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we endeavor to study nature in all her pert in applied dietetics and the remefullness, but in studying diseases and dial use of hot and cold water. Dr. their cure, we seem to forget nature Cowles of Somerville justly regards his with her indications, and to a very great two gymnasiums for men and women, extent investigate only symptoms. The in care of a specialist, as indispensable treatment of disease comes and goes as features in the treatment of most paa fad or as the fashions of dress, while tients from the better walks of life, and people continue sometimes to recover in his Turkish bath facilities, added to the spite of so much medication, and some cottage plan of the buildings, easily times they die from the same cause. place the McLean Asylum foremost The great reason more recover now than among progressive institutions of its formerly is not in the superior drug kind. medication ; but in the better knowl While seeming to wander from my edge of causes, more attention to and theme, I have been really indicating the better knowledge of hygiene for the sick natural therapeusis of sanitarium life. home, and a better knowledge of diete Sanitary and sanatory are the rival adtics, and better nursing."
jectives from which we must choose our Dr. O'Harra, another writer, says: nomenclature. Chacun a son gout. “If powder, potion and pill were no “Water as a remedy is at once the most longer our servants, great as the loss ancient, the most universal, the most would be, the medical profession would flexible and the most potent of all therastill be left the most exalted part of peutic measures" and one of the most duty."
agreeable and most innocent. “The Nor is the physiological factor in basis of its physiological action is more therapeutics to be ignored by the mod clearly defined and more susceptible of ern practitioner. The influence of en proof than that of most known drug remevironment and the quiet enforcement of dies.” Among the sixty-odd varieties of routine, the maintenance of a constant treatment by baths, inunctions, electriatmosphere of legitimate hope, diversion cal applications, etc., at the first instituand sunshine, the kindly, timely minis tion which I notice, may be emphasized tering to the mind diseased by the phy the Molière baths, the roof-life and the sician's presence, in brief, the regulation psychological training.
psychological training. The Molière is of the mind and feelings of the afflicted, a thermo-electric bath given in a cabicontribute to recovery in a way peculiar net. It is entirely different from a mere to institutional residence, and is the steaming or the ordinary hot-air conkeynote of success here, as Dr. Mitchell trivances. In its general therapeutic has emphasized it to be in the care of effect, the Molière resembles the Turkthe insane.
ish, but owing to the combination of I may say in this connection that com electricity with heat, perspiration is inbining the experience which has come duced at a lower temperature, and with to me from sanitarium life, which sug less taxation to the system. Moreover, gests by the class of patients taken a in the Molière, the patient breathes the family hotel or summer resort where the ordinary atmosphere of the room, while social elements, under thorough control, in the Turkish, air at a temperature of are at their best, and my work among two hundred degrees is sometimes taken the feeble-minded and insane, it seems into the lungs, which in some cases is to me that the next great advance among undesirable. The claims made for this the latter will be the introduction of san bath are : First, its remarkable power itarium methods of treatment, with a to equalize the circulation, making it of most decided gain in the percentage of special value to those who suffer from recoveries. Rest, better feeding, hydro- congestion and inflammation of internal therapy and massage, added to light oc organs. Second, its unrivaled efficacy cupation and exercise, will meet the in removing waste material from the sysmajority of indications, and give the tem. Thus in neuralgia, rheumatism, pharmacist leisure time to become an ex. gout, catarrh, and malarial affections, it
is one of the most effective measures of pillaries is desirable, I know of no better treatment. Again in many organic dis way than the Molière bath, none that is eases this bath greatly relieves suffer less enervating. ing and often prolongs life, as in Bright's With reference to the number of gendisease. For persons weary and debili eral patients-in the last ten years I pretated by care or overwork it is a most sume we have treated 5000. luxurious and strengthening bath.
The bath is one that should find its The doctor in charge, who is a gradu way into many private hospitals and ate of Bellevue Hospital Medical Col asylums. lege, and his wife, a graduate of the The most “ thoroughly scientific New York Infirmary for Women, known health establishment" in the United as the Blackwell College, in response to States has a plant embracing some 25 a recent letter of inquiry, says :
buildings. Physiological, microscopical, The cost of these baths well built of bacteriological and chemical investigaoak, or black walnut, or cherry, all com tions are constantly being carried on plete, is $300, and they can be set in any within its walls. The superintendent is room where you can get a waste pipe one of the remarkable men of our times, from them, and a water supply, together versatile, original, energetic, scientific with steam, without danger to anything and eminently successful. A graduate I consider the bath to be the best and of Bellevue, New York, he has studied most effective therapeutic agent in the in the medical schools and hospitals of treatment of all diseases that require de- London, Paris and Vienna, and has won puration, and I consider it more power- recognition at home and abroad by his ful than the Turkish bath really ; at any researches on respiration and on methrate it is more usable in the great major- ods of precision in the investigation of ity of cases, on account of the fact that disorders of digestion. He is also an the heat is not so enervating, and it extensive author and inventor. His agrees with many who cannot take the study of the causes which are responsible Turkish, because their head is in the for the growing physical weakness of open air. The bath can be run to ac American women, and his anthropomecommodate many, that is, you can take tric work are especially to be commended. one after the other as fast as is possible He has given us tables and apparatus, to give them good sweating baths, at now in use at Yale University, the Uniblood temperature, and the curious part versity of Montreal, West Point and of it is that people perspire more in what elsewhere, whereby to "diagnose accuis called the “cool” stage than in the rately the neuro-muscular force of an hot. I suppose as we run the bath, one individual and to give a precise prescrippatient following the other, the average tion of exercise.” May we not hope to temperature is probably 125°, and you see similar work especially in the doremember that steam can be given so as main of plıysiological chemistry, and a to make it a Russian bath practically, more thorough comprehension of the as well as a dry Molière, the head being body in health, issuing from our own out and in the free, cool air. I never medical schools, which have every facilsaw anything in all my practice that ity for this most valuable research? would take down the dropsy occurring When to the conveniences of a hotel in cardiac insufficiency and in the edema and the facilities of a thorough medical of Bright's like the Molière. I consider equipment are added the vis medicatrix it particularly good where free change of mountain charms, pristine woods, of tissue is desired, where increased purest of air and water, the wooing of metabolism is needed, and particularly streams, forest and river, then indeed in congestion of the capillary surfaces of the patient born to wrestle with malicithe mucous membranes of the body. In ous germs which haunt the low levels of all catarrhal and inflammatory conditions life can look up and take courage. It of the intestinal tracts, and congestion seems strange that capital has not thus of the liver, where to surcharge the ca pre-occupied the many favorable loca
tions along the Western Maryland Rail more enlightened, and as we get more road and the picturesque B. &0. Our sense, dosing will be recognized as a State has also an equable climate, a di very minor function in the practice of versity of scenery and a richly produc medicine in comparison with the old tive soil. Such conditions are what any measures of Asclepiades.
Each physician in large practice seeks for a class of invalids is trained to reform class of persons, who, exhausted by so their unhygienic ways and do works of ciety and business exactions, or the supererogation healthward.” The nervcares of housekeeping, cannot give the ous and neurasthenic learn to live more time, or command the conditions at in their muscles, to select their diet, to home, favorable to restoration to health. conserve nervous energy and cultivate Sanitarium life possesses great advan tone; the hypochondriacal and introspectages for convalescents, or for patients tive are inspired with a wholesome looking forward to grave surgical opera hatred of drugging and disease; and tions whom the doctor desires to have everybody comes away with the religion put in the best possible hygienic condi of cleanliness for once washed and soaked tion to react favorably. I recall a case into them. Very few people take genin the private practice of another which erously to water, and the basis of much succumbed to the shock of a perfectly ungodliness is dirt. I congratulate the successful operation of lithotomy, be community that at last we are promised cause of a violation of the summer rest an appropriation of $8000 for central enjoined by his adviser. At a properly public baths. ordered institution, all the conditions, In conclusion, where will you find the every detail of regimen, makes for the doctor himself taking his needed rest peace of the guest in a way that no mere and recreation ? Ask the author of hotel or summer resort or country home “When the Woods are Green," and you can ensure.
will wander far from the madding crowd, Furthermore, the educational value if you follow. Who has not learned to of a residence in a strictly professional feel with the poet : health cure needs only to be stated to receive the endorsement of every prac
“The murmur of a waterfall a mile away, titioner who deprecates the ignorance
The rustle when a robin lights upon a spray, and credulity of the “fool multitude
The lapping of a lowland stream on dipping
boughs, as Dr. Osler calls them, on which doctors work. Says Dr. Osler : Common
The sound of grazing from a herd of gentle
cows, sense in matters medical is rare, and is
The echo from a wooded hill of cuckoo's call, usually in inverse ratio to the degree of education. Clergymen, for example,
The quiver through the meadow grass at evenare notorious supporters of all the nos
Too subtle are these harmonies, for pen or trums and humbuggery with which the
rule, daily and religious papers abound, and I find that the further away they have
Such music is not understood by any school ; wandered from the decrees of the Coun
But when the brain is overwrought, it hath a cil of Trent, the more apt are they to be
spell, steeped in thaumaturgic and Galenical
Beyond all human skill and power, to make
it well.” superstition. As the public becomes
CHLOROFORM IN GASTRIC AFFEC- gests its value in dyspepsia. In each TIONS.-Stadnitzky (University Medical instance the experiment lasted fourteen Magazine), from his experiments with days, being divided into two equally chloroform administered internally to long stages, during the second of which seven young men, concludes that the the subject was given three to ten drops drug markedly improves all the func of the drug three times a day. tions of the stomach, which fact sug
IMMUNITY FROM INFECTIOUS DISEASES.
READ BEFORE THE RICHMOND ACADEMY OF MEDICINE AND SURGERY, MARCH 26, 1895.
By Mark W. Peyser, M. D.
Richmond, Va. The theories put forward to explain contest between the invading bacteria immunity are numerous. We shall con and the body, the weak cells of the latsider. 1. The exhaustive theory. This ter perish; the stronger survive, increase supposes that the invading microbe takes in power and transmit their strength to from the system a substance necessary their progeny, thus following the law of for its life and growth, exhausts it and inheritance. It may be called the conit is never replaced; so that germs of a genital resistance of the tissues and similar kind, seeking to attack the body, cells. can find no means of subsistence. Con It seems vow to be conceded by most cerning this theory, Roosevelt of New authorities that immunity to the infecYork says, “It would be hard to be tions is due to the presence of substances lieve that this could be the case if pro formed by the metabolism of the cells. vision were only made for the growth Investigations pursued in the past four and development of some one species of or five years, notably by Vaughan of germ; but when we are called upon to Ann Arbor, and Aulde of Philadelphia, believe that the majority of mankind have brought to light the fact that the comes into the world with a separate and bactericidal action of blood serum is due distinct substance suited to the needs to nuclein, a phosphorized proteid, of the micro-organisms of smallpox, formed chiefly by the multinuclear colineasles, yellow fever, etc, the imagina orless corpuscles. It is non-poisonous tion is staggered and the reason revolts and stimulates those organs whose funcagainst such a preposterous idea.” tion it is to protect the body against dis
2. The antidote theory supposes that ease. Aronson has, in all probability, microbes, after entrance to the body, recently obtained it from antitoxine. He, produce a secretion (toxine) which is in by the way, does not place faith in the imical to their own welfare. Upon it is antidotal action of this. based the action of antitoxine for diph The production of a leucocytosis may theria and tetanus. Reasoning by an be said to be synonymous with the proalogy is here brought into play. The duction of immunity, if the white cells excretions of many, if retained in the are healthy and are stimulated so as to body, produce septic intoxication; so secrete their nuclein. Leucocytosis exthe presence of their excretions render ists in all infectious diseases where there the infecting bacteria harmless. This is a local reaction, notably in croupous is plausible, but “we know of an or pneumonia. In typhoid fever there is ganic compound which is not excreted
notie. Cold water will produce it and or destroyed by the body within a short thus we have an explanation of the good time after its introduction into the sys effects of cold baths. Massage has the tem.” What goes on in the test-tube same property. is not always an index of what occurs in Nuclein when injected does not act as the organism. Pepsin, for example, a germicide directly, but stimulates the acts beautifully in the former; but how cells to renewed activity. often have we been disappointed in it in Attenuated cultures of microbes or the latter. In the test-tube the excre their toxins when injected into a living tion product remains; in the system they body, have the power of stimulating the are carted away as soon as formed. cells. The increased metabolism results
The third theory may be termed that in an increase of nuclein, and along with of the “survival of the fittest." In the it an increased power
We see then the action of antitoxine of the liver is the extinction of bacteria (sic), tuberculin, vaccine virus, erysipe- and their products, as noted by Ewing latous cultures, etc. Antitoxine has
Antitoxine has (New York Medical Journal, March 2, never yet been obtained directly from 1895). Nuclein stimulates this organ cultures in th test-ti be.
and thers that have to do with the forIt is probable that one of the functions mation of phagocytosis.
AN INTERESTING SPECIMEN OF HYDROSALPINX. READ BEFORE THE RICHMOND ACADEMY OF MEDICINE AND SURGERY, MARCH 26, 1895.
By Virginius W. Harrison, M. D.,
Richmond, Va. I wish to report a case in order to ex engaging our attention was this large hibit to you a very pretty specimen of and very pretty specimen of hydrosalhydrosalpinx. The case is also interest pinx of the right side, which I have ing because of the variety of morbid here this evening.
here this evening. Its measurements conditions presenting. On March 19, soon after extirpation were thirteen Mrs. H., aged 44, was sent by me to the inches in circumference, six inches in Virginia Hospital to be prepared for a length and five in depth. The adhelaparotomy for the removal of some sions to the pelvis and bowels were nugrowths. The next day I operated, merous, rendering its removal without ably assisted by Dr. Hugh M. Taylor, rupturing the delicate covering difficult. Dr. Geo. W. Ross administering chloro It was successfully done, however, the form. The first morbid condition seen tube tied and the stump cauterized. was a pedunculated uterine fibroid The ovaries were found in a degenerated weighing between two and a half and state and removed. In addition to the three pounds. It was attached to the hydrosalpinx, an intra-ligamentous cyst, upper portion of the posterior surface of about half its size, was found on the the womb by a pedicle about two inches right side. Unfortunately, in the atlong and as broad as my two fingers. tempt to remove it, it was ruptured. The pedicle was transfixed with a double The patient is doing well with every inligature of silk near the uterus, the tu dication of recovery, this being about mor tied off and the stump cauterized the middle of the seventh day since the with a Paquelin. The next condition operation was performed.
DIPHTHERITIC CONJUNCTIVITIS membranes on the palpebral conjuncTREATED BY SEROTHERAPY.—Dr. Jes tivae of both eyes, enlarged glands and a sup recently communicated a report to muco-purulent discharge from the nosthe Journal of the American Medical As trils. Two grammes of the antitoxine sociation of two cases of diphtheritic con were used in two injections and the false junctivitis treated by Klein's antitoxine. membrane disappeared in four days. The first case was that of a boy, aged Hayward examined the membranes in 19 months, with false membrane on the both cases and discovered large quanticonjunctivae of both eyelids of the left ties of the Löffler bacillus. In his opineye, with a patch on the uvula, swelling ion the cure was certainly due to the of the sub-parotid lymph glands and al- antitoxine, because these cases are genbuminuria. Three injections were made; erally accompanied with purulent ophthe total quantity of the antitoxine used thalmia and ocular lesions which are was three grammes. The membrane very slow in healing. Coppey of Brusdisappeared in five days without leaving sels has also reported a case in a little any trace on the conjunctivae, though girl of one year, with severe ocular diphthe only local application used was dis theria cured in four days after one intilled water. In the second patient, jection of Behring's serum. also a boy aged 8 months, there were