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It is well known that in the end of last century Dr. James Currie attained a remarkable degree of success in the treatment of exanthematic typhus and scarlet fever by means of cold water douches. But though his method was so successful, it found but few imitators, and was almost forgotten until the success of Priessnitz with his cold water cure brought Currie's method to remembrance. It is certain, however, that Priessnitz and his disciples did not commonly employ their method in cases of fever.
Ernst Brand, of Stettin, in 1861, wrote a book in which he vaunted the success of the cold water cure in typhus. But his recommendation fell dead on the ear of the profession.
It was not till the work of Bartels and Jurgensen, of Kiel, was pnblished in 1866, that attention was roused to the efficacy of the cold-bath treatment in lowering the temperature in fevers, and thereby obviating the ill-effects of the elevated temperature. These careful observers showed that cold baths could be given not only with impunity, but with immense advantage, as often as the elevated temperature rendered them necessary. They showed that the abstraction of heat from the patient should be carried out persistently day and night as often as the temperature as shown by the thermometer applied to the axilla reached or exceeded 39° C. It sometimes happened that as many as twelve baths had to be given in twenty-four hours, and that one patient had to get 200 baths in the course of his disease.
The results of this treatment were exhibited by the statistics of typhus abdominalis in the Kiel Hospital. From 1850 to 1861 there were treated 330 cases by the ordinary methods, of whom 51 died, showing a mortality of 15*4 per cent. Prom 1863 to 1866 there were 160 cases treated by the cold-bath system, of whom only 5 died = 3"1 per cent.
In Basel, where the abdominal typhus is extremely frequent and malignant, the success obtained in the hospital by the cold-bath treatment was equally striking.
Up to 1865 the treatment was the ordinary expectant treatment. In 1865, cold baths were employed to some extent, but as a rule only once, very seldom twice a day. But Dr. Liebermeister, having read Bartels and Jiirgensen's book in 1866, adopted the full cold-bath system administered by these gentlemen. The result is evident from the following table:
I. Ordinary treatment.
^* A paper by Dr. Behier, in the February number of the Practitioner, enables us to add to the statistics supplied by Dr. Liebermeister of the coldbath treatment of typhoid.
Brand treated in 1868, 171 cases, of whom 1 died.
1870-1, 89 „ 0 „
Elenard „ at Lyons, 12 „ 0 „
In the Leipzic hospital from 1851 to 1867, 1178 cases were treated by the old methods, of whom 213 died=18-1 per cent. From 1868 to 1872, 251 cases were treated by cold baths, with 18 deaths=7'2 per cent.
Mortality with treatment Mortality with treatment without baths. with baths.
Jiirgensen . . 15-4 per cent. 3'1 per cent.
Ziemssen and Immermann . 30'2 „ 7"5 „
Liebermeister and Hagenbach 26-2 „ 9'7 „
Kiegel . . • 20-0 „ 4-3 „
Stohr . . • 20-7 „ 6-6 „
This striking result of the cold-bath treatment of typhoid, whereby the mortality was reduced to nearly a fourth of what it had been under the ordinary expectant treatment, was confirmed by the experience of the hospitals of Munich, Erlangen, Wiirzburg, Nurnberg, Greifswald, Jena, Halle, &c, and there can be no doubt that it is a powerful remedial means that should not be neglected in the treatment of typhoid wherever it may occur.
But it is not only in typhoid that the cold-bath treatment is of use. It has been employed with success in typhoid pneumonia, in scarlatina, measles, the premonitory fever of variola, puerperal fever, pleurisy, meningitis cerebro-spinalis epidemica, &c.
The temperature of the water in the bath should be 20° C. or lower. The same water may be used for one patient repeatedly. The bath may stand in the patient's room ready for use, and he should remain in it for ten minutes at a time. The attendants should be instructed to take the temperature in the axilla every two hours, and whenever they find it 39° or upwards they should put the patient into the bath for ten minutes, then lift him out, wrap him up in a dry sheet, and let him rest for a time on the bed before putting on his night shirt.
Very weak patients should have the water rather warmer (24° C), and may remain in it a shorter time (seven or five minutes).
Such is the cold-bath treatment now so extensively employed, especially on the Continent, in the treatment of febrile diseases with a high temperature of the body. It promises to be a useful auxiliary to the best medicinal treatment of such diseases, and though like much of the medication of the so-called "rational" school, it is a mere treatment of a symptom, the increased temperature of the body, yet that should not prejudice us against it, for it is precisely this increase of temperature that constitutes the great danger in typhoid by the parenchymatous degeneration it is liable to produce. If by the use of cold baths we can effectually ward off this by no means insignificant peril, we shall afford to our specific remedies Baptisia, Rhus, Arsenicum, Phosphorus, and others, all the more scope for exerting on the essence of the disease those curative effects which would be rendered nugatory by the disorganisation that attends the elevated temperature.
Dr. Liebermeister does not trust entirely to the antipyretic action of cold water in the treatment of typhoid, but seeks to aid it by the administration of large doses of Quinine, Digitalis, or Veratrum, remedies which are not to be compared in efficacy with the medicines which the homoeopathic principle of selection furnishes us with.
A CALL UPON ALL HOMOEOPATHIC PHYSICIANS FOR THE PROVING OF MEDICINES UPON HEALTHY MEN AND ANIMALS *
Homoeopathy can only fulfil her task of curing men and animals of their diseases in proportion as she more or less thoroughly tests the medicines as to the artificial diseases which they are capable of producing on the healthy organism. She takes her stand solely on the ground of these "provings•" and according as they are sparingly carried on or discontinued, so her living power of progressive development comes to a standstill.
How could any one ever think of effecting a homoeopathic cure in cases where similar diseases have never been produced, either in healthy animals or healthy men, by provings of the remedies? How could any one hope, on a return of any given disease, as, e.g., Asiatic cholera, to become each time more surely master of the disease, if he does not constantly prove more rigorously the remedies hitherto used for cholera, and all the medicines most nearly related to them ?" Prove more rigorously," what does that mean?
The means of determining almost all morbid symptoms
* From the Internationale homoopathische Preise.
have multiplied with the progress of the natural sciences. Not one of these means should be overlooked or even imperfectly employed in our provings of medicine.
1. All physical methods of examination (auscultation, percussion, laryngoscopy, &c.) should be called to our aid with the greatest rigor and precision.
2. Every chemical examination of organic matters that have undergone morbid changes should be made with the aid of all the methods placed at our disposal through the advance of chemistry, methods aiming at the most precise determination of their internal chemical constitution.
3. The pathologico-anatomical new formations (morbid neoplasms) ought to be examined and determined with the utmost exactitude by macroscopic and microscopic observation.
The highest aim that any prover of a given medicine can propose to himself is to produce by the mutual action of that medicine and his healthy body a well-defined totality of morbid action, or else, in case he should himself be not perfectly healthy or too feeble for the purpose, it must be that of other healthy* persons placed under his immediate inspection, or, at the very least, that of some healthy animal.
Morbid symptoms that are perfectly isolated, provided only they be accurately determined, in case only one prover was in a condition to incur such symptoms, are welcome with a fully adequate recognition of their value as fragments of a totality of which others will avail themselves in order to complete the "picture" of the artificial disease.
In Vienna the medicines selected for proving will be tried upon animals in various localities. Approved zoologists, chemists, and histologists have promised their advice and aid in the experiments to be conducted by skilled provers of medicine.
Whoever has a mind to see for himself the procedure in the production of artificial diseases by given medicines on
* For which purpose also women, single and married, and also children, are desirable.