SUBSEQUENT HISTORY OF APPAR

ENTLY CURED CASES FROM

THE AREQUIPA SANA

TORIUM

Philip King Brown writes of the peculiar plan and function of the Arequipa Sanatorium for Wage Earning Women and the results thus far attained. Impressed by the fact that tuberculosis is quite as much a social problem as a medical one, the Arequipa Sanatorium planned so as to put great emphasis on all that pertained to the lives of its members and not merely on the tuberculosis. Three organizations are centered in the Sanatorium: one that takes up the problems of the applicants and begins the work with them before admission to the sanatorium; the sanatorium proper; and a committee that follows the women who need a change of job or work for the first time and that follows them year in and year out after they leave. Unusual endeavors are directed to the patient's mental state that this may be as comfortable as the physical well-being. The net result of the work is that 68 per cent of first stage cases have been back at work from one to five years; and 41 per cent of second stage cases as well.

Brown, Philip King. The Subsequent History of cases discharged "Apparently cured" from the Arequipa Sanatorium for Wage Earning Women during Six Years. American Review of Tuberculosis, February, 1919. Vol. II, No. 12.

CHEMICAL FOODS

There are probably few physicians in active practice who are not more or less familiar with, at least, the name of Fellows' Syrup of Hypophosphites. This valuable product has been prescribed by the medical profession for years. Its actual clinical value has been demonstrated too often and in too many hands to admit of any doubt or question. It is worthy of note, however, that

are.

much stress is being laid upon the value of those mineral constituents of foods to which the name has been given of "Chemical Foods," such as calcium, potassium, iron, and manganese which are all actually needed by the body quite as much as proteins or carbohydrates When deprived of a sufficiency of such "Chemical Foods," metabolism suffers. Therefore, to supply such "Chemical Foods" is a logical therapeutic measure, and to supply them in the form of Fellow's Syrup of Hypophosphites is not only logical but valuable because, in addition, the dynamic and cell activating properties of quinine and strychnine are also secured.

"Chemical Foods" and their uses have been briefly described in an interesting booklet issued by the Fellows Medical Manufacturing Co., Inc., New York, and copy of this booklet, together with samples of Fellows' Syrup, will be sent to any physician on request.

ARTIFICIAL PNEUMOTHORAX IN TUBERCULOUS PNEUMONIA.

H. F. Gammons, of Deerwood, Minn., reports a case treated by artificial pneumothorax which showed tuberculous pneumonia on the left and a few scattered rales in the right lung. The manometer showed a free pleural space with negative pressure. Twelve injections of air were given from April 27th to July 2nd in quantities of from 300 to 650 cc. and iron citrate hypoder mically every other day. The temperature immediately dropped from 102.6 to normal and remained so with a few exceptions of a fraction of a degree elevation. Cough and expectoration began to diminish gradually. At the time of the report cough and expectoration were absent, haemoglobin was 85% and red cells 6,000,000 per cmm. The patient walked to meals. Physical examination showed complete collapse of left lung and slight displacement of the heart on the right. The right lung was apparently inactive. Weight 125

pounds. It was felt that the pathological condition did not offer a mechanical barrier to complete collapse and stoppage of lymphatic circulation and that the infection probably followed an eruption of numerous caseous tubercles into the bronchial tubes of the left side from which by gravitation and aspiration the bacilli were scat tered in all of the alveoli of the lung at the base. As a prophylactic measure for ulcerative cases, especially bed cases with profuse expectoration, postural treatment to favor drainage would seem to be a logical procedure. Gammons, H. F.: Artificial Pneumothorax in Tuberculous Pneumonia, Am. Rev. Tub., 1918, Vol. II, No. 8.

EFFECTS OF TYPHOID FEVER AND ΑΝΤΙΤΥPHOID IMMUNIZATION ON PULMONARY TUBERCULOSIS

In the summer of 1917 a typhoid fever epidemic occurred at the Trudeau Sanatorium. Thirteen patients and two maids developed typhoid fever. Since the thirteen patients were all suffering from pulmonary tuberculosis in a more or less active form the opportunity was given to study the interacting effects, if there were any, between the two diseases. As soon as the presence of the epidemic was appreciated, antityphoid inoculation was performed on 124 tuberculosis patients at the sanatorium. The authors, Brown, Heise, Petroff and Wilson, report the results of their studies on these tuberculosis patients who had typhoid fever or prophylactic inoculation, and the deductions to be drawn therefrom. Results are tabulated in five tables and detailed case reports of every typhoid fever patient are appended at the end of the study.

Among the more important conclusions worked out by the authors are the following:

Inactive pulmonary tuberculosis exerted no appreciable effects upon the

course of the typhoid fever, but as the two deaths from typhoid fever occurred among those with active pulmonary tuberculosis, it appears possible that active pulmonary tuberculosis may influence the typhoid fever and render recovery less likely.

Typhoid fever does not influence inactive pulmonary tuberculosis and apparently also does not affect active pulmonary tuberculosis.

Antityphoid inoculations did not apparently influence the inactive pulmonary tuberculosis. No permanent untoward results followed in any case.

The immediate results of treatment in patients receiving antityphoid inoculations differed in no way from the immediate result obtained in two other years when such inoculations were not given.

Brown, Lawrason, Heise, F., H. Petroff, S. A., and Wilson, George E. A study of the Effects of Typhoid Fever and Antityphoid Immunization on Pulmonary Tuberculosis. History of a Typhoid Fever Epidemic at the Trudeau Sanatorium. American Review of Tuberculosis, February, 1919. Vol. II, No. 12.

Southern California

PRACTITIONER

$1.00 PER YEAR 1414 S. Hope St. Los Angeles

lactic meas

specially bed oration, pos

yphoid fever rudeau Sanats and two Fever. Since all suffering is in a more ortunity was ting effects, the two dissence of the antityphoid 1 on 124 tusanatorium. - Petroff and ts of their osis patients prophylactic ctions to be are tabulated case reports tient are apady.

tant conclu

thors are the

erculosis ex

ts upon the

monary tuberculosis.

Antityphoid inoculations did not apparently influence the inactive pulmonary tuberculosis. No permanent untoward results followed in any case.

The immediate results of treatment in patients receiving antityphoid inoculations differed in no way from the immediate result obtained in two other years when such inoculations were not given.

Brown, Lawrason, Heise, F., H. Petroff, S. A., and Wilson, George E. A study of the Effects of Typhoid Fever and Antityphoid Immunization on Pulmonary Tuberculosis. History of a Typhoid Fever Epidemic at the Trudeau Sanatorium. American Review of Tuberculosis, February, 1919. Vol. II, No. 12.

Southern California

PRACTITIONER

$1.00 PER YEAR 1414 S. Hope St. Los Angeles

SOUTHER PRAC

BY GEO. E. MALSBARY, M.D., ROE

The history of X-Ray therapy tensely interesting, and the subje not yet entirely emerged from th gerous chaos of the early work the more safe and efficient, exa standardized methods of the workers. The earlier workers ( realize the dangers of the ra Mok practically no precautions them, with the awful result of injury to many excellent burns innumerable among th tients. Thus X-Ray therapy cam falling into disrepute. With th nition of the possibility of dang the use of the X-Ray came the tion of precautions against the gers, with greater perfection in apparatus, so that the X-Rays der absolute control and the po of accidental burn or other da been eliminated.

me

In the galaxy of those w made rational X-Ray therapy ble, the names of Roentgen, S1 Coolidge are prominent. gave us the X-Ray, withou X-Ray therapy would be in Snook perfected the transfor fording us an ample supply

No. 6

X-Ray therapy is ing, and the subject has merged from the danthe early workers to d efficient, exact and hods of the modern rlier workers did not ers of the rays, and no precautions against wful result of serious excellent men, and ■le among their paCay therapy came near pute. With the recogibility of danger from -Ray came the instituns against those danr perfection in X-Ray _t) the X-Rays are unrol and the possibility n or other danger has

of those who have Ray therapy practicaRoentgen, Snook and rominent. Roentgen -Ray, without which would be impossible. the transformer, afmple supply of high

tension current for the production of X-Rays. Coolidge perfected the tube that enables us to use the X-Rays in massive and exact dosage. So long as the supply of high tension current was insufficient or inconstant, it was impossible to secure X-Rays that would give the best results in therapy. And with the old gas tubes there is so much fluctuation in vacuum that anything satisfactorily approaching a standardization of therapy is impossible, So that modern X-Ray therapy must date from the use of the Coolidge tube, which first gave us an ample supply of X-Rays under absolute control.

In gathering statistics on X-Ray therapy, much of the earlier work is of little value, because the apparatus used was inefficient, the danger of burns was great, and the work was incapable of standardization.