New clinical therapeutics; a handbook on the special treatment of internal disease

Front matter

Book O 5

Copyright^ i y J/ ^

COPYRIGHT DEPOSIT.

Preface To First Edition

This book deals alone with the treatment of the sick. Hence the homely ministrations at the bed-side (that mean so much to the patient), the feeding and the bathing, the technique of all mechanical and physical means of treatment, as well as the use of medicines, the choice of climate and resorts, and the indications for surgical intervention are all discussed.

As a profession we have erred in the past in giving too much medicine ; we err nowadays possibly in giving too little. With the development of modern pharmacology and the decline of crude empiricism; with the tendency to give a single drug to meet definite indications; with the revival of esthetic medication and the abandonment of nauseous polypharmacy, drugs are recovering their legitimate place in the therapeutic armamentarium even of the most skeptically inclined. In the meantime physical means of treatment, such as hydrotherapy, electrotherapy, massage ? the great principles of rest and exercise, all based upon accurate scientific observation, have won the position they deserve. Modern dietetics, founded on the newly-discovered laws of nutrition and metabolism, has become an exact, almost mathematical, procedure. Psychotherapy has been allotted a definite field of usefulness. Organotherapy and, above all, serumtherapy, promise much and encourage the hope that our small list of specific remedies will shortly be increased.

No attempt has been made to enumerate all the means and remedies that have at different times been recommended for the treatment of various diseases, for these belong to the historical rather than the immediately practical.

It is well to recognize our limitations in the field of treatment ; hence rather than fill pages with a futile confession of our inability to help, a discussion of those disorders that we at present are unable to influence by any treatment has been altogether omitted. For this reason no special Section on Diseases of the Nervous System has been arranged; for unforhmately the majority of the organic diseases of the nervous system, on account of the peculiar character of the lesions and the nature of the affected parts, are not amenable to internal treatment, and the functional disorders of the nervous system are, as a rule, successfully treated only in special institutions. The management of the latter class of cases

X PREFACE.

is discussed in the text under various headings and can be found by consulting the index.

Occasionally an independent classification and grouping of related clinical entities has been attempted, in which I have considered it necessary from the therapeutic standpoint to depart from orthodox anatomic and etiologic classifications. Wherever it was considered essential to a better understanding of therapeutic indications, I have prefaced the statement of the treatment by general remarks relating to etiology and symptomatology.

The author of a work on Therapeutics is of necessity forced to draw largely from personal experience^ modified, to some extent, by the opinions prevailing among established authorities. This attitude naturally gives the discussion a subjective flavor, so to speak, which does not appear to me to be undesirable, and, which, above all, can hardly be avoided in a book of this character.

In preparing certain chapters I have been so fortunate as to secure the co-operation of clinicians who enjoy exceptional opportunities for observing the diseases they have written on. Thus Dr. Heman Spalding, as chief medical inspector of Chicago, has had a broad experience with the subject of Small Pox; Dr. William H. Baum, as physician-in-charge of the contagious wards in the Cook County Hospital, has had unusual opportunities for studying Scarlet Fever and Measles. Dr. A. Mayer and Dr. U. Maes, of New Orleans, have written on Yellow Fever. Dr. Wm. A. Pusey has contributed paragraphs on the X-ray treatment of Leukemia and Pseudo-leukemia ; Dr. E. F. Wells has written the Section on Pneumonia; Dr. F. S. Churchill on Mumps and Whooping Cough; Dr. F. Kreissl, the Section on Syphilis and Cystitis and Urethritis and the paragraphs on intra-pelvic applications in the treatment of Pyelitis. To all these gentlemen I wish to express my sincere thanks for their earnest and valuable assistance.

In order to render this volume useful not only for consecutive reading, but also for rapid reference, marginal headings have been inserted throughout and particular care has been expended upon the preparation of a complete and exhaustive index.

Alfred C. Croftan.

Preface To Second Edition

Within the short period of a few months that has elapsed since the issuance of the first double edition no fundamental advances in clinical therapeutics have been made. A number of promising ideas have been advanced by different clinicians, but it is altogether too early to pass judgment on their validity ; for the present, therefore, I have preferred to omit them from the new text. Numerous suggestions, however, and a few criticisms that have been offered by readers of the first edition have^ whenever feasible, been duly considered and incorporated in the volume. To all those who have been so kind as to aid me in this way I wish to express my sincere appreciation. Alfred C. Croftan".

Preface To Third Edition

There has been little real advance in the therapeutics of internal disease within the last two years. Our main hope must lie in the field of specific remedies; here the use of Flexner^s serum in epidemic cerebro-spinal meningitis has fully vindicated its claim to usefulness; all other endeavors in the direction of preparing specific sera have so far led to no conclusive results. Consequently there is little that is fundamentally new to add to this Third Edition.

Alfred C. Croftan.

Preface To Fourth Edition

This fourth edition includes all that is new and therapeutically practical in the field of specific prophylaxis, serum therapy, autogenous vaccination and. the newer chemo-therapy. Hence the Chapter on Infectious Diseases principally has been enlarged.

Many of the newer synthetic remedies that have vindicated their claims to usefulness have been included in the text. A new Chapter on the Commoner Intoxications has been added and each chapter has been revised and amplified to correspond to the progress made in Therapeutics since the appearance of the last (third) edition. This implies the addition of over 100 pages to the text.

The Index has been enlarged by many items and a Clinical Index prepared for more ready orientation. I am much indebted to Miss S. S. Phelps for this labor.

Alfred C. Croftan.

CHAPTER I. Infectious Diseases Page 17

Prophylactic Injections. — The Treatment of Fever. Typhoid Fever. Pneumonia. Diphtheria. Malaria. Acute Articular Rheumatism. Dysentery. Influenza. Pertussis. Parotitis. Scarlet Fever. Smallpox. — Vaccination. — The Incubative Stage. — The Stage of Invasion. — The Eruptive Stage. — The Stage of Desiccation. Yellow Fever. Hydrophobia. Cholera. Plague. Streptococcus Infections. Staphylococcus. Anthrax. Colon Bacillus. Epidemic Cerebro-Spinal Meningitis. Pulmonary Tuberculosis. Syphilis.

CHAPTER. II. Diseases of the Blood Page 151

The Anemias. Progressive Pernicious Anemia. Spinal Anemia. Chlorosis. Leukemia. Pseudo-Leukemia. The Hemorrhagic Diathesis. Scurvy. Hemophilia. Purpura.

CHAPTER III. Diseases of Metabolism Page 187

The Laws of Nutrition. Diabetes Mellitus. — Dietetics of Diabetes of Medium Severity. — Dietetics of the Severe Type of Diabetes. — Medicamentous Treatment of Diabetes. — Exercise in Diabetes, — Treatment of the Complications and Sequelae of Diabetes. — Prophylactic and Causal Treatment in Diabetes. Obesity. — The Dietetic Treatment of Obesity. — The Science of Reduction Cures. — The Art of Reduction Cures. — Rheumatism. — Muscular Rheumatism. Chronic Rheumatism and

XIV TABLE OF CONTENTS

Bheumatoid Arthritis. Gout and Uric Acid Diathesis. Eetrocedent Gout — The Acute Attack of Gout. Osteomalacia. Diabetes Insipidus.

CHAPTEE IV.

Diseases of the Circulatory Apparatus Page 273

The Heart and its Membranes. Valvular Diseases of the Heart. — Treatment of Compensated Valvular Lesions of the Heart. — The Treatment of Valvular Diseases of the Heart with Failing or Broken Compensation. — Symptomatic Treatment of Stasis in Different Organs due to Decompensated Valvular Lesions. Treatment of Cardiac Dropsy and Edema. Myocarditis and Fatty Degeneration of the Heart. Acute Endocarditis. Pericarditis. The Arteries. Arterio-sclerosis and Chronic Aortitis. Aneurism of the Aorta. Neuroses of the Heart. Angina Pectoris. Palpitation. Arrhythmia.

CHAPTER V. Diseases of the Ductless Glands Page 327

Organotherapy: Historical Eeview and Critique. Diseases of the Thyroid Gland — M}^xedema and Cretinism. Exophthalmic Goitre. Simple Goitre. Addison's Disease.

CHAPTEE VI.

Diseases of the Urinary Apparatus Page 343

Nephritis, Acute Nephritis, Chronic Nephritis and Bright's Disease. Pyonephrosis and Pyelitis. — The Treatment of Pyelitis by lavage of the Eenal Pelvis. Nephrolithiasis. Nephrolithiasis Urica. Nephrolithiasis Oxalurica. Nephrolithiasis Phosphatica. Floating Kidney. Uremia. Diseases of the Bladder and Urethra. Cystitis. Acute Urethritis. Gonorrheal Urethritis. Prostatitis. Epididymitis. Cowperitis. Infection of the Para and Periurethral Ducts. Spermatocystitis. Bartholinitis. Gonorrheal Vulvovaginitis. Infectious Urethritis of Non- Gonorrheal Origin.

TABLE OF CONTENTS XV

CHAPTER VII. Diseases of the Mouth and Upper Air Passages Page 431

Diseases of the Buccal Cavity. Stomatitis. Gingivitis. Tonsillitis. Diseases of the Nose and Throat. Acute Rhinitis and Pharyngitis — Treatment of the Acute Attack. Coryza Vasomotoria and Hay Fever. Epistaxis. Acute Laryngitis.

CHAPTER VIII. Diseases of the Bronchi Page 453

Acute Tracheo-Bronchitis. Chronic Bronchitis and Bronchiectasis. Bronchiectasis. Bronchial Asthma. Capillary Bronchitis. Broncho-Pneumonia.

CHAPTER IX. Diseases of the Lungs and Pleura Page 471

Pulmonary Emphysema. Pulmonary Edema. Pulmonary Infarct, Abscess and Gangrene. Hemoptysis.

CHAPTER X. Diseases of the Digestive Apparatus Page 499

The Stomach. Acute Gastritis. Chronic Gastritis — The Use and Abuse of Hydrochloric Acid — Drugs in Chronic Gastritis — The Use of Digestive Ferments. Gastric Ulcer. Carcinoma of Stomach. Motor Insufficiency of the Stomach. (Gastric Dilatation, Gastric Ecstasy, Gastric Atony.) Gastric Hypersecretion and Hyperchlorhydria. Gastric Hypersecretion and Achylia Gastrica. Gastric Neurosis. Motor Neurosis. Secretory Neurosis. Sensory Neurosis.

CHAPTER XL

Diseases of the Intestine and Peritoneum Page 573

Acute Intestinal Catarrh. Chronic Intestinal Catarrh.

Intestinal Stenosis and Occlusion. Intestinal Ulcer.

- Membranous Enteritis and Mucous Colic. Chronic

XVI TABLE OF CONTENTS

Constipation. Diarrhea. Flatulency (Meteorism). Intestinal Parasites. Hookworm Disease ( Ankylostomiasis, Uncinariasis). The Peritoneum. Acute Diffuse Peritonitis. Acute Circumscribed Peritonitis, Perityphlitis, Appendicitis.

CHAPTEK XII.

Diseases of the Liver and Bile Passages Page 649

Catarrhal Jaundice. Chronic Inflammation of the Liver. Cholelithiasis — Treatment of the Acute Attack. Cholangitis and Cholecystitis.

CHAPTER XIII.

The Commoner Intoxications Page 671

Aconite. Alcohol. Alum, zimmonia. Amyl Nitrite. Antimony. Antipyrin. Arsenic. Atropine. Barium. Bee Stings. Belladonna. Botulism. Bromide. Bromin. Bromoform. Calcium. Carbolic Acid. Carbon Dioxide. Carbon Monoxide. Cheese Poisoning. Chloral Hydrate. Chlorate of Potash. Chlorin. Chloroform. Cocaine. Colchicin. Corrosive Sublimate. Digitalis. Ergot. Ether. Fish. Food. Heat Prostration. Hydrochloric Acid. Hydrocyanic Acid. Hyocyamin. Illuminating Gas. Iodides. Iodine. Iodoform. Lead. Lime Salts. Mercury. Morphine.

Mushrooms. Nitroglycerin. Nux Vomica. Opium. Oxalic Acid. Oysters. Phosphorus. Pilocarpin. Prussic Acid. Quinine. Salicylates. Salicylic Acid. Silver. Silver Salts. Snake Bite. Strophanthus. Strychnia. Sun Stroke.