By F.C. ROBINSON, M.D.
My experience in the use of water in almost every disease occurring in
this climate has long since satisfied me that it is less objectionable
and produces quicker and better results than any other treatment, and
can be used when all other medication is contra-indicated. Drinking
water should be pure, uncontaminated by animal or vegetable
impurities, and given _ad libitum_, unless, in rare instances, it
should cause vomiting or interfere with the capability of digesting
food. If children are comatose or delirious, as they frequently are in
typhoid fever, give water to them regularly, or force it upon them, if
they refuse to take it, as I was obliged to do with a child of six
years just recovering from that fever.
It is my custom to allow cold drinks of water in all cases of measles
whenever patients desire it, and I am satisfied that it aids the early
appearance of the rash, and certainly is cooling and grateful to the
patient. Hot drinks or vile and nauseous teas are unnecessary in this
disease, and should be discarded as useless, odious, and disgusting.
If congestion of the lungs or any intercurrent inflammation occurs, or
the rash is much delayed, a hot water bath or the old reliable corn
sweat will break up the complication with amazing rapidity, and if the
head is kept cool, will not generally be unacceptable to the patient.
Hot baths reduce temperature by causing free perspiration afterward,
and cold packs reduce it by cooling the surface sufficiently long to
reduce the heat of the blood, and, if used judiciously, seldom fail of
success. I have reduced the temperature four degrees in two hours by
wrapping around a child a sheet wet with tepid water, and no other
covering. Cold packs are sometimes objectionable, because of their
depressing effects, and should only be used to reduce high temperature
and when there is no congestion or inflammation of any of the vital
organs of the body.
Cold water poured in a small stream from a pitcher upon the head for
five or ten minutes will often relieve headache, and is a benefit in
all inflammatory brain diseases, if, at the same time, you can put the
feet into hot water containing mustard or pepper.
Large enemas of warm water will care for spasmodic colic, and I have,
in one instance, relieved strangulated hernia by the same method, and
at another time the same result was accomplished by a large injection
of warm linseed oil. I have often applied a cloth wet with cold water
upon the throats of children suffering with spasmodic croup, with
satisfactory results.
I have seen infants suffering with diarrhea or summer complaint,
sleepless, worrying, fretting, or crying from thirst, begging for
water, and the mother or nurse afraid to give it more than a
teaspoonful or two at a time, saying that it vomited everything it
drank as soon as taken. I have often, when visiting such cases, called
for a glass of cold water, and, to the surprise of the mother, would
allow it to take all it could drink, which usually would be retained,
and the child would soon be wrapped in a refreshing sleep. Without
medicine, a proper regulation of the child's diet would soon restore
it to health again.
The spasms of children, from whatever causes, or the eclampsia from
uræmic poisoning, are often readily controlled when immersed in hot
water or given a hot vapor bath or corn sweat. If the convulsions of
children are accompanied by a high temperature, put them into water of
100° and then gradually cool it down to 68° or 70°, and then keep them
in a room of the same temperature, with little covering. If the
temperature rises, repeat the treatment as frequently as necessary,
and I think you will not be disappointed in the results.
Scarlet fever and diphtheria, two of the most dreaded and formidable
diseases of children, are largely shorn of their terrors when, in
addition to an early and thorough medicinal treatment, the little
patients are bathed in as warm water as the surface will allow
frequently, or for thirty minutes wrapped in a warm, wet blanket,
followed by warm, dry coverings, to maintain the perspiration that
such treatment usually produces. It has proved to me a valuable aid in
eliminating from the blood the specific poison which causes these
diseases, and I can safely recommend it to your notice and trial.
There is no disease more favorably influenced by this treatment than
pneumonia, and in mild cases one daily warm bath or sweat, without
medicine, will be sufficient to arrest this disease, and it is among
the first things I usually order. If I find a child or infant with a
temperature of 103° to 105°, short, dry, and painful cough,
dyspnoea, rapid pulse, great thirst, or vomiting, with dry
crepitation in any part of the lung tissue, I order it rolled up in a
blanket or sheet coming out of hot water, and in thirty minutes change
it to warm, dry blankets, and soon the little fretful, worrying
sufferer would rest in a quiet, peaceful sleep.--_Peoria Med. Mo._
* * * * *
ON THE HEALTH VALUE TO MAN OF THE SO-CALLED DIVINELY BENEFICENT
GIFT, TOBACCO.
By J.M.W. KITCHEN, M.D., New York.
With perhaps the exception of heredity, the question of stimulants and
narcotics in their relation to the physical welfare of the race is
second to none in importance. With trifling exceptions, the whole
world is addicted to their use. The universality of such use has led
many to consider them a necessity to man, and that they are God's
gifts to him, and, if rightly used, are of physical benefit. It may
not be a perversion of judgment to consider that their widespread
popular use is greatly due to the efforts of the race to gain
anæsthesia for, and distraction from, those pains and punishments that
are the inevitable sequence of departure from hygienic and social law
on the part of the individual, his ancestry, and society in general.
The taste for these things is acquired, not natural, though the
acquisition may be through hereditary influence. An idea is held by a
majority of even fairly intelligent individuals that there is a
justifiable, harmless, and even beneficial use of these substances by
the general public, though acknowledging that beyond a certain
indefinite line this use becomes an abuse.
I believe that there may occasionally be cases in which the physical
benefits derived from their use outweigh the injury they inflict, but
I think this use is very much less than is generally supposed, and if
we can judge from the preponderance of evil effected by such use,
these substances ought to be considered as the materialized curses of
God rather than as beneficent gifts. The prevalent idea as to the
beneficent nature of these substances I consider to be a delusion that
can only be explained upon the hypothesis that there is a widespread
lack of appreciation of the fact that, though they may have an
immediate pleasant and agreeable effect upon the body, their injurious
effects are cumulative, and are usually ultimate, and so distant as to
be difficult of direct connection with their cause to ordinary
observation. The more moderate the use of these substances, the more
remotely is the effect removed from the cause and more difficult of
detection. That the ordinary habitual, so-called moderate use of
stimulants and narcotics, such as tea, coffee, tobacco, and alcohol,
is, in the vast majority of cases, really an abuse, is a proposition
that I think should be admitted by all who have given the subject an
unbiased study.
The idea that the user of tobacco and other injurious substances will
be cognizant of the injury inflicted by habitual use in moderate or
even excessive amounts is an undoubted fallacy. The daily, weekly, or
monthly injurious effect may be entirely unobservable to even trained
physicians, and yet the ultimate cumulative effect may be fatal. I can
instance numerous cases of physicians directly fatally injured by the
use of alcohol, who have never had the slightest cognizance of the
fact; and I can also instance cases of grave disease from the use of
tobacco where the patients never have believed that tobacco has been
the cause of their troubles, even after a unanimous opinion to that
effect has been expressed by a number of competent medical advisers.
The habitual consumption of opium, in doses of any amount, is
generally admitted by most people to be physically injurious outside
of its strict medicinal application. Moderate indulgence in alcohol as
a beverage is beginning to acquire a very widespread evil reputation.
But how about tobacco? Tea and coffee we can confidently leave to the
consideration of a somewhat remote posterity of a considerably
advanced intelligence and elevated hygienic ideals.
The relation of tobacco to the physical welfare of man can only be
fairly estimated by viewing the subject in its broadest aspect; by
considering its effects upon the race as a whole rather than in
individual cases; by taking into consideration economical and other
social conditions that at first sight might be considered as having
little relevancy to the medical side of the subject. But there can be
no just consideration of the matter otherwise. The direct deleterious
effects of the immoderate use of tobacco are readily observable; but
the great bulk of the evil physical effects due to the moderate use of
this plant are of an intermediate nature and not directly noticeable;
nevertheless, they are real, and worthy of medical attention. The
plainly marked results following the use of tobacco in relatively
large amounts seem to be due to quick and extreme interference with
nutrition, and a diminution of function of all kinds, which may be
represented by anything from a slight decrease of appetite and
digestive ability up to a complete loss of function of almost any
important organ. Tobacco has stimulating as well narcotic properties,
but as ordinarily used its stimulating effect appears to be slight as
compared with its narcotic influence. In this respect it differs from
alcohol, the use of which, owing to the usual method of introduction
in large amounts through the stomach, produces directly, by
stimulation, readily noticeable structural changes. But with tobacco
the direct evil results are mostly of a functional character, and are
more generally diffused, owing to the usual slow manner of
introduction into the body. These two properties have an effect upon
the body in moderate use as well as in immoderate use, the effect
being simply in proportion to the quantity used, though the effects of
moderate use may not be measurable by ordinary means. It is easy to
see the effects of large amounts of tobacco in the stunted growth of
adolescents; in functional cardiac disorders; in intellectual
sluggishness, loss of memory, and color blindness; in loss of
appetite, and other neuroses of motion, and marked blunting of various
functions of sensation, and in degeneracy of descendants; but that
lesser evils are produced must be proved mostly by inference,
circumstantial collateral evidence, and analogy.
The greater evils that are the outcome of a moderate use of tobacco
are probably due to prolonged slight interference with nutrition, and
consequent general decrease of vitality, which renders the individual
more susceptible through indirect influence to the invasion of
disease, and which lessens the capacity for productive effort.
It is of course difficult, and perhaps even impossible, to accurately
estimate the value of tobacco to the race; but let us glance at the
pros and cons, and then each one can roughly estimate for himself.
Tobacco may be used medicinally, but it is a dangerous and uncertain
remedy, and it probably has not one medicinal use that cannot be more
suitably met by other remedies. One can readily imagine easier
digestion as the result of the sedative influence of the after-dinner
cigar upon a disquieted nervous system, especially if the coincident
irritation of alcohol and coffee have need of correction; but it can
also be imagined that in most of such cases the remedy has been the
cause of and will further increase the disordered condition, and that
nutrition of deficiently nourished nerve tissue is rationally
indicated rather than partial narcotization. There then remains, so
far as I can see, the solace of moderate anæsthesia and, occasionally,
of occupation for idlers, as the only items that can be placed to the
credit of tobacco. There certainly are individual cases where such
usage may be more provocative of physical benefit than evil, but,
before judging for the race as a whole, compute the other side of the
question.
Tobacco injures the general health of the public through the economic
loss caused by its consumption. The people of our country spend
annually over seven hundred millions of dollars for tobacco--twenty
per cent. more than is spent for bread. This sum represents only a
minor part of the cost of the tobacco habit to the country. The crop
is immensely exhaustive to the soil. Its culture has blighted whole
sections of fertile territory. In the time consumed by the producer
and the trader in its production, manufacture, and sale, and by the
consumer in its use, and by the general interference with vital
activity and consequent decreased productive capacity, there is
represented an almost unimaginable sum of money. Certainly the people
at large are not so well fed both as to quantity and quality, or so
thoroughly clothed, or so hygienically housed that they can afford
this gigantic economic waste.
There can be little doubt that if the people had sufficient
intelligence and moral strength to taboo tobacco, this comparatively
senseless outgo would be largely devoted to supplying these and other
necessities of an exalted health status.
Tobacco injures health through its moral effects. The tobacco habit is
certainly a dirty and frequently a disgusting habit, and encourages
other dirty practices. Its use tends to make men cowardly, irritable
in temper, and low in spirits. It blunts ideas of purity and courtesy,
leading to invasion of the rights of others. It is presumed that few
medical men would visit a delicate, sensitive patient after saturation
with the "fragrant" effluvia of onions, but thousands whose systems
are saturated with nicotine and who reek with nauseating odor do not
hesitate to inflict their presence on sick or well. The time will come
when the tobacco user will not be allowed to poison the atmosphere
that is the common property of the public--will not be allowed to
force the inhalation of nicotine upon the general public, to say
nothing of being allowed to poison the infants and women in his own
family. What would be said of a man who introduced poison in any
degree into the food or drink of his child? Is the poisoning of the
household atmosphere by the ignorant, thoughtless, or selfish smoker
morally more defensible? Tobacco injures health through hereditary
influence. The tobacco user begets, more certainly than the non-user,
puny children with disordered nervous conditions. Luckily for our
race, the women, who have the most important prenatal influence in
guarding its physical well-being, are practically non-users of the
plant. The general health status of the race is improving, not because
the use of tobacco or the indulgence in other questionable practices
is harmless, but because, among other things, of the great advance in
general intelligence and knowledge of hygienic law.
A person, or the public in general, may practice an injurious habit,
and yet more than counteract its influence by opposing beneficial
practices.
Horace Greeley said, "Show me a drunkard who does not use tobacco, and
I will show you a white blackbird." In this country, where dietetic
drinking habits are not common in the family, the weakening of moral
fiber by indulgence in tobacco is usually the introduction into the
round of vicious indulgences, and thus directly or indirectly affects
health. Smoking induces dryness of the mucous membrane of the mouth
and consequent thirst. The partially paralyzed nerve terminals want
something more stimulating than water to afford relief. Furthermore,
blunted appetite induces deficient nutrition, and consequently there
is a call for some "pick-me-up;" hence we find that the use of tobacco
tends to the habitual use of alcoholic beverages, and there are very
few habitual users of alcohol who escape without structural injuries
to the body as well as perversion of its functions. Decrease of vital
activity in all the tissues of the body marks the use of tobacco. The
tendency is toward functional paralysis, though occasional signs of
stimulative irritation are to be noticed, especially in the
respiratory passages. The interference with intellectual activity is
marked. It is said that during a period of fifty years no tobacco user
stood at the head of his class in Harvard. The accumulated testimony
of investigating observers is conclusive that, other things being
equal, users of tobacco, in schools of all grades, never do so well in
their studies as non-users.
One head of a public school said he could always tell when a boy
commenced to use tobacco by the record of his recitations. Professor
Oliver, of the Annapolis Academy, said he could indicate the boy who
used tobacco by his absolute inability to draw a clean, straight line.
The deleterious effects of tobacco have become so clearly apparent
that we find its sale to minors is prohibited in France, Germany, and
various sections of this country. It is somewhat a question if, at the
present time, the race is not doing itself more injury by its use of
tobacco than it is with alcohol, because of its more universal use,
particularly by youth, and because of the respectability of the habit,
which comes of its use by a certain intelligent part of the race,
including teachers of morals and physics, and even temperance
reformers. There is a widespread sentiment in existence that it is not
a respectable thing to be even partly paralyzed by alcohol, but how
few there are who consider narcosis as in any way connected with the
use of tobacco. Its effect is more diffused and masked, and is not so
acutely serious in individual cases, but through its interference with
vital activity, tobacco is probably more generally injurious to the
race than alcohol.
The editorial fiat of "too long" prevents a full exposition of the
subject, but, in closing, let me say I hear millions of tobacco users
ask, "Why, then, was this plant given to man, if its general effects
are so decidedly evil?" The question presupposes design in creation.
Without subscribing to this theory, or pretending to have solved the
mystery of the presence of evil in the world, the answer may be
suggested that the overcoming of many seductive evils becomes to man a
means of his progressive higher development. Of one thing I am
convinced, that the physical development and welfare of man is
interfered with in strict sequence to his consumption of substances
that are unnecessary for his nutrition--stimulants and narcotics
inclusive.--_Medical Record._
* * * * *