acting principles, so that these agents should be taken raw. And if anyone will put up raw brains in a conveniently prescribable shape, I will cheerfully suggest its use to every doctor who does not read THE MEDICAL WORLD.

Chicago, Ill. W. F. WAUGH, M.D.

Treat Both Patient and Disease in Pneumonia.

Editor MEDICAL WORLD: - Somewhat recently I have read several articles on pneumonia and its treatment, in which the authors are pleased to say that they treat the patient and not the disease. Now this is indefinit, and may be misleading. If it is meant that they treat the patient for pneumonia, at all times recognizing the condition of the diseased organ, such expression or treatment may not be criticized. But if it is meant that when the patient shows increasing weakness, maybe great weakness, with the inflammation still unsubdued, with the lungs still greatly congested and engorged, that the antiphlogistic treatment is to be changed for a stimulant and tonic treatment, the benefit of such change may well be doubted. Pneumonia, as well as pleurisy, is a disease highly inflammatory, the patient early showing weakness, not because the inflammation is not of a high synochal grade, but because the lung functions of oxygenizing and decarbonizing the blood are so impaired and lessened that the heart no longer furnishes the system with healthy life-giving blood, but rather with a poisoned, weakening product, weakening all the life powers. Stimulants and tonics are hardly the remedies for this inflamed condition of the lungs, but rather remedies are still required that will lessen the inflammation; that will help to equalize the circulation; remedies, antiphlogistic tho they are, that will do most to relieve the congested and engorged lungs; that will, in a good degree, restore them to their normal functions.

Let us consider the yearly deaths from this disease in this and other countries, as indicated by statistics such as Hector Makenzie, the author, furnishes, who, in analyzing the report of the Registrar General of the United Kingdom, finds nearly

thirty-two thousand deaths annually from this disease alone-a number nearly equal to the deaths from enteric fever, diphtheria, small-pox, measles and scarlet fever put together. When we consider these facts we may well regard pneumonia as a serious, a most formidable disease; and yet I have, for these many years, regarded it as a disease quite amenable to treatment. I write not of the disease in a mild form, but of pneumonia when it has a firm grip on much of the lung tissue. While it is desirable to see this disease early, my observations have been such as to convince me that, seen early or late, the treatment should be a vigorous antiphlogistic treatment. The disease may be regarded as an enemy that will destroy the patient unless itself is destroyed. If it is expected to dislodge this enemy, it must be attacked in force, and having boldly bled the patient, the after treatment is comparativly easy, but must still be antiphlogistic, requiring vigilance, and must be continuous, with no interregnum till the diseased organ is well relieved. In malarious subjects quinin should be given as soon as the force of the disease is broken. Yes, treat the patient, at all times bearing in mind the enemy you have got to destroy. JOHN PHILLIPS, M.D.

Stevens Point, Wis.

to

The Medical Examiners for Life Insurance. Editor MEDICAL WORLD: There is more to an examination of an applicant for life insurance than many examiners at first think. A young M.D. but a few years out of a medical college is appointed examiner for a certain company. An applicant is presented for his inspection: The thought is liable present itself to him that the company merely wishes to know whether this is a healthy man now or not. This is important, but it is not all. He must form a rational opinion whether the applicant will probably live out his expectation, or if, on the endowment plan, whether he will live out the endowment period. In forming this opinion, how many remember the life expectations at the age of the applicant before us? And if we do not remember, how many take pains to look it up?

Another thing the examiner should bear in mind: The facts he is recording in making that certificate are to remain. They are liable to stare him in the face

when he most wishes they had never been written. He may be called upon to defend or explain them in a court of justice before opposing counsel. Then, if he has not done good, conscientious work, the unavailing regret will be that more care had not been taken when he was master of the situation. This will not occur to every one who has done poor work, but it is liable to occur to any one who has.

Let every one, however, bear in mind that his certificate is kept on file, and if there has been no occasion to bring it out before, it will be when proof of that person's death is furnisht the home office. It will then be dragged out of its dusty retreat and again thoroly studied in its relation to the actual cause of death. If he has done good, scientific and conscientious work, he can rejoice as a workman that need not be ashamed. Newport, N. H.

D. M. CURRIER, M.D.

Life Insurance for Both Doctor and Patron. Editor MEDICAL WORLD:-We can not resist suggesting a few thoughts to Dr. M. Dunn, of Colfax, La. (December WORLD, page 481.) Why does he not combine some essential oil with his methylene blue? He may thus prevent strangury, nausea, and other disagreeable after effects. We ordinarily use oil of myristica with the methylene blue; about one drop of the oil to each dose.

Why does not the Doctor, in those pitiful cases, persuade the father to carry life insurance in some good company which guarantees payment at death or reasonable profits at twenty years, if living, long before being attackt by the fatal illness? The uninterested Doctor may be sure of two things: (1) doing something for humanity and (2) not injuring himself, if he secure a $5.00 fee for making the examination. Thus that helpless family might have been protected. Suggest life insurance, but be sure you have the solicitor so firmly that the examinations will come to you. Refuse to make them for less than $5.00, but when you do make them, spend a third of a day on the applicant and then meditate another third of a day on your recommendation to the company before you mail it. You may at least be honest with the company, tho they have not been fair with you. Then go to work and organize all your town, township, or county physicians under an iron clad agreement not to make a life

insurance examination for less than a $5.00 fee.

The solicitor gets from 40 to 100 per cent. of the first annual premium on life insurance, while the doctor gets ordinarily from $1.00 to $5.00, most often but $3.00. The actual cost of insuring a life at 30 years of age is but about $11.00 per year for $1000. These profits go to the company for twenty years or for life, and the solicitor gets a good fee, but the doctor, at his best, gets a paltry $5.00 fee.

With all this, life insurance is a good thing for everybody. thing for everybody. The misguided Doctor needs it worst of all; but he is a dupe and worse than a fool, if he examin, or silently look upon his colleagues examining "risks" for less than a $5.00 fee.

The solicitor is unskilled in science. He was probably a "hired hand" at $15.00 a month before he became a "Solicitor for Assurance." Where is the Doctor's skill and experience?

Dr. Dunn's case has toucht a sentimental spot, but it has stirred our "risibilities" more. Why don't the profession get together for the self protection of themselves, their families, and the profession vs. the entire world. The matter has come to this.

A little business judgment; a modicum of professional activity; a slight push; and then one might take the defense of humanity and the profession against a greedy and scheming world.

Doctor! when you get the next poor man with a large family of young children speak to him about life insurance; a dollar or two a month will secure a nice sum for his family if he should die, and on the endowment plan, would give the same to him if he should live out the period. Pennsylvania.

"SECURITY."

the

Testimonial Fiends. Editor MEDICAL WORLD: As preachers say, I feel that I have a "message sage" for poor, credulous humanity. My message is, "Beware of testimonial fiends." These fiends are of all races, nations and tribes; they speak all languages and dialects; they are of all colors, sizes and previous conditions of servitude; they profess all kinds of religions and no religion at all; they follow all arts, trades, professions and occupations for a livelihood; they belong to both sexes, and if their testimonials are considered competent evidence, most of them have no sex at all

to speak of; they infest and infect all grades of society; they appear to have but little in common except physical and psychological degeneracy. There are many subjects on which these idiots can gratify their ruling passion, but for the purposes of this paper I shall confine myself to the mental and moral degenerates who have a mania for signing pseudomedical testimonials, as this variety is the most numerous, persistent and dangerous.

These testimonial fiends are to the quack what the capper is to the gambler. They serve the medico-religious impostor in the same capacity that the steerer serves the sandbagger; like the painted prostitute, they entice the unwary into robbers' dens; they are as dangerous to the credu lous as the syrens were to the ancient mariners, and if listened to, the result is the same-poverty, insanity, death. They are the decoy ducks and stool pigeons of mankind. On the testimony of these cranks are built all the monstrous systems of psychic hallucinations, medico-religious impositions, pseudo-scientific delusions and systems of organized quackery that rob the confiding invalid of what property, sanity and health he may have.

From the standpoint of the psychologist, the motiv of these maniacs is easily found, and their acts not hard to explain. They are monumental egotists and their craving for notoriety inhibits every faculty that safeguards the normal human being. Notoriety they mistake for fame. A desire to see their ignoble cognomens in print becomes a craze; and if in addition to that they can secure the insertion of a picture of their faces, often deformed by the earmarks of degeneracy and covered with the stigmata of all that is contemptible, base, and idiotic, the cup of their exultation simply runs over. For this, they will cheerfully lay bare for the inspection of friend and foe all the revolting secrets of their lives; for this they will advertise their depravity, debauchery and folly to the world; for this, women supposed to be modest will describe the condition and appearance of their sexual organs in public print for the eyes of all readers; and men will advertise themselves as masturbaters and victims of "lost manhood"; for this, these people are ever ready to proclaim their lechery, drunkenness, drug habits, debauchery, depravity, bestiality and nastiness to all,

with not a thought or care as to how their friends and family may be affected by it.

There is no hope of reformation for the testimonial fiend. You may pray for the harlot with a faint hope that your prayer may be answered; the drunkard and cocain fiend have been known to see the error of their ways and repent; the thief may become honest, and the ordinary liar occasionally speaks the truth; you may labor with the profligate with a slight prospect of success; but for testimonial fiends there is no hope. You cannot shame them, "for they glory in their shame." Logic is beyond their depth, ergo you cannot reason with them. They have no sense of wit or humor, therefore ridicule is lost on them; their judgment is inhibited, hence you cannot appeal to their conscience. Their diseased vanity and distorted egotism inhibits every other faculty.

When

The villainous activity of most evil doers is checkt by sickness and stopt by death. Not so with the testimonial pervert. His ruling passion is strong in death. Practise makes perfect, and as he approaches the end of his nefarious career his testimonials become stronger and more numerous. As he feels his vitality oozing away, he hastens to sign an affidavit that some patented nostrum has rejuvenated him. the pallor of death overspreads his countenance and hectic fever paints his cheeks, he solemnly affirms that some notorious quack to whom he was led by grace divine has cured him. When confined to his bed he will swear in canting phrase, and in what he supposes to be the dialect of the saints, that Christian science has cured him of a dozen incurable diseases that he never had, and proves it by the indubitable evidence of his own testimonials. In turn he certifies that osteopathy, absent treatment, mental science, magnetic healing and every other variety of fraud and idiocy of which he has ever heard, has restored him to robust health, and sends his testimonials to every one whom he thinks will print them. And when he feels the cold, bony hand of Death grasping for his heart strings, he breathes a prayer that his latest testimonials will appear in "Leaves of Healing," and dies happy in the knowledge that while the bull frog croaks a requiem over his lowly grave, his name will be printed in all kinds of "Lost Manhood" publications; and