Croupous pneumonia has during recent times been defined as “an infectious disease characterized by inflammation of the lungs and constitutional disturbance of varying intensity.”
The recognition of an infection as a cause of this disease necessarily implies the existence of a specific germ, and as corollary we may state that this germ, like all germs, has a limited existence.
During the cause of the inflammation three stages have been recognized—congestion, red hepatization, and gray hepatization. Now, on a physician being called to a case of this kind, the query is, what is the best thing to do in the way of medical treatment?
If one consults some of his associates he will find remedies recommended ad nauseam. One declares the fever does no harm, while another is not satisfied unless one of the chemical antipyretics keeps the temperature near the normal standard.
Varying results, of course, follow these different treatments.
Having for a long time accepted and practised the doctrine that many diseases can be modified and conducted to a safe issue by giving a remedy that will attack the diseased cell-function, I have treated my cases of pneumonia in this way. The three remedies that I employ are aconite, bryonia and iodine. If I am called to see a patient during the first stage I give aconite and iodide of potassium, and on the development of the second stage I continue the iodide and also give bryonia. The aconite is given with a view of relieving the vaso-motor tension, and thereby equalizing the circulation; this, if doing nothing more, produces a measure of comfort. The last two remedies are given for their local effect. Now, as to a dose: in a half goblet of water I put ten drops of tincture of aconite, and in another goblet containing same quantity of water I put five grains of iodide of potassium, and give a teaspoonful alternately every hour. As soon as the second stage comes on I substitute five drops of tincture of bryonia for the aconite and continue to give in alternation with the iodide. If the heart becomes weak give one-fourth of a grain of extract of nux vomica every three or four hours. If the patient has much pain, hot applications are used. This with suitable food constitutes a treatment that bears excellent results. The physician who believes in giving large doses of quinine, ammonia, etc., will sneer at these small doses and hotly declare that nature cures independently of the drugs. In view of this declaration there is a compliment paid to vis medicatrix naturæ that the writer recognizes, and to have such an ally is certainly a desirable help. Those who have faith in heroic dosage are not always mindful of this fact, nor yet of the condition which obtains under their hands, and that is a state of drug disturbance plus the disease. Nature here is hindered, not assisted.
S. B. Childs, M. D.,
The Brooklyn Medical Journal, Jan., 1894.
DRUG ACTION.
Chemistry makes such rapid strides of late that it is impossible for the medical man in ordinary practice to keep pace with it. We have ptomaines and leucomaines, and in the literature of the journals these two terms are used indiscriminately, which is unfortunate, as tending to create confusion. While ptomaines are those alkaloidal products of metabolism belonging to the cadaver, or to any dead organism, whether animal or vegetable, the term is now applied to the same products in living tissues and which really are not ptomaines, but leucomaines. Chemically speaking, both ptomaines and leucomaines exist in the forms of monamines, diamines, and triamines, and have hitherto been regarded as resulting from the oxidation of ammonium salts by abstraction of water or from acids by substitution of amidogen. Yet the bacteriologists assure us that they are the secretions, or rather excretions, of bacteria, just in the same way that the strata of non-igneous rocks of the earth are formed primarily by the secretion, and secondarily by the excretion, of calcareous shells of diatoms, or of the cretaceous shells of those protozoans entitled rhizapods. Elsewhere in the Summary I have expressed myself to this effect in nearly the same language, and while it may seem pedantic, it should be borne in mind that this is the age of terminology.