  INFLUENZA AND ITS TREATMENT.The manifestations of Influenza in this section of the country during the past two months have been numerous and varied, although the malady has been far less directly fatal than on its first appearance in the winter of 1889–90. The different types of the disease, the pulmonary, the nervous and the abdominal, have been less distinctly marked, but it has been especially severe in the case of elderly people when appearing as an intercurrent affection. Another noticeable feature is, that the disease has shown a greater disposition to attack children than in former years, although when children have been enjoying usually good health, fatal results have been rare. This, however, has not been the case with sickly or puny children, as the disease has manifested itself in various ways, such as throat, ear and other complications. In many cases nothing more than the peculiar pains characteristic of the disease have been noticed; in others, it has passed off with nothing more serious than would result from a bad cold, so that large numbers have fought it out on this line. The prevalence of the malady in the vicinity of Philadelphia, and we presume this observation holds good elsewhere, has been wide spread, showing conclusively that it is largely dependent upon atmospheric influences. Indeed, up to the present writing, the condition of the weather has been extremely favorable to the development of influenza, and we all hope that better weather during the remainder of the winter will tend to check its spread. Judging from published reports, the treatment of influenza during the present epidemic has been mainly symptomatic, simple remedies being employed in place of the powerful antipyretics and analgesics that were so extensively used three years ago, and this may account in part for the reduced mortality. In this connection the writer ventures to suggest the use of a limited number of remedies that have proven of signal service within the past two months. In the pulmonary type, to relieve the distressing and frequent cough, nothing has given better results than morphine hydrochlorate and pilocarpine hydrochlorate, given hourly in doses of one-fiftieth of a grain each, together. This combination seems to allay sufficiently extraneous irritation, while it favors the re-establishment of the normal secretions, and has shown remarkably favorable effects when broncho-pneumonia threatened to supervene. Given in these small doses, it produces neither narcotism nor depression, and the patient is ready to take his regular meals, to which is added liquid nourishment during the intervals. Hot milk—not boiled—and the free use of beef-tea made from a good extract of beef, are helpful in assisting to maintain the strength. In the abdominal type, with much pain along with mucous discharges from the bowels, showing involvement of the liver, a combination of mercury biniodide with codeine sulphate appears to control and modify the progress of the disease. One one-hundredth grain of the former with one-tenth to one-fifth grain of the latter may be administered every two hours, and along with this, where we It will be noted that nothing has been said in regard to the advisability of antiseptics, and for this reason, viz.: That although the disease may apparently be associated with a micro-organism, this microbe plays no important part in the various manifestations of the disease. Whatever influence it may possess is, as we have seen from clinical experience, counteracted, discounted, by what the older physicians were pleased to term the vis medicatrix naturÆ; and besides, we have absolutely nothing to warrant us in assuming that our present antiseptic measures and remedies exercise any perceptible influence when taken into the system, at least so far as regards this particular malady. Further investigations in this line may develop some new ideas in this respect, but for the present, we must rest content with the stern facts as we see them at the bedside. Special attention should be directed here to the theory of “Digestive Leucocytosis,” as elaborated by Professor Chittenden, published in another department of this number. AUTO-INFECTION IN ABDOMINAL DISORDERS.In view of the complications arising in the course of abdominal diseases from auto-infection, and with our recent knowledge in regard to this important but insidious factor, it behooves the physician to be on the look-out for such manifestations. Toxic anemia, as portrayed by Dr. John E. Bacon, in our last number, brings to light some valuable truths which should ever be uppermost in the minds of those having to deal with occult affections. Considering that we now have ample evidence that a sick person may be his own worst enemy, by reason of an unhealthy condition of the alimentary canal, it is not too much to assume that in many cases of prolonged illness, the complications arising may frequently be due to auto-infection, and thus, in addition to the disease which is seen, there is another disease engrafted upon the first which is insidious but persistent. The plan of using purgatives to unload the intestinal tract and relieve the portal circulation has its value, but the habit, once established, cannot be relieved permanently by this method. The addition of antiseptics is likewise a valuable feature in the treatment of this class of cases, and the two combined will often serve a useful purpose; but cases occur in which either method alone, or both combined fail, and it is then that we are compelled to study the philosophy of cell-function. In this connection, the studies of Pohl, as elaborated by Chittenden, promise to shed a flood of light upon the vexed and complicated problem which involves the theory of nutrition. If digestive leucocytosis, as delineated by these authors, be true, and we have no reason to doubt their conclusions, then we have a satisfactory explanation of the value of proper food for the sick, to say nothing of the nutrition of those who ordinarily enjoy good health. The fact being admitted that white blood-corpuscles or leucocytes are more rapidly developed after the ingestion It is time that the study of the class of cases under consideration should be placed on a scientific basis, in order that we may have some definite idea of the objects to be attained—and the method of attaining them—expressed in terms which may be comprehended by the merest tyro in therapeutics, and to this end the contributions of Metschnikoff, Pohl, Chittenden and Vaughan must be accepted as valuable preliminary data. The next thing in order will be to make these scientific facts clinical facts by making them practical, and it is therefore necessary that others should take up the task in order that the work may be carried to a successful termination. THE PRINCIPLE INVOLVED IN THE SUBCUTANEOUS USE OF BLOOD-SERUM.An important revelation has been made to the medical profession in the form of a communication to the Medical News (Jan. 13, 1894), by Dr. C. F. Darnall, of Llano, Texas. According to the report, twins suffered from ptomain-poisoning, and one of them died. The surviving child was treated by the subcutaneous employment of a normal salt solution, but without apparent benefit. Later, this was followed by the use of two ounces of blood-serum drawn from the arm of the father, a healthy young man. To quote the words of the author, “The child was carefully watched, and reaction occurred in about six hours. Improvement gradually took place, and in six days, upon a diet of thin corn-meal gruel at first, later by fresh milk prepared, the child was well. It was placed at the mother’s breast at regular intervals, and at the time of writing, nearly nine weeks after the onset of the illness of the children, the lacteal secretion is fully established.” Now, this is evidently a very interesting case, and all physicians who wish to understand the “whys” and “wherefores” would like to have some additional light thrown upon this occult subject. In this instance, there is no intimation that the father had been previously rendered “immune” to the peculiar ptomain which, in this case, is supposed to have been derived from a can of condensed milk. How, then, could this blood-serum have exerted a favorable change in the metabolism of the infant which was but ten weeks old? Our bacteriological friends will tell us that the benefits were due to the “natural antiseptic properties” of normal blood-serum; but the clinician and intelligent and conscientious physician will want to know from whence this peculiar property is derived. The blood is an alkaline fluid, and we are taught that antiseptic solutions, to be effective, must be acid. How does it happen, therefore, that blood-serum obtained from normal blood, which is alkaline, possesses antiseptic properties? This question has already taken up so much space in the journal that, aside from our prospective subscribers, it would not be advisable to take further time for its elucidation. It will be sufficient, however, to say that it involves a principle first developed from a scientific standpoint by Professor Vaughan, who has shown conclusively that the antiseptic property of blood-serum is due to the fact that the nucleus of the white corpuscles secretes an actively antiseptic substance, a substance having all the characteristic of a proteid, which he has denominated “nuclein.” EDITORIAL NOTES.The contents of this issue of the American Therapist are as usual varied, practical, interesting, original—carefully arranged to make the reading harmonious as well as profitable. We say this for the benefit of those casual readers of this issue who are not yet—but ought to be—subscribers and regular readers. The American delegates to the International Sanitary Congress, to meet in Paris this month, were named by the chief officer of the Marine Hospital Service; the delegates are Dr. Stephen Smith, New York City, Dr. Shakespeare, Philadelphia, and Dr. Bailhache, Washington, D. C. The advance copies of the “Minutes, Reports, Papers and Discussions of the 41st annual meeting of the American Pharmaceutical Association, held at Chicago, August 14th to 20th, 1893,” have just been issued to members of the association. The regular bound volumes of the “1893 Proceedings,” containing the notable annual report on “Progress in Pharmacy,” will be issued later. The Newberry Library.—Prof. Senn has made a munificent gift to this institution by giving to it his collection of medical books, including especially valuable works on anatomy and surgery, full sets of periodicals, and the collection of books of the late Professor Baum of GÖttingen. With this nucleus, added to by other donors, and its own already extensive collection and ample resources, the Newberry Library is apparently in the front rank, and will afford the profession in Chicago unexcelled bibliographical facilities. The four years’ course is gradually being adopted by all the leading medical colleges. The Jefferson Medical College (Philadelphia) has just concluded to make the four years’ course obligatory after this year, and the Medico-Chirurgical College (Philadelphia) is considering the advisability of making the same rule. The latter college, by the way, has just established new professorships of Otology, Genito-Urinary Diseases and Orthopedic Surgery; the new offices will be filled shortly. The Pennsylvania State Medical Society will hold its next meeting at Gettysburg, May 15, 16, 17, and 18, 1894. Those desirous of presenting papers are requested to notify, at an early date, the Chairman, or any other member of the Committee of Arrangements. Dr. E. E. Montgomery, of Philadelphia, is the chairman, and the other members of the committee are: Dr. Isaac C. Gable, of York; Dr. Geo. S. Hull, of Chambersburg; Dr. John C. Davis, of Carlisle; Dr. Henry Stewart, of Gettysburg; Dr. George Rice, of McSherrystown; Dr. E. W. Cashman, of York Springs. The American Medical Association meeting is to be held this year at San Francisco, on Tuesday June 5th. To Californians this date is a little late for showing off their City and State to best advantage; it will be a trifle too hot for comfort by that time. A better date would have been May 5th, and by arranging early excursions the visitors could have taken in Lower California in April, then the Mid-Winter Fair—which will undoubtedly extend to May—and wound up their hours with attendance at the Convention. Perhaps a general request to re-consider the date should result favorably with the Committee who make the date and all arrangements. After a spirited and quite acrimonious campaign, the New York County Medical Society held its annual election Monday evening, January 15th, 1894. All the candidates on the regular ticket, excepting Dr. McLeod for president, were elected on the first ballot. For the presidency three candidates were in the field, and none of them obtained a clear majority on the first ballot; a second ballot resulted in the re-election of Dr. McLeod. The candidacy of Dr. Alexander, urged by the younger and progressive members, was the disturbing cause in this election; the feelings of the contesting factions were wrought to a high pitch, and the proceedings were so turbulent that the daily press of New York took up the matter and regaled the public with entertaining accounts of the contest. All is now harmony again, we hope. |
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