Meetings of the Sections.
JUNE 19, 1895.
Materia Medica and Pharmacy. Chairman, H. K. WHITFORD, M. D.; Vice-Chairman, Eugene E. Bronson, M, D.; Secretary, John V. Stevens, M. D.
The Section of Materia Medica and Pharmacy was duly organized on Wednesday afternoon; Chairman H. K. Whitford, D., being absent, Vice-Chairman E. E. Bronson, M. D., took the Chair; Secretary J. V. Stevens, present.
The Epidemic Remedy.
PROF. JOHN FEARN, M. D., Oakland, California.
So far as I know, the late John M. Scudder, M. D., was the first to call particular attention to the thought that there was such a thing as an epidemic remedy. Since first I read from his pen his account of observations along this line, I have been on the watch for phenomena that would either prove or disprove his theory; and the longer I practice medicine and the more thought I give to this special feature of practical therapeutics, the more I am convinced that there is such a thing as an epidemic remedy. Before proceeding further let me define what I do not mean by the epidemic remedy.
I would not have you for one moment think that I teach that there is such a thing as a remedy that will hit every case curatively in the course of an epidemic! No! No!
This idea would never work with specific medication—in fact, it would be entirely contrary to that theory.
Now, let me in a few words express myself as to what I mean by the epidemic remedy. I mean when during an epidemic a majority of cases, presenting themselves to the physician, show such pathological wrongs, or such a train of abnormal symptoms, there is quite a similarity. The specific medicationist has been in the habit of meeting these wrongs by certain specified remedies. The remedy may be anyone of twenty or more. But that remedy which is most frequently indicated and most certainly successful has a right to be called the epidemic remedy.
Thousands of physicians, who are not in any sense specific medicationists, have noticed that during the existence of any wide prevailing disease, whether it be epidemic or endemic, many of the cases present abnormal conditions wonderfully similar in their manifestations.
The same disease prevails in the same locality a few years afterwards, and the abnormal manifestations are quite dissimilar, and the man who prescribes definite remedies for specific results will find himself prescribing entirely different remedies, though the diseases in both cases maybe the same in name; so that the epidemic remedy for 1895 may not be the one, and, in all probability, will not be the remedy which was so successful in 1893. So that this theory is entirely different from the theory of specifies for certain diseases.
Let me illustrate from practical experience. During the years '93-4-5, the majority of acute diseases coming under my observation, either as physician in charge or consultant, might be named as pneumonia, dysentery, bronchitis, typhoid fever and typho-malarial fever. During the experience of those two years I found four remedies principally called for, outside the special sedatives; those remedies were specific ipecac, baptisia, asclepias tuberosa and rhus tox, and I will make a few observations on each in the order named.
Specific ipecac.—For the two years mentioned I have no doubt that in my experience this was one of the pronounced epidemic remedies. For what cases was it prescribed? It was prescribed in diseases of the respiratory tract, where there was irritation of mucous surfaces, with tendency to cough; the cough being very pronounced at night, preventing sleep; the sputa was principally mucous, no great amount, or little hard to move. Specific ipecac 7 to 10 drops, in a glass of water—a teaspoonful frequently would loosen the secretion, allay the irritation, stop the cough—whether in child or adult. One little sufferer about five years old, who had been through a long siege, and had affusion on right side, was particular to see that I left him plenty of cough medicine, showing that the child had observed its beneficial results.
In irritation of the gastro-intestinal surfaces it was equally good. If the vomit was chiefly mucous with much straining from irritation, 5-8 drops, in a glass of water, were successful; in cholera infantum, in dysentery, with frequent mucous discharges, sometimes greenish and occasionally tinged with blood, the remedy was equally useful in a large class of such cases, leaving nothing to be desired. After the acute stage had passed, and the patient had come to that stage where tonics were needed, I found that small doses of specific ipecac added to spec. nux vomica helped the nux to act more rapidly and certainly; of course, if there was a call for aconite, that was added, but ipecac was a pronounced remedy.
Specific Baptisia.—I have beard physicians decry this remedy—say they got no good out of it. My experience has been entirely different. Those who decry the remedy must have either had a poor article, or they have used it in cases where it was not called for. To those who would give this remedy a fair trial I would say, if you cannot get the fresh drug to make an infusion, use none but the specific medicine, and, in the second place, use it according to the directions laid down in Scudder's Specific Medication; if you use it thus you will be delighted with its action. In my hands it has done good work acting as a stimulant and antiseptic. Wherever we have feeble capillary circulation, with tendency to ulceration, either of throat, stomach or bowels, and the tendency is to local death and decomposition, I have found this remedy to be a wonderful sweetener, getting, by its kindly stimulating properties a better local and general life. Recently, I was called in counsel in a very unpromising case of typho-malarial fever—other much-vaunted antiseptics had been used—I advised:
|Rx||Specific baptisia||20 drops.|
|Aqua disti||3 fluidounces|
|M. Sig. One dram every two hours, alternated with the special sedative.|
The results were very satisfactory. From this and many other experiences I put down very confidentially as one of the epidemic remedies for the period above-mentioned, baptisia.
Asclepias tuberosa.—If you get a good preparation of this root it is a good medicine. The root itself has poor keeping qualities, so we are obliged to use the tincture. Scudder speaks of this remedy as being a feeble remedy, well suited to children. I find it equally well suited to the adult. The remedy is slightly sedative; it allays that form of nervous irritability closely connected with imperfect skin action. It increases true skin secretion. The diseases in which it has been specially useful to me are pneumonia and pleuro-pneumonia; action of skin impaired through nervous irritation, and from same cause there is difficulty of expectoration; cough short, dry and irritable. I have been in the habit of adding to the special sedative, say:
|Rx||Specific aconite||5 drops|
|Specific asclepias tub||1 dram|
|M. Sig. One dram every hour, as needed.|
Under its influence the skin does its work, the secretion in the respiratory organs becomes reestablished, expectoration easier and the patient less nervous. It has done such good service for me that it has become a necessity in the treatment of such diseases, and may well deserve to be called an epidemic remedy.
Specific Rhus tox.—This remedy, for the same period, has been with me one of the most certain remedies when indicated. To save time I will ask the reader to turn to Scudder's Specific Medication, carefully read the several indications for its use. In typhoid fever, and in diseases of a typhoidal type, some of those pathological conditions have been very prominent, and no matter what the disease in which these conditions were presented, this remedy proved to be one of the certainties in medicine. I have seen it relieve nervous trouble, giving rise to loss of sleep; bring down temperature; relieve determination of blood to the brain, and even stop vomiting.
What I have said may not be conclusive to the readers of this article, but the experiences from which these statements have been deduced have to my mind been conclusive that we have epidemic remedies, and that for the past several years, the four remedies I have named have certainly earned the right to be designated epidemic remedies. In conclusion, I will say it will often call for close investigation and observation to find out the indicated remedy; the dividing line between symptoms calling for different specific remedies is often very fine, but when found and acted upon the results well repay us, and, I believe, the thought expressed and contended for in this paper will bear even a wider explanation.
Some years ago, I used with great success a combination of cocaine, Lloyd's colorless hydrastis, plumbi sub-acetatis in aqua distil. as an injection in gonorrhea. I cured the cases that came to me in my own practice rapidly and pleasantly, then a string of sufferers who had been vainly treated by my neighbors, came to me, they also were cured, until I began to feel like crying "Eureka." But suddenly my success was at an end, it cured no more. Why was it? I know not. The cases looked and acted similarly, but they were intractable to the old treatment.
If the gono-cocci had been carefully examined under a powerful microscope, the last intractable fellows might have been found harder to kill, in fact more virile and therefore, the old shot was not deadly enough. Let us at all times be careful in diagnosis, be quick to note pathological manifestations, then when we have located our game go for it with a dose small enough, and yet large enough to do execution.
Transactions of the National Eclectic Medical Association, Vol. XXIII, 1895-96, edited by W. E. Kinnett.