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an elective operation instead of an emergency opera with the toxemic conditions, after we begin to get tion.
albumen and casts in the prine, the worse it is for
that mother. If we know that a woman has had DR. SOMERS: I want to thank the gentlemen for
albumen and casts only a week or ten days, we are their criticisms; they are just, all of them. Of course
pretty safe; but if she has had them for weeks, or this report covers a much larger number of cesarean
possibly months, we are absolutely unsafe in doing a sections than twelve cases. As a matter of fact there
cesarian section. are probably more than a dozen cesareans on justominor flat pelvises with previous disastrous results included under one head; in all twenty-five or thirty; THE TREATMENT OF PNEUMONIA and the only disastrous results came from defective
N. H. D. COX, M. D., Arlington, Md. kidney conditions, from which the women died two months later. That is simply my personal experience The selection of a rational treatment presents extending over a period of ten or a dozen years.
a problem that deeply concerns a physician who My experience in these cases that Dr. Dorsey
is called to treat a case of pneumonia. Not until speaks of, pelvic posterior rotation, is that it is too late to do a cesarean section: you had better do a recently have I found a remedial agent that fully craniotomy to begin with. After the head has gone meets the requirements of a successful treatment into the pelvis and fails to rotate, it is a disastrous for this disease. I refer specifically to pneumonia condition as far as the baby is concerned, we will
phylacogen. admit right off. But that woman doubtless has been tired out by hours of labor; has been examined nu My first success in the application of phylamerous times, unless it is one of your own cases; and cogen therapy was in the treatment of a very the chances for that woman, or for the child, with stubborn case of rheumatism in an elderly lady cesarean section at that time, are bad, in my judg
who had received other antirheumatic treatments ment.
There is no way in the world that the average and obtained but little or no benefit. After adprimipara can be delivered so safely and so easily, ministering several doses of rheumatism phylaboth for herself and for her child, as by cesarean cogen she was at least temporarily relieved of the section, but you have to select your cases.
rheumatism. After this the patient passed from I no longer examine my pregnancy cases by the vagina. You can tell when you come to labor; and
under my observation for more than three years. I don't examine half of them when they get into I recently met a relative of this patient who inlabor. If I absolutely want to know about the condi- formed me that there had been no return of the tion of that cervix I don't know any way to tell ex
rheumatic condition. While this is but a single
rheumatic condition While this is host o sinal cept by a vaginal examination, but I make just as few as possible.
case, the results were so very much in evidence I will admit that the criticism of Dr. Brockman in that I decided to give the phylacogens a further regard to my cesarean section in a placente previa, trial. in which I packed the cervix, is just as a rule, and
My next case was that of a boy about three yet to explain: I am but a few years younger than my friend over here, and I haven't any kith or kin of years of age who developed bronchial pneumonia. my own. About ten years ago I conceived the idea The remedies usually applied in such cases failed of training a boy to take my business and to succeed to reduce the temperature or influence favorably me; so I took a man who had taken a full university
the progress of the pneumonic condition. The pacourse of six years, and taken a year in a hospital as an interne. I trained him the best I knew how for
tient was then given a few doses, at three day three or four years; then sent him down to New York intervals, of catarrhal vaccine combined, Parke, and had him put in eight months as house surgeon Davis & Company. As this vaccine did not seem of the New York Lying-In; and he has been back to produce a prompt effect upon the temperature, working with me about two years. Now I am not the obstetrician any longer; he is the obstetrician. He
I began the administration, on the days interis a trained obstetrician from the word go-an Iowa vening, 12 c.c. pneumonia phylacogen, repeating boy. too. Now, then, I knew in advance that this the dose every twelve hours. Following each of little woman was absolutely clean; I knew we ought these doses there was a marked favorable effect to empty that uterus after she had bled about twenty on,
upon the temperature and general condition of ounces. When I pack the cervix I always use iodoform gauze, and only allow it to remain twenty-four
the patient. On the ninth day the child was up hours at the outside. So her cervix was packed with and walking about the house, and two days later iodoform gauze and it did not bring on pain. Now, I there was no sign of cough or expectoration. had so much confidence in that case being clean under my own hands, or under the hands of my associ
A second case was that of the oldest brother, ate, that we took our chances on a cesarean section. aged 19 years, of the former case of pneumonia, If any other live man had packed that cervix we who developed an onset of pneumonia on the would not have done a cesarean section.
seventh day of the progress of the first case. I won't always trust any man's word as to how
Following initial chill the patient developed a many times he has made an examination. If it came out all right, good and well, possibly the next time
fever of 104, with considerable cough, temperawe might come out all wrong.
ture continued to rise to a maximum of 105.2. I haven't done a premature delivery, except in the This was followed by delirium and complete concase of a toxemia, in the last ten or twelve years. solidation of the right lung and involvement of If a woman has a defective pelvis, don't do a prema
the left bronchial area. I first tried the old time ture delivery; leave her alone to full time, and then do a cesarean. But if a woman is in a toxemic condi
"tame” remedies, as I now called them, but the tion, it is dangerous to leave her. The longer we wait stomach rebelled and refused to retain any reme
dies given by mouth. I then began to consider from results following the treatment of any small pneumonia phylacogen, but, owing to my famil- group of cases, yet the rapid disappearance of iarity with bacterial vaccine therapy, gave 1/2 c.c. dangerous and alarming symptoms that follow catarrhal vaccine combined. This brought the the administration of phylacogens is at least fever down two degrees, but it soon returned to deserving of very careful thought and considthe high point. Remembering the former ex- eration. This is especially true in the treatment perience with phylacogens, I gave the patient, on of cases for which our former therapeutics have the morning of the second day, 1 c.c. phylacogen so little to offer. and repeated the dose each twelve hours, increasing the quantity of each dose by 1 c.c. until the
KANSAS CITY EYE, EAR, NOSE AND maximum of 4 c.c. was injected at one time.
THROAT CLUB: ITS OBJECTS Following each dose of phylacogen the tempera
AND AIMS ture dropped from two to three degrees. While
HAL FOSTER, M. D., Kansas City, Mo. there was a tendency for the fever to rise several hours after the injection, it never reached an About five years ago a number of physicians alarming degree.
engaged in the practice of eye, ear, nose and Following the administration of each injection throat surgery felt the necessity of establishing of phylacogen the patient perspired freely, which a society where they could meet, read papers, hold seemed to offer considerable relief so far as the public clinics and witness each other treat and general condition was concerned. On the third perform surgical operations on patients. They day of the phylacogen administration, which was also desired to become better acquainted with the fifth day of the disease, the bloody sputum each other, and in this way cultivate a better and ceased and became more of the prune juice char- higher professional standing among all of its acter. On the ninth day the temperature was members. normal and there was but occasional slight cough A meeting is held on the third Thursday of ing. The general physical condition of the pa the month, from October until May, at 6 o'clock tient was exceedingly good, promptly developing preceded by a dinner at the Coates House, after normal appetite. Throughout the entire treat- which papers are read, new instruments and ment of this case the patient was given plenty of cases shown. Every other meeting a surgical fresh air, which seemed to be essential; any time clinic is held at some of the hospitals in greater the windows were closed the patient complained Kansas City, where patients are operated upon of respiratory depression.
by some of the members of the club, appointed In bacterial vaccine and phylacogen therapy I Dy the program committee. Occasionally some feel that we have a treatment of far greater value distinguished man from some other city is it in the treatment of acute infectious diseases than
es than vited to read a paper or hold a surgical clinic.
V any other remedial agents available at this time,
This club has had a wholesome and uplift and can be relied upon providing they are given
en effect among its members in every way. Physiin properly selected cases and administered early
cians of these states are eligible for membership, in the disease, before irreparable damage has
ha's Arkansas, Kansas, Oklahoma and Missouri. They been done.
must be members of their state and county soSince tabulating the cases referred to I have
cieties and have limited their practice to these treated a very interesting case of rheumatism,
specialties for five years, and be in good and regfollowing tonsilitis, with rheumatism phylacogen. ular standing. When the patient was first seen all the joints of Officers for 1918-19 are: President, Dr. J. E. extremities were involved, there was also de- Sawtell; first vice-president, Dr. D. E. Esterly; veloping endocarditis. As the case had failed to second vice-president, Dr. J. S. Lichtenberg: yield to ordinary antirheumatic treatment I start- secretary-treasurer, Dr. J. H. Laning; program ed on rheumatism phylacogen, giving 12 c.c., re- committee, Dr. Hal Foster, chairman; Dr. F. E. peating the dose at 24 hour intervals, gradually Curran, Dr. W. H. Schutz. increasing the size of the dose to 2 c.c. The The first meeting for 1918-19 was held Octopain was gradually relieved and after a total of ber 17th at the Coates House ; 6 o'clock dinner, 10 c.c. of the phylacogen was given the pain was as usual, preceded the business and professional entirely gone, and the endocarditis had practi- program. At this meeting Dr. J. H. Thompson, cally disappeared. She is now receiving strepto the dean of the club, delivered a lecture on "The coccus vaccine, 50 million per c.c., every third Use and Abuse of Glasses." Dr. Thompson was day. From this supplementary treatment we at his best on this subject and all enjoyed and hope to establish permanent immunity against were instructed by it. It was discussed by Drs. the possible return of rheumatism or endocardi- F. E. Curran, Curdy, Miller and Schutz. Dr. tis, which appears to be a complication coinci- Hugh Miller reported some very interesting eye dent to the joint infection.
cases. The cases were presented and demonWhile rational therapy cannot be established strated by the doctor. Dr. O. P. Bourbon read a
very timely paper on Influenza, and gave a his. The following named members of the club are torical review of the disease, its prevention and now in active service of the army in France or treatment. This paper was liberally discussed by in the cantonments: Drs. Moss, Kimberlin, all present. The president appointed Dr. R. J. Blakesley, McAlester, Wyeth, San Roberts, BelCurdy, Dr. H. W. Schutz and Dr. Hal Foster to lows, McCarty, May, Lichtenberg, Leonard, Forwrite some rules and regulations as to the best grave and Look. methods of preventing and treating the disease. These are doing duty either on local or mediThey were ordered by the society to be printed cal advisory boards: Drs. Thompson, Case, Hal in the local papers and a copy sent to the Health Foster, Lorie, Curdy, Sherer, Sawtell, Schutz and Board of Greater Kansas City, for the guidance Tureman. of the public.
The next meeting will be a clinical one. PaThe resolutions were as follows:
tients will be operated upon at the Bell Hospital "In view of the facts that there is no known
8 to 12 a. m., Thursday, Nov. 21st, by Drs. F. E. medicine, spray, vaccine, serum or other treat
Curran and J. E. Sawtell. 1 to 4:30, Kansas City ment that is a dependable preventive of influ
General Iłospital, Dr. J. S. Lichtenberg, Dr. J. H. enza; that perfect isolation of carriers of the dis
Thompson and Dr. A. J. Lorie. 6 p. m., dinner ease is impossible; that the closing of schools
at the Coates House, followed by this program: and theaters and the limiting of street car traffic
Dr. J. E. Logan, “Tumors of the Nose.” Disand retail business, though helpful, are not suffi
cussion opened by Dr. Alkaire of Topeka. Dr. cient to prevent the continuation of the epidemic;
H. E. Tureman, "Plastic Surgery of the Face and that influenza is communicated by the secretions
Nose.” Discussion opened by Dr. Neighbors of of the nose and throat passing from person to
Emporia. person in talking, coughing and sneezing; that
The club is anxious that every man attend the use of properly made gauze masks, as practiced in the hospitals treating contagious diseases,
and do his duty in order that the work may conis a measure entirely effective in preventing the
tinue while so many of the younger men are abspread of diseases which are communicated from
sent in war work. It will be expected when a and through the nose and mouth; that the use of
member is called upon by the program committee masks does not interfere with the ordinary activ
to either hold a clinic or read a paper he will at ities of work and business; we recommend that
once do so. These are busy times with the club the constant wearing of properly made masks
members, and each member has greater responsibe made obligatory on all persons appearing in
bility resting upon him than ever before. We any public place in the limits of Kansas City, Mis
should strive to keep the club alive and full of souri and Kansas; that no person be allowed on
the spirit that made the middle west great, so any street, in any street car, office, store, shop or
when the war is over, our members can return other public place unless wearing a properly
and take up the work and carry it on to a larger made mask, providing for the few necessary ex
field of usefulness in this great and growing city. ceptions, such as patrons of restaurants and barber shops.”
A Candy Emergency Ration—Chocolate bars The club recommended that under no circum- containing three other highly nutritious foodsstances should douches be used in the nose, be- wheat, nuts, and raisins—the first consignment cause nasal douches are so dangerous they should of an order for 1,100,000 similar cakes for the never be used, because the fluid is very apt to use of the American Red Cross in England, have find its way in to the Eustachian tubes and cause just arrived in London from an American facabscess of the ear drum and even mastoid ab- tory. The confection will be distributed gratis scess.
to the soldiers. Each bar is enclosed in a wrapThe October 17th meeting was one of the most per decorated with the American flag and the enjoyable and instructive meetings in the his- Red Cross emblem. A small card inside says tory of the club and was well attended. Each the package is a well balanced emergency ration, member should urge his medical friends engaged equal in food value to any one of the following: in this work to attend. Kansas City needs such Two lamb chops, two eggs, two plates of clam a club as this, and its members owe obligations chowder, one big glass of milk, two baked potato the medical profession, and should be willing toes, three apples, two ordinary cups of custard, to read papers and gladly hold surgical clinics, or two helpings of beans. or do anything to serve the club, especially since so many of our younger members are now on Pneumonia and Alcoholism—At a time when active war service of our country on the fields pneumonia is prevalent it is interesting to know of France, fighting that liberty and freedom may that the death rate among confirmed alcoholics not perish from the face of the earth.
is three times as great as among persons who do The social feature of the club is doing great not drink. Alcohol has no place in a community good among the members.
or nation that desires to be efficient..-K. C. Star.
The Medical Herald
Lesions and Treatment of Dichlo
rethyl-Sulphide (Mustard Gas) Exposure to mustard gas results in necrosis, more or less deep, of the skin, cornea, conjunctiva and mucus membrane of the respiratory tract. Ten minutes exposure to the concentrated gas is sufficient to produce, erythema, pigmentation and necrosis of all parts exposed, even under the clothing. Chest, abdomen, scrotum, thighs, even show lesions unless clothing be tight fitting.
Lesions persist for weeks even under hospital care, and after prolonged exposure of several hours death follows either from acute conditions or from depression weeks later.
Treatment is symptomatic. In the eyes warm vapor, atropea, 10 per cent sodium bicarbonate solution; iodoform ointment for the lids. As a first aid treatment soda bicarb solution is used both for the eyes and for the body. For the lungs opiates and expectorants, Best results have been obtained from Dakin's solution, as a spray, application or bath. It has exhibited marked ability to prevent infection, heal lesions, ease pain and prevent scars. The toxic effects of mustard gas are those of a local escharotic, by virtue of tissue destruction, skin, mucus membrane, cornea, etc. There are no absorption symptoms.
J. M. B.
The Editors' Forum
Venereal Diseases in
A recent publication from Washington gives
lis some startling figures regarding venereal disIt's up to the Allies to now and forever take ease, and also points to the source of it. Can the Germ out of Germany—a Germ that has in- we not awake to the terrible responsibility upon fected the evolution of the psychology of the civilian doctors not only in reporting such cases nation for fifty years; a Germ that stimulated and attempting to control it, but as well to urge Bismarck to read a friendly dispatch as an in- cooperation in our city councils by having meassult to Germany to justify his lust for the blood ures passed which will aid in removing this slur of France; a erm that has made Germany's upon American municipalities? Washington figcriminal statistics three times that of France, ures show that of all communicable diseases, inEngland or America; a Germ that evolved cluding pneumonia, typhoid, paratyphoid, meninthrough generations of “kultur," a national gitis and scarlet fever, venereal disease is by far mental status that is a most striking illustration the most prevalent. Out of 186 cases of comof a morbid psychology of the grandeur, thin municable disease in the national army 162 were edged, paranoid type; a Germ that has invaded venereal, leaving only 23 from all other forms of and infected the very interstices of the nation's infection. thought process till the highest ideals of Ger- During the twelve weeks ending December 7, man “kultur" are achieved through sacredly en- 1917, there were reported from 31 cantonments acted mental reservations that justify the Ger- 21,742 new cases of venereal disease. The inman embracement of perfected deceptions, ar- capacitation of these men involved not only loss tistically camouflaged lies and criminality, vic- of time; in addition, it cost the Government to iousness and if need be, the most wanton devasta- keep them during the period of hospital confinetion of every delicate and tender tie known to ment (which varies from one to eight weeks) the human heart—mother, babe, daughter, sweet- more money than was required to maintain the heart or wife, none exempt; a Germ that justifies entire command at Camp Dix (the cantonment in all this from the German morbid psychological New Jersey, with 20,859 men) plus an additional view point.
sum for medical treatment. Yes, it's time for the Allies to take this "kul- This is not all. Inevitably the disease will tur” Germ out of Germany.
S. G. B. relapse in hundreds of these cases, in many in
THE MEDICAL HERALD
stances after the men have been transported to This filth ultimately finds its way into the rivers, France and presumably put into condition for and in many cases disease is spread before it service at the front, at a cost to the nation of reaches the water. It is a movement demanding probably $1,500 for each man.
national attention. The former view held by The important fact in this connectin is that hygienists that rivers purify themselves after a a large proportion of venereal disease cases orig- flow of three or five miles by sedimentation and inate, not in the camp or in communities sur- air oxidation is no longer regarded tenable. Berounding the camp, but in cities and towns from cause of interstate management and health reguwhich the men come and through which they pass lations such a reform has in the past been imposon the way to camp. Reports from the Surgeon sible. The object of the present movement is to General's Office show this. Evidence is accumu- interest Hon. W. G. McAdoo, director general lating to show that the venereal disease rate is of railroads, and by national cooperation accomhigher in civil life than in the army and navy. plish some real advancement toward abating this The enormous cost to the Government on account menace to public health.
J. M. B. of venereal disease is due largely to conditions in civil life.
J. M. B.
St. Louis Medical Society
Closes Its Business Bureau
After an experience of over one year the St.
Louis Medical Society has decided that the con
duct of a business bureau is not a financial sucto the rich feast in store for them in the list of
cess. In commenting upon the outcome, the papers read at the recent meeting of the Medical
Bulletin of the society says: Society of the Missouri Valley. (See adv., page
"In closing the affairs of the Seabold Busi68). We also beg to remind our subscribers
ness Bureau it is estimated that the society will that in spite of the great advance in our postal
sustain a loss amounting to about $1,500. rates the subscription price will remain the same,
“Coming as it does at a time when the so$1.00, if paid in advance. If accounts are allowed
ciety can ill afford it owing to the fact that memto run until the end of the year, we will be com
bers in the service will not be expected to pay pelled to charge $2.00. Remit now for 1919.
dues, will seriously hamper the administration in
its work and also cause a deficit at the close of Refilling Narcotic
the year. Prescriptions
“It is to be hoped that if in the future any The Commisioner of Internal Revenue has attempt is made by the St. Louis Medical Society issued the following:
to enter the commercial field, the experience of "Owing to the extent of the epidemic of Span
the Business Bureau will serve to frustrate any ish influenza now prevailing in this country and such attempt.” consequent difficulty of persons in getting immediate medical attention and medicaments upon
Medical Association prescriptions issued by physicians, the provisions of Article II of Regulations No. 35 prohibiting
of the Southwest the refilling of narcotic prescriptions are modi i na nual meeting of this association was fied as follows: Prescriptions calling for mor- held in Dallas, Texas, October 15-17, under the phine, codeine, or heroin, which are written by presidency of Dr. E. H. Martin of Hot Springs. registered practitioners for patients suffering The attendance was not so large as usual owing from Spanish influenza and any pulmonary or to the influenza epidemic. An excellent program bronchial affections, may, until further notice, was carried out, however, and the welcome exbe refilled, provided that at the time of issuance tended by the Dallas profession was a cordial by physicians instructions are noted in the body one. of such prescriptions, “Repeat if necessary," and The following officers were elected: the druggist filling and refilling the same shall
President, Dr. M. M. Smith, Dallas, Tex.; note thereon each and every date upon which
vice-president, Dr. L. von Treba, Chetopa, Kans.; such prescription is refilled.'
vice-president, Dr. O. B. Ball, Warrensburg, Mo.;
vice-president, Dr. F. W. Jelks, Hot Springs,
Ark; vice-president, Dr. F. K. Camp, Oklahoma
City, Okla.; secretary-treasurer, Dr. F. H. Clark