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pant s much praisale in that lina Cross has
Neutralized hospitals, therefore, though intended which are good and sufficient, to its own mind at to ease up the horrors of war, have a tendency to least. prolong the struggle and increase the suffering. It would be far better to use the contributions for THE DRUG FAMINE AND AMERICAN the relief of Americans in distress due to the war.
MEDICINE. Charity begins at home, and the Red Cross has
The Eclectic Medical Journal has the following shown that it is invaluable in that line.
editorial upon this subject: There is much praise bestowed on volunteers on
The war in Europe has had a most disastrous account of their good intentions but that must not
of effect upon the American drug market. In sev
offer blind us to the fact that they are often unwelcome,
eral instances the price of drugs and chemicals has and are neglecting home distress which Heaven
become almost prohibitive; in others, an actual knows is bad enough already. There is need of
drug famine exists. Upon whom does the blow American surgeons in the American hospital in
fall most heavily? Paris, but that is an institution built and managed
For many years now, while assuming an exalted by Americans for Americans and now taking in
idea of patriotism and an exaggerated loyalty to
de sick and wounded of all nations. .
America and to American institutions and interThe Geneva convention has long been found to ests, a very large proportion of the medical probe absurdly impractical in other ways and com- fession in America, either willfully or ignorantly, manders must ignore it. The Red Cross, flag is have ignored American resources and the opporno protection whatever. No plan can be changed tunities they have offered. This is most noticeably because a hospital gets in the line of fire. To save true of American indigenous drugs and Americanit might lose a battle, yet we can rest assured that made pharmacals. Praise alone has been bestowed the newspaper stories of deliberate firing upon the upon foreign drugs and only foreign drug houses hospitals are not correct. The warring nations are have stood in the forefront in the great (!) medcomposed of the same races as ourselves and are ical journals of the country. American drugs equally humane and intelligent. Similarly if a have been unnoticed, neglected and often unjustly battle can be won by using the Red Cross vehicles condemned, either ignorantly or with malice aforeto bring up guns and ammunition, no one hesi
thought, while foreign products have been lauded tates.
and so much depended on that now, when a famine Nothing can be reserved for the use of the dis- in medicines is upon us, physicians who have been abled to the exclusion of the fighters' welfare. If biased in favor of the "made elsewhere” scarcely an ambulance can be seen, the enemy must con- know which way to turn for the medicines with clude that it is up to mischief. If a hospital har which to ply their calling. bors guns it must be fired on, yet the old brutality Not alone has the individual physician. taught to the wounded has entirely disappeared. The by a few leaders, brought about this dilemma, but Geneva convention was devised to end it and the neglect of home products has been fostered by has succeeded, because it was an expression of the medical press. It is a broad statement and a universal humanity protecting against past meth- bold assertion that is implied when we ask the ods. The new order of things would have come question as to when and where the most widely in time without its influence. Commanders now circulated medical journal in the country has exas then obey its provisions when possible and tolled or even supported the pharmaceutical ignore them if injurious.
products of the great laboratories of America; or Wars are recognized as national. The opposing when has it lost an opportunity to praise and soldiers have no personal animosities and are exploit the products of foreign markets. Furtherinvariably friendly when thrown together as help- more, not only has it neglected, with unpardonless prisoners. We must also reject the stories of able lack of home pride, but has actually waged brutal treatment of women, and children. There warfare upon legitimate medicines made by Amerare some scoundrels in every large body of men, ican manufacturers. and these will break both civil and military law Is it, think you, because of the superiority of when they think it safe to do so, but commanding foreign drugs and foreign chemicals? One who officers invariably make short shift of those who has watched crude shipments from the old world to are caught at it. Similarly it would be exceed- our shores can scarcely accept the affirmative of ingly unwise to form any judgment as to the this question, when all sorts of rubbish has been reasons of military measures. Each side invari- found as admixtures of plant products. The lists ably puts a sinister interpretation on what the of adulterations and sophistications of foreign enemy does. For its own conduct, it has reasons crude drugs that have been published from time to time in our journals of pharmacy show an from wintergreen? Is benzoic acid, so largely used appalling condemnation of the vaunted purity and in paregoric, when made from urine even though superiority of foreign crude drugs.' Can we ex- retaining the disgusting odor of the latter, so pect very much of all their chemicals? Where, much more desirable than the natural educt from too, have most of the fake preparations and pro- gum benzoin? Surely have the commercial “wool cedures, from the “elixir of life” to "twilight pullers” of the continent befogged the vision of sleep” so greedily sought for by enthusiasts for the American, who either through shortsightedness the novel come but from out the laboratories of or avarice, has been led to neglect the opportunithe old world? Has America produced any "fake ties offered by his forefathers in the land of his medicines” or slick business procedures that can birth. put to shame the Friedmann humbug? Can she Suppose the American physician had profited show any greater biological uncertainty than the by the examples set him by Barton and the Bigemany strains of anti-tuberculosis medicaments? lows, Rafinesque and Porcher, Thomson and Beach Can she hold up any greater swindles in variations and others, who sought strenuously to inculcate than the digitalins, the apiols, and the ergotins, the advantages of American vegetable medicines. and a host of similar but much sought-after po- Would he now be lamenting the fact that the tencies or proximate principles in medicine? Can world is confronted with a European drug famine? she uncover anything like the commercialism in Would he, too, have wrought the havoc in illness medicine that has made some foreign marvels a with powerful foreign synthetics that has now stench in the nostrils of those awake to the vile, become an opprobrious historic record ? ness of "big business"? Has she to her credit as Once more it is the turn of the Eclectic many death-dealing uncertainties as have come to be congratulated. While he may miss from the continental laboratories? No answer re aconite and belladonna and foreign digitalis quired. These are open questions, however, which and a few other potent agents that he has we propound to the individual physician, who may acquired through foreign teaching, yet is he have been one of the many victims of foreign so strongly intrenched in the knowledge of domination in American medical affairs.
hosts of American drugs that he need scarcely Isn't it about time that the American physician be disturbed by the war-locked conditions of arouse himself and shake off the shackles of Eu- the drug market? Belladonna, if needed, can ropean forging? Isn't it time that he began to be, and as successfully, raised here, and the digitake some notice of the vast resources of his own talis of this country, experimentally produced, country? In no field will he find so great and so does not have to yield position to the British leaf. neglected opportunities (by some) as lie in re- If aconitum napellus can not be had, possibly the search into American medical plant drugs and mountains of Montana can furnish its therapeutic their products.
cousin, the aconitum fischeri. Perhaps the reckWe can truthfully say, and say it without bit- less use of powerful febrifuges and narcotics will terness and reproach, but not without regret, that be prevented by the scarcity of such drugs. The the dominant school of medicine in this country happy thought remains, however, that the Eclectic has neglected the opportunity which was hers by has not neglected his home products and has at right of birth and priority to study and foster the his behest hundreds of potent agents, the heritage use of American plant drugs. She has been ob- handed down in the evolution of the American sessed with the idea, adroitly encouraged and dis- materia medica. While his rivals in medicine, if seminated through the writings of those whose inclined toward repentance of foreign domination, medical education was acquired in foreign schools will have to begin anew to study the American and from continental literature, that Europe, and resources, the Eclectic, forearmed and fortified by Europe alone, had special advantages of soil and the long study of these therapeutic agencies, need climate, and men of greater skill and training in give himself no worry and less alarm. the raising and collecting of medicinal plant
L ove you products. No digitalis will be accepted by the high “I suppose,” remarked Mr. Brown, now aviand mighty that has not been watched over by the ators are becoming so numerous and are actually lion and the dragon. No chemical is quite so good holding aeroplane contests that we may expect as those manufactured from the refuse of the to see a weekly paper published in their interdumps and wastes in the Vaterland, even though a ests." caution always flanks the statements of great ther- “Oh,” said Smith, “there has been a suitapeutic power. Power they certainly have—but able paper on sale for a long time now." death dealing. Has the salicylic acid from coal “Indeed! What is its name?” tar any advantage over the American product “Fly paper."
PHYSICAL REMEDIES FOR PAIN. : chief consideration being the dose, i. e., the length Last month we began the discussion of some of of time of application. the non-medicinal methods of treating pain. The Massage may be employed in the treatment of subject has developed considerable interest, hence pain, since in nearly all painful conditions there we continue it in this issue of The Medical Stand- exists muscular contraction (tonic), and the relaxard.
ation of these muscles follows gentle stroking, As we have already stated, it is time that the deep kneading, or rolling the muscles between the medical profession realized their responsibility in hands. Complete general relaxation of the patient this matter. While anodynes and analgesics are is the chief feature. The tension must be reduced indispensable to the practice of our profession, and the mind must be calmed. When complete they are two-edged tools and their use should be muscle relaxation is produced pain is relieved. avoided as far as possible. Most of us do not Doctor Shaller has also used the vibrator for take the pains we should to get at the causes of the relief of pain, applying it directly over the pain. True, the surgeon no longer tries to drown muscles until the pain has disappeared. He does the cry of the tissues with opium; but the physi- not believe that the stroke or the rapidity are of cian too often resorts to some standard tablet for great importance. The exit of the spinal nerve headache. If we understood the etiology of pain which is connected with the seat of pain, directly we could treat it always with greater intelligence, or through the sympathetic system, should be have more real cures, and without resorting so vibrated. The doctor states that while he is a often to the administration of anodynes.
so-called regular, he has relieved severe intercostal It is because we realize the importance of a and sciatic pains and migraines by means of chirothorough understanding of this symptom that we practice or spinal adjustments, and considers this urge every reader of these lines to purchase and method worth investigation. study Behan's masterly volume on "Pain," pub- In treating neuralgic or neuritic pains, Doctor lished by D. Appleton & Co., of New York. Shaller advocates direct treatment to the spine, at
We present herewith several more contributions the exit of the spinal nerve which is connected on the subject:
with the painful area. Sometimes this nerve is Dr. John M. Shaller, Cincinnati, Ohio, explains tender along its entire course; again the pain may the anodyne action of heat in the relief of neuric be reflected and the structures over the exit of or muscular pains as follows: Pain is produced the spinal nerves are tender on pressure. In these by tonic muscular contraction, or by congestion; conditions, vibration or the chiropractic thrust will irritation of some kind precedes either. Heat re- afford relief. laxes muscular contraction, and as muscular con- In cases of myalgia he employs vibration ditraction produces pain by its pressure, pain is rectly over the muscle, or at the exit of the spinal relieved when pressure is removed. Heat dissi- nerve which supplies the muscle, i. e., where it pates congestion and thus relieves.
leaves the vertebræ. A stimulating ointment, such Doctor Shaller does not believe that any definite as Rubifax, vigorously applied with the hand, will technique for the use of electricity can be given often be found useful in the treatment of myalgia, which must be specifically followed in order to as well as the use of the hot water bag. As for relieve pain. In his opinion every individual will medicinal remedies, he has found cimicifuga, bryprobably find that pain can be relieved by anyonia, rhus tox and aspirin of value in this kind of electricity, applied in almost any way, the condition.
For the relief of ocular pains and headache, and learned to my satisfaction that my suggestion Doctor Shaller suggests vibration of the muscles had been accepted and that a few hours in the and integument located over the second or third bath had given complete and permanent relief. cervical vertebra at the point of tenderness, which “In order to demonstrate the action of the conmay be found upon pressure. If the recti capitis tinuous bath as an anodyne, we can study its effect and oblique muscles are tender, which may be in burns; here it gives almost immediate, and even ascertained by deep pressure between the occiput complete, relief from pain, and can be regarded and axis, vibration may be applied over this region as the most excellent means of treatment. Even until the tenderness is lessened, say from five to if it offered no other advantages, it would be of ten minutes.
great value on account of this soothing effect when When there is deep-seated or visceral pain of the pairs are most excruciating. Another advaninflammatory origin, he examines the spine at the tage of the warm-water treatment is that the water exit of the spinal nerves of each side for tender- penetrates the burnt tissues, in consequence of ness and applies the vibrator at that point. In which they remain moist and soft. Without the acute conditions he relies on codeine for the relief immersion the cuticle which has been destroyed in of pain, while, of course, endeavoring to learn its whole depth would harden and form an imthe cause and correcting it.
penetrable covering over the underlying parts. Regarding the pains of severe and possibly in
Immersed in water, tissues which have becurable chronic disease, such as cancer, for
come gangrænous cannot dry up, but remain instance, Doctor Shaller says: “If there is no possible chance to remove the cause, I would treat such a patient as I would wish to be treated under similar circumstances. While pain does not kill very quickly, still I would prefer to be comfortable. I prefer in such cases a combination of morphine, hyoscine, cactoid, pilocarpine and caffeine (known as H-M-C Modified-Abbott). I would permit such a patient to try to obtain relief from any source in which he or she had faith. I would not take away hope, but make every endeavor to keep the mind on the idea of relief, with belief in its attainment.” He goes on to say:
Patients Method in the Continuous Hot Bath. “There is no doubt that the mind has much greater.
moist. They detach themselves easily and are influence than physicians are willing to ascribe to
washed away after having become detached. Thus it, in affording relief and even in producing cures.
the wound is constantly kept clean. There is no The sooner we begin, as a body, to train the mind
accumulation of pus, there are no crusts of desto control the body through effort of the will, the
sicated wound secretions, and most essential, no sooner will we benefit our patients. This is with
dressing is required. The patient has not to suffer out regard to the kind of treatment we give.”
the often painful process of change of dressing. Dr. A. Rose, New York, thinks that the con- “The most essential advantages of the continuous tinuous warm-water bath is the ideal remedy to bath are those which we understand from its phyrelieve pain. The monotony of Napoleon's life at siological action on circulation and innervation. St. Helena was interrupted by pains he suffered It eliminates the products of inflammation and from cancer of stomach and liver, and he found infection. relief by remaining in warm water for hours and “The warm bath, in surrounding the surface of even for whole days. The water had to be carried the body with an equally tempered medium, does to Longwood from a distant fountain. In his away with fluctuation of the loss of heat, and thus testament he wrote "if my captivity is extended acts soothingly. The thermic irritation of the to my remains, I wish to be buried at the foot of peripheric nerve-ends, while it lessens the sensathe fountain to which I owe so much relief.” tion of pain, calls forth at the same time, by way
"A few weeks ago," writes Doctor Rose, “I saw of reflex action, especially in the muscles, an ina colleague who had been suffering and was suf- creased metabolism. The fatigue or exhaustion of fering from severe abdominal pains and these muscles is caused by a supernormal accumulation pains had existed for weeks day and night. I had of the products of their function. To oxidize and not been attending him, only learned at my visit eliminate these products a certain amount of that some obscure duodenal trouble was the cause metabolism is required. The specific effect of the of his distress. I suggested the continuous bath warm bath is to afford immediate facility for
continuous warm bath on innerves action or the
oxidation. The changes of the physical and as in neuric pain. Wherever the pain is due to chemical conditions of the tissues, the augmenta- tension, of course, heat is contra-indicated. tion of the organic function, the acceleration of thermometer bo morconic functions this the large inntor
In cases where heat is unavailing, as where the blood circulation, the dilatation of the blood- pain is due to inflammatory, congestive conditions, vessels all depend on the specific action of the and where cold is equally undesirable because of continuous warm bath on innervation. When a its reactionary effect, we have an excellent agent part of the body is placed in warm water, the in the shape of electricity. The positive electrode nerve-ends of the skin become irritated. This of a galvanic battery, passed continuously over irritation is transmitted to the vasomotor nerves, the painful part, with the negative electrode on and is followed by dilatation of the blood-vessels some indifferent point of the body, contracts the and, consequently, by an acceleration of the circu- capillaries and lessens the congestion, at the same lation. This accelerated blood circulation facili time driving the excessive alkalies of the tissues tates the elimination of the products of inflam away from the affected part toward the negative mation and infection, and, with the removal of pole, thus relieving both the inflammation and the pyrogenous substances and toxins through the
pain. general circulation, the fever will be reduced, the
Massage the doctor regards as a mechanical pain relieved.
counterpart of heat as an analgesic agent. Indeed, “When reading history or studying ethnography he questions very seriously if it be not the transwe feel horrified upon learning of barbarous cru
formation of the friction into heat in the tissues elties, but nothing can surpass medical cruelty that produces the desired results. This, of course, when cases of extensive burns are treated with all refers to hand massage and other forms which kinds of dressings instead of resorting to the most massage the tissues en masse. With vibratory rational, the ideal method of placing the patients treatment, which is also a valuable physical agent into a warm bath.
for the control of pain, the case is perhaps a little “Of the soothing effects of the continuous bath different, especially with high frequency vibrations. in cases of arthritis, especially rheumatic arthritis, No doubt the effect of these vibrations, in addiI need not speak here in detail; they are too well tion to the heat which they generate, is a little known.
more genuinely physiologic—that is to say, they "Bauddocque, the great French obstetrician, who induce some degree of molecular vibration in the lived during Napoleon's time, made use of the con- tissues themselves, playing, as it were, the part of tinuous bath in cases of peritonitis.
a tonal potential, such as the spinal cord plays, "In conclusion I beg to refer to my book, "Car- and thus bring nourishment and defense to the bonic Acid in Medicine,' in which I have devoted affected parts. Vibratory treatment is especially a chapter to the continuous bath, describing also indicated in the pain of chronic conditions, and the arrangement for it in all details, and also to is a most valuable analgesic agent in these cases, my elaborate paper. The Continuous Warm- as well as an alterative one. Water Bath the Rational Remedy in Phymatia Dr. Atkinson does not look upon hydrotherapy (Tuberculosis) and Infectious Diseases in Gen- as anything more than a convenient mode of coneral,' International Clinics, Vol. II, 23d Series.” veying heat to or from the body, and that which
Dr. T. G. Atkinson, of Chicago, Ill., considers he has said under the heading of heat as an anothat the anodyne action of heat in neuric pain is dyne he wishes to be applied to the hydrotherapeualmost wholly due to its vasodilatory effect. Prac- tic treatment of pain. Cold applications he does tically all neuric pain is either toxic or anemic; not believe have any place in the relief of pain, due to either a perverted or an insufficient blood and very little place in the control of inflammasupply. In either case, the flood of wholesome tion. The reaction from cold makes it necessary blood, with its nutrient and defensive elements, that, for antiphlogistic purposes, it be applied which the expanding and relaxing influence of heat continuously, for long periods; and this is not brings to the part supplies the need of the suf- desirable in the great majority of cases, because of fering tissues and changes the nerve message from its lowering effect upon the vitality of the part. one of pain to one of comfort and well-being. In It is, in short, not physiologic; and is to be rethe case of muscular pain the same principle is served for those cases of exceedingly severe, exemplified, though in a slightly different way. sthenic inflammation in which we are obliged to Muscular pain is usually the direct result of spas- transcend and antagonize physiology. ticity, which is relaxed by the action of the heat, There is one use of water, however, says the and at the same time whatever toxic and anemic doctor, which has nothing to do with its heatfactors are present are removed in the same way carrying properties, which is a very valuable