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and a cough enuf to "knock my liver pin into a cockt hat." I could not walk a half mile without resting On the following Monday that brother took me with him on his working train out thirty miles to the end of the track on the upland prairie; there he introduced me to his corps of surveyors, bid me good day, and I was left as I then thought, to die; but as it proved, it was to live, and get well double quick, for in sixty days I had gained twenty pounds-up to my normal weight of 100. Then that wise brother placed me on a salary and let me remain with his surveyors, where I learned lessons more practical than I would had I not contracted the scourge of consumption. During the following winter (1857) we experienced a financial upsetting worse than any we have had since, and along with it came one of the most uncommon freshets, which knockt our new railroad "galletwest," and so crippled it that the managers did not know which way to turn. My brother wanted me to get more education and offered to help me thru college if I would go East and try it, which I did to my sorrow; for within one year I was nearly as bad off with consumption as when I went west before. I lost no time in making the second change, this time going on the upland prairies of central Iowa and workt at farming for six years, and I enjoyed good health. 1875 found me in Hahnemann medical College-from the plow to hold my end of the medical double-tree even with students fresh from literary colleges. I graduated in due time and immediately got into practise. Were I to tell all my experiences in private and hospital practise it would take at least one whole number of THE WORLD. So we will proceed to jump from 1876 up to 1891, when I found myself under "home-rule government" " from a severe fall which came near getting my tickets into the Kingdom taken up. It was during this time that Koch launcht his "lymph" treatment for consumption, which the medical profession was so ready to try on. I had only to recuperate from my fall, read the thousands of columns of press notices of his wonderful discovery, until one day it came to my mind to try my hand at criticising what I concluded would soon prove to be a gigantic “fad." I bethought how I had been cured from consumption by a radical change of climate, and that I had known of others get
ting similar benefits. So I made a "rush " to get an organization started, but I was not known outside a small circle. So I enlisted one prominent doctor in Chicago, T. O. Duncan, who was able to enlist others, and before August 1891 we had our organization which we called the American Health Resort Association in activ operation. I was appointed one of two special commissioners to make a study of climatic influences and mineral waters in our country for the benefit of the medical profession in America and Europe. I have devoted nine tenths of my time to this most enticing subject ever since, and now am only in the "primer class" along this line; but we have been able to prove thru our efforts that more than ninety per cent of the victims of consumption can be restored to health in a similar manner to that in which I was restored.
W. PINCKNEY ROBERTS, M.D.
[Dr. Roberts will continue his observations on climatic cure for consumption in next issue.-ED.]
The Sin of Mouth Breathing.
Editor MEDICAL WORLD: Mouth breathing is a physiological sin; and as such, is punisht by disease. We cannot violate any law, whether it be civil, moral or natural, without a penalty. The nose was made to breathe thru, and is an organ of respiration; the use of the mouth for habitual breathing purposes is a physiological sin, a violation of law, a perversion of function, and is justly followed by disease. It is a wise provision of nature to provide man with an extra breathing channel in case of emergency, but it is wrong to use this supplementary breathing channel habitually to the partial or entire neglect of the natural passage, the
Because a person can crawl on hands and knees, it is no reason he should do so to the exclusion of walking on the feet; and yet that is a parallel instance. Habitual crawling results in deformity and disease in hands and knees, and the feet become impaired and useless from disuse.
The deformity of the features, the result of mouth breathing, is very evident; the open mouth, exposed teeth, vacant stare, short upper lip, drooping jaw, give an expression almost idiotic, and is certainly a reproach to the human form divine.
Mouth breathing is a very common
habit; observe as you meet persons, and you will find many with separated lips, breathing thru the mouth during the day, whilst during sleep, many more-very many more-breathe thru the mouth.
Observation indicates that a large per cent. of persons are more or less addicted to mouth breathing, either day or night. Unless the fond mother takes the precaution to close the ruby lips of the little cherubs, and exercise more care with the children, this per cent. will greatly in crease in the coming years. There is no good reason why a child should be allowed to keep its mouth opened, and acquire the pernicious habit of mouth breathing, with evil consequences.
Every person knows that such diseases as catarrh, enlarged tonsils, sore throat and deafness are largely on the increase. Did it ever occur to you (if not, may this appeal reach with such force as to command attention and cause you to stop and think) that there must be a cause for the prevalence of these diseases? And that cause, in many cases, is mouth breathing. It is not possible to openly and persistently violate a natural, physiological law and not reap the consequences. Laws were mide to be observed, and not violated.
The inhaled air, in its passage thru the nose is increased in temperature, deprived of dust, foreign matter, and receives a certain amount of moisture, so that when it comes in contact with the delicate structures of the throat, larynx and lungs it is so modified as to have only a pleasant and healthful effect upon these surfaces; whereas, if the air enters directly thru the mouth, it is cold, dust laden, and devoid of moisture, and has the effect to irritate the tonsils, throat, bronchial tubes, vocal organs, and all the respiratory tract ; this is why mouth breathing is attended with such evil results as catarrh, cough, tickling and dryness of throat.
Many cases of deafness and ringing in the ears in persons of mature years, and in those who have past middle life, are due to mouth breathing; in such, the normal ventilation of the eustachian tube is deficient, hence follows tinnitus and deafness.
Just here allow me to state that tinnitus is an early symptom of oncoming deafness, and the subject should take immediate steps to prevent mouth breathing, and thereby prevent loss of hearing. In Mouth breathing the normal ventilation
of the eustachian tube is interfered with, hence ringing or noise in the ears, with deafness following.
In children, teach them to keep the mouth closed, by closing the lips during sleep, and frequently reminding the child to close the mouth during waking hours. Keep constantly reminding them to close the mouth; never relax the effort until successful. In older children, teach them the evil consequences of the habit; that it mars the features; that with open mouth and exposed teeth no face can claim personal beauty. Make an open and earnest appeal to their reason and individual pride; this will accomplish much.
In adult life, and especially in those who have past some years beyond maturity, it is more difficult to overcome; the habit is fixt, and the parts have adapted themselves to new conditions, and this must be overcome if we cure the results of mouth breathing.
Various measures may be used to overcome oral breathing during sleep, some of which we will mention. Lie on the side, as the mouth is apt to come open while lying on the back. Tie a small pillow, or tuck a portion of the covering under the chin; this gives useful support in some young cases. Paste the lips together with bits of adhesiv plaster. Pass a bandage under chin and over head. This is good, but so uncomfortable that few will use it.
I hope this paper will be sufficient to enlist the attention of the medical profession in regard to the evils of oral respiration, and that a well directed effort may be made toward the prevention of the practise. N. R. GORDON, M.D. Springfield, Ill.
Milk Douche for Catarrh.
Editor MEDICAL WORLD.-Having noticed a request in the October WORLD, page 444, for some one to suggest a cure for "Doctor's Daughter's" catarrh, allow me to say thru the columns of your valuable journal, my most reliable remedy is fresh cow's milk, supported by tonics, cod liver oil, etc., as the case may indicate. In order to explain my role of treatment fully, I will cite a case that occurred in my practise some four or five years ago, as that would be more in evidence of an establisht cure than one of a recent date.
A young man about 17 years of age came into the office one evening, and after introducing himself as a new comer to the
place, etc., stated that he was a sufferer from head trouble; that he had doctored until he was almost disheartened; yet was willing to place himself in my care providing I did not put him on the same old routine of treatment that he had already gone thru. He was six feet tall; very pale, and anemic, quite erect, and possest but little confidence either in himself or any one else. His occupation was working in a creamery with his father, the worst place he could find almost, on account of the damp and wet. After giving his head a thoro examination for obstructions, as adenoid growths, etc., and finding nothing, only a thickened, reddened membrane, with a foul heavy mucous discharge from both nares, I told him it lay in his power to cure himself if he would follow out my directions, and be willing to continue for six months at least. To this he agreed, provided, if at the expiration of a month or two, he could experience enuf improvement to encourage him to go on.
After pledging himself to assist all he possibly could in his own behalf, I handed him a quart glass bottle nasal douche with full instructions to wash out the head thoroly morning and evening regularly, with warm cows milk, using not less than a pint each time; also to reverse the nozzle from one nostril to the other, after the fluid began to flow; and never to forget to scald out the instrument well after each sitting; to follow these directions faithfully for one week, then report at the office. He claimed he had a fairly good appetite, therefore, I gave him no tonic; but I ordered pure cod liver oil; to begin by taking half teaspoonful, and increase. gradually up to a dessertspoonful before each meal. Advised woollen underwear to be put on immediately; to keep his feet dry, and take all the open air exercise he could, all of which he put into effect.
At the expiration of the six months, he walkt into the office and pronounced himself a well young man. But oh, dear! how proud! because he had assisted in bringing about his own recovery. He is the picture of health to-day, has prospered, is the possessor of a creamery of his own, and bids fair to become wealthy.
In some cases where the patient is very anemic, would advise iron given in some convenient form. It being a constitutional trouble, all attention must be paid to build
ing up the system along with the local treatment, or else our efforts will all be of no avail. It is also very important for patients to be very regular and prudent in all their daily habits.
Will conclude by saying that the above treatment has given much better results in my hands than any nebulizer I have ever tried; besides it is simple and inexpensiv. Will say to "Doctor's Daughter," that should she deem it worthy of trial, I would be very much pleased to learn the result. J. W. SILVARA, M.D. Ringoes, N. J.
Reply to " A Doctor's Daughter." Editor MEDICAL WORLD:-Having devoted several years to the study and treatment of tuberculosis, during which time I have seen hundreds of cases representing every stage and phase of the disease in individuals of nearly all ages and conditions, I feel that a duty would be shirkt if I failed to say something in response to the appeal of "A Doctor's Daughter" (page 444, October WORLD).
Her case has been diagnosed as catarrh. When we recall that catarrh is an inflammation of mucous membrane, it is seen that but little has yet been learned of this particular case. This much of the diagnosis is evident to most anyone. To recognize the cause of the inflammation is quite another thing, and it is this that often taxes the resources of the physician and makes experience count for so much.
As no history has been given of onset, development and progress, an opinion will be of less value than if it was made upon deductions from a fuller knowledge of her disease. But there are a few cardinal indications that bring up a train of thought, of which I will speak briefly.
One of the most common causes of chronic inflammation of the nas-opharynx is mechanico physiological, if you will allow the term. It is produced by hypernutrition of a local area, resulting in an overgrowth of the tissues of the affected part. The consequence is some degree of obstruction, which tends to mouth beathing. If the obstruction is bilateral and complete, mouth breathing is absolute. In addition to the drying of the epithelium of the tongue, which results in varying degrees of its decomposition, the air current impinges unheated against the pharynx, disordering its local circulation, and enters the lungs without the steriliz
ing influence of the normal bactericidal nasal secretion. At the same time there is behind the obstruction, whether partial or complete, a stratum of rarefied air which acts as a constant source of irritation to the part. The effect of this prolonged irritation is engorgement, first of the superficial capillaries, later the deeper ones, and finally a continuous congestion with excessiv mucous secretion with exfoliation of the external layer of the membranous cells, and lastly erosion and ulceration.
This is the typical course, but if the person is robust, if he lives much in the open air, if he is free from inherited or acquired weakness, and if he is not handicapt by the many other things which make life a survival of the fittest, these changes may be arrested at any point between slightest irritation and bony
Probably the next most common cause of post-nasal and pharyngeal inflammation is that dyscrasia whose chief manifestation is lowered vitality. There is usually no recognizable form of disease present, yet we believe such persons will hardly live their expectancy. There appears to be some modification of the constituents of the body which, if it were possible to trace to its origin, would be found back of the first principles of life itself.
The mucous membrane of this class, the same as other parts of the body, is very vulnerable; a slight irritation will produce great effect. A septal spur, a hypertrophied turbinal, or any other disorder regarded as trivial in other cases, may be followed by most unpleasant symptoms. In persons of this type we generally obcerve polypoid degenerations and excessiv lymphoid growth. It is from among these that the largest compliment of recruits are furnisht to the ranks of the tuberculous, for they supply that peculiar soil in which the bacilli thrive best, and from which they are hardest to uproot.
I would advise "A Doctor's Daughter" to have the nose and throat examined by a competent physician. If any enlargements are found, have them removed or reduced. Correct any defect in the throat, and get the tonsils removed if they are enlar 1. Any tonsil that projects beyond the pilla is enlarged.
The condition of the mucous membrane of the upper respiratory tract, and the pains in the chest, imperativly demand
that the condition of the lungs be fully investigated. Go a long way if need be to find a physician who is expert in this line of work, and who knows that he knows how to interpret any abnormal evidences that may be present. If he is still uncertain after two or three examinations, have him give you a hypodermatic injection of tuberculin, purified, or watery extract of tubercle bacilli (von Ruck). This, when properly done, is without danger, and is almost absolutely certain. In addition to this the pulse and temperature should be observed, before and after the use of the tuberculin. The former should be noted several times daily under varying degrees of rest and exercise. The latter, every two hours from the rising to the bed hour. Be sure that the mercury has been shaken down to 96° each time before taking the temperature observation. A persistently low is as significant as a high temperature. A series of unpublisht cases warrant this statement.
If tuberculosis is found to be the cause of the troubles, don't despair of the result: The disease is very curable in its early stage, when the patient is properly cared for and treated. Do not waste time hoping that the doctor may be mistaken, and that you are one of fortune's favorits. Go to an institution in a proper climate for the exclusiv treatment of tuberculosis, and put yourself under such care. There you get every detail of your daily life overseen, and every effort is made to bear on the single end of cure. Do this and you will then have every opportunity that modern therapeutics can offer for your recovery-and they are many.
LOUIS FIELDING HIGH, M.D. Southern Pines, N. C.
Editor MEDICAL WORLD:-In answer to "A Doctor's Daughter," concerning her case of catarrh, described in the October WORLD, I will say: Take impalpable pow der of boracic acid, and dust it into the nares with a powder blower, or by snuffing it up the nose, till it causes a slight burning sensation, but not enuf to cause severe pain. This will cleanse the mucous membrane and stimulate it to healthy action. Once a day is enuf. In addition to this local application, dress the body, particularly the chest, neck and arms, warmly, so that the circulation of blood in the skin will be activ, thereby relieving the mucous membrane of engorgement.
bles; also whether she overeats, drinks coffee, wears thin soles, etc. A. F. RANDALL, M.D. Port Huron, Mich.
Editor MEDICAL WORLD :-On page 444 "A Doctor's Daughter" asks for a remedy for catarrh that she says her father cannot cure. Simple catarrh is easily cured, but I suspect that this case is not catarrh, but some faulty construction of the nasal tract. If the nasal tract is clear-if she can at all times breath readily thru her nose, either side, then the case is simple and all these cases that the patient breathe easily remedied. First, it is necessary in thru the nose at all times, particularly at night. In order to accomplish this the patient must sleep on her side. Nasal catarrh never causes lung trouble, but mouth breathing sets up lung trouble very frequently, which is the forerunner of consumption. Let this young lady learn to breathe with her mouth shut always, and sleep physiologically; that is, on the right side principally, but always on the side and never on the back. Have her nose and throat treated twice daily with her globe nebulizer, using Dobell's solution. If the tonsils are enlarged, rough and
crevassed, her father should brush them three or four times weekly with a mild solution of nitrate of silver. She should take ten drops of tr. ferri chlor. in water
before her meals. If this treatment is carried out, she will get rid of her trouble. However, this young lady may live in a malarial district; if so, then she must take enuf quinin to eliminate the malaria, and take brisk exercise in the sunshine at least one hour every fair day, remembering always to breathe thru the nose. JAMES W. McCoy, M.D. Wheeling, W. Va.
Editor MEDICAL WORLD:-In October WORLD page 444, " A Doctor's Daughter" inquires for a cure for catarrh. She asks something that can not be promist. I would advise the lady to get a nasal douche holding one pint, also a quantity of nasal tablets of the formula of Dr. Carl Seiler, in the Medical Record, Feb. 27, 1888. [This formula has appeared several times in WORLD.-Ed.] Dissolv eight tablets in one pint of warm filtered water, pass the liquid thru each nostril in succession, using, all told, one pint (or one-half