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A Weekly Journal of Medicine and Surgery
Vol. 70, No. J5.
Whole No. J875.
New York, October 13, 1906.
$5.00 Per Annum.
Single Copies, tOc.
THE BATH TREAT.MExXT OF TYPHOID
FEVER OF PRIVATE PRACTICE.*
Bv SIMON BARUCH. .M.D..
li- the choice of title of this paper devolved upon
myself it would read "The Bath in Typhoid
Fever." It has long been my contention that the Order Vibramycin Online
expression "treatment of fever" should Vibramycin 50mg be rele-
gated to the Purchase Vibramycin Online past, because the modern physician
no lonj^er treats the fever, l)ut the patient.
In the maiiat;cment of a case of typhoid fever
the chief aim of the well-informed clinician is the
enhancement of the ])atient's resisting capacity
to the toxemia which menaces his life, .\bundant
observation at the beilside made by many physi-
cians in hospital and ])rivate practice in various
countries has established the fact that the chief
lethal element in this disease arises from toxemia,
and that in proportion to the intensity Vibramycin Acne of this
toxemia is the prognosis of each case ; the extent
to which the vital organs are afTected by the toxic
agents set free in the blood by the pathological
factors introduced into the system governs the
outcome of the case. The damage sustained Vibramycin Antibiotics by
the nerve centers which preside over the life-
sustaining functions of the organism is the meas-
ure by which we are forced to gauge the Buy Vibramycin Online mildness
or severity of a case of typhoid fever.
In the mild cases the action of the toxic mate-
rial is as obviously upon the nervous system as it
is in the more severe types, as is evident in the
apathy which finds expression in headache, dull-
ness of intellect, shallow respiration, diminished
pulse tension, and depreciated secretory and ex-
cretory action. When the system is overwhelmed
')y these toxic agents the manifestations pointing
to involvement of the central nervous system are
uinre pronounced: delirium, coma vigil, subsultus
tendinum. cyanosis, elevated temperatures, stu-
por, cardiac failure indicated by feeble, dicrotic,
and rapid pulse : hypostatic congestions, sleepless-
ness, renal insufficiency with its resulting diminu-
tion in the quantity and toxicity of the urine —
these point unerringly to a seriously crippled
nervous system. This is the broad gateway lead-
ing to the dissolution of the vital machinery. To
inhibit the latter, we must sustain, refresh, nour-
ish the former : whenever and wherever the ner-
vous .system is threatened the medical attendant
must be alert and ready to meet the attack. This
is the lesson of the bedside as I have learned it
from many a hard-fought battle with this, alas
biit too prevalent, disease. I have learned it sadly
from many a defeat, and I have learned it gladly
from many a victory.
How much the bath has contributed to Buy Cheap Vibramycin my vic-
* Read by invitation at a meeting of the Medical Society
"f Vibramycin Doxycycline Hyclate the County of New York. September 21. 1906.
tories during the past twenty-five years of prac-
tice and how much previous unfamiliarity with
this remedial agent has led to defeat is so deeply
engraved upon my mind that I would be derelict
to duty as a physician were I to permit any occa-
sion for expression of the plain and incontroverti-
ble experience it has been my privilege to gather
in hospital and private practice Vibramycin Mg to pass. That Vibramycin For Acne I
was long a sceptic on the value of the bath in
tyi)hoid fever may not seem a correct statement
of fact to those who have so often heard me in
the.se halls as a persistent and ardent advocate.
My conversion was not sudden, but an evolution
of bedside observation. Well do I remember a
note from the lamented Brand of Stettin in which
he twitted me with the statement I had made in
the Academy of Medicine that "the Brand method
may be adapted to the robust German soldier, but
that the .American would not be a favorable sub-
ject for so heroic a measure."
It is an erroneous habit of the physician to trust
entirely to experience in accepting a therapeutic
agent. Hippocrates himself has said "Art is long,
life is short, judgment diflficult, experience falla-
cious." The dark ages of medicine were the
times when experience alone was the guide to
practice; the brilliant achievements of modern
medicine are coeval with the rise and progress
of Generic Vibramycin enlightened pathology, and a therapeusis based
upon the latter and upon a correct rationale of
the action of the remedies applied.
So long as the principal testimony in favoi of
the bath was derived from the statements of the
empirics who boasted of their experience with
water, it failed to appeal to my judgment. When,
however. Brand demonstrated that the Vibramycin Suspension action of
the bath in typhoid fever was based upon a ra-
tionale derived from its physiological action as a
thermic and mechanical irritant— a rationale first
insisted upon by Winternitz and his school— and
when this clear rationale was substantiated bv
large statistical material, the evidence became
overwhelming that the bath constituted a most
important therapeutic agent in this disease.
.\lthough the cold bath had long been applied
in fevers with more or less success (usually the
latter), it remained for Ernst Brand to insist that
the cold bath was not valuable because of its
antithermic efTect, but by reason of its action as
a sustaining agent of the crippled nervous sys-
tem, ani th.it when properly executed and applied
early the bath was a prophylactic against all the
lethal conditions which existed in tvphoid fever.
It was Brand who insisted, despite strongest op-
position and scepticism, that treating the lethal
complications arising in this disease symptomati-
cally was a fatal error, to which the enormous
mortality of the disease may be traced Vibramycin Tablets quite
often. It was Brand who taught the fatal fallacy
of treating temperature elevation by the bath or
otherwise : it was he who taught us the inestimable
value of friction during the bath. For these and
[Oct. 13, 1906
other reasons upon which the enormous benefi-
cence of tlie Brand method and its superiority
over all bath methods is based, for the persistence,
earnestness, courage, love of his kind, for the
polemic ability and logical brilliancy with which
he battled for his method for Vibramycin Cost thirty years, Ernst
Brand is entitled to be regarded as one of the
benefactors of mankind.
While I still regard Order Vibramycin this well-thought-out and
practically-demonstrated method as the ideal
treatment of a large proportion of cases of typhoid
fever in private practice, and while I still believe
that this method is more applicable in private
than in hospital practice, by reason of the latter
usually being admitted too late to obtain its chief
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