Gambar halaman
PDF
ePub

the inside of the thighs. In May, 1871, he was in excellent health, and was in good health when discharged, in 1874.

Case 13.-P. M., aged 25, had indurated sores, indurated glands in the right groin, and roseola. Lotio nigra was used for a few days, and the only other drug employed was spirit of nitrous ether in camphor mixture. He was treated in February, 1866. In May, 1866, he had scarcely a trace of disease about him. He was in good health when he deserted, in 1869.

Case 14.-Q. L., aged 26, had an excavated hard chancre, four enlarged glands in the left groin, a roseolar and papular eruption, and condylomata of the nates. Lotio nigra was used for a few days, when water dressing was substituted. He was treated in April, 1868, and made a rapid recovery. In June, 1869, he was in vigorous health, with no evidence whatever of disease about him. In March, 1871, he was in excellent health. In 1878 he was in the service, and in good health.

Case 15.-R. F., aged 23, had a chancre in great cartilaginous induration; the inguinal glands on both sides were enlarged and hard. He had an eruption over the whole body, of a roseolar, papular and squamous character; and tonsilar ulceration. Lotio nigra was used for a few days. He was treated in February, 1870. In June, 1870, he was in good health. In September, 1871, he was in very good health. He was in good health when discharged the service, in 1876.

Case 16.-S. N., aged 22, had a circular hard sore, indurated glands, and macular rash. Lotio nigra was used. He was treated in October, 1871. In 1876, he was in good health, married, and the father of one healthy child.

Case 17.-T. J., aged 21, had a solitary sore, enlarged glands, roseolar, pharyngeal ulceration, and condylomata of the nates, scrotum and thighs. The only mercurial preparation used was the milder ointment of nitrate of mercury, occasionally, at night. He was treated in January, 1868. In May, 1868, he was much improved in health. In August, 1868, he had not a trace of disease about him. In March, 1871, he was in excellent health. In 1877, he had no trace of disease; his health was good.

Such local applications as black wash, calomel, red precipitate, or citrine ointment do not in the least degree, in my opinion, diminish

the value of the cases in establishing the fact that syphilis can be cured without the specific action of mercury. In my cases, the actual amount of mercury imbibed by the system must have been very small indeed. The remedies were not at all pushed-quite the contrary; and any one who could attribute to their use the good results which followed, must be a believer in the Hahnemannian doctrine of infinitesimal doses. It must be remembered that advocates of mercury contend that, without approaching the direful effects of salivation, a cure can only be effected by introducing a considerable quantity of the mercury into the system, and by protracting its use over a long period.

The cases of syphilis in which I have used mercurial preparations locally have, with great complacency, been quoted against me, as mere illustrations of cases cured by diaphoretics, alteratives, and small doses of mercury. I admit nothing of the kind. When I reflect on the composition of these local applications, and on the quantity likely to have been absorbed into the system, I say it is a perversion of the facts to attribute the recoveries in such cases to small doses of mercury. I have, however, treated too many cases of syphilis without any mercurial preparation whatever to doubt that the disease may be cured without them. My sheet anchor has, in all cases, been the frequent employment of hot water baths; and the patients being a good deal confined to bed, the most scrupulous attention being paid to personal and surrounding cleanliness, full hospital diet always allowed, and with some exceptions, a pint bottle of the best ale daily. Iodide of potassium took second place in the treatment, and other salts of the same alkali were freely used at times.

The majority of the patients were young men, and when they contracted the disease were in good health.

During their treatment, they were the subjects of rigorous discipline.

For the purpose of illustration, I have chosen from the hundreds of cases of venereal diseases which I have treated, only examples of those in which characteristic secondary manifestations followed indurated chancres without suppurating buboes. I thus silence those who might contend that perhaps my cases were not cases of syphilis at all.

I would beg of those who hold that the specific action of mercury is absolutely necessary for the eradication of syphilis from the organism, to consult the works of Hughes Bennett, Lancereaux, etc., for a list of observers, committees, or councils that have declared in favor of the simple treatment of syphilis.

My experience as an army medical officer of fifteen years' service, ten of which were passed with one regiment, compels me to believe that syphilis is as curable without mercury as is smallpox or typhoid fever. And until I have some better proof than a mere ipse dixit that all the patients that I have treated without mercury are still under the influence of the syphilitic poison, I certainly cannot admit it. To the logic, however, of well sustained facts, I am quite vulnerable.-British Medical Journal.

CLINICAL TEACHING.

BY J. M. HOLE, M. D., SALEM, OHIO.

This subject embraces an important part of a branch of the medical art, and those who attempt to assume the role of a clinical practitioner, or that part of physic which prescribes medicine and regimen to bed ridden persons, should not only possess a knowledge of "pathology," but also a very thorough knowledge of physiology. In fact, in order to be a first class clinical physician, one must be possessed of a trinity of the following sciences: physiology, pathology and clinicology.

Physiology, in its general sense, is the science of life. Pathology, that of disease. While clinicology, or the clinical science, discovers, determines, advises, and instructs in the proper administration of medicine and regimen of the sick, both as to the local and general difficulties incident to humanity, with a view of restoring them to health.

Is it not clear, then, that none but those who are in the possession of all the foregoing branches of the healing art, in a preeminent degree, are qualified as they should be, to assume the grave and responsible position of a clinical practitioner?

More forcibly to illustrate our position, we will compare the human system to a walled city, as was once the great and illus

trious city of Babylon, when her destroyer, Cyrus, with his legions of officers and soldiers, surrounded it, only waiting the opportunity to enter and destroy. This city, like all others, has her gates, avenues, port of entrance and port holes for protection, through which supplies of all the necessaries of life are obtained; also her sewers and other eliminating orifices, through which the scavengers remove the cast off filth and decomposed matter, all of which, in view of the surroundings, must be guarded with the greatest vigilance both night and day, by a corps of soldiers, who are commanded by a general well posted; for if any of those avenues of supply were permanently interrupted, fatal results must follow, or, on the other hand, if the sewers were closed up, so that the cast off and refuse matter could not be got rid of, equally fatal results must be the consequence. So that upon the vigilance and strict integrity of the commanding officer, and the faithful performance of the duties intrusted to his subordinates, could the once strong and famous city of Babylon hope to retain her standing, when besieged by such a formidable and relentless foe as that of Cyrus, king of Persia. To digress for a moment; history tells us, that at a grand banquet given by the king, when wine flowed freely, and the people were having a grand and glorious drunk and debauching revelry, the commanding officers, like the others, all intoxicated, then it was that the gates were entered by the soldiery of Cyrus, the king slain and the city captured. An awful admonition to a drunken doctor or general of an army, either of whom should, for such an offence, while on duty, be cashiered and dismissed the service, or placed in front to stop bullets at the first opportunity.

The human system, like the city, has its gates, avenues and thoroughfares, through which its supplies are received; also its sewers and other avenues of escape for her refuse and cast off matter, all of which have sentinels carefully posted. These sentinels are called nerves. They are constantly on duty; the system being so well guarded, that not the smallest pointed instrument can penetrate any part of the body without their notice, and in an instant the whole body is warned of approaching danger. The various organs of the system are like a well regulated family; when one member is abused, all more or less sympathize with them.

In view of this condition of things, is it not clear that the clinic should be so well posted he could detect the slightest departure from a state of health in his patient, either local or general, and also to what extent it has interrupted or disturbed the normal condition? In the second place, to be able to point out the most favorable conditions obtainable by the patient as to location, atmospheric influences, and all other external surroundings; the kind of food, quality, quantity and time of eating and drinking; and, lastly, the kind of medicines and proper time of administering the same, as well as all necessary mechanical appliances each case may require. This, and much more, should be well understood, in order to become a successful clinical practitioner.

EDITORIAL NOTES AND SELECTIONS.

PRISON REFORM.

A report has just been made to the legislature which reflects heavily upon the managers of nearly all the county prisons in this State. In fact, the penitentiaries have been found to have been badly managed; so much so that the governor is required to appoint a special board of inspectors. We very much apprehend that our own county institutions, both local and State, should receive a passing notice, for it is possible that reform in many respects would be conducive to the health of their inmates. And that there are, in many instances, not only bad treatment, but violations of statute law, in regard to imprisonment for debt. On this subject, we copy the following article from the daily Graphic of July 7, 1879. This article refers to facts of vital importance, many of which have been noticed by the press of our city, and no doubt greater attention will be given to this subject, when the provisions contained in the new law are carried out:

AN UNEXPECTED POSSIBILITY.

It looks as though the speculators who have, in the management of Ludlow Street jail, built up so admirable a private business for themselves, "have builded better than they knew." The investigation which their treatment of their victims has excited extends

« SebelumnyaLanjutkan »