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undiluted glycerin should be brought in contact with the parasites, and that the thirst for water should not be first slaked by absorption from the tissues of the throat and stomach. For this reason Dornblueth suggested that Unna's claim for keratin should be acted upon, and that the glycerin should be inclosed in soft capsules of keratin and expressed past the acid stomach, to be dissolved in the alkalin fluids of the bowels, and discharged there, where it could meet the parasites while undiluted, and exercise on them its full hygroscopic

powers.

One case Dornblueth treated: A man had eaten freely of measly-trichinouspork; he was given emetics and cathartics, and a tablespoonful of pure, water-free glycerin at frequent intervals. Prompt recovery followed, and the clinician believed that the glycerin had been quite effective. But experiments made by American pharmacists did not substantiate Unna's claim that keratin would not be dissolved in the stomach; in fact, the solvent powers of the human gastric juice have as yet not been delimited. The matter stops just short of that extended clinical trial that offers the final evidence for or against any medical hypothesis.

Bouchard asserted that any intestinal antiseptic to be effective must be insoluble; as otherwise it might be absorbed and disappear from the alimentary canal. But it is difficult to see how any agent can be active unless it is in solution; and the standing of his chosen remedy, betanaphthol, depends rather on somewhat favorable clinical trials than on his a priori reasoning. Alphanaphthol has also had its advocates, and these bodies seem to be quite effective when administered in large doses. objection is that they are not wholly innocuous, and hence one must have care not to pass the line of safety in the endeavor to reach the point of asepsis.

The

This applies as well to salol, which otherwise would appear to be almost the ideal. Insoluble in the acids of the stomach, it is claimed that it reaches the alkalin intestins, to be there broken into phenol and salicylic acid, both effective locally. But salol has a toxic point, and cannot be given safely beyond a certain dosage.

The phenolsulfonates, better known as sulfocarbolates, are perhaps the most widely used of all these agents. They are official in the pharmacopeia. When employed in chemical purity there is no toxic point of

the phenolsulfonates, and they can be administered up to the full limit of gastric tolerance with absolute impunity. The evidence for their efficacy, while wholly clinical, is very strong.

Few, if any, clinicians accustomed to the regular use of calomel, will be found to doubt its efficacy as an antiseptic. Whether the old explanation of an action in stimulating the liver have any foundation or not, the results following the exhibition of calomel, in very many affections, are too decided and sure to permit of mistake. It is significant that those who employ other antiseptics invariably urge a preliminary course of the mild chlorid.

Emetin has as yet proved successful only against animal parasites, but its success has been so decided that it goes far to upset the hypotheses of those who assert the impossibility of rendering the bowels aseptic. Rogers also urges the use of calcium permanganate, but as yet it has not received a general trial. Some readers may remember the furore that followed the recommendation of potassium permanganate as a remedy for amenorrhea-and the glowing reports in its favor, altho the salt could not have passed the stomach unchanged.

All the volatil oils possess antiseptic powers, in widely varying degree; and the profession cannot have forgotten Wood's advocacy of the oil of turpentine in late typhoid fever. Comparative tests showed that the oil of cassia was more powerful as an antiseptic than any other of this group.

Iodin and chlorin, in many forms, have been lauded likewise; and it is noteworthy that, whenever a clinician commences the use of any of these agents as antiseptics he surely becomes quickly enthusiastic over it -the response seems to be certain and decided.

Meanwhile the great question is unsolved -can the alimentary canal be rendered aseptic? and how? The pathologists assert that it cannot; the vast mass of clinicians assert that whether this is true or not, the administration of these remedies is followed by benefits so decided and striking that their utility is to be explained rather than questioned. Here, however, sterilization is the object to be attained. It is not a clinical cure we seek, but absolute destruction of the pathogenic organisms inhabiting the bowels.

Remains the bacillus Bulgaricus. Strongly urged, used with little discrimination and no knowledge of its biology, the evidence is

still imperfect. Experiments made in a laboratory showed that very few of the preparations on the market contained living bacilli in sufficient numbers to exercise any perceptible action. Only after two weeks' administration of a really active preparation, in commensurate doses, was the bowel so densely populated with the bacillus as to secure the object desired. If during this period a saline laxative were taken, the protective bacilli were swept out, and the process of stocking the bowel had to be commenced again. If any effect is had upon typhoid bacteria in the bowel, no records of this have appeared.

The need is plain. We must have a means of destroying these organisms in the bowel. Modern science has her work laid out. Let us see if she is equal to the emergency.

WILLIAM F. WAUGH, A.M., M.D. Muskegon, Mich.

Summer Ailments.-Eczema, Diarrhea and Dysentery.

EDITOR MEDICAL WORLD:-Hot weather is with us. What effect has it on the human body? Does it not relax and weaken all of the tissues, especially dilating and detoning the cells of the skin and mucosa of the alimentary canal, provoking eczema of the one, and diarrhea or dysentery of the other?

For the eczema of the skin what better than dusting with borated talcum powder; or, if obstinate, an ointment of subnitrate of bismuth, 1 dram, to 4 drams of white petrolatum, to which in some cases 1 or 2 grains of carbolic acid may be profitably added.

But the bowel troubles are more complex. Digestion is impaired. Fruits and vegetables, so craved and vividly eaten, sour and ferment into an irritant mass provocative of gaseous distension, pain, increased peristalsis, diarrhea and dysentery.

How shall we meet these pathologic conditions? First we must cleanse the alimentary canal with as much certainty and as little irritation as is possible. To this end I know of no agent as certain and reliable as castor oil. After this cleansing a tablet of calolactose hourly will disinfect the canal, promote biliary action and complete the cleansing.

Then with the patient in a cool, wellventilated room, apply over the abdomen an ice coil or a rubber bag of crushed ice, enveloped in a soft cloth to prevent shock

in a child or delicate adult. This will cool the inflamed parts, numb the pain, tone up and astringe the weakened tissues.

Internally we may give mistura cretæ or bismuth subnitrate every 2 hours, with enough tinct. opii camphorata to quiet pain and tenesmus, and should direct once daily an enema or lavement of 1 dram of acetate of lead to 4 pints of boiled water, thus cleansing and astringing the rectum and colon.

What shall the patient eat? The sick must have food, not so much, but more often than the well, if we would keep up vitality. Shall we not forbid fruits, vegetables and fried meats-all difficult of digestion and hence liable to fermentation or putrefaction?

What better can we prescribe than cream toast, boiled milk, well-cooked cereals, eggs, malted milk, toasted crackers, barley water, albumin water, lemon flavored and sweetened?

For many years summer diseases of the alimentary canal in both children and adults treated along these lines have been marked by a success surprising and gratifying alike to myself and my neighboring physicians. J. N. COONS, M.D.

Palmyra, Mo.

Nor is

[It is not likely that the relaxation of the skin due to the warm weather causes eczema, but it may render the skin more vulnerable to the cause of eczema. it likely to cause diarrhea or dysentery. Diarrhea is usually due to the ingestion of decomposing food, to errors in diet that neutralize the acidity of the stomach or the alkalinity of the bowel or inhibit the secretion of digestive ferments. Dysentery is due to a bacillary or an amebic infection. Dr. Waugh's article on intestinal antiseptics in this issue is also useful in this connection. The sulfocarbolates are distinctly useful in these summer bowel troubles.ED.]

Sciatica.

DEAR DR. TAYLOR:-For Dr. C. P. Graves,

Alden, Ill., who asks help: Give 2 drops tr. apocynum in 1⁄2 wineglass water 4 times daily. It cures 60% of cases. G. P. GEHRING, M.D.

Los Angeles, Cal. DEAR DR. TAYLOR:-The "knockout" which Dr. C. P. Graves (June WORLD, page 235) seeks awaits him in the proper application of the static wave current, which is a specific in such troubles. I have yet to witness a single failure, either in the young or old, and I have treated at least two hundred cases. E. G. CHARBONNEAU, M.D.

Newark, N. J.

Some Diseases Prevalent Among Indians of the Southwest and Their Treatment.

EDITOR MEDICAL WORLD:-The statements presented in this article are obtained from Bulletin 34 of the Bureau of American Ethnology, which is a summary of the results of extended research among a large number of Indian tribes of the southwest made by Dr. Ales Hrdlicka, Curator of Physical Anthropology in the National Museum. They will, it is hoped, afford at least a glance at the numerous conceptions and practises of those Indians.

The Southern Utes suffer from various digestive and pulmonary disorders, including consumption, while among the Apaches in Arizona and New Mexico the disease probably of greatest prominence is pulmonary consumption. Epilepsy and insanity are also occasionally encountered. On

large quantities, indigestion necessarily results. The increasing use of large quantities of black coffee also have a bad effect in producing headaches and vertigo. Rheumatic pains, particularly in the lumbar region, are quite common among old people, as well as simple ophthalmia and irritation of the eyes.

Among the Hopi Indians the most common diseases are ophthalmia and gastro-intestinal disorders, the former being generally caused by windblown sand. As a result, a comparatively large number of them become more or less blind. Among the Hopi children were noticed several cases of fevers, 3 of chickenpox, 3 of dry eczema, 2 of scrofula, 1 of strabismus, numerous instances of conjunctivitis and some of cough.

The most prevalent and fatal diseases among the Zuñi are those of the intestinal tract-enteritis of different forms, but not typhoid; pneumonia,

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one reservation among a population of about 3,000, there occurred from 1901 to 1903, 255 deaths, of which over 36% were due to different forms of tuberculosis. The conditions are still worse among the Mescaleros.

On the White Mountain reservation such cases are less common, but again become more frequent among the Jicarillas, and with this tribe several deaf and dumb children were observed. Both adults and young people of the Walapai tribe were found to suffer from stomach and intestinal disorders.

The Navaho Indians are, as a rule, healthy, except perhaps those around Fort Defiance, and their common disorders are those affecting the digestive tract. Within recent years they have learned to make an inferior kind of bread in which they use much cheap baking powder, and as the bread is not baked well, and is eaten in

tuberculosis (particularly pulmonary), and various infections.

The Papago Indians seem to be healthier than some of the other Southwestern Indians, while among the Pima tribe tuberculosis in its different forms, including scrofula, is quite frequent. One case apparently of elephantiasis of the foot and one case of marasmus were also observed among the Pimas. They say that if a stalk of the bush Cul-ick-un-ek (Dondia suffrutescens) wounds a man and is not promptly removed, it is liable to cause blood-poisoning that may have fatal results. Contact with the plant ha-van-tatat ("crows' feet": Phacelia, probably infundibuliformis) is followed by inflammation of the skin, and the Pima Indians say that when this plant touches the naked arms or legs it produces sores which, tho they do not spread, will last for three weeks to a month.

With the Mohave Indians the most common complaints were found to be those of the stomach and intestines, and muscular rheumatism.

The most prevalent diseases among the Yamas seem to be malaria and venereal troubles, while among the Opatas those of the digestive system are the most common. Malarial fever is also prevalent.

The Yaquis are very sturdy, tho along the valleys, especially in the midsummer rainy season, they suffer from fevers, probably of a malarial nature.

A certain amount of irregularity of living and unhealthiness of the lowlands, with too frequent use of "tesvino," subjects the Tarahumare Indians to numerous disorders, the commonest of which are affections of the digestive organs and various forms of malaria. An affliction much spoken of and often fatal is "dolores costales," a term prob

FIG. 2.-Gemiwûnac ("Sailing in the rain"), a Chippewa healer, who sang the "healing song" when a member of the Midewiwin was dying, and also administered medicinal herbs.

ably including both pleurisy and pneumonia. Contagious diseases, such as variola, visit these Indians occasionally. While insanity is very rare, cases of temporary mental aberration following drink are well known. Deaf and dumb people occur in this tribe and blindness is more or less frequent as the result of smallpox or injury of some kind.

Malarial fevers, dysentery and a chest disease, probably pneumonia, seem to be most frequent causes of death among the Tepecano Indians in Jalisco.

The Cora Indians seem to suffer chiefly from calentura (mild thermic fever) and outbreaks of

smallpox. Pulmonary tuberculosis occurs, tho rarely, and intestinal disorders among the infants

are common.

Results from the abuse of intoxicants are said to mark the Otomi Indians, while epilepsy and other neuropathic conditions are met with quite frequently.

The most common disease among the Tlahuiltecs, besides the effects of alcoholism, are various calenturas and pneumonia.

From the preceding remarks the following are a few of the general deductions made as to the health and diseases of Indians in the Southwest and Northern Mexico. On the whole, the health of the Southwestern and North Mexican noncivilized Indians is superior to that of the whites living in larger communities. Pathologic conditions of the blood are very rare, while anemia is occasionally met with in the later stages of malaria, or in a lighter degree in some of the taller schoolgirls who have become debilitated. Diseases of the respiratory apparatus are relatively common and cause numerous deaths. Disorders of the digestive apparatus are very common, but rarely serious, except in the case of infants. Typhoid is very rare. Certain forms of diarrhea or dysentery attack both adult and young Indians, especially in the low-lying parts of Mexico. Intestinal parasites occur very seldom. Venereal diseases prevail more or less in the tribes near railroad centers and near large white settlements. Diseases of the skin are restricted to eczema, favus, or ulcers in children, acne in adolescents or young adults, and some ulcers, due to neglect, in older individuals. Headache is quite common among the nervous, and mental disorders occur, while vertigo occurs only occasionally, and hysteria of light or moderate form is met with occasionally in growing girls. Diseases and defects of the sense organs include numerous ophthalmias, some trachoma and occasionally a cataract. Strabismus is very rare, and so are ear diseases and defects of hearing. Of contagious and infectious diseases the most dangerous is smallpox. Localized epidemics of measles are quite common. Scarlet fever is very uncommon. Whooping cough is not very rare. Influenza was reported from several localities, and pneumonia in isolated cases has appeared in an epidemic form. Malignant diseases and hernia seem to be very rare, while rheumatic afflictions are quite common. Pathologic obesity does not exist.

In studying the defects of pigmentation, Dr. Hrdlicka met with two apparently related classes of phenomena. One of them was a regular, more or less complete and extended congenital lack of the usual pigmentation, or what may be termed albinism proper; the other being a generally irregular, more or less incomplete and extended, depigmentation occurring at some period of life and known more commonly as vitiligo. Both of these conditions, originally probably neuropathic, yet seemingly radically different, explains Dr. Hrdlicka, were met with among the Indians visited, but in the Southwestern States the cases found were comparatively few in number and were restricted to a few tribes, while no instance of either kind was encountered among the Mexican Indians excepting the Tarahumare.

Taking up the Indian conception of disease, its prevention and treatment, including folk medicin and medicin-men, Dr. Hrdlicka remarks that

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among them illness is regarded as a deleterious spell which includes bodily suffering, is generally inimical to physical welfare, and may even bring an untimely death. Ailments caused by certain natural conditions, such as extreme heat or cold and accompanied by various symptoms, as pain, debility, fever, etc., are viewed rationally, but similar symptoms arising without their cause being observed cause suspicion of natural or supernatural secret agencies, and often the Indians suspect as the actual agent of a disease some material or magic object such as in his belief might cause the principal symptoms if introduced into the body in a natural way and with his knowledge. Thus there are to his mind "two chief classes of ailments: (1) those of an ordinary character which have their origin in extreme old age, acci

regarded as the work of supernatural agencies superior in power to the counter-agencies employed as a cure.

As a result of the Indians' effort to find persons endued with the supernatural powers to control and counteract the powers that caused the disease, there arose a class of "medicin-men" and "medicin-women" who were supposed to have extraordinary and mysterious powers, which they acquired prenatally or received in dreams or in connection with some notable event in their lives. By means of these gifts and with the aid of fetishes they are supposed to recognize the mystic causes, to choose the most efficacious way of preventing further action of this cause, and to remove or neutralize the objective agent to whose presence the suffering is due.

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A small piece of cactus (Lophophora), which, on account of its medical properties and wonderful effect on the imagination, is regarded by the Indians as a vegetal incarnation of a deity. A whole system of myth and ritual has grown up in connection with its use. The rite originated among the more southern tribes and has come thru the Mescaleros and Comanches to the Kiowas within the last seventy years.

dents or some other accountable manner, and (2) those of a mysterious nature, incited by some adverse natural or supernatural power, sustained often by magic or particularly by some material agent introduced secretly into the body and requiring special, largely thaumaturgic, treatment." In brief, these people believe that all serious or protracted illness, the cause of which is not apparent, is due to occult influences of men, animate or inanimate objects, spirits or deities, and that the influence is exercised by a magic or secret introduction into the body, particularly during sleep or thru touch while awake, of some noxious object as poison, a worm, an insect, a hair, a thorn, or a live coal, which produce and maintain the morbid manifestations. Death from disease, especially in the case of a young male adult, is

The treatment accorded by the medicin-man may consist of repeated prayers to the elements or deities, depositing prayer sticks or countercharms in shrines, appeals to the patient's personal protector or totem, the use of songs, rubbing or kneading, extracting the objective cause of the disease, blowing air or tobacco smoke on the patient, etc., etc. There are also medicinwomen in several of the tribes, a few of whom practise in the same manner as the men, but most of them serve as midwives and herbalists. They are said not to be tricky like the men, and usually apply simple remedies, such as herbs. Quite independently of supernatural cures there is among the Indians much simple general knowledge of actual remedies, the medicins usually taking form as a decoction of some plant, tho they are also

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