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Philippine Islands, Manila July 28 — Aug. 4- Provinces July 28-Aug. 4 ■ . ■ CHOLERA FOREIGN. India, Bombay Aug. 14-28. Calcutta Aug. 4-17... Madras Aug. 4-17... Rangoon .^ug. 11-18. , 38 731 30 ,';34 8g 8 19 PLAGUE — INSULAR. Vibramycin Hyclate Hawaii, Honohilu Aug. 1S-2S PLAGUE — FOREIGN. Brazil, Rio de Janeiro Aug. 1 2-Sept. 2. . Pemambuco Aug. i-iS- Egypt, Alexandria Aug. 28-20 Suez Aug. 24-25 India, General July 28-Aug. 1 1 . Bombay Aug. 14-28 Calcutta Aug. 4-11 Karachi Aug. 12-26 Rangoon Aug. 4-18 Japan, Formosa Aug. Vibramycin Syrup 10-20 Vibramycin Antibiotic Peru, Lima Aug. 18-25 Mollendo Aug. 18-25 Paita Vibramycin Indications .\ug. 18-25 167 61 20s 3 4 Medical Record 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. Original Artirlpa. THE BATH TREAT.MExXT OF TYPHOID FEVER OF PRIVATE PRACTICE.* Bv SIMON BARUCH. .M.D.. NBW VORK. 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 562 MEDICAL RECORD. [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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