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J. A. (Joel Asaph) Allen.

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made, with reference to a study of the bacilli of enteric fever,
seem to point out the fact that both the bacillus coli communis,
and the bacillus of Eberth, are instrumental in producing the
disease.

<* Arloing has reported the results of a study of the bacillus coli
communis, and the bacillus of Eberth, made by Rodet, Roux, and
Vallet. In an examination of the water supply of a community,
in which 119 of the 215 persons were attacked with enteric fever,
Rodet found an organism that possessed almost all of the charac-
teristics of the bacillus of Eberth. Examination of two other
water supplies used by communities in which enteric fever was
prevalent, disclosed the presence of organisms that resembled the
colon bacillus more closely than the bacillus of Eberth. Roux
made a corresponding observation. Rodet and Roux now studied
the stools of a number of enteric fever patients, and found some
cases in which only the colon bacillus was present in the stools,
and other cases in which the bacillus of Eberth was found in the
spleen and the colon bacillus in the intestines. It was not pos-
sible to make a distinction between the two organisms from a
study of their morphology, biology, or pathogenicity. These and
other experimenters seem to have arrived at the conclusion that
the colon bacillus and the bacillus of Eberth represent two
species of the same organism, and that the human economy
favors the transformation of the colon variety into the Eberth
variety."*

Drinking water, contaminated by fecal discharges from typhoid
fever patients, is, perhaps, the most * common source or vehicle of
typhoid fever. The disease has been traced to milk diluted with
infected water, and apparently, in some cases, to emanations from
cesspools and sewers. That the disease is sometimes caused by
the inhalation of the specific microorganism seems to have been
proven. At the present time, however, the weight of opinion
seems to be that the specific germ must be swallowed, and thus



1. Caton, of Liverpool, calls attention to a possible means of dissemination of enteric
fever from the employment of liquid manure obtained from cesspools, in the cultivation of
lettuce, celery, and other vegetables.



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CLABK : CONTAGIOUS AND INFECTIOUS DISEASES. 200

gain an entrance into the stomach and small intestine. And the
way in which this usaally comes about, is that the germ is swal-
lowed with our food and drink. The literature of the disease
teems with illustrations of this fact.

The work of Eoch and other investigators has left little doubt
in the minds of the profession as to the true cause of cholera and
its method of action. Like typhoid fever, the germ or bacillus is
conveyed very largely by food and drink supply. Like it, also, it
must find its way into the gastro- intestinal canal. Therefore, it
must be swallowed, and not inhaled, to produce its specific effect.
It is endemic only in some parts of Asia, and when other countries
have it, it is always carried along the lines of commercial inter-
course by land or water. Its diffusion has no relation to the direc-
tion or velocity of the wind. On land it creeps from place to
place, and never invades an inland town or seaport without having
been carried by some person or agency from a place already
affected with the disease. A high atmospheric temperature is
everywhere associated with the prevalence of cholera ; its origin
in a hot climate proves this beyond a doubt. The disease disap-
pears to a great extent in very cold weather, and attains its
greatest intensity in the hot summer months. Difference in tem-
perature explains the fact, that of two ships arriving from Havre,
France, in December, 1848, one at New York and the other at
New Orleans, the former did not disseminate the disease, but the
latter formed the starting point of an epidemic which lasted all
Winter.

Much has been said and written about the predisposing causes
of cholera, such as poverty, over-crowding, filth, intemperance,
depression of spirits, etc.; that they all have a certain influence,
cannot be doubted. They are the same factors which favor the
spread of all infectious and contagious diseases. They never pro-
dace them per se, but simply afford powerful aids to the growth
and development of their germs. This is especially true of over,
crowding and its usual accompaniment — filth.

Some of the infectious diseases thrive better on filth than
others. This is notably true of cholera and typhoid fever. One
of the most graphic exhibits of the relations of filth to cholera
and to typhoid fever is that prepared by Dr. Joseph von Foder, of
Bada-Pesth, who tabulated the results of his investigations and
study of the subject in Buda-Pesth for a period of fifteen years,
1863 to 1877 inclusive, as follows :



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210 GLABK : CONTAGIOUS AND INFECTIOUS DISBASE8.

TYPHOID PEVEE AND CHOLEBA IN BUDA-PESTH, 1868 TO 18'7'7.

1. Influence of filthy houses :

r 1. Very clean 92

Deaths from cholera per 100 houses when i 2. Clean 199

the Interior of the dwelling was ] 3. Dirty 268

4. Very dirty 402

1. Very clean 165

2. Clean 177

8. Dirty 182

4. Very dirty 356

1. Very clean 188

2. Clean 214

3. Dirty. 263

4. Very dirty 889

1. Very clean 159

2. Clean 186

8. Dirty 208

4. Very dirty 282



Deaths from typhoid fever per 100 houses
when the interior of the dwelling* was.

2. Influence of filthy yards :

Cholera deaths per 100 houses when the
yard was



Typhoid fever deaths per 100 houses
when the yard was



The specific cause of cholera, then, is taken into the alimentary
canal, and through it produces the specific and characteristic symp-
toms of the disease. It is conveyed from the sick to the well by
the discharges from the bowels and the vomited matter of the
persons affected ; that is, the food and water supply becomes
contaminated with these discharges, and are thus swallowed by
the patient. The virus, or germ, can be carried in clothing and
articles of merchandise, and is said to preserve its vitality for a
long time. Personal wearing apparel of persons who are not
cleanly in their habits affords a good vehicle for the transportation
of the specific poison. There are good reasons for believing that
the poison does not enter the system through the lungs. If the
bacillus floats in the air, and is thus taken into the mouth, it must
needs be swallowed to produce its specific effect.

I must leave the subject here, not because it is uninteresting,
but because it is too comprehensive for one evening's discussion.

It is a subject on which volumes have been written, and at the
present time is receiving more attention from sanitarians and law
makers than ever before in the history of the human race. In fact,
all departments of sanitary science are being studied by physicians,
legislators, and the people, with an eagerness that is truly aston-
ishing. The people, with the physicians, are coming to believe



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GLABK : CONTAGIOUS AND INFECTIOUS DISEASES. 211

that preventive medicine is t6 be the medicine of the futare, and
that the chief end and aim of many doctors of the future will be
to restrict and limit the progress of disease by the application of
the principles of preventive medicine. It is a noteworthy truth,
that ^ an ounce of prevention is worth a pound of cure," and the
people who pay the taxes are awaking to the fact that it is much
cheaper to keep disease out of a given locality than it is to fight it
after having once gained an entrance. The losses and hardships
entailed by the present financial distress in our country, are a mere
trifle compared to those which would result if cholera should
become epidemic within our border. The intelligent portion of
our people are always, as a rule, ready to aid and cooperate with
our health authorities in preventing and stamping out disease when
the necessity and wisdom of such cooperation is clearly shown to
them.

They realize that private or personal hygiene is good so far as
it goes, but that it is per se totally inadequate to restrict and pre-
vent any of those diseases which now cause the largest death-rate.
'^ For protection against the dangerous communicable diseases, the
general cooperation of all classes of people is essential. Each
person is so continuously exposed, directly or indirectly, to other
persons in all ranks of life, that no person can live to himself alone.
The safety of each, in consequence of the many and insidious means
by which contagious and infectious diseases are transported and
communicated, is bound up with the safety of others, so that each
individual has a vital interest in the general health, and in general
and special measures for the preservation of the public health.*'
In view of these facts, it is evident that the public health, and all
matters pertaining thereto, must be looked after by the public
health officials, aided and backed up by a vigorous and intelligent
public press and public opinion. Lord Beaconsfield gave utter-
ance to a great truth when he said : <* The health of the people is
the first duty of the statesman."

This forms a pleasing contrast to the opinions held by the
people not many years ago, " when the most enlightened public view
of the subject of general sanitation included not much more than
the abatement of nuisances and the restriction of small-pox." <'We
know, however," and intelligent people to a large extent share our
knowledge, "that the important diseases which are spread by
ordinary filth are few compared with those which are spread by
particular * specific ' causes, which cannot be recognized by any



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212 KBAUSS: NEUBOLOGY.

of the senses unaided." The specific causes of some of the most
dangerous diseases have no odor. They are not visible, except
through the aid of the microscope, or of some special method of
cultivation, requiring the services of a skilled bacteriologist.:, Sani-
tarians have learned the cause of << the pestilence which walketh in
darkness and wasteth at noonday," and are able to set forth to the
people methods which will, undoubtedly, be effective for the pre-
vention of that dread scourge, tuberculosis, or consumption, that
causes more deaths than any other and of several other pestilences,
which, like diphtheria and scarlet fever, rank only a little below
that great white plague.

Is it too much to hope and believe that the rapidly revolving
wheels of time will bring the human race, by-and-by, to a
period when, as a result of patient study and laborious research,
they will be able, fully and absolutely, to recognize the cause of
each and every type of contagious and infectious disease ? If
the cause be a germ, or bacillus, as we are all coming to believe,
will they not be able to study its method of development and
propagation ? This much accomplished, will it not be a com-
paratively easy task to compass the absolute destruction of these
deadly germs, and forever wipe from the face of the earth the
terrible scourges which now afflict the human family in the shape
of what we now know as the contagious and infectious diseases ?



WHAT THE NEWER THERAPEUTIC PROCEDURES
HAVE DONE FOR NEUROLOGY.'

Bt WILLIAM C. KRAUSS, M. D., Buffalo, N. Y.

The epoch in which we live may well be called the sky-rocket period
of the XIX. century. Men, like methods, approach their zenith
with an increasing roar and gusto, burst into sparkling brilliancy,
and as suddenly fade and fall to the ground with a dull and heavy
thud. What was yesterday a seemingly brilliant success becomes
today a glittering failure, and the shores of time are laden with
the wrecks of " wonderful discoveries."

Hypnotism, suspension, and the method of Brown-S^quard have
each enjoyed their sky-rocket experience, and the impressions
which they left after spending their force is what we propose to
study tonight.

1. Read before the Section on Medicine of the Buffalo Academy of Medicine, October
10, 1803.



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KBAUSS : KBUROLOGT. 213

The first reports of the method of Brown-S^quard read like a fairy
tale, and the ^'Elixir of Life," so-called, seemed to be the magic fluid
that philosophers had sought to compound for centuries back. No
doubt, Brown-S^quard was perfectly honest in the thought that he
had invented a method unsurpassed and hitherto undiscovered, but
on searching the alcoves of the National Library of Paris several
brochures have been found, written by Dr. Mizauld, which contain
much of interest if not of actual worth. This physician lived in
Paris in the XYL century, and the following passage must cer
tainly establish for him a certain right to priority in favor of a
method which, sleeping for several centuries, was re-awakened by
Brown-S^qnard. He says: '^ If the genital organs of a red bull be
bruised in a mortar and taken by a woman in some wine or soup,
it will give her a disgust for love, while, to the contrary, the same
beverage taken by a debilitated man will re-awaken his amorous
desires." Brown-S^quard said nothing any more explicit in his
well-known communication to the Soci^td de Biologie of Paris, on
June 1, 1880.

It seems that Brown-S^quard had been at work on this project
for many years, for, in 1869, he expressed a belief that if it were
possible to inject spermatic fluid into the veins of old men they
would experience a rejuvenation — sexually, mentally, and physically.
After repeated experiments upon rabbits, dogs, and guinea-pigs, he,
in a true scientific spirit, injected some of the testicular fluid into
his system, and his experiences and results form the most interest-
ing part of his memorable communication to this learned
society:

The author of this communication, now seventy-two years old, has
for the past twelve years watched his physical powers slowly and con-
tinually decline. The laboratory work has become laborious and
heavy, and after each meal I have been obliged to take a short nap.
After the third injection a complete change took place. The work in
the laboratory has become agreeable, not the least fatiguing, and after
three and a half hours of such work I have been able to edit a memoir.
The dynamometer showed an increase of 6.7 kilogrammes, the bowels
regained their former activity, and, in short, I have regained all that
I have lost.

For some time the most enthusiastic reports were received,
especially by Hammond and Loomis in this country, D'Arsonval,
y illeneuve, Mairet, Gley, Hirschberg, and £gasse in France, Marro
and Rivano, Ventre, Copriati, and Mosso in Italy, Owspenski in



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214 KBAUSS : NEUB0L06T.

Rassia, and a host of other observers, each one eager to land his
results on the ground floor. The diseases treated were general
debility, locomotor at^ia, insanity, impotence, cholera, tubercu-
losis, cardiac weakness, nervous dyspepsia, lumbago, hemiplegia,
myalgia, neurasthenia, etc. All of these affections have either
been cured or else greatly benefited by injections of testicular
juice, that is, in 1889 and 1890 especially.

Gradually the reports became less numerous and less encourag-
ing, save those which came from the master himself and some of
his former pupils. Perhaps the greatest check to this movement
was the fact that Charcot and his pupils refrained from using these
injections, or, at least to my knowledge, never gave it their sanction.
Negel, of Jassy, France, has reported recently his experience with
this fluid, and in a large number of cases treated, of various affec-
tions of the nervous system, failed to obtain any results whatever.
Pulawski, of Warsaw, Russia, made a series of experiments upon
twelve cases, and came to the following conclusions :

Local pain and abscess formation ; fever with chills ; no
specific action ; subjective and positive amelioration were depen-
dent upon suggestion.

Copriati studied the effect of testicular juice in four cases of
insanity, and found that it had no dynamogenic influence on the
nerve centers, its effects being limited to temporary stimulation of
the nervous system. The unkindest cut of all was the report of
F6r6, one of the ablest of French neurologists, who, at the request
of I>*Arsonval, gave the method a thorough trial at the Bic^tre
hospital. In his communication to the Soci^t^ de Biologie, just
four years after Brown-S4quard's, he, in unmistakable language, dis-
approves of the method and cites nine cases which had been under
treatment. No favorable result was obtained in any case ; on the
contrary, the injections seemed to act as a depressant. Ovarian
juice has, according to Brown-S6quard, given similar though less
marked results.

Spermine is the name of another fluid extract derived from
Brown-S^quard's testicular juice by Poehl. Its action seems to be
similar to the testicular juice, acting upon the motor areas of the
cerebro-spinal axis, increasing the strength of the arms and legs^
regulating the sexual, urinary, and digestive functions, and in
improvement of the general sensibility.

Brown-S^quard's method today is not used by neurologista
either in America or Europe, but is still being experimented with



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KBAUSS: NEUROLOGY. 215

by its champion and his pupils apparently with good resalts in a
certain class of functional nervous diseases.

Following closely upon this method of treatment Gley, decided
to inject the juice of thyroid glands in dogs thus deprived of these
glands, and, instead of dying, they recovered without any serious
difficulties. In the human family it has been found that after
removal of the thyroid gland through disease, that a certain train
of symptoms will develop, which have received the name of myxe-
dema, a disease characterized by swelling of the face, body, and
extremities, loss of hair, sub-normal temperature, etc. Horsley
attempted to transplant the thyroid gland of animals to these
patients, and met with partial success. Dr. Murray, of Newcastle,
England, then injected hypodermically a glycerine extract of thy-
roid gland into patients suffering with myxedema, and his efforts
were rewarded with beneficial results. Brown-S^quard and
D'Arsonval were conducting similar experiments about the same
time with equally good success. It was found, however, that the
injection of this substance was followed in many cases by pain,
inflammation, and abscess formation. To overcome these hin-
drances, Fox of Plymouth and Mackenzie advised and practised
the treatment of myxedema by feeding with sheeps' thyroid glands,
and the results seemed to be in every way satisfactory.

The writer has had a little experience in treating two cases of
myxedema, but he has been unable to attain anything like the
results claimed by the English and French writers. In fact, his
experience has been negative, and not even obtaining temporary
improvement.

MaoAlister, of England, has treated cases of pseudo-hypertrophic
paralysis with injections of thymus gland extract ; also a case of
lymphadenoma with a mixture of red and yellow marrow, with
seemingly good results.

Dieulafoy, of Paris, has injected extracts of the cortical portion
of the kidney into patients suffering with Bright's disease. He
proposes the name Nephrine for this particular fluid.

Comby and Dieulafoy have also injected the extract of pancreas
in cases of diabetes with temporary good results.

Following the footsteps of Constantin Paul, of Paris, an
American experimenter has injected a large list of specific agents
into our vis medicatrix. Cerebrine (Hammond) and cerebrin
(Parke, Davis & Co.), medulline, cardine, ovarine, testine, muscu-
line, etc., are the newly-coined words which describe these prepar-



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216 KRAU88 : NEUBOLOGT.

ations. I ne^d not tell you what has been claimed for these fluids,
for, no doubt, you have all read the paper extolling their virtues
and efficacy, published in nearly every medical journal of America.

I have tried to give cerebrin a good, fair trial, and have used
it in two cases of locomotor ataxia, two of epilepsy, two of neuras-
thenia, and one of general debility. Not a single one reported
improvement ; not even did a reaction set in. The only visible
effect was the disappearance of the patients.

Archie Stockwell, in an interesting paper published in the
Medical News, August 26, 1893, describes his experience with the
two rival cerebrines, and a mixture of borax, glycerine, and water.
He comes to the conclusion that the^e three preparations are
equally efficacious, or rather equally inert for good or evil. Negel,
of Jassy, also experimented with cerebrine without any appreciable
results. Negative results, when reported, have a greater significance
than successful results, because many observers are unwilling to
have their failures paraded in the medical press; besides, many editors
are averse to publishing articles detrimental to their advertisers.

My conclusions, then, in regard to the animal extracts, are :
That since recent experiments fail to corroborate the results
obtained immediately after the introduction of Brown-S^quard's
method, the whole matter must be left open for further investiga-
tion. Secondly, that many of the results obtained were through
suggestion and auto-suggestion, and that no specific action has
been discovered.

In regard to the treatment of myxedema, although my results
were negative, I believe that there is some virtue in the various
methods of introducing thyroid glands into these patients, but the
disease must be of recent standing and the patient not advanced
in years.

As to the injection of the i-n-e compounds, I believe that it is
all rot. I cannot be convinced that injections of musculine will
cure an atrophied muscle, due to destrviction of the ganglion cells
of the ventral horns of the spinal cord ; or that meduUine will
cure a sclerosed cord, the most common form of cord disease ; or
that cerebrine will cure apoplexy cerebralis, perhaps the most
common form of brain disease.

Just recently there has appeared a work by Charon, of Paris,
who writes pointedly on this subject. He says :

All liquids, when introduced under the skin, produce identical
effects, provided they are not toxic and have no specific toxic action.



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KBAUSS : NEUB0L06Y. 217

They increase arterial tension, and, in the diseases in which these fluids
have been used, a degree of hypo- tension has existed, which being
relieved by injections, temporary results have followed.

SUSPENSION.

Raymond, a pupil of Charcot, while studying the Russian
University system in 1888, discovered Motchouskowski, of Odessa,
suspending his cases of locomotor ataxia with beneficial results.
Motchouskowski had himself discovered this method by accident
in 1883, and, although published at that time, it had been entirely
unheeded and forgotten. It was found that the lancinating pains,
vesical and sexual disorders, eye symptoms, and the ataxic gait,
would yield when all other remedies had failed. On returning to
Paris, this method was tried secretly by the internes at the Sal-
petriere, and after obtaining satisfactory results, was divulged to
Charcot, who at once instituted a thorough trial. I had the
pleasure of being in Paris at this time, and saw and examined
many of the patients thus treated. New treatment gives new
results, and many of the old stagers declared they were much
improved and getting well. Charcot never claimed that suspen-
sion would cure locomotor ataxia, or any other organic disease of
the cord, but the report gained ground that it would cure perman-
ently, and the method soon fell in disrepute. All that was
claimed for it was that it would relieve some of the terrible symp-
toms, and now, five years after its re-introductioH to the profes-
sion, let us see what is still claimed for it.

Yon Bechterew, perhaps the foremost Russian neurologist, says
in Neurologiaches Centralblatty September 16, 1893 :

The suspension treatment has continued to exert a favorable influ-
ence on all cases thus far treated; particularly beneflcial has it been in
locomotor ataxia, spinal syphilis, transverse and central myelitis.
compression myelitis, and compression of the spine. In some of these
cases it has produced seemingrly permanent good results, as nearly a
year has elapsed and the patients still enjoy good health.

Writing, on April 1, 1893, in the same journal, he recounts the
favorable influence it has upon the optic nerve in spinal-cord
affctions. Sprymon has had similar good results in locomotor



Online LibraryJ. A. (Joel Asaph) AllenBuffalo medical journal → online text (page 22 of 78)