Billeder på siden
[ocr errors]

the standpoint of the new etiology, i. e., the pure cultivations must be carried bacteriology of the disease.

through successive generations of the orInfection is considered as an intoxication ganism; (3) a pure cultivation thus obtained in the present article, but is a special intoxi- must, when introduced into the body of a cation by the specific poison of a patho- healthy animal, produce the disease in quesgenic bacterium, and is the result of the tion; (4) in the inoculated animal the same creative synthesis of the bacteria and comes micro-organism must again be found. The from their bodies. These specific poisons germ theory affirms that the microbes are are termed ptomaines or toxines, a name really the sole agent of putrefaction and of given to certain alkaloidal bodies which are

infectious diseases, and, just as the inaniproduced from animal or vegetable sub- mate do not alter and ferment with the stances during putrefaction, and formed by

intervention of microbes, so the process of the action of bacteria on organic matter, the latter is indisputable for the production and constitute a transition stage between

of infectious diseases. an organic and an inorganic condition of At the most active moment of the life of matter in process of putrefaction. Gautier microbes they are said to be devoid of all in 1872 demonstrated the first animal alka- toxic properties, but when they cease 10 loids, and thus far but few exert little or no multiply and become least active their spepoisonous influence, the virulence in cases cific poison becomes alkaline and more and of typhoid fever depending on the amount more toxic. The anatomical lesions in of the alkaloid generated in the body. typhoid do not come from the microbes ás Brieger obtained from cultures of typhoid a living organism, but from their chemical bacilli a ptomaine which he named typho- poison, so there is a close analogy between toxine-C7 H17 NO2—whose physio- microbial toxicology and bacteriology; the logical action was quite poisonous, but former has for its object the study of their having no specific action.

chemical nature. As to the concurrent inThe pathogenic bacteria are characterized

fection of typhoid bacilli in the fetus, its reby their power to develop in the living or

lation to the mother, and the passage of the ganism and to invade it, acting on the ani

bacilli into the fetus, Elberth was able to mal organism by means of the poison which

examine the fetus of a woman sick from they produce. The principal channels of in- typhoid fever and hence procure a decided fection are the water and the atmosphere. proof of the passage of the typhoid fever The materies morbi may also be introduced

bacillus from the organism of the mother to into the economy along with the food

the fetus-Hospital Fiderete (Copenhagen). which is eaten. The typhoid germ inhaled

None of the microbian poisons has been with the air of respiration is arrested by the So well studied as the bacillus of tetanus. epithelium of the fauces and pharynx, and Tizzoni and Cattani found that it was imby deglutition finds its way into the intesti- possible to vaccinate against tetanus aninal canal, where it determines its specific mals that are deprived of their spleen. lesions. There it fixes itself and multiplies In conclusion I must say, considering the in the closed follicles, especially Peyer's

especially Peyer's fecundity of baceria of infectious diseases at patches, and their vicinity. It has been certain times, it would seem as if native learned that certain microbes, separated had, in a cynical moment wreaked venfrom their morbid products, were able to geance on the living organism by making produce determinate diseases, and it is now it a microbian store-house and a synthetic known with certainty that typhoid fever laboratory. T. G. Stephens, V. D., is due to the action of the microbial poison Sidney, Iowa. of the bacillis typhosus—it never occurs de novo.

Non-Development of Cranial Bones.-To ReTo establish the pathogenic character of

store Suppressed Lochia. bacteria, according to Koch, it is necessary

Editor Medical World :-I wish to report that (1) the micro-organism must be found through your valuable journal a case, the in the blood, lymph or diseased tissues of parallel of which I never read of or saw beman or animal suffering from or dead of fore. On the evening of August ist I was the disease; (2) the micro-organism must called to see a primipara in confinement be isolated from the blood lymph or diseased Upon my arrival I found that the child tissues, and cultivated in a suitable media, was born and dead. I made a careful exi. e., outside of the animal body. These amination to learn the cause of death, when years old.


[ocr errors]
[ocr errors]

to my astonishment I discovered the head 25, I was roused from bed to attend the to be a pulpy mass, the cranial bones not patient, her own physician not having rehaving developed sufficiently to protect the sponded to a call made some two hours brain; hence the head, in passing the pelvic previously. I found her in a delirious concanal, was crushed into a homogeneous dition, face congested and dark; pulse 124; mass, a portion of the brain being forced temperature, 103; respiration panting. She out through the nasal passages. I also was frantic and was restrained with diffifound, by further examination, that the culty from the windows. I immediately period of utero gestation was normal, or gave 15 grains of phenacetine and 1-2 gr. nine months. The child weighed 6 pounds. of morphia. In about fifteen minutes she The mother is a healthy lady about 22 recovered consciousness and complained of

The father is also a person in great pain. good health.

The principal points of the above history The mother said she suffered from a se- were elicited hurriedly and hot applications vere fright, or scare, some three or four made to the abdomen. The pains were very months prior to her confinement. Could hard and in a few minutes, on examining, that have caused the deformity? I would I felt the feet coming down. With careful be pleased to hear from others of more manipulation I succeeded in delivering enexperience.

tire the body of a badly decomposed fetus Dr. L. L. Aultz, June World, page 231, of five months. After this the uterine conasks for a prescription for suppressed lo- tractions ceased, and I found it impossible chial discharge. I use the following for- to get the placenta. As the patient was mula, which has never yet failed in my prac- pretty well exhausted I thought it better to tice:

leave her to repose for an hour or so. After R FI. ext. blue cohosh,

that time I made an attempt to remove it. Fl. ext. ergot..

oz. 1 Sweet spts, nitre,

but could find very little, and, as, in my Spts. lavender comp..aa.

M. Sig.-Teaspoonful four times a day. judgment, such things are better not leit, I Trenton, Ia. . Geo. T. Mason, M. D., sent for a brother practitioner to give

chloroform and removed it. On his arrival An Abortion Case.

he did not agree with me, but advised giv

ing ergot and leaving the case to nature. I Editor Medical World:--I have a case

have never done such a thing, but as he which may prove interesting reading. Patient married, one child of 16 months.

spoke highly of the practice I thought I

would try it. No miscarriages. Menses stopped five months before. Had been to family physi

In the meantime her physician arrived cian and was told she was probably not

and made light of the case. Said he: “She pregnant and he thought the cessation due never was in any danger." I of course, to sudden shock from the unexpected death

expected to step out of the case and when of her father some weeks before. After a

the husband brought him to my office, time (two months), it was suggested to him

asked him if he would like to see the child. that “her child is very young and it would

He said: “Oh, no. It can't be of much acbe well to be quite certain.” He then made

count.” I told him it was a five months an examination and pronounced her to be

fetus, and he replied, pityingly: "Oh, doc

tor, you are much mistaken. 'I examined non-pregnant. There is a little confusion in the history just here, as the patient and

her two months ago and she was not pregher husband declare that the situation was

nant then. It can only be four or five

weeks.” accepted gladly and no more was done. But in that case it is a little singular that she

When I showed him the fetus the look of should have begun to take medicine from blank astonishment on his face was somethe same physician and a steady flow began, thing to see. He informed me that he which was allowed to run for eight weeks; would see me in regard to the case the next as her physician said "Since it has begun

day, and I, of course, thought it only a

fraternal courtesy. to come away it had better all come." During all this time she was passing a foul, In the meantime the patient developed a dark discharge, accompanied by several fever and a return of delirium, together with hard, large clots. She called on her physi- a hard chill, and I decided that "ergot and cian several times, but the same state con- nature" must be assisted. They didn't work tinued. Finally, on Sunday morning, Aug. quick enough for me. So I got in a trained


nurse and some chloroform and all the rest On the 29th, four days after the operaand prepared for the operation Monday. tion, the temperature fell to the neighborThis I did at the request of the husband, hood of 99 and a fraction and the pulse to who informed me that he had told the fam- 72. The antiseptic douches of carbolized ily physician that his services would no water were given twice daily. The pulse longer be required in that house. In the went down to 60 on Monday seven days midst of the preparations her physician after the operation, and the temperature came in and insisted on retaining the case. remained at 98 to 99. The patient could The discussion was needless, as I was quite not take stimulants on account of headache ready to step out, but was only acting in and nausea, so arom. spts. of ammonia was the interest of the patient, as her condition used, with good results. did not admit of any further delay. He At the present writing, twelve days after acted very unwisely, as he not only lost his the birth of the child, the patient is able temper, but refused to withdraw to an- to sit up a part of each day and eat solid other room as "his patient might be preju- food. She is yet weak, but improving daily diced against him. He wanted her to have under tonics. her choice in the matter." As soon as she The point I wish to draw attention to is could be made by him to understand the the waiting for "ergot and nature," and I affair she used her freedom in the way of a would like a few opinions (your own esmost emphatic refusal to allow him to con- pecially) on the advisability of such tinue his visits.

course. After his departure I then proceeded with

The whole case is instructive in one way, the operation. The patient was anesthe- as exemplifying ingratitude. The physician tized and after the usual antiseptic precau- in charge has lost his practice in a large tions I introduced my hand into the uterus.

family, his prestige in a great measure (for There was very little to come away, it be- they talk constantly of the case) and his ing a foul dark mess, almost like feces.

own self-respect, all ( as I believe) through There was one small piece at the fundus a foolish yielding to the desires of a perwhich was so firmly fixed that it could not verse woman. Some months ago I lost a be scraped off, and when I desisted through family through such a refusal, but I kept fear of an inverted uterus, it was only par

my practice with all the family but the wotially loosened. There were small clots and man herself, and to-day feel much better a dark foul liquid in the uterus. After every

over the whole thing than this physician thing was cleared out I gave intrauter

can possibly do. If young doctors, and in ine douches of 2 per cent. hot carbolized

fact all, would only look at the matter in water. The patient came out from the chlo

such light they would find no cause for hesroform nicely and was given an opiate for itation when applied to in such cases. rest. However, restlessness and irritability

I advise Dr. Young, page 355, to use set in towards night and distress and fever ethyl chloride in stopped tubes as a local towards morning. The pulse was 124 to

anesthetic. Dr. Maisden, page 355, should 146 and temperature 102 to 105 during the

look to the kidneys of his patient. The night succeeding the operation. At 6 the

diarrhea may be conservative. Dr. Hanext morning the patient suffered from mier, on the same page, will find an exceldyspnea and restlessness. The face was lent recipe for dandruff given in The World pale, with dark circles around mouth and in the issue of last April or May. eyes. The urine had stopped, and, on pass

N. G. Le Grand, M. D., ing a catheter none could be obtained. The Brooklyn, N. Y. respirations were slow and sighing and the (The "ergot and nature" method is oldskin cool and clammy. The patient was fashioned and is now regarded by all wellgiven fresh infusion of digitalis every two informed practitioners as very bad prachours, with the result that urination took tice. The family physician's course was very place after the second dose. The bowels reprehensible.—Ed.) were moved by enema and after an hour half a vessel of foul dark feces were passed, although the bowels had been emptied be

Don't fail to send for a copy of Skin Chart, reduced

from 50c, tɔ 15c. Also “The Physician as a Business fore the Operation. The fever ranged from

Man," reduced from $1 to 50c. 101 to 104 for several days, being controlled MEDICAL WORLD Binder, 35c.; worth much more; by Warburg's tincture, given every 2 hours. 3 for $1, including awl.

Quiz Department.

dog, he was killed immediately after biting

the child and had no symptoms of rabies. Questions are solicited for this Column. Communications

Troy, Pa. not accompanied by the proper name and address of the

Cady Smith, V. D., writer (not necessarily for publication), will not be

noticed. The great number of requests for private answers, for the

Broken Bones. information and benefit of the writer, makes it neces. sary for us to charge a fee for the time required. This

Editor Medical World:-First-Set bone fee will be from one to five dollars, according to the or bones by extensions, counter extension amount of research and writing required.

and manipulation, if necessary.

Second-Keep in place until splints are Editor Medical World:-Will the World's readers kindly send the reports of cases of applied. Retain splints by strips of stout diphtheria treated with antitoxin?

material, long enough to go twice around

on outside of splints, and tie tightly with a I wish to compile statsics ior publication

double bow knot on splint, four to six ties for the benefit of the profession.

will be enough. Please report according to this formula:

Then apply what other (a) Child or (b) adult; (c) time after incep

splints may be required.

Third-Do not use inside roller bandage tion of disease antitoxin was used; (d) quan

to prevent muscular twitching—as well-padtity used; (e) case mild or severe; (f) additional treatment if any; (g) result. Cases

ded splints properly applied will keep evbefore puberty designated as children, after

erything quiet. This method has produced

good results in my hands. puberty as adult.

First few years in practice I made splints Please report all cases. The World will

out of material at hand—shingles, dry get the benefit of the compilation. I have treated two cases with antitoxin

goods boxes, etc. Of late use Welsh's

splints; at the end of a week, plaster or and if you are willing I will send an account

starch bandage, if necessary. of them for publication. A. I. Hunt, M. D.,

On leaving, I tell people that if pressure

is too much, to loosen ties a little, one at a Hamilton Square, N. J.

time, but not so much as to allow of pos(Doctor, we should be pleased to have

sible displacement of splint. By this plan your report of cases.-Ed.)

you can see the injured part at any time and

know that bones are set right. A Recurrent Ailment Attributed to a Former

On August 24 last my right leg was broDog Bite.

ken two inches below knee, by a kick from Editor Medical World:-I wish to report a horse; was knocked back some four feet, a case that to m at least seems peculiar. fell against stable, cutting my head. ImmeMrs. C. brought her little daughter Edna, diately there was conical protrusion of age 7 years, for treatment for an ulcer, one- bones, shortening, foot retracted; pain and half by three-fourths inches, situated three- shock so great it was impossible to more. fourths of an inch beneath the left orbital Wife pulled on foot, which gave some relief. fissure. She gave the following history: First doctor had “never put on splints, did When the child was one and one-half years not know what to do.” Under my direction of age she was bitten at this point by a dog, splints were put on, but badly applied. A since which time once each year, during dog few days after another doctor came. Plasdays, the eye has become inflamed with ter of Paris was put on without extension marked photophobia and purulent dis- or counter extension. That was late in the charge, lasting about twenty days. She evening. Next morning a window was cut then would recover very rapidly. Treatment over the wound; doctor examined, and said: did no good. At this examination the eye “Bones are three-quarters of an inch out of revealed, in addition to the above symp- place." Bandage cut down to toes, foot toms, the ulcer already spoken of, this year depressed, upper end of lower fragments being the first time that an ulcer had formed elevated. Compress under calf then tied at the site of wound. As regards the his- up. That was pain all over again for me tory, I consider the mother healthful. There was quite a flow of blood at first,

The question naturally arises, had the which has now about ceased. To-dar original injury anything to do with the (Sept. 3) wife noticed pus. I have been an above described condition? If not, why invalid more or less from birth. Thirty does conjunctivitis, photophobia, etc., recur years ago doctors said: “You have deposit at the same time each year. As regards the in lungs." Have had cough and free ex

pectoration for many years. Am 65 years Editor Medical World:MI have a case old. I

I am down; want help and sympathy. which I would like to place before the readA notice in The World will be appreciated ers of your journal for diagnosis and treator a letter from any of its subscribers. The ment. pain and confinement has done me harm A man came to me two months ago comTo-day I wrote doctor to come and take plaining of a peculiar feeling in the head. off bandage and put on a lighter one, so History as follows: Age, 35; married; for that I can get out on crutches.

the past two years he has been driving a C. H. Donnelly, M. D. team, doing hard laborer's work. Three Utopia, Texas.

months ago he complained of a feeling as if there was a hole in his brain on the right

side. In connection with it there was a Editor Medical World:-1 desire to

feeling, prickly, hot and feverish, with a thank those who have so kindly answered

heavy weight as though it needed a supmy request for help. I desire help, also, in the following case: Lady, aged 45; weight port, passing over the left side of the face

and down on the neck and sometimes 115; always subject to headaches; mother of

down into the left arm and leg. He says it three children; regular headache in both

is a burning sensation and can only describe temples, back of head and neck. Some

it as a feeling like the touch to a smooth times vomits. Overexertion seems to be

baked apple-kind of sleek feel. It goes a cause sometimes. At times worse at the menstrual period. Headache lasts thirty- hard exercise and mental worry it is worse.

away for a while and returns again; after six to forty-eight hours. Takes two or

When the mind is diverted from business three days to get over the effect of it. Urine

cares and he takes rest he is better. The specific gravity of water. What will help? left eye is not so good as the right. The Filley, Neb S. J. Smith, M. D.

sight is blurred in the left eye. He states: (This would seem at first sight to be the headache of uric acid, but the Doctor gives took a warm bath and stayed in the house

"Yesterday I took your pills as directed and us a surprise in the last sentence. A complete urinalysis would seem to be of the perfectly well, strong and healthy; appetite

and slept nearly all day, and to-day I feel most urgent necessity.-Ed.)

first class—can't get enough to eat.” At

this writing, two days after, the numb senEditor Medical World: August 27 I was

sation has returned in the left leg—a concalled to prescribe for Miss C., who was tracted feeling in calf of leg and under the suffering severely from ivy poisoning. Her knee. The pills referred to above were face and neck were completely covered, and “Waugh's laxative granules,” to act on the her eyes were swollen shut. Her suffering, liver of the patient, as the patient is of a as she described it, was intense. Her fath- bilious temperament. I ordered eight pills, er had been making local applications, and night and morning. The bowels have alhad just given her a one-quarter grain mor

ways been regular, but he is troubled after phine pill

. I prescribed local applications a hearty meal, throwing up his dinner. The of permanganate of potassium dissolved patient is a hearty meat eater, and for years in milk, to be used freely. This seemed has had the habit of eating between meals cooling, and relieved the itching and burn- two or three times. He can't seem to get ing to some extent. In four hours she had enough to eat, and it makes no difference another one-quarter grain morphine pill, al- if he is working out doors or loafing, the so another in four hours more. She con

appetite remains the same. The patient had tinued the permanganate the next day, and a fever seven years ago called typhoid. He I was called in to give a hypodermic injec

was sick nine months and has never aption of morphine. I gave one-third grain, peared the same kind of a man as before but it failed to produce any effect. The

the attack. My treatment for the past few next day the lady was better.

weeks has been iron, quinine and strychnine The question in my mind is: Did the tonic, also phosphorus, nux vom. and iron skin, in its congested condition, absorb suf- pills, alternated. His mother is living ficient quantity of the permanganate of po

and states she had an attack twenty-five tassium to counteract the effect of the mor- years ago called paralysis of the face, causphine R. J. Baird, M. D. ing some distortion of the corner of the

corner mouth-in laughing the

of thie Creston, Ohio.

« ForrigeFortsæt »