When a live insect or fly enters the ear a number of safe methods may be developed. If the ear is immediately turned to a bright light the insect may come out of its own accord. It may be floated out with salt water, or it may be smothered with sweet oil or castor oil after which it may be floated or syringed out. If it is necessary to employ a syringe this should be used gently. A foreign body may remain in the ear for days or weeks without doing any harm. This suggests that any unnecessary poking or prying should not be undertaken, because this may wedge it in tighter and to injure the drum membrane.
Foreign Bodies in the Nose.—Children may put any of these articles into the nose. Very often they do, and do not know enough to tell. If such is the case the first symptom calling attention to the fact that something is wrong is the appearance of a thick foul discharge from one nostril or some obstruction to breathing on the same side.
When the foreign body may be seen the child should be made to blow the nose, first closing the well side with the finger. If this does not expel the object the child should be made to sneeze by tickling the free nostril with a feather or by taking snuff. The mother should never permit the use of instruments by one unskilled in an effort to rid the nose of an obstruction. There is great danger of seriously injuring the delicate structure of the nose in this way or of pushing the object so far in that it may necessitate an operation to extract it. It is much safer to seek medical aid before any damage is effected. It seldom does harm to wait until the right assistance is at hand; it often does serious harm to be too smart in these little matters.
Foreign Bodies in the Throat.—If the foreign body is in the upper part of the throat and can be seen it may be removed with any instrument that can grasp it. The child may be immediately held up by its feet when the article may be shaken out. If it is further back or in the air passages the child should be made to vomit by tickling the throat with a feather or with the finger held in the throat till it does vomit.
When the object interferes with breathing a physician should be sent for in a hurry. In the meantime the family may try to dislodge it by having the child bend forward or by holding it with the head downward and, while in this position, sharply striking the back with each cough. Striking the chest when in this position may effect the same purpose. If no success follows this procedure try the reverse position. Have the child bend backward over the arm of a sofa, for example, or put him in bed with the body hanging out of the bed face upward. If none of these effect relief you must depend upon the skill of the physician.
A Bruise or Contusion.—A bruise or contusion is an injury to the tissues underneath the skin, but this does not imply that the skin itself is opened or damaged. In every bruise the small blood vessels are ruptured, and the blood collects in the tissues causing distention, swelling and pain. The blood is held in the tissues, it is stagnant, becomes dark in color and so produces the bluish discoloration that we see in all bruises. The color varies according to the extent of the collected blood. At first it is red and inflamed looking, then purple, then black, then greenish and finally citron. The so-called "black-eye" is a typical example of this degree of bruise. After a bruise the parts swell from the collection of blood and from the accompanying inflammation. This causes pain which persists for a day although the spot may be sore and tender for a week or more.
In all mild varieties home remedies may suffice, but in the more serious and extensive bruises it is advisable to seek medical assistance. It is essential to completely put the part to rest and to elevate it. This will relieve the pain and favor the absorption of the exuded blood. If the bruise is on the foot, the leg should be elevated until the foot is higher than the hip. If, on the hand, it should be so held that it will be higher than the elbow and it may frequently be held higher than the shoulder to relieve the throbbing and the pain.
As a rule, cold should be applied as soon after the injury as possible, cloths wrung out of ice water, or a piece of ice may be bound on the part for a short time. The object of the cold is to stop the internal bleeding. If the injury is slight, as are most of the injuries of the household, the mother may apply repeated cloths wrung out of very hot water. This procedure tends to aid the immediate absorption of the blood and prevents a discoloration of the part. If there is great pain relief may be afforded by applying a firm bandage saturated in the lead-water and laudanum mixture which may be obtained in the drug store under the name of lead and opium wash. The bruised part should be massaged every day and a simple ointment may be applied to soften the inflamed area.
If any complication arises in the treatment of a bruise, it will be necessary to consult a physician.
Wounds.—A wound implies an injury to the skin in addition to injury to the underlying parts to a lesser or greater extent. The skin may be opened by cutting, or stabbing wounds; or it may be punctured, torn, contused, or bruised open. These injuries are effected in various ways. We speak of machinery or mechanical wounds, or gunshot wounds, bites, cuts, stabs and other varieties of wounds.
It is very important to know exactly how a wound is produced and the nature of the instrument which opened the skin. We try to obtain this information in order to estimate the probable degree of poison that may or may not have entered into the wound.
The first thing to do in treating wounds is to stop the bleeding. If the patient is suffering from shock he should be given active treatment for this condition as described elsewhere. If the wound contains any foreign bodies these should be removed. The wound should then be cleansed, closed and dressed and kept at rest. If the wound is poisoned, or if there is any fear that lockjaw may arise, or if the wound has been caused by a mad dog it will require special treatment.
It is far better not to interfere if you do not know what to do than to do harm. One should offer no advice if they are not qualified to give advice. Much harm has resulted from doing the wrong thing in these cases. The instruction in the following pages is given so that the average mother may know what to do in emergency but not with the intention that she may regard her knowledge as sufficient to dispense with the aid of the physician.
Arrest of Hemorrhage.—When there is a wound there is always bleeding; this means that some blood vessels have been cut or torn open allowing blood to escape. The character of the hemorrhage will determine the nature of the treatment to be employed. On general principles, the first thing to do in the presence of bleeding is to elevate the part, if that is possible. If there is simply a general oozing of blood, it may be controlled and arrested by pressure. This pressure should be steady and prolonged. It is best accomplished by wetting a clean handkerchief or a pad of gauze in ice cold water, placing this on the part and binding it on firmly with a bandage.
If the discharge of blood flows in a steady stream and is rather dark the hemorrhage is coming from a vein. We know that veins carry blood toward the heart so that any pressure or constriction employed to stop a venous hemorrhage should be tied on the side of the wound further removed from the heart. Inasmuch as veins have soft walls the right kind of pressure will in most instances stop the bleeding. The part should be elevated after the pad is adjusted in place. Any tight band on the limb as a garter or sleeve band should be removed as they tend to interrupt the return circulation.
If the hemorrhage is from an artery the blood is bright red. It spurts out forcibly, is difficult to control and demands immediate attention. Arteries carry the blood from the heart to the extremities. They beat with every pulsation of the heart so that blood coming from an artery spurts with every pulse beat. Even a small artery may be responsible for a very considerable hemorrhage in a very short time. Whatever is done must be done quickly. The parts should be freed from all clothing and if possible elevated. Pressure may be tried, if it succeeds it must be strong and steady pressure. The point to press must be on the heart side of the bleeding artery since the blood stream is coming that way—this the mother will note is the reverse from treating bleeding from a vein as previously explained. The artery at this point may be felt beating. It is frequently necessary to clamp the whole limb to stop an arterial hemorrhage. This may be done in the following manner. Take a strong piece of cloth or bandage and tie above the bleeding point. Insert a short piece of stick between the bandage and the limb and twist around until the bleeding stops. This should not be kept on longer than one hour. A tourniquet of this character shuts off all the blood in the limb and if kept on too long the parts may mortify. The best means to stop a hemorrhage of this character is by means of a rubber bandage sold for the purpose. It is applied by stretching at every turn. It exerts uniform pressure and in this way does no injury to the parts. All these measures are, of course, only temporary expedients as the artery will finally have to be caught and tied by a physician.
Removal of Foreign Bodies From a Wound.—When the foreign bodies are large enough to be seen they may be picked out with the fingers after the hands have been rendered sterile. Smaller bodies may be picked up with forceps, or they may be washed out with water that has been boiled and cooled slightly, or a bichloride of mercury solution in the strength of 1 to 2000 may be used; or a normal salt solution may be used. As a general rule the physician should be allowed to undertake this procedure so that you may not be blamed for something that may come up later.
Cleansing a Wound.—The simplest way, and the most effective, to cleanse a wound, no matter how caused, is to procure a brush and paint it thoroughly with tincture of iodine. The iodine should be painted right into the raw wound, it is then bound up and left if it is small and does not need any stitching. When the physician comes he can attend to any further procedure that may be necessary.
Closing and Dressing Wounds.—If the wound is small, its edges may be drawn together with narrow strips of adhesive bandage after it has been painted with iodine. It is then bound up and kept at rest. It should be inspected the following day to see if it is healing properly.
If the wound is large or torn, it should be seen by a physician and dressed and closed by him. All wounds do better if they are kept at rest.
The Condition of Shock.—When a person suffers a serious injury, loses a large quantity of blood, or is subjected to a profound emotion, it affects the vital powers to such an extent that the individual is said to be suffering from shock. Shock expresses itself in varying degrees of apathy. The patient may or may not be conscious. If conscious he gives no evidence of feeling, he is silent and motionless although he will respond to directions and may answer questions. The eyes are dull and listless, the face pale and pinched, and the general expression is apathetic. The skin is cold and there may be perspiration; the pulse is feeble and irregular, and the breathing is shallow. The whole attitude of the victim is one of indifference and apparent inability to appreciate the seriousness of the situation and a seeming immunity to pain or discomfort.
When this condition exists it must always be regarded as serious because the patient may die as a direct result of the condition of shock. The various symptoms depend upon a temporary paralysis of the blood vessels which deprives the brain of blood. There is always a certain degree of shock with all injuries. Mothers should know what to do in these cases before the physician comes. The general treatment in all cases is to keep the patient warm and quiet, and to use stimulants carefully.
The patient should be put in bed or on a flat surface with the feet higher than the head. If raising the feet should cause the face to become blue it will be advisable to restore the patient to the horizontal posture. Artificial heat must be applied to the patient's body and extremities by means of hot water bags, bottles, bricks, plates, or any other handy device. Blankets should be put around the patient and every possible means resorted to, to maintain body heat. Mustard plasters may be put to the heart, spine and shins. Stimulants are necessary, such as hot black coffee if possible or hot water, in which a small portion of brandy may be put. If brandy is not obtainable the patient may take aromatic spirits of ammonia in hot water every twenty minutes for a number of doses. In every case of shock a physician should be sent for immediately.
Dog Bites.—When a child is bit by a dog every effort should be made to get the dog. It should be kept in a safe place for a week so that it may be definitely known whether it is sick or not. If the dog dies within a few days after biting anyone it may be assumed that he had rabies. Its head should be sent to the local health authorities who can tell after examination if it was mad. If there is any reason to assume that the dog was infected, the child should receive the Pasteur treatment. This treatment will, if conducted under favorable circumstances, absolutely prevent hydrophobia.
The mother should sterilize the wound as thoroughly as possible. This may be done by using pure hydrogen peroxide. A little piece of absorbent cotton is wound round the end of a tooth-pick or match, dipped in the peroxide and the incision thoroughly rubbed clean. This may be done a number of times to ensure thorough cleansing. No effort should be made to cauterize the wound. It is not considered proper to employ this method with dog bites. When the physician examines the wound he may or may not open it further for more extensive inspection and sterilization.
Mothers should remember that there are thousands of bites by dogs that never cause any trouble, and if it is known that the dog is healthy no worry need trouble the family. It is also wrong to inform the child of the probability of hydrophobia. The child may worry himself sick with fear and if the mother is nervous and excitable he is apt to be made sick with the dread of what may follow. It is better, therefore, to remain quiet, to keep cool, and not to excite the little patient at all.
Sprains.—Every joint is held together by ligaments which are attached to the bones forming the joint. If these ligaments are subjected to a sudden twist in a direction in which the joint is not constructed to move, the resulting injury is known as a sprain. The ligaments are stretched, though they may be torn apart and even small pieces of the bone may be split off if the wrench is great enough. The injury is an exceedingly painful one and frequently renders the limb useless for some time. It is always accompanied with some degree of swelling and more or less inflammation.
A sprained joint should be immediately put at absolute rest. The best dressing is the lead and opium wash. Two pints of it may be obtained at the drug store. Pour into a large bowl, saturate a large piece of thick absorbent cotton, wrap around the joint and bind in place. This dressing may be repeated as often as the cotton becomes dry. When the swelling has disappeared and the pain is gone, it is desirable to have the joint supported with strips of adhesive bandage. These must be put on in a certain way in order to properly support the joint. Consequently a physician should put them on. If a sprain is not attended to effectively there is danger of the joint being more or less incapacitated for life.
Dislocations.—A dislocated joint is one that has been put out of place. It is best to allow a physician to treat a dislocation. Unskilled handling of a dislocated joint may not only increase the damage but it may permanently put the joint out of business. Until the physician arrives the part should be kept absolutely at rest.
Wounds of the Scalp.—Children frequently get injuries of the scalp. These wounds bleed freely and as a rule they occasion a great deal of unnecessary worry and apprehension. Usually they are not of much importance. We must keep in mind, however, the probability of fracture as a consequence of severe injury. The first thing to do when there is bleeding from the scalp is to cut or shave away the hair surrounding the wound. This should be done for an inch around the wound so that thorough disinfection may be possible. The wound should now be cleansed as previously instructed and an effort made to stop the bleeding. The best method is to first apply pads of gauze wrung out of very hot water. When success is evident a pad made of boiled cotton should be placed on the wound and held tightly in place for some time. If the wound is of such a character as to demand stitches a physician should of course put them in.
Run-Around: Felon: Whitlow.—When pus germs enter around a finger nail and lodge in the soft tissue a "run-around" is the result. It is accompanied with pain, swelling, redness and inflammation. The loss of the nail may follow.
A felon or Whitlow is a more extensive and a more serious condition. It is not always possible to trace the cause of a felon. The fact that germs gain an entrance, however, is soon established. Sometimes a bruise, or scratch, or a wound is the primary cause. The last joint of any of the fingers may be the seat of a felon. A end of the finger becomes hot, tense, swollen and very painful; the pain is intense if the hand is held down. The surface may or may not be red. There is as a rule some fever. If the felon is on the little finger or thumb the condition is worse than on the others as a rule,—the inflammation extending to the hand and often into the arm. The condition affects the palmar surface of the fingers. If the felon results in the "death" of the bone, the last joint will have to be taken off and the hand may be distorted, crippled, and rendered permanently disabled. Blood poison may set in and death is possible as a result of this complication.
Treatment.—Every effort should be made to abort a felon. Continuous application of equal parts of alcohol and water night and day may abort it. Tincture of iodine applied to the entire end of the finger may be effective. The hand must be at rest, carried in a sling during the day and slung over the head to the bed-board at night. If these efforts are not successful after twenty-four hours hot poultices should be resorted to, but they must be changed every twenty minutes. If, at the end of another twenty-four hours, there is no improvement the finger must be freely cut open by a surgeon and the poultices continued.
Treatment of "Run-Around."—Apply iodine freely, cold applications, and if the inflammation persists use poultices. It is frequently necessary to incise the run-around. Patients suffering from either of these conditions need general tonic treatment and should be under the care of a physician.
Burns and Scalds.—Burns result from undue exposure to dry heat. Scalds are produced by the action of hot liquids and steam.
There are always produced two results from a burn or a scald. First the local effect, and, second, the general effect. The general effect may produce shock, the symptoms of which have been described in the previous pages. The degree of shock depends upon the extent of the local injury and may be severe enough to result in death. If the local injury covers more than two-thirds of the body death as a rule takes place within two days.
How to Extinguish Burning Clothing.—The thought to keep in mind is to smother the flames effectively. If we deprive the flame of all air or oxygen it will immediately subside. This may be done quickly by wrapping the burning part in a carpet, rug, blanket, overcoat or any large woolen material at hand. If none of these articles are at hand the victim may roll on the floor and try to smother the flame by pressure, aided by the hands. It is a good plan to throw water on the patient immediately after the fire has been put out, so as to extinguish the smoldering fire.
When a person is scalded by steam or boiling water or other liquid, it is advisable to pour cold water freely over the wound.
How to Remove the Clothing.—When it is necessary to remove the clothing it is essential to be gentle in order not to do greater injury. The clothing must not be pulled. The garment should be cut so that they fall off. If any part sticks to the skin, it must be left, not torn away. Later, it may be removed by moistening it with salt water.
Treatment of Scalds and Burns.—All slight burns or scalds may be effectively treated with Unguentine. This substance may be obtained in any drug store. It is spread on a cloth and applied directly to the injured part, bound securely on and renewed every day until the wound is healed. If Unguentine is not readily obtainable the part may be covered with any of the following mixtures or oils: carbolated vaseline, equal parts of linseed oil and lime water, olive oil, castor oil or kerosene, cloths soaked in a solution of baking soda, or a solution of phenol sodique.
In severe burns or scalds the mother should not attempt to treat the child. A physician should be summoned at once. The child may be given a little whisky or brandy in warm water, and if the pain is great a dose of laudanum may be given. The dose of laudanum is one drop for each year of life. If the child has a chill he may be put into a warm bath of 100 deg.F. It is not wise to cut a burn blister. The water may be let out by puncturing with a sterile needle, but the skin must be left intact until the new skin is grown. The treatment of burns must be done with the greatest cleanliness because if infected with germs they may prove serious.
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The Dangerous House Fly—Diseases Transmitted by Flies—Homes Should be Carefully Screened and Protected—The Breeding Places of Flies—Special Care Should be Given to Stables, Privy Vaults, Garbage, Vacant Lots, Foodstuffs, Water Fronts, Drains—Precautions to be Observed—How to Kill Flies—Moths—What Physicians are Doing—Radium—X-Ray Treatment and X-Ray Diagnosis—Aseptic Surgery—New Anesthetics—Vaccine in Typhoid Fever—"606"—Transplanting the Organs of Dead Men into the Living—Bacteria that Make Soil Barren or Productive—Anti-meningitis Serum—A Serum for Malaria in Sight.
THE DANGEROUS HOUSE FLY
Mothers should become thoroughly acquainted with the grave consequences which may result from fly-infected foods, and from the possible carriage of disease by means of flies, even where foods are carefully protected. The transmission of the following diseases by means of flies has been conclusively proven: typhoid fever, tuberculosis, cholera, Oriental plague, inflammation of the eyelids, serious infection of wounds. Summer diarrhea of children is also transmitted in this way.
Typhoid fever and summer diarrhea of children in this country, and cholera and Oriental plague in the countries in which those diseases exist, may be transmitted through the various foods that are eaten in an uncooked state, if infected by flies, through cooked foods infected by flies after the process of cooking, through drinking water which has been infected by flies, and through milk similarly infected. Fruits are especially likely to be infected by the small fruit fly commonly found around markets and stands. Fish may be infected by flies, and in consequence will undergo rapid decomposition. Decomposition caused in this way has resulted in many cases of diarrhea and dysentery. What is commonly known as fly speck is the excreta of the fly, and frequently contains virulent disease germs. These specks are often found on foodstuffs that have not been properly protected.
Transmission of disease may also occur by the infection of open wounds through contact with infected flies. This is true of all pus formation in wounds. The simple contact of a fly infected with the disease may cause Oriental plague, sore eyes, and possibly granular eyelids. A fly infected with dysentery or typhoid fever may cause either of these diseases by simply coming in contact with the lips of susceptible persons.
The fly in the house should be relentlessly pursued and destroyed. The house which is carefully screened and protected from flies is infinitely safer than one not so protected. In the spring of the year the house fly begins to take on life. Eggs which were laid the preceding fall begin to hatch. At first the fly is only a little worm wriggling in some pile of filth. The eggs are usually laid and the grub developed in a manure pile or some mass of garbage or other filth. Before the grub develops into the fly it is easily destroyed. If everything in and about the house were kept scrupulously clean, and if every manure pile were kept carefully screened or covered so as to protect it from flies, there would be no difficulty in preventing the fly nuisance. The most effective way to accomplish this is to destroy the breeding places. The importance of this may be seen when it is considered that one fly produces one hundred and twenty-five millions or more of its kind in one season.
Stables.—Manure is by far the commonest material in which the fly lays her eggs. All stables should be kept scrupulously clean. No manure should be allowed to accumulate where it will be exposed to flies for even a few minutes. Immediately after it is dropped by an animal, it should be removed and covered. Manure may be treated with considerable quantities of lime without interfering with its fertilizing value, and in this way the development of the eggs laid in it by the flies can be practically prevented. The floors of stables should be thoroughly flushed with water at least once in every twenty-four hours.
Privy Vaults.—Human excrement also affords an excellent breeding place for flies. In army camps the latrines are the points from which much infection is transmitted to troops, and thousands of the men have lost their lives by contracting typhoid fever transmitted in this manner. During the summer time all open vaults and dry closets should be treated continuously with lime, crude creolin or crude carbolic acid, and they should be carefully cleaned out at frequent intervals.
Garbage.—As a medium for the development of flies, garbage may be considered next in importance to excreta. The eggs of the fly hatch in about twenty-four hours, and garbage which is retained in the kitchen for that length of time may contain flies in the grub stage. To prevent this development, all garbage should be covered and pails should be emptied as often as possible. In country districts garbage should be burned in the kitchen or buried in the garden at frequent intervals, twenty-four hours being the maximum time it should be retained.
Vacant Lots.—Vacant lots frequently contain appreciable quantities of organic matter in a state of decomposition, affording favorable breeding places for flies. These vacant areas should be maintained in a state of scrupulous cleanliness.
Foodstuffs.—In order to prevent contamination of foodstuffs, all foods that are eaten in the raw state and all foods that are exposed for sale after having been cooked should be carefully protected from contact with flies, by screens or covers.
A point where rapid development of flies takes place is along the city's water front. This is due to the fact that many of the sewers do not discharge below the level of the water. All open drains should be eliminated, whether they be sewers, private house drains or drains from cess-pools.
Precautions to be Observed.—Keep the house free from flies. Every fly should be considered a possible disease carrier and should be destroyed.
Keep the windows of the house, especially the kitchen windows, carefully screened during the spring, summer and autumn.
Protect children from exposure to flies, particularly children who are ill, and do not allow nursing bottles to be exposed to flies.
Protect milk and other foodstuffs from contact with flies.
Keep the garbage outside of the house, carefully covered.
Abolish open drains near dwelling places.
Stable manure should be frequently sprinkled with lime and kept covered.
Earth closets and privy vaults should be treated with lime, crude creolin or crude carbolic acid at frequent intervals.
Earth closets and privy vaults should be cleaned frequently in order to prevent excrement accumulating to an undue extent.
To Kill Flies.—Dissolve one dram of bichromate of potash in two ounces of water, add a little sugar to this solution and put some of it in shallow dishes and place about the house. Sticky fly paper and fly traps may also be used.
To clean the room where there are many flies, burn pyrethrum powder (Persian insect powder). This stupefies the flies and in this condition they may be swept up and burned.
Probably the best and simplest fly killer is a weak solution of formaldehyde in water (two teaspoonfuls to the pint). This solution should be placed in plates or saucers throughout the house. Ten cents' worth of formaldehyde, obtained in the drug store, will last an ordinary family all summer. Don't smell formaldehyde in the pure state; it is very pungent and strong. In the solution of the strength used for flies it has no offensive smell. It is fatal to disease organisms, and is practically non-poisonous except to insects. Flies will not stay in the house when this solution is around.
Moths.—Late spring and early summer is the time to guard against moths and beetles. Many of these fabric-destroying insects are brought into the house on flowers.
May and June are especially bad months, as both moths and beetles are only dangerous to fabrics in their young or grub stage.
These insects will destroy almost anything from coarse rugs to the finest of ball gowns and dress suits. Carpets that are rarely swept and garments that are seldom disturbed are most liable to damage.
The substitution of the frequently removed and easily cleaned rugs for carpets will greatly lessen the danger from the destructive moth and beetle grubs. Carpets laid on tight floors are much less liable to injury than where numerous cracks furnish safe retreats for the insects. Tarred paper under a carpet is an excellent preventive.
All clothes presses should be thoroughly cleaned at frequent intervals. The garments should be removed, aired and vigorously brushed. Any larvae which are not dislodged in this way should be destroyed. It is a bad plan to keep odds and ends of woolen or other materials in attics where these pests can breed and thus spread to more valuable articles.
Spraying with benzine two or three times during hot weather is a good way of preventing injury to furniture or carriage upholstery and other articles which are in storage or not in use for a long time. If you are certain that woolens and furs are free from the pests they may be stored in safety by placing them in tight paste board boxes and sealing the covers firmly with gummed paper.
Both moths and carpet beetles are harmless at a temperature of 40 degrees Fahrenheit—a fact very well known to advantage by the large fur storage companies. They cannot survive furthermore a temperature of 120 decrees if subjected to it for about twenty minutes.
What Physicians are Doing.—It is desirable that the ordinary non-medical individual should know what the science of medicine is doing and what it is accomplishing.
During the past fifteen years the art of curing and preventing disease has taken on giant strides. The man or woman most ready to question the accomplishments and the ability of the humble family physician or the motive of the science of medicine, is the one who appreciates least that it is due to the skill and intelligence of the medical men of to-day that he owes his comfort, his health, and his freedom from pestilence, plague and disease. Unthinking people laud and praise some upstart whose ability lies in his faculty to fool the gullible, or they will rush to seek the false aid of some nondescript science, because it is popular and well advertised, while they pass by or ignore the men whose labors have made the world what it is, and who alone possess the ability to intelligently wage the battle in the interest of humanity against disease.
The medical profession has repeatedly pointed out that there are, on an average, six hundred thousand lives lost every year in the United States from preventable disease and accidents. Six hundred thousand lives which medical science has at hand the remedy to save, but which the medical profession sacrificed because of inadequate legislation. Few people can comprehend just what six hundred thousand lives mean. Let us put it in another way. There are destroyed by preventable disease and accidents every day American lives equal in number to the crews of two battle ships, equal in three months to more than the total combined numbers of the Army and Navy of the United States; equal in one year to more than the total number of lives lost in all our wars since the Declaration of Independence.
The Titanic disaster shocked the public for a moment, and seemed to impress them as though it was a terrible and unheard of waste of good human lives. Yet in the loss of life due to preventable causes we have in this country every day in the year a destruction of our citizens exceeding in magnitude that which occurred when the Titanic sank. Think of it! A Titanic disaster a day, and yet the public does not rise up and demand in a spirit of anger and determination that steps be taken at once to put an end to this appalling and unnecessary waste of lives.
Under modern hygienic conditions, the average length of existence for an individual in Great Britain has increased ten years in the last half century. Among all the enlightened and advanced nations, the expectation of the individual for long survival is greater. Since the appearance of uncheckable and epidemic disorders is less frequent and the percentage of cures is greater.
Since quarantine has been regularly established and the sewage system made efficient in large cities, and since the sanitary plumbing laws have been made compulsory, the general death rate has decreased enormously. These regulations have been the product of regularly educated medical or sanitary experts. No 'ism or 'ology has ever established any scientific principle which has contributed to the general welfare of the people. We no longer fear the plague, or typhus or yellow fever, cholera, diphtheria, typhoid, consumption, and other diseases which once were a constant menace to the race. The plague, for example, is practically limited to the Far East, where modern methods cannot evidently be introduced efficiently. At one time it periodically devastated Europe, where it cannot now get a foothold because of the introduction of sanitary systems and hygienic principles.
Tetanus or lockjaw and hydrophobia are now amenable to cure while formerly all cases were practically fatal. The mortality of diphtheria has been reduced more than fifty per cent. Antiseptic precautions in surgical cases, first introduced by the famous surgeon, Lord Lister, have made possible and successful operations that formerly could not be undertaken, thus broadening the whole field of surgical possibilities. The Boer war and the war with Spain proved this truth in a way that could not be denied. Smallpox is almost a medical curiosity in New York City, where it once was a scourge. The mortality of childbirth has been reduced to about one-fifth of what it was by the introduction of antiseptics and anesthetics. The new methods of making and preparing drugs, the sterilization and inspection of milk, the methods devised for the care of and preparation of infant foods have all enormously contributed to checking disease, to preventing disease, and to increasing the length of life and its happiness.
These are all facts which may be proved by any one, no matter how incompetent they may be. If we were to give up all these hard earned victories, cease to investigate or experiment, deny the existence of disease, and depend upon the questionable methods of hysterical emotionalists we would soon find ourselves facing all the horrors of the past. Can we afford to lose the priceless benefits we have achieved and are attaining? Can we sit still and permit the profession of medicine, which has always contained the best of the race in its membership, the best intellects, the most sympathetic and unselfish characters, the noblest and most steadfast souls, to be maligned and assailed, to have its means of well-doing assaulted and threatened, when we know that it should be supported and protected for the sake of all it has done in the past in the interest of humanity?
Every mother should be acquainted with these facts so that she may lend her influence in behalf of honest effort and honest inquiry.
The following summary comprises a brief review of what medicine has been doing in the recent past:
Radium.—This element was discovered about fifteen years ago by Professor and Mme. Curie. It possesses the wonderful property of giving out inexhaustible stores of energy. It virtually possesses the property of perpetual motion. Professor Becquerel was the first one to suggest that it might possess therapeutic or healing powers. The suggestion came to him in a curious way. He carried a tube of radium in his vest pocket and was severely burnt as a consequence. The incident suggested to him that, if radium could attack healthy tissue in such a short time, it should be able to similarly attack diseased tissue. Experiments were soon instituted, and are still being conducted to exactly define its curative value and scope.
It was hailed as a cure for cancer and other serious conditions, but we have found that it is not a cure for these ailments. It is, however, exceedingly valuable in the treatment of certain skin diseases. In lupus, epithelial tumors, ulcers, papillomata, angiomata and pruritus, it is being widely and successfully used. It was later discovered that it can quickly kill disease-producing bacteria. It is also well known that it will efficiently purify water.
X-Ray Treatment and X-Ray Diagnosis.—Professor Roentgen gave to the world an exceedingly valuable discovery in the X-Ray. He discovered that a certain form of electrical energy, when applied in a certain way, would produce shadows that differentiated between a certain degrees of opacity. For example, it would, if directed upon the human hand, produce shadows that clearly indicated whether the substance through which the rays passed was bone or muscle. The chief value of the X-Rays has been found to be this property rather than any healing value which has been attributed to them. The fact that these shadows can be photographed has rendered them of supreme value in surgery and medicine. Previously it was essential that the surgeon should depend upon his own diagnosis, upon what he could learn from his sense of touch and from surrounding conditions. With the X-Rays at his disposal he can quite eliminate the personal equation. His pictures are precise and mathematically accurate; he can prove the truth of his diagnosis before he cuts. We can take pictures of fractured bones and from what we learn we can immediately tell how they should be set to attain the very best results. We can actually tell if there is a stone in the kidney before we subject the patient to a serious operation. We can actually take pictures of the stomach at various stages of digestion and tell what disease affects the individual with a degree of precision that was not possible before the X-Rays were introduced. These examples only suggest its use. There are a multiplicity of uses for these as yet unknown rays which have greatly aided in diagnosis and consequently in successful treatment.
Aseptic Surgery.—The utility of the aseptic principle in surgery was demonstrated by the Japanese army surgeons during the war with Russia in 1904-1905. Their success in preventing deaths from suppurating wounds amazed the world. Their method was to discard the use of antiseptics and to depend upon absolutely clean instruments, dressings and hands. The most terrible wounds healed under this method without festering. This is, of course, the method in vogue to-day all over the civilized world. The Japanese did not discover aseptic surgery, but they were the first to put it to actual test in a large way. The old method was to depend upon drugs to kill the germs which might find their way into wounds and operations. To-day we prevent the germs from getting into the wound and depend upon nature to do the rest.
New Anesthetics.—Several important advances have been made in methods of giving anesthetics and in the nature of the products used. Temporary unconsciousness with electricity was induced in 1909 by Dr. Stephane Leduc. Stovaine was invented by Dr. Jonnesco, of Bucharest. He injected it into the spinal cord after the method made famous by Biers with cocaine in 1899. Dr. W. S. Schley invented novocaine for the same purpose. Temporary unconsciousness was accomplished by the use of epsom salts injected into the spinal cord by Dr. Samuel J. Meltzer. All of these efforts to discover a harmless anesthetic by spinal injection were made possible by investigations and experiments of Dr. J. Leonard Corning, of New York, who worked along this line as far back as 1885. The most revolutionary discovery, however, was that of Dr. S. J. Meltzer at the Rockefeller Institute, New York, when he inserted a tube into the windpipe, through which he pumped the anesthetic into the lungs. While doing this he at the same time pumped oxygen to aerate the blood, thus ensuring the patient against possible accident during the course of difficult and tedious operations on the lungs and heart.
Vaccine in Typhoid Fever.—Inasmuch as typhoid fever has played an important part in the conduct of all wars, it has always been a source of much careful study by military and naval surgeons in every civilized country in the world. We had not, however, reached a stage when it was possible to hope for its extermination until medical science began to appreciate the possibilities of vaccine therapy. The Cuban, Boer and Russian wars, because of the terrible experiences of the soldiers with typhoid in each of them, stimulated inquiry along the line of discovering a serum of vaccine that would be effectual against it. American, British, French and Japanese military and naval surgeons instituted experiments simultaneously to discover an anti-typhoid vaccine. In the fall of 1909, American army surgeons were experimenting with a serum at Washington and on Governor's Island with success, but the first public announcement of an absolutely successful vaccine was made by Captain Vincent of the French navy on June 20th, 1910, before the Academie de Medicine in Paris. The final success of the anti-typhoid serum has been conclusively proved by elaborate tests upon soldiers and sailors in many nations.
It is difficult for the ordinary individual to appreciate the significance and importance of a discovery of this character and magnitude. When one thinks calmly of the thousands and thousands of men who have lost their lives during wars because of typhoid epidemics, and of the thousands of others who have returned home practically invalided for life from the same cause, it is possible to, at least, conceive of the benefit to the race such a discovery promises. And when we learn that the discovery is a product of the same principle or method which gave to the world a cure for smallpox, diphtheria and syphilis, we must begin to believe that the medical profession is on the path which is unlimited in its field of promise so far as efficient treatment is concerned. Yet to-day we have people who do not believe in vaccination or in anti-diphtheritic serum. We may not live to see the time, but it is not far distant in the opinion of men qualified to speak with authority, when every disease will be amenable to the serum therapy, and when drugs will virtually be discarded by the human race.
"606."—One of the most important discoveries in the history of medicine was recently given to the world by Dr. Paul Ehrlich.
He called it "606," because it was the 606th experiment he had made with the same end in view. It was designed with the purpose of curing the most terrible disease known to man, syphilis. The name of the remedy is salvarsan. That it will do all that was first claimed for it is still doubtful, but salvarsan and its improvements, neosalvarsan, etc., are accepted by the profession as by far the best treatment yet devised for this dread disease. It points the way for improvement along the same line to an ultimate specific.
Transplanting the Organs of Dead Men Into Living Men.—To take from a recently dead individual a kidney, or a bone, or an artery, and by immersing them in certain fluids thereby keeping them alive indefinitely, and later transplanting them in the body of a living individual so that they will continue to live and perform their function in the new environment, is a revolutionary and a seemingly incredible performance. Yet Dr. Alexis Carrel of the Rockefeller Institute, New York, has accomplished this wonderful task. The smallest imagination can picture the possibilities of this kind of surgery, but, inasmuch as the discovery is so recent and the opportunities for testing it upon human beings are so relatively few, that time alone can tell how far it may be possible to go.
Anti-Meningitis Serum.—Another important discovery that has emanated from the Rockefeller Institute is the Anti-Meningitis serum. The death rate from spinal meningitis, before the introduction of the serum, was 70 per cent., the use of the serum has reduced this percentage to 30. We owe this important contribution to Dr. Simon Flexner.
A Serum for Malaria Now Possible.—Dr. C. C. Bass, of Tulane University, has succeeded in extracting malaria-producing parasites from human blood and keeping them alive in test tubes. This feat had been long attempted but never before with success. The significance of this achievement is that it is the first step toward preparing a serum that will give immunity to malaria.