Vol. XXXV.

No 1

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"THE MEDICAL SUMMARY,"

A SUITABLE HOBBY FOR THE DOCTOR.

Much has been said the last few years concerning hobbies for doctors. It has been clearly pointed out that the physician needs. certain interests that are not directly concerned with his professional work. We believe that a majority of SUMMARY readers are so situated that they might derive an immense lot of satisfaction from a systematic campaign of beautifying their own homes, or at least they should own them. Landscape gardening may sound like a pretentious term, and a thing only within the realm of the idle affluent class. The idea is equally applicable to even the owner of the humblest cottage. Just now there is on foot a general propaganda for the beautifying of our homes and home surroundings. This is more than an academic movement, for many colleges are sending out skilled instructors to point out to people ways and means of beautifying their lawns, streets and highways. In many towns and cities clubs have been formed having for their purpose the beautifying of certain localities or neighborhoods. The idea usually meets with the greatest favor in suburban or sparsely settled places and often a few neighbors of kindred spirit unite and endeavor to accomplish something by carrying out the same beautifying scheme. In every instance where a well directed system of tree-planting and decorating has been put into effect the property has been greatly enhanced in

material value, aside from the esthetic side of the matter. A piece of property having desirable shade trees on it sells much more readily and at a much higher price than a similar piece of property that is treeless.

It is always a matter of surprise and comment how quickly suitable trees will develop into beauty and usefulness. Before planting trees it is always wise to consult those who have actual knowledge on the subject in order that the most suitable kind may be secured. Certain trees are not adapted to certain soils and climates and may therefore come short of your expectations. Every State has in its university a department that will furnish the desired information without cost. Certain magazines and literature may be secured which will throw light on this subject.

In any decorative scheme of this sort a certain unity and harmony should, so far as possible, be carried out. In planting shrubbery and flowers the amateur is likely to overdo the thing and a veritable riot of colors is the result. The blend and harmony of the scheme must ever be borne in mind if the results would be "a thing of beauty and a joy forever." Many pretty houses do not look inviting because they lack the touch of beauty which appropriate flowers and shrubbery might add. If a home lacks privacy it may be, in a couple of years, screened in tastily by suitable shrubbery. Not a few persons obscure themselves from obnoxious neighbors by building high fences. The right kind of trees and shrubs would accomplish this end much more artistically. And the back fence and alley! Here is where the ashes, tin cans and other debris are prone to collect. How easy it is to start vegetation in this place! Climbing plants and vines, or even a row of sunflowers, would add an effect that would be pleasing to the eye.

Now as the long days of spring are approaching with its usual lull in professional work, the doctor should adopt a hobby that will afford him much satisfaction, and incidentally enhance the value of his property. Doctor, what have you accomplished along this line in years past? If you have any definite ideas that would be of interest to SUMMARY readers write us now. This is the time to get your lawns ready for the

summer.

THE TREATMENT OF "GRIP”-INFLUENZA.

Dr. Charles E. Page, in the Medical Times, speaks of the futility of drugs, food and the other routine methods of treating influenza, naively known as "grip." "My first procedure when called to a case of influenza," says the writer, "is to order a hot foot bath to the point of profuse perspiration, and then a thorough going all-over sponge bath with a very mild mixture of acetic acid and lukewarm water (about I to 24) to stimulate the skin to lively action * * with the freest ventilation of the sick room and therapeutic fasting for the sick man, who is allowed all the fresh water he wants in addition to a half teacupful of moderately hot water every four hours during the day time." The writer speaks of the baneful effects of administering food. or so long as the system is engaged in fighting any critical acute disease, the digestion and assimilation of other food than water and fresh air is simply impossible. Hence food is ingested into the stomach for pure and simple putrescence, and instead of 'keeping up the strength' it keeps up the weakness; it is feeding for pyrexia and all manner of 'complications,' and hence to delay if not prevent recovery."

Dr. Page speaks of colds being a misnomer, and that even old Ben Franklin stated that it was a condition neither dependent upon wet or cold, but usually to causes arising from within. Arctic explorers never suffer from colds, although the temperature may be low enough to freeze off their fingers and toes. Colds only made their appearance after a warmer latitude was reached. It is undoubtedly true that the main factors in the production of colds and influenza is lowered vital resistance, autotoxemia and the wearing of an excessive amount of clothing. Active women who go clad in scant attire in accordance with the dictates of dame fashion suffer less from these troubles than do men who swaddle themselves in clothing, thus weakening that greatest of all regulators of bodily heat and vitality, the skin. A stamp and letter directed to Dr. Charles E. Page, Boston, will doubtless bring the reader a reprint of this rather comprehensive essay.

THE MOUTH AND TEETH.

More and more we are coming to a realization of the fact that good sound teeth and clean healthy mouths are essential to our health and well being. A decayed tooth is a veritable culture tube for germs, many of which may be pathogenic and none of which are wholesome. Pyorrhea alveolaris is a specie of slow poisoning. Poor teeth augment other ailments, because faulty chewing means bad assimilation, and the latter means impoverished blood. If the teeth are imperfect and chewing difficult, the nooks and crannies of the oral cavity are choice lodging places of food products which, in the careless person, become putrescent. Unclean mouths harbor the germs of scarlet fever, diphtheria and other pathogenic organisms; in many cases these may remain in an innocuous state until some slight deviation from health results in an infection. The average individual thinks little of any need of hygienic attention to the mouth or throat until some trouble arises from these sources. A little daily hygiene applied here would go a long way in obviating many cases of sore throat and acute infectious diseases. The warmth and moisture of the mouth, with the tendency of its remote recesses to catch and hold detritus of all sorts, make it a most fertile breeding ground for organisms.

What is the remedy? Teach our clientele to carry out a persistent mouth hygiene. In addition to brushing the teeth, gums and buccal cavities after each meal, the mouth should be thoroughly lavaged and throat gargled with boiled water, to which any mild antiseptic has been added. These rigid measures are of course more essential in those who have poor teeth and gums or are subject to sore throat. No one need fear overdoing mouth hygiene; lack of it may cause untold suffering and trouble. It sounds trite to speak of seeking early the services of a good dentist. The majority of people are disposed to defer this luxury until the trouble is bad enough to make them literally sit up and take notice. Even small cavities are a source of danger, and the longer they are neglected the more will the individual in the end suffer, both physically and financially

COCAINE ANESTHESIA.

on

We have frequently called for reports of the best and safest method of producing local anesthesia. The demand comes account of the number of accidents following the use of cocaine and some of its derivatives. In an editorial in Medical Fortnightly on this subject it is pointed out that dentists have met with frequent mishaps for the following reasons: They use too strong solutions; they inject the cocaine with the patient sitting up; they permit the patient to stand up, walk around, and go away too soon after the operation.

Local anesthetics of choice are cocaine and novocaine. The cocaine solution employed by men employing local anesthesia range from 1/15 to 1/5 per cent. Novocaine solutions are usually employed three or four times stronger, as its anesthesia is slower in appearing and more fleeting in effect. For prolonged operations under cocaine and all operations with novocaine the addition of five minims of adrenalin chloride to each ounce of solution is to be recommended to prolong the anesthesia until completion of the operation. Under this conservative plan one dental surgeon reports several thousand extractions without a mishap.

The infiltration of the tissues with water as a means of producing anesthesia has in the past had considerable vogue. Water produces a certain measure of anesthesia if sufficient amount is injected to paralyze the nerves from pressure, but as soon as the water is absorbed and the pressure removed the sensibility to pain returns. Normal saline solution has been recommended for this purpose instead of plain water.

HELEN KELLER.

The editor recently listened to a lecture by this wonderful woman, as well as to her teacher, Mrs. Macy, who is equally wonderful. The story of Helen Keller is known to every reader, how the seemingly insurmountable obstacles of being deaf, blind and dumb were overcome to the extent that she was enabled to graduate from Radcliff College with honors. The idea of such an individual who never heard the sound of a voice, learning to talk, sounds

minded individual, who saw a hippopotamus for the first time, and then remarked, "There isn't any such an animal," we felt for the time being that this Helen Keller business was almost a myth. But the facts of this girl's woeful handicaps in being bereft of the most important senses, together with her marvelous achievements, are so well and widely known that no one can question their veracity. All in all it is one of the greatest marvels of this country. A consideration of the subject opens up new avenues of thought. After all how little we know of appled psychology and the workings of that mass of tissue known as the human brain! Are there other roads to the brain aside from the well known special senses? This brain is as yet almost an uncharted sea so far as our understanding of its function is concerned. The story of Helen Keller, fairylike and fascinating in its appeal, is a powerful object lesson to those who magnify their mole-hills of handicaps into mountains of despair. This messenger and her message coming out of the land of silence and darkness should make a forceful appeal to those who, "having eyes see not, and having ears hear not."

RESPONSIBILITY.

The conscientious physician feels the responsibility resting on him when he treats a grave case. That anyone can steel himself to a sort of philosophical indifference as to the outcome of a case is something inconceivable. It is impossible to feel no any iety in the practice of medicine. We may be often doubtful whether we are pursuing the right line of treatment. In serious cases we may ransack the brain, even when trying to compose ourselves for a night's refreshment of mind and body, but the specter of a very sick one haunts our couch. When a case seems to hang in the balance we are in the habit of looking everywhere for light to guide us safely through. To the younger members of the profession there is nothing which worries him more than losing a patient, taken by the grim reaper.

failed to apply the proper remedies. He can't dismiss from his mind the doubt as to whether he was not mistaken perhaps in diagnosis, and surely surprised at the prognosis. A physician will learn by experience that his diagnosis and prognosis will often fail; and all he can do is to apply his remedies to the symptoms as they appear. With close study and careful observation he will finally be able to correctly differentiate symptoms and arrive at a correct diagnosis.

DIFFERENTIATION.

Among the most important and difficult of the efforts to properly diagnose disease is the art of differentiation. So many symptoms are common to all diseases, especially in their formative stages, and when specific signs have not become clearly prominent, it is a good diagnostician who does not treat cases in a kind of emperical way. There is no such thing as an unerring and ready diagnosis in very many ills. We all treat symptoms till we are able to differentiate, and surely determine the true disease. It would be very foolish to do nothing till the disease is clearly made out. We are sure of having virtually carried many cases to a successful issue before we were able to positively diagnose them. Who hasn't? Will we fold our arms and wait till we know what's the matter? Surely

not.

If we don't apply anything else but a placebo it will satisfy the patient at least. Direct your treatment toward relieving urgent symptoms, and keeping your "weather eye" open, fight for time. It takes finesse and tact to frame an answer to the patient and those concerned upon your first visit. We usually say the symptoms have not clearly manifested themselves, but that the first thing demanded is to afford as much relief as possible. It is bad practice to jump at a sudden conclusion in the early stages of a malady, as you may find yourself humiliated later for having made an error in diagnosis. Be very guarded, and don't be in too much of a hurry to diagnose a case. Differentiation is the key to finding out the true nature of any disease.