A. (Abraham) Jacobi.

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THE LIBRARY

OF

THE UNIVERSITY
OF CALIFORNIA

LOS ANGELES



COLLECTANEA JACOBI

IN EIGHT VOLUMES



VOLS. I, II AND III, PEDIATRICS
VOLS. IV AND V, GENERAL THERA-
PEUTICS AND PATHOLOGY
VOLS. VI AND VII, IMPORTANT AD-
DRESSES, BIOGRAPHICAL, AND HIS-
TORICAL PAPERS, ETC.
VOL. VIII, MISCELLANEOUS ARTI-
CLES, AUTHORS' AND COMPLETE TOP-
ICAL INDEX



DR. JACOBI'S WORKS

COLLECTED ESSAYS, ADDRESSES,
SCIENTIFIC PAPERS AND MIS-
CELLANEOUS WRITINGS

OF

A. JACOBI

M. D. UNIVERSITY OF BONN (1851); LL. D. UNIVERSITY OP MICHIGAN

(1898), COLUMBIA (1900), YALE (1905), HARVARD (1906).
Professor of Infantile Pathology and Therapeutics New York Medical College
(1860-1864); Clinical Professor of Diseases of Children, New York University
Medical College (1865-1869); Clinical Professor of Diseases of Children, Col-
lege of Physicians and Surgeons, Columbia University (1870-1899) ; Pro-
fessor of Diseases of Children in the same (1900) ; Emeritus Professor
of Diseases of Children in the same (1903) ; Consulting Physician to
Bellevue, Mount Sinai, The German, The Woman's Infirmary,

Babies', Orthopedic, Minturn and Hackensack Hospitals.

Member of the New York Academy of Medicine (1857), Medical Society of the
City and County of New York, Medical Society of the State of New York,
Deutsche Medizinische Gesellschaft of New York, New York Pathological
Society, New York Obstetrical Society, Association of American Physi-
cians, American Pediatric Society, American Climatological Association,
Congress of American Physicians and Surgeons, American Medical
Association, International Anti-Tuberculosis Association, Association
for the Advancement of Science; Associate Fellow of the College
of Physicians in Philadelphia, Societ6 de Pediatrie de Paris,
Soci^tfe d'Obstetrique, de Gynecologic et de P6diatrie de Paris,
American Academy of Arts and Sciences; Foreign Member
of the Gesellschaft fur Geburtshulfe in Berlin; Corre-
sponding Member Physicalisch-Medizinische Gesell-
schaft of Wiirzburg, Gynecological Society of Boston,
Obstetrical Society of Philadelphia, Gesellschaft fur

innere Medizin und Kinderheilkunde in Wien.

Honorary Member Yonkers Medical Association, Louisville Obstetrical
Society, Abingdon, Va., Academy of Medicine, Brooklyn Medical
Society, Medical Society District of Columbia, New York Obstet-
rical Society, Medical and Chirurgical Faculty of Maryland,
American Laryngological Association, Pediatric Society of St.
Petersburg, Pediatric Society of Kiev, Royal Academy of
Medicine, Rome, Deutsche Gesellschaft fur Kinderheilkunde,
Verein fur Innere Medizin of Berlin, Royal Society of
Medicine of Buda Pesth.



IN EIGHT VOLUMES



EDITED BY WILLIAM J. ROBINSON, M. D.

NEW YORK

1909



CONTRIBUTIONS

TO

THERAPEUTICS

BY

A. JACOBI, M.D., LL.D.

VOL. IV

EDITED BY WILLIAM J. ROBINSON, M.D.




NEW YORK
THE CRITIC AND GUIDE COMPANY

12 MT. MORRIS PARK WEST
1909



COPYRIGHT, 1909,
BY MARJORIE McANENY



Library

10
7



CONTENTS

PAGE

PHASES IN THE DEVELOPMENT OF THERAPY . 9

An address delivered before the Medical School of
Yale University, June 26, 1905. Yale Medical Jour-
nal, July, 1905.

I

EXPECTANT TREATMENT ......... 47

Written for the Medical Society of the State of New
York, 1901. American Medicine, Aug. 10-17, 1901.

DOSES OF DIET AND DRUGS ....... 59

An address delivered before the Ohio State Medical

Association, Cedar Point, 1907. Ohio State Medical
Journal, September, 1907.

FEVERS AND FEVER REMEDIES ...... 89

Read before the Medical Society of the State of New
York, Jan. 30, 1900. Albany Medical Annals, May,
1900.

ON THE HYDRATE OF CHLORAL ...... Ill

Read before the Medical Society of the County of
New York, Nov. 1, 1869. Medical Record, Dec., 1869.

MEDICAL TREATMENT OF THE DISEASES OF

THE STOMACH . . ......... 131

Medical Record, Feb. 2, 1895.

GASTRIC ULCER . ........... 141

Read before the Medical Society of the County of
Albany, April 10, 1907. Albany Medical Annals, June,
1907.

THE DISINFECTION OF THE ALIMENTARY CANAL 161
An address delivered before the Medical Society of
the State of New York, February 1, 1899.



809757



CONTENTS

PAGE

INOCULATIONS WITH PROF. KOCH'S "TUBER-
CULIN " 185

Read before the Medical Society of the State of New
York, February 4, 1891. Medical Record, Feb. 28 and
March 7, 1891.

GUAIACOL IN THE TREATMENT OF PULMONARY

TUBERCULOSIS 225

Read before the American Climatological Association,
June 24, 1892. International Medical Magazine, Nov.
1892, and Transactions American Climatological As-
tociation, 1892.

PROLONGED MEDICATION WITH SPECIAL REF-
ERENCE TO DIGITALIS 233

The Medical News, January 11, 1902.



THE TONSIL AS A PORTAL OF MICROBIC AND

TOXIC INVASION 241

Presidential address at the Eighteenth Annual Meet-
ing of the American Pediatric Society, Atlantic City,
N. J., May 30, 1906. Archives of Pediatrics, July,
1906.



TONSILS, OR GENERAL LYMPH APPARATUS OF

THE PHARYNX WHICH? 251

Archives of Pediatrics, Sept. 1906.

FOLLICULAR AMYGDALITIS 25T

Read before the Section of Theory and Practice of
Medicine, New York Academy of Medicine, Nov. 16,
1886. Medical Record, Nov., 1886.



ARSENIC AND DIGITALIS IN PHTHISIS ... 271
Transactions New York State Medical Society, 1884.



FUNCTIONAL CARDIAC MURMURS 281

Transactions American Climatological Association,
1899.



CONTENTS

PAGE

THE INFLUENCE OF MENSTRUATION, PREG-
NANCY, AND MEDICINES ON LACTATION . . 295
Read before the Obstetrical Society of New York.
Mostly from A. Jacobi : " Die Pflege und Ernahrung
des Kindes," in Prof. C. Gerhardt's " Handbuch der
Kinderkrankheiten," vol. i. Tubingen, 1877.

ERGOT IN CHRONIC MALARIA . 307

Read at the Annual Meeting of the American Cli-
matological Association at Bethlehem, N. H., Septem-
ber 1, 1898. Medical News,_Oct. 32, 1898.

REMARKS ON STRYCHNINE 319

Prepared for the Annual Meeting of the American
Climatological Association, June, 1901. International
Clinics.

METHYLTHIONIN HYDROCHLORID IN INOPERA-
BLE CANCER 331

Remarks made in the Section on Pharmacology and
Therapeutics of the American Medical Association, at
the Fifty-seventh Annual Session, June, 1906. Jour-
nal American Medical Association, Nov., 1906.

ENTERALGIA AND CHRONIC PERITONITIS . . 335

Transactions of the Medical Society of Virginia, 1889.

PERIBRONCHITIS AND INTERSTITIAL PNEU-
MONIA 349

An address delivered before the Philadelphia Pediatric
Society, December 9, 1902. Archives of Pediatrics,
Jan., 1903.

STOMATITIS NEUROTICA CHRONICA 369

Transactions of the American Association of Physi-
cians, 1894.

HYPERTHERMY IN A MAN UP TO 148 F. . . . 381
Transactions of the Association of American Physi-
cians, J1895.

HEMORRHAGE FROM A PYOTHORAX .... 421
Transactions of the Association of American Physi-
cians, 1901.



CONTENTS

PAGE

JACKSONIAN EPILEPSY; ADENOMA OF LIVER;

ACUTE ASCITES WITH TUBERCLE BACILLI . 425

Transactions of the Association of American Physi-
cians, 1897.

PARTIAL, AND SOMETIMES GENERAL, CHOREA

MINOR FROM NASOPHARYNGEAL REFLEX . 443
Archives of Pediatrics, November, 1890.

DISCUSSION ON LARYNGEAL TUBERCULOSIS . 451
Read before the New York Academy of Medicine,
1907.



PREHISTORIC times canirot have been without therapy.
Wounds and diseases found sympathy and such aid as
bystanders could give. Animals lick each other's bruises
and the human animal cannot have been an exception to
the rule. Later the power and practice of healing must
have been considered a high privilege, for two or three
thousand years B. C., the high priests and kings of Egypt
practiced it. Their technique in many things was excel-
lent. We know their rules for enemata, emetics, purga-
tives, bathing and frictions, circumcision, and embalming,
and the number of specialties was at least as great as it is
to-day.

The communication between countries and parts of
countries was defective. That is why the healing art re-
mained gross individual empiricism more in some countries
than in others. Herodotus tells us that in his own time
the sick person in Babylon was carried to the market place
for they had no physicians, he says to be benefited by
the advice of the wayfarers. For it happened at that time,
as in 1905 after Christ, that your neighbors boasted of
having enjoyed exactly the same disease and ache and knew
all about its cure.

About the middle of the fifth century B. C., Hellas,
whose first tales of legendary medicine dated back into
the Homeric period when the " healing man was of more
value than a host of others," had well-organized medical
schools though not always unanimous in their teachings ;
a good beginning of public and private hygiene, and an
extensive knowledge of many pathological and therapeut-
ical facts.

Medicine and its main object, therapy, did not remain
individual. Long before the Christian era about 437

9



DR. JACOBI'S WORKS

the Buddha king of Ceylon, Pandukhabayo, established san-
itary institution's, amongst which there was at least one
hospital, and one of his successors Dathagamini, who died
137 B. C. is said to have supported with ample means
hospitals in eighteen different cities and to have had med-
icines prepared in them by medical practitioners.

Buddha's humane teaching extended westward to Persia
and Asia Minor not to Judea, however, where we know
of isolation houses only for the leprous where the king
Usia had to terminate his life and to Greece and Rome.
The iatria of the asklepiads and the institutions established
by Antoninus Pius were dispensaries and a few clinical hos-
pitals. A few centuries after Christ the Christians found
their gratification in helping one another in dangers and
diseases, and nursing the sick in their homes and in hos-
pitals. It is evident that the humane element prevailed
in most of the cultured parts of the human family.

With us only that is different. Only three weeks ago
town supervisors refused to the New York City Health
Department permission to locate a tuberculosis sanitarium
in an out-of-the way mountain region. But it is true they
are the Shawamnunk mountains and the town board is that
of Mamakating, and the Indian names still correspond
with the tomahawk spirit of the uncouth savage, not amen-
able to instruction or humanity.

Though the Roman Emperors favored the physicians,
medicine deteriorated under secular and clerical oppression.
The belief in miracles, spirits and demons, and ascetic
mysticism took the place of the naive unscientific medicine
of older times. Thus medicine perished though sciences
in general were still nursed and though the study of the
law flourished. Physicians were replaced by magicians
and sorcerers; those few who clung to Hippocrates and
Galen were suspected of heathenism. The Christian clergy
established its own schools, the most famous of which was
that of Edessa, in which the psalms of David and the
Tabernacle were the preparations for medicine. When
finally the Christians obtained the political power there came
the end of philosophers and physicians. Only after the
sixth century did the Benedictine monks begin again the

10



DEVELOPMENT OF THERAPY

study of Galen. The school of Salerno five hundred years
afterward contributed its " regimen sanitatis " ; which con-
tains dietetics, with a brief pathological, pharmaceutical,
and therapeutical appendix.

Meanwhile the Arabs studied botany and pharmacology,
and used many remedies, metals, narcotics, stimulants,
cosmetics, and aphrodisaics. Surgery and obstetrics, how-
ever, were thoroughly neglected. Before they had time to
influence European practice at all medicine had a low
standing. Jews and the lowest ranks of monks only were
permitted to practice. When an illness appeared danger-
ous, the doctor had to provide a guarantee. When a noble-
man died of a venesection, the doctor was delivered into
the hands of the family. That was not only usage, it was
law according to the West Gothic code. When a slave
died in Venice, about 1100, the doctor had to pay; if he
were a Hebrew he was hung. Thus it happened that only
loud-mouthed charlatans were respected, and low monks,
old women, shepherds and mountebanks would render
their alleged services in the market places and at their
kirmesses.

The first legislative recognition 1 was bestowed on medi-
cine in 1140, by King Roger of Sicily, who restricted the
practice of medicine to those who were licensed. The Ger-
man Emperor Friedrich II (1224) required three years'
study of logic and five years of medicine and surgery
according to Hippocrates and Galen, also a magisterial de-
gree and a state license. A rate for services was estab-
lished and the physician* forbidden to keep an apothecary's
shop. King Sigismund appointed a city physician in 1426.
The master physician was to have 100 florins annually,
the poor had the medicines gratis, the others paid the apoth-
ecary. The king adds in the court if not courteous
language of his appoinmerrt " For the big masters in
physics serve nobody for nothing, that is why they go to
hell." The supervision of medicine was no longer with the
clergy.

The numerous universities of the eleventh and twelfth
centuries made room for medicine after a while, but Arnold
of Villanova says there was nothing in the teaching but

11



DR. JACOBI'S WORKS

grandiloquent theory. In spite of all their learning they
" did not know how to apply an enema or to cure an
ephemeral fever." The pedantic expounding of adulter-
ated editions of Hippocrates, Galen, and the Arabs was
still more perverted by scholastic methods. One of their
best teachers, Arnold of Villanova, about 1400, on account
of his doubting the propriety of combining dialectics with
medicine was charged with heresy by the inquisition. He
attributed to the drugs an actual property and a " com-
plexio potentialis," which could only be appreciated by
reasoning, but by no empirical method. Still, it was pro-
claimed to be after all the most important.

You notice that the history of medicine repeats itself.
Four hundred years after him Hahnemann, who was quite
learned, picked up from Arnold the idea of " potential "
drug action. According to Hahnemann also no medicine
was active as long as chemically or microscopically the
slightest trace of the original substance could be detected.

John Gaddsden in the same fifteenth century wrote a
" Rosa Anglica." He eulogizes his own secret remedies,
uses liquor as a panacea, hog dung for hemorrhages and
cures the vermin of the eyebrows with purgatives. Pos-
sibly it is here that Hahnemann picked up his Psora. Per-
haps it is not amiss to remind you that only two centuries
ago Paullini wrote his " Dreckapotheke "dirt pharmacy
'which recommends urine, feces of animals and men, and
other sweetnesses as all-healers. The best there is in this
transgression of Paullini's who otherwise was quite * a
meritorious man is that he lived exactly at the same time
when books were written on the cure of diseases by whip-
ping, another by music, another by the breath of young
girls. That is, as you are aware, what the elders recom-
mended for the benefit of King David when he was old
and decrepit.

Drug therapeutics were visibly aided in the fourteenth
century by the establishment of apothecaries' shops, such
as those of Esslingen 1300, London and Ulm 1364, Nurem-
berg 1338, Leipzig 1409- Regulations for their conduct
were made in Paris 1484, Stuttgart I486, Berlin 1488,
Halle 1493.

12



DEVELOPMENT OF THERAPY

The compendium aromatariorum 1468, is a very copious
collection of drugs by Saladin of Asculo.

For centuries, however, the main effort was spent on the
search for a universal medicine which prevented and
healed every disease, guarded against death, and changed
metals into gold. Practitioners would spread the belief
in their possessing the gold-making power. Even Robert
Boyle, the man who first drew attention to the elasticity of
the air, studied it in its transition and change into organic
bodies and suggested the agency of imponderables in nature
and in the causation of infectious diseases, the very man
who died as late as 1691 as President of the Royal Society
of Sciences, believed in gold-making. He abstained from
making it, however, fearing that by so doing he would
disturb the equilibrium of the world. No less a man than
Isaac Newton praised him for this unselfishness. Gold
was a most precious remedy, it needs must heal the gravest
diseases, mainly in the rich. Culpepper wrote in 1675:
" I fear to view the compound of gold, musk, and lapis
lazuli, and horn of unicorn ; it is a great remedy and invig-
orating, but it weakens the purse." Gold was kin to the
sun, it healed everything " unless recovery was contrary to
the will of God." The sun tincture which was said to con-
tain liquid gold, was soon without it, however. Even the
books taught that all the gold was found in the refuse.
But three drops would save life. Even William Burton
speaks of it about the time that Boyle flourished. It was
part of the " Quintessence," the compound of plant, ani-
mal and mineral. Our own Massachusetts and Connecticut
Governor Winthrop was after the stone of the philosophers
and the all-healer, gold. Nowadays they say gold is made
by those who are not afraid of disturbing the equilibrium
of the universe.

On the other hand, the most nauseating materials were
used as medicines, but chemistry also was studied and
many useful preparations were discovered. Bisam, ambra,
and precious stones, and compounds of numerous herbs and
other objects were utilized. The great theriac was a com-
pound of seventy articles. Syrups, pills, ointments, oils,
and plasters were in common use.

13



DR. JACOBI'S WORKS

Of the nature of diseases they learned at those times
but very little. Even long afterwards variola and morhilli
are treated as synonyms. All sorts of plagues are men-
tioned; the sacred fire (erysipelas?) without discrimination.
That is why the theory of the modern, mainly American,
origin of syphilis could be asserted up to our present time.
For skin diseases were general, and were not diagnosticated.
But the nursing of the sick became a religious duty and
a political office. Isolation houses were established and
lepra disappeared in a few centuries from central Europe;
the Norwegians have accomplished the same result in a
more humane way during the last thirty years. That
should be a lesson to us who are prevented by a narrow
egotism and shortsightedness and the waste of the earnings
of the people on wars of conquest and extermination 1 from
putting an end to the great white plague of the world.
Hospitals were founded and nursing went far enough to
become an absurd fad. Elizabeth of Thuringia cleansed
the leprous, washed their feet, and kissed their boils and
ulcerations. That is why she died very young and was
sainted.

Meanwhile Therapeutics was not at all simple. The
non-clerical physicians had to submit, or were fain to sub-
mit, to fast-days, processions, prayers, donations to
churches and monasteries, incantations, sympathetic reme-
dies all for the purpose either of exorcising or of calling
the aid of the evil spirits.

A very important progress was toward the end of the
thirteenth century, the foundation of the surgical college
of Paris. It was made independent of the clergy and of
the medical faculty. With the latter it was in constant
conflict; the best minds were engaged in it, and for all
times the surgical part of medicine has determined the lat-
ter's fate in France. Guy de Chauliac wrote on wounds,
hemorrhages, fractures, ulcers, and operations.

Of a similar, perhaps greater influence, was the ap-
pearance of formidable epidemics the black death, the
English sweat, angina, typhus, syphilis, which then was
more formidable than ever before, and scurvy. They could

14



DEVELOPMENT OF THERAPY

not be managed according to the books and compelled the
doctors to think for themselves.

The Hippocratic teachings founded upon the observation
of nature arrd a healthy empiricism got lost during the
Middle Ages. Aristotle misrepresented in garbled copies,
and Plato, who looked for the explanation of material facts
in mere reasoning, controlled what should have been medical
thinking. The medicine of the Arabs was hated by most of
the Christians because it was infidel.

Gross superstition was rife, however. Miracles were per-
formed as in antiquity. Suetonius tells us that Vespasian
cured the blind by his saliva and the lame by his touch in
the temple of Serapis at Memphis. According to Nepo-
tianus the right toe of Pyrrhus of Epirus cured diseases
and deformities, "remedio erat si cupus renes tumentes eo
tetigisset." That is why when the body was incinerated
the beneficent toe remained intact and could be preserved
in a gold box in the temple of Dodona. The practice was
continued in the Christian middle age. Scrofula was cured
by the touch of Edward the Confessor and Philippe of
France, and Olaf of Norway in the eleventh century. So
it was called the king's evil. They lived at the wrong time,
however, they required physical touch to-day distant
treatment is preferred. Both are of equal efficacy.

The inheritance of a glorious past was forgotten. The
cloaca maxima of Rome erected two thousand years pre-
viously was disused and survived in ruins, and the 800
baths constructed in Rome within 600 years between 400
B. C. and 180 A. D. were neglected.

Physicians were rrot trusted, still they were made re-
sponsible, not only for individual cases, but for natural
events. During an epidemic in Prague, 1161, on the
charge of having poisoned the wells, eighty-six Jewish phy-
sicians were burned to death. Before the time of Pope
Urban IV, hundreds were burned. John of Bohemia, the
same who fell in the Battle of Crecy, suffered from his
eyes. In Breslau he consulted a French oculist; because
he could not cure him he was drowned in the Oder; and
centuries afterward Helmont was imprisoned by his Bishop

15



DR. JACOBI'S WORKS

because he doubted the therapeutical competence of
religion.

Pietro d'Albano followed the teachings of Arab med-
icine, the only one which clung to Hippocrates. That is
why he was- to be burned. But he outwitted them by dy-
ing in their dungeon, 1250 after Christ. But the pious
people took their revenge on Cecco d'Ascoli, whom they did
burn in 1257. Still Venice appointed in* 1348 three phy-
sicians of public health, with the right to isolate houses and
districts for forty days the first beginning of our quar-
antine. During the fifteenth century large cities of Ger-
many established the office of City Physician.

The period of religious reformation was also the source
of some independent endeavor in medicine. It is true that
Luther, Calvin, and Zwingli established incontestable
religious autocracies in place of those they had overcome,
but they could not help raising doubts and independent
thoughts in many minds. Luther himself thought very
little of doctors. He employed them, but did not pay them.
He recommended his family physician to the Elector of
Saxony by writing that he was all right and cheap ; the
only thing he ever gave him was a glass of beer. That
was his clerical fee. Calvin did worse he burned Serveto.

One of the mooted questions about that time was that
of the Arabic and the Hippocratic venesection. It shows
to what extent apparently small things may embarrass
human minds, mainly when the stock of actual knowledge
is small. The Arabic method consisted in the opening of
a vein at a distance from the diseased part; the Hippo-
cratic, in* close proximity to it. Peter Brissot, professor
in Paris, favored the latter and caused the division into
contra-Arabists and Arabists. This dispute lasted long
after Brissot's death, to the end of the sixteenth century.
His teaching was claimed to be as heretical as that of
Luther. But after a while the Faculty of Salamanca and
Charles the Fifth, to whom appeal was made, decided in
favor of the Hippocratic method and of the dead Brissot.

About the same time Germans, Dutch, Italians, and Swiss
studied botany, mineralogy, and zoology. Directly and in-
directly therapeutics became enriched. The new anatomy

16



DEVELOPMENT OF THERAPY

was the best aid of mostly surgical therapeutics. For in-
ternal diseases blood-letting was still the main topic of dis-
cussion, and Botalli was the Bouillaud of the sixteenth cen-
tury. His teaching, however, was declared heretical by
the Paris Faculty. Drugs were nearly all vegetable, in
very complicated formulas, mostly. Metals were disdained,



Online LibraryA. (Abraham) JacobiDr. Jacobi's works. Collected essays, addresses, scientific papers and miscellaneous writings of A. Jacobi .. (Volume 4) → online text (page 1 of 38)