Alcohol, a Dangerous and Unnecessary Medicine/Chapter 8
CHAPTER VIII.
DISEASES, AND THEIR TREATMENT WITHOUT ALCOHOL.
The question, "What shall I take instead of wine, beer or brandy?" is frequently asked by those who have been trained to think some form of alcohol really necessary to the cure of disease, but, who, from principle would prefer other agents, if they knew of any equal in effect. This chapter deals somewhat with the answer to that question.
Alcoholic Craving:—The craving for alcohol may be present for a time after a person has commenced to abstain from all beverages containing it. Or, it may occur periodically, as a sort of irresistible impulse. For the periodical craving Dr. Higginbotham, of England, recommends that a half drachm of ipecacuanha be taken so as to produce full vomiting. He says the desire for intoxicating drinks will be immediately removed. The craving is caused by vitiated secretions of the stomach; the vomiting removes these. Dr. Higginbotham says:—
"If a patient can be persuaded to follow the emetic plan for a few times when the periodical attacks come on, he will be effectually cured."
Some men in trying to abstain have found the use of fresh fruit, especially apples, very helpful. Nourishing and digestible food should be taken somewhat frequently. A cup of hot milk or hot coffee taken at the right moment has saved some.
Anæmia:—In this complaint there is a deficiency of the red corpuscles of the blood. It may be the result of some fever or exhausting illness; it may accompany dyspepsia, and is then due to imperfect digestion and assimilation of the food. The poverty of the blood produces shortness of breath, and often palpitation of the heart also, especially on a little exertion. There is generally more or less weariness, languor and debility, sometimes also giddiness, sickness, fainting and neuralgia.
"In the treatment of anæmia, port wine and other alcoholic liquors are worse than useless."—Dr. J. J. Ridge, London.
"The common prescription of wine or some form of spirits for states of general exhaustion and anæmia, is a serious mistake. It assumes that the temporary increase in the action of the heart is renewed vigor, and that some power is added to the failing energies. This theory rests solely on the statement of the patient that he feels better. In reality the exhaustion is intensified, though covered up."—Medical Pioneer.
"Deficiency of nutrition, of light and of pure air may be mentioned as common causes of anæmia. ***** It is evident that the first step in the treatment of this disease is to remove the cause. If the cause is dyspepsia, this must receive attention; if intestinal parasites, they must be dislodged; if prolonged nursing, nursing must be interdicted; if too little food, a larger quantity of nourishing, wholesome food must be employed. Such simple and easily digested foods as eggs, poached or boiled, boiled milk, kumyzoon, good buttermilk, purée of peas, beans or lentils, boiled rice, well-cooked gruels and other preparations of grains are suitable. Beef tea and extracts are worthless. *****
"A careful course of physical training is essential to securing perfect recovery in cases of chronic anæmia due to digestion, or any other serious disturbance of the nutritive processes."—Dr. J. H. Kellogg.
Appetite, Loss of:—"There is often disinclination for food because it is not required. Many cannot eat much breakfast, because they have had a hearty supper. Or having had both a hearty breakfast and luncheon, they feel but little desire for a dinner of four or five courses. Generally the stomach is right and the habits wrong. What is to be done then, for such lack of appetite? Simply go without food until appetite comes.
"When ale or beer is taken regularly with meals the stomach learns to expect them, and the food is not relished without them. The appetizing power of beer and bitter ales is chiefly due to the hop or other bitter ingredients which they contain. When it seems necessary to assist the appetite temporarily, a small quantity of simple infusion of hops may be taken.
"Sometimes appetite fails because of exhaustion of body and mind. This may be nature's warning against overwork, and cannot be neglected with impunity. Life will inevitably be shortened if it is found necessary to rely upon the aid of alcohol in any form in order to do a day's work.
"Bouillon, or beef soup, at the beginning of a meal are in centives to appetite. Change of scene, and life in the open air are the very best aids to appetite, when aids are really required."
Apoplexy:— "There is a popular idea that whenever a person is taken ill with giddiness, fainting or insensibility, brandy should be at once procured and poured down his throat. Nothing can be more dangerous in apoplexy. This disease is due to the bursting of some blood-vessel in the head, and the poured-out blood presses on the brain and leads to more or less insensibility. If fainting occurs, it may possibly save the patient's life, because then the blood-vessels contract, and the flow of blood ceases immediately; time is thus given for the ruptured blood-vessel to became sealed up by a clot, which will prevent further loss of blood. If brandy is given, there is, first, great risk of choking the patient: if that danger is escaped and the brandy is swallowed and absorbed, the vessels become relaxed and the heart recovers its force; hence the ruptured vessel, if not sufficiently sealed by clot, may be started again, and fatal hemorrhage result.
"The only treatment which unskilled hands can adopt is to lay the patient on his back on the floor or sofa with the head and shoulders somewhat raised; to loosen all the dress round the neck and body; to apply cold to the head and hot flannels or a hot bottle to the feet and hands, or to soak them in hot mustard and water, and to gently rub the arms and legs."—Dr. J. J. Ridge.
Dr. Alfred Smee, surgeon to the Bank of England, says:—
"Give nothing by the mouth. Apply a stream of cold water to the head. If the feet are cold apply warm cloths. If relief is not soon obtained, apply hot fomentations to the abdomen, keeping the head erect."
Bed-Sores:—Some object to using alcohol even as an outward application. Dr. Ridge recommends that when a patient is confined to bed the parts pressed on be well washed every day with strong salt and water or alum water, and carefully dried. Glycerine of Tannin may then be applied. If any redness appears, especially if any dusky patch is formed, collodion may be applied with a brush, and all pressure should be taken off the part by a circular air-pillow or by a cushion; or small bran or sand-bags may be made and carefully arranged. If the skin is broken, zinc or resin ointment may be applied.
Some recommend finely powdered iodoform sprinkled over the surface of the sore.
Boils and Carbuncle:— "In many cases these troubles result from an overloaded condition of the system, which is the result of taking too much food, or some error in diet. The boils are an effort of nature to be rid of offending matter. In some cases they are due to the use of impure water, or the presence of sewer gas in the house. In others, overwork, or other debilitating causes, may have produced the state of the digestive organs which usually causes the boils. Carbuncle is, essentially, an extensive boil.
"Apply iodine early or a piece of belladonna plaster. The diet should be plain and unstimulating, condiments being avoided and plenty of fresh vegetables taken, if possible. Fresh-air, exercise and proper rest should be obtained, and late hours avoided.
"Medical advice is requisite in carbuncle. The popular notion that port wine is absolutely necessary is both erroneous and mischievous." Ridge.
Catarrh:—Among the causes are repeated colds; errors in diet, especially excess in the use of fats and sugar, and an inactive state of the liver.
Cut off from your bill of fare all salted foods, avoid fats and condiments; drink freely of pure water; live in the open-air and sunshine as much as possible, taking much out-door exercise. Take a cold sponge or towel bath every morning, beginning at the face and finishing by plunging the feet into a foot-tub. Follow with vigorous rubbing with a crash or Turkish towel. Those subject to sore throat should hold the head over a basin of cold water and lave the neck with the water for about two minutes. The writer was formerly subject to frequent sore throats, but has had none for over two years, as she believes, because of the adoption of this measure, together with the towel bath every morning, summer and winter.
Care should be taken to avoid exposure to draughts, or any other means which will produce liability to cold. Care in diet, good ventilation and the morning cold bath are essential if a radical cure is desired. Local measures, while giving relief, will not remove the predisposing causes. Dr. Kellogg recommends saline solutions in the form of the nasal douche, a teaspoonful of salt to a pint of soft water, adding twenty to thirty drops of carbolic acid, if there is offensive odor, as a relief measure.
Sleeping in a poorly ventilated room is said to be one cause of catarrh.
Hay Fever is a form of catarrh. The vapor bath is recommended as very helpful in this trouble. Nature Cure says that two vapor baths and a two or three days' fast will cure any case of hay fever. The use of pork and other clogging foods should be avoided by those afflicted with this trouble. The bowels should be kept in good condition. If constipated, the use of prunes, figs, grapes, apples and other such fruits will be very beneficial; walking, and massage of the bowels, being added if the fruits are not sufficient. No one able to walk should depend upon drugs to relieve a constipated condition.
Colds—:"If the bowels are constipated, the skin over-burdened and clogged with bilious matter, and the lungs weak, it is as easy to take cold as to roll off a log. If, on the contrary, the lungs are well developed, and the respiratory power large, providing abundant oxygen to keep bright the internal fires, the colon clean, the skin daily washed, and the system hardened by the cold bath, taking cold is next to impossible.
"The first remedial agent for a cold should be a copious enema. Then open the pores of the skin by a hot bath; take a glass of hot lemonade and go to bed."—The New Hygiene.
Chills: For chill, take a hot foot and hand bath, with mustard in the water, ¼ pound to a gallon; then go to bed in a well ventilated room. Drink freely of hot lemonade or hot water. Catarrh, colds and hay fever may all be effectually relieved by hot baths. Relief may be gained also from inhaling the vapor from pine needles or hemlock leaves. Put them in a bowl, pour boiling water over them, hold the face down over the bowl, the head being covered, and inhale the vapor well up into the nostrils and head. A few drops of hemlock oil in the hot water will do as well.
Coughs and Hoarness;—Boil flaxseed in pint water, strain, add two teaspoons honey, 1 ounce rock candy, and juice 3 lemons. Drink hot. Also; roast a lemon till hot, cut, and squeeze on 3 ounces powdered sugar.
Colic: This may arise from cold, or from error in diet. If the latter it is desirable to induce vomiting. For the pain, apply hot flannels or fomentations; drink hot water. In severe cases, sprinkle a little turpentine on flannel, wrung from hot water, and apply to abdomen. Colic resulting from the accumulation of fecal matter should be treated with hot enemas until relieved. A hot hip-bath is sometimes necessary to relief.
The colic of children and infants should never be treated with alcoholics. In infants it generally arises from excessive or improper feeding; care should be taken that the milk provided them is not sour.
In severe cases the babe should be immersed in warm water, keeping the head above water, of course. This is also the best remedy in convulsions. The hot bath, with a copious enema of warm water, has saved the lives of many babes.
For adults, hot water, with a pinch of red pepper added, will do all that brandy can do, and more.
Cholera:—Brandy has been considered by many a really necessary medicine in cholera. The following is a discussion upon Alcohol in Cholera which was held at the annual meeting of the British Medical Temperance Association, in May, 1893, and is taken from the Medical Pioneer of June, 1893:—
"Dr. Richardson opened a discussion on Cholera in relation to Alcohol. He said he would bring forward five points on the subject.
1. The negligence among the people at large produced by alcohol in the presence of a cholera epidemic. There was no doubt on the part of any who had seen an epidemic of cholera as to the mischief done by alcohol, apart from its action as a remedy. People rush to the public houses and take it to ward off the danger, or to relieve them when they begin to feel ill, and the result is very bad morally. He had seen this in different epidemics. Or people got in spirits to face the danger, and many became intoxicated and less able to resist.
2. Its misuse by those affected. It was often given to cheer them up and remove their fear and nervousness. In his opinion it invariably produced mischief.
3. He was unable to find any physiological reason for giving it. There was a constant drain of fluid, causing spasms and cramp, both of the muscles and blood-vessels, and difficult circulation through the lungs. Spasm may be relaxed by alcohol, but, on the other hand, alcohol is exceedingly greedy of water, and so increases the flux. But it also reduces animal temperature, which is a strong feature of cholera, so much so that he could almost diagnose cholera blindfold in the stage of collapse, by the icy coldness.
4. Its uselessness as a remedy during the acute stage. He had seen a great deal of cholera and never saw alcohol do any good whatever. There was a temporary glow which passed away in a few minutes, and then the evil it does in other ways was brought out. Water was far better, even if cold. The College of Physicians had given some instructions and ordered great care in the administration of alcohol; this was not far enough, but good as far as it went. The recoveries were best where the treatment was simplest, such as external warmth with plenty of diluents. He had given creasote largely.
5. Its injuriousness during the stage of reaction. The reactive fever following collapse caused a great number of deaths. In this stage alcohol was absolutely poisonous. He could recall many such cases in which he had given alcohol through ignorance, and always with disaster.
"Brigade-Surgeon Pringle said that when he went out to India he thought alcohol was something to stand by, but he had soon found out his mistake; he had himself suffered from it. He could confirm what Dr. Richardson had said as to the demoralization produced by alcohol to which men resort to keep up their spirits, and men seized under these circumstances were in the greatest danger. Nature effects a cure in many cases without assistance, and often with wonderful rapidity. People apparently dead and about to be buried, he had known to get up and recover. When alcohol is given during collapse there is often no absorption until reaction occurs, and then the quantity accumulated speedily produces intoxication. It was the same with opium; he had found pills unchanged in the stomach for hours. He recommended hot drinks; he had tried every kind of medicine and had little faith in it. The nursing was very important, and it was important that the nurses should abstain.
"Dr. Morton said it was easy to see that on physiological grounds alone, alcohol, with its strong affinity for water and its tendency to lower temperature, could not be a useful drug in the treatment of cholera collapse, and with its powers of paralyzing vascular inhibition and checking elimination of effete matter, could not be otherwise than harmful in the stage of reaction. As these conclusions were corroborated by practical experience he did not think members would hesitate to banish it from their equipment against cholera.
"Dr. Ridge said it should be remembered that Doyen had made experiments on guinea-pigs and had found they were proof against cholera, unless they had previously had a dose of alcohol. This explained why drunkards and hard drinkers were so much more liable to have cholera, and have it badly as all observers declared to be the case. Another reason might be that small quantities of alcohol, such as would be found circulating in the blood, favored the growth and multiplication of bacteria, certainly those of decomposition, and probably those of cholera. Hence, other things being equal, the abstainer had a great advantage.
"Dr. Norman Kerr said that he had observed both in America and Glasgow that not only notorious drunkards but free drinkers suffered; abstainers were less liable unless they took contaminated water, and the less liquid taken the less chance of taking cholera; beer-drinkers often took more than abstainers. The alcohol-drinker uses up more water from his blood and so has less to flush out the system. Alcohol, given to a patient, disguised his condition so that he might seem better though really worse. Hence it is better and safer not to give any. The doctors and nurses ought to be abstainers. A doctor after dinner was more likely to take a roseate view of a case, looking at it through an alcoholic pair of spectacles. Alcohol was not really a stimulant, but a depressant, and this is a very depressing disease; it was important to have our vital resisting power as vigorous as possible. Hot water both relaxes and stimulates, and the whole cry of the sufferer is for water. Many persons who died in cholera did not die of the disease, but of the drugs such as alcohol and opium. Acid drinks should be given, as the bacilli could not live in acid mixtures. Cholera might come, but he believed we were better prepared to meet it and to treat it.
"Surgeon-General Francis sent a communication which was read by the Honorable Secretary. He said: 'Having had many opportunities of treating cholera in various parts of India and amongst all classes, I have no hesitation in affirming that alcohol in any shape is one of the very worst remedies. Life is, so to speak, paralyzed, and we give a remedy which, apparently stimulating, is in reality a paralyzer and therefore mischievous; the death-rate might be considerably reduced provided alcohol were rigidly excluded.'"
Dr. Norman Kerr in a valuable paper upon Cholera says:—
"The first thing is to get rid of the poison. How? By assisting it out; but alcohol keeps it in by blocking the doors, just as the doors were blocked in the terrible calamity at Sunderland not long ago. The alcohol makes the heart and circulation labor more. Alcohol not only retains the cholera poison, but retards the action of the heart. Brandy and opium used to be employed, but the records show that if the object had been to make cholera as fatal as possible, that object was achieved by the indiscriminate administration of brandy and opium. Better leave the victim alone, and his chances of recovery will be greater than if he have a thousand doctors, and as many nurses, administering to him brandy and opium. Alcohol is especially dangerous in the third stage, that of reactive fever, because it adds to the fever. Then, alcohol is not only unsafe in the three stages of genuine cholera, but especially unsafe in the premonitory diarrhœa stage, which gives nearly every one warning before they are attacked by genuine cholera. Brandy is taken simply because it puts away the pain. If there are only the pain and slight diarrhoea, speaking medically, it is all right, but if there is anything behind the pain, it is all wrong. After the alcohol, the mischief is going on, only the patient does not know it, and valuable time is lost. All the alcohol does is to deaden sensation. ***** Here I can thoroughly recommend ice and iced water. I have always treated cholera patients with these. Let them drink iced water to their hearts' content; they can never drink too much; and this opinion is fortified by that of Professor Maclean, of Netley. There is no need of a substitute for brandy in cholera, because in ordinary circumstances in that disease the action of a stimulant is bad. Flusing of the blood is required, and water will do it. Milk will not do it, because it is too thick nothing but pure, cold water, all the better if iced."
In 1893 Dr. Ernest Hart, editor of the British Medical Journal, read an able paper upon Cholera before the American Medical Association. His argument was that the introduction of such a substance as alcohol, itself being a product of germ action, into a system already suffering from the toxic influence of a ptomaine, could not be otherwise than pernicious.
Cholera Morbus:— Dr. Kellogg says: "The stomach should be washed by means of the stomach-tube when possible. A large hot enema should be given after each evacuation of the bowels. The addition of tannin, one drachm to a quart of water, is serviceable. When the vomited matter no longer shows signs of food, efforts should be made to stop the vomiting. Give the patient bits of ice the size of a bean to swallow every few minutes. At the same time apply hot fomentations over the stomach and bowels. If the patient suffer much from cramp, put him into a warm bath. The first food taken should be farinaceous. Oatmeal gruel, well boiled and strained, is useful."
Cholera Infantum:—"Iced water may be given in very small quantities every few minutes. Give the stomach entire rest for at least twenty-four hours. There will be no suffering for want of food as long as the stomach is in such a condition. Withhold milk until nature has had time to rid the alimentary canal of the poison-producing germs. White of egg dissolved in water is an excellent preparation in these cases. Egg enemata may also be advantageously used.
"Warm baths, the hot blanket pack when the surface is cold, and the hot enema are all useful. Keep the child wrapped warmly.
"Great care should be taken in returning to the milk diet. The milk should be thoroughly sterilized by boiling for half an hour, and should be mixed with some barley water so as to avoid the formation of large curds in the stomach. Cream, diluted with water, may be used instead of milk."
CONSUMPTION.
Dr. Koch, the celebrated German microscopist, pronounces consumption contagious, because during its progress a very minute bacterium is developed which may be transmitted from one person to another.
It is said that a person with healthy lungs might daily breathe millions of tubercle bacilli without any danger, and that the best preventive of this disease is to live much in the open air, or if this is impossible to spend ten or fifteen minutes a day in deep breathing exercises in the open air. "Fresh-air and disease-germs are antagonistic."
Alcohol, chiefly in the form of whisky, was for many years considered of great value in the treatment of consumption of the lungs. Indeed, it was looked upon not only as a curative, but also as a prophylactic, or preventive, of great service to those predisposed to this disease by reason of narrow chest and weak lungs.
Sir Benjamin Ward Richardson was the first medical scientist who showed plainly that alcohol, instead of being a preventive of consumption, is really the sole cause of one type of this disease, the type now classed under the head of "alcoholic phthisis." For this kind of phthisis there is no hope of cure.
French physicians some years ago came to the conclusion that alcohol was a prolific cause of tuberculosis and that the administration of alcoholic liquors in tubercular troubles was a great error, and in the International Anti-Tuberculosis Congress held in Paris in 1905, about 2000 medical scientists being present, they presented the following resolution, which was adopted: "In view of the close connection between alcoholism and tuberculosis, this Congress strongly emphasizes the importance of combining the fight against tuberculosis with the struggle against alcoholism."
Since that time a great crusade against tuberculosis has been carried on by means of exhibits and lectures, and in connection with these, almost invariably the people are warned against intemperance. For example, a pamphlet sent out by the Boston Association for the Relief and Control of Tuberculosis says: "Do not spend money for beer or other liquors, or for quack medicines or 'cures.' Self-indulgence and intemperance are very bad. Vice which weakens the strong kills the weak." The New York State Charities Aid Association, working with the State Board of Health, says in a pamphlet: "Patent medicines do not cure consumption. They are usually alcoholic drinks in disguise, and the use of alcoholic drinks is dangerous to the consumptive." At the great exhibit in Washington in September, 1908, in connection with the International Anti-Tuberculosis Congress different warnings against alcohol were upon the walls. Among these was a large poster of white cloth on which was printed the opinions on alcohol, in brief, of some of the best-known authorities on consumption. The opinions as given on that poster are given here, with others, in order to show the great change of sentiment regarding alcohol and consumption which has come about within a few years:—
Dr. Knopf in his prize essay on "Tuberculosis and How to Combat It," says in several places: "Avoid all alcoholic beverages." He says also, "Alcohol should never be given to children even in the smallest quantities."
"It is a recognized fact in the medical profession that the habitual use of alcoholic drinks predisposes to tubercular infection. It is also recognized, I think, by most physicians that alcohol as a medicine is harmful to the tubercular invalid."—Frank Billings, M. D., Chicago, 111., Former President American Medical Association.
"Alcoholic liquors are of damage to consumptives because they tend to impair nutrition, disturb the action of the stomach, and give a false strength to the invalid on which he is sure to presume. Besides, we know that in countries where drinking prevails most, the ravages of tuberculosis are most marked."—Edward L. Trudeau, M. D., Adirondacks Sanitarium for Consumptives, Saranac Lake, N. Y.
"In my judgment whisky should not be used by people who have consumption, and in my practice I prohibit its use absolutely. At the White Haven Sanitarium and Henry Phipps Institute we do not use alcohol in any form in the treatment of our patients."—Lawrence F. Flick, M. D., Vice-President of the National Association for the Study and Prevention of Tuberculosis, Philadelphia, Pa.
"I do not feel that I can emphasize strongly enough the harm that can be done by the use of alcohol in tuberculosis, and the indiscriminate use of it certainly borders on the criminal. I do not believe that any legitimate reason can be given for the routine employment of alcohol in the treatment of tuberculosis. I furthermore know of no emergency in which it is indispensable. My experience with patients who have been accustomed to the use of alcohol, especially moderately, is very unsatisfactory. They seem to show an abnormally low resisting power to the tubercle bacillus. The fact has been established that alcoholism is a very potent factor in the causation of tuberculosis. I find it not only unnecessary in treatment but believe it to be contraindicated."—F. M. Pottenger, M. D., Superintendent the Pottenger Sanitarium for Diseases of the Lungs and Throat, Monrovia, California.
"I have met with a small class of consumptive patients who could take alcoholic liquors freely for a length of time, without deranging either the stomach or the brain, and with a decided amelioration of the pulmonary symptoms, and an arrest of the emaciation. Some of these have actually increased in embonpoint, and for three to six months were highly elated with the hope that they were recovering. But truth compels me to say that I have never seen a case in which this apparent improvement under the influence of alcoholic drink was permanent. On the contrary, even in those cases in which the emaciation seems at first arrested, and the general symptoms ameliorated, the physical signs do not undergo a corresponding improvement; and after a few months the digestive function becomes impaired; the emaciation begins to increase rapidly; and in a short time the patient is fatally prostrated."—Dr. Nathan S. Davis, Sr., of Chicago.
"The use of whisky in this disease positively interferes with digestion which must under all circumstances be kept as perfect as possible in order that the patient may assimilate the food which is so necessary to the upbuilding of the system and to gain strength to fight the onslaught of the disease.
"Its constant use would not only interfere with digestion but would have a tendency to create disease in other organs of the body so that we therefore consider the use of whisky in tuberculosis positively contraindicated.
"Wishing you success in your laudable campaign."—Dr. M. Collins, Superintendent National Jewish Hospital for Consumptives, Denver, Colorado.
"It is difficult for many people to adapt themselves to a methodical plan of life long enough to establish a permanent cure in consumption. I have known many a young fellow with only a slight trouble in his lungs to die in the Adirondacks more from the effects of whisky than from the disease itself."—Dr. Henry P. Loomis, of New York City, in a Lecture on Consumption. (See page 232, of Handbook, on the Prevention of Tuberculosis.)
"The majority of our patients receive no medication whatsoever. The stomach is rarely in condition to bear excessive medication, and the promiscuous use of creosote and similar preparations is to be condemned. Milk and raw eggs are the best articles of diet in addition to a regular diet of simple food."—James Alexander Miller, M. D., of the Vanderbilt Clinic, New York. (From Medical Record.)
"In my specialty, the treatment of pulmonary diseases, I rarely prescribe alcohol in any form, and in the sanitaria with which I have been connected it is the exception where alcohol in any form is prescribed. I have advised against its use where such has been the custom, believing that as a rule alcoholic liquors do more harm than good in the treatment of this disease."—Prof. Vincent Y. Bowditch, M. D., Harvard Medical School, Boston.
"From personal experience in handling pulmonary tuberculosis, not only at the Nordrach Ranch Sanitorium, for the past five years, but in an active practice of thirteen years, I am more than convinced that whisky and liquor, in any form, are absolutely poisonous to the consumptive.
"Whenever we admit a patient to the Nordrach Ranch Sanitorium, we ascertain whether the individual is an alcoholic or not; and we invariably find that such an individual is lacking in vitality enough to combat the disease. They may look fat and strong, pulmonary tuberculosis usually makes quick work of them.
"It is also a noticeable fact, proven by various statistics, that a very large percentage of alcoholics become tubercular; and if we ever stamp out tuberculosis, we will also have to stamp out intemperance.
"Trying to cure consumption with whisky is like trying to put out a fire with kerosene. This is very easy to understand when we stop to consider the nature of this disease. In the first place, we have a very rapid heart's action, dating from the very earliest manifestations of the disease. The pulse is often in excess of 100, even in incipient cases, and if the stimulation of alcohol is added, we have what might be called a 'runaway heart'; and if there is one thing needed in the long combat against tuberculosis, it is a good heart."—John E. White, M. D., Medical Director Nordrach Ranch Sanatorium, Colorado Springs, Colorado.
"You ask me my opinion as to the use of whisky in the treatment of consumption. In reply permit me to say that I regard its use in this disease as most universally pernicious."—Porf. Charles G. Stockton, M. D., Buffalo Medical College, Buffalo, N. Y.
"It was formerly thought that alcohol was in some way antagonistic to tuberculous disease, but the observations of late years indicate clearly that the reverse is the case, and that chronic drinkers are more liable to both acute and pulmonary tuberculosis. It is probably altogether a question of altered tissue soil, the alcohol lowering the vitality and enabling the bacilli more readily to develop and grow."—Dr. Osler, formerly Professor of Medicine in Johns Hopkins University, Baltimore, Md., now of Oxford University, England.
"Upon investigation I found 38 per cent, of our male tubercular patients were excessive users of alcohol, 56 per cent, moderate users. From my study of the cases I am led to believe that in a vast majority of these cases drink has been a large factor in producing the disease, by exposure, lowering of vitality, etc. I believe that alcohol has no place in the treatment of tuberculosis. Many patients are deceived by the false strength it gives them."—O. C. Willhite, M. D., Superintendent of Cook County Hospital for Consumptives, Dunning, Ill.
"In tuberculosis there is a state of over-stimulation of the circulatory system due to the toxins. The use of alcoholics simply makes the condition worse. It reduces resistance and makes the person more susceptible to the disease."—H. J. Blankmyer, M. D., Sanatorium Gabriels, in the Adirondacks, N. Y.
"The practice of taking alcoholics of any sort, and in any quantity, over a considerable length of time, is certain to produce more or less injury to a tubercular patient, and their use by tubercular people cannot be too strongly condemned."—H. S. Goodall, M. D., Lake Kushaqua, N. Y.
Most of these opinions were written for the author of this book in response to letters of inquiry. Are they not indicative of a day when the medical profession will lay aside alcoholic liquors in the treatment of all diseases? It is acknowledged that the past usage of giving whisky and cod-liver oil to consumptives was an error; some day, it may be not far distant, a larger acknowledgment may be made, and the medical use of alcoholic liquors will be entirely a thing of the past.
Rev. J. M. Buckley, D.D., editor of The Christian Advocate, was in early manhood considered an incurable consumptive. Being a man of great will power and indomitable perseverance, he resolved to try the open-air cure, together with the use of an inspirator. The result was perfect restoration to health, so that, as is well known, he can be easily heard by audiences of thousands at Chautauqua and other places where he is greatly in request for lectures. He has written a pamphlet giving a full history of his case. It can be obtained from Eaton & Mains, 150 Fifth Avenue, New York, for fifty cents, and should be read by all consumptives who have any "grit" in their composition.
Dr. Forrest, a hygienic physician, says:—
"What is to be done if the germs have already obtained lodgement in the lungs? Increase the general nutrition of the body in every way, and then the lungs can resist the inroads of the disease. The first thing necessary to improve the nutrition of the body is to stimulate the digestive and absorbent functions of the stomach and intestines. Naturally then, you must throw the so-called cough medicines out of the window. The drugs used to stop a cough are sedatives. Now, no sedative or nauseant is known that does not lock up the natural secretions and thus lessen the digestive powers. The cough is nature's method of expelling offending matter from the lungs and bronchial tubes. It is infinitely better to have this stuff thrown out of the lungs than retained there."
Keep the bowels clean is this physician's next recommendation.
Sweet cream is preferable to cod-liver oil as it is not so likely to derange the stomach. Easily digested food is necessary, as the organs of digestion are in weakened condition.
Again Dr. Forrest says:—
"The consumptive should live as much as possible in the open air.
"Dr. Trudeau inoculated twelve rabbits with tubercle or consumptive germs. Six of these he turned loose on an island where they ran wild. The other six were kept confined in hutches such as rabbits are usually kept in. Results All the six rabbits in the open air recovered from the inoculation and remained well. Five of the confined rabbits died of tubercles in the lungs and different parts of the body. The sixth was still lingering, badly diseased, when the experiment was brought to a close. Fresh air and exercise enabled the first six to overcome the disease germs. Confinement gave full play to the disease in the others.
"Now, you house lovers, sleepers in close bedrooms, people afraid of cold air, you are the rabbits in the hutches. Beware, lest the verdict be in your case, 'Died of tubercles in the lungs.' If you are not able to leave your home, live with open windows, day and night, summer and winter.
"Exercise systematically, especially those exercises, accompanied by deep breathing, that open and strengthen the lungs exercises without fatigue.
"If you are hoping that some wonderful, mysterious drug has been or will be discovered, a drug that will cure consumption without your help, you are hoping against hope. Improved nutrition is your salvation, and that must come through exercise, diet and fresh air."
Dr. J. H. Kellogg, in his Home Hand-Book of Hygiene and Medicine, recommends a salt sponge bath upon retiring, to arrest night sweats, or sponging with hot water. He adds:—
"It is important that patients should know that the sweats are greatly aggravated by opium in any form, and hence are increased by cough mixtures of any sort which contain this drug. Very simple remedies are often effective to relieve the most distressing cough, such as gargling of water in the throat, holding bits of ice in the mouth, taking occasional sips of strong lemonade, and similar remedies. As a general rule, patients run down and the disease progresses much more rapidly, after beginning the use of opium in any form. Sometimes it is best that the cough should be encouraged instead of being repressed. When the patient expectorates very freely, The cough is a necessary means of relieving the chest of matters which would seriously interfere with the functions of the lungs if retained, by filling up the bronchial tubes and air-cells. The kind of cough needing relief is an irritable, ineffective cough, unaccompanied by any considerable degree of expectoration. Loaf sugar, honey or a mixture of honey and lemon juice, and other simple, familiar remedies are often effective in relieving such a cough. *****
"It is perhaps needless to add that the numerous quack remedies for consumption advertised in the newspapers are wholly without merit. There is no known drug which will cure this disease, or in any certain degree influence its progress. Numerous remedies have been recommended as curative, but not one has thus far stood the test of experience."
Displacements of the Uterus:—These conditions are not among those for which alcoholic liquors are likely to be advised by a physician, but women frequently resort to Lydia Pinkham's Compound and other alcoholic preparations in the vain hope of finding the relief so positively promised in the nostrum advertisements. Women are sometimes seriously injured by using the nostrums specially advised for uterine weaknesses, for this reason: a drug which may be of service in an anæmic condition of the womb may do much damage in an inflamed or engorged condition, yet the nostrum vendors advise their preparations for all alike, without a word of warning as to possible dangers.
Ordinary displacements may be recovered from by cleanliness of the parts and by exercises which strengthen the muscles in the pelvic region. The writer has known a considerable number of women who have been restored to health by exercises after months, in some cases, and several years in others, of weakness and misery. One of these women was a close relative of a celebrated specialist in women's diseases. He said he could not do any more for her, and gave permission for her to try the exercises, which were given her by a well-equipped teacher of physical training.
There are three kinds of displacements: anteversion, retroversion, and prolapsus. The causes of these troubles are various; lack of proper care in child-bearing, miscarriages, heavy lifting, a hard fall, jumping out of a carriage, straining, too violent exercise in gymnasium work, and tight-lacing, also gradual weakening of the ligaments which sustain the uterus in position.
An abdominal supporter should be worn constantly during the day for a year or so, then left off gradually an hour or two at a time. It should be worn during the second year whenever any extra work is to be done.
There is a supporter sold by the Battle Creek Sanitarium which is highly recommended, but any physician can get one for a patient.
Perfect cleanliness is necessary. For this purpose a hot vaginal douche should be taken two or three times a day. This douche should be made astringent by adding to a pint of water a quarter ounce of alum or tannin. The hot astringent injections tone up the lower supports of the uterus, and cleanse the passage. The patient should remain in a recumbent position for some hours after the douche if possible. Considerable rest hastens a cure. Take the rest in the fresh air when weather permits. Persistent use of sitz baths will be found helpful.
For prolapsus the simplest form of internal supporter is a small roll of cotton. After the organ is carefully put into position this supporter should be pressed up against the mouth of the womb, the patient meanwhile lying upon her back. The ball of absorbent cotton should be large enough to be retained in position, and should be saturated with a weak solution of glycerine and alum or glycerine and tannin before being applied. A piece of white cord should be tied firmly around the centre of this tampon by which it may be removed. Remove before taking the douche.
Persons who feel unable to purchase an elastic or other abdominal supporter can make a substitute (not so good, but of considerable service) from unbleached muslin made in the shape of the letter T, and having the cloth double. It should go up to the waist and be made to fit over the hips, then should be fastened firmly in front with safety-pins, and the cross-piece be drawn up from the back and fastened securely in front.
The daily exercises are the most important part of the treatment. They must be begun gradually, and taken at greater length as strength is gained. Those for prolapsus will be given first:—
The patient should lie upon a rug, or on a firm long sofa or couch. The feet should be drawn up as close to the body as possible. Now lift the lower part of the body so that the hips and lower portion of the trunk will have no support but what comes from the feet and shoulders. Hold this position for a minute or two (longer when able without much fatigue). After a few minutes' rest repeat. This exercise may be continued from twenty to thirty minutes, according to patient's strength. The elevation of the hips in this exercise aids in the restoration of the organ to its natural position. This exercise should be continued daily, the number of times being increased as strength increases.
A second exercise which is very helpful in prolapsus is to support the body on the toes and elbows with the face downward, and the hips raised as high as possible. Another exercise may be taken with an assistant; the patient should lie face downward, supporting the body by the chest, and keeping the limbs rigid while the assistant lifts the feet as high as possible without hurting. These movements strengthen the abdominal muscles and draw fresh blood to the weakened parts, and cause quickened circulation in addition to restoring the displaced organ to natural position. They should be taken at night just before retiring after a hot douche. The bowels should be kept open by the free use of fruit. The patient should sleep with the hips elevated as much as can be endured without real discomfort and sit with the feet on a stool. When strength sufficient is acquired the exercises for anteversion will be found useful, and any other exercises which strengthen the abdominal muscles, such as bending backward and forward, and sideways. Kneading and percussing the abdomen by an osteopath or masseur strengthens, and also relieves constipation. Rest during the day should be taken with the feet higher than the head.
Prolapsus due to laceration in child-birth may require a surgical operation.
In case of antiflexions the first exercise given for prolapsus should be taken daily. (The advice for the prolapsus treatment and the exercises are taken from the writings of Dr. J. H. Kellogg, superintendent of the Battle Creek Sanitarium.).
Antervision:—Persons suffering from anteversion or retro version should sleep without pillows under the head, and lie flat upon the back; they should sit with the feet as high as convenient and avoid high seats which hinder the feet from touching the floor. They should discard corsets and tight stocking supporters which push or hold down the organs which need to be replaced. Stocking supporters should be fastened over the hips and comfort waists can be bought in place of corsets.
It is well to have an attendant to prepare weak patients for first exercises in all uterine troubles by the use of towels wrung from hot water applied to the back and abdomen for a few minutes to relax the muscles, or a hot water bottle, or hot salt bag may be used. Then, with the patient lying with head low, the attendant should give the abdomen and small of the back a thorough rubbing or kneading for ten minutes or less according to strength of patient. Olive oil can be used on the hand in the rubbing.
First Exercise for Anterversion:—Lie on bed or rug; fold arms on chest; hold trunk of body still; stretch legs, and hold the position about half a minute, then relax at the knee and ankle. Then point the toes down and stretch upper leg muscles; relax; then stretch under leg muscles by stretching heel out. The patient will feel the exercise as far as the shoulders, and should be careful not to lift the body from the floor at first. When patient can hold stretching exercise for a minute then lift first the right, then the left leg, and take same exercise until the person can give a quick little kick for, say, twelve times, as the leg is straightened.
Second Exercise:—Lying on the back, stretch to full length; move the left leg out at the side, then up and back to position, forming a semi-circle, keeping muscles tense throughout. Then move right leg out at the side—left—stretch toes long—relax—stretch heel, lift a little higher and bring back to place in a circle and rest. Same with left leg and then both together. Few people can do this easily at first, the weight of the legs is too much for the weak muscles at the back; but some one can hold the foot at first. When the patient can do this easily without bringing on any pain or ache, she may sit in a low chair and take arm lifting exercises.
Raise both arms out at the sides, then slowly raise them up close to the head and consciously lift all the organs of the body up, relax, and lower arms down front and repeat slowly, six or ten times at first, until for five minutes the patient can do this sitting. Then take it standing for ten minutes or more. Stand with feet wide apart. Dr. Anderson says, "A woman who will do this twenty times each day can never have anteversion, if she dresses properly, for it lifts the organs in place each time." It lifts the chest and abdomen up, and brings a feeling of exhilaration if done in the open air.
After the patient has taken exercises for five or six weeks she may lie flat on the back, fold arms and raise body up to sitting position without unfolding arms. Then turn on right side and do the same, then on left side and do the same. This is fine for back and abdomen muscles.
Anteversion needs the Rest Cure, and resting with the body in a position in which nature can right things is an important thing to remember. Rest always after exercise, either with a pillow under the knees or with the legs hanging over a low foot-board, or lying on a couch with the feet higher than the head. Exercise will relax the muscles and call for blood which will revitalize and stimulate the weakened conditions. A woman with this trouble should be careful about bending quickly over, or climbing stairs, until she gains strength.
Retroversion:—Place the patient with face downward on bed or mat and with a small pillow under the lower part of the abdomen. Relax the muscles by applying a hot towel, hot salt bag or hot water-bottle just below the small of the back, and lower part of the abdomen for ten or fifteen minutes. (Hot salt bags are most effective and are easy to handle.) Then rub the back briskly with a circular movement; if tender in front, do not rub the abdomen. The circulation will gradually carry away any inflammation as soon as the muscles reach a normal condition, though kneading of back and abdomen, using sweet oil on the hand, is helpful if the patient can bear it.
The patient must remember that these conditions have been months in coming and only painstaking work and time can restore the weakened organs. The manner of dress is very important; loose, comfortable clothing must be worn. Sleep with the face down as much as possible; nature will correct itself, if allowed, many times.
First Exercise:—Fold arms under forehead and draw right knee up close to body and hold two minutes (unless painful) and slowly straighten, and stretch very slowly. Do the same with the left leg until the patient can repeat the exercise twelve times with each leg and hold five minutes instead of two, with the knee close to the body. It will probably take two weeks to gain strength for this. After that time raise the body up on hands, and move legs just as a baby does when creeping, except that the patient only follows the movement and does not move along.
Second Exercise:—Patient take sitting position on floor and clasp hands under knees, and bring knees up, so that chin and knees meet and hold. Then straighten legs, slide hands toward the heels as far as hands can reach, (stretch hands toward heels); make a continuous movement of this.
Third Exercise:—Sit on floor. Place the hands on floor at sides, legs straight out in front, lift the body from the floor with the arms, up and down. This is a fine exercise for raising up the misplaced organs.
Fourth Exercise:—Place the patient flat on back and push the body up to sitting position with hands quite far back and palms down, recline again, up and down until arms and back are very tired. Then sit up, legs straight in front, raise the body from the floor, (an inch) and move backward, resting weight on hands, then move over on knees as at first exercise and creep, then sit up and move backward again. These will take a month to perfect. Begin by exercising five minutes and gradually work up to half an hour, rest between, always. The patient must have the right mental attitude, must think that she is trying to replace the uterus by lifting it to its natural position. The exercises must not be lazily done.
Sitting in a tub of hot water is most helpful where there is much tenderness, or inflammation. Witch-hazel in hot water douches or a weak solution of hot salt water is a wonderful tonic in some cases.
Exercise for Replacing Uterus to be Taken just Before Retireing:—Kneel on the bed; bend forward until the chest is touching the bed and the hips are elevated as high as possible. The inlet of the vagina should then be opened so as to admit air. As soon as the air enters the womb falls into position. Lie down at once and give nature a chance to regain strength while you sleep.
The tampon soaked in glycerine and alum, and the douches of hot water, in which a little alum is dissolved, are both of great service in controlling the flooding which so frequently accompanies change of life and miscarriages. (Exercises for anteversion and retroversion supplied by a successful teacher of such work.)
The writer of this book asked a well-known medical writer why physicians do not advise exercises for the cure of displacements instead of operations. He said it is because women are not willing to do anything to help themselves. They expect the physician to cure them, and the only way a physician can "cure" is to operate. Sensible women, however, will be glad to practice helpful exercises.
Debility:—"The debility of convalescence requires fresh air, easily digested food, the avoidance of over-exertion, with a gradually increasing amount of exercise. Such debility is only aggravated by alcohol, though it may for a time be partially masked thereby. Milk, eggs, fresh fruit and farinaceous articles are the best foods. General debility without obvious cause, may be treated by cold or tepid bathing. Salt added to the bath is helpful. Change of air is a good tonic. Port wine and other alcoholics while giving a false sensation of increased vigor, really reduce the tone of the pulse, and therefore tend to enfeeble the system. Alcohol is a relaxant, not a tonic."
Depression of Spirits:—"Learn the Delsarte exercise for the 'blues,' and practice them daily. Hot air baths. Avoid rich food. Take out-door exercise."
Diarrœa:—"This is a symptom of the presence of an irritant of which the stomach is trying to be rid. Do not arrest it permaturely, but assist it. If it persists, arrowroot, or corn starch, or flour, mixed with cold water to the consistency of cream may be taken, a tablespoonful at a time. 2. Bread charcoal with cold milk. 3. A tablespoonful of cinnamon water with a teaspoonful of lime water, mixed, every one, two or three hours. Smaller dose for a child. Diet should be confined to toast, milk toast, milk, cold or boiled. Tea, broth, meat, etc., are sure to renew the trouble. Diarrhœa in infants is generally due to errors in feeding, either over-feeding or the use of improper kinds of food. Boiled milk thickened with flour is a simple remedy in light cases. Alcoholics are utterly unnecessary in diarrhœa, and to order them for young children is quite wrong. A full enema of water, as hot as can be borne, will remove offending substances from the bowels.
"Beware of diarrhœa medicines containing opium in any form. They are unnecessary and dangerous, particularly for young children."
Dysentry:—"At the beginning of the disease the stomach should be relieved by the use of a large warm-water emetic. The quantity of food should be restricted to the smallest amount compatible with comfort. Ripe fruits, especially grapes, and most stewed fruits, may be used in abundance to keep the bowels regular. Salads, spices and other condiments, fats and fried foods should be strictly avoided, together with tea, coffee, alcoholics and all other narcotics.
"The diet should consist chiefly of simple soups, well boiled oatmeal gruel, egg beaten with water or milk, and similar foods. In many cases regulation of the diet is sufficient. Either the hot or the cold enema may be employed.
"The use of opium, which is exceedingly common in this disease, is not advisable, as it produces a feverish condition of the system, decidedly prejudicial to recovery. Herroner, an eminent German physician, very strongly discourages the use of opium in this disease."—Dr. J. H. Kellog
Dyspepsia:—" It is commonly supposed that a little good whisky or brandy aids digestion, while on the contrary it has been proved conclusively by observing the processes of digestion upon persons who have fistula of the stomach, or by evacuating the contents of the stomach by means of a stomach-pump about an hour after taking a meal—in one instance after taking an ounce of alcohol, and in another where no alcohol was taken that alcohol coagulates the albuminoids, throws down the pepsin, decreases the acidity (the combined chlorin and free hydrochloric acid), and increases the fixed chlorids. Any one can make the observation upon himself, that a meal taken without alcohol is more quickly followed by hunger than one with it.
"Blumenau says: 'On the whole, alcohol manifests a decidedly unfavorable influence on the course of normal digestion even when ingested in relatively small quantities, and impairs the normal digestive functions.'
"Dr. Chittenden, professor of physiologic chemistry in Yale College, as a result of some investigations made by himself and Dr. Mendel, states in the American Journal of Medical Sciences, that he finds that as small a quantity as three per cent, of sherry, porter, or beer lessens the activity of the digestive powers."—Bulletin of A. M. T. A.
"It should be observed that doses of alcohol which have no appreciable effect in delaying digestion, are so small as to be practically useless for any beneficial action."—Medical Pioneer.
One doctor writes:
"What makes dyspepsia so hard to cure? This very alcohol taking. The best cure is to refuse all alcoholic drinks, at meals and all other times, and drink nothing but water."
The causes of dyspepsia are various; errors of diet being the most common. Others are mental worry, care and anxiety, and the use of drugs. An eminent writer upon this disease says:—
"My main object in the treatment is to prevent the sufferers from resorting to drugs, which in such cases, not only produce their own morbid conditions, but also confirm those already existing.
"The extensive and often habitual use of alkalies for acidity, of purgatives for constipation, nervines and opiates for sleeplessness, and after-dinner pills to goad into action the lagging stomach, has been a potent factor in the production of a large class of most inveterate dyspepsias."
Underdone bread, cake, and pie, are unfit for any stomach, yet are seen upon many tables. "Breakfast foods," cooked for ten or twenty minutes, are also dyspepsia producers. All breads, cakes, pies and cereals, require thorough cooking to fit them for digestion. Most cereals are better for supper than for breakfast, as they should be cooked in a double boiler for several hours. A young man, troubled with dyspepsia, learned to his amazement that the oatmeal, which he supposed was his best food, had much to do with the giddiness which often overcame him. He was advised to use dry foods, such as toast, zwieback and shredded wheat. This diet, together with the abandonment of nostrums, led to a cure. Zwieback is bread sliced, and dried in a moderate oven until light brown. Whole wheat bread is best. It is very delicious and is quite easily digested. In the case of the young man, it is probable that the difficulty with the oatmeal was the lack of sufficient cooking. Oatmeal made into gruel, well cooked, and diluted with a large quantity of scalded milk is easy of digestion. Eating between meals, and excess in eating, lead to stomach derangement.
"The best remedy for acidity of the stomach is hot-water drinking. Two or three glasses should be taken as hot as can be sipped, one hour before each meal, and half an hour before going to bed. The effect of the hot water is to wash out the stomach, and so remove any fermenting remains of the previous meal. Heartburn may be treated the same as acidity."
Persons troubled with slow digestion are better to eat only two meals a day. The writer has personal knowledge of a goodly number of women who have been benefited wonderfully by adopting the two meal a day plan.
Some persons, much troubled with dyspepsia, have adopted the plan of prolonged fasting advocated by Dr. Dewey, and testify to a cure by this method. While heroic, it is certainly more rational than drug treatment. For acute dyspepsia a fast is requisite.
All that alcoholics can do for dyspepsia is to allay the uneasy sensations for a time, while adding to the trouble. It has been abundantly proved that alcohol must pass from the stomach before digestion can begin.
Dr. Ridge says :—
"Many cases which seem to be relieved by the use of beer are really benefited by the hop, or other bitter, which the ale or beer contains. Hop tea is a useful stomachic, and a quarter of a pint, or half that quantity, may be taken cold. It is made in the same way as tea, using a handful of hops to a pint of boiling water. Make fresh every day."
Dr. Kellogg says :—
"In cases of chronic dyspepsia the use of alcohol seems to be particularly deleterious, although not infrequently prescribed, if not in the form of alcohol or ordinary alcoholic liquors, in the form of some so-called 'bitters,' 'elixir' or 'cordial.' Nothing could be further removed from the truth than the popular notion that alcohol, at least in the form of certain wines, is helpful to digestion. Roberts showed, years ago, that alcohol even in small doses, diminishes the activity of the stomach in the digestion of proteids. Gluzinski showed, ten years ago, that alcohol causes an arrest in the secretion of pepsin, and also of its action upon food. Wolff showed that the habitual use of alcohol produces disorder of the stomach to such a degree as to render it incapable of responding to the normal excitation of the food. Hugounencq found that all wines, without exception, prevent the action of pepsin upon proteids. The most harmful are those which contain large quantities of alcohol, cream of tartar or coloring matter. Wines often contain coloring matters which at once completely arrest digestion, such as methylin blue and fuchsin.
"A few years ago I made a series of experiments in which I administered alcohol in various forms with a test meal, noting the effect upon the stomach fluid as determined by the accurate chemic examination of the method of Hayem and Winter. The result of these experiments I reported at the 1893 meeting of the American Medical Temperance Association. The subject of experiment was a healthy young man whose stomach was doing a slight excess of work, the amount of combined chlorin being nearly fifty per cent, above normal, although the amount of free hydrochloric acid was normal in quantity. Four ounces of claret with the ordinary test meal reduced the free hydrochloric acid from 28 milligrams per 100 c. c. of stomach fluid to zero, and the combined chlorin from .270 to .125. In the same case the administration of two ounces of brandy with the ordinary test meal reduced the combined chlorin to .035, scarcely more than one eighth of the original amount, the free hydrochloric acid remaining at zero. Thus it appears that four ounces of claret produced marked hypopepsia in a case of moderate hyperpepsia, whereas two ounces of brandy produced practically apepsia."
Fainting or Syncope:— The following letter from the late Sir B. W. Richardson was addressed to a lady who had sought the great physician's advice on the subject:—
"25 Manchester Square, W., July 18, 1896.
"Dear Madam: There is no substance which acts as a substitute for alcohol, nor is anything like it wanted. The human body is a water engine, as I have often described it, and alcohol plays no part in its natural motion. The idea that when it begins to fail, a stimulant has to be called for, springs merely from habit, and if, whenever any of the symptoms of fainting you speak of occur, the person merely lies down on the side or back and drinks a glass of hot water, or hot milk and water, all that can be done is done. In the London Temperance Hospital I have been treating the sick for diseases of all kinds and during all stages, and have never administered a minim of alcohol, or any substitute for it, and we have got on better than when I—feeling it at all times at command made use of it in the ordinary way.
" I am, dear Madam, faithfully yours,
"B. W. Richardson."
Treatment: "Lay the patient down in a current of air with the feet raised higher than the head, preferably on one side in case of sickness occurring, or bend the head down to the knees, to restore the flow of blood to the brain. Loosen all clothing. Rub the limbs, chest and over the heart with the hand or a rough towel. Sprinkle cold water on the head and face. Smell ammonia, strong vinegar, smelling salts or any pungent odor. Put hot bottles to the feet, and in severe cases a mustard plaster over the heart. Sip hot milk, hot water, hot tea, hot black coffee, beef tea or a meat essence. Crowding round the patient and all excitement should be avoided. In 999 cases out of 1,000, no medicine is necessary.
"Faintness often proceeds from indigestion, flatulence inducing pressure on the heart."
Faintness, Weakness, Exhaustion, Fatigue: "The truth is that for simple weakness, faintness, exhaustion, fatigue, cold or wet, the best remedies are simple fresh air, pure water, digestible food and rest. These are nature's restoratives, and the sooner both physicians and people learn to rely upon them instead of upon drugs the better it will be for all parties. And as the effect of alcoholic liquors are directly depressing to the strength and activity of all the natural functions and processes of life, as shown by the most varied and scientific investigations, it is important that this fact be taught to both doctors and people everywhere."—Dr. N. S. Davis.
Fits:—"Whether the fit be apoplexy or epilepsy all alcoholics are extremely bad, both at the time and afterwards. Alcohol, the 'genius of degeneration,' is the chief cause of apoplexy, and also a cause of epilepsy, especially when taken in the form of beer. It diminishes the tone of the arteries and blood vessels, and thus tends to cause, aggravate and maintain a congested state of the capillaries throughout the whole body. In the treatment of epilepsy, therefore, neither alcohol nor any so-called substitute should be given. *****
"In the convulsions of children alcohol is equally injurious."—Dr. Ridge.
Flatulence:—"Many uneasy sensations or pains, even in distant parts of the body, are due to wind in the bowels, resulting from indigestion. Asthma, cramps, depression of spirits, faintness, giddiness, hiccough, prostration, sinking sensations and sleeplessness, are all frequently due to the same cause. The diet needs careful attention where there is much flatulence; tea is often a cause. Charcoal biscuits are useful in some cases; lemon juice in others. Fluid Magnesia may be taken. Watch for the cause and remove it."
Headache:—The New Hygiene says: " This is the manifestation of a deeper-seated trouble, usually in the stomach. The use of stimulants is a sure promoter of headache. All users of alcoholic liquors are, I believe, subject to headache, and it is also a sure result of overindulgence in tea and coffee.
"To prevent the attacks, live regularly, avoid late hours and excessive brain work; avoid tea, coffee and alcoholic beverages, also sweets of all kinds, including sauces and pastries, and anything fried in fat. Eat plenty of good, plain food, including fruit, especially oranges. Eat none late at night. Exercise regularly in such a way as to bring all the muscles into play, at least once a day.
"To relieve an attack flush the colon.
"Headaches, which so largely result from the retention of impure matter in the body, will be cured if a good quantity, say two or three glasses, of hot water be drank in the morning or at night, and then the next regular meal omitted, so that an interval of house-cleaning can be had before other material is moved in."—Life and Health.
"Avoid pills and powders. Persons suffering from headache need to be warned against taking remedies that contain opium and alcohol, and also against the use of a recent popular remedy, usually called a 'white powder' or 'white tablet.' They take the latter readily because the druggist or physician says it contains no opium. This is true, but it is one of the lately discovered coal tar preparations (anti-febrine, acetanilid, etc.) and is very depressing to the human system. Headache is usually a symptom of trouble somewhere else, often in the alimentary canal, and overloaded stomach, constipation, or tight clothing. Learn the cause and remove that, and the headache will disappear."—Dr. H. J. Hall, Franklin, Ind.
"Gentle massage is helpful and the use of cold compresses. Lack of sufficient sleep will cause headache. Women often bring on nervous headache by overwork and worry."
Hemmorrhage: "Never give alcohol in a case of profuse hemorrhage. The faint feeling, or irresistible inclination to lie down is nature's own method of circumventing the danger, by quieting the circulation and lessening the expulsive force of the heart, thus favoring the formation of clot at the site of the injury."—Clinique.
"For uterine hemorrhage an emetic to induce vomiting is the best cure."—Dr. Higginbotham in British Medical Journal.
"If the faint is dispelled too quickly, and the blood-vessels are relaxed by alcohol, or the heart aroused to energetic action by any remedy, the hemorrhage may recommence, and may prove fatal. Quiet, the application of cold, pressure, the elevation of the wound where possible, and the absence of stimulants, are the cardinal points of treatment in most cases."—Dr. Ridge.
"If then, it seems absolutely necessary to rouse a person out of a dead faint, what can be done? Swallowing is out of the question, lest the patient choke. The head must be laid low, and the face and chest flapped with a cold wet cloth, or alternately with hot wet cloths; smelling salts (not too strong) may be applied to the nose.
"When the faint has been recovered from, but the hemorrhage continues so much that it is feared another faint may occur, and, perhaps, be fatal, it may be warded off by drinking any hot liquid; if Liebig's extract of meat, or strong beef tea, is at hand and can be given hot, there is nothing better."
Heart Disease:—Dr. Ridge says: "I trench here on a delicate subject, because, when there is real disease of the heart, medical advice will of course have been obtained, and very probably a doctor may have said that some alcoholic liquor is essential. There are, also, several different forms of heart disease which require altogether different treatment, and only a physician can tell the difference, or appreciate the necessity for the particular treatment required. But it may be pointed out that alcohol is utterly unable to 'strengthen' the heart, or give tone to the blood-vessels, or to the system at large.
"The alteration in the pulse due to alcohol is chiefly owing to its paralyzing action on the blood-vessels, and when they are too contracted, and thereby cause the weakened heart to labor too much, the alcohol will give relief for the time. But we have in nitrite of amyl, a fluid which will act more quickly and more powerfully; but this must not be employed without medical direction. It is very useful in cases of angina pectoris, or breast pang, but is rarely required in the majority of cases in which the valves of the heart are diseased. The paralyzing action of alcohol is not generally produced by less than half a wine-glassful of brandy or whisky, or twice that quantity of wine, and often much more is required. The relief to uneasy sensations which much smaller quantities sometimes produce is due to their anæsthetic or benumbing action, by which the nerves of the patient are rendered less sensible, although the danger is by no means diminished, * * * * *
"The only sensible way to avert the evil consequences of heart disease is to strengthen the heart, and that is to be done by strengthening the body generally. The amount of exercise, the kind of baths, etc., which should be taken, have to be modified in accordance with the nature of the case. If these natural health-giving measures cannot be employed nothing is an effectual substitute.
"Weak or feeble heart is a common complaint, and is as ordinary an excuse for resorting to alcoholic liquors as 'Timothy's stomach.' If there is no organic disease; if the valves of the heart are healthy and act properly, all anxiety on this point may be entirely banished. The slow pulse, the feeble pulse, the cold feet, the want of energy, these are not to be got rid of by such a mere temporary agent as alcohol, even if relief can be thus obtained from day to day. The constant application of alcohol to the tissues of the body alters them gradually by its chemical action. In addition to this, the balance of the nervous system is altered, an unnatural condition is produced, and the unhappy patient becomes more liable to disease and more easily succumbs when attacked.
"Many of these 'feeble hearts' mean too little exercise, very often also, too much or improper food and drink.
"The best remedies are cold sponging (according to the season); avoidance of coddling; plain, wholesome food; abstinence from tea, hot drinks and condiments; regular out-of-doors exercise and all similar true tonic measures."
Dr. Kellogg says :—
"Persons subject to attacks of angina pectoris should carry with them a small bottle containing a sponge saturated with nitrite of amyl, and place it to the nose when necessary.
"Sympathetic palpitation may be relieved by bending the head downward, allowing the arms to hang down. The effect of this measure is increased by holding the breath a few seconds while bending over. Another ready means of relief is to press strongly upon the large arteries on either side of the neck.
"Palpitation of the heart is often mistaken for real organic disease of the organ. ***** A careful regulation of the diet is in most cases all that is necessary to effect a cure."
Dr. Edmunds, of London, was asked during a medical discussion what he thought of the use of alcohol in heart disease. His answer is embodied in the following :—
"With regard to the use of brandy in cases of heart disease, he was convinced it was a mistake to use it in such cases. There were many forms of heart disease, but the most common kind arose from the heart being too fat. Excess of fat debilitated the heart and injured its working, just as a piece of wax attached to a tuning fork would impair its usefulness. In such cases he dieted his patients in order to reduce their weight. Every dose of brandy taken for heart disease increased the evil. The moment brandy was taken for heart disease, or any other chronic complaint of a similar kind, the disease was increased. If doctors recommended alcohol to their patients, he had been asked what abstainers should do. In such cases, as had been suggested, he thought the patients might ask what the alcohol was to do for them, and if the reply was not satisfactory, they should get another doctor."
Dr. T. D. Crothers, of Hartford, Conn., has deduced some valuable facts from his experiments with the sphygmograph, upon the action of the heart. He has found by repeated experiments that while alcohol apparently increases the force and volume of the heart's action, the irregular tracings of the sphygmograph show that the real vital force is diminished, and hence its apparent stimulating power is deceptive.
Dr. C. W. Chapman, of the National Hospital for Diseases of the Heart, wrote in the Lancet:—
"The very thing (alcohol) which they supposed had kept their heart going was responsible for many of its difficulties."
Of cases of palpitation and irregularity caused by business anxieties or indigestion, he said:—
"To give alcohol is only to add fuel to the fire."
Heart Failure:—"In cases of cardiac weakness, the thing needed is not simply an increased rate of movement of the heart, or an increased volume of the pulse, but an increased movement of the blood current throughout the entire system. In the application of any agent for the purpose of affording relief in a condition of this kind, the peripheral heart as well as the central organ must be taken into consideration. In fact, the whole circulatory system must be regarded as one. The heart and the arteries are composed of essentially the same kind of tissue, and have practically the same functions. The arteries as well as the heart are capable of contracting.
"Both the heart and the arteries are controlled by excitory and inhibitory nerves. These two classes of nerves are kindred in structure and in origin, the vagus and the vasodilators being medullated, while the accelerators of the heart and the vasoconstrictors of the arteries are non-medullated and pass through the sympathetic ganglia on the way to their distribution.
"Winternitz and other therapeutists have frequently called attention to the value of cold as a cardiac stimulant or tonic. The tonic effect of this agent is greater than that of any medicinal agent which can be administered. The cold compress applied over the cardiac area of the chest may well replace alcohol as a heart tonic. The thing necessary to encourage the heart's action is not merely relaxation of the peripheral vessels, but, as Winternitz has shown, increased activity of the peripheral circulation in the skin, muscles and elsewhere. Alcohol paralyzes the vasoconstrictors, and so dilates the small vessels and lessens the resistance of the heart action; but at the same time it lessens the activity of the nerve centres which control the heart, diminishes the power of the heart muscle, and lessens that rhythmical activity of the small vessels whereby the circulation is so efficiently aided at that portion of the blood circuit most remote from the heart. A continuous cold application applied to that portion of the chest overlying the heart stimulates the nerves controlling the walls of the vessels, and at the same time energizes the corresponding cardiac nerves. It is wise to remember that the vasoconstrictor nerves are one in kind with the excitor nerves of the heart, while the vasodilators are in like manner associated with the vagus. With this in mind, it is clear that while alcohol paralyzes the vasoconstrictors, it at the same time weakens the nerves which initiate and maintain the activity of the heart; while, on the other hand, cold excites to activity those nerves which produce the opposite effect.
"The apparent increase of strength which follows the administration of alcohol in cases of cardiac weakness is delusive. There is increased volume of the pulse for the reason that the small arteries and capillaries are dilated, but this apparent improvement in cardiac action is very evanescent. This is a natural result of the fact that while the heart is relieved momentarily by sudden dilation of the peripheral vessels, the accumulation of the blood in the venous system, through the loss of the normal activity of the peripheral heart, gradually raises the resistance by increasing the amount of blood which has to be pushed along in the venous system. This loss of the action of the peripheral heart more than counterbalances the temporary relief secured by the paralysis of the vasoconstrictors.
"Thermic applications, general and local, may safely be affirmed to be the true physiological heart tonic. In the employment of the cold pericardial compress as a heart tonic, the application should generally be continued not more than half an hour at a time, and its use may be alternated with general cold applications to the surface. A cold towel rub, or the cold trunk pack is the best form for application if the patient is very feeble.
"The cold towel rub is applied thus: wring a towel as dry as possible out of very cold water, and spread it quickly and evenly over the surface; rub vigorously outside until the skin begins to feel warm; then remove, dry the moistened surface, rub until it glows, and make the same application to another part; and so on until the whole surface of the body has been gone over. The procedure should be rapid and vigorous.
"If the cold trunk pack is employed, a sheet of not more than one thickness should be wrung as dry as possible out of very cold water, and wrapped quickly about the body, after first dipping the hands in water, and rubbing the trunk vigorously. In cases of extreme cardiac weakness, very cold and very hot applications may be alternately applied over the region of the heart. The duration of the hot and cold applications should be about fifteen seconds each.
"Any one who has ever witnessed the marvelous effects of applications of this sort in reviving a flagging heart will never doubt their efficacy, and will have no occasion to resort to alcohol, or any other intoxicant, to stimulate a flagging heart. The writer has employed these measures for stimulating the heart for more than twenty years, and might cite hundreds of instances in which their efficiency has been demonstrated. They are applicable not only to the cardiac depression encountered in the adynamic stage of typhoid and other fevers, but in cases of heart failure from hemorrhage, of surgical shock, collapse under chloroform or ether, opium poisoning, coal gas asphyxia, drowning, etc."—Dr. J. H. Kellogg, in Bulletin of the A. M. T. A., Jan., 1899.
Dr. N. S. Davis tells of a case of threatened collapse where he was called in consultation. Patient was in a small, unventilated room.
"It was easy to see that what she needed was fresh air in her lungs. Instead of giving alcohol in any form she was moved into a large, well-ventilated room. All symptoms of 'heart failure' disappeared. Had she begun to take whisky or brandy, physician and friends would have attributed her recovery to that, when in fact it would have retarded recovery by hindering oxygenation of the blood."
"It would also be a very great mistake to suppose that when reaction follows collapse, in cases in which alcohol has been given, this result is always due to the alcohol. I have seen so many cases of severe collapse recover without alcohol that I cannot but be skeptical as to its necessity, and even as to its value. I was much struck many years ago by a case of post partum hemorrhage which was so severe that convulsions set in. I should then have given brandy if there had been any to give, but there was none in the house and none to be got. I administered teaspoonfuls of hot water and the patient revived and recovered; next day, except for anæmia, she was as well as ever, with no reactionary fever or other disturbance, as would almost certainly have been the case if brandy had been given.
"In collapse from hemorrhage, we have learned the value of injections of warm saline water, either into the veins, the skin or the rectum, and the same treatment is available in other cases of collapse with contracted vessels.
"Another measure which has proved most efficacious is the inhalation of oxygen gas. This is especially useful in cases in which alcohol is decidedly injurious, namely, those in which there is increasing congestion of the lungs, which the heart, though doing its utmost, is unable to overcome. Alcohol only increases the congestion, and the heart is already over-exerted and nearly exhausted. The effect of the oxygen is apparent in a few seconds, and cases have been rescued in which death appeared to be inevitable and imminent."—Dr. Ridge.
Heart Stimulants—:"The advantage of beef extract over alcohol as a stimulant was demonstrated on a large scale in the Ashantee war."—Dr. Ridge, London.
For those who must have a drug; aqua ammonia, 8 drops to ½ cup of hot water, or 20 grains carbonate ammonia to ½ cup water. Hot water alone is a useful stimulant; also water, hot or cold, with a few grains of Cayenne pepper added. The latter is good, not only to start the heart's action in collapse, but also to relieve violent pain. Hot milk is a most valuable stimulant. Many persons to whom hot milk has been given during the extreme weakness of acute disease have testified afterward to its good effects in comparison with the wine formerly administered. The wine caused an after-feeling of chilliness and weakness, while the milk gave warmth and added strength.
Inosmnia or Sleeplessness:—"A person who suffers from sleeplessness should avoid the use of tea and coffee, tobacco, alcoholic liquors and all other disturbers of the nervous system. Eating immediately before retiring has been recommended, but the ultimate result may be an aggravation of the difficulty instead of relief. If a person suffers from 'all gone feelings' so that he cannot sleep, he should take a few sips of cold water or a glass of lemonade. As complete relief will generally be obtained as from eating, and the stomach will be saved work when it should be resting. A warm bath just before retiring, a wet-hand rub, a cool sponge bath, gentle rubbing of the body with the dry hand, a moist bandage worn about the abdomen during the night, are all useful measures. When the feet are cold, they should be thoroughly warmed by a hot foot or leg bath, and thorough rubbing. When the head is congested, these measures should be supplemented by the application of cold to the head, as the cold compress or the ice-cap."
A walk in the evening, or gentle calisthenics, may help those of sedentary habits. Bicycle riding and horse-back riding in the evening have helped many.
The practice of long deep breathing will often put persons to sleep when all other devices fail. The lungs should be filled to their utmost capacity, and then emptied with equal slowness, repeating the respiration about ten times a minute, instead of eighteen or twenty, the natural rate. Those who fall asleep upon first going to bed, and after a few hours awake, and are unable to sleep again, may find relief by getting out of bed, and rubbing the surface of the body with the dry hand. Or walk about the room a few minutes, exposing the skin to the air, go back to bed and try the deep breathing.
"The use of drugs for the purpose of inducing sleep should be avoided as much as possible. Opium is especially harmful. Sleep obtained by the use of opiates is not a substitute for natural sleep. The condition is one of insensibility, but not of natural refreshing recuperation. Three or four hours of natural sleep will be more than equivalent to double that amount of sleep obtained by the use of narcotics. When a person once becomes dependent upon drugs of any kind for producing sleep, it is almost impossible for him to dispense with them.
It is often dangerous to resort to their temporary use, on account of the great tendency to the formation of the habit of continuous use. The use of opiates for securing sleep is one of the most prolific means by which the great army of opium-eaters is annually recruited. Chloral, bromide of potash, whisky and other drugs are to be condemned almost as strongly as opium."—Dr. Kelogg.
Dr. Furer, of Heidelberg, Germany, in a paper before the International Congress against alcohol, held in Basle, Switzerland, in Sept., 1895, said:—
"The sleep from alcohol does not act as a mental tonic, but leaves the mind weaker next day."
Some noble specimens of manhood have become wrecks through accepting the advice to try "whisky night-caps." Edison recommends manual labor, instead of going to rest, for aggravated insomnia. He says sleep will soon come naturally.
La Gripper:—" Alcohol has no place in the treatment of la grippe; on the contrary it is because of the too frequent use of this, and other narcotics, that epidemics make such fearful headway in our land, and such must be the rule until the people study the laws of health and obey them. Profuse sweating, followed by a careful bathing of the body in tepid water, gradually cooling it to a normal temperature, and avoiding unnecessary exposure, will relieve. The patient should sleep in pure air and eat as little as possible, and that only when hungry. ***** Quinine is essentially a nerve poison, and capable of producing a profound disturbance of the nervous centres. A drug of such potency for evil should be employed with the greatest care, and never when a milder agency will secure the result. Exceedingly pernicious is the habit of dosing children with this drug."—Dr. Charles H. Shepard, Brooklyn, N. Y.
"A late surgeon of the gold coast of Africa wrote the following to the London Lancet of Jan. 2, 1890: 'Some of the worst cases of this disease, the grippe, remind me of an epidemic I saw among the natives of the swamps of the Niger. ***** Irrespective of disinfectants and inhalations there is a simple, effective and ready remedy, the juice of oranges in large quantities, not of two or three, but of dozens. The first unpleasant symptoms disappear, and the acid citrate of potash of the juice, by a simple chemic action decreases the amount of fibrine in the blood to an extent which prevents the development of pneumonia.'"
The Syracuse (N. Y.) Post-Standard contained the following during the epidemic of 1899 :—
"Dr. George D. Whedon declared to a Post-Standard reporter yesterday that there is practically no subsiding of the grippe in this city. Dr. Whedon said that the weather conditions have little, if anything, to do with the disease, and that it is impossible to define the conditions which produce it. It is some morbific agency, the influence of which, Dr. Whedon said, is exerted upon the pneumogastric nerve.
"Dr. Whedon was emphatic in denouncing treatment by means of alcoholic stimulants, and coal tar derivatives. In discussing the subject at some length he said:—
'I find that infants and young children are practically exempt from the disease, and the liability increases with age. In my own experience, which has since 1889 amounted to an aggregate of 3,000 cases, alcoholic stimulants have appeared to be usually of little or no value; their usual stimulating effect does not seem to be realized in this condition. Unless malarial complications exist quinine appears of no benefit, and then should not be used in larger than two grain doses. Large doses depress the weakened heart, and in all cases increase the terrible confusion and headache constantly present in severe cases.
'From the views I entertain of its pathology, and from the terrible fatality which has attended the extensive use of the coal tar derivatives in treatment of la grippe, I argue that the manner in which they have been prescribed in the beginning of the disease, to reduce fever, and relieve the often intense suffering, lowers the heart's action, which is already sufficiently incapacitated by the toxic agent producing the disease.
'The intention is usually to stimulate later, but later is in many cases unfortunately too late. The heart being overwhelmed by the poison, and by the added depression of all coal tar preparations, cannot keep up the pulmonary circulation. The swelling of the lungs increases, and the result is fatal.
'I am aware of the weight of authority for their administration and of the relief they afford, but am just as well assured that were their use discontinued, the greatly increased death-rate from la grippe would cease to appear.
'These coal tar remedies are being used everywhere, and the medical journals recommend them despite the fatal results. They are being used every hour in the day in Syracuse, and, as a result, are knocking out good people. Among the most popular coal tar derivatives I might mention anti-kamnia, salol-phenacetine, anti-pyrine and salicylate of soda.
'Prognosis is favorable at all ages. Patients should be kept warm, and perfectly quiet in bed, and supplied with such nutritious and easily digested food, at frequent intervals, as the partially paralyzed stomach can take care of. All nourishment must be fluid and warm rather than cold.'"
The Journal of Inebriety for April, 1889, says:—
"The present epidemic of influenza has proved to be very fatal in cases of moderate and excessive alcoholic drinkers.
"Pneumonia is the most common sequel, breaking out suddenly, and terminating fatally in a few days. Heart failure and profound exhaustion, is another fatal termination. One case was reported to me of an inebriate, who, after a full outbreak of all the usual symptoms, drank freely of whisky and became stupid and died. It was uncertain whether cerebral hemorrhage had taken place, or the narcotism of the alcohol had combined with the disease and caused death.
"A physician appeared to have unusual fatality in the cases of this class under his care.
"It was found that he gave some form of alcohol freely, on the old theory of stimulation. Another physician gave all drinking cases with this disease alcohol, on the same theory, and had equally fatal results. It has been asserted that alcohol, as an antiseptic, was useful in these bacterial epidemics, but its use has been followed by greater depression, and many new and complex symptoms. The frequent half domestic and professional remedy, hot rum and whisky, has been followed by more serious symptoms, and a protracted convalescence. Many facts have been reported showing the danger of alcohol as a remedy, also the fatality in cases of inebriates who were affected with this disease.
"The first most common symptom seems to be heart exhaustion and feebleness, then from the catarrhal and bronchial irritation, pneumonia often follows."
The vapor or Turkish bath is the best means of "breaking up" this disease, together with hot lemonade and rest in bed for a day or two. The inhalation of hot steam should be tried when there is much bronchial irritation.
Life-Saving Stations, The Use of Alcohol In:—
"There is no possible useful place for alcoholic liquors in connection with a life-saving station. Applied externally the rapid evaporation of alcohol reduces the temperature; taken internally it diminishes the efficiency of both respiration and circulation, and by increasing congestion of the kidneys it directly increases the danger of secondary bad effects from exposures of any kind. To restore warmth and circulation to the surface, light, rapid friction and the wrapping with dry flannel is the safest, cheapest and most efficient, while free breathing of fresh air, and frequent small doses of milk, beef-tea, ordinary tea or coffee, or even simple water, will afford the greatest amount of strength and endurance, and leave the least secondary bad consequences. It is just as easy to keep at hand a jug or flask of any one of the articles named as it is to keep a flask of whisky or brandy. There is no need of keeping them hot, as they act well at any temperature at which they can be drunk."—Dr. N. S. Davis, Chicago.
Measles:—"In mild cases, very little treatment is required, except such as is necessary to make the patient comfortable. Good nursing is much more important than medical attendance. If the eruption is slow in making its appearance, or is repelled after having appeared, the patient should be given a warm blanket pack.
"The old-fashioned plan of keeping the patient smothered beneath heavy blankets, and constantly in a state of perspiration is wholly unnecessary. The irritation of the skin, as well as the sensitiveness to cold, may be relieved by rubbing the skin gently two or three times a day with vaseline or sweet oil. There is no danger from the application of cold water to the surface except in the last stages of the disease, after the eruption has disappeared.
"The patient should be allowed cooling drinks as much as desired. During the disease a simple but nutritious diet should be allowed, but stimulants of all kinds should be prohibited."
"It is wholly unnecessary, and dangerous as well, to give whisky to bring out the eruption."—Dr. I. N. Quimby, Jersey City.
"Any hot drink, such as ginger tea or hot lemonade, may be used to hasten the eruption, if delayed."
Malaria:—Observers of this disease in such regions as the gold coast of Africa have noted the fact that malarial attacks are generally preceded by impaired digestion. The disease is said to be due to animal parasites. These parasites are supposed to generate in the soil of certain regions, and thence, through the drinking water, or otherwise, find entrance to the human body.
"A healthy stomach is able to destroy germs of all sorts, hence the best protection from malaria is the boiling of all drinking water, and the maintenance of sound digestion and purity of blood by an aseptic dietary."
Dr. J. H. Kellogg says in The Voice:—
"It must be understood, however, that fruit in malarial regions, especially watermelons, may be thickly covered with malarial parasites and the parasites may sometimes find entrance to the fruit when it becomes over-ripe, so that the skin is broken. It is evident, then, that care must be taken to disinfect such fruit by thorough washing, or by dipping in hot water, which is the safer plan. The same remark applies to cucumbers, lettuce, celery, cabbage and other green vegetables which are commonly served without cooking. Not only malarial parasites but small insects of various kinds are often found clinging to such food substances, their development being encouraged by the free use of top dressing on the soil, a process common with market gardeners.
"The treatment of malarial disease is too large and intricate a subject for proper treatment in these columns. We will say briefly, however, at the risk of being considered very unorthodox, that the majority of cases of malarial poisoning can be cured without the use of drugs of any sort. In fact, in the most obstinate cases of chronic malarial poisoning, drugs are of almost no use whatever. Quinine, however, is certainly of value as a curative agent in these cases, either in destroying the parasites, or in preventing their development; but as it does not remove the cause, its curative effect is likely to be very transient. The practice of habitually taking quinine as a preventive of malarial disease is a most injurious one, as quinine is itself a non-usable substance in the system, and therefore must be looked upon as a mild poison, to be dealt with by the liver and kidneys the same as other poisons. By habitual use it may itself become a cause of disease. One or two periodical doses of quinine often prove of great service in interrupting the paroxysms of an intermittent fever, but other treatment must also be employed to develop the bodily resistance, and fortify the system against disease. The morning cold bath, followed by vigorous rubbing, is a most excellent measure for this purpose, but the old-fashioned German wet-sheet pack is one of the best remedies known. The paroxysm itself can generally be avoided by means of the dry pack, begun before the chill makes its appearance; but this requires the services of an expert nurse. In not a few cases it is wise for a person who suffers frequently from malarial disease to seek a change of climate to some non-malarial region."
"Col. T. W. Higginson of the First South Carolina Volunteers, in 1862, said of Dr. Seth Rogers, an eminent Southern physician, who was surgeon of the regiment: 'Fortunately for us, he was one of that minority of army surgeons who did not believe in whisky, so that we never had it issued in the regiment while he was with us, and got on better, in a highly malarial district, than those regiments which used it.'"
Maternity:—Dr. Ridge says:—"It is one of the greatest mistakes to make use of alcoholic beverages to 'keep up the strength' during labor. It is, of course, impossible to predict at the commencement how long the labor will last; if then brandy, or other similar drink, is resorted to early, it acts most injuriously. The desire for food is often entirely removed; the demand of the system being therefore unperceived, and so not supplied, a state of weakness and prostration is in time produced, if the labor should be protracted, which may be really serious. The nervous system becomes exhausted by the repeated action of the alcohol. If a fatal result is not occasioned, yet the prostration of body and mind after delivery is aggravated, and convalescence thereby retarded. Alcoholic drinks produce paralysis and congestion of the blood-vessels, and in this way largely increase the liability to flooding after the labor is over. Alcohol also increases the liability to a feverish condition.
"It is necessary to take small quantities of plain, nourishing food at regular intervals, and nothing is of greater value than well-cooked oatmeal; other farinaceous food may be substituted, if preferred. If there is much prostration, meat extracts or beef tea are of great value. Tea tends to produce flatulence and to prevent sleep.
"After the labor is over, the best restorative is a cup of hot beef tea or an egg beaten up in warm milk or a cup of warm gruel. Rest, and absence of excitement and worry are essential and alcohol is specially injurious."
Mensturation, Painful:—Young girls often resort to the use of brandy during the monthly period, and parents ask anxiously, "What can they use instead of the brandy?"
The very best thing that can be done is to go to bed, wrapped in flannels, with a hot-water bottle or other hot application to the abdomen, and to the feet. Take hot ginger tea, or pepper tea.
A warm hip-bath taken at the beginning may give relief, or a large hot enema retained for half an hour or so. Rest is necessary.
For those who must go to work, Dr. Ridge recommends five drops of oil of juniper, to be taken on sugar.
Neuralgia:—" The principal cause of neuralgia is defective nutrition of the nerves. Disorders of digestion are very often accompanied by neuralgia in various parts of the body. It may also result from taking cold, from loss of sleep, from dissipation, and also from the use of tobacco, alcohol, tea and coffee.
"The patient's general health must be improved by a wholesome, simple diet, and the employment of tonic baths, as a daily sponge bath, and massage in feeble cases. Sun-baths and exercise in the open air are of first importance. Ordinary neuralgia may almost always be relieved by either moist or dry heat. In some cases, cold applications give more relief than hot. As a rule, abnormal heat requires cold, and unnatural cold requires hot applications. In many cases it is necessary to give the patient a warm bath of some kind. Electricity often succeeds when all other remedies fail.
"For facial neuralgia apply hot fomentations, together with the use of sitz baths, or hot foot baths. The head may be steamed by holding it over hot water, adding pieces of hot brick occasionally to keep water steaming, head being covered.
"There is no complaint, perhaps, in the treatment of which the use of port wine will be more strongly urged by kind friends, with the assurance that it is impossible to get well without it. This is quite untrue, as thousands can testify."
—Dr. Ridge.
"Avoid opiates of all sorts. 'It is better to bear the ills we have than fly to others that we know not of.' The pangs of neuralgia are as nothing to endure compared with the sufferings of an opium wreck. Build up the general health, and the neuralgia will disappear."
Nausea.—"A feeling of sickness is not uncommonly due to indigestion. If it is caused by rich food take a pinch of bicarbonate of soda in a little water, or a teaspoonful of fluid magnesia. The acidity of the food will thus be neutralized, and this course is far preferable to benumbing the stomach with brandy. If indigestion is the cause, it is often salutary to miss one or two meals, so as to allow the stomach to recover.
"When due to pregnancy, a little aerated water, or soda water is useful; sometimes a small wafer or a crust, eaten before rising in the morning, will check it. An early morning walk, if the weather is pleasant, is helpful.
"The moist abdominal bandage is a very excellent means of relieving nausea during pregnancy. It should be worn constantly for a week or two, and then omitted during the night. Daily sitz baths are also of great advantage. In many cases electricity relieves this symptom very promptly. In very urgent cases in which the vomiting cannot be repressed, and the life of the patient is threatened, the stomach should be given entire rest, the patient being nourished by nutritive injections. Fomentations over the stomach, and swallowing small bits of ice, are sometimes effective when other measures fail."—Dr. J. H. Kellogg.
Outgrowing the strength:—"There is sometimes debility or weakness in rapidly growing boys and girls which is attributed to this cause. It is popularly supposed that port wine or beer, is the great remedy; but nothing can be worse. It is true that gin given continuously to puppies will keep them small, but no one would advocate the amount of spirit required in proportion by a lad or girl to produce the same effect. If the growth could be checked by chemicals it would be most injurious to do so.
"In the treatment of such cases fresh air by day and night is essential; cold sponging, followed by friction with a rough towel, and exercise are desirable."
PNEUMONIA.
Dr. Julius Poheman says in Medical News:—
"The effect of alcohol upon nearly all the organs of the body has been carefully investigated. But, strange to say, literature contains only a few straggling hints upon the action of alcohol on the pulmonary tissue. It has long been known that the abuse of alcohol is a predisposing cause of death when the drinker is attacked with pneumonia. No experimental evidence has been published of the action of alcohol in producing pathological conditions in the lungs. In order to determine this action, a series of experiments was made upon dogs in the winters of 1890–1891 and 1892–1893. The dogs were a mixed lot of mongrels gathered in by the city dog catchers. They varied in weight from fifteen to twenty-five pounds, and were apparently in good health. In all, thirty animals were experimented on.
"The experiments were performed as follows:—A carefully etherized animal had injected into his trachea just below the larynx a quantity of commercial alcohol varying from one dram to one ounce in amount. The effects of equal amounts of alcohol upon animals of the same weight varies greatly. Two dogs, weighing twenty-five pounds each, were injected with two drams of alcohol. One died in one hour, and the other in six hours after the injection. Four other dogs, two weighing twenty-four pounds each, another eighteen pounds, and the fourth fifteen pounds, were all injected with the same amount, two drams. All four survived, and were as well as usual in four weeks. Another dog of eighteen pounds died five minutes after an injection of two drams, while another of fifteen pounds took one ounce and recovered.
"The symptoms in the dogs were all alike, dyspnea, increasing as the inflammation increased, until the accessory muscles of respiration were called into play. The stethoscope showed that air had great difficulty in entering the bronchi and air vesicles, and showed also the tumultuous beating of the heart in pumping blood through the lung. It was impossible to take the temperatures. Post-mortem examinations showed the lungs dark, congested and solid in some places. The air passages were filled with frothy, bloody mucus, even in the dog that died in five minutes. On section, the lungs were dark, congested, and full of bloody mucus. This shows how acutely sensitive the respiratory passages are to the action of alcohol. On microscopic examination of the lungs, the air tubes and vesicles were found filled with immense numbers of red and white corpuscles and much mucus. The same picture was presented as in a slide from the lungs of a broncho-pneumonic child.
"The striking similarity between the two is enough to prove that the pathological condition is the same, and that alcohol has produced a lesion very closely resembling, if not absolutely like, that of broncho-pneumonia in the human subject. This to some extent explains why drunkards attacked by pneumonia succumb more readily than the temperate. The sensitive lung tissue is enveloped in alcohol—flowing through the capillaries of the lung on one side, and exhaled, filling the air vesicles and tubes on the other. The condition must create a state of semi-engorgement or of mild inflammation, similar to the drunkard's red nose, or his engorged gastric mucous membrane. Such a state will reduce the vitality of the pulmonary tissue, and its power of resistance to external influences. Add to this an inflammation such as a pneumonia, and the lungs find themselves unable to stand the pressure."
As previous chapters contain much showing the reasons why alcohol is dangerous in pneumonia, space need not be taken here to do more than indicate briefly some points of non-alcoholic treatment.
Pneumonia is generally supposed to result from a cold; it is ushered in by the symptoms of a chill, followed by fever, headache, shortness of breath, pain in chest, etc. It sometimes occurs as a complication of typhoid fever and other acute diseases.
"It is not a very fatal disease in young and healthy subjects, but in weak children, old persons and habitual drinkers, it is a very fatal malady."
Nature Cure recommends a vapor bath immediately upon the appearance of the first symptoms, together with copious drinking of hot lemonade, and a good supply of pure fresh air in the room, together with the application of alternating hot and cold compresses, and no drugs.
Dr. Kellogg says:—
"Cool compresses or ice-bags, alternated every three hours by hot fomentations for ten minutes, should be applied to the chest, particularly to the affected side, the seat of pain. The hot fomentations relieve the pain, and the cold compresses check the diseased process. The compresses should be wrung out of cold water, and changed every five to eight minutes, or as often as they become warm. Although the cool compresses are not usually liked by the patient, they will soon give relief if their use is continued, and they do much towards shortening the course of the disease. Care should be taken to keep the patient's body from being wet except where the treatment is applied. The cold compress is much used in the large hospitals of Germany. When the pulse becomes as rapid as 95 to 110 or more, cool sponging, the wet-sheet pack, the cool full bath or the cool enema should be employed. When much chilliness is produced by the contact of water with the skin, the cold enema is a most admirably useful measure. The amount of water required is from half a pint to a pint. The temperature may be 40 to 60 degrees. The apartment should be kept as cool as possible without discomfort, and an abundance of fresh air should be continually supplied.
"The diet of the patient should consist of milk, oatmeal gruel, ripe fruit, and similar easily digested food. No meat, eggs or other stimulating food should be allowed.
"Discontinue the cold treatment after the first twenty-four to forty-eight hours. If the surface is cold, apply hot sponging or a hot pack. Avoid causing chilliness."
Pre-Natal Influence of Alcohol:—."The use of beer as a medicine during pregnancy is without doubt perilous to the health and vigor of the offspring. Children born under such conditions are sickly and feeble, and suffer from disease more severely than others, or die early. Alcoholic prescriptions to pregnant women are, from all present knowledge of the facts, both dangerous and reprehensible in the highest degree."—Dr. T. D. Crothers, Hartford, Conn.
"M. Fere, an eminent French physician, recently reported to the Biological Society of Paris the results of experiments which he had been conducting for the purpose of throwing light upon this question. These experiments demonstrate that the exposure of hen's eggs to the influence of the vapor of alcohol, previous to incubation, retards the development of the embryo, and favors the production of malformations. It is evident from these experiments that alcohol may act directly upon the embryo when there is no marked influence of alcoholism in the parent."
Pain After Food:—"This may occur in acute or chronic gastric catarrh, or in a neuralgic or oversensitive condition of the stomach, or in ulcer or cancer of that organ. In all these it comes on soon after food has been swallowed; but, if occurring a long time after a meal, it is probably due to atonic dyspepsia. Alcohol will undoubtedly sometimes relieve this kind of pain by deadening the nerves of the stomach so that the pain is not felt so much; but this effect soon passes off, and if the cause of the malady is not removed by other means, increasing quantities of alcohol will be required to give relief. Many cases of drink-craving have originated in this way. Medical aid will generally be required. A small mustard poultice over the pit of the stomach is often useful, especially in inflammatory cases, or any other outward application of heat. Food should be fluid, or semi-fluid, and digestible. Ginger tea, or peppermint water, may serve to disperse gas."
POISON, ANIMAL.
The following by Dr. Chas. H. Shepard, of Brooklyn, who introduced the Turkish bath into America, is taken from the Journal of the A. M. A., for Nov. 13, 1897:—
"Animal poison is by no means uncommon, and so quick and mysterious is its action that a prompt remedy is a vital necessity. There is good reason to believe that the numerous remedies that have been recommended from earliest times as antidotes for animal poison are worthless, as they have not the properties commonly ascribed to them. The paucity of remedies is so great that alcohol is the one which comes most quickly to the mind of those who have been taught in the traditions of the past, and who are not fully aware of its action on the human system. We shall endeavor to show that the action of alcohol is not helpful, but on the contrary is really detrimental; and also that there is a better way out of the difficulty.
"If we get a splinter in the body, vital energy is aroused to get rid of the offending substance, inflammation is set up, and sloughing goes on until the splinter is voided. If the splinter is covered with acrid material, the same process is intensified, and nature endeavors to eliminate the offending substance through the natural excretions. Upon the peculiarity of the material depends the direction of this elimination.
"It is well known that some poisons are thrown off by the kidneys, some by the lungs, while others again are attacked by all the emunctories. The difference in the power of the system to absorb different substances, appropriate whatever can be utilized, and throw off whatever can not be used, is sometimes called idiosyncrasy, but more properly it may be called vital resistance, and upon the integrity of this power rests the ability to combat disease in all its forms, whether it be the absorption of any animal virus or the poison resulting from undigested food. This ability is in proportion to the integrity and soundness of every tissue and organ of the body. This may be illustrated by the fact that with a person suffering from kidney disease, which necessarily impedes elimination, the ordinary effects of a poison are intensified; therefore whatever aids in the promotion of good health, or in other words, the normal action of all the functions, will contribute to the safety of the individual in any and every emergency.
"When a person dies from the effect of poisoning, it is simply because the system was unable to eliminate the offending substance and was exhausted in the effort. There is a tolerance of some substances which frequently results in chronic disease, and again it is shown in what is called the cumulative effect or acute disease.
"Those who would hold that a substance is at one time a medicament, and at another time a poison, have much trouble in drawing the line between the beneficial and the poisonous effect. The idea that poisonous substances act on the system is responsible for many grave mistakes, whereas always, and under all circumstances, it is the system that does all the action.
"There might be some excuse for the idea that disease is an entity, from the facts that have been brought to light by the germ theory, but this theory is of recent date, while the entity theory is as old as superstition.
"Snake poison, which may be cited as a type of other animal poisons, takes effect through the circulation, and acts by paralyzing the nerve centres, and by altering the condition of the blood. In ordinary cases death seems to take place by arrest of respiration, from paralysis of the nerves of motion. The poison also acts septically, producing at a later period sloughing and hemorrhage.
"Dr. Calmette, a noted French scientist, claims that what is poisonous in the snake's bite, is not the venom absorbed into the blood, but a principle which the blood itself has developed out of the poison. This would necessitate very quick action when the poison is inserted in one of the large veins, as that is followed by instant death.
"The following cases fairly represent some of the tragedies that are occurring in our everyday life.
"A man 60 years old falls and dislocates his finger, he goes to the hospital, where in a short time he dies from blood poisoning. ***** Another man 48 years old, many years a wine merchant, whose great toe was severely crushed by a heavy man stepping on it, was taken with blood-poisoning and in spite of all treatment, even to the amputation of the leg, he soon succumbed to the disease. *****A young woman 24 years old, picks a pimple on her chin and at once her face begins to swell. In vain was all medical treatment, for in a few days she died in terrible agony. ***** About a year ago there died in Brooklyn, N. Y., a physician in his 38th year, who six days previously received a slight scratch in his hand while performing a post-mortem examination. All that medical science could suggest was done to no avail. ***** In the summer of 1896 a young woman 22 years of age was bitten on the leg by an insect. Several physicians were called in but their treatment gave no relief; blood-poisoning set in; it was decided to amputate the leg, but before it could be done she died. ***** In July, 1896, a veterinary surgeon 34 years of age, while removing a cancer from a horse pricked his finger with his knife. The wound was so slight that he forgot all about it. A few days later blood-poisoning set in and in a short time his end came. ***** Some forty years ago a man named Whitney was teasing a rattlesnake in a Broadway barroom, was bitten by it, and, though whisky was poured down his throat by the quart, he soon died.
"Such results seem entirely unnecessary were the proper course pursued, and at the same time they are a fearful commentary on the medical resources of the day.
"The latest researches in regard to alcohol reveal it as a poison to the human system in whatever way it may be diluted or disguised. Its effect is always the same in proportion to the amount taken. It is impossible to habitually use it in any form, even in small quantities, without disease and degeneration resulting therefrom. When taken into the stomach the action is the same as with any other narcotic; the meaning of this word is to become torpid. It benumbs the nerves of sensation, and thus the vital resistance to any offending material is reduced, and while the patient feels less of any disturbance the real harm goes on with accumulated force because of the lack of vitality and non-resistance of the nervous system.
"When the body is in the throes of a vital struggle with a virulent poison it would seem, to any unprejudiced mind, the height of folly to further weaken the vital resistance by the administration of any narcotic, and especially alcohol.
"The eminent German, Professor Bunge, says: 'All the results which on superficial observation appear to show that alcohol possesses stimulant properties, can be explained on the ground that they were due to paralysis.' ***** Professors S. Weir Mitchell and E. T. Reichert, in Researches on Serpent Poison, make this notable statement: 'Despite the popular creed, it is now pretty sure that many men have been killed by the alcohol given to relieve them from the effects of snake bite, and it is a matter of record that men dead drunk with whiskey and then bitten, have died of the bite.'
"As a great contrast to the weakness of the mass of our people who are drug-takers and alcohol-consumers, and who are liable to almost any epidemic that comes along, and quickly succumb to a serious injury, may be mentioned the Turkish soldiers of to-day, who know nothing of drugs as we use them and never use alcohol in any form. During the late controversy with the Greeks, one of them who was reported as having been shot in the stomach, remained in the ranks, and afterward walked ten miles. Another one who was wounded twice in the legs and once in the shoulder, continued attending to his duties for twenty-four hours, until an officer noticed his condition and ordered him to the hospital. The heat was tremendous, but the troops endured it without complaint, and the doctors were astonished at the wonderful vitality of the wounded Turks, who recovered with remarkable rapidity. This, with good reason, is attributed to their abstemious lives.
"It has been stated that the Moqui Indians handle the rattlesnake with impunity, and are not inconvenienced by its occasional bite.
"The rational treatment of animal poison is to endeavor to prevent the entry of the virus into the circulation and to neutralize it in the wound before it is absorbed; but when it has entered the system everything should be done for its elimination.
"The most powerful aid to the human system, and the most perfect eliminator known to man is heat. It is used with much advantage, and great success by means of water, both internally and externally, but above all is its use by hot air, as in the Turkish bath, which works in harmony with every natural function, promoting the action of all the secretions, and more particularly the excretions. By this means will the system unload itself of an accumulation of impurities in an incredibly short space of time, while the heat aids in destroying whatever there may be of virus therein.
"Calmette, whom we have previously quoted, has shown that whatever be the source of snake venom, its active principle is destroyed by being submitted to a temperature of about 212 degrees for a variable length of time.
"In the not remote future thousands of human beings will owe to the Turkish bath not only an immunity from disease in general, but also an escape from the horrors of a premature death from hydrophobia, the poison of snake bite, or the slower action of infectious disease.
"The mass of testimony that has been accumulating for over thirty years past is more than sufficient to convince any reasonable mind that is willing to examine the facts.
"The medical profession has searched the world over and under for the means of controlling disease, while within the human body itself lies the vital power which needs only to be cultivated and exalted to its true function to banish the mass of disease from the land."
Dr. Shepard states in another article that Turkish baths are now used in London and Paris for the cure of hydrophobia.
Dr. J. H. Kellogg says:—
"A great number of remedies have acquired the reputation of being cures for snake bites. The partisans of each one of these have been able to produce a large number of cases, which apparently supported their claims; the uniform testimony of all scientific authorities upon this subject, however, is that all these so-called antidotes are worthless. Prof. W. Watson Cheyne, M. B., F. R. C. S., surgeon of Kings College Hospital, London, England, states, in the International Encyclopedia of Surgery, that 'there is no known antidote by which the venom can be neutralized, nor any prophylactic.' This eminent authority also remarks further: 'Hence medication with this view is to be avoided altogether, and the aim of treatment should be to prevent the poison from gaining access to the general circulation, and to avoid its prostrating effects if its entrance has already taken place.' The same writer asserts that the only aim of the constitutional treatment should be 'to sustain the strength until the poison shall have been eliminated.' The idea that the saturation of the body with whisky to the point of intoxication, if possible, is beneficial in these cases, is in the highest degree erroneous. Whisky intoxication, according to Dr. Cheyne, actually 'favors the injurious effect of the poison. What is required is to keep the patient alive until the poison has been eliminated.' Whisky will not do this, but actually aids the poison in its fatal work by lessening the resistance of the patient, and hence lessening his chances for recovery.
"The reputation of whisky as a remedy in these cases is due to the fact that on an average only one person in eight who is bitten by a rattlesnake is really poisoned; the reasons for this were fully explained in an interesting paper on 'Rattlesnakes,' by the eminent Dr. S. Weir Mitchell, and published in the Smithsonian Contributions to Knowledge for 1860. If the snake strikes several times before inflicting a wound, the sacs containing the venom may be emptied, so that the succeeding bite will introduce only the most minute quantity of poison not enough to produce serious, or fatal results. If the part bitten is covered by clothing, the poison may be absorbed by the clothing, so that but very little enters the circulation. In various other ways the snake is prevented from inflicting a fatal wound. The popular idea, that every bite of a rattlesnake is necessarily poisonous, is thus shown to be erroneous. It is not at all probable that the administration of whisky has ever in any case contributed to the long life of a person bitten by a rattlesnake.
"Whisky is often recommended by physicians with the idea that it will sustain the energies of the patient, or will stimulate the heart, etc.; but it has been clearly shown that alcohol in all forms is not only useless for these purposes, but does actual damage, since it lessens the resistance of the patient, weakens the heart, and helps along the prostration which is the characteristic effect of the rattlesnake venom. Alcohol has, for many years, been used as an antidote for collapse under an anæsthetic administered for surgical purposes, but no intelligent physician nowadays thinks of using alcohol for such a purpose; instead, alcohol is given before the anæsthetic for the purpose of facilitating its effect. Errors of this sort which have once become established are very hard to uproot. Probably some physicians will continue to use alcohol for shock, exhaustion, general debility and similar conditions as well as for rattle-snake poisoning for another quarter of a century, but such use of alcohol does not belong to the domain of rational medicine and is not supported by scientific facts."
"Under the Pasteur method, a man who did not take alcohol was much more likely to recover from the bite of a mad dog than one bitten under the same conditions, who used that drug; while in lock-jaw there was absolute failure to secure immunity if the patient had taken alcohol. In India it used to be given in large quantities for snake bite, but it was found that it had a direct effect in interfering with the processes of repair, and so is being abandoned."—Dr. Sims Woodhead, of the Royal College of Physicians and Surgeons, London, Eng.
"Nothing could be more irrational and dangerous than the popular notion concerning the antagonism of whisky and snake-bites, and Willson reports that several of the fatalities in his series were directly due to alcohol rather than to the bite."—Editorial, Journal of the American Medical Ass'n.
Rheumatism:—"Unquestionably, the most active cause of rheumatism, as well as of migraine, sick-headache, Bright's disease, neurasthenia and a number of other kindred diseases, is the general use of flesh food, tea and coffee, and alcoholic liquors. As regards remedies, there are no medicinal agents which are of any permanent value in the treatment of chronic rheumatism, The disease can be remedied only by regimen,—that is, by diet and training. A simple dietary, consisting of fruits, grains, and nuts, and particularly the free use of fruits, must be placed in the first rank among the radical curative measures. Water, if taken in abundance, is also a means of washing out the accumulated poisons.
"An individual afflicted with rheumatism in any form should live, so far as possible, an out-of-door life, taking daily a sufficient amount of exercise to induce vigorous perspiration. A cool morning sponge bath, followed by vigorous rubbing, and a moist pack to the joints most seriously affected, at night, are measures which are worthy of a faithful trial. Every person who is suffering from this disease should give the matter immediate attention, as it is a malady which is progressive, and is one of the most potent causes of premature old age, and general physical deterioration. American nervousness is probably more often due to uric acid, or to the poisons which it represents, than to any other one cause." —Good Health.
"Alcohol favors the development of rheumatism. It does this by preventing waste matter from leaving the system. Beer and wine, because they contain lime and salts, are said to cause rheumatism, or at least to aid in its development. These salts are absorbed into the system, unite with the uric acid, and form an insoluble urate of lime, which is deposited around the joints, thus causing them to become enlarged and stiff *****
"The success of the Turkish bath treatment has been phenomenal. Of over 3,000 cases treated here at least 95 per cent, have been entirely relieved, or greatly helped. Some who were treated over twenty years ago have stated that they have not had a twinge of rheumatism since. Very few have persevered in the use of the bath without experiencing permanent relief." —Dr. Charles H. Shepard, Brooklyn.
"Those having a bath cabinet can have a good substitute at home for the Turkish bath. Remember that if tobacco and alcohol are indulged in, there can be no permanent relief."
The New Hygiene says:—
"Under no circumstances take any of the thousand and one nostrums advertised as sure cures for this disease. Pure unadulterated blood is the only remedy. This can only be produced by cleansing the system of impurities, and giving it the right kind of material out of which to make it. Keep out the poisonous physic, clean out the colon, strengthen the lungs, and feed the system with proper food, and this disease will vanish like a fog before the rising sun."
The same book in advocating the use of the Turkish bath for rheumatism, says :—
"The fact, which is well attested, that when a person enters the bath the urine may be strongly acid, but, on leaving the bath, after half an hour, it is markedly alkaline, shows that the bath has a strong effect upon the system."
Dr. Ridge says of rheumatic fever:—
"I would urge most strongly the desirability of avoiding every form of alcoholic liquor, from the very commencement of the disease, as affording the best chance for a speedy and safe recovery. The highest authorities are agreed on this point, but there is a lingering practice which makes reference necessary in order to confirm the wavering."
In Mt. Sinai Hospital, New York, the hot blanket pack is used in acute rheumatism, almost to the exclusion of other methods. The pack should be continued two to four hours at least, and may be repeated two or three times within the twenty-four hours with advantage.
Nature Cure says that thorough massage, and half a dozen cups of hot lemonade will cure a severe case of sciatica:—
"The massage should be commenced moderately, and increased as the patient can bear it. Rubbing and slapping of the muscles with bare hands will hasten a cure, and be agreeable to the patient. One to two hours treatment, if vigorous, will effect a cure."
Sea-Sickness:—Brandy is a common resort in this trouble, many taking it under such circumstances who would under no other. Yet it frequently adds to the sickness, instead of relieving it.
"Be sparing in diet for two or three days before the expected voyage. If very sensitive, take to your berth as soon as you go on board, or lie down on deck; get near the centre of the vessel, and lie with your feet to the stern. Go to sleep if possible. Iced water may be sipped, but nothing solid should be taken at first; after a while a cracker or wafer may be taken."
It is said upon good authority that if two or three apples are eaten shortly before going on board, or before rough water is encountered, sea-sickness is entirely averted. It will be well to partake of no other food for some hours previous to the voyage when trying this.
Good Health says:—
"If any of our readers have occasion to cross the ocean in the stormy season, we recommend three things; keep horizontal, with the head low; put an ice-bag to the back of the neck, keep the stomach clean, free from greasy foods and meats, and eat nothing till there is an appetite for food. A habitually clean dietary before going on board is doubtless a good preparation for such a voyage, as well as for any other nerve strain, or test of endurance. It pays to be good—to your stomach, as well as in other ways."
The following is guaranteed by a Russian physician to be an effective cure and a means of avoiding sea-sickness when the symptoms first make their appearance. Take long and deep inspirations. About twenty breaths should be taken every minute, and they should be as deep as possible. After thirty or forty inspirations the symptoms will be found to abate. This is recommended for dyspepsia also.
Sore Nipples:—" Alum water, or tannin, used for several months in advance will harden as effectually as brandy. If there is soreness on commencing to nurse, put a pinch of alum into milk, and apply the curd to the nipple."
Spasms:—"These are caused by flatulence, as a result of indigestion. A little hot ginger tea, or capsicum tea, may do all that is required. If these are not at hand, loosen every tight band, rub well the region of the heart and stomach, flap the face with the corner of a wet towel, and give sips of cold water."
Shock:—"In shock, or collapse, the state is similar in some respects to that which is present in fainting. Every function is almost at a standstill; absorption from the stomach and elsewhere is at its lowest point, because the circulation of the blood is so much interfered with. Hence much of the brandy which is so often given, and to such a wonderful amount, with very little apparent effect of intoxication, is really not absorbed at all, and is very often rejected from the stomach by vomiting, when reaction does occur, if not before.
"The patient should be wrapped up warmly, and put to bed as soon as possible. The limbs may be rubbed with hot flannels, and hot water bottles put to hands and feet. In some cases, also, towels wrung out of hot water may be wrapped around the head. Hot milk and water, hot water slightly sweetened, or with a little peppermint water in it, should be given as soon as the patient can swallow. Hot beverages will warm the skin more rapidly and powerfully than any alcoholic liquor.
"If the patient cannot swallow, an enema of hot water, or hot, thin gruel, should be administered, and may be of use in addition to hot drinks. Beef extract may be added to the hot water with advantage.
"In the vast majority of cases there need be no anxiety so far as the shock is concerned; reaction will occur in due time if ordinary care be taken, and will be more natural and steady if the system is not embarrassed by the presence of the narcotic alcohol. In the state of collapse the voluntary nervous system is depressed; alcohol diminishes the power and activity of the nervous centres of the brain, hence its action is undesirable in shock or collapse."—Dr. J. J. Ridge, London.
"No procedure could be more senseless than the administering alcohol in shock. A stimulant of some kind is necessary in such cases, and alcohol, instead of being a stimulant is a narcotic. ***** Alcohol causes a decrease of temperature, the very thing to be avoided in cases of shock."—Dr. J. H. Kellogg.
"I am perfectly sure that a large dose of alcohol in shock puts a nail in the coffin of the patient."—Dr. H. C. Wood of the University of Pennsylvania.
Sinking Sensations:—Many women have a feeling of weakness or "goneness" at about eleven o'clock in the morning, and are led by it to the injurious practice of eating between meals. It is often due to indigestion, or to the use of beer or wine. A few sips of hot milk, of fruit juice, or even of cold water will often relieve it, especially if total abstinence is persevered in.
Sudden Illness:—"Those taken suddenly ill are likely to fare best if placed in a recumbent position, with head slightly elevated, all tightness of garments about the neck or waist relieved, and a little cold water given in case of ability to swallow. A mustard plaster on the back of the neck, or over the stomach, and hot water or hot bottles to the feet, are never out of place, while vinegar, or smelling salts, or dilute ammonia to the nostrils is reviving."—Ezra M. Hunt, M. D., late secretary of New Jersey State Board of Health.
"Both the popular and professional beliefs in the efficacy of alcoholic liquids for relieving exhaustion, faintness, shock, etc. are equally fallacious. All these conditions are temporary, and rapidly recovered from by simply the recumbent position, and free access to fresh air. Ninety-nine out of every hundred of such cases pass the crisis before the attendants have time to apply any remedies, and when they do, the sprinkling of cold water on the face, and the vapor of camphor or carbonate of ammonia to the nostrils, are the most efficacious remedies, and leave none of the secondary evil effects of brandy, whisky or wine."—Dr. N. S. Davis.
Sunstroke:—"There has lately been a correspondence in the Morning Post on the subject of 'Sunstroke and Alcohol.' We quite agree with the statement that 'nothing predisposes people to sunstroke so much as this pernicious habit of taking stimulants (so-called) during the hot weather.' As far as this country is concerned, nearly every case of sunstroke might be more appropriately designated 'beerstroke.' One effect of alcohol is to paralyze the heat-regulating mechanism; the blood becomes overloaded with waste material, and the narcotism, and vasomotor paralysis, produced by the alcohol, is added to that produced by the heat. Abstainers, other things being equal, can always endure extremes of temperature better than consumers of alcohol."—Medical Pioneer England.
"During the month of January, 1896, there occurred over three hundred deaths from sunstroke in Australia. When called upon to offer suggestions relative to its prevention, the medical board promptly informed the Colonial government that, of all the predisposing causes, none were so potent as indulgence in intoxicating liquors, and in its treatment nothing seemed to have a more disastrous effect than the administration of alcoholic stimulants."—Medical News.
The Bulletin of the A. M. T. A. for August, 1896, contained the following:—
"Recently a leading medical man, a teacher in a college, warned his student audience against the anti-alcoholic theories urged by extremists and persons whose zeal was greater than their intelligence. He affirmed positively that the value of alcohol was well known in medicine, and established by long years of experience.
"Not long afterward a man was brought into his office in a state of collapse from sunstroke, and this physician and teacher ordered large quantities of brandy to be administered; the patient died soon after."
Dr. T. D. Crothers tells of a case where alcohol was administered to a child for partial sunstroke, and says, "there were many reasons for believing that the profound poisoning from alcohol gave a permanent bias and tendency that developed into inebriety later."
"When a person falls with sunstroke (or heatstroke) he should at once be carried to a cool, shady place. His clothing should be removed, and cold applications made to the head, and over the whole body. Pieces of ice may be packed around the head, or cold water may be poured upon the body. Cold enema may also be employed. In case the face is pale, hot applications should be made to the head and over the heart and the body should be rubbed vigorously."—Dr. J. H. Kellogg.
TYPHOID FEVER.
As many lives are lost by this disease, its treatment must ever be one of intense interest, not only to physicians, but also to all humanity. Since non-alcoholic treatment has reduced the death-rate in typhoid to five per cent., the views regarding such treatment expressed by leading practitioners will doubtless be read with eagerness.
The following is a paper by Dr. N. S. Davis taken from the Medical Temperance Quarterly.
"Alleged Indications for the use of Alcohol in the Treatment of Typhoid Fever:—On the first page of the first number of a new medical journal bearing date July, 1895, may be found the following statement: 'The question of administering alcohol comes up in every case of typhoid fever. In mild cases, especially when the patient is young, healthy and temperate, stimulants are not needed so long as the disease follows the typical course. Here, as elsewhere, alcohol should be avoided when not absolutely demanded. There is, however, generally such a dangerous tendency toward nervous exhaustion, that in a majority of cases more or less alcohol is required. The indication which calls for its use is an inability to administer enough food. ***** Again, the existence of high temperature nearly always makes it necessary to stimulate the patient, as does threatened nervous exhaustion and heart failure, for immediate effect, likewise a weak, small, compressible, rapid pulse, with impaired cardiac impulse and systolic sound, is a frequent indication; other remedies may be required, but alcohol cannot be dispensed with.' The next paragraph continues: 'It is necessary to give alcohol in serious complications of typhoid fever, such as pneumonia, pleurisy, hemorrhage and severe bronchitis or diarrhœa. It is best to begin giving it early and in small quantities: two to six ounces is a moderate amount, eight to twelve ounces daily is not too much for adynamic or complicated cases.'
"The foregoing quotations purport to have been condensed from one of our recent authoritative works on practical medicine, and doubtless fairly represent the prevailing opinions concerning the use of alcohol in the treatment of typhoid and other fevers, both in and out of the profession. A careful reading will show that the whole is founded on the following four assumptions:—
"1. That alcohol when taken into the living body acts as a general stimulant, and especially so to the cardiac and vasomotor functions. 2. That in mild, uncomplicated cases of typhoid fever in young and previously healthy subjects, stimulants are not required and no alcohol should be given. 3. That in a 'majority of cases' the tendency toward dangerous 'nervous exhaustion' and 'heart failure' is so great that the giving of 'more or less alcohol is required.' 4. The amount required may vary from two to twelve or more ounces per day.
"In the two preceding numbers of this journal, I have endeavored to show that the chief causes of nervous exhaustion and heart failure, in typhoid and other fevers were impairment of the hemoglobin and corpuscular elements of the blood, deficient reception and internal distribution of oxygen, and molecular degeneration of the muscular structures of the heart itself. These important pathological conditions are doubtless caused by the specific toxic agent or agents giving rise to the fever. Consequently the rational objects of treatment are to stop the further action of the specific cause, either by neutralization, or elimination, or both; to stop the further impairment of the hemoglobin and other elements of the blood; and to increase the reception and internal distribution of oxygen, by which we will most effectually prevent further fatty or granular degeneration of cardiac and other structures. The language of the paragraphs I have quoted, fairly assumes that alcohol is a stimulant capable of relieving nervous exhaustion and cardiac failures, regardless of the causes producing those pathological conditions, and consequently its use is necessary in the 'majority of cases' of typhoid fever.
"Can such an assumption be sustained by either established facts, or correct reasoning? Can nervous and cardiac exhaustion, induced by the presence of toxic agents in the blood, with deficiency of both hemoglobin and oxygen, be relieved by a simple stimulant, that neither neutralizes nor eliminates the toxic agents, nor increases either the hemoglobin or oxygen? That alcohol does not neutralize or destroy toxic ptomaines, or tox-albumins, is proved by abundant clinical experience, and also by the fact that chemists use it freely in the processes for separating these substances from other organic matters for experimental purposes. That its presence in the living body retards metabolic changes generally, and thereby aids in retaining instead of eliminating toxic agents of all kinds, has been so fully shown in the pages of preceding numbers of the Medical Temperance Quarterly, that the leading facts need not be repeated here. That its presence does not increase the hemoglobin, or favor oxy-hemoglobin or increased internal distribution of oxygen, but decidedly the reverse, has been equally well demonstrated by numerous and reliable experimental researches in this and other countries.
"Then it must be conceded that alcohol is not capable of fulfilling either of the important indications presented in the treatment of typhoid fever as stated above. Nevertheless, the advocates of its use apparently recognize but two ideas or factors in these cases, namely, the popularly inherited assumption that alcohol is a stimulant, and as the patient is in danger from nervous and cardiac weakness, therefore the alcohol must be given, pro re nata without the slightest regard to the existing causes of the weakness, or the modus operandi of the so-called stimulant.
"This is proved by the fact that they group together as stimulants, and give to the same patient in alternate doses, remedies of directly antagonistic action, as alcohol and strychnine, or digitalis, etc.
"The accepted definition of a stimulant in medical literature, is some agent capable of exciting or increasing vital activity as a whole, or the natural activity of some one structure or organ.
"For instance, both clinical and experimental observations show that strychnine directly increases the functional activity of the respiratory, cardiac and vasomotor nervous systems, and thereby increases the internal distribution of oxygen, which is nature's own special exciter of all vital action. Therefore it is properly a direct respiratory, cardiac and vasomotor stimulant and indirectly a stimulator of all vital processes. But the same kind of clinical and experimental observations show that alcohol directly diminishes the functional activity of all nerve structures, pre-eminently those of respiration and circulation, and also of all metabolic processes, whether respirative, disintegrative or secretory. Consequently it not only acts as directly antagonistic to strychnine, but equally so to all true stimulants or remedies capable of increasing vital activity. Instead, therefore, of meriting the name of stimulant, alcohol should be designated and used only as an anaæsthetic and sedative, or depressor of vital activity.
"And a thorough and impartial investigation will show that its use in the treatment of typhoid and other fevers, while deceiving both physician and patient, by its anæsthetic effect in diminishing restlessness, both prolongs the duration and increases the ratio of mortality of the disease, by its impairment of vital activity in the organizable elements of both blood and tissues."
Equally interesting is the following outline of treatment pursued by Dr. W. H. Riley, of the Battle Creek Sanitarium.
"The purpose of the present paper is to give briefly an outline of the method of treatment of typhoid fever as used by the writer in a considerable number of cases.
"A consideration of the pathology of this disease does not properly come under this head, but we wish simply to call attention to the well-known fact that typhoid fever is a germ disease. The germ which causes this fever has generally been supposed to be the bacillus of Eberth. More recent bacteriological studies rather indicate that the bacillus coli may also cause the disease. These germs are usually carried into the body in food or drink, and, lodging in the small intestines, begin to grow and multiply, and by their life produce poisonous ptomaines which are absorbed and carried by the circulation to all the organs and tissues of the body.
"It is these ptomaines, thus carried to all parts of the body, that are largely the immediate cause of the pyrexia and attending symptoms. The organisms which produce these poisons for the most part remain in the intestines, although they have been found in the spleen.
"The indications for treatment are:—
"1. To remove or destroy the cause (to eliminate the germs and ptomaines from the body).
"2. To sustain the vital and resisting powers of the patient.
"If the patient is seen early in the disease, it has been my practice to immediately put him to bed and give a free dose of magnesium sulphate. This is preferably given in the morning or forenoon, and may be repeated once or twice on successive days. Besides this the patient should have a large enema of water at a temperature of from 75° to 80° F.; and this may be repeated daily or even oftener, for some time, if necessary, to keep the bowels empty of the poisonous substances.
"The salines and enemas thus used carry out bodily a large number of germs and ptomaines that are present in the intestines; and further, the salines, by producing an increased secretion of the mucous membrane of the intestines, tend to disentangle and set free many of the germs that have found a lodging place in the walls of the intestines.
"For the elimination of the ptomaines which have been absorbed into the circulation and carried to the tissues, nothing is better than the internal use of water. From three to five pints should be drunk during every twenty-four hours. It should be taken in small quantities six to eight ounces every hour or two during waking hours, except when food is taken. I will refer to this point more in detail later.
"A consideration of the general care of the patient properly comes under the second head of the indications for treatment as given above. The patient should be put to bed in a large, light, well-ventilated room. At least two sides of the room should communicate directly by windows with out-of-doors, in order that the room may be properly ventilated.
"All unnecessary articles of furniture, such as carpets, couches, upholstered chairs, pictures, etc. should be removed.
"The room should be thoroughly cleaned before the patient is put into it.
"There should be two beds in the room for the use of the patient. These should be, preferably, narrow and so placed in the room that there is a free approach to both sides of the bed, for the convenience of the nurse in giving treatment. Iron bed-steads are preferable to wooden. The bedding should be firm, yet soft and smoothly drawn. There should be just sufficient covering to protect the body. The patient should be changed from one bed to the other daily. This may be done by placing the two beds side by side and carefully moving the patient from one to the other. The sheets on the bed from which the patient has been taken should be washed and disinfected at each change of the beds, and all other bedding should be thoroughly aired and exposed to the sunlight daily.
"The patient should have the care of a thoroughly educated, careful and competent nurse, one who understands perfectly the various methods of using water in the treatment of fevers.
"There is no other single remedy that I consider so valuable in the treatment of fever as the internal use of water. As above stated, the patient should drink six or eight ounces every hour during the waking hours, except for about two hours after food is taken. The water should be thoroughly sterilized, and as a rule may be taken either cool or hot. Ice water is objectionable. Hot water is often preferable. This is a simple remedy, but nevertheless is efficacious. It should be given to the patient whether he calls for it or not, and it should be considered an important part of his treatment. When water is taken into the stomach and absorbed into the circulation, it throws into solution the ptomaines which have been absorbed from the intestines and are present in the circulation and tissues, and thereby puts them in a favorable condition for elimination. It increases the activity of the kidneys, and thus hastens and increases the elimination of the poisons in the system.
"In the early stage of the fever, when the pulse is full, and the action of the heart increased, it is best to give the patient cool water. Later in the disease, when the action of the heart is weak, and the patient feeble, it is best to give the water hot.
"Winternitz, many years ago, demonstrated that hot water taken into the stomach acts as a cardiac stimulant, and the increased heart's action is immediate, or at least before the water has time to absorb, which indicates that the water in the stomach acts reflexly as a cardiac stimulant. The water after absorption also increases the circulation by filling the blood-vessels, and increasing arterial pressure. The writer has frequently noticed a decided increase in the fullness, and rapidity of the pulse, after a patient has drunk a glassful of hot water.
"The external use of water also forms an important part of the treatment. The patient should be sponged off with tepid water every hour or two when the temperature is 103°, or above. When the temperature is less than this, it is not necessary to sponge the body so frequently. Sometimes a hot sponge bath is more efficacious in reducing the temperature than the tepid or cool bath. The sponge bath reduces the temperature, relieves many of the distressing nervous symptoms, is refreshing to the patient, and promotes sleep. The temperature of the body may also be reduced by the use of cool compresses placed over the abdomen, and changed frequently.
"The matter of diet is an important factor in the treatment of typhoid fever. The diet should be aseptic, easily digested, and should contain the necessary food elements. Probably no one article of diet meets all these requirements as well as sterilized milk. The patient should take from two to three pints daily. The milk is best taken four times during the day at intervals of four hours, taking eight to ten ounces at a time. Should the patient become tired of the milk, gluten gruel may be substituted for the milk.
"The diarrhœa and bowel symptoms, when present, may be relieved by the application of hot fomentations to the abdomen, warm or hot enemas and twenty grains of subnitrate of bismuth given every four hours.
"The patient should be kept as quiet as possible, and should be turned in bed at intervals, to prevent hypostatic congestion and the formation of bed-sores. The bony prominences which are apt to become eroded should be sponged frequently with a solution of tannic acid in equal parts of alcohol and water; a dram of the tannic acid to a pint of alcohol and water, is about the proper strength to use.
By the methods briefly outlined above—that is by the free use of water internally and externally, by keeping the intestines thoroughly emptied of poisonous material by the free and frequent use of enemas, by proper feeding and the careful attention of a good nurse to the patient and his surroundings—the duration of the fever may be shortened and the severity of the disease lessened; heart failure, and other complications will seldom occur, and the patient will in nearly every instance make a good recovery. The best method to pursue to prevent heart failure is to keep the poisons which are generated in the bowels and absorbed into the body, and which are the direct cause of the heart failure, eliminated from the body. Should the heart become weak, it may be effectually stimulated by giving hot water to drink, applying heat to the heart in the form of a fomentation, and the application of fomentations to the upper spine.
"In the treatment of a large number of cases of typhoid fever, extending over several years' practice, the writer has never made use of alcohol internally to support the action of the heart, or for any other purpose.
"The number of cases of death from typhoid fever coming under the writer's observation, where the method of treatment pursued has been similar to that briefly indicated above, have been very few, a much smaller per cent, than in practice where alcohol has been used as a 'cardiac stimulant.' I believe that the use of alcohol in the treatment of typhoid fever is not only useless, but absolutely harmful."
Dr. Kate Lindsay, of Battle Creek Sanitarium and Hospital, contributed an article upon Typhoid Fever to the Bulletin of the A. M. T. A. for January, 1896, from which a few notes are here taken:—
"The chief toxic centre is evidently the intestinal tract, especially the termination of the ileum. The ulcerations, necroses, perforations and hemorrhages are most frequently found in the last twelve inches of the small intestine, and may extend into the large intestine. The ulcerated surface and open vessels increase the facility with which the poison finds entrance into the circulation. The microbes, blood clots, necrosed tissue and pus, furnish abundant supplies of toxic matter, which, saturating the system, over-power and stop the activity of the functions of all the organs of the body, causing degeneration of tissues. Death is said to take place from heart, lung or brain failure, but the failure involves every other organ as well.
"Regarding the intestinal tract as any other abscess at this time, the physician should seek for methods of treatment or remedies which will remove the morbid matters, and destroy, or at least inhibit their action, thus decreasing the fever and stimulating the circulation. Secondary toxic centres often develop in the course of this disease, notably in the glands, lungs and dependent organs, the hypostatic congestion resulting from lying in one position, causing stasis of blood, death and necrosis of tissue, both of the external and internal organs. All vessels connected with the dying tissues carry toxins to other parts of the body. Suppurating glands, and phlebitis of the femoral veins are examples of this secondary infection, and are accountable for the heart failure and collapse so often fatal during the second, third and fourth weeks of typhoid, fever. *****
"The old idea that in peristaltic action lay the great danger of increase of the hemorrhage and perforation of the bowels, is giving way to the more rational view that gaseous distention and septic absorption, are what bring about fatal results from these complications, and that the moderate peristalsis of the intestinal walls lessens these dangers by closing the gaping ends of the injured vessels, and expelling the septic matter and foul gases. To meet these indications I have found lavage of the bowels, even during hemorrhage, with water of 105° to 110° F. or even hotter, given in moderate quantity of from one pint to three, to give great relief by freeing the large intestines of blood clots, fecal matter and other morbid matter. It also increases peristaltic action in the small intestines, thus favoring the expulsion of gas. The heat stimulates the circulation in the peripheral vessels of the intestines, and overcomes the tendency to blood stasis.
"In the cases cited, ice-bags, alternated with fomentations, were used over the abdomen externally, and heat, or hot and cold, to spine. The extremities were kept warm. From ten to thirty minims of turpentine, in an ounce of gum acacia or starch water, increased the efficiency of the enemata, and aided in expelling the gas and checking hemorrhage.
"The tendency to hypostatic congestion and bed-sores, was prevented by frequent change of position, and the use of hot and cold to the spine by fomentations and compresses, or better still, hot fine spraying, or the alternate hot and cold spray. In one grave case, spraying was kept up for about twelve hours, with only short intermissions. The heart was stimulated by heat applied over it, whenever depression and collapse threatened, and by hot and cold sponging of the spine."
Dr. Noble said some time ago in the London Times: —
"Although it is true that alcohol is an antipyretic, yet its exhibition neither shortens nor modifies (favorably) the diseases of which the fever is but a symptom. The paralysis of the brain which is so frequent a cause of death in typhoid fever, is more often brought about by alcohol than any other cause, and more than one woman suffering from puerperal fever has been done to death by the administration of this substance, which, not being convententer naturæ, is contra naturam"
J. S. Cain, M. D., in an able paper, read at the Nashville Academy of Medicine, on "Rational Suggestions in the Treatment of Typhoid Fever," dissents from the practice, which still obtains largely in the medical profession, of administering alcoholic liquors, in the belief that they are "stimulants, conservators of force and even nutrients," and says:—
"After a careful and thoughtful study of this subject, I have reluctantly, and against firm early convictions, been forced to the conclusion that these theories with regard to the beneficial effects of alcohol in disease are wholly fallacious. The only rational conclusion at which I can arrive is that the agent is ever, and under all circumstances, a depressor of temperature; that it arrests the physiological interchange of carbonic acid gas and oxygen in the tissues, as well as in the air vesicles of the lungs; that it impedes the elimination of tissue waste, and causes the accumulation of this refuse in the system; that it is lethal anæsthetic in all quantities; that it is not stimulant in the true sense, and never exerts that influence; and that it supplies no element to the diseased and vitiated system calculated to antagonize disease, repair waste, or invigorate lowered vital forces, and therefore for these purposes is not called for in the rational treatment of typhoid fever."
At the annual meeting of the American Medical Association held in Atlanta, Georgia, in 1896, Dr. G. B. Garber, of Dunkirk, Ind., read a paper upon "Alcohol in Typhoid Fever" from which a few points are here taken:—
"The fact that the mortality from typhoid fever seems to be gradually lowering is no doubt due in great measure to the non-use of alcohol in the treatment of the disease. Hardly a week passes that some of our journals do not report a series of cases treated without the aid of alcohol in any form. I used alcohol in the treatment of the disease until two years ago, when I became alarmed at the mortality; so I changed my plan, and in 1894 I treated thirty-seven well marked cases of varying degrees of intensity. I had two fatal cases, and in both of them I had used alcohol. In 1895 I treated thirty cases of about the same type, with no death. I only used alcohol in one of them, and it caused me more trouble than any of the others. As this case was in the family of a saloon-keeper, I could not control the matter, as they would give it during my absence. On my return I would find the face flushed, the temperature high, the pulse rapid and the patient nervous. By close inquiry I would find that some of the family had given 'just a little good whisky' which had been in the house for twenty years.
"In closing, I wish to state that I am well convinced that in the treatment of typhoid fever our patients will do better and stand a greater chance of recovery, if we abstain entirely from the use of alcohol in the treatment of the disease."
Prof. J. Burney Yeo, of London, in a paper read before the International Medical Congress held at Rome, Italy, said:—
"In order to maintain the intestinal antisepsis which forms an essential part of this method of treatment, I insist on the necessity of scrupulous attention and caution in feeding patients suffering from enteric fever, great danger arising from a failure to note the extremely limited digestive and absorptive capacity exhibited by such patients.
"In conclusion, the use of alcoholic stimulants, and the common employment of depressing antipyretic agents, must be condemned."
In a report of the treatment of typhoid fever by seventy-two physicians of Connecticut, thirty-eight declared that they did not use alcohol in any stage of this disease. The remainder used it sparingly in the last stages, and only two considered it valuable from the beginning of the disease.
In a discussion of typhoid fever by a medical society meeting in Rochester, N. Y., recently, sixty physicians being present, only three spoke in favor of using alcohol in this disease.
Hygienic physicians all insist upon a rigid fast as long as the high temperature continues, or until the patient is sufficiently hungry to eat a piece of plain, stale, graham bread, "dry upon the tongue." Dr. Charles E. Page of Boston says there would be very few relapses if this plan were carefully carried out. He contends that the whisky and milk diet, together with the not over-fresh air of the average sick room is enough to produce fever in a healthy person, hence is not likely to be conducive to recovery in one already infected with the disease.
In an article in the Arena of September, 1892, Dr. Page says :—
"In my fever practice I have frequently observed the effect of fasts of six, eight, ten and twelve days to be in the highest degree productive of the health and comfort of patients, as, on the other hand I have, during the past twenty years observed the deplorable effects of the almost universal plan of constant feeding. In some of the most distressing cases that have happened to be thrown in my way, when all hope in the minds of friends had been abandoned, I have found that withdrawal of food, drugs and stimulants, and the substitution of simple, fresh, soft water, has produced results that seemed almost miraculous."
Fruit juices are now permitted by many physicians in fever, a few drops of lemon or orange juice, being a grateful addition to the water. Grape juice, unfermented, is highly recommended by some.
A young minister of great promise died recently of typhoid fever. His young wife, only one year married, is in settled melancholy, because she cannot understand why "God took her husband." Inquiry developed the fact that the physician in attendance was a believer in alcohol as a remedy, and used it in this case. In view of the better chances of recovery under non-alcoholic treatment shown by comparative death-rates, may it not be that the alcohol was responsible for the young man's death, instead of its being "God's will to take him?" The Author of all good has too frequently been held responsible for the errors of physicians, and the carelessness of nurses.
Vomiting:—"If the vomiting is due to undigested food, and the sickness can be traced to excess, or to improper diet, draughts of hot water should be taken in order to be rid of offending matter in the stomach. After the stomach is empty bits of ice may be sucked, or cold water sipped. A quarter of a Seidlitz powder may be taken. A flannel, folded to four thicknesses, dipped in hot water, and wrung dry in a towel, may be applied to the pit of the stomach. Cover the flannel with a hot plate, being careful to have the flannel large enough to prevent the plate's burning the skin. Pin a dry towel over all, around the body. This may be renewed every half-hour or hour, as required. Sometimes a cold wet compress on the pit of the stomach, covered with a dry towel is more efficacious, heat developing by reaction. Fluid magnesia is often helpful."—Dr. Ridge.