SMALL-POX SUCCESSFULLY TREATED. In the year 1871, many populous districts of England were visited by that scourge of our race, small-pox. As usual, it began, like other filth-diseases of a typhoid character, in the crowded abodes of the most wretched, poor and squalid of the population, and spread speedily through all classes of society. It was my lot to reside and practice in a town on the seaboard, having over 400,000 inhabitants. For years previous the strictest attention had been paid to the vaccination of the masses. It was not of the slightest utility. The disease spread like wild-fire, fed everywhere by suitable fuel. Every public institution for infectious disease was filled to repletion. Sheds were erected in the open fields, outside the town. Large unoccupied houses were employed for the occasion, as hospitals, in the suburbs. Alarm prevailed everywhere. Employers insisted on their employees being re-vaccinated; this being optional, and no allowance made for it by law. Medical men reaped a fine harvest during this season of excitement. The people were mulcted to the extent of their means, ranging from 50c. to $5 each. The investigation showed that a small per cent. only of the stricken had not been vaccinated. The "regulars" taught that it was not to be depended upon as a preventive, but rather as a modifying agency mitigating the virulence of the attack. In this respect my own experience proved the notion to be false; for almost every patient I attended had the disease in the confluent form. In the case of those who had it not in this form, I attribute their exemption to the prophylactic means employed, viz.: to stimulate the skin, liver, stomach, kidneys and bowels. From this mode of treatment I had decided results, such as would surprise every unprejudiced observer. In the following case, which was an average one, some of the above remarks are illustrated: In May, 1871, I was called to see Miss E., age 19; of nervoussanguine temperament; good family connections. She had been vaccinated, and was employed in a dry-goods store. While attending to her duties, a person convalescing from an attack of small-pox entered the place, and applied to her for some small article. The sickening sight which he presented, made such an impression on her mind, that in less than fortyeight hours, the common eruption of the disease began to appear. The seriousness of this attack may be understood if it be remembered what Trousseau asserts on the incubation of the disease, page 52, vol. ii., New Sydenham Series, London, 1870: "The fact is, that the longer the eruption is in appearing, the less serious will the disease prove; and the less delay there is in its appearance, the more dangerous will the disease prove." For twelve hours previous to the appearing of the eruption, the temperature of my patient had ranged from 102° to 104° F., with a corresponding pulse; intense pain in the lumbar region (rachialgia) which soon moderated, as did also the temperature, after the eruption appeared. The mind and nervous system, which up to this time had been greatly disturbed, became more calm. The subsequent stages of the disorder were all severe. There was much tumefaction of face, eyelids, and generally; the pustules were deep, large, and filled with pus. The treatment adopted was of such a character as to meet the various symptoms and stages of the disease. Sedative mixtures and potassium bromide were given to control the fever and brain-excitement. A three-grain pill containing the alcoholic extract of Podophyllum pelt., Hydrastis Canadensis, aa, extract of Arnica rad. and a minute portion of ferrum sulphate was administered every three or four hours, with a view to evacuate the bowels twice a day. To prevent "pitting" an oleo-extract of Althea officinalis was applied, by means of a camel's hair pencil, over all the exposed surfaces of the face and hands. The room was kept dark; the patient's linen and bed clothing were changed every second day, and placed in a strong solution of chloride of lime as soon as removed, which at once destroyed all germs of infection. The ventilation of the room was strictly enforced; and a small vessel of carbolic acid stood constantly within and without the patient's room. This in substance was the whole of my treatment, both in this and in the second epidemic. I did not lose a single patient, nor was any one of them disfigured for life. In many of these cases, not a single "pit" remained after full convalescence; while most of those treated by the "regulars " bore for years afterward the sad evidences of their misfortune. In 1876, the same town was again visited by this fell pestilence; and again it became diffused through the whole community, differing only from the first epidemic in that it was less fatal. The fallacy of the theories about vaccination was again apparent, viz.: that to be continuously effective it should be repeated every seven years. In this case here were two epidemics of small-pox in the same town within six years; and many of those who were vaccinated during the alarm attendant on the first, were smitten with the disease during the second visitation. But, while I know that vaccination is an utter and miserable failure as a prophylactic in this disorder, my experience shows that by the use of purifying and toning-up medicines, the disease may be so controlled that persons exposed to the contagion and residing in the same house may escape attack altogether; and others will have the disorder so mildly, that but for the presence of the epidemic no notice would be taken of it; the only inconvenience being loss of appetite, slight pain in the head, and a few pimple-like pustules which pass off in from one to four days. In numerous instances the result was the same. In no instance had I more than two cases of a severe type in a family, however large. The other members of such families were at once put upon a course of treatment, such as I have indicated. HEMMORRHAGE FROM THE BLADDER. By A. P TAYLOR, Sunbury, Ohio. A CASE IN PRACTICE. On the 11th of June, 1879, Mrs. F―presented herself, at my office, for examination and treatment. Her age was forty; and she had been the mother of four children, the youngest of them, six years of age. The prominent symptoms were as follows: A dull, heavy, full sensation over the region of the kidneys; difficult micturition; occasionally a stoppage of the flow for a few moments, occasioned by small clots of blood obstructing the urethra. Upon straining and making a strong effort, the clots would be voided and a free passage of urine follow. Some of the clots were cylindrical in form, while others resembled larger clots broken down. There were also shreds of membranous substance which appeared like brokendown substance of the kidneys. Sometimes the blood would resemble arterial blood, and clot after passing away in quantity. The urine was very acid, changing blue litmus paper to red; but I was able only ouce, by use of heat and acid, to detect the presence of albumen. 1 The bowels were costive; the appetite poor; tongue furred at base, exhibiting a yellow, dirty-looking coat; the pulse ranged from 85 to 100, quite soft and small whenever the hæmorrhage was excessive. The pupils were dilated; the head, dizzy; and there were sensations of chilliness over the entire surface. The patient was restless at night; and occasionally the flow of blood was greater during that period. She menstruated regularly. I began the treatment with the use of gallic acid and Pond's Extract of Hamamelis. It was unavailing, although these remedies had been never-failing in my hands. I then changed my medicines, varying them from time to time, according to the indications; using oil of Erigeron, ergot, tincture of ferrum perchloride, and ferrum subsulphas, one at a time. I also employed irritants, and the cold-water pack over the loins and abdomen. Flaxseed lemonade was used for drink, when ever the urine was not surcharged with acid; but in such case, I gave instead the potassium acetate or bicarbonate. I was able to arrest the periodical discharges of blood in large quantities by night with quinia; but the lesser hæmorrhage was more obstinate. The constipation was met by the use of the improved compound cathartic pill, or the syringe, as the necessity appeared. We continued in this way for four months. My patient would appear for a time to improve gradually, and then relapse. I finally began to apprehend that the case was hopeless. The loss of blood was marked in her appearance, and she became very weak. I decided to drop all my remedies and employ the plumbum acetate. Requiring the patient to keep her bed strictly, I began to administer two grains every four hours. This was kept up for several days without apparent benefit. The doses were doubled; she seemed to improve; but the reHef was not permanent till symptoms of lead-poisoning had appeared. The hæmorrhage then ceasing, I began a course of treatment for the difficulty, by using potassium iodide to counteract the lead-poison, and opium to relieve the colic from which the patient suffered. She soon recovered; and with the aid of bitter tonics and iron, the cure was completed. She has had no return of the hæmorrhage. |
