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electricity as utilized in medicin (also and will be utilized more than they are. relegated to special experts).
They broaden out into the wide field of Notwithstanding the large number and euthenics, the effects of improved convalue of the methods I mention briefly or ditions of environment, specialized into describe and advocate, they are not yet constructiv and reconstructiv hygiene. regarded by the older and more “con- In order that we may comprehend the servativ" (or rather prejudiced) members workings of the human body sufficiently to of the profession with the confidence they guide it, in and out of health, we should deserve. There is such a vast amount of learn to approach the problems from several evidence growing in favor of their elemental separate, but correlated, points of view. efficiency that it will soon be impossible to The undergraduate student is supplied an disregard them.
admirable general concept, with elaborations The main reason for this is that these of the natural history of disease; also trainphysicians had no systematic instruction ing in how to meet the effects of disease by therein during student days or formativ reputable laboratory and pharmacodynamic periods. Unfortunately, certain of the best resources. The physicodynamic afford other of physicodynamic principles of healing additional means. We shall have a vastly have been exploited by shrewd, farseeing, better group of medical advisers when but blatant and unreliable persons. Hence, several preliminary years are devoted to a natural repugnances are formed, their poten- study of the normal structures and functial integrity is questioned and the profession tions, also variations from the norm and refuses to inquire open-mindedly into what the earlier phenomena of abnormality. is undoubtedly a promising and valuable Even now special research workers add field of endeavor. It is even difficult to most to advances who give the most time obtain a hearing before medical organiza- to studying normal problems of clinical tions.
histology and physiology. For example, Novel, unusual, especially the more simple recent testimony is to the effect that the principles and methods, however efficient marvelous revelations of the X-ray. can they may prove to be, always have been, only be rightly interpreted by men who are and always will be, assailed by those ignorant thoro masters of anatomy, physiology and of their scientific foundations and the pathology, as well as of special technicalities. unimpeachable evidence afforded.
The student of the future must devote a The one essential of the pioneer, as
longer, more protracted and thoro course Huxley has said, the capability of judiciously of study to the normal structures and exercising imagination (vision, the long actions before he can become a master perspectiv) is absent in them.
clinician. The purpose of my lectures is to give the In so brief a communication, it is only students succinct practical hints whereby possible to indicate a few of the mechanical they can broaden and amplify their help- factors which must be reckoned with. fulness to patients, and supplement whatever Let us here consider the human body special or particularized forms of medication first from the standpoint of a series of are indicated or being employed. Some of psychomotor and hydrostatic mechanisms, the measures described are not only efficient
and dwell upon the simple, yet practical in themselves, but much more available, standpoint of the spinal reflexes. prompt, thoro and free from possible or
The functions of the human body may doubtful by-effects than is medication. be studied as a “temple for the soul” or maintain that medicins, oftentimes, are the spirit, animated by a vital flame, or domionly agents which can perform the work nating mind, whose mechanisms are largely required ; also, are more applicable for
more applicable for controlled by the psyche. many reasons; occasionally, are the only
The human body itself should be studied agencies which can turn the tide of morbid as a living entity, an animal (primate) and forces or save life.
appraised from different angles of approach. None the less, many occasions arise when In my course at Temple University, the so-called “home remedies” amplified by human body is described as a psychoexperience, illuminated by science and physical vitalized mechanism dominated by elaborated to meet specific needs are the a sentient mind, and students are shown, very ones on which it is important to rely. first, how the mind affects itself, acts or
Principles of mechanics, statics, hydro- reacts in, thru and upon itself; and, next, statics, thermodynamics, and the like can how it affects the workings of the body in
and out of health. This we may call cut away, etc. The whole group of tubular psychodynamics, a colossal subject, the mechanisms act thru reflexes which cause nature and extent of which is by no means them to open and shut, hence, to propel defined and is the battleground of vast the contained fluids and distribute them. controversies. None the less,
Many reflex acts are so perfectly coutilize certain fairly well defined experiences ordinated that one is constrained to believe and make use of them to advantage under that in the spinal cord there exists a subthe heading of psychotherapy. There is sidiary brain. The most mystifying pheevidence to show that so delicate a mechan- nomena, however, often rest upon the least ism as the human body, so responsiv to complex causes. stimuli, psychic and physical, demands All diseases are manifested by a direct open-minded attention at all times and
and indirect series of phenomena; the latter under all circumstances. New points of embrace the reflex symptoms. Some invision must constantly arise, but always dividuals have exaggerated reflexes. It is there are simple guiding fundamentals and desirable, indeed essential, to familiarize my chief object is to simplify the concept one's self with the more dominant, broadly of the human body as a vitalized mechanism acting, and more readily controllable reflexes, subject to and interpreted by the laws of such as the spinal (or vertebral), the vagus, physics. Hence, we can profitably study the vasomotor (sympathetic), and the autothe body from the standpoint of physico- nomic. dynamics, as well as biodynamics, both as
It becomes a study in clinical physiology to diagnosis and treatment. All modern of the action and reaction thru these advances in knowledge of the body processes reflexes. involve a review of the physicodynamic The leading points can readily be learnt phenomena.
from textbooks, others from clinical papers; The mind and the body are equally trans- then one can use with advantage any one formers and transmitters of energy.
of the now numerous excellent charts, and Physics is the study of matter and soon the seeming mysteries will clear up energy.
after repeated experiences and verifications. It includes a knowledge of mechanisms, For some years, the term “reflex dishow they work, how energy is transmitted turbance" became a dumping ground for and directed and controlled. Among the ignorance, and the subject was deservedly subjects deserving occasional review by the condemned by neurologists. student of medicin, at whatever age or Unfortunately, the general practician thus degree of proficiency, are: Laws of motion, came to pay less rather than more attention statics, equilibrium, gravity, friction, prop- to the subject; hence ignorance was added erties of matter, of gases, of liquids (hydro- to indifference. Now, attention is again statics), of solids, malleability, ductility, being directed to this most promising field. elasticity, elastic limits, elongation, bend- It is quite possible to learn enuf, especially ing, torsion, etc.; laws of heat, expansion, of diagnosis as well as treatment, thru changes of state, etc.; laws of vibration, of regulating the reflexes and to encourage tonicity, etc.; with all or most of these it research and thus simplify many obscure is essential to become familiar in order to phenomena. begin to understand the human body at All or nearly all of the often remarkable work.
and excellent results of that group of I will end this paper with a few remarks irregular healers who pre-empt the backon reflexes and the rôle they play in clinical bone as their domain are achieved by phenomena.
primitiv, often unconscious, but efficient, Control of body function depends largely stimulations of the spinal, the vasomotor upon reflexes. They lie at the basis of all and autonomic reflexes. This can be done acts of life. We may divide them roughly by the deft hand alone in many instances. into the major and minor reflexes. Among A few hints will suffice to guide, and close the minor are the automatisms; the acts of observation and experience can do more. vegetativ life, analogous to habits, e. g., The moment one turns one's attention to respiration, circulation, deglutition, walking, the subject of reflexo-diagnosis, valuable
etc., become free from volitional control, facts will present themselves, enlarging our instinctiv, adaptiv impulses. Some parts
means of knowing how functional percan act independently of the central nervous turbations can be appraised and controlled. connections, e. g., the heart after nerves are The first thing to do after acquiring a fair foundation of knowledge of the underlying include all treatments applied by the hand, principles is to examin the surface of every that most marvelous and adaptable instrupatient by vision and also by touch, be- ment of sensitiv appreciation, apperception ginning with the back, combining this and and application. Hereby we can influence verifying it by all the other means cus- surface and deep structures in their mass tomarily employed, e. g., auscultation, per- and induce reactions thru both direct and cussion, etc. Many points will be thus indirect approach. revealed and new means afforded of ap- Direct: By squeezing and relaxation, preciating the powers of our auxiliary separation of muscle fibers, skin and fascia clinical resources.
by lifting subdermal structures, by traction Among the objects to be determined are and torsion of joints, etc. varying degrees and kinds of resistance, Indirect: By surface stimulation, which alterations in densities, relaxation and also tends to induce the visceral reflexes of conlocal tendernesses, hypersensitivness of
traction and dilation, tho not so emphatimasses, points of pain in or near nerve cally as by concussion of vertebra. centers and in their continuity, etc.
Mere routine massage is of limited useAgain, thru the vasomotor subcenters in
fulness. the cord circulation can be largely influenced.
Particularized and intelligently directed The paravertebral tissues (erector spinæ manipulation by a real expert is of enormous muscles innervated, as they are, by the
collateral utility. So few medical men take
. posterior primary divisions of the spinal the trouble to learn this craftsmanship that cord) are useful. Steady pressure on these
it has never filled the rôle it deserves. areas dilate the peripheral vessels; alter- I strongly recommend that every clinician nating pressures induce vasoconstriction. shall learn the rudiments, and from several
Tender spots usually indicate some pe- experts. They can then oftentimes perform ripheral disorder, which can be delimited in
remarkable exploits of betterment in a few accord with innervation.
moments where nothing else can suffice. Here is the whole story in a nutshell of
In another time and place I shall endeavor dominant control of the ebb and flow of to prove my contentions. arterial blood; hence, of local congestion, or anemia; hence, of nutrition and repair.
Vaccination Legislation in New York. Take one crude illustration of the spinal Editor MEDICAL WORLD:As showing the reflexes. The vagus can be stimulated; , vicissitudes of compulsory vaccination legishence, vasoconstriction induced, also the lation, a curious and interesting condition reflex of contraction in the heart, larger of affairs has arisen in New York State. blood vessels, aorta, etc., by concussing the The Commissioner of Health began, during seventh cervical vertebra. To induce the the past year, to enforce a law requiring opposite, dilation, concuss the tenth thoracic. the vaccination of school children in the The whole subject of the visceral reflexes of rural districts, and caused the vaccination contraction and dilation has been reduced of some 300,000 children. As a result of to simple factors by Abrams' original work. this campaign, which was apparently very
To be able to contract at will the viscera unpopular with the people, a number of is to open up vast avenues of betterment in bad arms developt and some children were losses of motor tone in hollow and tubular attackt by tetanus, but only those in the organs. Also expert pressures with the country districts; none in the cities. finger can induce desirable effects
A bill has been introduced into the New nerves in continuity, awaking their action York Assembly, known as the “Tallett when dormant, relaxing spasm or stimu- Bill," which was in large part instigated by lating to renewed action.
a Mr. Loyster, who lost a son from polioThus it will be plain that the domain of myelitis, which he attributed to vaccinaauxiliary therapeutics, the play of mechan- tion. This bill makes no provision for ical forces on the organism, is a rich field for vaccination of school children except when research, as well as of practical utility. smallpox exists in any school district or
Yet another means of cliciting desired city or in the vicinity thereof. The bill reflex responses is thru expert manipulation. was supported by the Commissioner of By this, I do not mean the perfunctory Education and by Dr. Biggs, Commissioner rubbings and slappings as given by ignorant of Health, who, however, wisht it to apply routinists.
only to the rural districts, and not cities of I use the term manipulation to broadly the first and second class. The bill was
opposed by the New York State Board of patient must be fed notwithstanding, for if Health and by the Medical Society of the nutrition be withheld, heart failure may State of New York. Curiously it was supervene. Only easily digested food should bitterly opposed by the antivaccinationists, be given every two hours, such as milk, who felt that it was worse for them than the eggs, rice, soups, syrups, etc. On above existing law, because it gave large dis- treatment a well-fed patient rarely succretionary powers to the Commissioner of cumbs. Health.
It has been suggested that veratrum The situation is really one which, in viride tends to heart failure. On the conrelation to vaccination, is quite unique. I trary, its effect in removing the lung obthought that you might perhaps desire to struction lifts the burden from the heart. make use of some of this information. My Heart-weakness in the later stages should personal belief is that the bill will be passed. be met by hot, nourishing food, hot milk
. Our venerable friend, Dr. Abraham Jacobi, punch, quinin and strychnin. If hepatiwas one of the four speakers for the State zation persist a large plaster of cantharis Society. Jay F. SCHAMBERG, M.D. applied over affected area will usually give 1922 Spruce St., Philadelphia.
prompt relief. Stimulation of the healthy Lobar Pneumonia: Basic Principles of
organs often brings them to the aid of the Treatment.
diseased lung. Hence the value of diuretics, EDITOR MEDICAL WORLD: The following
diaphoretics, cholagogs, etc.
Palmyra, Mo. JAMES N. Coons, M.D. are my principles:
1st. Clear the alimentary canal--for thru it all medicins and food must pass.
Colds.-A Different View. 2d. Reduce the volume and flow of blood DEAR DR. TAYLOR The Symposium on to and thru the inflamed lung.
Treatment of Colds in the December numplethoric by general venesection, but ordi- ber of THE WORLD I have read with great narily by cupping over the inflamed area, interest. As the views there presented differ or by giving at intervals of two hours 6- so materially from mine, I am presuming to drop doses of Norwood's saturated tincture give my view, based on personal experience of veratrum viride till the too rapid pulse and observation. I have nothing to say has been reduced to normal frequency and about colds being a "filth” disease or force, adding to each dose a small modicum "autotoxemia from the absorption of pu(1/16 grain) of acetate of morphin to prevent trescence from the alimentary tract”; that nausea and to quiet pain and restlessness. may be all right; but as to the cause, and
Sometimes a stimulating liniment over the how to prevent, I have somewhat to say. chest, a mustard plaster or a light blister In my youth I read some popular writers of emplastrum cantharis, will accomplish on hygiene which gave me the impression the purpose, or aid in it. But I must urge that the more I exposed myself, and the the veratrum viride for its effect not only less clothes I wore, the more hardy I should in reducing heart action, but also in pro- become. I took cold shower baths, somemoting diaphoresis, moistening the skin, times would strip and run out of doors and and liquefying the secretion of the clogged pour a pailful of cold water over me, and lungs, thus promoting its expulsion. A this when the ground was frozen or covered warm, moist atmosphere about the patient with snow. I do not know that it hurt me, is a great help to th same end. A cough but am sure it did me no good. We were mixture of syrup of scilla, ipecac and sweet specially counseled not to wear anything spirit of niter is also a contributory agent. about the neck. This I avoided even in the
When the veratrum has brought the cold winters of Maine. But I contracted a pulse to normal frequency, it should be bad sore throat. discontinued or given only in 1-drop doses Up to this time I had never worn undersufficiently often to keep the pulse near clothing, except a cotton shirt, and for some normal. A drop or two of tincture of time had no overcoat. I will say about my sanguinaria cortex added to the cough sore throat that it seemed to be a pharynmixture may supplement the veratrum at gitis. There was no laryngitis, for I was this stage. If the patient be weak, sweetened not hoarse. but there was a sore spot just cream and brandy may now do yeoman above the larynx too low down to be seen; service.
so sore it was that any use of my voice It must not be forgotten that usually all was very painful. It would seem as if a appetite is lost in pneumonia, but the
were being scraped. I so far
recovered that I was able to sing and teach. sitivness, I accepted a call to a church in But I had learnt to protect my throat, Connecticut. I had to use great precautions wearing a flannel around my neck and against cold and chill. So people noticed keeping warm generally. In fact, I adopted it, and many said I should not be able to and inculcated in others the motto, “If stand the work. But I did. I visited the you would avoid taking cold keep warm.” people and attended meetings as I had
I illustrate further by later experiences. been in the habit of doing, and besides did After taking my degree in medicin and considerable medical work. My health practising several years, I yielded to what gradually improved and I continued my I believed to be a higher call
, and entered labors in that state something more than the Christian ministry. Besides on the six years. In 1899 I returned to my home, Sabbath preaching morning and evening, where I am now, in Brentwood, N. H., sometimes attending an extra service in the since which time, until within a few years, afternoon at some out-station, I always I have supplied pulpits, done some medical held an evening service, at times driving out work, and when not thus engaged, workt two or three miles for this. I occupied any
on my farm.
Tho realizing some failure where from two to six evenings a week from the lapse of years. I am still able to
, conducting meetings several miles away, do light work on and about the farm; still all thru the fall, winter and spring. In using great precautions against taking cold, doing this I was careful to keep warm and and very rarely take cold. I suffer one or dry. I instructed the people to keep the two mild attacks a year. I give these details room warm till service was closed so people to illustrate the course I take and recomwould not have to go out in the cold when
mend to others. I have practised on this chilled. To the best of my recollection I plan in my family, and whether on account never took cold in going home from a of it or in spite of it, my wife lived with me meeting, tho I was naturally exercising more than fifty-seven years and passed vigorously during the service, and might away at the age of 78; the 8 children born sometimes be in somewhat of a perspiration. to us are all living, married and raising Of course, I would avoid that when possible, children, so that my grandchildren number but I would rather be so than chilly; for 24. I myself am nearly 82, in comfortable I would put on wraps enuf to keep warm. health notwithstanding what I have told, I do not say I never had a cold during those and besides having suffered in my 18th to years, for colds are often epidemic and 20th years from chronic diarrhea and contagious; but unless a cold was unusually enteritis so that I was entirely disabled severe, I kept going.
from activ work, and was expected by Late in the year 1889, I think it was, people in general to die, and which disease when influenza was prevailing in a very
has lingered in my system all these years, severe form, I suffered an attack, from the has often broken out and thrown me down, effects of which I have never fully recovered. and always, like a wild beast, been crouchAfter the acuteness of the attack had ing in ambush ready to pounce upon me, passed I tried to keep up my work.
I compelling me to be constantly on my recovered my usual strength, but was pe- guard.
E. B. PIKE, M.D. culiarly sensitiv to cold. I could not bear
Exeter, N. H., R. R. No. 1. to touch cold things nor let cold air strike [It has been our experience that people
I had to warm all my clothes with tender skins like yours will overcome when I put them on; could not sit on a their susceptibility to catching cold by bare chair at the ordinary temperature of hardening their skin by cold baths. We the room in which I lived. To do any of have known it to succeed repeatedly. Unsuch things would make me sick. I would doubtedly these same people may catch wrap up, throw a shawl over my head and
cold in spite of this if other conditions are face, and let some one drive me to the not satisfactory. They may live in overstation so I could go to my preaching heated houses or hug the fire too closely appointment; for I was laboring some ;
when indoors. An excess of external heat fifteen miles from my home. I struggled or a surplus amount of clothing will relax along thru the winter, sometimes failing to the skin and open the pores at any time. meet my appointments, and then resigned Then is when a person catches cold. But my charge.
a matter that is probably still more imSome two and a half years after, having portant is to increase the internal resistance partially recovered from this morbid sen- to cold. This is accomplisht by anything