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between your so-called "suffocativ catarrh" and our well known capillary bronchitis of children, before claiming our attention for an alleged new or unrecognized old disease. S. M. MANN. Grafton, Iowa.
[Doctor, do not toss rocks recklessly till you have protected your own domicile. You speak confidently of easy diagnosis in capillary bronchitis; would you stake your life on the post-mortem findings in confirmation of your diagnosis? We are afraid if we did, we would soon need crape on our sanctum door knob. We may percuss, auscultate, palpate, inspect and then guess, in such cases. Laennec gave more attention to this condition than any other investigator has done since his time; and it was he who gave the affection the term "suffocativ catarrh." Tyson (Practice of Medicin, 1900, page 280) says, "For such a state of affairs the term suffocativ catarrh given by the older authorities is well chosen." Many other of the best authorities prefer such a nomenclature. This discussion is too technical. Doctor, tell us next fall what you do in your cases of capillary bronchitis, and how you make your absolute diagnosis. You write forcibly, and THE WORLD needs to hear more from you. Better let us have something now on some of the summer diseases; it is getting late for pulmonary troubles.-ED.]
Editor MEDICAL WORLD:-In the July number of THE MEDICAL WORLD, 1896, you will find an article on miner's consumption, written by myself. In that article I stated that as long as the men workt in the mills it seemed to retard the rapid advance of the fatal disease.
Working upon this idea, and analyzing the ores workt in the mills running here, I found they contained large quantities of arsenic, sulfur, zinc and iron; and I find by administering these metals as remedies I have had a reasonable amount of success in treating this disease. I also find protoneuclein an excellent addition to the above remedies in these cases. I wish to call attention to the almost uniform fatal termination of said disease. A report from the Miners' Union of Virginia City, Nevada, states that seven-tenths of their loss by death is caused by miner's consumption. J. A. HUNTSMAN, M.D. Austin, Nevada.
Whisky in the Treatment of Snake Bite. Editor MEDICAL WORLD:-I ask to differ from Dr. W. F. Waugh as to whisky not being a specific for rattlesnake bite. If the Doctor had had as much experience in the western country as some of us, he would think quite different. He may have had an extensiv experience along the line of snakes in the boots, and perhaps has been disappointed in his expectation as to the effects of whisky. Doctor, have you had the experience of an attack with a rattler, and his venomous poison in your blood? I have, and have tested the utility of whisky in the treatment of snake bites. I find it to be a sure specific if given in time. J. F. BILBY, M.D. Stroud, Okla.
Carbolic Acid for Rattlesnake Poison. Editor MEDICAL WORLD:-In answer to inquiry for remedy for snake poison in the February WORLD, I would advise carbolic acid, five drops in water every half hour; also apply a cloth wet with a solution of carbolic acid. This cured two Mexicans with limb swollen and black.
San Diego, Cal. DR. H. SCHAFER.
Calcium Sulfid.-Dose of Strychnia.-Com
Editor MEDICAL WORLD:- When read the experience of several physicians on calcium sulfid, as on pages 90-93, March WORLD, we are reminded of the old copy in our copy-books: "Many men of many minds." I have used the drug in a great many cases. In some cases of boils and carbuncles it has "acted like a charm," but in a large majority of cases it has failed to do any good. Several years ago I had a crop of carbuncles on my neck and I took it almost every hour night and day for three weeks. I could not tell that it did any good at all. Nor did any other treatment. They got well "when they got ready," and after I recovered I had better health than I had been having during the previous five years. Did the carbuncles or the calcium sulfid do this? During the time I was taking the calcium sulfid, Dr. H. L. Tynes, of Tynes, Miss., told me to continue the medicine, and I did, as he had been very successful with it in such cases. My failure was not due to an inferior article, for during or about the same time I treated a case of boils successfully with the same lot of medicins. Some of us
have learned to expect too much from its use. As Dr. Waugh says: "It is no specific."
Like Dr. Commons, page 105, when I read of a physician who has had a very large number of cases of pneumonia, membranous croup or other dangerous disease without a single death, I always think some one is "short on diagnosis." If all writers would be very careful in diagnosis, our medical journals would be more valuable.
In regard to the danger point in giving strychnin, pages 93-95, I would say that I have known a man to go from a doctor's office with one-sixth of a grain by hypodermic syringe, and never stop his regular business. The same day another man showed almost alarming symptoms from one-thirtieth of a grain, administered the same way. It is nearly always best to begin with small doses; some people are more easily poisoned than others.
Dr. Pennington, page 112, asks if there could have been any successful treatment for his case of hematoma- -an infant that died when five days old. If astringents applied locally did no good, I doubt very much if anything else would. It is more than probable that the child's death was a blessing, as it might have suffered thru life mentally and physically.
Dr. McCutcheon, of Michigan, page 109, certainly suggests the "oddest of all odd" theories in regard to determining sex. In this matter nature does as she pleases in all cases, regardless of the theories of men, and it is best that it is so. If the doctor would count the "even" and "odd" days from the full or change of the moon, his theory would be more reasonable, at least in our latitude; but how about the Arctic regions, where the days and nights are so long?
The notes on ergot, etc., in hemorrhage from the lungs, page 116, are worthy of careful attention. Ergot has never been a successful remedy for any kind of hemorrhage in my hands. In hemorrhage from the lungs ipecacuanha in large doses, as recommended by Trousseau, has served me well in more cases than any other remedy.
On page 115 the question is askt: "Can two germ diseases exist in the same patient at the same time"? There is more in this question than many realize. In the study of this matter we may find the means of preventing many diseases. That
more than one disease can exist at the same time in the same patient I have no doubt; but I am perfectly satisfied that there are many diseases which cannot
exist two or more at a time in the same patient. C. KENDRICK, M.D. Kendrick, Miss.
"Are Acetanilid and Sweet Spirits of Nitre Incompatible?"
Editor MEDICAL WORLD:-On page 163 of April WORLD Doctor Hart of Ill. makes the above query. Pardon me for saying that these drugs are not in any sense of the word incompatible. I have been using them in combination for several years and have not seen any green color produced, nor any disagreeable results from their administration in combination
in fact I rarely give acetanilid to children until I have first make a solution of it by the addition of sweet spirits of nitre. The drug which Doctor Hart and the Editor had in mind is antipyrin. Try it with your nitre and see the results, provided your sweet spirits of nitre really contains nitrous ether. If your nitre has undergone partial or complete decomposition you will not be likely, or will not, as the case may be, get any reaction. And moreover, the green "which is produced by this combination (iso-nitroso-antipyrin) is not poisonous. DR. W. C. Gordon. Gordonville, Tex.
Editor MEDICAL WORLD:-Dr. J. D. Hart, in April WORLD, asks if acetanilid and spirits nitre are incompatible. I cannot answer that question, but several years ago a number of medical journals publisht articles on the poisonous nature of a combination of antipyrine and spts. nitre dulc. N. C. NUTTING, M.D. Meredith, N. H.
Editor MEDICAL WORLD:-F. S., age 17, out for a hunt, the loaded shotgun was for a time set up against a log. With boyish carelessness, Fred, taking the gun by the barrel, drew it toward him, when the hammer coming in contact with the log was raised, and springing back when released, discharged the whole load directly against his body slightly above the gall bladder, inflicting an ugly wound. He was able to walk home, about one quarter of a mile. His suffering was intense for several hours, except as relieved
by morphin and local applications. Askt if it caused much pain at the time of the accident, he replied he did not feel it. Two shots only, with some wadding, etc., were taken from the wound, which was mostly a contusion and much swollen. The charge past thru a thick, woollen coat and vest, and one thickness of a heavy pair of leather suspenders, many shots being arrested between the two folds. The hole thru the clothes to the skin, except the above, was complete. The whole charge apparently, with the exception of the two shots found in the wound, were discovered in his clothes. The shots were
all very rough and irregular in shape, like we anticipate they would be if thrown in water singly when melted.
The urin for nearly twenty-four hours afterwards was very bloody. Recovery satisfactory.
1. Was it not remarkable that the boy was not killed?
2. What transformed the shots into such shapeless masses?
3. What caused the hematuria? Attercliffe Station, Ont. CHAS. SHUPE.
Report of a Case of Diphtheria. Editor MEDICAL WORLD :-At 10 o'clock a. m., Monday, January 14, 1901, I was called to the bedside of Mr. Frank H.'s little six-year-old daughter. The following symptoms were prominent: aphonia, fever (103°), stertorous breathing, tumefaction about angles of jaw and around the neck, coated tongue, enlarged and inflamed tonsils covered with a filthy-looking white membrane; the nasal cavity was obstructed by the same, and with head mirror and Andrew's tongue depressor the chink of the glottis could be seen covered with the same characteristic membrane.
ful operator would have performed intubation immediately.
The parents stated that the child had been croupy for seven or eight days, not able to speak above a whisper, and sleeping but little at night. She was very restless, no appetite, and had slight bronchitis. They considered it of no great consequence and treated her with domestic
On Monday morning she had an unusually severe suffocativ attack which excited them, and I was called in to take charge of the case. While waiting for the arrival of the antitoxin sent for, I placed the patient upon the following plan of treatment: Every two hours gave a
calomel gr., pulv. bismuth gr. 1, sprayed the nose and throat every hour with the following:
powder consisting of gr.,
Hydrozone Chlorate pot. Pulv. alum. Chloral hyd. Water ..
q.8. ad. 3iij Administered whisky freely.
In addition I applied a flannel cloth wrung out of hot lard all around the neck, in front completely enveloping the throat, changing it every fifteen minutes. Gave warm soup or milk whenever she would consent to swallow it. At times the breathing was so labored it seemed that she would suffocate, the face becoming extremely cyanotic. Each spraying made the breathing much easier for a short At eight p. m. 1000 units of P. D. & Co.'s antidiphtheritic serum was injected into outer side of thigh. Continued the other treatment.
My diagnosis was diphtheria affecting the naso-pharynx, tonsils, and more severely the larynx. The stridulous breathing, the loss of voice, the energetic and desperate use of all the muscles of respiration in the effort of breathing, the cyanosis, the anxious expression of face and appealing look of the eyes for help, and the paroxysmal attacks of suffocation showed plainly and unmistakably that the main trouble was in the larynx. It was evident to all present that the little sufferer would soon pass into the great beyond unless relieved. Perhaps a skill
Patient grew worse. At twelve that night gave another 1000 units in the opposit thigh. Continued other treatment carefully and persistently. Patient continued to become weaker with very feeble and rapid pulse. This made the 2000 units in four hours. I thought she needed the full dose at once, but administered it four hours apart thinking the four hours would have no deleterious effect.
At four a. m., Tuesday, we thought she was dying. We had watcht and workt faithfully all thru the long hours of the night to no purpose it seemed. The pulse was barely perceivable at the wrist. Administered sulf. strych. hypodermically in heroic doses. At six a. m. she had rallied somewhat. I now gave 5 gr.
This preparation was blown into the fauces, and even down into the larynx at times, every two hours, alternating with the spray. Occasionally this caused some momentary strangulation, but it always did good service by clearing out filthy mucus and debris. Continued the minute doses of mercury and ipecac for three days, every two to four hours. About eight a. m., Wednesday, thirty-six hours after beginning the antitoxin, the membrane began to exfoliate considerably, the case steadily improving, but very slowly. Wednesday noon we began to lengthen the time between medicines, giving more time for rest. She could now sleep quietly for a short time, breathing comparatively
I now gave her 1⁄2 gr. sulf. strych., 15 gtts. dil. phosphoric acid, 1 gr. quinin, 1 dram liq. pepsin, every four hours for some time, then six hours apart for a day or two, then three times daily after eating. Pusht the stimulants and nourishing diet now. The spray and powder soon cleaned out the exfoliating membrane and filthy secretions.
On Friday I made my last visit, but had the father to report to me every day for several days. The power of audible articulation is slowly returning.
This was a happy termination of what seemed to be a hopeless case. I verily I verily believe the case would have terminated fatally before the antitoxin could have conquered it but for the vigorous treatment carried out beforehand and during its administration. I believe the gravity of the case warranted the frequent interference by giving medicin, spraying, etc. I also believe strongly in the salutary effects of antitoxin.
Beech Grove, Ky. I. J. ToWNES, M.D.
A Mountain of Trouble.
Editor MEDICAL WORLD:-Mrs. O. B., aged 46 years, and mother of eight children, eldest 21, and youngest 2 years of age. She had always enjoyed good health. Dark hair, brown eyes, of medium size, and in weight about 160 pounds. She descended from a very healthy and longlived family, as she has three aunts now living whose ages are respectively 86, 89 and 96 years. February 24th, 1900, hemorrhage set in without pain. Rest in bed, opium and ergot were used to control it. On the 26th hemorrhage again returned; the same treatment quieted it in about twenty-four hours. On the 27th there was a chill; now pneumonia made its appearance, tho in a mild form. Quinin, Dover's powder, carb. ammonia, aided with turpentine stupes, cured it in about eight days. In the meantime, while the lung was healing, a pain commenced in the right knee, and extended to the foot; the limb became stiff, white and glistening; some inflammation, but entirely helpless. No pain was felt if the limb was left at perfect rest. The lower part of the limb became 'full of boils as large as a cherry stone; these boils contained blood and pus. Bandaged in cotton and sweet oil, these boils healed very readily; yet they left an open cavity. In about five days this limb was of service again. The pain now entered into the left limb at the same place, and acted precisely as in the right. Severe chills, of an hour and at times an hour and a half, accompanied these boils. Chills were irregular, sometimes one in twentyfour hours, and at times two, or even more in that time. A high fever followed the chills. After chill was gone, the patient felt sore over her whole body. Medicins were of no avail in either chills or fever. Sponging in tepid salt water six times in nine hours, reduced the fever three-fourths of a degree. Sponging was relied upon in reducing the fever. A dry, sore, and crackt tongue was an early symptom, and it continued. Bowels and urinary organs continued almost normal. A pale and orange-like appearance of the skin was present towards the last, more noticeable in the face. A good appetite prevailed. Full consciousness remained to the last, as also did speech; the latter gradually fell into a whisper some six or eight hours before death. Death, which was calm and painless, seemed to merge
March 7, at 10 a. m., March 7, at 2 p. m., March 7, at 6 p. m., March 8, at 7 a. m., March 8, at 3 p. m., March 8, at 7 p. m., March 9, at 7 a. m., March 9, at 2 p. m., March 9, at 7 p. m March 10, at 7 a. m., March 10, at 2 p. m., March 10, at 7 p. m., March 11, at 7 a. m., March 11, at 1 p. m., March 11, at 5 p. m., March 12, at 7 a. m., March 12, at 1 p. m., March 12, at 8 p. m., March 13, at 7 a. m., March 13, at 7 p. m.,
Fourteen hours after this last date, or 7 p. m., death had claimed its victim.
The treatment was governed by the symptoms as they appeared.
Diagnosis and treatment of this case is respectfully solicited.. May the Editor also have his say. H. H. BORDNER.
Shamokin Dam, Pa.
[You do not say where the hemorrhage came from, whether from the lungs or uterus. The chills were caused by blood poisoning, and the pneumonia was probably also caused by the septicemia. After the hemorrhage it became a case of blood poisoning, and the symptoms arose from that condition. There may have been decomposing blood at the seat or in the track of the hemorrhage, which was absorbed into the blood. Treatment ould have been addressed accordingly,
not aimed at the symptoms, but at the cause: blood poisoning and its source. The greatest loss that can befall a man is that of a wife like the one above described. We all extend our sympathy.--ED.]
A Case of Choking.
Editor MEDICAL WORLD:-One day last October I was very greatly interested in reading the finishing chapter of "Janice Meredith," when I was very hurriedly called to see a negro woman, age about forty-five,one mile and a half from town, whom the messenger boy said was "choking to death." When I reached her house I found quite a good many of the darktown people gathered in. After they had tried all the remedies they knew of and failed to make her "cough up," they sent for me. The woman was almost unconscious, and almost having convulsions. Her husband said she got choked while eating dinner, and had been that way for over an hour before my arrival. I at once administered o grain apomorphin hypodermically, and in five minutes she threw up a "meat skin" two by four inches. Made an uneventful recovery.
CHARLEY COLVILLE ROSs. Pikeville, Tennessee.
Quinin and Post Partum Hemorrhage. Editor MEDICAL WORLD:-A few years ago I was puzzled to know why cases of post partum hemorrhage had become so frequent in my practise, whereas in a long practise they had been so rare. I had two cases within a short time that flooded freely. In one of the cases I had the women to feel the contracted uterus, and told them what it was, and also told them that whenever they felt that lump there was no danger of flooding. In a short time, however, my patient flooded freely. Soon after this I saw in a medical journal that some physician had collected twelve cases of post partum hemorrhage, claiming that they were due to quinin as an oxytoccic. It flasht upon me that that was the cause of the flooding in my cases. I had gotten into the practise of giving quinin to excite labor pains. I quit it and have had no flooding after labor since, tho I had a case of purpura hemorrhagica in a primipara in which I feared flooding.
I look back some twelve years to a case that was nearing confinement; she had malarial fever. I gave quinin to prevent