3AS1C PATH 
 
 OLOC 
 
 IFIC TREATMENT 
 
 DIPHTHERIA, TYPHOID, AND ALLIED DISEASES 
 
 LIBRARY OF CONGRESS 
 
 OOOIOQH^ 42 
 
LIBRARY OF CONGRESS. 
 
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 UNITED STATES OF AMERICA. 
 
THE 
 
 BASIC PATHOLOGY 
 
 AND 
 
 SPECIFIC TREATMENT 
 
 OF 
 
 DIPHTHERIA, TYPHOID, ZYMOTIC, SEPTIC, 
 
 SCORBUTIC, AND PUTRESCENT 
 
 DISEASES GENERALLY. 
 
 BY 
 
 GEO. J. ZIEGLER, M. E> 
 
 Late Physician to the Philadelphia Hospital; Member of the Philadel- 
 phia County Medical Society, of the American Medical Association, 
 etc. Author of " Zoo-adynamia," " Researches on Nitrous 
 Oxide," "Natural Laws of Marriage," etc. 
 
 ^V 
 
 >ioyo~G 
 
 PHILADELPHIA : 
 
 O- BO. T- ZIEG-LEE, ZMI. ID. 
 1884. 
 
*% 
 
 < 
 
 v^ 
 
 Entered according to Act of Congress, in the year 1883, by 
 
 GEO. J. ZIEGLER, M. D., 
 
 In the Office of the Librarian of Congress, at Washington, D. C. 
 
PREFACE 
 
 In the following pages I have endeavored to present 
 a general summary of the basic pathology and specific 
 treatment of some of the most formidable and destructive 
 diseases that afflict and destroy mankind and the lower 
 animals, for they are directly linked in one continuous 
 pathological as well as physiological chain of life. I 
 have therein tried to show that all the varied and com- 
 plex diseases classed as scorbutic, necrsemic, typhoid, 
 zymotic, septic, infectious, malarial, gangrenous, pu- 
 trescent, and allied affections, by whatever name desig- 
 nated, from the simplest to the most malignant, are 
 dependent upon, or complicated with, one common 
 basic, alkaline, pathogenic factor, mostly the volatile or- 
 ganic alkali — Ammonia, incidental to all forms of life, 
 and differing only in quantity and the constitutional 
 and local manifestations and complications arising from 
 diverse aetiological and pathological conditions, yet 
 underlying and intensifying them all, and thus often 
 complicating and rendering more severe every form 
 of disease, even of the simplest kind, for the successful 
 treatment of which, this primal morbific factor must 
 be decomposed, neutralized, or removed, which can 
 usually be readily effected by acidulous, antalkaline, 
 resolving, and counteracting agents, thus simplifying 
 the hygienic and therapeutic problems in general, and 
 giving more definiteness and certainty to sanitation 
 and therapeutics, or both preventive and curative 
 medicine. 
 
 (3) 
 
Thus, the recognition and subversion, or neutraliza- 
 tion and elimination of this one common alkaline 
 factor of disease, pestilence, and death, inherent in the 
 vital economy, as well as derived from extraneous 
 sources, cannot fail to improve the health and greatly 
 facilitate the prevention and resolution or cure of 
 disease of all kinds, especially those typhoid, septic, 
 zymotic, contagious and malignant maladies directly 
 occasioned thereby, that so largely endanger and de- 
 stroy the lives of human beings and the inferior 
 creatures. With the special agents for this purpose, 
 I have also briefly considered its collateral relations and 
 morbific complications, with the particular remedies 
 and measures indicated for the prevention and treat- 
 ment of these diseases, both simple and complex. 
 
 I have thus embodied in general, the results of my 
 own observations, experience, and studies thereon, with 
 confirmatory evidence from other sources, believing 
 them to be correct and in direct accord with science 
 and truth. But as individual observation, experience, 
 and effort are necessarily limited, I present them for 
 the serious consideration of the medical profession, 
 and the severest practical test to which they can be 
 put in every way in hospitals and sanitaria for the 
 sick, as well as in private practice, and in quarantine, 
 and elsewhere throughout the world, for preventive 
 and curative purposes ; believing that both directly 
 and indirectly their practical application will result in 
 great good in the prevention and cure of some of the 
 most malignant and devastating diseases, with the 
 minor "ills to which flesh is heir," that so sorely 
 scourge and destroy human beings with the inferior 
 forms of life. 
 
As it would, of course, require a large volume to 
 treat of these subjects in extenso, I have merely pre- 
 sented a general outline of the main points and basic 
 principles of the most practical importance in a hy- 
 gienic and therapeutic point of view, to more directly 
 concentrate attention thereon and better enable sanita- 
 rians and physicians to avert, counteract, and resolve 
 these morbific plagues with their concomitant evils. 
 
 Philadelphia, November 15, 1883. 
 
CONTENTS. 
 
 Page 
 
 Preface, 3 
 
 I. Introduction, 7 
 
 II. J3TIOLOGY AND PATHOLOGY, 11 
 
 III. Treatment, 70 
 
 IV. External Treatment, 157 
 
 V. Prevention, 161 
 
 VI. Conclusions, 194 
 
THE 
 
 BASIC PATHOLOGY 
 
 AND 
 
 SPECIFIC TREATMENT 
 
 OF 
 
 Diphtheria, Typhoid, Zymotic, Septic, Scorbutic, 
 Putrescent, and Mephitic Diseases Generally. 
 
 I. 
 
 INTRODUCTION. 
 
 The treatment of diphtheria, typhoid, zymotic, 
 scorbutic, septic, putrescent and correlative diseases, 
 like all other morbid states, must necessarily be based 
 upon their basic and true pathology, and although a 
 knowledge of this is most desirable for the greatest 
 certainty in the application of remedial measures, 
 yet, independent thereof, much practical information 
 of therapeusis may be acquired by enlightened obser- 
 vation, experiment, and practice, as well as the more 
 purely empirical and tentative treatment, or the 
 casual juvantia and lsedentia, especially if supple- 
 mented with logical induction and deduction, and this 
 too, even when the aetiology and pathology of any 
 disease is most obscure and undetermined, as shown 
 for instance, in the empirical discovery of the very 
 general specific effects of cinchona bark with its prin- 
 cipal alkaloid, quinia, in the prevention and cure of 
 
 m 
 
BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 intermittent and other malarial fevers, though the 
 materies morbi and pathology thereof are so indefinite 
 and occult. 
 
 The same holds true in diphtheria with other zymotic 
 and septic diseases, for though their precise aetiology 
 and pathology may not be fully known, yet a definite 
 amount of information thereon has been practically 
 acquired, while clinical experience teaches certain 
 truths with regard to their successful treatment based 
 upon scientific principles and practice as well as em- 
 pirical effort and unenlightened observation, so that 
 these latter are not to be entirely disregarded, as they 
 sometimes afford valuable data for accurate induction 
 and correct treatment. But in the meantime, while 
 the exact aetiology, pathology and treatment of these 
 formidable diseases are still so largely sub judice, 
 reasoning in a scientific spirit, based upon personal 
 and professional, with general observation and ex- 
 perience, cannot fail to greatly aid in the solution of 
 these truly vital problems. 
 
 In scientific medicine theory precedes and directs 
 practice; while in empirical effort practice precedes 
 intelligent thought, and is but tentative and experi- 
 mental at the best, as it can only prove accidentally 
 useful and of most value when carefully conducted 
 in an inductive spirit, but if at random, without due 
 discretion and judgment, will ensue in hap-hazard and 
 destructive rather than in beneficent results. Hence, 
 the most extensive experience without due thought 
 and reflection is but reckless empiricism and usually 
 more injurious than beneficial, for truly "if experi- 
 ence is not directed by theory it is blind," says Bacon, 
 and necessarily more or less confusing if not mislead- 
 ing, as is often exemplified in the empirical treatment 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 9 
 
 of disease and all other matters. Indeed, purely em- 
 pirical experience is like a lamp without a light, it is 
 an inert or dead fact that has the basis but not the 
 principle of light within it, yet which when lighted 
 illuminates everything around it and enables those 
 that can see to direct their work and movements with 
 the greatest precision and certainty, instead of other- 
 wise floundering about in the dark tentatively and 
 often injuriously or even destructively to themselves, 
 things and persons about them. Thus theory is a 
 light and compass that enlightens and directs practice, 
 and establishes a scientific and positive, for an empiri- 
 cal and doubtful art of hygiene and therapeutics in 
 the prevention and treatment of disease. In fact 
 then, for scientific accuracy and positive certainty, 
 theory, thought or deduction must precede practice 
 in medicine as in every other branch of knowledge 
 having the slightest claims to the title of science and 
 scientific art; pure empiricism being but a series of 
 blind or random experiments that maims and kills 
 oftener than cures, and long before even logical in- 
 duction will guide to correct practice. Indeed, it is 
 only by the union of the two co-ordinate systems of 
 induction and deduction that the highest results can 
 be secured so as to develop a true science and art of 
 medicine — culminating in hygiene and therapeutics, 
 the ultimate expression thereof. Legitimate deduc- 
 tion will as surely lead aright to correct conclusions, 
 practice, and discoveries in medicine as it directed 
 Leverrier to the knowledge and discovery of a new 
 planet, and it matters not whether the medical any 
 more than the astronomical discoverer is the practical 
 demonstrator of his own cognitions, the truth and 
 honor are the same in either instance. Hence, from 
 
 B 
 
10 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 facts to principles, and from theory to practice, should 
 be the rule in medicine as in all other branches of 
 science, to insure a scientific art of sanitation and 
 rational methodus medendi, or true system of preventive 
 and curative medicine. 
 
 But as in general, both inductively and deductively, 
 individual thought, investigation and experience must 
 necessarily be limited, it is usually far better to regard 
 the combined observations, experience, experiments, 
 and cognitions of the many as most apt to lead to correct 
 conclusions and practice. Therefore, taking as a basis 
 the observations, experience and knowledge in general, 
 with my own limited investigations and cognitions 
 thereon, I venture to present the following views 
 respecting the aetiology, pathology, prevention and 
 treatment of diphtheria, typhus, cholera, zymotic, 
 septic, infectious, scorbutic, putrescent, mephitic, colli- 
 quative and cognate diseases generally, believing them 
 to be founded upon truth and the immutable laws of 
 nature, hence must necessarily be correct and successful 
 in the degree that they are properly applied. With a 
 view then to a clearer exposition of the specific means 
 for the prevention and treatment thereof, I will first 
 briefly present a general outline of the basic source 
 and proximate — if not often the immediate — cause of 
 these destructive maladies as manifested in their 
 etiology and pathology, from the standpoint of my own 
 observations, experience and studies, with confirma- 
 tory evidence from other sources. 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES, 11 
 
 II. 
 
 ETIOLOGY AND PATHOLOGY. 
 
 While in general, abnormal departures from the 
 normal standard of health are spontaneous from 
 various non-specific intrinsic and extraneous causes, 
 in some there are more immediate special exciting 
 influences or specific contagia, vet in all these varied 
 though correlative maladies there seems to be one 
 common basic morbific factor, promotive of the incep- 
 tion and malignancy of the diverse scorbutic, zymotic, 
 septic, putrescent, contagious, colliquative, adynamic 
 and cognate diseases generally, both constitutional 
 and local. This may be engendered within or be in- 
 troduced from without the vital economy, or be ab- 
 normally increased therein by both. It is of an 
 alkaline nature, resulting from general organic trans- 
 formation and decomposition in both plants and 
 animals, and without which the specific contagium 
 or exciting cause in each case, whatever it may be, 
 could not develop and act upon the living organism 
 with such intensity and deadly effect as usual in 
 zymotic, infectious and septic diseases, while in some 
 it may be the sole pathogenic factor developing 
 spontaneously various scorbutic, toxic, putrescent 
 and adynamic diseases of a milder type which are, 
 however, the basis of the more malignant and con- 
 tagious diseases, the intensity, variety and complica- 
 tions thereof depending upon its quantity. It is thus in 
 fact a veritable fons et origo mali, and gives the type of 
 malignancy to all diseases, local as well as general. 
 This is strikingly manifested in scurvy, purpura, 
 
12 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 necrseniia and typhus, as well as in all other septic 
 and infectious diseases arising from the ordinary 
 conditions of life, notably erysipelas, which may be 
 idiopathic or be excited by the slightest bruise or 
 scratch whenever the susceptibility or superalkaline 
 condition of the blood and system exists. This is 
 likewise the case in ship, and doubtless also in yellow, 
 congestive, malarial, and all other malignant fevers, 
 with diphtheria, the exanthemata and the scorbutic 
 type, necrsemic tendency, putrid, typhoid, infectious, 
 and dissolutive crasis of diseases generally, as all the 
 symptoms thereof point to this general basic superal- 
 kaline condition of the blood and economy, while 
 investigation has demonstrated it to a certain extent. 
 This common basic morbific alkaline agent of all 
 such diseases is the well-known organic alkali — 
 Ammonia, which is being constantly engendered 
 spontaneously within the living organism from the 
 combination of its constituent elements in the chemi- 
 cal reactions and normal disintegration of the com- 
 ponents of the body, and often in excess from heat, 
 undue effort and other active causes of organic 
 decomposition, as well as excessive accumulation 
 therein from its abnormal retention within the vital 
 economy. It may also be more or less freely 
 introduced from without the system by imbibition 
 in impure water, and the direct inhalation of its vapor 
 extraneously engendered, or its evolution from various 
 malarious, decomposing and putrefying substances, as 
 it is highly volatile, especially when influenced by 
 heat and moisture, which are so active in tropical 
 climates and warm weather, and in close, hot and 
 moist places everywhere. 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 13 
 
 Thus, in general, in all these varied scorbutic, 
 typhoid, zymotic, septic, pyretic, malarial, infectious, 
 putrescent, colliquative, and allied diseases, there is 
 this one common basic, underlying and omnipresent 
 morbific factor of an excess of the volatile organic 
 alkali — Ammonia, either generated or retained unduly 
 within, or introduced from without the body, or all 
 combined according to circumstances, of itself en- 
 gendering and superinducing a scorbutic, necrsemic, 
 colliquative, pyrexial, phlegmonous, typhoid, mephitic, 
 infectious, and malignant type of disease. This am- 
 monsemia or superalkaline condition of the blood and 
 system, thus induces an undue solution and fluidity 
 of the liquids, and softening of the solids of the body, 
 with scorbutic, necraemic, toxic, septic, phlogistic, 
 febrile, contagious, adynamic, and decomposing con- 
 ditions, and tendency to serous and albuminous states 
 and defluxions, congestions, haemorrhages, inflamma- 
 tions, eruptions and other local lesions, as well as con- 
 stitutional disorders of a mixed sthenic and asthenic 
 type, and of a putrescent, infectious, gangrenous, dis- 
 solving and disorganizing character, especially mani- 
 fested in typhus, ship, yellow, congestive, bilious, 
 enteric, puerperal and other low fevers, with small-pox, 
 scarlatina, measles, diphtheria, angina maligna, apthae 
 and gangrene of mouth, throat, lungs and other parts, 
 anthrax and carbunculoid affections, erysipelas, in- 
 flammation and abscess of liver, haematemesis, hema- 
 turia, albuminuria, anasarca, lencorrhoea, diarrhoea, 
 choleraic, suppurative, and other serous, haemorrhagic, 
 lymphoidal, catarrhal and purulent fluxes, with ady- 
 namic, febrile and malignant forms of typhoid, zymotic, 
 septic, contagious, mephitic and colliquative diseases 
 
14 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 generally, which are specially manifested according to 
 complicating circumstances. 
 
 That this ammoniacal and superalkaline condition 
 of the blood and system is a potent underlying mor- 
 bific factor, and an active exciting, as well as predis- 
 posing cause of all such diseases is manifest from all 
 their correlative phenomena and general nature, 
 though it has also been largely demonstrated by obser- 
 vation and experience, as well as by practical thera- 
 peutics, a brief outline of which I will present in 
 confirmation thereof, with a view to their direct 
 application to the prevention and curative treatment 
 of these toxical, disorganizing, contagious, pestiferous, 
 and destructive maladies, with the minor scorbutic and 
 mephitic disorders. 
 
 Thus, according to Dr. Waring {Practical Therapeutics), 
 "Hufeland observes that the officinal and probably all 
 the salts of ammonia have the property to a greater 
 or less degree of dissolving the blood-corpuscles, 
 although slowly, and the protean textures generally. 
 When blood is combined w r ith an ammoniacal salt, it 
 acquires generally a brighter red, but this soon passes 
 into a brownish red hue; it does not coagulate, but 
 forms at best, a loose semifluid cruor, the corpuscles 
 begin to disappear, and the whole becomes more limpid. 
 Blood thus decomposed, progressively evolves distinct 
 traces of ammonia. It is very probable that we may 
 partially explain, upon chemical grounds (solution and 
 disengagement of ammonia), why large doses of 
 hydrochlorate of ammonia act as poisons, and smaller 
 doses, long continued, induce a scorbutic condition. 
 Yet the same salt, judiciously exhibited, furnishes a 
 valuable stimulant to the secretory and excretory 
 apparatus. That chemical attraction is inadequate to 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 15 
 
 account for the therapeutic and poisonous quality of 
 the hydrochlorate is obvious, inasmuch as it exercises 
 a general action, and induces inflammation of the 
 stomach even when introduced into the subcutaneous 
 cellular tissue. 
 
 " Dr. B. W. Richardson has confirmed the statement 
 that the effect of the addition of ammonia to freshly 
 drawn blood, is to prevent coagulation, and to destroy 
 and alter the blood globules. In this respect the action 
 of ammonia resembles that of the fixed alkalies. When 
 ammonia or its carbonate is administered for some 
 time to animals or man, the effect is to modify the 
 blood-corpuscles; they become easily soluble, crenate 
 at the edge, many-sided, colorless, transparent, col- 
 lapsed, and loosely agglomerated, but not in rolls; and 
 the blood when drawn, or after death, is absolutely 
 fluid or loosely coagulated. These changes in the 
 blood, he thinks, correspond closely with those ob- 
 served by Jenner in the blood of patients suffering 
 from typhus fevers. By making animals breathe or 
 swallow ammonia, Dr. Richardson has been able to 
 induce a condition resembling the typhoid in man. 
 A superalkaline condition of the blood from the 
 presence of an excess of ammonia is observed in yellow 
 and typhus fevers, and other diseases of the typhoid 
 type, and in cases where the function of the kidney is 
 suppressed. In such conditions, therefore, he believes 
 that the administration of ammonia and other alkalies 
 is contraindicated. The ammoniacal condition of the 
 blood is recognized by the ammoniacal condition of 
 the breath, tested by a rod dipped in hydrochloric 
 acid/' 
 
 But, better still, even before ammonia can be thus 
 detected in the breath by the scorbutic condition of 
 
16 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 the blood itself, and the general appearance of the 
 tongue and lips, or mucous membrane- of the interior 
 of the mouth, which have a diffused reddish-brown, 
 purplish or dark cerulean hue, as if the blood was 
 imcornpletely oxidized, and the red corpuscles collapsed 
 with their coloring matter diffused through the serum. 
 This ammoniacal or superalkaline condition of the 
 blood is also often manifest in the countenance and 
 general surface of the body, especially in the hands 
 and feet, sometimes to a very marked degree, though 
 a similar scorbutic state may likewise result from an 
 excess of the fixed alkalies, particularly from potassium 
 and its salts. 
 
 Moreover, Dr. Richardson found that "the presence 
 of ammonia effectually arrested the oxidation of various 
 substances, and even prevented the action of ozone. 
 Believing that by an extension of the same law, 
 animal substances exposed to ammonia could be pre- 
 vented from putrefaction, he kept blood and portions 
 of tissues in contact with simple ammoniacal vapor, 
 and with results which were most remarkable. Blood 
 in an ordinary stoppered bottle, if charged with 
 ammonia so as to give a faint ammoniacal odor, would 
 retain its freshness and many of its properties for years. 
 Animal structures in like manner placed, even so as to 
 be massed together in bottles containing ammonia 
 vapor, would retain their freshness apparently for an 
 unlimited time 
 
 11 The last point to which Dr. Richardson drew 
 attention was the cause of the antiseptic power of 
 ammonia. Ammonia, being a product of decomposi- 
 tion, had been looked on commonly as a substance 
 provoking decomposition. But ammonia was truly 
 the most powerful antiseptic known ; it acted catalyti- 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 17 
 
 cally, by preventing the action of oxygen with oxidi- 
 zable bodies. . . . . . 
 
 " In conclusion, the results presented tended to throw 
 a light on the influence of the ammonia, as the pro- 
 ducing causes of some diseases, and as the curative 
 remedies in other diseases. The same rule that per- 
 tained to dead pertained to living organic matter. 
 Hence, long exposure to ammoniacal vapor, by 
 arresting oxidation, produced extreme anaemia and 
 a low depraved condition of the system altogether, 
 with reduced respiration, reduced appetite, reduced 
 muscular power, and reduced energy. On the other 
 hand, in cases where a rapid oxidation of the body was 
 being determined, attended with increase of heat and 
 rapid disintegration of tissue, the administration of 
 ammonia, by arresting these changes, became, in 
 judicious hands, the most powerful and effective of 
 remedies. It checked decomposition by its action on 
 oxygen ; it held the blood fluid by its solvent power 
 as an alkali; and, being volatile, it inflicted no imme- 
 diate injuries on the structures of the body." — British 
 Medical Journal and Dublin Medical Press. 
 
 Yet, ammonia in excess is a powerful caustic and 
 irritant, as well as solvent, while its volatility dissemi- 
 nates it rapidly throughout the system, dissolving and 
 disintegrating the blood corpuscles, exciting, irritating 
 and inflaming the heart and vessels with all the other 
 organs and structures of the body, disorganizing the 
 fluids and solids of the vital economy, and actively 
 promoting dissolution and death as often manifested 
 in ammoniacal and stinking blood, urine and other 
 fluids, with corresponding abnormities, so that for 
 medicinal purposes it has to be given carefully in 
 moderate doses. Hence, while it may preserve dead 
 
18 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 animal structure, it devitalizes living tissue, and dis- 
 orders and arrests life action. As the presence of 
 ammonia in excess prevents due oxidation of the 
 living as well as dead blood and tissues, it thereby in 
 the proportion of its accumulation or quantity in the 
 body, subverts normal arterialization, hsematosis, nu- 
 trition and chemico-organic or vital metamorphosis 
 generally, while by its solvent, irritant, and volatile 
 properties, it causes abnormal liquefaction, excitement, 
 deterioration and disorder of the components, struct- 
 ure and functions of the living organism, thus predis- 
 posing and giving rise to numerous and varied diseases 
 of a mixed inflammatory, septic, infectious and ady- 
 namic character, both constitutional and local, accord- 
 ing to concurring and complicating circumstances, so 
 frequently manifested in typhus, yellow, puerperal, 
 enteric and other asthenic fevers, diphtheria, angina 
 maligna, erysipelas and correlative phlegmasia, w^ith 
 haemorrhages, albuminous, serous, choleraic and other 
 defluxijus, mephitic, malignant, infectious, and colli- 
 quative diseases generally. 
 
 Besides the constant spontaneous evolution of 
 ammonia in the body from the direct union of its 
 elements in the normal chemico-organic processes of 
 the living economy, it may be, and often is, abnor- 
 mally increased by undue retention therein, as well as 
 by various inherent and extraneous agencies, until a 
 state of ammonsemia ensues, which, according to its 
 degree of intensity and concurring circumstances of 
 climate, season, weather, temperature, moisture, pesti- 
 lential and other agencies, occupation, exposure, 
 alimentation, conditions, habits and modes of life, 
 becomes an active predisposing and exciting cause of, 
 with the minor ills, some of the most malignant and 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 19 
 
 pestiferous diseases that afflict and destroy mankind 
 with the lower forms of life. 
 
 Thus, in addition to its internal chemico- vital sour c :- - , 
 ammonia may be introduced from without the 
 by imbibition or inspiration from decomposing organic 
 matter, or from its artificial evolution as is bo common 
 and profuse in that pernicious miasm — tobacco smoke, 
 which is diffused s<:» freely everywhere throughout the 
 world, on land and sea, in ships and houses, in hamlet 
 and palace, city and country, indoors and outdoors, in 
 every country and clime. - that scarcely any one can 
 be free from its forced involuntary inhalation and 
 baneful effects. Moreover, with the volatile ammoi 
 therein, tobacco smoke contains those most r tent 
 narcotic poisons — nicotia. nicotianin, collndine and 
 other active sedatives, which also deteriorate the 
 blood and depress the nervous and general system, 
 thereby strongly predis] sing to, and causing ady- 
 namic, scorbutic, septic, infectious, mephitic and 
 colliquative diseases, to which men, women and 
 children are thus so freely exj everywhere 
 
 having their nostrils, throats, air p: ind lungs 
 
 irritated, and their blood and bodies frequen 
 saturated with the noxious fumes of tobacco, in addi- 
 tion to other active causes of disease and d< :he 
 separate and combined influence of which sickens, 
 disables and destroys myriads of human beings. 
 
 Tiiat tobacco is a potent acro-narcotic and prolific 
 source of ammonia with other morbid and 
 
 baneful agents, and its use or exposure _ :• its noxious 
 fumes largely introduces it and them into the system, 
 thereby irritating the nares, mouth, pharynx, air 
 passages, lungs, and heart, corrupting the blood, 
 vitiating the humors, perverting the secretions, de- 
 pressing the nervous, muscular, mental, and vital 
 
20 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 energies, and poisoning the entire economy, ample 
 evidence is afforded everywhere, and much scientific 
 testimony could be adduced in proof thereof, but we 
 will merely present the following of more immediate 
 practical relation to the subject of discussion : 
 
 Thus, Dr. Headland states (Action of Medicine), 
 "The vapor of burning tobacco contains carbonate of 
 ammonia in considerable quantity. This must neces- 
 sarily be absorbed to a large extent by the mucous 
 surfaces of the mouth and lungs of smokers" (and 
 likewise of those obliged to inhale it). "Regarded 
 in this point of view, the practice of smoking when 
 continued, may be looked upon in the same light as 
 a course of alkaline medication. It may be attended 
 with the same risk or advantage. It must be ill- 
 suited to those in whom there is a tendency to 
 alkalinity of the humors, and better adapted to the 
 case of those gouty or dyspeptic subjects with whom 
 the contrary obtains. But of course the therapeutic 
 action of the nicotia and other volatile principles of 
 tobacco must be separately taken into account." (p. 143.) 
 
 " The smoke of tobacco contains its alkaloid nicotia. 
 This is a powerful poison. If it were allowed to 
 accumulate in the blood the act of smoking would 
 probably be fatal. It is certainly absorbed to some 
 extent, but it passes quickly into the urine where it 
 may be detected by simple chemical tests. Even the 
 small quantity at one time in the system will produce 
 a very marked intoxication in some persons. It is 
 only not a poison because slowly taken into the system 
 in small amounts and eliminated pari passu. Dr. Paris 
 has plausibly conjectured that nicotia may be the fc juice 
 of cursed Hebanon' mentioned in 'Hamlet. 5 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 21 
 
 "The careful experiments of Dr. Snow appear to 
 have established the fact that the volatile inebriants are 
 powerful in inverse proportion to their solubility : also 
 that whether inhaled or absorbed from the stomach 
 their action obeys very closely the following law; com- 
 plete narcotism is established as soon as the blood has 
 dissolved one fifty-sixth part of the quantity it is 
 capable of holding in solution. 5 ' (p. 269.) 
 
 Dr. B. W. Richardson presents in the Medical Times 
 and Gazette, the following summary of the noxious 
 effects of tobacco: "1. The effects that result from 
 smoking are due to different agents imbibed by the 
 smoker, viz., carbonic acid, ammonia, nicotine, a 
 volatile empyreumatic substance, and a bitter extract. 
 The more common effects are traceable to the carbonic 
 acid and ammonia; the rarer and more severe to the 
 nicotine, the empyreumatic substance, and the extract. 
 2. The effects produced are very transitory,* the 
 poisons finding a ready exit from the body. 3. All 
 the evils of smoking are functional in character, and 
 no confirmed smoker can ever be said, so long as he 
 indulges in the habit, to be well; it does not follow, 
 however, that he is becoming the subject of organic 
 and fatal disease because he smokes.f 4. Smoking 
 produces disturbances: (a) in the blood, causing 
 undue fluidity and change in the red corpuscles; (6) on 
 the stomach, giving rise to debility, nausea, and, in 
 extreme cases, sickness; (c) on the heart, producing 
 
 * Sometimes, however, they are severe and and persistent ; from 
 a slight exposure to the fumes of tobacco I have known them to 
 continue for days and produce very serious illness and prolonged 
 invalidism. 
 
 f Although it is a frequent result thereof, as seen in cancer of 
 lip, ulceration of throat, disease of heart, brain, kidney, etc. 
 
22 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 debility of that organ and irregular action ;* (d) on the 
 organs of sense, causing in the extreme degree dilata- 
 tion of the pupils of the eye, confusion of vision, bright 
 lines, luminous or cobweb specks, and long retention of 
 images on the retina, with other and analogous sym- 
 toms affecting the ear, viz., inability clearly to define 
 sounds, and the annoyance of a sharp, ringing, sound 
 like a whistle or a bell ; (e) on the brain, suspending 
 the waste of that organ, and oppressing it if it be 
 duly nourished, but soothing it if it be exhausted; 
 (/) on the nervous filaments and sympathetic or 
 organic nerves, leading to deficient power in them, 
 and to over-secretion in those surfaces — glands — over 
 which the nerves exert a controlling force; (g) on the 
 mucous membrane of the mouth, causing enlargement 
 and soreness of the tonsils (smoker's sore-throat), 
 redness, dryness, and occasional peeling off of the 
 membrane, and either unnatural firmness or contrac- 
 tion and sponginess of the gums; (Ji) on the bronchial 
 surface of the lungs when that is already irritable, 
 sustaining the irritation, and increasing the cough. 
 5. The statements to the effect that tobacco smoke 
 causes specific diseases, such as insanity, epilepsy, 
 St. Vitus' dance, apoplex}^, organic diseases of the 
 heart, cancer and consumption, and chronic bronchitis 
 have been made without any sufficient evidence or 
 reference to facts; all such statements are devoid of 
 truth, and can never accomplish the object which those 
 who offer them have in view.f 6. As the human body 
 
 * With sometimes neuralgia and spasm of the heart, angina 
 pectoris, paralysis, and sudden death. 
 
 f Nevertheless, ample evidence of the truth of such could be 
 adduced if space permitted, some of which we will present, with 
 others the writer can testify to its production of neuralgia, in- 
 sanity, organic as well as functional disease of the heart, bron- 
 chitis, consumption, haemoptysis and correlative affections. 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 23 
 
 is maintained alive and in full vigor by its capacity, 
 within certain well defined limits, to absorb and apply 
 oxygen, as the process of oxidation is most active and 
 most required in those periods of life when the 
 structures of the body are attaining their full develop- 
 ment, and as tobacco smoke possesses the power of 
 arresting such oxidation, the habit of smoking is most 
 deleterious to the young, causing in them impairment 
 of growth, premature manhood and physical degrada- 
 tion," 
 
 The evils of tobacco are not, however, thus so 
 exclusively limited to the young, but extends to all 
 of every age and both sexes, subject to its noxious 
 influence by its use in every form and manner or 
 exposure to its poisonous fumes. 
 
 In a paper upon the subject {Georgia Medical and 
 Surgical Encyclopedia), Dr. Hollified thus notices some 
 of the evil effects of tobacco upon the human system. 
 " Tobacco effects the system by producing weakness, 
 languidness, vomiting, vertigo, stupor, giddiness, 
 paralysis, nervousness, and great debility, with often 
 fatal prostration. It also acts upon the nervous and 
 circulatory systems to an extent that is both terrifying 
 and alarming, often causing death. When chewed or 
 rubbed it exerts a great influence upon the mucous 
 membrane of the mouth, and also upon the salivary 
 glands, the sublingual and submaxillary, causing them 
 to secrete a larger amount of saliva than nature 
 intended them to do, or than- is necessary for the 
 purpose of accomplishing the duties assigned them, 
 thus robbing the system of a portion of its fluids 
 which are required for the healthy maintenance of its 
 animal functions, merely for the gratification of a. 
 morbid appetite. The sense of taste is generally 
 
24 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 perverted or greatly impaired in all those who either 
 rub or chew the noxious weed. 
 
 " When tobacco is smoked it acts as an irritant, and 
 frequently a portion of the smoke is carried into the 
 lungs rendering the air breathed hot and impure. It 
 then acts as a sedative upon the circulation, and often 
 irritates the lining membrane of the air-cells in the 
 lungs, which brings on inflammation, laying broad and 
 deep the seeds of disease which may in time hurry its 
 victim to an early grave. Death has resulted from 
 the inhalation of the smoke," and blindness has been 
 occasioned by it in the case of a gentlemen addicted 
 to smoking, whose sight repeatedly improved when 
 he relinquished the habit. But this " was too strong; at 
 last he gave way to it entirely, and in 1855 was almost 
 totally blind, being only able to distinguish night from 
 day, becoming according to his own acknowledg- 
 ment, at the early age of twenty-eight years, a victim 
 to the immoderate use of tobacco." 
 
 If pertinent to our present purpose, much more evi- 
 dence upon this latter point might be presented, but 
 we can merelv refer to the following, thus : " Dr. Mack- 
 enzie, in his great work on Ophthalmology, expresses 
 his belief that tobacco is & frequent cause of amaurosis 
 and adds, i one of the best proofs of tobacco being a 
 cause of amaurosis is in the great improvement in 
 vision — sometimes complete restoration — which ensues 
 giving up the use of this poison,' and cites a very 
 striking case in illustration. With him I agree, also, 
 in the conviction that tobacco is a commou cause of 
 the cases of partial loss of sight that are daily to be 
 found at our hospitals." (J. C. Wadsworth, Lancet.) 
 
 In a report on the progress of Ophthalmology for 
 1867, Dr. G. Hay, of Boston, refers {Medical Archives) 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 25 
 
 to researches by Hutchinson respecting a form of 
 amaurosis supposed to be due to tobacco, published in 
 the Medico-Chiurgical transactions. "The subjective 
 symptoms given are dimness of vision merely; every- 
 thing to him seems a fog, but he has no pain in his 
 eyes, nor any photophobia or photopsia. In many 
 cases the patient becomes at length absolutely blind; 
 but in others the disease, having advanced to a certain 
 point, is arrested. 
 
 " The intrinsic pathological condition is atrophy of 
 the optic nerve. Mr. Hutchinson observes: 'During 
 the last three vears I have held it to be a bounded dutv 
 to warn all who present the symptoms of this disease 
 against smoking, and in only a few instances (provided 
 the patient was seen early), did the disease afterwards 
 progress to blindness.' Mr. Wordsworth and Mr. 
 Critchett are equally positive in their opinion in regard 
 to the deleterious effects of tobacco, and state that 
 much smoking is the ordinary cause of the atrophy. 
 Granting that a similar condition is occasioned bv 
 other causes, the former, before the Hunterian Society, 
 delared that he believed he could with the opthalmos- 
 cope pick out smokers from non-smokers in cases of 
 optic nerve atrophy. Abstinence is the cure. Mr. Crit- 
 chett commits himself unhesitatingly to the opinion 
 that although in many cases all medical treatment will 
 be unavailing vet the abandonment of tobacco will 
 arrest the further progress of the disease." 
 
 The Medical Press and Circular states that "in a 
 prize essay on tobacco, Hampton Brewer, L. R. C. P., 
 London, quotes Dr. Hardwicke, Mr. Curgenven, Dr. 
 Menzies, Dr. Broadbent, Mr. Hutchinson and Dr. C. 
 R. Drysdale, as being convinced that tobacco smoking 
 produces palpitation of the heart, impotence, in some 
 
26 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 cases; irregularity of bowels, congestion of the fauces, 
 susceptibility to cold, dyspepsia, amaurosis, and palsy 
 in some cases. We heartily agree with the author in 
 his opinion as to the very injurious effects of tobacco? 
 in whatever form it may be used." 
 
 In relation to the noxious effects of tobacco smoke 
 upon children, Dr. E. Decaine contributes to The Revue 
 de Therapeutique Medico- Chiurgicale, February 15, 1869, 
 Dublin Quarterly Journal and Half- Yearly Abstract. 
 " Having described his experience in relation to this 
 matter, he concludes : 1. That the pernicious effects of 
 tobacco smoke upon children are incontestable. 2. It 
 produces pallor, chloro-ansemia, palpitations of the 
 heart, diminution of the normal number of blood glo- 
 bules, and difficult digestion. 3. The ordinary treatment 
 for chloro-ansemia and anaemia produces no effect so 
 long as the habit of smoking is persisted in. 4. Children 
 who are addicted to smoking exhibit a want of intelli- 
 gence, and have a likiug more or less decided for strong 
 drinks. Children who abandon the practice of smok- 
 ing before any serious organic lesions are produced, 
 speedily recover from disorders of the system, of which 
 even traces do not generally remain." 
 
 But comparatively few children, though many ado- 
 lescents, use tobacco, yet great numbers of all ages, 
 from the newly-born infant to the oldest adult, are 
 more or less freely exposed to its pernicious fumes 
 and noxious miasma, sufficiently to either actively 
 sicken or induce a state of semi-invalidism, and 
 reduce their vital power below the norme, so as to 
 render them more liable to intercurrent and epidemic 
 diseases, which they would otherwise escape. 
 
 Upon the deleterious effects of tobacco, Sir Benjamin 
 Brodie, thus writes in a letter to the London Times, 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 27 
 
 republished in the Medical Times and Gazette: " The 
 effects of this habit are indeed various, the difference 
 depending on difference of constitution and difference 
 in the mode of life otherwise. But, from the best 
 observations which I have been able to make on the 
 subject, I am led to believe that there are very few who 
 do not suffer harm from it to a greater or less extent. 
 The earliest symptoms are manifested in the derange- 
 ment of the nervous system. A large proportion of 
 habitual smokers are rendered lazy and listless, indis- 
 posed to bodily and incapable of much mental exertion. 
 Others suffer from depression of the spirits, amounting 
 to hypochondriasis, which smoking relieves for a time, 
 though it aggravates the evil afterwards. Occasionally 
 there is a general nervous excitability, which, though 
 very much less in degree, partakes of the nature of the 
 delirium trew.ens of drunkards.* I have known many 
 individuals to suffer from severe nervous pains, some- 
 times in one, sometimes in another part of the body. 
 Almost the worst case of neuralgia that ever came 
 under my observation, was that of a gentleman w r ho 
 consulted the late Dr. Bright and myself. The pains 
 were universal, and never absent ; but during the night 
 they were especially intense, so as almost wholly to 
 prevent sleep. Neither the patient himself nor his 
 medical attendant had any doubts that the disease was 
 to be attributed to his former habit of smoking, on the 
 discontinuance of which he slowly and gradually re- 
 covered. An eminent surgeon, who has a great 
 experience in ophthalmic diseases, believes that in 
 
 * Dr. Chapman and others have recorded cases simulating delirium 
 tremens from the use of tobacco. ( Vide TJ. S. Dispensatory, and 
 reports of insane asylums). The writer also hid an obscure case 
 of insanity which nothing relieved until tobacco smoking was dis- 
 covered as the cause, and discontinued, whei recovery speedily 
 ensued. ( 
 
28 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 some instances he has been able to trace blindness 
 from amaurosis to excess in tobacco, smoking; the 
 connection of the two being pretty well established in 
 one case by the fact that on the practice being left off, 
 the sight of the patient was gradually recovered. It 
 would be easy for me to refer to other symptoms indi- 
 cating deficient power of the nervous system to which 
 smokers are liable ; but it is unnecessary for me to do 
 so ; and, indeed, there are some which I would rather 
 leave them to imagine for themselves than undertake 
 the description of them myself in writing. 
 
 " But the ill effects of tobacco are not confined to 
 the nervous system. In many instances there is a loss 
 of the healthy appetite for food, the imperfect state of 
 the digestion being soon rendered manifest by the loss 
 of flesh and sallow countenauce. It is difficult to say 
 what other diseases may not follow the imperfect 
 assimilation of food continued during a long period of 
 time. So many causes are in operation in the human 
 body which may tend to a greater or less degree to the 
 production of organic changes in it, that it is only in 
 some instances we can venture to pronounce as to the 
 precise manner in which a disease that proves mortal 
 has originated. From cases, however, which have 
 fallen under my own observation, and from a considera- 
 tion of all the circumstances, I cannot entertain a doubt 
 that, if we could obtain accurate statistics on the 
 subject, we should find that the value of life in 
 inveterate smokers is considerably below the average. 
 Nor is this opinion in any degree contradicted by the 
 fact that there are individuals who, in spite of the in- 
 halation of tobacco smoke, live to be old, and without 
 any material derangement of the health; analogous 
 exceptions to tne general rule being met with in the 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 29 
 
 case of those who indulged too freely in the use 
 of spirituous and fermented liquors." 
 
 Moreover, exceptional cases are also met with in 
 those who use opium, arsenic and other poisons, and 
 long-lived persons are met w T ith in malarious regions, 
 but these anomalous instances do not prove that such 
 noxious agents as alcohol, tobacco, opium, arsenic, 
 malaria, etc., are conducive to health and longevity, 
 when the general experience overwhelmingly pre- 
 ponderates in demonstrating their potent deleterious 
 and destructive properties, Besides, even if the lives 
 of a comparatively few persons are prolonged in spite 
 of the baneful effects of such pernicious influences as 
 tobacco, alcohol, etc., it is only the lower vegetal and 
 animal existence that persists, the higher intellectual 
 and ps} 7 chical life being more or less deadened, so 
 that the nobler faculties of the soul, that every one of 
 any aspiration above the nature of the inferior 
 creatures so earnestly desire, are debased and stifled, 
 while the offending or exposed individual is pro- 
 portionably reduced in the scale of being nearer to 
 the plane of brutes rather than refined and developed 
 toward the more exalted spiritual attributes of man- 
 kind, to say nothing of the higher affinity with the 
 Godhead. 
 
 Respecting the evil effects of tobacco on the brain 
 and nervous system more particularly, Dr. Willard 
 Parker, of New York, states {Med. and Surg. Reporter), 
 " This poison enfeebles the mind. The Emperor 
 Napoleon had his attention called to this subject in 
 1862 bv a scientific statistician. It was observed from 
 1812 to 1862 that the tobacco tax averaged twenty- 
 eight millions of francs annually and there were eight 
 thousand paralytics and insane in the hospitals of 
 
30 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 France. In 1832 the tobacco revenue had reached 
 one hundred and eighty millions, and, in the hospitals 
 were forty-four thousand paralytics, etc. The un- 
 doubted inference is that tobacco has a strong 
 influence in producing these classes of nervous dis- 
 eases. 
 
 " A commission was then appointed to inquire into 
 the influence of tobacco in the schools and colleges. 
 After a full and careful investigation this commission 
 reported that it had divided the people into two 
 classes the users and non-users of tobacco, and then 
 proceeded to compare them physically, intellectually 
 and morally. The result was that those who do not 
 use tobacco were stronger, better scholars and had a 
 higher moral record. In consequence of this report 
 an edict was issued prohibiting the use of tobacco in 
 these national institutions, by which thirty thousand 
 persons were at once forced to abandon it." 
 
 But these observations take no cognizance of the 
 many thousands of innocent persons of all ages and 
 both sexes, from the newly-born babe to the most 
 aged, degenerated, enfeebled, diseased and degraded — 
 physically, mentally and morally, or destroyed en- 
 tirely by the enforced inhalation of this potent poison, 
 inflicted upon them by smoking barbarians, almost 
 everywhere against every principle of sanitation, 
 right and justice. 
 
 On the " Influence of Tobacco in Diseases of Nerve 
 Centres," Mr. Tamisier states in the Bulletin de V As- 
 sociation Franc, cont VAbus du Tabac, quoted in the 
 Doctor {Med. and Surg. Reporter), " That out of fifty- 
 nine grave affections of the nerve centres observed 
 from 1860 to 1869 among men, forty occurred in 
 smokers. In fifteen cases of hemiplegia, nine abused 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 31 
 
 tobacco and two used it moderately, four did not 
 smoke. Of eighteen cases of paraplegia, five were 
 great smokers, three moderate smokers, and ten ab- 
 stained from tobacco. Out of sixteen cases of 
 locomotor ataxia, ten were great smokers, five 
 moderate and one abstained. Tamisier thinks that 
 it is especially, if not wholly, to this cause that we 
 must attribute the disease in the majority of cases of 
 hemiplegia and of ataxia he has noticed since 1869. 
 M. Lefevre, of Louvain, thinks it indubitable that 
 excessive smoking causes paralytic mania; because, 
 (1) nicotine causes in animals progressive enfeeble- 
 ment of the muscles of motion up to paralysis and 
 congestion of the nerve centres ; (2) analogous 
 symptoms have been noticed in numbers of persons 
 who abuse tobacco in smoking or chewing; (3) it 
 has been found in all countries that there is a 
 constant relation between the consumption of tobacco 
 and the increase of general paralysis." 
 
 " Effects of Alcohol and Tobacco on the Sight, on 
 the subject of color blindness and amblyopia, Dr. 
 Eichard H. Derby {New York Med. Journal)^ says, 
 ' Almost always both eyes are affected. This form of 
 amblyopia occurs almost solely in men ; out of fifty- 
 six cases only three were women. It is a disease of 
 adults, its frequency increasing from the twentieth to 
 the fortieth year. In a portion of the cases abuse of 
 alcohol was certainly the cause of the affection and in 
 others the excessive use of tobacco undoubtedly 
 contributed to produce the disease. Forster, in a 
 paper on the injurious action of tobacco on the vision 
 attaches still greater importance to this agent as a 
 cause of amblyopia, supporting the views of Macken- 
 zie, Sichel, Hutchinson, Lureiro, and others. The 
 
32 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 author cites twenty cases in which there was a central 
 scotoma with a horizontal diameter of 18° to 25°, 
 within which large letters could still be recognized. 
 All of these patients suffer from some affection of the 
 digestive and nervous system. Loss of appetite, 
 constipation, loss of sleep were common symptoms. 
 Each one of the twenty patients was a strong smoker, 
 and in eleven of these cases a very marked improve- 
 ment was observed when the use of tobacco was given 
 up." — [Detroit Review of Medicine and Pharmacy.) 
 
 In some observations in the Anti-Tobacco Journal on 
 the effects of this agent upon the animal economy, 
 Dr. John C. Warren makes the following remarks in 
 relation to its deleterious action on the tissues of the 
 mouth : k< Tobacco is by some persons recommended 
 as beneficial to the teeth, but while it can have no 
 material effect in preserving the bony substance of the 
 teeth it has a real influence on their vitality by 
 impairing the healthy action of the gums. These and 
 also the adjacent parts are very subject to cancer, 
 particularly the tongue and lips. For more than 
 thirty years I have been in the habit of inquiring of 
 patients who came to me with cancers of these parts, 
 whether they used tobacco, and if so, whether by 
 chewing or smoking. If they have sometimes an- 
 swered in the negative as to the first question I can 
 truly say that to the best of my knowledge and belief 
 such cases are exceptions to the general rule. When, 
 as is usually the case, one side of the tongue is 
 affected with ulcerated cancer, it arises from the 
 habitual retention of the tobacco in contact with 
 this part. The irritation from a cigar or even from a 
 tobacco pipe frequently precedes cancer of the lip. 
 The lower lip is more commonly affected by cancer 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 33 
 
 than the upper in consequence of the irritation 
 produced in this part by acrid substances from the 
 mouth. What is more likely to cause a morbid 
 irritation terminating in disease, than the frequent 
 application of tobacco juice ? The want of attention 
 to cleanliness often connected with this practice and 
 the consequent lodgment of the particles of tobacco 
 on the surface of the lip has a great influence in these 
 cases. 
 
 " Aged persons are very liable to cancer especially 
 about the face, and when any irritating substance is 
 applied habitually, the skin becomes disordered and 
 takes on a cancerous action. This irritation may be 
 produced by the use of tobacco in the interior of the 
 mouth, by the habitual application of a cigar to the 
 lips and even by a pipe applied to the same parts. 
 Few days pass without my having an opportunity of 
 witnessing the verification of these facts. " 
 
 In relation to cancer in smokers the Med. arid Surg. 
 Reporter states that " M. Bouisson, of Montpelier, 
 has given another blast against tobacco in deducing 
 the increased prevalence of labial cancer from its 
 excessive and long-continued use. He relates sixty- 
 eight cases affected with cancroid and cancerous 
 tumors in persons addicted to smoking and thence 
 traces a complete pathological history of the disease/' 
 • ••*••• 
 
 " There is no doubt says M. Bouisson, that cancer 
 of the lip and other parts of the 1 mouth has become 
 more frequent in proportion to the increased number 
 of smokers and to the increased amount of smoking 
 among those who had already contracted the habit 
 
 the disease has progressed with the habit 
 
 Besides the increased frequency of labial epithelioma, 
 
34 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 the author brings the following reasons to his aid, 
 viz. : it attacks the lower lip mos,t frequently on 
 which the pipe-stem or cigar habitually rests; it is 
 rare among women and children. M. Bouisson 
 speaks of a woman who was affected, but she was an 
 inveterate smoker, and the older the smoker the 
 more common is the disease, most of the cases being 
 in men over forty years of age. Among the poorer 
 classes who smoke short pipes and bad tobacco the 
 disease is developed sooner than among the rich who 
 smoke delicate cigars and long pipes and who 
 neutralize the local effects of the combustion of the 
 tobacco by hygienic means. The local action of the 
 heat on the lips has probably some effect in the 
 production of the disease, but tobacco alone would 
 suffice. M. Bouisson gives the case of a physician of 
 Barcelona, from whom he removed some epithelial 
 vegetations in the nostrils, which he had no hesitation 
 in ascribing to the practice so common among the 
 Spaniards of eliminating the smoke of their cigarettes 
 through the nose, and it is thus probably that in 
 many cases epithelial cancers of the tongue, cheeks, 
 arch of the palate, gums and tonsils are produced." 
 Other surgeons testify to the same effect, Mr. Jona- 
 than Hutchinson states [Med. Times and Gazette), that 
 " Frorn the statistical analysis of 127 cases of 
 epithelial cancer in the lip, I was able to show, first, 
 that women are the subject of this disease in the 
 proportion of only five to every one hundred males, 
 second, that when it does occur in women it is usually 
 in those who have been accustomed to smoke." 
 
 In a recent discussion upon the subject of the use 
 tobacco in the Suffolk District Med. Society, Mass. 
 {Jour. Amer. Med. Assoc, Feb. 9, 1884), "Dr. H. I. 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 35 
 
 Bowditch said that it is high time that some measures 
 were adopted to stop, or at least restrain the use of 
 tobacco. For thirty years he has continuously found 
 a certain number of patients who have presented the 
 symptoms of grave functional disturbance of the heart, 
 for which no cause could be found except tobacco. 
 There is no organic cardiac lesion, but it is a nervous 
 weakness. This condition was very commonly 
 observed during the late war. Nearly all the soldiers 
 smoked and many gradually acquired what was 
 appropriately named ' the tobacco heart.' 
 
 " In habitues of tobacco we frequently find errors 
 of digestion, sometimes of the most refractory char- 
 acter, though many persons commence to smoke from 
 the supposition that the digestion is benefitted by the 
 use of tobacco. There is no question upon the fact 
 that mental disease may be induced by the poisonous 
 action of nicotine, and many smokers who are not 
 insane have been rendered exceedingly nervous and 
 irritable by the prolonged use of tobacco, and 
 immediately give unmistakable evidence of absolute 
 derangement if the customary indulgence is for any 
 reason withdrawn." 
 
 Yet they cannot recover unless they do discontinue 
 the use of the poisonous drug, and the observation of 
 the writer and others proves that it is essential to the 
 restoration of health, which often promptly follows its 
 disuse. 
 
 Dr. Prince observed that " In cigarette smoking 
 the vapor is inhaled and coming in contact with the 
 delicate mucous membrane of the air passages, its 
 active properties are at once absorbed and produce 
 an immediate effect, which can be perceived to the 
 tips of the fingers. The succeeding sensation is one 
 
36 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 of ennui, malaise, indolence, and muscular hebe- 
 tude, which soon becomes burdensome unless the 
 stimulant be renewed and prolonged by a fresh 
 cigarette." This, however, necessarily only increases 
 the evil, like drinking spirituous liquors to tem- 
 porarily whip up the system from its resulting 
 depression. 
 
 " Dr. Langmaid stated that the most important 
 questions in cigarette smoking are these : Does the 
 inhalation of the vapor induce any disease of the 
 mucous membrane with which it comes in contact? 
 Does the smoke act upon the mucous, membrane 
 simply as smoke or from the fact that it contains 
 nicotine? Does smoking increase naso-pharyngeal 
 catarrh? To these an affirmative reply must be 
 given. If the mucous membrane is irritated, smoking 
 invariably makes it worse. Will smoking produce a 
 catarrhal state when none exists, or awaken a new one 
 in a patient who has been cured of the disease ? 
 Observation teaches that it can do this. There is an 
 increased secretion from the membrane and all the 
 other features of a catarrhal condition. Singers 
 almost invariably abstain from smoking on those days 
 upon which they expect to sing." 
 
 " Dr. Bowditch added that he will not treat a 
 patient for sore throat unless smoking is abandoned 
 for the time." 
 
 Thus, irritation, inflammation, ulceration of and 
 defluxion from the mouth, throat, and air passages are 
 excited by tobacco, with ammonsemia, superalkalinity 
 and scorbutic condition of the system, which induces a 
 malignant tendency to all diseases, local and general, 
 and develops such diseases as diphtheria, cynanche 
 maligna, typhoid fever, choleraic and other gastro- 
 intestinal affections with cognate maladies, in both 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 37 
 
 those who use and are exposed to this pernicious 
 acro-narcotic poison. 
 
 Besides, the local action of tobacco both upon the 
 mucous membrane and skin is more immediately 
 dangerous and may occasion speedy death, especially 
 when applied to abraded or ulcerated surfaces, as 
 exemplified in the following instance, with others on 
 record. U A case of death from nicotine recently 
 occurred at Cohoes, N. Y., under the following 
 circumstances : The father of a little girl in an 
 endeavor to ' heal a sore on her lip,' applied to it the 
 contents of a ' rank' pipe-stem. The victim was 
 almost immediately seized with the peculiar symp- 
 toms of tobacco-poisoning and died a few hours 
 afterward." — Med. Record. 
 
 " Even the external application of the leaves or 
 powder [of tobacco] is not without danger espe- 
 cially when the cuticle is removed. A case of death 
 is on record occurring in a child eight years old, in 
 consequence of the application of the expressed juice 
 of the leaves to the head for the cure of tinea capitis. 
 Death has also been produced by the inhalation of the 
 smoke." — U. S. Dispensatory. 
 
 Before, however, there is one case of cancer or 
 speedy death thus produced by tobacco, there are 
 numerous instances of local irritation, inflammation 
 and ulceration of the mouth, fauces, nares, and 
 contiguous parts, with general poisoning of the blood 
 and system by saturating the body with ammonia, 
 nicotia and its other noxious ingredients, thereby 
 preventing oxidation of the fluids and solids of the 
 economy, causing anaematosis, dyspepsia, mal-nutri- 
 tion, diseases of the throat, air passages, lungs, heart, 
 stomach, liver, kidneys, brain, nervous, muscular and 
 
38 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 general system, in fact, deterioration, depression and 
 disease of both body and mind ; often ending in 
 inanition, consumption, insanity, paralysis and death, 
 not the less sure because it is so generally insidious 
 and slow, though frequently directly well-marked and 
 prompt in its poisonous action, corroborative evidence 
 of which might be adduced sufficient to fill a volume in 
 proof of the local and general poisonous influence of 
 tobacco upon the vital organism, but it is believed the 
 preceding will amply suffice for the special designs of 
 this work, though the following instructive case may 
 serve to further demonstrate the potent toxic power 
 of this noxious drug. 
 
 A striking example of the certainty and rapidity 
 with which a superalkaline, scorbutic, and poisoned 
 condition of the blood, with oppression of breathing, 
 depression of the heart, nervous and general system, 
 may be produced by even a slight exposure to the 
 noxious fumes of tobacco is presented in the case of a 
 gentleman under my care, who is a martyr to its 
 baneful effects and has suffered untold misery there- 
 from. Thus, a very moderate inhalation of the fumes 
 of tobacco emanating from the body and clothes of a 
 smoker, and so much the more from the smoke itself, 
 always causes a sw r ooning sensation (even before he 
 smells it or is otherwise aware of its presence), with 
 headache, neuralgia of the maxillary and facial nerves, 
 neuralgia, spasm, and soreness of his heart, feeble, 
 intermitting pulse, shortness of breath, huskiness of 
 voice, sickness of stomach, torpor of liver, cholaemia, 
 and such a deterioration of his blood as to induce 
 swelling and soreness of his gums, with sometimes 
 bleeding therefrom, looseness of his teeth, alveolar 
 abscess, suppression and disorder of the functions of 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 39 
 
 the chylopoietic viscera, and general prostration, with 
 even an occasional attack of cholera morbus. Some 
 years since a slight exposure to the fumes of tobacco 
 (wilfully inflicted upon him, as he verily believes, by 
 one who knew his infirmity), laid him up in bed for 
 ten days with congestion of, and haemorrhage from 
 his lungs, and invalided him for a long time there- 
 after. In fact, he is so susceptible to the poisonous 
 effects of tobacco, directly upon his blood, heart, and 
 nervous system, as to seriously endanger his life and 
 induce a state of enforced invalidism from occasional 
 accidental exposures thereto, so that he is obliged to 
 carefully avoid it, and every one that uses it, hence to 
 live a very retired life to be free therefrom ; during 
 which his health is generally good though not vigor- 
 ous, except a persistent tendency to alveolar abscess, 
 and laryngeal irritation with tubercular sputum there- 
 from that sinks at once in water, and weakness of 
 voice, which get better or worse with the varying 
 states of the S3 7 stem, according to freedom from, or 
 exposure to the pernicious action of the tobacco 
 miasm, as in his efforts to maintain himself he is com- 
 pelled to go about more or less, although at much risk, 
 having thus to struggle against a state of enforced 
 invalidism, seclusion, and privation, inflicted upon him 
 by this smoking barbarism of the age from those thus 
 engaged in artificially generating and diffusing this 
 potent pestiferous tobacco miasma, which he is power- 
 less to resist even in a moderate degree, and unable to 
 altogether avoid by an isolated life, so that after 
 enduring untold torture of body and mind therefrom, 
 he will doubtless fall a sacrifice to this baneful poison 
 and barbarous custom of tobocco smoking. 
 
40 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 This, of course, is an extreme case, but with other 
 evidence, it strongly illustrates the pernicious power 
 of tobacco to induce a superalkaline, scorbutic, and 
 toxic condition of the blood, arrest oxygenation and 
 circulation, subvert nutrition and secretion, and pro- 
 duce depression of the nervous, muscular, and general 
 system, directly dangerous to life, as well as promotive 
 of congestive, hsemorrhagic, toxemic, necraemic, scor- 
 butic, zymotic, septic, mephitic, lithsemic, ■ and ady- 
 namic diseases, with local disorders of the nares, 
 mouth, throat, air-passages, lungs, heart, stomach, 
 liver, bowels, brain, kidneys, and other organs, accord- 
 ing to special tendencies and circumstances, or a toxic 
 state of nicotism, analagous to narcotism and alcohol- 
 ism. This potent tobacco poison thus strikes at the 
 very basis of life — the blood, heart and circulation, 
 with the nervous and nutritive systems, and kills 
 many who are thought to die with other forms of 
 toxaemia, paralysis of the heart, brain, and nervous 
 system, or affection of the lungs, kidneys, with other 
 diseases, when the real cause is nicotism of the blood, 
 heart, lungs, kidneys, brain, nervous, and general 
 system, especially in weakly and sensitive men, women, 
 and children, who are largely afflicted and sacrificed 
 thereby. Nor is this singular in view of the peculiar 
 constitution of tobacco, it being a congeries of some 
 of the most powerful alkalies and poisons known, the 
 principal of which are ammonia, with nicotia, nico- 
 tianin, colludine, the pycoline bases, and other noxious 
 agents, nicotia alone being a potent alkali, emetic, 
 cathartic, narcotic and sedative, ranking next to prussic 
 acid, which itself is said to be a constituent of tobacco 
 smoke by eminent authorities. [Vide National, U. S. 9 
 and other Dispensatories.) 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 41 
 
 Thus, this aramonsemia and superalkalinity of the 
 blood and body from whatever cause, whether from 
 intrinsic systemic or extraneous sources, or both com- 
 bined, has a direct basic influence in the production of 
 a great variety of constitutional and local diseases, of 
 a more or less grave and pestilential nature according 
 to special morbific circumstances of alimentation, 
 climate, meteorological, malarial, and other pathogenic 
 conditions, occupations, habits and modes of living, 
 such as scurvy, purpura, congestive, typhus, typhoid, 
 yellow, bilious, remittent, puerperal, and other low 
 fevers, with small-pox, cerebro-spinal meningitis, scar- 
 latina, measles, cynanche maligna, diphtheria, erysipe- 
 las, eczematous, with carbunculoid affections, cholera, 
 and correlative zymotic, septic, mephitic, infectious, 
 scorbutic, adynamic, and colliquative maladies, some of 
 which may be excited, and all intensified, by exposure 
 to the pestiferous miasm of tobacco smoke, with other 
 ammoniacal, or alkaline, sedative, and noxious agents. 
 
 Besides its general influence to produce an ammoni- 
 cal or superalkaline, poisoned, and scorbutic condition 
 of the blood, with disorder of the circulation, and 
 depression of the nervous and general vital energies, 
 tobacco also exerts a special ^etiological power to 
 excite disease of the nares, mouth, throat, air-passages, 
 lungs, heart, stomach, liver, bowels, kidneys, brain, 
 and other organs, even in adults, and so much the 
 more in children who are so susceptible thereto and 
 freely exposed to its noxious influence everywhere. 
 Hence, as this tobacco miasm produces similar patho- 
 logical conditions both local and constitutional, it is 
 more than probable that it is a prolific exciting as well 
 as predisposing cause of that generally prevalent and 
 fearfully destructive disease — diphtheria, and actively 
 
42 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 increases its inception, intensity, and fatality, with 
 that of all other correlative zymotic, septic, and ady- 
 namic maladies previously indicated. Smokers are 
 thus actively engaged in poisoning, degenerating, 
 diseasing, and destroying themselves, children, and 
 others (of all ages and both sexes), by engendering 
 and diffusing everywhere, this pestiferous tobacco 
 miasm, that all exposed thereto must inhale and poison 
 their blood and bodies therewith nolens volens, the per- 
 nicious effects of which are usually attributed to some 
 occult infection, microzyme, or other obscure cause, 
 when they are really entirely due to this baneful 
 tobacco malaria, independent of, though often compli- 
 cated with, other morbific and specific pestilential 
 agents. 
 
 In the pathology of diphtheria there are three promi- 
 nent lesions, viz. : (a) of the blood and circulation, 
 of a superalkaline, scorbutic, and toxical nature ; 
 (6) of the throat, with congestion and inflammation, 
 ulceration and plastic exudation, though this latter 
 may also occur in other parts of the body; and, (c) 
 of the nervous centres more directly connected with 
 the pharynx, as well as of the system in general of an 
 adynamic type; all of which are thus of an asthenic 
 character. But while in the lesion of the throat, the 
 most marked characteristic of the disease is of an in- 
 flammatory nature, it is of a low grade and more 
 analogous to erysipelatous and gangrenous, than 
 ordinary croupous inflammation, though closely allied 
 therewith, the membranous exudate being alike fibrous 
 in both. Yet, in general, croup and diphtheria differ 
 widely in both their pathology and treatment, the 
 former being of a more purely local sthenic inflamma- 
 tion, with fibro-plastic exudation independent of a 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 43 
 
 primary scorbutic and toxemic complication and sys- 
 temic debility, while the latter is of an asthenic in- 
 flammatory character dependent upon, or complicated 
 with, ammonaemia, septicaemia, and general adynamia. 
 
 These diseases, however, correlate and merge in 
 every degree with each other, like all other inflamma- 
 tory and septic disorders, though the extremes are 
 well markefl, and which give rise to such endless con- 
 fusion both in pathology and therapeutics. 
 
 In diphtheria the basic lesion is in the blood, that 
 vital fluid becoming deteriorated, scorbutic, toxemic, 
 septic, and infectious, from apparently an excess of the 
 organic alkali — Ammonia, engendered within, or in- 
 troduced from without the body, or both together with 
 other deleterious agents. This ammoniacal state of 
 the blood, or ammonaemia, induces a toxical, solvent, 
 and inflammatory condition thereof, with disposition 
 to congestions, defluxions, and plastic exudations, with 
 purulent and gangrenous affections and low forms of 
 disease, from local irritation of any kind, often more 
 particularly in the liver, lungs, air-passages, and 
 pharynx, perhaps from their supersusceptibility to 
 extraneous with intrinsic exciting causes of disease, of 
 which the irritant, depressing, alkaline, and toxic 
 fumes or smoke of tobacco are an active exciting, as 
 well as predisposing, cause thereof, though the same 
 agencies and dyscrasia will operate to produce a variety 
 of asthenic diseases — local and constitutional, accord- 
 ing to special tendencies, and complications, specific 
 infections, climatic, malarial, meteorological, and other 
 influences. 
 
 Thus, this one pernicious miasm of tobacco alone, 
 supplies all the active aetiblogical and morbific factors 
 to engender diphtheria, with correlative affections, as 
 
44 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 by its ammonia and nicotia, it induces superalkalinity 
 of the blood, and still more general toxaemia from these 
 and its other noxious constituents, besides those cor- 
 rupt products secondarily developed and retained in 
 the blood and body from its baneful action thereon, 
 while it directly irritates the throat and air-passages, 
 and excites congestion, inflammation, and ulceration 
 therein, powerfully depresses the nervous and vital 
 energies, and paralyzes the heart, brain, nervous, 
 .muscular, and general system, even of adults, and so 
 much the more of children, who are so susceptible to 
 this pestiferous poison and disease. Moreover, w 7 hen 
 to this is superadded other potent morbific factors, as 
 various forms of malaria, cold and moisture, undue 
 exposure to bad weather, confined and impure air, 
 draughts, and other causes of ammonsemia, septi- 
 caemia, and catarrh, with defective dietary, and bad 
 modes of living, it is not wonderful that diphtheria 
 is so frequent and fatal, but that it should not be more 
 prevalent and deadly. 
 
 The origin of this frequent and fatal disease — diph- 
 theria, with all allied maladies, is, I believe, of a more 
 purely chemical or chemico-organic character, inherent 
 in the system, rather than dependent upon extraneous 
 organic entities, especially of the now fashionable 
 microzymes, the presence of these being secondary and 
 subordinate, rather than primary and supreme factors 
 of this, with other diseases, now so exclusively at- 
 tributed thereto. The germ theory is defective in 
 that it assumes sequents for antecedents, effects for 
 causes, and disregards too much the inherent chemico- 
 organic and bio-dynamic basis of disease as well as 
 health, disease and death with life and health being 
 inherent in the vital organism, independent of 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 45 
 
 extraneous agencies, though necessarily correlated 
 therewith, especially those chemical and dynamical 
 influences comprised in food and air, heat, light, 
 electricity, etc., essential for organization and life 
 action. If the germ theory was so generally true 
 where did the primordial germ receive its morbific 
 germ from to excite disease ab initio ? While there 
 may be parasites ad infinitum, there must necessarily 
 have been none such with the primeval organism 
 which started anew from its constituent chemical 
 elements, the abnormal variations or aberrations of 
 which with their affinitive forces created abnormal 
 conditions, or disease. It is, therefore, apparent that 
 these accredited pathogenic micro-organisms cannot 
 always or even so frequently as usually thought, be 
 the primary ^etiological factors of disease, but rather 
 secondary and sequential products or concomitants 
 and complications thereof, the ammoniacal, scorbutic, 
 septic, and necrsemic conditions of the blood and 
 components, or humors and tissues of the diseased 
 economy affording an appropriate nidus for their 
 development, existence, and activity, organic decom- 
 position everywhere being a prolific source and 
 support of microzymes and the lower organisms. 
 
 Diphtheria, in my opinion, is frequently of spon- 
 taneous origin from morbid systemic and local chemico- 
 organic and dynamic action, as well as often developed 
 and intensified by extraneous chemico-toxic and 
 alkaline agents like tobacco, ammonia, sewer gas, 
 foul air, meteorological, and other inorganic agencies, 
 independent of micro-organisms or infection, though 
 like erysipelas, capable of transmission after its 
 spontaneous as well as secondary inception, when 
 there are favorable conditions for its communication, 
 
46 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 as a specific contagium is engendered in both 
 instances. The same rule applies, I believe, with all 
 the zymotic, septic, contagious and infectious diseases, 
 which may originate spontaneously and engender a 
 specific virus in each instance, that will extend their 
 special maladies indefinitely unless counteracted by 
 some suppressing power, the intensity thereof being 
 proportionate to the basic superalkalinity of system. 
 This spontaneous development of specific disease and 
 contagium is clearly manifested in grease, glanders, 
 hydrophobia, gonorrhoea, erysipelas, puerperal, and 
 typhus fevers, with, in my opinion, all other correla- 
 tive maladies from the least to the most contagious, 
 which though usually transmitted, often also originate 
 denovo, like fire in spontaneous or artificially developed 
 combustion, and secondarily communicated whenever 
 the essential factors of either are brought together by 
 accident or design. In fact, in accord with the 
 general laws of nature, it is most probable that all 
 diseases — from the most benign to the most malignant 
 and contagious, originate spontaneously, as all the 
 former, and some of the latter, are known to do, 
 whenever concurring circumstances are favorable, 
 which it is the object of science to discover and 
 counteract in all cases alike. 
 
 That there is thus some insidious potent and gene- 
 ral cause of diphtheria with allied septic, contagious, 
 and adynamic affections, independent of the usual 
 extraneous morbific agencies, is manifest from their 
 frequent spontaneous development where there is 
 comparative freedom from the ordinary most active 
 pathogenic influences both contagious and innocuous, 
 even where the sanitation seems to be so perfect as to 
 avert or counteract the tendency to the milder 
 
DIPHTHERIA, TYPHOID, AMD ALLIED DISEASES. 47 
 
 abnormities much less to permit the origin of any 
 malignant disease. In relation to this subject, with 
 regard to a recent epidemic of diphtheria in Mansfield, 
 Ohio, Dr. Mary J. Finley thus concludes {Cincinnati 
 Lancet and Clinic), " A careful study of a number of 
 reports of diphtheria in different parts of the United 
 States and in other countries, has convinced me that 
 epidemic diphtheria occurs with almost equal malig- 
 nancy under the best and the worst sanitary condi- 
 tions. The most desirable hygienic surroundings, 
 and the most irreproachable water supply, afford no 
 security against its attack." 
 
 Yet, while there may be almost perfect sanitary 
 precautions and conditions in other respects, there is 
 one potent miasm and morbific factor of diphtheria 
 with allied diseases artificially engendered and diffused 
 almost everywhere throughout the world from the 
 hovel to the palace among all classes and conditions 
 of people, from the lowest to the highest, in the 
 omnipresent and pestiferous tobacco smoke that 
 penetrates and pollutes the lungs, blood, and bodies 
 of all exposed to its pernicious influence, alkalizing 
 and poisoning the fluids and solids of the body, 
 depressing the nervous and vital energies, irritating 
 the throat, air-passages and lungs, and specially pre- 
 disposing to, and exciting adynamic and malignant 
 diseases, both local and constitutional, and directly 
 and indirectly of the pharynx as well as other parts of 
 the system. Hence, in view of the almost universal 
 presence and powerful morbific influence of this 
 potent alkaline and acro-narcotic tobacco miasm, it is 
 not at all surprising that diphtheria and its pestiferous 
 analogues arise and spread spontaneously so frequently, 
 generally, and fatally. It does not follow that because 
 
48 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 this powerful acro-narcotic is unsuspected or disre- 
 garded that it is less actively poisonous and destruc- 
 tive, any more than the unrecognized presence of 
 carbonic acid would diminish its baneful and deadly 
 effects. 
 
 Dr. Willard Parker, of New York, says (Medical 
 and Surgical Reporter), " That tobacco is a poison, 
 is proved beyond question. It is now many years 
 since my attention was called to the insidious but 
 positively destructive effects of tobacco on the human 
 system. I have seen a great deal of its influence 
 upon those who used it, and worked on it, or in it. 
 Cigar makers, snuff manufacturers, etc., have come 
 under my care in hospitals and private practice ; and 
 such persons never recover soon and in a healthy 
 manner, from any case of injury or fever. They are 
 more apt to die in epidemics, and more prone to 
 apoplexy and paralysis, the same is true, also, of all 
 who chew or smoke much." And, it might have been 
 truthfully added, likewise of those who are exposed to 
 the baneful influence of this pernicious poison in any 
 manner or form. 
 
 " M. Mercier in corroboration of the unsuspected 
 effects of tobacco in generating disease, related a case 
 in which a cough, which had persisted for a year, 
 and purpura, which had lasted for seven months, soon 
 yielded after the cessation of smoking, which had 
 been excessive. His own practice had furnished him 
 full proof of the depressing effect of this agent upon 
 the generative functions."* — U Union Med. and British 
 and For. Med. Chir. Rev. 
 
 * In moderate quantities, however, tobacco excites the sexual 
 passions, and stimulates to vice and immorality. 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 49 
 
 But cases are frequently presented of affections of 
 the mouth, throat, nares, air-passages, pulmonary, and 
 other organs, blood, nervous and general system, 
 usually attributed to various other causes, that are 
 really directly produced by this potent tobacco poison, 
 as demonstrated by the marked improvement and 
 rapid recovery when relieved therefrom. 
 
 The following observations of repeated outbreaks of 
 diphtheria in isolated places far away from contagious 
 influences and previous existence of the disease, 
 strongly support this view of its frequent development 
 de novo, when concurrent conditions are favorable to 
 its occurrence. 
 
 Dr. T. J. Hutton, of Minnesota, states in the Medical 
 Record, quoted by the Scientific American that within the 
 past three years he has treated sixty-four cases of diph- 
 theria. " These cases were all in comparatively new 
 houses, iu a belt of country where white men never 
 lived before, so that the soil contained no sewage, 
 and had no accumulation of surface filth. Diphtheria 
 had never before been there, and could not have been 
 brought by visitors ; it was of a malignant type, and 
 some families lost five and six members each. All of 
 these cases were included in seventeen rural out- 
 breaks, three of which were in summer, and seventeen 
 in winter, and every house attacked was small and 
 greatly overcrowded. Many of the winter outbreaks 
 happened when the temperature was 30° to 40° F. 
 below zero, which w r ould have- been death to all 
 ordinary surface germs, and in one instance the 
 thermometer registered 60° below, when the surface 
 of the earth and all bodies of water were frozen 
 solid." In the absence of most of the usually at- 
 tributed causes thereof, Dr. Hutton infers that 
 
50 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 " diphtheria is caused by ochlesis or crowd poison," 
 and " may occur sporadically, any small overcrowded, 
 ill ventilated house may prove a diphtheria factory/' 
 That temperature directly has none, but indirectly 
 much to do with it, as overcrowding with confined air 
 is most apt to occur in cold weather, hence " an 
 abundance of pure air is the first requisite in treat- 
 ment. I have seen patients apparently moribund, 
 restored by fresh air and food alone. So have other 
 observers." 
 
 But this so-called " crow T d poison" is largely com- 
 posed of the ammoniacal and organic excreta from 
 the lungs, blood, and bodies of many human beings 
 confined in a limited space. While in the cases cited 
 they were doubtless augmented and intensified by the 
 additional baneful miasm of tobacco smoke, with its 
 noxious component ammonia, nicotia, and other 
 poisons, which are generally so freely and recklessly 
 engendered and diffused everywhere to the injury of 
 sensitive and sickly men, women, and children 
 especially, thus acting both as predisposing and excit- 
 ing causes of diphtheria and allied throat, with other 
 asthenic diseases — local and constitutional — in persons 
 of all ages, young and old, weak or strong, who are 
 incapable of resisting the potent morbific influence of 
 any one of these baleful poisons, much less the 
 compound and combined power of all these active 
 materies morbi and causes of disease, concentrated, 
 particularly in crowded and close places, where 
 tobacco smoke with other forms of malaria are usuallv 
 so common. 
 
 Further evidence of the spontaneous origin of 
 diphtheria is afforded by the observations, experience, 
 and experiments of various scientists, notably recently 
 
DIPHTHERIA, TYPHOID, AXD ALLIED DISEASES. 51 
 
 of Drs. Wood and Formad, thus presented in the 
 Philadelphia Ledger^ among the views of prominent 
 physicians of that city, upon the subject, collected by 
 visiting reporters thereto. 
 
 "Dr. Horatio C. Wood, of the Faculty of the Uni- 
 versity of Pennsylvania, and one of the Philadelphia 
 cientists who has made a special study of diphtheria, 
 was also visited and cheerfully furnished the following 
 facts relative to the subject. Several years ago Dr. 
 Wood and Dr. Henry F. Formad, under the auspices 
 of the National Board of Health, entered upon an 
 
 aborate investigation into the nature of diphtheria, 
 and in his conversation with the Public Ledger repre- 
 sentative he frequently referred to the points pre- 
 sented as having been the results of the joint labors. 
 
 M< We find that there is always present in the mem- 
 wanes a small microscopic plant, and that in some 
 cases of the disease, with violent fever and other 
 general disturbances, this plant forces its way through 
 the lymphatic vessels of the neck into the blood 
 vessels and attacks certain parts of the blood, grows 
 in the kidneys, marrow of the bones and in some 
 other of the internal organs. We succeeded in pro- 
 ducing diphtheria in the lower animals with mem- 
 branes from the throats of children who had been 
 afflicted; then rubbing up the membranes with water 
 and filtering out all solids, found that the w r ater was 
 not capable of producing the disease in animals, but 
 that the solid particles left after the filtration con- 
 tained the poison. It was also found that the plants 
 escaped in an isolated condition with the urine from 
 the kidneys, and that thus isolated it acts as a deadly 
 poison, producing diphtheria in the lower animals. 
 We also succeeded in cultivating the plant entirely 
 
52 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 away from any animal body, and, by the third or 
 fourth generation of the plant, produced diphtheria 
 in the lower animals. The disease as it was produced 
 in the lower animals resembles exactly the disease in 
 man. It is contagious, produces membrane, and the 
 animal dies with symptoms similar to those of a sick 
 child. 
 
 " ' The various veterinary surgeons/ continued Dr. 
 Wood, ' have from time to time asserted that it occurs 
 spontaneously in animals, and that it may be passed 
 from the lower animals to man. Dr. Forraad once 
 observed such an epidemic among rabbtis, and a 
 number have occurred in which dove-cotes in Bel- 
 gium have been visited and the birds destroyed by 
 the disease. I have known cases in which there 
 was reason to believe that children contracted 
 diphtheria from handling cats which suffered from 
 the disease in a mild form. 
 
 " ' A very careful study of an epidemic among calves 
 was made by the head of a Hanoverean College of 
 Veterinary Surgery. The calves were believed to 
 have contracted the disease from a child of the hostler 
 of the inn who died from it. The disease attracted 
 so much attention that a professor was sent for, he 
 found a large number of calves sick, proved that the 
 disease was contagious, and advised the veterinary 
 surgeon in charge to apply remedies to the throats of 
 the calves as in cases of human diphtheria. In four 
 or five days the local veterinary surgeon was seized 
 with diphtheria, and suffered from a violent attack. 
 The person who followed him in applying the 
 remedies to the calves was similarly affected, but the 
 attack was less virulent. 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 53 
 
 " ' It seems, therefore, well established that it is 
 Dossible for diphtheria not only to pass from men to 
 animals, but from animals to men. A curious in- 
 stance of such passage was met with by Dr. Formad 
 ind myself, during our researches. In the woods of 
 Michigan an isolated household was attacked, and the 
 slops from the sick room was thrown into the pig-sty 
 and devoured by one of the pigs. This pig sickened 
 and died. At the autopsy the stomach was found to be 
 covered with a dense diphtheritic membrane, which 
 was fall of the plant peculiar to the disease. The 
 blood, kidneys and other vital organs were also full, 
 precisely as in the cases. of children who have died in 
 malignant diphtheria. This case is important as 
 being in accord with experiments which show that 
 the plant has little tendency to enter the blood 
 primarily, but finds its first lodgment in the throat 
 or some other part, and afterwards enters the blood 
 through the ulceration of the part. 
 
 "' Diphtheria is, therefore, in the majority of cases,' 
 Dr. Wood went on to say, 'primarily a local disease, 
 and is to be arrested by local treatment. Another 
 important fact which we have arrived at was that the 
 plant of diphtheria is not different in kind from a 
 plant which is always present in the mouth of 
 healthy people, but that, under certain conditions, 
 this ordinarily harmless plant begins to grow 
 with great rapidity. In its ordinary condition 
 it has little tendency to grow, and is not noxious, 
 because it is inert. During its active stage it is 
 injurious, because it continually tends to develop 
 itself at the expense of the animal in which it is. 
 It is evident that the condition which favors the 
 passage of the plant from the inert to the active 
 
54 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 condition may exist inside the body of a person, or 
 may exist on the outside of him. In our studies it has 
 become very apparent that such towns as Williamsport 
 and similar centres in lumber districts are especially 
 proven to suffer from extraordinarily violent epidemics 
 of diphtheria, and this seems to depend upon the 
 presence of great masses of sawdust. In Michigan, 
 a large town in the winter of 1880-81 was visited by 
 an epidemic which was confined to those wards that 
 were built upon a ground made by filling up a swamp 
 by sawdust. The public schools were broken up, 
 but one-eighth of the children were said to have died. 
 In such localities, I believe,, with Dr. Formad, that 
 the conditions favorable to the growth of the plant 
 exist outside of the human system. It passes from 
 the inert to the active condition, so that the air 
 becomes full of the poison and an epidemic results. 
 On the other hand, a weak, sickly child gets a cold 
 and a sore throat. The plant in its mouth, in an 
 inert condition, finds exudation and tissues of low 
 vitalitv, excessive warmth and all the conditions 
 stimulating it into activity. The plant thus favored 
 passes from an inert into an active condition, and the 
 result is that a simple sore throat is converted into 
 diphtheria. In the first case mentioned an epidemic 
 has arisen ; in the second, a self-generated diphtheria. 
 The plant, which has in the mouth of the child passed 
 from the inert to the active condition, escaping from 
 the mouth is ready to grow and produce diphtheria 
 in the throat of the second child; so that the diph- 
 theria which has originated spontaneously is con- 
 tagious and may finally give rise to an epidemic. 
 
 "' The plant does not differ from a similar organism 
 found in putrid wounds. If it alights upon a sore 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 55 
 
 nger or any wound it produces disease at that point. 
 
 Many physicians and nurses have lost their lives by 
 
 loughing wounds produced in this way. We believe, 
 
 herefore,' continued Dr. Wood, speaking for himself 
 
 ind Dr. Formad, 'that diphtheria is nothing more or 
 
 ess than that which was called forty years ago, 
 
 putrid sore throat." 
 
 ui The fact that the plant escapes from the kidneys 
 
 n so active and virulent a condition and in such 
 
 nasses shows the importance of disinfecting the 
 
 lischarges at once in all cases. The vessels should 
 
 iave the disinfecting material placed in them before 
 
 ise, so that if possible the plant should be killed 
 
 mmediately. The researches at the University of 
 
 Pennsylvania .-how that while carbolic acid, arsenic 
 
 md many other substances have the power of killing, 
 
 here is no ordinary agent equal to corrosive sub- 
 
 imate. It should be borne in mind that carbolic 
 
 \cid is not less poisonous than corrosive sublimate; 
 
 t has taken life in 1?> minutes. Corrosive sublimate, 
 
 n proportion to its power over the organism, is less 
 
 dangerous than carbolic acid, and probably a solution of 
 
 the former, to which some mal-odorous substance is 
 
 added to prevent its being taken by mistake, would be 
 
 ^ safer and more efficient disinfectant than carbolic 
 
 icid. 
 
 11 'What has been said shows the supreme importance 
 }f very careful attention to all cases of sore throat in 
 3hildren, especially weakly childreh. The child is only 
 more apt to suffer from diphtheria than the adult 
 because the membrane of the throat is more tender, 
 nore readily becomes inflamed, and is more easily 
 penetrated. The great check to the growth of the 
 liphtheria organism is always the vital power of the 
 
56 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 tissues opposing it. A weakly child has lower re- 
 sistive power in its tissues; owing to such low resistive 
 power a sore throat in a child of that character is 
 very prone to become diphtheritic. The second point 
 alluded to is the great importance of local treatment 
 of the throat. This should have two objects: First, 
 to subdue the inflammation and check the sore throat, 
 and second, to kill the plant. The general treatment 
 of children should have for its object the destruction 
 of the plant within the body, but no agent is known 
 which is poisonous to the plant which is not also 
 poisonous to the child, and therefore it can do little 
 good to kill the plant if at the same time the patient 
 is destroyed. All that can be done is to sustain the 
 child, as to increasing its resistive power. It is a 
 battle between the life of the child and the life of the 
 organism. Unfortunately we cannot take life from 
 the organism, but we may add life, force, or vitality 
 to the child, and in some cases this addition may be 
 sufficient to decide the fate of the conflict in favor of 
 the child. 
 
 "'The relations of diphtheria to scarlet fever/ con- 
 tinued Dr. Wood, ' also have great light thrown on 
 them by the results obtained at the University. The 
 membrane in the throat of a scarlet fever patient 
 contained myriads of plants — micrococci — precisely 
 like those of diphtheria, and in the blood of some 
 cases of scarlet fever there is finally an abund- 
 ance of these plants, which are also to be found 
 in the kidneys and other organs. In malignant 
 measles the same plant is found in the throat and in 
 the blood finally. It is plain that this plant, always 
 being in the mouth, is ready always to pass from the 
 inert to the active condition. A child gets scarlet 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 57 
 
 fever and an inflammation of the throat follows. The 
 diphtheritic plant begins to grow, and it may be that 
 finally it becomes very active, produces a diphtheritic 
 disease, enters the blood and kills the child. The 
 child may have escaped the first evil effects of scarlet 
 fever poisoning to die of diphtheria, which is second- 
 ary to the scarlet fever, an indirect effect of scarlet 
 fever poison. "We believe that in many acute diseases 
 the cause of death is this secondary septic poison. A 
 curious element of prognosis has been made out in 
 the course of our study as important in all the dis- 
 eases. So long as the white corpuscles of the blood 
 are not attacked by the organism, the chances are 
 favorable to the patient, but whenever the microscopic 
 examination shows the presence of the organisms in 
 the white corpuscles the chances are greatly against 
 the patient, however unimportant other symptoms 
 may seem.'" 
 
 " Dr. Henry F. Formad, of the University of Penn- 
 sylvania, expressed himself against the prevailing 
 view that diphtheria is a direct contagious disease, 
 although he admitted that clinical evidence often 
 indicated a diphtheritic contagion. He had repeatedly 
 observed spontaneous diphtheria in animals and in 
 many instances in man. Experimental evidence was 
 also not in favor of the contagiousness of diphtheria. 
 From his observations he rather believed that similar 
 exposure, habits, surroundings and conditions of life, 
 and not the actual transmission of a poison, were the 
 agencies at work through which a number of indi- 
 viduals in one house, or of one street, or a whole 
 community, become attacked by diphtheria. 
 
 "From his experiments, in conjunction with Prof. 
 H. C. Wood, under the auspices of the National 
 
 D 
 
58 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 Board of Health, he had come to the conclusion that 
 every case of diphtheria was a primary origin and a 
 local disease, and only secondarily becoming consti- 
 tutional. He believed that diphtheria was merely a 
 putrid sore throat, either without or with secondary 
 blood-poisoning, and only in the latter case leading 
 to a fatal termination. Death, however, also may 
 ensue from suffocation, this being occasionally brought 
 on through the mechanical blocking up by false 
 membranes of the windpipe. The secondary blood- 
 poisoning in diphtheria he considered to be due to 
 the introduction of minute round fungi (micrococci) 
 into the blood. 
 
 " These micrococci exist in countless numbers upon 
 the mucous membrane of every healthy individual, 
 but they acquire a morbid life activity if bred in the 
 purulent exudate of an intensely inflamed throat, and 
 gain easily entrance to the system by means of the 
 blood-vessels and lymphatics, which are torn open in 
 the local sloughing ulceration. Diphtheritic inflam- 
 mation and exudates occurs in various parts of the 
 body, and may complicate any ulcerating wound 
 without doing any harm if attended to well, locally. 
 On the other hand, any intense simple inflammation 
 in the throat (particularly that of tender children), 
 with its numerous lymph-glands, blood-vessels and 
 absorbing channels, may lead to the formation of a 
 false membrane, and finally to that fatal constitutional 
 malady called diphtheria. When occurring in the 
 windpipe it is designated as croup, and it is here that 
 death from suffocation is common usually long before 
 any constitutional symptoms from blood-poisoning 
 can develop. Pathologically, croup and diphtheria 
 are identical ; clinically they differ ; on account of the 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 59 
 
 anatomical peculiarities of the parts affected the 
 symptoms and terminations are of necessity at vari- 
 ance. Concerning treatment Dr. Formad did not 
 express any opinion, leaving this to practicing physi- 
 cians. Moreover a variance treatment may be indi- 
 cated in each individual case. He considered, 
 however, local treatment of supreme importance; 
 the object of local cauterization being to transform a 
 putrid sloughing surface into a healthy granulating 
 one, which, under proper hygienic measures could 
 heal. Such means judiciously applied can, if success- 
 ful, prevent the absorption of septic matters into the 
 system." 
 
 Furthermore, it is stated in the Journal of the Ameri- 
 can Medical Association, that, according to the remarks 
 of Dr. H. C. Wood, at the recent meeting of the 
 Pennsylvania State Medical Society, in relation to 
 diphtheria and micrococci, besides this microphyte 
 " in the ordinary natural saliva of every person's 
 mouth that cannot be distinguished from the micro- 
 coccus of the most malignant diphtheria," being 
 " as far as could be discovered identical. The 
 same micrococci were found in great abundance 
 in cases of puerperal metritis, sloughing sores, and 
 gangrenous wounds, from which he infers that 
 diphtheria is not a specific disease, but simply a 
 putrid or septic sore throat, of greater or less severity 
 in different cases. This is returning very nearly to 
 the opinions derived from clinical observation fifty 
 years since." 
 
 It is thus seen that the same microbes exist in both 
 health and disease of various kinds, and their 
 relative degree of development, activity, and innocu. 
 ousness or malignancy depend upon the character of 
 
60 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 the soil most favorable for their evolution and energy, 
 both within and without the living organism. Now, 
 as ammonia is constantly engendered more or less 
 freely in the earth, air, and vital economy, and is the 
 common basic food of plants from the smallest to the 
 largest, while it is both frequently produced and 
 introduced in excess within the living system, it is 
 most probable that the development, activity, and 
 malignancy of these parasitic microphytes depend 
 upon the ammoniacal condition of the fluids and 
 solids of the body, which thus affords within itself the 
 basic pabulum, materies morbi, predisposing and 
 exciting causes of all such malignant microzoa and 
 diseases, as manifested in diphtheria, angina maligna, 
 scarlatina, typhoid, ship, yellow, enteric, puerperal, 
 and other septic fevers, with small-pox, erysipelas, 
 cholera, and correlative maladies, as well as the more 
 contagious and mephitic types and complications of 
 all other diseases — local and general, many of which 
 are ordinarily of a mild, incorrupt, and non-infectious 
 character, but become putrescent, malignant, and 
 contagious, whenever this ammonsemia and super- 
 alkalinity of system results. 
 
 Thus, there is identity of cause with multiple 
 diseases, or autogenesis of both materies morbi and 
 morbidity, with autosepsis, autoinfection, adynamia, 
 malignancy, zymosis, and contagion, variously mani- 
 fested and complicated. 
 
 This ammoniacal state of the fluids and solids of the 
 vital economy is thus doubtless, in fact, the basis and 
 underlying complication of every form, variety, and 
 grade of disease — functional and organic, acute and 
 chronic, local and general, of a scorbutic, necrsemic, 
 septic, zymotic, contagious, mephitic, and putrescent 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 61 
 
 type, as it supplies the essential pabulum for the 
 development of microzymes, toxic, and contagious 
 principles, the degree of activity and malignancy 
 being proportioned to its preponderance, and pro- 
 duction, or retention, and introduction into the 
 system, while the special variety, specific contagia, 
 and manifestations, depend upon secondary and 
 extraneous conditions of a chemical, mechanical, 
 dynamical, and organic character, intrinsic in, or 
 extrinsic to the vital economj 7 . 
 
 While thus this ammoniacal and superalkaline 
 dyscrasia may originate and increase the virulence of 
 all the malignant forms of disease, it also often 
 complicates, intensifies, and corrupts all other diseases 
 of an ordinarily benign character — both local and 
 general. Thus by its irritant, solvent, toxemic, 
 septicemic, and dissolutive action, it increases the 
 tendency to, and complexity of, inflammatory, hemor- 
 rhagic, albuminous, lymphoidal, serous, and purulent 
 degeneration, disorganization, colliquation, and ex- 
 travasation in general. For instance, in srnall-pox 
 augmenting the pyrexial, necremic, septicemic, con- 
 fluent, and purulent disposition, deliquescence, and 
 malignancy, with, likewise, the same in all the ex- 
 anthemata, and correlative maladies. While, in an- 
 gina, bronchitis, pneumonia, consumption, and cog- 
 nate affections inducing the same general typhoidal 
 diathesis and dissolutive disposition, with spticemic, 
 hemorrhagic, gangrenous, suppurative, and purulent 
 tendency. Likewise in cerebritis, cerebro-spinal 
 meningitis, gastritis, hepatitis, enteritis, metritis, 
 nephritis, phlegmasia dolens, and other internal with 
 external phlegmasie, causing a similar toxemic, 
 pyemic, gangrenous, and disorganizing type, which 
 
62 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 are also manifested in the minor disorders of the 
 surface in carbunculoid furunculi, erysipelatous 
 wounds and abrasions, bruises, burns, injuries, 
 punctures, and scratches, that otherwise would be 
 mild and readily heal, with various purpuric, hsemor- 
 rhoeal, albuminoid, serous and choleraic defluxions 
 within the interior as well as from the surface of the 
 body, and intestinal, renal, vaginal, and other tissues 
 and passages. Indeed, it thus gives a scorbutic, 
 necrsemic, septic, erysipelatous, infectious, and malig- 
 nant type to every form and variety of disorder, from 
 the simplest pimple, bruise, abrasion, or lesion — 
 internal or external, up to the gravest diseases. Thus, 
 in fact a general depraved cachexia and tendency 
 is thereby excited to scorbutic, toxemic, septic, 
 necrsemic, contagious, congestive, apoplectic, hemor- 
 rhagic, albuminous, uremic, anasarcous, serous, 
 eczematous, erysipelatous, gangrenous, purulent, 
 mephitic, and disorganizing forms of disease — both 
 genera] and local. Hence, in all such ammoniacal 
 and superalkaline diatheses and complications, am- 
 monia and its compounds are necessarily contraindi- 
 cated, the opposite neutralizing, antalkaline agents 
 being essential to subvert and counteract its toxic, 
 morbific, and dissolutive effects. 
 
 With regard to the relation of ammonia to bacteria 
 and contagious affections, Dr. Geo. M. Sternberg 
 observes in his report to the National Board of 
 Health (Sanitarian, Dec. 6, 1883) : 
 
 "The term albuminoid ammonia much used in the 
 analysis of air, as well as of water, has usually 
 represented a whole series of unknown factors. 
 
 " It was first noticed by Gay Lussac that all the 
 nitrogen of organic matter, when heated with caustic 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 63 
 
 hydrates, appeared as ammonia. Albuminoid com- 
 pounds, when disorganized by the growth of the 
 lower forms of organisms, set free ammonia, and the 
 quantity of the freed ammonia may in a general way, 
 serve as a standard to indicate the amount of decom- 
 position which has taken place. 
 
 " The term albuminoid ammonia, on the contrary, 
 stands for the quantity of nitrogenous material in air 
 and water which may serve as food for the growth of 
 these infinitesimal organisms. This as yet undecom- 
 posed organic matter is not by any means in itself 
 necessarily hurtful, although always objectionable. 
 Combined with moisture at ordinary temperatures, it 
 furnishes the condition for bacterial growth and may 
 prove sufficient for the development and spread of 
 an epidemic of some one of the class of contagious 
 diseases. We can have no chemical test for dis- 
 criminating between hurtful and harmless organic 
 matter, since the poisonous infection is vital, and 
 where found must be looked upon with suspicion." 
 
 But, it is obvious, that these microzoa cannot be 
 developed or exist without their essential nutrient 
 material for organization and support — ammonia or 
 its nitrogenous equivalent, and according to the 
 abundance of this so will be their increase, activity, 
 and power; and, per contra, its absence or diminution 
 will proportionably prevent the appearance and limit 
 their growth and energy, so that they must necessarily 
 be secondary and subordinate factors of this basic 
 ammoniacal source of disease, infection, and dissolu- 
 tion. Yet, even admitting the primary action of 
 microzymes in the production of ammonia and 
 zymotic diseases, a safe and appropriate chemical 
 treatment will both neutralize this alkali, starve and 
 
 o 
 
64 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 kill them directly and indirectly, as well as resolve 
 their morbid concomitants, thus nullifying the basic 
 and initial factors of these pestilential and allied 
 diseases, with the concomitant infectious principle 
 and microbes, and the so common complication of the 
 same malignant pathogenic causes with the usually 
 benign abnormities, which thereby render them 
 likewise infectious and destructive when they would 
 otherwise remain innocuous. 
 
 Further evidence of the spontaneous origin, basic 
 chemical nature, and identity of the primal ammonia- 
 cal cause of all zymotic, septic, malignant, infectious, 
 and cognate diseases, might be largely adduced, such 
 for instance, as are presented in an interesting paper 
 on the " Community of Origin of Diphtheria, Typhoid 
 Fever and Scarlatina/' (Journal American Medical As- 
 sociation, August 30, 1884), by Dr. E. 0. Bardwell, of 
 Malone, 111., which, he says, " appear to me to 
 support the proposition that these three disorders owe 
 their origin to a common source, that the same nidus 
 may cause at one time the evolution of one malady, 
 and at another time of a different one. What the 
 peculiar predisposing force consists of which favors 
 the production of one disease in preference to 
 another, it is impossible to say, although various 
 hypotheses with pages of text to support them might 
 easily be written." 
 
 The examples presented are too lengthy for quota- 
 tion, but they all tend to prove the causal identity of 
 origin and spontaneous development of diphtheria, 
 scarlatina, and typhoid fever in isolated hamlets, 
 apparently induced by insanitary conditions within 
 and about the dwellings, engendering ammonia, 
 malaria, and infectious matter, far away from any 
 secondary sources of contagion. 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 65 
 
 He further observes "judging from these cases I 
 cannot arrive logically at any other conclusion than 
 that these diseases are originally caused by disregard 
 of the laws of hygiene. Their spread after develop- 
 ment is another question entirely, and one with 
 which we have at the present time no concern more 
 than to venture the remark that the innocent in- 
 evitably suffer with the guilty; the person whose 
 doors are kept clean suffer the penalty of allowing 
 their neighbors to live in ignorance of plain sanitary 
 laws. If improper sanitation is the primordial factor 
 in the evolution of these disorders, then it is not so 
 important to ascertain in just what form and by what 
 means disease is disseminated, as it is to strike at the 
 root of the evil, to annihilate the first cause, without 
 which there can be no elements of disease to be 
 carried about by the air, by innocent micro-organisms, 
 or by distinct varieties of minute life created for this 
 special purpose/' 
 
 Other examples might be cited of similar spon- 
 taneous development of pestilential diseases, for, as 
 correctly observed by Dr. N. S. Davis (Ibid), " It 
 would be easy to find thousands of isolated farm- 
 houses resting upon soil impregnated with the drip- 
 pings of the kitchen, the cesspools, and the barnyard, 
 and in which typhoid fever, diphtheria, scarlatina, 
 etc., are almost annual visitors." These predisposing, 
 and often also exciting causes of ill health and disease 
 of various kinds, even of the most malignant type, 
 are largely avoidable, for " it would be a compara- 
 tively easy task for a large proportion of our farmers 
 and inhabitants of villages, to turn all the contents or 
 drippings of the cesspools and barnyards, through 
 drainage pipes to neighboring cultivated fields, where 
 
66 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 it would increase the harvest in the very act of 
 
 undergoing effectual epuration For say 
 
 what we please about the seeds or germs of disease 
 and the laws of their diffusion, it is certain that none 
 of them thrive well in impure air accompanied by 
 pure water and a clean soil." — {Ibid,) 
 
 But, even after all these general impurities and 
 sources of ammonia, malaria, disease, and pestilence 
 are removed, there still remains the active, ever- 
 present, insidious, special factors of morbidity, cor- 
 ruption, and death from vicious habits and personal 
 contamination of the people themselves, many of 
 whom not only poison themselves but others, for, 
 despite the utmost efforts to keep the blood and 
 body pure and clean, any one may be befouled and 
 suffer from the pernicious practices and toxic emana- 
 tions from those who disregard the laws of health, 
 and the rights of all persons to be free from enforced 
 pollution, sickness, affliction, and death, w r hich bane- 
 ful infliction is so markedly exemplified in the general 
 production and diffusion of that most noxious and 
 disease-generating tobacco miasm by smokers almost 
 everywhere in public as well as in private, without 
 the least regard for the rights, health, and lives of 
 their fellow-beings, and which can only be obviated 
 by a rigid observance and enforcement of personal 
 with public sanitation. 
 
 Moreover, decomposing nitrogenous matter and 
 doubtless also ammonia favor the formation of those 
 lately discovered poisonous alkaloidal substances 
 termed ptomaines, which were thought at first to 
 be exclusively of cadaveric origin, but as stated by 
 R. N. Wolfenden, M. B., Lecturer on Physiology in 
 the Charing Cross Hospital Medical School (Lancet, 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 67 
 
 and Journal American Medical Association), " Investiga- 
 tions are rendering it more and more probable that 
 alkaloids of a poisonous nature occur in certain 
 pathological conditions, and possibly also normally 
 as a product of change of living tissue. Selmi sup- 
 posed them to be products of putrefaction of organized 
 nitrogenous material. 
 
 " There can be no further doubt that these bodies 
 are largely produced in the process of decomposition 
 of nitrogenous or proteid tissues. There are many 
 varieties of them and they vary much in their nature, 
 according as the length of time after death is long or 
 short. Stinking fish, bad meat, etc., all contain 
 poisonous principles which can be extracted after the 
 manner of ptomaines. The gastro-intestinal irritation 
 and profound toxic symptoms produced by the inges- 
 tion of bad food are probably at the bottom processes 
 of alkaloidal poisoning. By decomposition of neurin 
 and albumin toxic bodies may be obtained much 
 resembling muscarin. Both from freshly prepared 
 peptone made by the action of gastric juice on pure 
 fibrin, and from stinking peptone by boiling with 
 caustic soda, evaporating, extracting and purifying, 
 toxic alkaloids can be obtained which kill frogs and 
 rabbits in a few minutes. Putrefying casein, brain 
 substance, liver and muscle also yield these products. 
 
 " These ptomaines are met with as a constituent of 
 normal tissues or juices. In this case they are pro- 
 ducts of tissue metamorphosis." - They are also found 
 in the saliva and urine. Likewise " in certain patho- 
 logical conditions. In the urine of patients suffering 
 from progressive paralysis there are two volatile 
 bases, the one like nicotin, the other like coniin. 
 In the urine voided during a case of interstitial 
 
68 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 pneumonia were two alkaloidal bases one having the 
 odor of stinking fish, the other of ammonia. Two 
 similar bases were found in the urine of patients with 
 abdominal typhus. In tetanus a base like coniin was 
 discovered in the urine. In the urine of ' miliary 
 fever' an alkaloidal base having the odor of stinking 
 fish has been observed. 
 
 " Some of these ptomaines are not poisonous, but 
 most possess strongly toxic characters, and cause 
 profound symptoms when injected under the skin, 
 such as paralysis more or less complete, of hinder ex- 
 tremities, dilatation of pupils, convulsions, muscular 
 flaccidity, slowing or acceleration of the heart, loss of 
 cutaneous sensibility and of muscular contractility, 
 possessing many of the characteristic physiological 
 actions of muscarin or atropin. They answer to 
 nearly the same reactions as the vegetal alkaloids." 
 
 It is thus seen that an ammoniacal, superalkaline, 
 dissolutive, and corrupt state of the living organism 
 is not only favorable for the development of microzy- 
 mes, but also a class of poisonous alkaloidal sub- 
 stances, and doubtless likewise of the most virulent 
 forms of contagia as well as of the milder varieties of 
 infectious and toxic matter, with the spontaneous 
 origin of all the varied zymotic, septic, contagious, 
 and mephitic maladies, with the scorbutic, typhoid, 
 infectious, and putrescent complication of all the 
 minor and ordinarily innocuous disorders — both 
 general and local, internal and external, of every 
 grade and character, for while this primal obnoxious 
 and morbific agent — ammonia, is thus always the 
 same, the secondary and complicating poisons and 
 concomitants, or contagious principles, pathogenic 
 influences, and morbid states may vary indefinitely 
 according to special conditions and complications. 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 69 
 
 These considerations are of paramount importance 
 for the correct appreciation of the aetiology, pathology, 
 and treatment of all diseases of every form and 
 nature, contagious and non-contagious, and especially 
 of that infectious, malignant, and destructive variety 
 of which diphtheria is a type. Without therefore, 
 disregarding the presence of microzymes with toxic 
 and other subordinate concomitants in diphtheria and 
 correlative diseases-, yet in the prevention and treat- 
 ment thereof they should be regarded as of secondary 
 rather than of primary importance, while special 
 effort should be made to subvert the basic chemico- 
 organic and dynamic morbific factors, and particularly 
 the primal ammoniacal pathogenic substratum, with, 
 at the same time, destruction of infectious and toxic 
 matter, extinction of the parasitic micro-organisms, 
 and other probable causes of zymotic, contagious, and 
 septic diseases, as true sanitation and therapeusis 
 require extirpation of all elements of disorder or 
 pathogenic causes — primary and secondary, with the 
 use of all means of preserving and restoring health in 
 the most certain and positive manner. What these 
 specific measures are we will now proceed to show in 
 the prevention and treatment of diphtheria, typhus, 
 and all other zymotic, septic, infectious, scorbutic, 
 putrescent, mephitic and allied diseases. 
 
70 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 III. 
 
 TREATMENT. 
 
 While in general a priori, it would not seem prob- 
 able that any single remedy or class of agents would 
 prove specific in the cure of diphtheria, typhus, 
 remittent, and other malarial, zymotic, septic, con- 
 tagious, scorbutic, putrescent, colliquative, and 
 cognate diseases, especially with widely diverse local 
 lesions, from their apparently distinct and complex 
 pathology and the consequent varied indications for 
 their treatment, yet investigation and experience 
 prove that such is largely the case. It is thus shown 
 that there are single agents and a class of substances 
 that prove more or less specific in the prevention and 
 cure of these infectious and malignant diseases, by 
 their disinfectant, antitoxic, antizymotic, antiseptic, 
 antalkaline, neutralizing, resolving, and restorative 
 properties, in destroying, nullifying, and subverting 
 the morbific principle and underlying conditions upon 
 which their occurrence and existence depends, and 
 thereby jugulating the basic aetiological factor ab origo, 
 as well as aborting and resolving its morbid sequelae. 
 From the preceding exposition of the the basic 
 ammoniacal, superalkaline and toxemic aetiology and 
 pathology of these diseases, such specific remedies 
 and treatment would naturally and logically be indi- 
 cated in the antalkaline, neutralizing, disinfectant, 
 antiseptic, antizymotic, antiscorbutic, resolving, and 
 restorative agents included in the class of Acids, 
 vegetal, animal, and mineral, of which the last are in 
 general the most active, and, independent of all such 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 71 
 
 ^etiological and pathological considerations, prophylac- 
 tive and therapeutic experience have shown their great 
 practical efficiency in preventing and resolving these 
 septic, infectious, and malignant maladies with the 
 minor abnormal analogues. Of the mineral acids, 
 hydrochloric and nitric acids separately, or combined 
 in the nitro-hydrochloric acid, are the most generally 
 efficient, though it is probable that hydrobromic acid 
 will also prove very useful to some extent in the 
 asthenic as well as sthenic disorders, to which latter it 
 is most applicable. 
 
 Hydrobromic Acid is antalkaline, antipyretic, re- 
 frigerant, disinfectant, antizymotic, antiseptic, anaes- 
 thetic, antispasmodic, and resolvent, with a special 
 soothing, depurant, and relaxing effect upon the 
 throat, air-passages and alimentary canal, properties 
 particularly desirable to a limited extent in diph- 
 theria, scarlatina, yellow fever, and correlative dis- 
 eases, though in general, a more invigorating treat- 
 ment is required therein from their asthenic character, 
 yet, in all sthenic stages and types of fevers, anginose, 
 and gastro-enteric affections, with allied conditions 
 this agent is strongly indicated. 
 
 "Like the bromides it has been successfully em- 
 ployed in a variety of nervous disorders induced by 
 reflex irritation, such as vomiting, cough, muscular 
 spasm, whooping-cough and neuralgia, and in coughs 
 excited by bronchial or laryngeal irritation. In cases 
 also of cerebral hypercemia due to excessive mental 
 activity in study, business, etc., it, appears to have the 
 same influence as the bromides. In tinnitus aurium 
 and other subjective sensations in the ear, especially 
 those of a throbbing or knocking character, depend- 
 ing upon vascular congestion, the medicine has 
 
72 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 proved very efficient." — (National Dispensatory). Of 
 the dilute acid, dose from thirty minims to one fluid 
 drachm in sweetened water or other appropriate 
 vehicle, taken through a non-corrosive tube, as indi- 
 cated, it being caustic in a concentrated state like its 
 analogues. 
 
 But, chlorine alone, or in some of its combinations, 
 if not the best, is certainly a most powerful disinfect- 
 ant, antalkaline, antiseptic, and germicide, with 
 other active sanative properties, especially in the form 
 of acids, and, for internal exhibition is most generally 
 applicable and efficient in hydrochloric and nitro- 
 hydrochloric acids, a brief resume of the medical 
 properties of w 7 hich we will present in order to show 
 more clearly their special value in the prevention and 
 treatment of diphtheria, typhus, ship, yellow, malarial, 
 and other fevers, with small-pox, scarlatina, and all 
 other zymotic, septic, contagious, mephitic, putres- 
 cent, and scorbutic diseases. 
 
 Hydrochloric Acid, Strong muriatic acid is a powerful 
 escharotic, hence must be freely diluted for internal 
 use. It is antalkaline, disinfectant, antiseptic, anti- 
 zymotic, refrigerant, febrifuge, resolvent, tonic, 
 depurant, alterative, digestive, mild cholagogue, 
 secernant, and laxative. It allays thirst and fever, 
 improves the tone of the digestive organs, liver, and 
 bow 7 els, promotes digestion, nutrition, secretion, and 
 defecation, purifies the blood, destroys noxious sub- 
 stances w r ithin, and favors the elimination of effete 
 matter from the body. It is an efficient germicide, 
 and u is regarded by Dr. Paris as an effectual pre- 
 ventive to the generation of intestinal worms," 
 (Waring 9 s Practical Therapeutics), who also "has given 
 it w T ith success in malignant cases of typhus and 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 73 
 
 scarlatina administered in a strong infusion of quassia. 
 [t may also be added with advantage to infusions of 
 3olombo, gentian, and cinchona. It proves a good 
 adjunct to gargles in ulcerated sore-throat and 
 scarlatina maligna/' — {United States Dispensatory). 
 
 " In Typhus and Typhoid Fevers, the internal use of 
 Hydrochloric Acid appears to prove highly service- 
 ible. In an epidemic of Typhus Fever which pre- 
 vailed in Stockholm in 1841-2, Prof. Huss states that 
 this acid was the most relied upon, particularly in 
 3ases attended with cerebral symptoms. He em- 
 ployed a mixture composed of f5j of the acid in 
 fgxij of decoction of Mallows, in doses of a table- 
 spoonful every two hours. It was given in the earliest 
 stage (after a purgative) and persisted in so long 
 as the pulse continued full, firm, or compressible, 
 and the sounds of the heart remained normal, or the 
 first sound shorter than in the natural state. Its 
 employment was not contraindicated by the state of 
 the tongue, or of the gastric organs; it was given 
 whether the tongue was loaded or not, red and fissured, 
 moist or parched ; it was given also whether the 
 abdomen was painful or not, tense or flaccid; in 
 constipation and in diarrhoea. The sole contraindication of 
 its use was bronchial or pulmonary congestion, which 
 was aggravated by it. Phosphoric acid was substi- 
 tuted when the pulse began to lose its fulness. For- 
 dyce, Paris, and others bear testimony to its great 
 value." 
 
 " In the continued Fevers of Children, it appears to 
 
 have a beneficial influence In scarlatina, 
 
 Dr. McSherry speaks highly of Hydrochloric Acid in 
 doses of gutt. j-iij, largely diluted. He regards 
 purgatives as injurious." {Waring' s Practical Thera- 
 peutics). 
 
74 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 As muriatic acid promotes the action of the 
 stomach, liver, and bowels, purgatives in con- 
 junction therewith are generally unnecessary, and 
 often detrimental in the exanthemata and morbid 
 conditions to which it is applicable, though laxatives 
 may sometimes prove useful in moderation, while in 
 gastro-intestinal fluxes, except in conjunction with iron 
 and other constringents, it is mostly contraindicated, 
 the astringent acids being more appropriate therein. 
 
 Hydrochloric, in combination with Nitric acid 
 forms a most powerful and valuable medicinal agent, 
 and as nitric acid is of itself a potent remedy in like 
 diseases, we will premise some general observations 
 thereon, before treating of this compound acid. 
 
 Nitric Acid, in a concentrated state is powerfully 
 caustic, but when properly diluted is a safe and effi- 
 cient medicament. It is antalkaline, disinfectant, 
 antizymotic, antiseptic, antiperiodic, antipyretic, re- 
 frigerant, febrifuge, alterative, resolvent, sialagogue, 
 cholagogue, secernant, laxative, and tonic. It is 
 especially useful in intermittent, with all malarial, 
 putrid, infectious, and other adynamic fevers, whoop- 
 ing cough, constitutional syphilis, chronic hepatitis, 
 torpid liver and concomitant constipation, chronic 
 affections of the spleen, and inactivity of the secretions 
 and system in general. 
 
 " If continued for a long period it causes salivation ; 
 it has also apparently a more direct action on the liver 
 than other acids, but it disagrees with the stomach 
 sooner than Sulphuric Acid. It is an excellent 
 alterative after long courses of Mercury, renovating 
 the strength, and improving the tone of the system in 
 a remarkable manner. As it acts injuriously on the 
 teeth, any medicine containing it should be sucked 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 75 
 
 through a quill or glass tube, and the mouth should 
 be rinsed out with an alkaline solution after each 
 dose/ 5 — Waring- \s Practical Therapeutics. 
 
 Nitric acid is especially applicable in diphtheria, 
 cynanche maligna, scarlet, bilious, remittent, typhus, 
 ship, yellow, and other fevers, with small-pox, 
 the exanthemata, septic, infectious, and putrescent 
 diseases generally, both constitutional and local. It 
 is very useful as an application to haemorrhoids, 
 indolent, phagadenic, gangrenous, and sloughing 
 ulcers, particularly cancrum oris, and like ulcerations 
 of the mouth, gums, and throat, in full strength or 
 diluted as required. In doses of from five to twenty 
 minims of the dilute acid in three or more fluid 
 ounces of sweetened water or lemonade it forms an 
 excellent acid drink, and, at the same time, service- 
 able disinfectant and stimulant lotion for the oral and 
 faucial surfaces, as well as the gastro-intestinal canal, 
 especially applicable in local complications thereof, 
 with septicaemia and systemic atony, as in diphtheria, 
 or malignant anginose affections, bilious, yellow, and 
 other fevers, with similar disorders, both contagious 
 and non-contagious. 
 
 Nitric acid is very active as a fumigating and 
 disinfecting agent, yet not considered equal to chlo- 
 rine, though in its absence, or in conjunction therewith 
 and chlorinated compounds it may be resorted to 
 with advantage. The fumes are readily evolved by 
 pouring sulphuric acid upon nitre in an earthen dish 
 upon heated sand. It is, however, in combination 
 with the hydrochloric acid as nitro-hydrochloric acid, 
 that it is of superior value, as this combines the most 
 useful properties of its constituents with additional 
 ones of greater utility both in medicine and the arts. 
 
78 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 in connection with the other mineral, animal and 
 vegetal acids, and doubtless with as decided beneficial 
 effects in the former as in the latter. 
 
 But, while perhaps, I have applied this acid treat- 
 ment most generally and freely from the theory of the 
 chemico-organic, ammoniacal, or superalkaline origin 
 of these scorbutic, zymotic, septic, contagious, 
 putrescent, and correlative diseases, and present it as 
 the true basic and specific treatment therefor, its 
 value does not rest upon my own limited experience 
 alone, as the correlation of the superalkalinity of the 
 blood with low fevers and the usefulness of the 
 mineral acids in their treatment, has long been recog- 
 nized to a certain extent. 
 
 Thus, according to Dr. Headland (Action of Medi- 
 cines), " The natural alkalinity of the blood is due to 
 the presence of free Soda and Ammonia." . . . 
 " A free acid may act as a Restorative in cases where 
 there is an excess of alkali in the blood. It may either 
 remain in the blood after entering into combination, 
 or it may pass off by the urine, supplying there the 
 place of a natural acid, which it leaves behind in the 
 system. It is on such a theory as this that the action 
 of mineral acids in typhoid and putrid fevers has been 
 explained. Huxham long ago recommended acids to 
 counteract the ' putrid crasis,' in fevers. They are 
 certainly sometimes of marked service in these dis- 
 orders. Dr. Murchison recommends the treatment 
 of Typhus and Typhoid fevers by mineral acids. Of 
 230 cases of continued fever in St. Mary's Hospital, 
 Dr. Chambers treated 109 on 'general principles/ 
 121 with Hydrochloric acid. Of the 109, 23 died; 
 of the 121 only 4 died. i Continuous liquid nutri- 
 ment,' of beef-tea and milk was given along with the 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 79 
 
 Hydrochloric acid, (Med. Chir. Soc, April 28, 1863). 
 Dr. Henderson found at Shanghai that the mortality 
 from continued fever was reduced by the employment 
 of the acid from 28 to 7 per cent. (Medical Times, 
 March, 1863). Mr. Day, of Stafford, has found nitric 
 acid of great use in malignant scarlatina. In the 
 Yellow fever of tropical climates, an excess of alkali 
 was discovered some years since by Dr. Blair. This 
 alkali seems to be Ammonia. I do not affirm posi- 
 tively that there is in all of these fevers an excess of 
 alkali in the blood. Although likety, it is not proved. 
 The explanation is plausible." 
 
 Yet, this superalkalinity of the blood, mainly from 
 Ammonia in these septic, contagious, and adynamic 
 diseases, is almost positively demonstrated both ex- 
 perimentally and therapeutically, as well as in their 
 Btiology and pathology, from the free natural evolu- 
 ion of this alkali within the body, and its artificial 
 ntroduction from without into the system, with the 
 r ell-marked and specific effects of the acid treatment 
 herein. Besides other evidence which might be ad- 
 luced, this was clearly exemplified in seventeen or more 
 ases of Ship Fever which came into the Philadelphia 
 lospital under my care at one time. These patients 
 vere seriously ill, spotted with the maculae of typhus, 
 md so offensive and contagious that it was dangerous 
 o go near them, yet with the free administration of 
 nineral and vegetal acids — nitro-hydrochloric acid 
 >eing the principal, they were soon disinfected, 
 mrified, revivified, and restored to health, every one 
 ecovering, except one brought in moribund and 
 lying before treatment could be instituted. 
 
 Dr. Waring states (Practical Therapeutics), that " in 
 Typhus Fever, the mineral acids have been recom- 
 lended in all countries from the days of Forestus, 
 
78 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 in connection with the other mineral, animal and 
 vegetal acids, and doubtless with as decided beneficial 
 effects in the former as in the latter. , 
 
 But, while perhaps, I have applied this acid treat- 
 ment most generally and freely from the theory of the 
 chemico-organic, ammoniacal, or superalkaline origin 
 of these scorbutic, zymotic, septic, contagious, 
 putrescent, and correlative diseases, and present it as 
 the true basic and specific treatment therefor, its 
 value does not rest upon my own limited experience 
 alone, as the correlation of the superalkalinity of the 
 blood with low fevers and the usefulness of the 
 mineral acids in their treatment, has long been recog- 
 nized to a certain extent. 
 
 Thus, according to Dr. Headland (Action of Medi- 
 cines), " The natural alkalinity of the blood is due to 
 the presence of free Soda and Ammonia." . . . 
 " A free acid may act as a Restorative in cases where 
 there is an excess of alkali in the blood. It may either 
 remain in the blood after entering into combination, 
 or it may pass off by the urine, supplying there the 
 place of a natural acid, which it leaves behind in the 
 system. It is on such a theory as this that the action 
 of mineral acids in typhoid and putrid fevers has been 
 explained. Huxham long ago recommended acids to 
 counteract the 'putrid crasis,' in fevers. They are 
 certainly sometimes of marked service in these dis- 
 orders. Dr. Murchison recommends the treatment 
 of Typhus and Typhoid fevers by mineral acids. Of 
 230 cases of continued fever in St. Mary's Hospital, 
 Dr. Chambers treated 109 on 'general principles,' 
 121 with Hydrochloric acid. Of the 109, 23 died; 
 of the 121 only 4 died. < Continuous liquid nutri- 
 ment,' of beef-tea and milk was given along with the 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 79 
 
 Hydrochloric acid, (Med. Chir. Soc, April 28, 1863). 
 Dr. Henderson found at Shanghai that the mortality 
 from continued fever was reduced by the employment 
 of the acid from 28 to 7 per cent. (Medical Times, 
 March, 1863). Mr. Day, of Stafford, has found nitric 
 acid of great use in malignant scarlatina. In the 
 Yellow fever of tropical climates, an excess of alkali 
 was discovered some years since by Dr. Blair. This 
 alkali seems to be Ammonia. I do not affirm posi- 
 tively that there is in all of these fevers an excess of 
 alkali in the blood. Although likely, it is not proved. 
 The explanation is plausible." 
 
 Yet, this superalkalinity of the blood, mainly from 
 Ammonia in these septic, contagious, and adynamic 
 diseases, is almost positively demonstrated both ex- 
 perimentally and therapeutically, as well as in their 
 aetiology and pathology, from the free natural evolu- 
 ion of this alkali within the body, and its artificial 
 introduction from without into the system, with the 
 well-marked and specific effects of the acid treatment 
 therein. Besides other evidence which might be ad- 
 duced, this was clearly exemplified in seventeen or more 
 cases of Ship Fever which came into the Philadelphia 
 Hospital under my care at one time. These patients 
 were seriously ill, spotted with the maculae of typhus, 
 and so offensive and contagious that it was dangerous 
 to go near them, yet with the free administration of 
 mineral and vegetal acids — nitro-hydrochloric acid 
 being the principal, they were soon disinfected, 
 purified, revivified, and restored to health, every one 
 recovering, except one brought in moribund and 
 dying before treatment could be instituted. 
 
 Dr. Waring states (Practical Therapeutics), that "in 
 Typhus Fever, the mineral acids have been recom- 
 nended in all countries from the days of Forestus, 
 
80 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 Sydenham, etc. The theory of their action is obscure; 
 but as Dr. Murchison observes, their beneficial effects 
 are undoubted. Dr. Murchison adds (On Fevers, 
 1862), that during the last few years he has used 
 these acids in hundreds of cases, and he believes them 
 superior to any other method of treatment, though far 
 from ascribing to them the wonderful effects at- 
 tributed to them by some writers. He states that he 
 usually commences with the hydrochloric (tgjxx) and 
 nitric acids (wrx) every three hours, each dose being 
 diluted with the patient's drink. In the advanced 
 stages of severe cases, when the ' typhoid state' is well 
 marked, he prefers sulphuric acid (tnxv-xx). every 
 three hours, with Ether and small doses of quinine. 
 He states that he has often observed marked improve- 
 ment follow the commencement of the acid treatment, 
 at whatever stage of the fever it was prescribed, and 
 although no wine or brandy was given with it. In 
 Typhoid (Enteric) Fever, Dr. Murchison considers that 
 no remedies are superior to the mineral acids, and 
 that they are often of real service, though their powers 
 have been overrated. Here he prefers the hydro- 
 chloric and sulphuric acids, ^xv-xxx of the dilute 
 acid every three or four hours. With each dose he 
 combines about half a grain of quinine, believing it to 
 be of great service, especially when the disease has 
 anything of a remittent character." 
 
 From the general character of the disease, the 
 nitric, hydrochloric, nitro-hydrochloric, and other 
 acids — mineral, animal, and vegetal, are specially 
 indicated in the prevention and treatment of yellow 
 fever, and if given freely therein will doubtless act as 
 efficiently as in ship, typhus, remittent, adynamic, and 
 putrid fevers generally, with other diseases of the 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 81 
 
 same general class and nature. The mineral acids 
 and particularly nitrohydrochloric acid are specific- 
 ally adapted to meet the varied indications in yellow 
 fever presented in the superalkaline, or ammoniacal, 
 toxemic, septic, scorbutic, necrsemic, and hemorrhagic 
 condition, pyrexia, jaundice, defective, vitiated secre- 
 tion and torpor of liver, bowels, kidneys, and general 
 economy, with thirst, sickness of stomach, tendency 
 to black vomit, collapse and death, by neutralizing 
 and destroying all the ^etiological factors, resolving 
 their pathological sequelae, disinfecting and depurating 
 the blood and body, restoring the normal chemico- 
 organic operations, secretions, and functions of life, 
 and refreshing and invigorating the entire system at 
 the same time. 
 
 The dilute nitro-hydrochloric acid may be given in 
 doses of from v-xx minims properly diluted to a 
 pleasant acid taste. In water, lemonade, infusion of 
 barley, or other mild acidulous and bland liquid, 
 sweetened to taste, it forms an acceptable, antalkaline, 
 disinfectant, antiseptic, nutrient, restorative, and 
 refreshing beverage, very agreeable and invigorating 
 to those suffering with scorbutic, malarious, bilious, 
 septic, febrile, infectious, and mephitic affections. As 
 a nutritive diluent to promote its efficiency and 
 increase the ingestion of acid, I usually give it with 
 the juice of one lemon, in a goblet of sweetened water 
 or other menstruum, as freely as required and the 
 stomach will bear. To protect the teeth, it should be 
 taken through a glass, porcelain, straw or other non- 
 corrosive tube, and the mouth rinsed out subsequently 
 with lime, or other alkaline and plain water, though 
 in edentulus children and adults it may be directly 
 taken without such precautions, its localized action 
 
82 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 on the mouth being often desirable, always avoiding, 
 of course, its contact with metallic spoons or other 
 neutralizing and contaminating substances. 
 
 Phosphoric Acid, is also very efficacious in adynamic 
 fevers and conditions and is particularly applicable 
 when a more stimulant effect is required, and either 
 alone or with orange, lime, lemon, or other vegetal 
 acid juice in water, infusion of barley, lactic acid, 
 buttermilk, coffee, tea or other appropriate men- 
 struum, sweetened to taste, forms a very pleasant, 
 refreshing, cooling, stimulant, restorative, tonic 
 drink. It is especially useful in atonic conditions 
 and low fevers, as it is antalkaline, and actively 
 stimulates the brain, nervous, and vascular systems, 
 while it reduces temperature, allays fever, and 
 quenches thirst most effectually. It invigorates the 
 general system, promotes secretion, nutrition, and 
 depuration, and may be alternated advantageously 
 with the more potent disinfectant and antiseptic 
 mineral acids. 
 
 11 In Typhus and Typhoid Fever it has been given with 
 advantage. In the epidemic fever which appeared at 
 Stockholm in 1842, Prof. Huss employed Phosphoric 
 Acid in all the cases which came under his notice. He 
 commenced its use when the pulse began to lose its 
 fulness, and the first sound of the heart became short 
 like the second, f Siij of the acid were diluted with 
 fgxij of decoct, malvse; and of this one or two 
 dessert spoonfuls were given every two hours." — 
 ( Waring' s Practical Therapeutics). 
 
 But if necessary phosphoric acid may be exhibited 
 more frequently and freely, being careful not to over- 
 stimulate the brain, as it has a special tendency 
 thereto, and may be generally employed, either alone 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 83 
 
 or in combination, as phosphate or lacto-phosphate of 
 iron, quinia, strychnia, lime, and soda, according to 
 special indications, whenever a stimulant, tonic, anti- 
 scorbutic, antiperiodic, and restorative is required. 
 As a refrigerant, febrifuge, assuager of thirst, secer- 
 nant, resolvent, depurant, stimulant, tonic, and 
 restorative, or invigorant of mental, nervous, mus- 
 cular, and general vital energy, phosphoric acid and 
 its compounds are far superior to alcoholic liquors of 
 any kind, which in fact, diminish secretion, excite 
 and increase thirst, poison the blood both directly and 
 indirectly, prevent depuration, induce scorbutic, 
 toxemic, irritative, and adynamic fever, with ataxia, 
 and depress rather than increase nervous, muscular, 
 and vital tonicity, or mental and bodily strength, 
 ample evidence of w T hich is presented everywhere 
 throughout the world. 
 
 Sulphuric Acid, though powerfully caustic when 
 strong, is, properly diluted, a safe and valuable ant- 
 alkaline, antipyretic, antiseptic, antizymotic, disin- 
 fectant, refrigerant, astringent, styptic, and tonic. It 
 is especially applicable in low fevers and infectious 
 diseases, with haemorrhages, diarrhoea, choleraic and 
 other defluxions, as well as in the less complicated 
 forms of the latter generally. It is particularly useful 
 in haematemesis and haemorrhage from the bowels, as 
 well as from the lungs, uterus, and general surface, 
 and hence is especially indicated in the gastrointes- 
 tinal haemorrhages of yellow and typhoid fevers, with 
 those of allied affections. In the, diarrhoea of typhoid 
 or enteric fever, with choleraic and atonic defluxions 
 generally, it is very serviceable. 
 
 " In the Diarrhoea of Typhoid Fever, Dr. H. Kennedy, 
 states, after ample experience, that by far the best 
 
84 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 remedy is diluted Sulphuric Acid (f 5 j to f 3 iij ad Aq. 
 
 fgviij). It is best to begin with a small dose and 
 increase it as required. The diarrhoea should not be 
 too suddenly checked. Opiate enemas to allay 
 tenesmus are to be used." 
 
 " In the advanced stages of continued Fevers and in 
 Typhus Fever, the internal administration of Sulphuric 
 Acid, with some tonic infusion, appears to be of great 
 service. Prof. Huss found that when there was 
 profound prostration, with commencing bed-sores, 
 and persistent diarrhoea, Sulphuric Acidin combination 
 with Infus. Rosse or Infus. Arnicse mon. was productive 
 of much benefit." 
 
 " In Confluent Small-pox, when the pustules are 
 filled with a bloody sanies, and the urine contains 
 portions of broken down coagula of blood, dilute 
 Sulphuric Acid is stated by Dr. Thompson to be a 
 remedy of the highest value, indeed the only one 
 that can be relied upon. Its use should be com- 
 bined with wine, tonics, etc." — [Waring 9 s Practical 
 Therapeutics). 
 
 Sulphuric acid is also beneficial both constitutionally 
 and locally, in scarlatina, ulcerated sore throat, ptya- 
 lism, colliquative sweats, cholera, choleraic affections, 
 and defluxions generally. Mr. Buxton, of London, 
 attested in 1851 to the " remarkable efficiency of 
 diluted sulphuric acid," and in 1853, Dr. H. W. 
 Fuller, of St. George's Hospital u strongly recom- 
 mended it in choleraic diarrhoea, from his own 
 experience and that of his friends in more than ninety 
 cases without a single failure. The dose employed 
 was half a fluid-drachm, diluted with water, given 
 every twenty minutes in ordinary cases, every quarter 
 of an hour in severe cases. The vomiting, purging, 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 85 
 
 and cramps usually ceased after the third or fourth 
 dose." — ( United States Dispensatory). 
 
 In passive diarrhoeas and other defluxions the 
 aromatic, is preferable to the simple sulphuric acid. 
 Both may be given in the compound infusion of roses, 
 tea, or with gallic acid, cinchona', and other tonics, 
 in doses of from ten to thirty drops in a wineglassful 
 of plain or sweetened water, as often as required, 
 sucked through a non-metallic tube with the same 
 precautions to protect the teeth as the other mineral 
 acids. 
 
 Other acids, as sulphurous, carbolic, and salicylic 
 acids, with their respective salts and combinations, as 
 sulphites, sulpho-carbolates. salicylates, etc., of soda 
 more especially, are more or less useful in zymotic, 
 septic, contagious, mephitic, aud allied diseases, but, 
 in general, are neither so safe, convenient, efficient, 
 or pleasant to take, as the several mineral and vegetal 
 acids indicated, with their compounds of iron, lime, 
 soda, quinia, strychnia, etc. 
 
 The predominent indications in the preventive and 
 curative treatment of all zymotic, toxemic, septic, 
 and contagious diseases, is to avert the production, 
 abort, neutralize, and destroy the basic morbific 
 alkaline agent, infecting principle, and concomitant 
 poisons, disinfect and purify the body, the interior as 
 well as exterior, every particle thereof, in its entirety, 
 the vital economy within itself being an active 
 generator as well as recipient of poisonous matter and 
 contagium, and resolve the morbid lesions and com- 
 plications. 
 
 While the single elements chlorine, iodine, bro- 
 mine, sulphur, etc., are active neutralizes of alkaline 
 substances, germicides, disinfectants, antiseptics, 
 
86 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 depurants, and resolvents, they are not so eligible to 
 exhibit medicinally as their compounds, especially 
 the acids, though in some conditions may be usefully 
 resorted to for special purposes, their protective and 
 resolvent influence in these affections being very 
 efficient. But, in general, the acids— mineral, vege- 
 tal, and animal, are most useful as antalkalies, anti- 
 septics, antizymotics, and for the disinfection and 
 purification of the living organism, with other 
 salutary purposes, particularly the citric, lactic, 
 salicylic, carbolic, sulphurous, sulphuric, phosphoric, 
 nitric, hydrochloric, and nitro-hydrochloric acid. The 
 last is especially potent, not only in the milder 
 disorders of a scorbutic, infectious, zymotic, septic, 
 and mephitic character, but also in the most malignant 
 and contagious, as typhus and scarlet fever, diph- 
 theria, small-pox, and others of a like virulent type. 
 
 From many years' experience in the more or less 
 free use of these acids, hydrochloric and nitro-hydro- 
 chloric, particularly, with the vegetal acids, in 
 scorbutic, necrsemic, zymotic, septic, contagious, and 
 mephitic diseases generally, for it has been my custom 
 to exhibit them freely in all such maladies, I can 
 strongly testify to their superior value as potent 
 antalkalies, disinfectants, antiseptic, antizymotic, feb- 
 rifuge, remedial, and sanative agents, both for pre- 
 ventive and curative pcrposes in these dangerous and 
 destructive affections so prevalent throughout the 
 world. Thus, it is not only in those pernicious types 
 of toxemic and typhoidal blood dyscrasia — as in the 
 more purely ammoniacal or superalkaline, scorbutic, 
 necreemic, septicaemic, and infectious conditions, that 
 these acid remedies are so markedly efficient, but 
 also in those systemic disorders with local lesions of 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 87 
 
 various kinds from the extreme eruption of variola to 
 the slightest local manifestation of a general super- 
 alkalaemia and toxicosis, though when these are in 
 the gastro-intestinal canal they must be given more 
 circumspectly, and the more soothing, conservative 
 and astringent acids selected, as in enteric fever for 
 instance, so as to act most favorably upon the local 
 affection of the bowels, neutralize the superalkalinity 
 of the blood, destroy septic and contagious matter, and 
 depurate and support the system at the same time. 
 Hence in typhoid fever, cholera, and like affections 
 with gastro-intestinal lesions, the milder and more 
 astringent acids with their compounds are most 
 applicable, as muriatic acid, chloride of iron, phos- 
 phoric and sulphuric acids, with their combinations 
 of phosphate of iron and lime, sulphate of iron, or the 
 still more sedative hydrobromic acid, and bromide of 
 iron and lime, carbolic, and sulphurous acid, and 
 sulpho-carbolates, with their analogues, of acetic acid 
 and acetates, etc., and corresponding vegetal acid 
 principles, juices, and jellies, according to the special 
 indications of irritation, inflammation, ulceration, 
 heemorrhage, diarrhoea, etc., to thus most specifically 
 counteract and overcome the local with the consti- 
 tutional disorder, neutralize and destroy the basic 
 alkaline and concomitant materies morbi in the blood, 
 tissues, and section implicated, resolve the disease 
 altogether, and restore the healthy integrity and 
 tonicity of both the part affected and of the general 
 system. 
 
 But, notwithstanding this marked ammoniacal and 
 superalkaline condition of system in typhoid fever 
 and correlative diseases, as the primal cause thereof, 
 it is strongly urged that ammonia is the sure remedy 
 
88 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 for the former. Thus, in an interesting paper on the 
 Treatment of Typhoid Fever, read at the last meeting, 
 and published in the Jour. Amer. Med. Assoc, August 
 16, 1884, Dr. S. K. Jackson, of Norfolk, Va., after 
 some general observations on its pathology observes: 
 
 " Another possible, if not probable, cause of this 
 nitrogenous waste of the system is due to the con- 
 sumption of this important element by the parasitic 
 organism which is the acknowledged serological 
 factor in the production of enteric fever. That this 
 microzoon is a nitrogen feeder, is evident from the 
 fact that he lives and is developed in nitrogenous 
 matters, in urea and all nitrogenous excreta. These 
 furnish its peculiar pabulum, in them it is generated 
 and thrives. Old timbers saturated with urea, the 
 rotted logs of a country cabin against which men 
 have constantly micturated, have been known to be 
 fruitful sources of this disease. The most serious 
 outbreak of typhoid fever I have ever known, occur- 
 red during our late war (1862), in a Mississippi 
 brigade, who were encamped at the foot of a mountain 
 slope where a large amount of leaf mould had been 
 for years accumulating. This spongy mass when 
 saturated with their urinary deposits, and probably in 
 a state of fermentation, caused the most malignant 
 epidemic of this disease that has ever occurred in my 
 experience. I hope some day, to obtain access to the 
 official records to ascertain the great numbers who 
 fell victims to it; they are numbered by hundreds. I 
 hope I may be pardoned for mentioning here, that of 
 223 cases that were taken under the treatment I am 
 now advocating, not one died." .... 
 
 " If further proof be needed that this microzoon is 
 a consumer of nitrogen, it is furnished by the am- 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 89 
 
 moniacal exhalations emitted by "a typhoid fever 
 patient, from the breath, the skin, as well as by the 
 urine, which, when freshly passed, as is known to all, 
 emits the odor of ammonia, like stale urine in a state 
 of decomposition." 
 
 " These exhalations are undoubtedly due to the 
 decomposition of the nitrogenous constituents caused 
 by this micro-organism."* .... 
 
 " It is clear then that our aim should be to supply 
 this nitrogenous waste. How is it to be done ? By 
 nitrogenous food, you will say; a very rational way 
 of accomplishing that desirable end, were it not for 
 the utter impossibility of digesting and assimilating 
 this food.f There is only one way, known to me, of 
 effecting this purpose, and that is by the free adminis- 
 tration of ammonia, even to saturation. 
 
 " Fortunately this nitrogenous base furnishes us 
 with salts of such different therapeutical powers that 
 we have no difficulty in finding one adapted to any 
 and every stage of the disease and every probable 
 condition of the patient during its existence or 
 progress. It supplies us in the nitrate with the most 
 sedative salts we possess, and in the carbonate, with 
 the most stimulant salt in our Materia Medica. The 
 only other salts of ammonia'I have been in the habit of 
 using in the disease are the acetate and hydrochlorate, 
 in conditions which will be presently pointed out." 
 
 Still, notwithstanding the high degree of success in 
 the treatment of typhoid fever, with these salts of 
 
 * Or rather, that the development and activity of the microzymes 
 are due to the excess of ammonia, their pabulum vitae. 
 
 f But food may be artificially digested by acids, pepsin, etc., 
 and its assimilation promoted by oxygenating and other corrobo- 
 rating agents. 
 
90 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 ammonia this alkali is obviously contraindicated in 
 this disease, while the constituent acids of its com- 
 pounds, which are usually in excess therein, are 
 especially applicable as neutralizing, antalkaline, 
 antiseptic, antipyretic, antizymotic, disinfectant, and 
 corroborant agents. Besides, instead of increasing 
 the already excessive solvent and irritant ammonia in 
 the system and further tending to its destruction by 
 colliquation and otherwise, as well as to augment the 
 undue alkaline pabulum promotive of the develop- 
 ment and activity of the parasitic microzoa, thus 
 doubly taxing the struggling economy to expel this 
 alkali, which is being conservatively eliminated at 
 every pore, and resist at the same time, the destructive 
 action of the concomitant sepsin, infection, and 
 microzymes, a more rational method would seem to 
 be to exhibit such agents as would subvert the 
 production, neutralize, and counteract the ill effects 
 of this noxious alkali — ammonia — in excess, nullify 
 its morbific sequents, and starve and destroy the 
 accessory microzoa, which can be most readily 
 effected by acid, antalkaline, antizymotic, antiseptic, 
 disinfectant, resolvent, and restorative medication and 
 alimentation. 
 
 The general tendency of preventive and curative 
 medicine is in this direction, and clinical experience 
 is demonstrating that it is the only true and specific 
 method of treatment of typhoid with all allied diseases. 
 
 Thus among others that might be cited in proof 
 thereof, Dr. D. A. Sheffield, of Apple^River, 111., after 
 inviting attention to salicylate of bismuth as presented 
 by Prof. Henri Desplats, as " the great desideratum' 5 
 in enteric fever {Med. Record), highly commends 
 sulphurous acid in this class of diseases, and states 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 91 
 
 {Jour. Amer. Med. Assoc), "A course of experimen- 
 tation with the drug, extending through a period 
 of more than twenty years, in almost every variety 
 of zymotic disease, convinces the writer that its 
 power over and adaptability to the medication of 
 this variety of ailment has not been recognized and 
 appreciated by the majority of the profession." 
 
 " That it is capable of modifying both the violence 
 and duration of typhoid fever, has been demonstrated 
 to my own and my patients' satisfaction so many 
 times, that without the drug I should approach the 
 treatment of a case of that disease with considerable 
 trepidation. Given in moderate doses during the 
 period of dry skin and parched brown tongue, its 
 effects are often magical. 
 
 "This disease, however, is but one of the many in 
 which sulphurous acid may be used both as a remedy 
 and a prophylactic. The acute infectious diseases are all 
 modified, aborted, or wholly prevented by its use J' 
 
 Bisulphite of soda has been mostly exhibited 
 "though in a few cases a solution of sulphurous acid 
 diluted with glycerine has been employed, giving 
 equally as good results, but not as well tolerated by 
 the patient." 
 
 " To demonstrate its utility use a saturated solution 
 of bi-sulphite of soda in water, giving one teaspoonful 
 every two or three hours until the system is brought 
 fully under the influence of the drug; afterward one 
 dose every six hours will be sufficient to maintain its 
 effect." 
 
 The sulpho-carbolate of soda has also been found very 
 serviceable in these diseases, and the corresponding 
 salt of lime, or sulphite of lime singly, will doubtless 
 also prove useful therein, the carbolic acid being 
 
92 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 likewise a "potent antalkaline, antiseptic, and germi- 
 cide, while the lime promotes the healing of local 
 lesions and the reconstruction of tissues. But, for 
 this purpose the phosphate of lime with the acid in 
 excess is most useful as a nutrient, antalkaline, and 
 stimulant to the nervous and general system. 
 
 Iodine has also been highly commended in the 
 treatment of typhoid fever, but, as it is a disintegrant 
 and sorbefacient as well as local irritant, it has a 
 tendency to promote intestinal excitement, morbid 
 waste and emaciation, already too active, hence is 
 contraindicated therein, and especially in combination 
 w 7 ith potassium w 7 hich increases the superalkalinity, 
 solvent, scorbutic, and dissolutive condition of the 
 blood and body, depresses the heart, nervous and gene- 
 ral system, and still more favors the concomitant 
 inanition and prostration of the disease. The sodium 
 salt is far better when a resolvent is required, and 
 ordinarily better still the iron compound of iodine, 
 the syrup particularly. But chlorine and bromine 
 with their compounds are far more conservative, 
 reparative, and applicable than iodine, in this and 
 correlative disorders, especially in their acid form, as 
 well as with iron, soda, and lime, the bromides of 
 iron and lime particularly for their local soothing and 
 healing effects upon the gastro-intestinal canal, while 
 bromide of quinia — when the latter is required, is less 
 exciting than the sulphate, this salt combining the 
 mean of the valuable properties of its constituents. 
 Yet, while hydrobromic acid is a potent febrifuge and 
 calmative, it, with the bromides except that of quinia 
 and its analogues, are rather too sedative for free use 
 in this disease, as in general, a more supporting and 
 invigorant treatment is needed therein. Hence, as a 
 
DIPHTHERIA. TYPHOID, AND ALLIED DISEASE-. 93 
 
 most active antalkaline, antiseptic, refreshing stimu- 
 lant, tonic, analeptic, corroborant, and restorative, 
 phosphoric acid and the phosphates of iron and lime, 
 with sometimes, quinia and strychnia, the latter often 
 better subcutaneously, are invaluable in enteric fever 
 and cognate diseases, employed judiciously according 
 to special indications, singly or in conjunction with 
 other remedies as required by the varying conditions 
 and exigencies of the cat Moreover, when an 
 
 actively diffusible stimulant is necessary therein, 
 instead of the obnoxious alcoholic liquors usually 
 freely exhibited, the oil of turpentine is far better 
 in every respect — internally and externally, by inhala- 
 tion, deglutition, and otherwise. While for alimentary 
 purposes, peptonized milk and lime water or sulphite 
 of lime, with corresponding light albuminoids, and 
 the astringent acid fruit juices and jellies form the 
 basic and principal food, as the stomach and chylo- 
 poietic viscera are incapable of much digestive effort 
 in this affection and cognate disorders. 
 
 Thus, the local lesions and manifestations with the 
 -temic dvscrasia of these varied scorbutic, necraemic. 
 zymotic, septic, contagious, malignant, colliquative, 
 and adynamic maladies, may require a modification 
 of this basic acid treatment, without, however, chang- 
 ing its essential character, with the addition of other 
 compatible remedies to meet the special indications 
 in the different phases and complications thereof, but 
 all of which are more or less directly dependent upon 
 the underlying ammoniacal, superalkaline, toxemic, 
 septic, and constitutional derangement. Hence, in 
 general, the acids and their analogues, by neutraliz- 
 ing, subverting, and destroying the primal superin- 
 ducing ammoniacal or alkaline cause and condition, 
 
94 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 undermine, nullify, and resolve at the same time their 
 concomitant toxic and morbid sequelae, 
 
 Besides the many minor manifestations of its power 
 the efficacy of this acid and antalkaline treatment is 
 strikingly exemplified in that formidable exanthem — 
 variola. In the virulent superalkalinity, septicaemia 
 and toxicosis of smallpox, with the extensive erup- 
 tions on the surface of the body, the mineral and vege- 
 tal acids are remarkably efficient as antalkaline, anti- 
 septic, disinfectant, alterative, tonic, resolvent, and 
 curative agents. The carbolic, sulphurous, sulphuric, 
 and salicylic acids have been thus highly spoken of 
 in the resolution and cure of variola, with allied 
 septic and contagious diseases. According to my 
 own experience the hydrochloric and nitro-hydro- 
 chloric acids act as basic and specific resolvents 
 of both the constitutional malady and local lesions 
 in small-pox as well as in cognate abnormities, 
 as they neutralize the superalkalinity of the organic 
 fluids and solids, disinfect and depurate the blood 
 and genera] system, destroy the septic and infect- 
 ing virus, and nullify the underlying amrnoniacal 
 cause, thereby subverting the basic exciting factor of 
 the dyscrasia, pestiferous condition and eruption, 
 inducing their speedy subsidence, and exterminating 
 the materies morbi, contagious principle and disease 
 at the same time. In particular, nitro-hydrochloric 
 acid is very active as a prophylactive and curative 
 agent in aborting the variolous disease altogether 
 when taken in time, and cutting it short after its 
 inception, by neutralizing the basic superalkaline 
 pathogenic factor, breaking up the primary fever, 
 preventing the eruption, checking suppuration, drying 
 up the pustules, disinfecting the blood and body, and 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 95 
 
 destroying the contagium and noxious emanations. 
 It may be given in conjunction with lemon juice and 
 other vegetal acids as freely as the system will tolerate, 
 in doses proportioned to the age and necessities of 
 the case, in solution as previously indicated. Sour 
 buttermilk may also be taken largely as both adjunct 
 acid medicine and food with corresponding acidulous 
 .medicaments and regimen. I believe I have thus 
 aborted the prodromic fever of variola with this acid 
 medication and alimentation, though of course, this 
 is difficult to prove, as there must always remain a 
 doubt whether it was not a casual or ephemeral fever, 
 hence can only be settled by an extensive series of 
 cases in hospitals and elsewhere under the most 
 adverse circumstances. Therefore, I present this as 
 my experience and belief to excite such a course of 
 practical investigation for the prevention and subver- 
 sion, as well as cure, of this terrible malady, though 
 as nitromuriatic with other mineral and vegetal acids 
 will suppress it, they should of course be able to 
 abort it ab initio. 
 
 The mineral, animal, and vegetal acids, especially 
 the hydrochloric and nitro-hydrochloric acids thus 
 appear to be effective preventives of, and most basic 
 and specific remedies for, small-pox, with correlative 
 maladies. Other preparations of chlorine, as chlorine 
 water, chlorinated soda, chloride of iron and lime, 
 chlorates of soda and potassa are likewise applicable, 
 with doubtless also sometimes in the more sthenic 
 stages, hydrobromic acid and the bromides of sodium 
 and potassium, though the alkalies always with care 
 from their liquefacient tendency ; but better usually 
 in the asthenic and colliquative conditions, sulphuric 
 and phosphoric acids, with their corresponding salts 
 
96 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 of iron, quinia, and strychnia, or lacto-phosphate of 
 the same with lime. 
 
 Oil of turpentine, oxygen, peroxide of hydrogen, 
 nitrous oxide, and other stimulants, haemostatics, and 
 corroborants are also indicated therein more or less 
 freely according to special type, stage, and complica- 
 tions of the disease, its general tendency being of an 
 adynamic character. In general, the vegetal acids, 
 citric, tartaric, acetic, etc., or better in the form of 
 lime, lemon, orange, tamarind, and other acid fruit 
 juice, jelly, and drinks, or vinegar properly diluted 
 and sweetened, with stewed acid fruit and more sub- 
 stantial food afforded in sour butter-milk and acid 
 albuminoids are useful adjuncts to the acid mineral 
 and other medicaments, and doubly beneficial as 
 remedies and aliment in variola with like maladies. 
 
 The same remedies, regimen, and principles also 
 apply in the treatment of the exanthemata generally, 
 as scarlatina, measles, etc., with the other septic, con- 
 tagious and scorbutic diseases, in which they are very 
 efficient, as I can testify from long experience there- 
 with in such affectious, it being my invariable and 
 basic practice therein from the successful results of 
 their application. These mineral and vegetal acids, 
 with acid food and fruit are also preventive as well as 
 curative of such maladies. 
 
 In the treatment of that correlative and fatal dis- 
 ease — diphtheria, the mineral, animal, and vegetal 
 acids, and especially the hydrochloric and nitro- 
 hydrochloric acids, are also the basic and specific 
 remedies, the local lesion and malignant affection of 
 the throat being secondary and subordinate to the 
 constitutional disorder which is dependent upon the 
 ammoniacal, superalkaline, and toxic condition of the 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 97 
 
 blood, with atony of the general system, though the 
 pharyngeal outbreak is the most immediately danger- 
 ous, and must receive due and simultaneous attention. 
 So far as my experience goes, nitro-hydrochloric acid 
 is the most potent and reliable specific remedy for 
 diphtheria there is, and should I be obliged to depend 
 upon any single agent alone, would prefer it to any 
 other, but this is not necessary as it may readily be 
 supplemented with other acids and remedies accord- 
 ing to the special type, stage, intensity and complica- 
 tions of the case under treatment. Thus, ordinarily, 
 I give the dilute nitro-hydrochloric acid in doses of 
 from ten to fifteen drops in a goblet of lemonade, 
 consisting of one lemon in that quantity of water 
 sweetened to taste, which may be sucked through a 
 glass or other non-corrosive tube ad libitum, so as 
 speedily as possible to introduce enough acid to 
 neutralize the superalkalinity and destroy the septic 
 matter of the blood, disinfect the throat, alimentary 
 canal, and body, and restore the normal equilibrium 
 of htematosis, circulation, nutrition, secretion, and 
 health. In its passage through the mouth, fauces, 
 oesophagus, and stomach, or gastro-intestinal canal, it 
 acts as a direct germicide, solvent, disinfectant, de- 
 purant, alterant, and resolvent, as well as antalkaline, 
 refrigerant and tonic, locally and generally. In 
 young children and adults without teeth, it may of 
 course be taken directly, as it forms a very pleasant, 
 attractive, and refreshing drink, though frequent 
 small quantities are better than occasional large 
 draughts, the frequency and quantity of the dose 
 being proportioned to the age of the patient and 
 intensity of the disease. This may often be sufficient 
 of itself and especially with corresponding acidulous 
 
98 BASIC PATHOLOGY AND SPECLFIC TREATMENT OF 
 
 regimen of fruits, juices, jellies, and other food, 
 particularly sour butter-milk, specified elsewhere, to 
 resolve the disease altogether. 
 
 In the more adynamic varieties of diphtheria and 
 cognate diseases, I give in addition, a mixture of 
 muriates of iron and quinia, with muriatic acid in 
 lemonade or sweetened water, but when the dispo- 
 sition to faucial inflammation and exudation is strong, 
 omit the quinine and add small quantities of potassium 
 and sodium chlorate. Hence to supplement the 
 nitromuriatic acid and better meet the special indi- 
 cations to counteract the plastic exudation in the 
 throat, degeneration of the blood, and tendency to 
 adynamia and paralysis, with the general septic con- 
 dition, I usually combine in prescription, tincture of 
 chloride of iron, hydrochloric acid, potassium or 
 sodium chlorate, or both together in small doses, with, 
 in cases of active disposition to, or much depression, 
 tonic doses of muriate of quinia, all in orange, plain, 
 or better still, tar-water — infus. picis liq. as a men- 
 struum and mild stimulant, disinfectant, depurant, 
 and alterative. Thus, for an adult, in the ratio of 
 from ten to twenty drops of the dilute muriatic acid, 
 ten to fifteen minims of the tinct. of iron, two grs. of 
 the potassium and three of the sodium chlorate, one 
 gr. of the muriate of quinia, and a tablespoonful to 
 an ounce or more of tar water according to its 
 tolerance, in one dose, all of which may be given in, 
 or be followed with a draught of lemonade, sweetened 
 barley, or plain water, as often as may be necessary. 
 The acid and chloride of iron act locally and generally 
 as antalkaline, antizymotic, astringent, disinfectant, 
 antiseptic, haematic, and tonic agents. The potassium 
 is a solvent of the plastic exudate and resolvent of the 
 
DIPHTHERIA, TYPHOID, AND ALLIED} DISEASES. 99 
 
 inflammatory disposition, though it should be care- 
 fully given even in small doses, and subordinate to 
 the acid treatment, as it will increase the superalka- 
 linity, fluidity, and disorganization of the blood, and 
 depress the action of the heart, circulation and system 
 in general; hence, unless the exudative tendency is 
 strong, it is better omitted altogether, and in all cases 
 withdrawn so soon as the acute stage resolves, espe- 
 cially as it may be substituted by the milder sodium 
 chlorate, which is likewise solvent, but not depressing, 
 though apparently too diaphoretic sometimes, so also 
 to be watched and diminished or withdrawn as the 
 exudative disposition and inflammatory condition 
 subsides. In fact, the sodium salt is often preferable 
 from the beginning in this and other diseases, where 
 a solvent and resolvent effect is desirable, though they 
 may sometimes be combined with advantage. 
 
 This local inflammatory and exudative tendency in 
 the pharyngeal region varies greatly, and according 
 to its activity and non-complication with the consti- 
 tutional dyscrasia or ammonamiia and septicemia of 
 diphtheria, it approximates true croup and ordinary 
 cynanche, or more purely local inflammatory affec- 
 tions of the throat, which require the opposite 
 alkaline treatment more exclusively, such as potas- 
 sium and sodium chlorate, nitrate, citrate, etc., or 
 when there is much irritation and spasmodic action 
 alone or in conjunction therewith, better doubtless, the 
 corresponding acid and salts of bromine, or hydro- 
 bromic acid, bromides of sodium and potassium, as they 
 exert a special amesthetic, relaxing, and resolving effect 
 upon the fauces, yet, being in general, too depressing 
 in diphtheria which requires a more exclusively sup- 
 porting acid, antalkaline, and tonic treatment. 
 
100 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 Iodoform is also too depressing in diphtheria and 
 its asthenic correlatives, but will doubtless afford 
 more direct and speedy relief in croup, especially its 
 spasmodic form, with other sthenic anginose affections, 
 as it is a prompt and potent local, pharyngeal, and 
 general anaesthetic, antispasmodic, and resolvent, as 
 well as germicide, antiseptic, and sorbefacient. It 
 usually soon allays irritation, relaxes spasm, annuls 
 pain, and produces sleep. It relieves urethral, utero- 
 vaginal, intestinal, and oesophageal spasm and 
 stricture, checks vomiting and cough, resolves swell- 
 ing, promotes absorption, and diminishes excitability 
 of the nervous and general system, acting both 
 directly and indirectly in discussing oral, pharyngeal, 
 bronchial, and pulmonary affections, and quieting the 
 neuroses connected therewith. Hence, it is specially 
 indicated in croup, mumps, hiccough, whooping- 
 couo-h, with like affections, and those still more 
 formidable maladies — hydrophobia, cerebro-spinal 
 meningitis, epilepsy, eclampsia and tetanus, with 
 sthenic irritability, supersensibility, spasm, sensori- 
 motor, phlegmonous, neurotic and psychotic affections 
 generally. The dose should be proportioned to the 
 emergency, but, ordinarily I find that one grain every 
 hour or two hours, more or less frequently, is usually 
 soon sufficient to overcome quite active disorder, even 
 one pill alone of gr. j of iodoform, and 1J grs. of iron 
 (Warner's), will often allay severe pain and neuralgia, 
 of the face and head especially, and induce sound 
 sleep, though followed sometimes by temporary 
 languor, but permanent relief. If taken too freely, it 
 will produce chilliness, gastro-intestinal disorder, 
 diarrhoea, and depression, with other evidences of 
 intoxication therefrom. 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 101 
 
 Hydrarg, bichlorid, which has of late been so highly 
 recommended as a disinfectant, germicide, and re- 
 solvent in diphtheria and correlative diseases, is also 
 more applicable to the sthenic inflammatory stage 
 and type than the more purely asthenic condition of 
 such anginose affections, and may be used when 
 necessary in conjunction with its compatibles, espe- 
 cially as a substitute for the alkalies when they are 
 contraindicated, though I have never found it advis- 
 able to resort to it therein. In a discussion upon this 
 subject at the late meeting of the Illinois State Med, 
 Society, Dr. E. P. Cook, of Mendota, a former Presi- 
 dent of the Association, stated (Jour. Amer. Med, 
 Assoc), "that he had a limited experience in the use 
 of bi-chloride of mercury. His experience of its use 
 was that in follicular pharyngitis the patients all got 
 well, but in malignant diphtheria they died. In the 
 latter form of the disease, seven out of a group of 
 eight of his patients had died after treatment with 
 bi-chloride of mercury." Prof. Pepper and others 
 commend its efficacy in diphtheria, but, at best it is a 
 dangerous remedy, and apparently applicable more in 
 the croupous than the malignant form of diphtheria, 
 wherein, however, the alkalies are safer and usually 
 promptly resolvent, though in smaller doses the} 7 may 
 be commingled where their combined effects are 
 desired. 
 
 Thus, diphtheria and croup with the more purely 
 inflammatory forms of cynanche, differ widely in both 
 their pathology and treatment, the former mainly 
 requiring acids, the latter alkalies, though they often 
 merge and blend with each other in every degree and 
 variety, so as to need a mixed course of the neutral 
 salts with acids or alkalies correspondingly, or the 
 
102 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 more exclusive acid or alkaline treatment as the 
 pathological conditions of the one disease predominate 
 over the other, while the extremes are so distinct as 
 to necessitate the free exhibition of either accordingly, 
 the acid, antiseptic, and tonic treatment being basic 
 and essential in diphtheria. Usually, in the acute 
 stage of this disease, quinine is not so strongly indi- 
 cated, and should not be given therein unless the 
 adynamic disposition is active from the beginning. 
 Besides, it is useful only in small and tonic doses of a 
 grain or less, large doses being sedative and injurious 
 in all cases. Hence, as the acute inflammatory stage 
 diminishes I withdraw the alkalies, or withhold them 
 altogether when they are contraindicated ab initio, and 
 add the quinine to the iron and hydrochloric acid, 
 with in addition thereto muriate of strychnia in doses 
 proportioned to the age and necessity, as from the 
 thirtieth up to hundredths of a gr., to more fully 
 counteract the tendency to the paralysis which is so 
 apt to ensue more or less suddenly as the active 
 excitement declines in diphtheria. The solvent tar 
 water serves the double purpose of an efficient adjunct 
 and menstruum, as it is a mild stimulant, antiseptic, 
 alterative, secernant, diuretic, and tonic, as well as 
 local disinfectant, depurant, and alterant to the 
 mouth, throat, and gastro-intestinal canal, though it 
 is not very pleasant to take, and may be substituted 
 by more agreeable, less active, aromatic infusions, as 
 of eucalyptus, orange, water, or other convenient 
 menstruum. 
 
 When a more decided diffusible stimulant is re- 
 quired, instead of alcoholic liquors, the effects of 
 which are evanescent and obnoxious, I exhibit the oil 
 of turpentine, as it is a more useful remedy, being an 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 103 
 
 active arterial and nervous stimulant, antizymotic, 
 antiseptic, germicide, disinfectant, diuretic, diaphor- 
 etic, alterative, resolvent, depurant, and restorative, 
 and, from its volatility may be administered freely 
 and steadily by inhalation without drugging the 
 stomach, thus acting favorably directly and continu- 
 ously upon the pharynx and air-passages, blood, 
 secretions, and general system of both the patient 
 and attendants, the vapor of turpentine serving to 
 disinfect the air and bod}-, overcome the disease, sup- 
 port and restore the patient, and protect those exposed 
 to the infection. " Turpentine being a germicide 
 even in so weak a solution as one part to seventy-five 
 thousandths," according to Dr. R, F. Weir, surgeon 
 to the New York Hospital.— (N. Y. Med. Jour.) 
 
 Thymol is also an active volatile disinfectant and 
 germicide, with the great advantages of having a 
 pleasant odor and being non-irritant to the throat and 
 air-passages. It may be exhibited singly or in con- 
 junction with turpentine to disguise its offensive smell 
 to many. 
 
 A still more potent nervous stimulant is phosphoric 
 acid, which is also antalkaline, antipyretic, refreshing, 
 and corroborant, but not so disinfectant and antiseptic 
 as hydrochloric and nitromuriatic acids. It may be 
 given as an adjunct thereto, or. in conjunction with 
 its salts of iron, quinia, and strychnia, as phosphates 
 or lacto-phosphates thereof, be alternated or substi- 
 tuted for the muriates of the same, especially in the 
 latter stages and in convalescence, to counteract the 
 scorbutic, superalkaline, and adynamic states of diph- 
 theritic with cognate disorders — the paralytic particu- 
 larly, re-invigorate the system, and restore the normal 
 tonicity of health. Oxygen, peroxide of hydrogen, 
 
104 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 and nitrous oxide are also applicable as potent dis- 
 infectants, antiseptics, haematics, revivifiers, depur- 
 ants, stimulants, tonics, and restoratives, in this with 
 correlative affections. 
 
 In diphtheria, with all the zymotic, septic, scorbutic, 
 mephitic, infectious, and allied diseases, the free 
 administration of the mineral acids should be sup- 
 plemented by the liberal use of the vegetal and 
 animal acids ad saturandum, either in solution as 
 lemonade, or preferably when the stomach is intole- 
 rant of much fluid, in the concentrated juice of limes, 
 lemons, oranges, grapes, and other acid fruit, with 
 the jelly of cranberries, or other acidulous berries, and 
 stewed apples, cherries, plums, prunes, and like edible 
 sour vegetals, with as much sugar as desired, this 
 being a valuable antiseptic, as well as corrigent, and 
 and nutriment. Ripe, pulpy, juicy, acidulous fruit, 
 as peaches, pears, plums, grapes, tamarinds, and the 
 like, also afford both remedial food and medicine that 
 may be taken more or less freely with advantage, 
 laxative substances being in general, more essential in 
 these diseases, though when otherwise, the astringeM 
 acid remedies, fruit, and food may readily be sub- 
 stituted. 
 
 For the more concentrated and purely nitrogenized 
 aliment sour buttermilk, and cottage cheese when 
 tolerated, with like acid albuminoids, with sugar, are 
 most appropriate, agreeable, highly nourishing and 
 restorative, the lactic acid therein acting as a digestive, 
 antalkaline, antiscorbutic, antiseptic, antiphlogistic, 
 febrifuge, and hsematosic. It is a solvent of the 
 membranous exudate, and depurant of the throat, 
 stomach, and bowels, with the general system, thus 
 acting beneficially both locally and constitutionally. 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 105 
 
 This acid fluid and solid food is in general, most 
 acceptable and digestible, and preferable to extracts 
 of beef or other meat, as such aliment is not ordinarily 
 fancied or easily digested in this and cognate diseases, 
 
 rom lack of acid gastric juice. For the same reason, 
 soused pig's feet, pickled tripe, acidulated oysters, 
 eggs, caviare, and other albuminous food with vinegar 
 or other acid, are most palatable and nourishing in 
 such maladies, vinegar being also antalkaline, solvent, 
 digestive, secernant, antiseptic, refrigerant, disinfect- 
 ant, and depurant, useful both locally and generally, 
 and may also be employed as a gargle and drink in 
 these diseases. Peptonized food is also applicable 
 when necessary, pepsin itself being an active solvent 
 of the membranous exudate and may be exclusively 
 employed therefor. Amylaceous aliment is usually 
 undesirable and unnecessary, as it cannot readily be 
 transformed, and its saccharine ultimate can be 
 directly had sufficiently in both the cane and grape 
 sugar with the acids and other food without taxing or 
 clogging the stomach and bowels therewith. With 
 these various articles the system can be supplied with 
 an abundance of appropriate aliment, albuminous, 
 saccharine, and acidulous, the most essential in such 
 cases, in the most concentrated, easily digestible and 
 assimilable form. 
 
 Thus, in fact, in diphtheria and correlative diseases 
 generally the digestive and nutritive processes are 
 more or less seriously impaired, and it is not only 
 useless, but injurious to overload the stomach and 
 
 ystem with food it cannot transform and appropriate, 
 under the false idea of supporting, when it is really 
 taxing and depressing the vital energies, and in- 
 creasing the complications and danger of the disease. 
 
106 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 Hence a judicious discrimination in the nature, 
 quality, quantity, and condition of the food is all 
 essential in this with all other diseases, as alimentation 
 is the basis of medication in all cases, and the more 
 exclusive acid aliment and remedies being most ap- 
 plicable in diphtheria and cognate maladies. 
 
 With this general acid and conjunct treatment no 
 special local applications to the throat are required in 
 diphtheria and its correlatives cynanche maligna, 
 scarlatina, etc., though they may be employed to any 
 extent indicated, particularly ice or cold externally as 
 well as internally in the acute stage, as the acidulous 
 remedies and regimen indicated act directly thereon 
 and correct the gangrenous tendency, prevent the 
 formation, and disintegrate, dissolve, and disinfect the 
 fibro-plastic exudate, cleanse the pharynx, destroy the 
 micrococci, fsetor, and contagion, neutralize the super- 
 alkalinity, antisept and purify the blood and body, 
 resolve the local and constitutional disorder, restore 
 the balance of chemico-organic action, nutrition, 
 secretion and defecation, invigorate the nervo-motor 
 system, and re-establish the tonicity of health in 
 general. 
 
 Moreover, in diphtheria, and all the zymotic, septic, 
 scorbutic, and putrescible diseases generally, there is 
 more or less intense instinctive craving for acids and 
 acidulous substances, which clearly indicates their 
 necessity and use. Usually patients take them 
 eagerly and freely until the superalkalinity of the 
 blood is neutralized, the scorbutic, septicemic, in- 
 flammatory, and febrile condition allayed, the equilib- 
 rium of nutrition, secretion, and excretion restored, and 
 the general system disinfected, depurated, and invigor- 
 ated, the desire therefor proportionately diminishing 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 107 
 
 till it ceases altogether and they become repugnant, 
 so that ordinarily this instinctive appetite for acids 
 is a sure guide to their use, though from false ideas, 
 perverted tastes, and acquired habits, it cannot always 
 be relied upon, the pathological and physiological 
 conditions being the best indications to the physician 
 for their administration or withdrawal. Some of 
 these are prominently presented in the appearance of 
 the blood, mucous membrane, and general surface, 
 especially in the lips, mouth, tongue, and countenance. 
 These with the hands more particularly show a more 
 or less diffused or mottled redness of a brownish, 
 dusky, purplish or venous and scorbutic hue, varying 
 somewhat according to the type and intensity of the 
 disease, which disappears as the ammon?emia and 
 superalkalinity is neutralized, and the lips, tongue, 
 and complexion assume a clearer, lighter, and 
 healthier color. This is usually so decided that the 
 observing physician can surprise his patient by telling 
 him he is loosing his relish for acids and that they 
 begin to taste too sour and be repugnant, in marked 
 contrast with their previous agreeability, so that they 
 need not be taken so freely and be gradually withdrawn 
 as the disease subsides and the corresponding necessity 
 for them diminishes, being continued in a modified form 
 in conjunction with the acid muriates, phosphates, or 
 lacto-phosphates of iron, quinia, and strychnia, in the 
 adynamic states of diphtheria and' other diseases until 
 the health is entirely restored. Chlorine vapor, 
 chlorine water, and chlorinated soda, lime, sulphur, 
 carbolic, sulpho-carbolic and other acids, with their 
 analogues and combinations are also useful in diph- 
 theria with septic diseases generally, but are not so 
 safe, pleasant, easily or freely taken as the acids and 
 compounds thereof designated. 
 
108 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 Thus, while microscopists find the same micrococci 
 and fibro-plastic elements in the morbid condition and 
 membranous exudate of the pharynx in diphtheria, 
 croup, and other anginose affections, and see no 
 essential difference between these local disorders of 
 the throat, the physiological chemist and pathologist 
 find in addition, the blood superalkaline or ammonia- 
 cal, deteriorated, and toxemic, with an infectious 
 principle, and a concomitant paralysis — mostly 
 pharyngeal, though sometimes more general in the 
 former, while the therapeutist putting all these to- 
 gether, logically deduces the specific treatment 
 thereof in accord with the laws of chemistry, physi- 
 ology, pathology, hygiene, and scientific medicine 
 generally. This consists as indicated in the removal 
 of all the active and remote causes thereof so far as 
 possible, with the free use of acids — mineral, vegetal, 
 and animal, especially the hydrochloric and nitric 
 acids or nitro-hydrochloric, with chlorine and the 
 chlorides particularly of iron, quinia, and strychnia, 
 and sometimes the chlorates of potassium and sodium, 
 as potent antalkalies, disinfectants, antizymotics, 
 antiseptics, alteratives, resolvents and tonics, with the 
 more exciting, nervous and general stimulants and 
 haemostatics, oil of turpentine, thymol, phosphoric 
 acid, and phosphates or lacto-phosphates of iron, 
 quinia, and strychnia, with oxygen, peroxide of hydro- 
 gen and nitrous oxide, to counteract the adynamic 
 and paralytic tendency and invigorate the general 
 system, the acids, their elements and analogues being 
 the essential basic and specific remedies to neutralize 
 the ammoniacal or superalkaline and toxaemic con- 
 dition, destroy the microzymes, disinfect, and depurate 
 the throat, blood, and body, and restore the normal 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 109 
 
 chemico-organic and dynamic balance of life, they 
 being often of themselves sufficient, especially in the 
 earlier stages of the disease to resolve it altogether, 
 both in mankind and at least one, if not all the lower 
 animals, as I had a favorite cat with the prominent 
 symptoms of diphtheria that was promptly cured with 
 sour milk I ordered her. 
 
 With this general plan of treatment with the acids 
 — mineral, vegetal, and animal, as a basis, both in 
 medicine and aliment, I have always found this 
 dangerous disease — diphtheria, to resolve more or 
 less speedily, and the patients soon recover their usual 
 health without ordinarily any complications or pro- 
 longed convalescence. In fact, when seen in time, it 
 may be thus aborted altogether, or rendered so mild 
 as not to confine the patient to the house. In other 
 malignant anginose affections and ulcerated sore 
 throat, this acid treatment is also markedly efficient. 
 Indeed, I believe that by proper sanitation and 
 alimentation with the appropriate ingestion of acid 
 juices, drinks, fruits, buttermilk, and other acidulated 
 food as previously indicated, cceteris paribus, not only 
 diphtheria, but all other zymotic, septic, infectious, 
 necrsemic, scorbutic, putrescent and cognate diseases, 
 could be largely prevented, as well as more or less 
 promptly cured by the additional more active medica- 
 tion with the stronger mineral acids and adjuvant 
 resolvent, stimulant and tonic remedies. In fact, 
 there is little doubt but what these diseases often 
 occur in consequence of defective acid alimentation 
 to neutralize the ammonia constantly evolved within 
 the body in the normal chemico-organic processes, 
 with that introduced from without the economy, and 
 the frequent concomitant superalkalinity of the blood, 
 
110 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 which is the basis and primary cause of these scor- 
 butic, septic, zymotic, toxemic, contagious and ady- 
 namic maladies. Hence the best preventive thereof 
 is the avoidance as far as possible of all their super- 
 inducing causes, especially that most potent one 
 tobacco in every form, with the due use of acid 
 aliment, and remedies. Moreover, whenever or 
 wherever diphtheria, or any of these, correlative, 
 zymotic, septic, and contagious diseases occur, every 
 one exposed thereto should be put on this acid 
 regimen, and closely watched so that if any symptoms 
 thereof appear the mineral and stronger acids with 
 cognate antalkaline and other appropriate measures 
 may be immediately resorted to. 
 
 Confirmatory proof of the special value of acids in 
 the treatment of diphtheria by the practical experience 
 of physicians with the various forms thereof might be 
 adduced, but I am not aware that they have ever been 
 used as basic and specific remedies therefor in general 
 by reason of their peculiar acid nature, much less 
 upon the scientific principle of their efficacy as ant- 
 alkalies, and particularly in neutralizing a common 
 ^etiological morbific alkaline factor of this, with all 
 other zymotic, septic, contagious, mephitic, and allied 
 diseases, with consequent abortion as well as direct 
 extinction of their concomitant toxicoses and infec- 
 tion, and all of which are dependent upon an excess 
 of that ever-present volatile organic alkali — Ammonia, 
 constantly engendered so freely within the living 
 organism itself, as well as introduced from without in 
 various forms of malarial and other noxious ingesta. 
 
 Testimony is occasionally presented of the practical 
 value of some one or another of the acids in the cure 
 of diphtheria, and recently it is stated in the Scientific 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. HI 
 
 American, by a California physician, Dr. Czartoryski, 
 who lived long in the interior of China, that the 
 Chinese freely take the fresh juice of limes with the 
 fruit itself in diphtheria and consider it a specific 
 therein as it hardly ever fails to effect a cure. In his 
 own practice in Louisiana and California he has used 
 limes and their juices with the greatest success even 
 in the most desperate cases of diphtheria, wherein he 
 orders " limes to be administered as freely as possible 
 in any manner the patient can be prevailed to take 
 them, especially in the form of hot lemonade, sweet- 
 ened with white sugar or honey, or cut in slices with 
 powdered white sugar." With lime juice, which he 
 considers acts by affording an excess of oxygen to the 
 blood, thereby preventing the development of vibri- 
 ones, etc., he exhibits such drugs as may be indicated, 
 with appropriate stimulants and nourishment to 
 restore strength. Usually, however, cold lemonade, 
 with acid water ice, or tart ice cream, ice, and iced 
 drinks are most grateful and useful in the height of 
 the disease, and hot acidulous drinks in the more 
 asthenic conditions, although they may be given at 
 any temperature according to the desire and mor- 
 bid conditions of system. Lemon juice and other 
 acidulous, with mucilaginous substances, as gum 
 arabic, flax-seed, etc., have long been empirically 
 popular in anginose affections. 
 
 Thus, experience proves that vegetal, animal, and 
 mineral acids act specifically in resolving diphtheria 
 with all other superalkaline, zymotic, septic, scorbutic, 
 and allied maladies. But, while such experience is 
 valuable, it is more purely empirical and blind, and it 
 is only when duly correlated with other facts in 
 aetiology, pathology, hygiene, and therapeutics, that 
 
112 BASIC PATHOLOGY AND SPECIFIC TREATMENT OP 
 
 scientific principles and a true theory can be established 
 that directs to the most accurate and successful treat- 
 ment from positive knowledge of all the essential 
 data upon the subject. 
 
 From the fact that this class of varied acid sub- 
 stances with cognate disinfectant, antalkaline, neutral- 
 izing, and resolving agents are so generally efficacious 
 in scorbutic, zymotic, septic, iufectious, putrescent, 
 and correlative diseases, it supports the view of their 
 common origin and dependency upon a superalkaline 
 condition of the blood and system, of which the most 
 general and active morbific element of the kind both 
 from inherent and extraneous sources, is the volatile 
 organic alkali — Ammonia, the existence of which in 
 excess has been to a certain extent directly demon- 
 strated in such maladies. Furthermore, from the 
 correlative facts that this same organic alkali — 
 ammonia, is being constantly engendered de novo 
 from its elements within the body in the normal 
 chemico-organic transformations, and that it may be 
 abnormally increased by various causes as excessive 
 heat, bodily exertion, molecular and morbid metamor- 
 phosis, with perverted disintegration and undue ac- 
 cumulation from insufficient elimination, as well as be 
 more or less freely introduced from without in 
 malaria and contaminated water from decomposition 
 of organic matter, and more excessively with other 
 alkaline and noxious substances in such pernicious 
 agents as the juice, vapor, and smoke of tobacco, 
 with the so frequent defective counteractive acid 
 alimentation, and other aberrant influences, in ad- 
 dition to its potent volatile, permeating, solvent, 
 irritant, and morbific power, it is not wonderful it 
 should produce a general pathological state of the blood 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 113 
 
 and body, and induce those disorganizing scorbutic, 
 toxemic, necnemic, febrile, infectious, and mephitic 
 conditions so often manifested in such a variety of 
 constitutional and local dicases of a septic, contagious, 
 and adynamic typo, intensified and modified accord- 
 ing to casual cooperative meteorological, pestilential 
 and other agencies that so seriously afflict and destroy 
 mankind with the lower forms of life the world over. 
 Nor is it singular that the same general acid and cor- 
 relative neutralizing, antalkaline, and antagonizing 
 Mis should act as basic and specific remedies in 
 such a variety oi diseases from an identical, underly- 
 ing alkaline cause and dyscrasia, with or without the 
 
 addition of special adjunct- appropriate to the 
 nihilities of each, according to their respective 
 manifestations and complications. But, while there 
 is thus such a close connection of these varied innocu- 
 ous and malignant affections, both pathologically and 
 clinically, there is a wide difference between a purely 
 »n and a local manifestation or complication 
 of a constitutional dyscrasia, though they are so often 
 combined, and what commences as a benign local 
 disorder may become from the additional superim- 
 posed ammoniacal and superalkaline condition of the 
 system, a most malignant, infectious, and fatal 
 malady, as is bo frequently exemplified in the ordinary 
 innocuous anginose affections becoming diphtheritic 
 and contagious, as well as slight local lesions in 
 different parts of the body becoming erysipelatous 
 and malignant, with in like manner, all correlative 
 maladies being intensified or assuming a virulent, 
 contagious, and pestilential type. 
 
 Thus, the common naso-pharyngeal affections, both 
 acute and chronic, may assume a diphtheritic and 
 
114 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 infectious type from anything which surcharges the 
 blood and system with an excess of ammonia, as well 
 as the more direct. toxic emanations from others that 
 would otherwise in its absence be comparatively 
 innocuous, it being but a matter of degrees between 
 the most benign and the most malignant anginose, as 
 with all other diseases. Diphtheria and contagia may 
 be thus developed and communicated whenever 
 this superalkalinity of system and concurring circum- 
 stances are favorable, which are doubtless more 
 frequent than is generally suspected, as this am- 
 moniacal condition of the blood and body may occur 
 in every degree of intensity from the norme to a 
 saturated morbific and pestiferous state. 
 
 In an interesting paper upon " Diphtheria Spread 
 by Adults," -read before the Medical Society of the 
 County of New York (N. Y. Med. Journal), Dr. A. 
 Jacobi presented facts to prove that there are a great 
 number of cases of latent and chronic diphtheria in 
 adults, which were regarded as but simple sore-throat, 
 yet sufficiently contagious to disseminate the disease 
 indefinitely among the people, by the patients being 
 able to go about their usual business, and infecting 
 many who came in contact with them, especially 
 when they were in more or less immediate close 
 relations therewith, as nurses, servants, and children, 
 for as he forcibly observes, " There is as much diphtheria 
 out of bed as in bed ; nearly as much out of doors as in 
 doors. Many a mild case is walking the streets for 
 weeks without caring or thinking that some of his 
 victims have been wept over before he was quite well 
 himself." 
 
 Hence, it behooves every one to carefully cleanse, 
 disinfect, and purify their mouths, throats, and air- 
 passages, as well as blood and body generally, and 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 115 
 
 avoid exposure to infection, with particularly, the 
 predisposing and exciting causes thereof from all 
 noxious agencies that produce sore-throat or angina 
 and ammonaemia or a superalkaline state of the 
 system, the most common and potent of which are the 
 baneful fumes and smoke of tobacco, so recklessly 
 diffused everywhere, which not only excite naso- 
 pharyngeal, bronchial, pulmonary, and other local 
 disorders, but, furthermore create a pernicious con- 
 stitutional dyscrasia that engenders toxic and infec- 
 tious principles, with malignant types of disease, and 
 intensify pre-existing abnormities — both local and 
 general, thus often converting an innocuous affection 
 into a virulent and contagious malady, as well as 
 developing de novo pestiferous forms of disease that 
 may be extended indefinitely. 
 
 Thus, the common pharyngeal affection in croup, 
 quinsy, or ordinary sore-throat and cynanche gene- 
 rally, and so dangerous from its locality, though 
 intrinsically benign within itself, is dependent more 
 or less directly upon some local irritant or noxious 
 vapor, and the same general meteorological cause of 
 dampness and cold, or change of temperature, ex- 
 posure, and other like causes, but while the local 
 disorder may be similar, how different is the essential 
 character, complications, danger, and treatment, of 
 such abnormities when there is an existing ammon- 
 semia, superalkaline or scorbutic condition of the 
 blood, which renders both the local complaint and 
 systemic derangement of a more or less virulent 
 and infectious nature, as in diphtheria, cynanche 
 maligna, and scarlatina, with erysipelas, and other 
 local expressions or complications of a constitutional 
 dyscrasia in different parts of the body, and which 
 
116 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 require the same basic and specific acid or antalkaline 
 treatment, so opposite and distinct from the former, 
 to subvert and counteract the underlying superalka- 
 linity and toxaemia, abort and destroy the contagia, 
 and resolve the local lesion with the systemic malady. 
 This is remarkably exemplified in erysipelas, 
 which may occur in any part of the economy from 
 various traumatic and other agencies, or idiopathi- 
 cally, apparently from the intensity of the arnmon- 
 semia, concomitant blood poison, and systemic 
 dyscrasia, without any immediate perceptible exciting 
 cause, but, notwithstanding its multiple local mani- 
 festations, may be usually successfully treated upon 
 the same general principles applicable to diphtheria 
 and its congeners, with the mineral, animal, and 
 vegetal acids, the muriatic or nitromuriatic espe- 
 cially, muriated tincture of iron, quinia, and tar 
 water, with the acid regimen, and appropriate local 
 applications, though sometimes the salts of potassium 
 and sodium chlorate, may be conjoined in moderation, 
 when it is of a more active phlegmonous and exudative 
 character, yet are inadmissible in the more purely 
 gangrenous variety in which the acid and tonic 
 treatment is exclusively required. The sesquichloride 
 or muriate of iron particularly, has obtained a well 
 deserved repute in the cure of erysipelas, but it is 
 probable that its efficiency is due more to its chlorine 
 and acid than the iron, though the latter is doubtless 
 also remedial therein, as erysipelas frequently occurs 
 in plethoric persons whose blood is not apparently 
 deficient in iron, but ammonsemic, toxemic, corrupt, 
 and loaded with noxious and excrementitious matters, 
 which chlorine, acids, and other antalkalies, dis- 
 infectants, and antiseptics, neutralize, destroy and 
 
DIPHTHERIA, TYPHOID, AND ALL! 117 
 
 eliminate. The m acids alone are often ent 
 
 to relieve and prevent this d: amplified in 
 
 and spirit drinks ect 
 
 thereto, and by whom the lactic, citric, and ot 
 
 in the form of sour buttermilk, sauer kraut, 
 lemonade, and acidulous fruits and food g ly are 
 
 ,uently empirically r> rted to advantageov 
 
 satisfv th e craving for acid and antalka- 
 
 - 
 
 line 
 
 The same instill :or acids is 1: le mani- 
 
 I >bacco isomers to neutralize the aj 
 ficially indu .peralkalinity of the blood and - 
 
 tern, from the ing ated ammonia, nicotia, and its other 
 baneful ingredi . with al- normal thirst for 
 
 stumulants to overcome the c —ion from this 
 noxious poison, hence the use of tobacco and spirit- 
 uous liquors usually g g ::ier, acting and :ng 
 
 :i each other, both d : . and ind: 
 
 morbid a] with de I conditions of b 
 
 and mind, and debase, d nd d man- 
 
 kind. Ii. : . ~ raving for i is thus so i re- 
 
 dominant in individual consul tobacco and 
 
 alcoholic liquors, and is so general, as to become a 
 : national iliarity in people addicted or 
 
 reto, as ind in the following remarks 
 
 on " Tobacco and Pi in the Dr< cular: 
 
 •• The Dutchman of to-d s gi :it a smoker as 
 
 ther. The pipe has, how- 
 . ;nd the meanest lab<: 
 indulges himself, often when at work, with th e ' 
 
 which sts him less ::ian a farthing 
 
 The teetL fi Dutchman is n; 
 
 the skin of an Englishman who ha- a lon^ 
 
 time in Indi. much discolored, and many : 
 
118 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 the incisors are carious. The Odontological Society 
 will find the best specimens of discolored teeth from 
 smoking among modern Dutchmen. The Dutchman's 
 partially for pickles is peculiar, yet easily explained. 
 In Rotterdam, but more largely in Amsterdam, pickle- 
 stalls are not much less frequent than apple-stalls in 
 London. The pickle-stalls seems to be, with many 
 workmen, the half-way house between the work-shop 
 and the dining-room. This nation of confirmed 
 smokers abounds in dyspeptics; and the poorer classes 
 give their clammed palates a filip occasionally with 
 the sour and acid substances sold in the streets." 
 
 Gastric troubles, however, are not the only local dis- 
 orders from tobacco, as it also, as before stated, causes 
 diseases of the mouth, throat, nares, air-passages, lungs, 
 heart, liver, kidneys, and other important organs, with 
 the general state of superalkalinity, toxaemia, and 
 adynamia, for the relief of which the instinctive 
 craving for acids and stimulants or tonics indicate 
 the basic and predominant means of cure, similar in 
 general to that required in erysipelas and allied 
 dangerous manifestations of a like constitutional 
 dyscrasia, with of course the removal of the cause 
 as well as treatment of the effects. 
 
 Moreover, in a similar internal local expression of 
 a general dyscrasia from ammonsemia and its con- 
 comitants, which is engendered more particularly by 
 the prolonged physiological function of gestation, as 
 well as excited by parturition, although the former is 
 usually the remote cause of the superalkalinity and 
 toxaemia and the latter the immediate excitor of 
 metro-peritonitis and septicaemia or puerperal fever, 
 the same basic and specific acid and collateral treat- 
 ment is best adapted, and will promptly relieve ac- 
 cording to my experience. Thus, for example, in the 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 119 
 
 case of a primipara, from whom, after ineffectual 
 efforts to deliver herself even with the aid of ergot, I 
 had to remove the child with the forceps while she was 
 under the influence of ether, and resuscitate it after 
 much effort, I found on attempting to extract the 
 placenta that it was retained, and on examination dis- 
 covered an hour-glass contraction of uterus, which 
 I overcame by gentle and steady pressure with my 
 folded fingers, enough to reach and carefully remove 
 the secundines from the fundus. Metro-peritonitis, 
 scanty lochia, with an ominous cadaverous odor, 
 general sinking, and febrile symptoms, with other 
 evidences of septicaemia and puerperal fever soon en- 
 sued, but by the acid treatment as a basis, of nitro 
 and hydrochloric acids, sesquiehloride of iron, potas- 
 sium and sodium chlorate, and quinia in tar water, 
 with active stimulation by the oil of turpentine 
 alone, locally and generally, without alcoholic liquors 
 of any kind, and appropriate aliment, she so speedily 
 and perfectly recovered, that in less than two weeks, 
 contrary to my most earnest advice, she took her 
 babe and went out to the Centennial, several miles 
 distant, it being the last day of the Exhibition, de- 
 termined to be able to say that she and her child had 
 been there, which visit, though necessarily attended 
 with considerable risk and fatigue, fortunately did not 
 result in any mishap. 
 
 As spirituous liquors promote the development of 
 such ammoniacal, toxemic, erysipelatous, and phleg- 
 monous conditions manifested in puerperal metritis, 
 septicaemia, fever, and allied affections — local and 
 general, they are contraindicated therein, while the 
 acids and their cognate elements and salines, with the 
 oil of turpentine, quinia, and other antalkalies, disin- 
 fectants, resolvents, stimulants, and tonics, according 
 
120 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 to the special type, stage, complication, and depress- 
 ion, are most applicable and useful to neutralize the 
 superalkalinity, destroy, nullify, and eliminate the 
 poisons, discuss the disease, and restore the vigor of 
 health. 
 
 Alcohol promotes the inception of, and is opposed 
 to resolution and recovery in puerperal fever with all 
 allied affections, as it deoxidizes and asphyxiates every 
 blood-corpuscle, molecule, and part of the system, and 
 induces a state of toxaemia both directly and indirectly, 
 with a scorbutic, septicaeinic, an d erysipelatous cachexia, 
 hence is doubly injurious therein. Much evidence 
 might be presented in proof thereof. Thus, for in- 
 stance, in an interesting article on the a Toxic Effect 
 of Alcohol in Exsanguinity," (Jour. Amer. Med. Assoc, 
 March 8, 1884,) Dr. Joseph Sager pertinently observes 
 in this connection : 
 
 "Alcoholic toxaemia will produce a constitutional 
 tendency to inflammation. This we notice in de- 
 bauchees. While in this debauched condition from 
 alcohol, the least lesion tends to inflammation. The 
 worst case of cellulitis I have had, was a case of this 
 kind." 
 
 " In my early practice I remember a physician who 
 invariably ' dosed 'his puerperal patients with whisky. 
 This physician had more puerperal fevers to contend 
 with than any other physician in his vicinity. He 
 finally sacrificed his own wife to this sinful practice." 
 
 " I know of a bleeder, who whenever she would take 
 wine, the haemorrhage was increased. She finally re- 
 fused to take it at all. I gave her credit for her good 
 
 sense." 
 
 Alcohol not only promotes ammonaemia, congestion, 
 haemorrhage, and inflammation, but also lithaemia, sep- 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 121 
 
 ticaemia, pyaemia, uraemia, anasarcous, albuminuric, 
 and correlative abnormities with their destructive 
 concomitants — both systemic and local, in fact, it 
 variously enervates and disorders body and mind, 
 hence it is especially pernicious and objectionable in 
 the pregnant and puerperal state with all cognate con- 
 ditions tending to a superalkaline and toxic, as well as 
 in a pre-existing morbid and malignant state of system. 
 Conversely, the acid regimen is adverse to such 
 abnormities, and is very appropriate during the whole 
 period of gestation as a rule, to prevent ammonaemia, 
 uraemia, and their concomitants, with the terrible 
 puerperal eclampsia as well as fever so apt to ensue 
 from pregnancy and parturition, though it is probable 
 they depend to some extent upon urate of am- 
 monia and concomitant toxic agents, rather than the 
 more simple uraemia, as urea is an active diuretic and 
 hence not easily retained in the body without renal 
 obstruction, while both ammonia and uric acid are 
 more freely formed and kept therein from defective 
 oxidation and elimination in such conditions of the 
 system. But, as the acids promote oxidation, di- 
 minish the production, increase the final evolution 
 and expulsion of such excreta, they are strongly in- 
 dicated in the gestative and parturient periods as well 
 as in general, to subvert such dangerous tendencies 
 and sequelae. Hence, a judicious use of lemon, lime, 
 and other acid juices, jellies, fruits, and the more 
 nutritious articles of the acid regimen, sour butter- 
 milk especially, as fancied and required, will directly 
 counteract the basic causes of sickness of the stomach, 
 and other disorders of pregnancy, with puerperal 
 eclampsia and fever, as they subvert the ammoniacal 
 
122 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 dyscrasia, neutralize the superalkalinity of, and de- 
 purate the blood and body, promote the normal secre- 
 tion and action of the stomach, liver, bowels and 
 kidneys, with nutrition and the healthy functions of 
 life generally, refresh and invigorate the system, and 
 proportionably favor gestation and parturition, with 
 the general physiological processes of restitution. 
 
 As thus indicated, the excessive production and 
 accumulation of ammonia, uric acid, and their con- 
 geners in the body is both a cause and consequence 
 of defective oxygenation, nutrition, albuminuria, and 
 disordered action of the kidneys, with Bright's disease, 
 as well as numerous other local and general abnormi- 
 ties, especially when other emunctories, as the lungs 
 and skin are unable to excrete them sufficiently. 
 "Ammonia has long been recognized as an exhalation 
 from the human body in health, from the skin as well as 
 
 the lungs Reuling has shown that the 
 
 quantity of ammonia in the expired air is increased in 
 certain diseases, particularly in uraemia. Its characters 
 in the expired air are frequently so marked that 
 patients who are entirely unacquainted with the 
 pathology of uraemia sometimes recognize the am- 
 moniacal odor in their own breath." {Flint's Physiology.) 
 Thus not only by the superabundance, but active excre- 
 tion of ammonia and its congeners through the kidneys, 
 lungs, and skin, renal, pulmonary and cutaneous, with 
 other diseases are originated. Besides congestion of, 
 and haemorrhage from, with other diseases of the kid- 
 neys, lungs, and skin, they are thus doubtless more or 
 less active in the production of that intractable variety 
 of eczematous disease which require and often yield to 
 the basic acid and antalkaline treatment, especially 
 with iron and other constructive and restorative agents. 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 123 
 
 Furthermore, in the minor though often severe and 
 dangerous local affections of anthrax or charbon, 
 malignant pustule, and carbunculoid affections, with 
 gangrenous and sloughing wounds and ulcers, pur- 
 ulent, scorbutic, and mephitic manifestations generally, 
 likewise so largely dependent upon ammonaemia and 
 concomitant toxaemia, the mineral, animal, and vegetal 
 acids are of supreme importance as basic and constitu- 
 tional remedies as well as general resolvents of the local 
 disorder. These local affections with the more general 
 systemic maladies being often a result of defective 
 alimentation and sanitation, from insufficient acid diet, 
 impure air and malaria, tobacco, alcohol, bad hygiene, 
 overcrowding, overwork, and undue heat, as well as 
 injuries, or traumatic, toxic, and other causes, the 
 immediate ill effects of which in causing this ara- 
 monaemia or superalkalinity of the blood with toxaemia, 
 necraemia, septicaemia, and often sudden death, is seen 
 in close confinement in hot places particularly, and 
 from sun and heat stroke, as well as in ill-fed, over- 
 exerted and over-driven men and cattle which 
 frequently die so suddenly and decompose so rapidly. 
 A notable instance of the rapid spontaneous develop- 
 ment of this ammousemia, putrid crasis, septicaemia, 
 and contagious fever is presented in the case of the 
 survivors of the notorious Black Hole, of Calcutta, 
 who were immediately seized with a malignant 
 typhus fever from their short imprisonment and 
 inhalation of poisonous exhalations from their com- 
 panions in misery, with the noxious matter engendered 
 in their own bodies. 
 
 The same general pathological condition of the 
 blood from the excessive evolution of ammonia in the 
 body as well as introduction therein from without, 
 
124 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 and special local tendency to the liver with other 
 organs, is largely induced by excessive heat, especially 
 in hot weather, seasons, and climates, with the conse- 
 quent production of hepatic and other disorders as 
 inflammation and abscess of the liver, and such fevers 
 as bilious, remittent, congestive, as well as the more 
 profound typhus and ship, and doubtless also that 
 formidable one of tropical climes — yellow fever, as it 
 has been shown that in common with the others, it is 
 largely dependent upon an ammoniacal and super- 
 alkaline condition of the blood, ammonia being the 
 most probable alkaline morbific agent therein, as it is 
 so freely spontaneously engendered by heat and 
 organic transformation, or decomposition within as 
 well as without the living organism, though the same 
 general superalkaline, scorbutic, and toxic condition 
 may also be engendered in cold climates, and in fact, 
 at any time, anywhere. Heat alone, but with 
 moisture, so commonly combined in warm climates 
 and places, being still more active in the production 
 of such maladies as bilious, ship, typhus, congestive, 
 yellow, and other malignant fevers, with the other 
 pestilential diseases and plagues that so often and 
 largely destroy both human beings and the inferior 
 animals in hot seasons and climes. Thus the heat 
 excessively increasing the development of ammonia in 
 the vital economy, while the moisture in the air 
 prevents its escape with other effete matter from the 
 system, besides its free production outside the body 
 in the decomposition of organic substances and intro- 
 duction therein from the same causes, thereby doubly 
 charging the blood and body with an excess of 
 ammonia and other noxious matter, and inducing a 
 superalkaline, toxsemic, and febrile state thereof with 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 125 
 
 often local inflammatory and gangrenous lesions. 
 Ammonia concentrated or in excess, being irritant 
 and corrosive, and having a special tendency to excite 
 inflammatory, febrile, and disorganizing conditions of 
 the blood, tissues, organs, and system in general, 
 which is intensified by external heat, malaria, defective 
 alimentation and sanitation, bad habits and modes of 
 living, tobacco miasm, alcoholic liquors, and other 
 noxious agencies, is thus a potent cause of the most 
 malignant zymotic, septic, necrcemic, infectious and 
 putrescent maladies, as well as the less virulent 
 scorbutic, mephitic, phlegmonous and gangrenous 
 diseases. In a minor degree, this ammoniacal and 
 toxic condition of blood and system is manifested 
 in, and experienced by, every one, in the oppression, 
 languor, prostration, and feverish feeling in close, 
 warm, moist weather, for the relief of which the 
 milder acids and acid regimen is so efficient, but in 
 the more intense febrile states as common, bilious, 
 remittent, tj'phus, ship, and other fevers, the stronger 
 mineral acids are required, and as the acid treatment 
 is so effective in these it will doubtless also prove as 
 efficacious in j^ellow fever. 
 
 The value of acid medication in this formidable 
 disease has recently been shown by the successful use 
 of phenic and sulphurous acid in yellow fever, as it is 
 stated in the Med. and Surg. Reporter, that Dr. 
 De Lacaille, of Rio Janeiro, "professes to have cured 
 thirty-eight consecutive cases of yellow fever by the 
 use of Deelat's preparation of phenic acid, sulpho- 
 phenic acids, and in grave cases the phenate of am- 
 monium. In the early stages the hyperdermic 
 method is necessary. He contrasts very favorably 
 his recent experience with his former sad failures 
 without these drugs." 
 

 126 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 But as the body is already charged with ammonia 
 in yellow fever, the greatest success' would doubtless 
 result in the treatment thereof as in allied diseases, 
 by omitting it and its compounds, and exhibiting the 
 mineral, animal, and vegetal acids more exclusively, 
 with corresponding regimen as elsewhere indicated, 
 with ol. terebinth, and like disinfectant, febrifuge, 
 alterative, stimulant, and corroborant measures, 
 according to the special indications in the varied 
 states and complications of the disease. 
 
 Besides the strong mineral acids with the vegetal 
 acid fruit juices, some of which as lime and lemon 
 juice are sometimes difficult to get in the colder 
 climates, and more secluded places in times of 
 emergency, there is the concentrated citric, acetic, 
 lactic, tartaric, and other vegetal acids in various 
 forms and solutions, more or less specifically useful 
 in all such heated scorbutic, febrile, septic, infectious, 
 putrescent, and mephitic conditions of system, from 
 the most benign to the most malignant, prominent 
 among which is the common compound of acetic acid 
 in the form of vinegar. 
 
 Vinegar is an active antalkaline, digestive, refriger- 
 ant, febrifuge, styptic, antizymotic, resolvent, disin- 
 fectant, depurant, secernant, diaphoretic, and diuretic. 
 As a condiment with food it is in common use 
 advantageously, and in water duly sweetened, it forms 
 a very agreeable, refreshing, cooling drink, and has 
 long been so used as a beverage in heated states of 
 the system as well as in disease, and will doubtless 
 prove as valuable in yellow fever as in all other 
 diseases of the same general character, both internally 
 and applied to the surface. "It displays decided 
 soothing and refreshing properties, and is employed 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 127 
 
 with advantage in inflammatory and bilious fevers, 
 quenching the thirst, calming the vascular excite- 
 ment, re-establishing the perspiratory function of the 
 skin, and restoring the action of the kidneys. . . . 
 It proves a direct antidote in poisoning by the alkalies. 
 In these cases it is a safe and efficient remedy." — 
 ( Waring' s Practical Therapeutics). 
 
 From its usefulness in putrescent and infectious 
 diseases, vinegar disguised or aromatized, has been 
 covertly applied by robbers to protect themselves in 
 epidemics while pursuing their nefarious business, as 
 in the plagues of Southern Europe and the East, 
 hence has gained an empirical celebrity and designa- 
 tion as " Thieves' Vinegar," and, though greatly 
 overrated as a protective agent by ordinary inhalation 
 in such cases, yet when freely vaporized and inhaled, 
 or directly applied to the throat and surface of the 
 body, is quite useful in gangrenous affections of the 
 nose, mouth, pharynx, air-passages, lungs, and septic 
 conditions of system, as in diphtheria, cynanche, 
 scarlatina, putrescent fevers and affections generally. 
 Taken internally, properly diluted and sweetened, it 
 is of much practical value as an antalkaline, anti- 
 pyretic, antiseptic, disinfectant, and restorative, 
 though as Dr. A. T. Thompson observes, " In its 
 undiluted state, it is a powerful stimulant," (irritant?) 
 " and when daily taken in large doses, in its diluted 
 form, it produces great uneasiness, cramps, and colics, 
 and gradually destroys so effectually the texture of 
 the stomach, and its digestive functions, as to cause 
 emaciation of the body." — (Ibid.) 
 
 The undue use of vinegar will even cause consump- 
 tion, but in malignant fevers with infectious, putres- 
 cent and scorbutic diseases generally, its free use 
 
128 BASIC PATHOLOGY AND SPECIFIC TREATMENT OP 
 
 internally and externally, until these are overcome, 
 will be corrective and beneficial, although it should 
 not be employed to the exclusion of the more potent 
 acid and other remedies therefor, but rather in their 
 absence or in conjunction therewith. The old and 
 well-known mixture of vinegar, molasses, and water, 
 forms a very refreshing antalkaline, antiseptic, and 
 antipyretic drink, useful not only in ordinary heated 
 conditions of system, but also in the malignant 
 fevers, and allied affections, and may often be resorted 
 to with advantage when the finer and stronger acids 
 are not at hand. 
 
 The acid treatment with the mineral and vegetal 
 acids, especially the hydrochloric, nitro-hydrochloric, 
 phosphoric and citric, with the *other mineral and 
 vegetal acids, and acid vegetal, and animal regimen 
 previously indicated, is also applicable and will no 
 doubt prove as basic and specific in the prophylaxis 
 and treatment of yellow fever as in the correlative 
 maladies of ship, typhus, remittent, and other malig- 
 nant fevers, with small-pox, scarlatina, diphtheria, 
 and other zymotic, septic, contagious, mephitic, and 
 adynamic diseases. Fortunately in general, these 
 mineral and vegetal acids can be readily obtained, 
 though when some of the latter are not to be had in 
 the fresh state as lime and lemon juice, etc., in times 
 of emergency on ships at sea, and elsewhere, they 
 may be substituted by their basic Citric acid, and as 
 this is so efficient in the prevention and cure of scurvy, 
 scorbutic, and septic diseases in general, it will doubt- 
 less prove as specifically useful in yellow fever. 
 
 " Lemon juice owes its efficacy to Citric Acid. . . . 
 Dr. Bence Jones finds that an ounce of Lemon juice 
 contains from twenty-seven to twenty-eight grains of 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 129 
 
 anhydrous Citric acid, and about three-quarters of a 
 grain of Potash, equivalent to two grains of Citrate of 
 Potash." His experiments with the juice " show that 
 its action on the animal system is in all respects 
 identical with that of free Citric acid and entirely 
 distinct from that of a neutral Potash salt. ' For all 
 practical purposes/ concludes Dr. B. Jones, i we may 
 regard Lemon juice as a free solution of Citric acid/ 
 Lemon juice from which the free acid has been 
 removed by Lime, is of no use in Scurvy at all." 
 
 " Citric acid, given alone, is an admirable Antiscorbutic. 
 Dr. Trotter long ago stated that he had experienced 
 the power of this acid to be equal to any effect he had 
 ever observed from the recent fruit in its most perfect 
 state. And of the juice of the fruit he records that it 
 was found ' a most infallible remedy/ both in the 
 prevention and cure of Scurvy. The advantage at- 
 tending the use of this acid in sea voyages is recorded 
 by Sir Gilbert Blane and Dr. Bryson. Dr. Mc Wil- 
 liam, who has had a large experience of its use 
 assured me that he had found the simple Citric acid 
 an admirable remedy in Sea-scurvy. Dr. Ritchie 
 gives sometimes Citric acid, sometimes Lemon juice, 
 and finds them equally serviceable. ... So that 
 the positive experience of these and other physicians 
 is in direct confirmation of the probability already 
 established, that Lemon juice owes its remedial 
 efficacy to this acid." — Headland/ (Action of Medicines.) 
 
 In fact the experience of physicians everywhere is 
 to the effect that Lemon juice and Citric acid are 
 specifics for scurvy and scorbutic affections generally, 
 and that the latter is the active principle of the 
 former, though sharper, and perhaps not quite so 
 
 G 
 
130 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 pleasant and lenitive, hence the juice with the mucil- 
 age of the pulp of the fruit is usually most acceptable 
 and will admit of freer use, as well as supply a larger 
 modicum of nutriment especially grateful and useful 
 when combined with sugar. 
 
 Citric Acid is antalkaline, antiscorbutic, antiseptic, 
 germicidic, antperiodic, refrigerant, febrifuge, dia- 
 phoretic, diuretic, secernant, digestive, depurant, 
 laxative, and restorative, though in large doses 
 sedative and depressing. Property diluted and 
 sweetened, " Citric acid constitutes a most service- 
 able and agreeable beverage in fevers, and in those of a 
 typhoid character. This is rendered more grateful and 
 refreshing by using water impregnated with carbonic 
 acid gas. In the ordinary condition of the stomach, 
 Citric Acid, either pure or combined, does not weaken 
 the stomach; and in some irritable states of that organ, 
 characterized by a sensation of heat, painful diges- 
 tion, an unpleasant taste in the mouth, and a disgust 
 for food, it removes these symptoms, and proves de- 
 cidedly beneficial ; but, on the other hand, when the 
 stomach is highly irritable, and its nervous suscepti- 
 bility great, Lemon juice or Citric Acid, even when 
 largely diluted, cause heat, uneasiness, pain, and not 
 unfrequently obstinate vomiting. Nevertheless as 
 Mr. Broussais has remarked, the Citric is that acid 
 which the stomach supports the best when suffering 
 from inflammation.' 5 — [Waring' s Pract. Therapeutics.) 
 
 Some of this gastric disorder and intolerance, is 
 caused by the large quantity of fluid with the Citric 
 acid, and its uncombined state, which may be avoided 
 by giving it in sweetened gum arabic or barley water, 
 and by letting the patient suck or sip the juice of 
 limes, lemons, or oranges with as much sugar as they 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 131 
 
 desire, or they may be incorporated together as a con- 
 fection and taken at pleasure. Citric acid or lemon 
 juice is especially useful in inflammations, fevers, 
 scorbutic, septic, infectious, dyspeptic, hepatic, costive, 
 anuric, and dropsical affections. It is particularly 
 active in quenching thirst, reducing heat, and arterial 
 excitement. "Dr. Owen Rees found that Lemon 
 juice in doses of §j thrice daily, caused a great de- 
 pression of the heart's action, in one case it fell from 
 120 to 75 ; in another from 110 to 74; the pulse at the 
 same time being rendered smaller. These effects 
 were observed in patients suffering from acute Rheu- 
 matism, but the same effect was observed in the healthy 
 body; thus, a clinical clerk took f§j of Lemon juice 
 thrice daily for three days, and carefully noted his 
 pulse, which was naturally full, and about 75 in the 
 minute. After five doses the pulse became much 
 weaker, was more compressible, and numbered 70 in 
 the minute. On the third day the pulse became as 
 low as 66, and was very small and compressible. The 
 urine was always acid, and also natural in quantity, 
 till the third day, when it increased somewhat; the 
 Sp. Gr. was then 1.017, and there was a deficiency of 
 Lithic Acid. As an antidote to acro-narcotic poisons, 
 Lime or Lemon juice is often very effectual. Its modus 
 operandi is obscure, but its effects are often very re- 
 markable. In overdoses of Croton seeds (Croton 
 Tiglium), I have witnessed almost immediate cessa- 
 tion of the vomiting, purging, and pain, from a single 
 draught of lime juice." — (Ibid.) 
 
 In the sickness of stomach, superalkalinity of blood, 
 toxaemia, biliousness, thirst, constipation, and other 
 disorders from that potent acro-narcotic poison — 
 tobacco, Lemon juice or lemonade with other acids 
 
132 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 also afford relief, doubtless by neutralizing the inhaled 
 alkalies and promoting secretion with the elimination 
 of the poison from the body. This was practically 
 discovered by the gentleman mentioned as so sus- 
 ceptible to the noxious effects of tobacco, who finds 
 that lemonade and the acid regimen afford more direct 
 relief than anything else, though anodynes are re- 
 quired to relieve the concomitant neuralgia therefrom, 
 with general abstemiousness from much food until the 
 stomach and system recover their normal tone. Citric 
 acid and lemon juice are also useful in sickness of 
 stomach from pregnancy, and in nausea and vomiting 
 from other causes, especially when dependent upon 
 ammonsemia with its concomitant toxaemia, and mal- 
 arial or scorbutic conditions of system, hence is 
 strongly indicated in yellow fever, both to prevent 
 and correct the emesis so frequent therein, as well as 
 for its general antalkaline, febrifuge, antiseptic, resol- 
 vent, secernant, diaphoretic, diuretic, depurant, re- 
 storative, and other remedial effects required in this 
 pernicious disease with others of a like character. 
 Thus in all sthenic fevers, the juice of limes and 
 lemons, or citric acid in the form of lemonade, con- 
 centrated and cold or iced, may be given as freely as 
 the stomach will bear, while in the asthenic form, non- 
 febrile, scorbutic and adynamic states, hot lemonade is 
 often preferable, with other adjuvant acid remedial 
 agents as indicated. 
 
 Lemon juice or its analogues may often be advan- 
 tageously combined with coffee or other corroborant, 
 whenever a refrigerant stimulant tonic is required. 
 Lemon juice in coffee is very efficient as an anti- 
 periodic, antalkaline, alterative, and restorative in 
 chronic paludal affections especially, as well as the 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 133 
 
 more acute malarial disorders, the latter itself being 
 also a potent antiperiodic, and tonic. I have found 
 this combination very effective in breaking up chronic 
 intermittents, exhibited in the strength of the juice of 
 a medium-sized lemon to a cup-full of strong coffee 
 sweetened to taste, as often as required. This will 
 sometimes succeed when quinia and the usual anti- 
 periodics and tonics have failed, though it may be em- 
 ployed in conjunction therewith, according to the 
 special indications. It is especially applicable as a 
 preventive as well as cure of malarial diseases. 
 
 In a paper read at the last International Medical 
 Congress, in Copenhagan, Prof. Conrad Tommasi 
 Crudelli, of Rome, thus testified to the value of lemon 
 juice in malarial diseases [Medical Record): "It is 
 well known that in Italy, Greece, and North Africa, 
 that they often use lemon juice or a decoction of 
 lemon seeds, as a remedy in malarial fevers of moder- 
 ate intensity; and in Gaudaloupe they use for the 
 same purpose a decoction of the bark of the roots of 
 the lemon tree. All these popular practices tend to 
 show that the lemon tree produces a febrifuge sub- 
 stance, which resides in all parts of the plant, but 
 which would seem to be most abundant in the fruit. 
 In fact, among the popular remedies employed against 
 malarial infection, that which I have just described is 
 the most efficacious for it can be employed with good 
 effects in acute fevers. But it is especially advanta- 
 geous in combating the chronic infection, which is so 
 rebellious to the action of quinine, and in removing 
 or moderating its deplorable effects." 
 
 Moreover, according to Dr. Schulz, France, [Boston 
 Jour, of Chemistry), Citric acid is a potent antiseptic 
 
134 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 and germicide. He " found that one drop of a solu- 
 tion of one part of acid to one thousand of water 
 placed in a liquid containing bacteria and other 
 organisms instantly caused their death as observed 
 under the microscope." Besides, he " found a five 
 per cent, solution of the acid to prevent meat from 
 decomposing." 
 
 Ihrtaric Acid, with which citric acid is sometimes 
 adulterated, is also useful to a limited extent as an 
 antalkaline, febrifuge, laxative, etc., and may be used 
 in small doses for the same purpose, largely diluted in 
 water sweetened to taste, as a cooling, refreshing, re- 
 solvent drink in yellow, as in other febrile, inflamma- 
 tory, heated, septic, and scorbutic states of system. 
 But it should always be exhibited with care, and 
 rather in the absence of better remedies, for " although 
 cheaper and consequently more used than Citric Acid, 
 it is inferior to it in many respects, being more apt to 
 disorder the digestive organs, to produce colic, and to 
 purge. In large doses it acts as an irritant poison. 
 One ounce dissolved in half a pint of water caused 
 violent inflammation of the alimentary canal and 
 death in nine days. When its employment in medi- 
 cinal doses, is followed by a red and dry tongue, 
 it ought to be discontinued — (Dr. Thompson). It is 
 said to be the best artificial solvent of mucus, and 
 may be advantageously given when this exists largely 
 in the bowels." — (Waring's Pract. Thera.) 
 
 Lactic Acid, is also another organic acid, of both 
 animal and vegetal origin. It is especially useful as 
 antalkaline, digestive, antiseptic, antizymotic, febri- 
 fuge, resolvent, depurant, and restorative, applicable 
 in the prevention and treatment of diphtheria, typhoid, 
 yellow and other fevers, with cognate zymotic, septic, 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 135 
 
 contagious, scorbutic, and mepliitic diseases. In 
 fact, as it is constantly engendered in the system, it 
 may be partly from its deficiency at times that am- 
 monaemia or superalkalinity of the blood with lithoemia, 
 toxaemia, and their febrile and other morbid concomit- 
 ants often ensue, though when in excess, it may excite 
 inflammatory or other disease, as rheumatism, cardiac, 
 and arthritic disorders for instance. 
 
 In this connection Dr. Headland says (Action of 
 Medicines): "It has long been considered probable, 
 but may now be said to have been proven by the re- 
 searches of M. Becquerel, that in febrile disorders and 
 in inflammations there is excreted in the urine an 
 excess of Urea and Urate of Ammonia, substances 
 which are formed by the oxidation of the Nitrogenous 
 tissues. This extra-oxidation probably arises from a 
 deficiency of that matter which is the proper food of 
 oxygen in the system. This, as we have seen, being 
 the step between grape sugar and Carbonic acid, must 
 either be Lactic acid, or something similar to it. It 
 must be remembered that no food is usually taken in 
 fever; this would at length quite cut oft* the usual 
 source of this Lactic acid, which is the starch and 
 sugar of the food, and render it necessary that the 
 animal tissues should continue to undergo oxidation 
 to maintain the animal heat. Rheumatism and Gout 
 are an exception to this." 
 
 Hence, to correct this deficiency of acid and ali- 
 ment, neutralize superalkalinity of blood, allay fever, 
 restore the equilibrium of chemico-organic action, 
 calefaction, and nutrition, Lactic acid should be given 
 in solution with sugar, or better still, in its natural 
 connection with nitrogenized aliment, as in sour 
 
136 BASIC PATHOLOGY AND SPECIFIC TBEATMENT OF 
 
 buttermilk, sweetened to taste. This supplies appro- 
 priate medicine, refrigerant and refreshing drink, 
 with the most essential food in an acceptable form to 
 the palate and stomach at the same time, an impor- 
 tant advantage — indeed, often vital necessity in yellow, 
 ship, typhus, puerperal, and other low fevers and 
 correlative diseases, in which the more substantial 
 animal aliment in the usual forms is frequently re- 
 pugnant and the stomach so intolerant of everything. 
 In the absence of better remedies the juice of sauer 
 kraut, sour cider, and sour wine, might be resorted to 
 as acid remedies in zymotic, septic, contagious, scor- 
 butic, putrescent and allied diseases, though in 
 general, spirituous liquors of all kinds are objection- 
 able in such maladies, as alcohol parches the mouth 
 and throat, irritates the stomach and liver, diminishes 
 the secretion of the gastro-intestinal canal and general 
 system, dries the skin, increases thirst, prevents 
 oxygenation, arterialization, hsematosis and normal 
 chemico-organic metamorphosis, pollutes and induces 
 a toxic and scorbutic condition of the blood, and 
 promotes congestion, inflammation, and hcemorrhage, 
 particularly of the stomach and liver, with special 
 tendency to emesis and those forms of disorder ex- 
 pressed in the general term of " mat des ardens" which 
 are usually so predominant in typhus, yellow, ship, 
 bilious, puerperal, and other fevers, with erysipelas, 
 diphtheria, infectious, and septic diseases generally. 
 In fact, alcoholics everywhere the world over, espe- 
 cially in hot weather and tropical climes, are subject 
 to abnormal thirst, dyspepsia, congestions, inflamma- 
 tions, and defluxions of stomach, liver, lungs, brain, 
 and kidneys, with gastric, bilious, blood, nervous, and 
 epidemic maladies, that disable and destroy them 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 137 
 
 largely. Hence alcoholic liquors are contraindicated 
 in typhus, ship, yellow, bilious, puerperal, and all 
 other fevers, with small-pox, erysipelas, diphtheria, 
 septic and scorbutic diseases generally. They are 
 unnecessary even in small quantities for stimulant 
 purposes, which at best is but temporary and soon 
 followed by reactive depression, or sedation, as phos- 
 phoric acid and ol. terebinth., with other agents, are 
 superior, and far more appropriate not only as 
 stimulants, but also for other essential uses in such 
 cases, their action being more direct, physiological, 
 radical, permanent, and remedial, in marked contrast 
 with the noxious, morbific, and baneful effects of 
 alcohol both immediate and remote, unless used with 
 the utmost circumspection in small quantities, there 
 being no greater fallacy than its free use as a stimulant 
 and food, when it really enervates, relaxes, narcotizes 
 and starves the system, and acts as a pernicious 
 poison, both directly and indirectly. 
 
 Alcohol neither supplies nutriment, heat, nor force 
 to the vital economy, but robs it of all, and is in no 
 sense an aliment, but a noxious drug, that coagulates, 
 hardens, toughens, and renders food less digestible; 
 diminishes, precipitates, and prevents the transform- 
 ing action of the digestive ferments; arrests the 
 chemical processes of digestion, oxidation, and ar- 
 terialization ; counteracts sanguification, assimilation, 
 and nutrition; and subverts both formative and 
 retrogressive chemico-organic metamorphosis; as well 
 as deadens, disorders, and destroys the higher 
 dynamical functions of nervous, mental, and moral 
 life, of which the common phenomena of intoxication, 
 and the myriads of poisoned, diseased, degraded, and 
 dying human beings therefrom are ample evidence 
 
138 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 presented everywhere throughout the world, alcohol- 
 ism being a prevalent endemic in all times and climes, 
 whenever or wherever this potent alcoholic poison 
 under whatever guise, is ingested. Therefore, as 
 alcohol does not render food more, but less digestible; 
 does not quench, but produces thirst; does not en- 
 hance, but nullifies the activity of the digestive 
 ferments; does not nourish, but starves the body; 
 does not increase, but diminishes oxygenation and 
 calorification ; does not promote, but prevents sangui- 
 fication; does not purify, but corrupts the blood; does 
 not facilitate, but subverts normal chemico-organic 
 metamorphosis and depuration ; does not augment, 
 but lessens vital energy; does not invigorate, but 
 enervates the system ; does not support, but destroys 
 health ; does not prevent, but induces disease ; does 
 not refine, but debases the physical, mental, and 
 moral nature ; does not diminish, but increases vice, 
 crime, and licentiousness, with concomitant evils; 
 does not promote, but subverts healthy procreation, 
 and hereditarily entails deformity, dementia, de- 
 pravity, and debasement of body, mind, and morals 
 upon progeny; does not ennoble, but brutalizes 
 mankind; does not lengthen, but shortens life; it has 
 no quality or application whatever as a food and 
 beverage, and but a limited use as a drug. Though 
 the principal medicinal value of alcohol is as a stimu- 
 lant, yet it is but an evanescent excitant in small 
 quantities, and a powerful intoxicant, narcotic, and 
 relaxant, or stupefacient and depressant of body and 
 mind, in large or frequent small doses, its secondary 
 and reactive depressing with its other deteriorating 
 effects so predominate, as to render it inapplicable 
 for prolonged stimulant with collateral restorative 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 139 
 
 purposes. In fact, in many respects, independent of 
 its obnoxious properties, it is inferior as a remedial 
 agent to other drugs, especially the oil of turpentine, 
 to which we will now invite attention as an efficient 
 substitute therefor, in its connection more particularly 
 with malignant fevers and correlative diseases, and 
 disorganizing and depressed conditions generally. 
 
 Oleum Terebinthince. The oil of turpentine is a 
 powerful stimulant, disinfectant, germicide, anti- 
 zymotic, antiseptic, alterative, haemostatic, depurant, 
 secernant, diaphoretic, diuretic, purgative, and anthel- 
 mintic, and externally a rubefacient and vesicant. It 
 stimulates the heart and circulation, brain, nervous, 
 and general system, disinfects and depurates the blood 
 and body, obviates the tendency to, and checks 
 haemorrhage and putrefaction, promotes normal 
 secretion of the air-passages, mouth, gastro-intestinal 
 canal, skin, and kidneys, destroys microzymes, in- 
 testinal and other parasites, and acts as a general 
 alterative, resolvent, stimulant, and corroborant. It 
 has, moreover, the superior attribute of being so 
 volatile that it can readily be introduced into the 
 blood and body ad saturandum, by involuntary inhala- 
 tion without dosing the stomach, which is especially 
 important in diseases of the throat, air-passages, lungs, 
 heart, and blood, ship, typhus, bilious, puerperal, and 
 other low fevers, cholera, collapse, and depressed 
 conditions of the system in general, though sometimes 
 its local action on the stomach and bowels is desirable 
 therein, as in the hemorrhagic and ulcerative states 
 of yellow and enteric fever, serous, choleraic, and 
 other asthenic gastro-intestinal affections. It is also 
 readily absorbed through the skin and rectum, 
 rapidly enters the circulation and appears in the urine 
 
140 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 and breath, so that its volatility, penetrability, diffusi- 
 bility, stimulant, and other properties render it 
 peculiarly valuable in the treatment of many dis- 
 orders of a toxsemic, infectious, and adynamic char- 
 acter, particularly when patients are intolerant of 
 gastric medication or in a depressed, collapsed, and 
 insensible state, in which it has extensive and varied 
 uses as demonstrated by the following evidence from 
 different sources. 
 
 Thus, with other applications, Dr. Waring states 
 [Practical Therapeutics), that in " Typhus and Typhoid 
 Fevers and in the advanced stages of continued and 
 inflammatory Fevers, the Spirit of Turpentine by 
 mouth, in enemata or externally in fomentation, is a 
 remedy of the highest value, when the vital energies 
 are greatly depressed, when Coma or Stupor are present, 
 or if Delirium with Subsultus Tendinum, etc., exists. Tur- 
 pentine, either by mouth or in the form of enema, 
 often rouses the vital powers, and exercises the most 
 beneficial influence. In the Tympanitis of Fever, it also 
 proves most essentially useful, Drs. Graves, Copland, 
 and others speak highly of its efficacy; the former 
 advises it in doses of f 5 j, with f 5 iss of Castor Oil, to 
 be repeated every sixth hour; and the latter ad- 
 ministers it in enemata, and applies it externally to 
 the abdomen in fomentation, I have seen striking 
 benefit result from its employment; indeed there are 
 few remedies which deserve more confidence. In 
 Intestinal Haemorrhage, Hiccough, etc., it also proves 
 highly serviceable, removing these conditions and 
 tranquillizing the nervous system. Prof. Huss states 
 that, in the epidemic of Typhoid Fever which pre- 
 vailed at Stockholm in 1841-2, he found Turpentine 
 fomentations extremely useful, they were applied to 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 141 
 
 the abdomen when the diarrhoea was profuse, and to 
 the chest w T hen pulmonary complications existed. Its 
 external application should never be omitted in the 
 latter stages of Typhus. It may also be given in- 
 ternally with advantage. Dr. Shapter considers that 
 in the third or last stage of Remittent Fever, the Oil of 
 Turpentine, in doses of gutt. xxx, is perhaps one of 
 the most safe and useful medicines which we can 
 employ. He remarks, that it often immediately con- 
 trols the character of the symptoms, and changes en- 
 tirely the nature of the alvine secretions. Stimulants, 
 etc., are advisable at the same time. Dr. Ward, in 
 the treatment of the Malarious Intermittens of Ceylon, 
 found great advantage from the administration of 
 foss-foj of Spirits of Turpentine (with a sufficient 
 quantity of Castor Oil to act as a cathartic) at the 
 commencement of the cold stage. The remedy was 
 repeated every succeeding cold stage, and he frequently 
 found no other treatment was required. In the Bron- 
 chitis of Typhus Fever and other Adynamic Fevers, the 
 effects of Turpentine internally, to use the words of 
 Dr. Murchison, are sometimes marvellous. In 
 extreme cases, when the tubes are filled with secre- 
 tion, the face livid, and the patient has not the 
 strength to cough, or when other remedies fail, 
 recourse should be had to Turpentine. It may be 
 given as follows: ]^. 01. Terebinth. ^ x-xx, Ether 
 Sulphuric, vel Chloric, ^ xv-xxx, Spt. Juniper Co. 
 ^ xxx, Mist. Acacia f 5 iss, M. This may be repeated 
 every two hours at first, until the desired effect is 
 produced. After a few doses, the patient often begins 
 to cough and to expectorate large quantities of viscid 
 mucus, with great relief to the respiratory symptoms. 
 Under its use the urine is increased." 
 
142 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 " In Puerperal Fever, the internal exhibition of the 
 Oil of Turpentine, in doses of one or two tablespoon- 
 fuls every three or four hours, in cold water, and 
 sweetened, was first proposed by Dr. Brenan, of 
 Dublin. He regarded it as a specific, and in this 
 opinion he is joined by Drs. Douglass, Blundell, 
 Copland, and other judicious practitioners. Dr. 
 Murphy agrees with Dr. Copland in stating that there 
 is certainly no remedy so efficacious as a decided and 
 judicious use of the Spirit of Turpentine in doses of 
 f § ss, with Castor Oil, every three or four hours." 
 
 " In Inflammation, Dr. Copland observes that after 
 watching its effects for thirty years, he believes there 
 is no remedy more deserving of confidence, if ap- 
 propriately and prudently prescribed. The operation 
 of this medicine depends upon the dose, the frequency 
 of repetition, and the combination of it with other 
 remedies. Hence it may be made available in every 
 form of inflammation/ 5 
 
 " In Hemorrhage, the Oil of Turpentine has long 
 been highly esteemed as a styptic. Its use is generally 
 confined to atonic and passive Haemorrhage, but Dr. 
 Copland considers that the existence of inflammatory 
 action does not contraindicate its use, for it lowers, he 
 observes, vascular excitement, and prevents effusion, 
 and the formation of coagulable lymph, especially 
 when given in sufficiently large or repeated doses. 
 When the powers of life are much impaired, and after 
 copious evacuations of blood, small and frequent doses 
 of it only ought to be given, conjoined with tonics, 
 aromatics, restoratives, etc." 
 
 " In Purpura Hcemorrhagica, Dr. Neligan employed 
 the oil of Turpentine with invariable benefit. He 
 gave it in doses sufficient to purge freely, which 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 143 
 
 object is more certainly obtained by combining it 
 with Castor Oil." 
 
 Others testify to the same effect, but the haemo- 
 static, stimulant, and alterative effects of turpentine 
 can in general, be obtained by smaller and more 
 frequent doses by the mouth, rectum, and lungs in 
 inhalation especially, without purgative or other per- 
 turbative treatment. 
 
 Further evidence is presented of its efficacy in 
 various forms of haemorrhage, and general experience 
 testifies that in gastric, intestinal, uterine, pulmonary, 
 renal, purpuric, and other forms of hremorrhcea, 
 especially of an atonic character, the oil of turpentine 
 is very efficient and often of itself sufficient to arrest 
 the bleeding as well as to correct the hemorrhagic 
 diathesis, but may be often advantageously combined 
 with other remedies to meet special indications in 
 particular cases. 
 
 Moreover, in defective or perverted secretion of the 
 air-passages, mouth, throat, gastro-intestinal canal, 
 and other parts, especially of the kidneys, the oil of 
 turpentine is extremely useful, and will sometimes 
 succeed in restoring the urinary and other secretions 
 when the most active secernants and diuretics have 
 failed. Besides, in serous, anasarcous, choleraic, and 
 purulent defluxions it is a very efficient remedy 
 exhibited both internally and externally, and particu- 
 larly by voluntary as well as involuntary inhalation, 
 when a more speedy and decided effect is required, as 
 in chill, effluxion, and prostration generally. 
 
 Furthermore, in conditions of a necnemic, phleg- 
 monous, putrefactive, and lethal character, it is highly 
 useful, as for example, in "Erysipelas. Mr. Nunnely 
 observes that it is certain that in some instances 
 
144 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 where coma has been intense, the pulse sinking, the 
 tongue dry and glazed, and the teeth imbued with 
 sordes, after other remedies have been abandoned in 
 despair, the administration of the Oil of Turpentine 
 has apparently saved the patient. In extreme cases it 
 should always be employed, and may be given in 
 the manner advised in Typhus Fever (ante). Dr. Cop- 
 land advises Turpentine fomentations to be locally 
 applied. 
 
 " Ulcers of the Extremities. The internal use of tur- 
 pentine appears in these cases to hasten the healing 
 process. Mr. H. Hancock, of Charing Cross Hospital, 
 relates a case illustrative of its efficacy. Water 
 dressings were applied locally, and the following 
 mixture was given internally: 1^. Sp. Terebinth. 
 f5vj, Pulv. Acacia 5vj, Aq. Menth. Pip. f^vij, 
 M. Sumat. f § j ter in die." — (Ibid). 
 
 Besides atonic and chronic ulcers, oil of turpentine 
 is specially applicable for the prevention and treat- 
 ment of bed-sores, and all the disorganizing, 
 ulcerated, gangrenous, and sloughing tendencies — 
 internal and external, of typhoid, diphtheria, angi- 
 nose, and asthenic conditions generally, in which it 
 must necessarily be conjoined with a due supply of 
 appropriate acid, mineral, and alimentary basic 
 principles, essential for normal construction, nutrition, 
 reparation, and life action. 
 
 To further exhibit the valuable medicinal applica- 
 tions of ol. terebinth. I present the following from the 
 U. S. Dispensatory, by Dr. Geo. B. Wood : 
 
 " Oil of turpentine is stimulant, diuretic, occasion- 
 ally diaphoretic, anthelmintic, in large doses cathartic, 
 and externally rubefacient. Swallowed in moderate 
 quantities it produces a sense of warmth in the 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 145 
 
 stomach, accelerates the circulation, and increases 
 the heat of the skin, without especially affecting the 
 functions of the brain. In small doses, frequently 
 repeated, it stimulates the kidneys, augmenting the 
 secretion of urine, and often producing, especially if 
 long continued, painful irritation of the urinary pas- 
 sages, amounting sometimes to violent strangury. . 
 . . In large doses it occasions slight vertigo, or a 
 sense of fulness in the head, sometimes amounting to 
 intoxication, attended frequently with nausea, and 
 succeeded generally, though not always, by speedy 
 and brisk catharsis. ... In some constitutions it 
 produces, even when taken internally an erythematic 
 eruption on the skin." 
 
 "The oil is employed in numerous diseases. As a 
 stimulant it sometimes proves serviceable in low 
 forms of fever. We have found it extremely useful 
 in the advanced stage of typhoid or enteric fever, and 
 especially in cases in which the tongue has partially 
 or completely thrown off its fur in flakes, and after- 
 wards become dry, with a surface destitute of its 
 ordinary papillary appearance, and often contracted 
 and fissured. The remedy has, in our hands, proved 
 almost uniformly successful under these circum- 
 stances. With small doses of the oil frequently 
 repeated, the tongue becomes moist and again coated, 
 the tympanic state of the bowels disappear, and the 
 patient goes on to recover as in a favorable case of 
 fever. . . . The medicine has been recommended 
 as a counter-irritant in yellow and puerperal fevers, 
 and may undoubtedly be given with advantage in the 
 later stages of these diseases, and in other instances of 
 gastric and enteric inflammations, which require a 
 resort to stimulation. ... It has also been much 
 
146 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 extolled as a remedy in neuralgia, in epilepsy, and 
 tetanus, in passive haemorrhages, particularly from 
 the bowels, in disordered conditions of the alimentary 
 canal attended with sallow countenance, foul tongue, 
 tumid abdomen, sour or fetid eructations, and general 
 depravation of health, in obstructions of the bowels 
 in chronic dysentery and diarrhoea, in obstinate gleets 
 and leucorrhcea, in suppression of urine, and retention 
 and incontinence of urine from debility, and in 
 chronic nephritic and calculous affections. In certain 
 states of dysentery, whether acute or chronic, when 
 the tongue is quite dry, and smooth as if from defect 
 of the papillary structure, no remedy has been so 
 efficient in our hands as oil of turpentine. We have 
 seen it also very beneficial in haemoptysis. As a 
 vermifuge it is highly esteemed especially in cases of 
 taenia." 
 
 " The dose for ordinary purposes is from five to 
 thirty drops every hour or two in acute, and three or 
 four times a day in chronic diseases, administered on 
 sugar, or in emulsion with gum arabic, loaf sugar, 
 and cinnamon or mint water. No remedy is more 
 effectual in tympanites than the injections of the oil 
 of turpentine. From half a fluid-ounce to two fluid- 
 ounces may be administered suspended by the yolk of 
 eggs in half a pint or pint of water, or some mucilagi- 
 nous fluid. Externally applied, oil of turpentine 
 irritates and inflames the skin, and in low forms of 
 fever with coldness of the surface, is when heated, one 
 of the most efficacious rubefacients." 
 
 These lengthy extracts are presented to show more 
 strongly the special adaptation of the oil of turpentine 
 to the treatment of the inflammatory, necraemic, in- 
 fectious, disorganizing, putrescent, and adynamic 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 147 
 
 states of ship, typhus, yellow, malarial, puerperal, 
 congestive, enteric, and other fevers, with erysipelas, 
 diphtheria, small-pox, purpura, haemorrhages, gastro- 
 intestinal disorders, choleraic and other defluxions, 
 and toxemic, zymotic, septic, contagious, and de- 
 pressed conditions general^. It is thus especially 
 indicated therein as an energetic stimulant, disinfect- 
 ant, antiseptic, germicide, haemostatic, diuretic, 
 diaphoretic, general secernaut, alterative, resolvent, 
 and restorative. As a hemostatic in scorbutic, ne- 
 cramic, and purpuric conditions particularly, it will 
 prove in general more useful than any other remedy 
 
 " it has been used with success in almost every 
 form of hcemorrhage, but most successfully when the 
 bleeding was passive. The special affections include 
 
 (axis, hcemaiemesis, hcematuria, menorrhagia, past par- 
 turn haemorrhage, purpura^ and the multiple haemor- 
 rhages occurring under the iniluence of the haemor- 
 rhagic diathesis. Even in external and traumatic 
 haemorrhages it has proved efficient. Its efficacy 
 justifies the opinion of John Hunter, who termed it 
 ' the best, if not the only true styptic.'" — Dr. Alfred 
 Stille (National Dispensatory). 
 
 Oil of turpentine is not only thus applicable to 
 arrest bleeding and exudation, but also to subvert the 
 hemorrhagic and colliquative diathesis, prevent the 
 necraemia and transudation of the blood in its entirety 
 from the various tissues and organs, as in scurvy, 
 black vomit, etc., with the separate effusion of its 
 albuminous and aqueous constituents, as in leucor- 
 rhcea, dropsy, and cholera in its various forms, in 
 fact, in haMnorrhagic, lymphoidal, and serous deflux- 
 ions generally. It is thus efficient both as a prophy- 
 lactive and curative of the necnenric, transudative, 
 
148 BASIC PATHOLOGY AND SPECIFIC TBEATMENT OF 
 
 and diarrhceal disposition, and likewise of the general 
 typhoidal and collapsing, with their concomitant fatal 
 tendencies, though as all such abnormities depend so 
 directly upon the ammoniacal and superalkaline 
 dyscrasia, its efficiency may be largely enhanced 
 therein by the conjoined use of acids, with ergot, iron, 
 and other constringing and tonic agents. Besides, in 
 the minor affections as a cardiac and general stimu- 
 lant, etc., and substitute for alcohol, it may often be 
 given beneficially in small and frequent doses on 
 su^ar, or in emulsion with aromatics and tonics. 
 
 From its volatility the oil of turpentine may be 
 given more or less freely and continuously by inhala- 
 tion in ordinary inspiration, by keeping a cloth 
 saturated with it in front and near the face of the 
 patient, as well as by its more general diffusion in the 
 air the patient breathes, supplemented if necessary by 
 voluntary inhalation, especially in cases of sudden 
 depression as in cholera, yellow fever, uterine haemor- 
 rhage, chills, and syncope from any cause, if the 
 patient be able to make the necessary effort. Other- 
 wise it may be given by the mouth or bowels, or both, 
 particularly for its more immediate internal local 
 effects upon the gastro-intestinal canal. Whenever 
 indicated in all such diseases and depressed conditions, 
 I thus habitually exhibit the oil of turpentine by 
 inhalation in preference to its administration by the 
 mouth or rectum, more or less freely according to 
 necessity, until its specific effects are obtained, 
 although the latter method is also conjoined or more 
 exclusively employed where the occasional or local 
 internal use of this valuable remedy is necessary, 
 graduating of course, the dose and mode of administra- 
 tion according to the special indications therefor and 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 149 
 
 effects required, though a gentle continuous disinfect- 
 ant, diaphoretic, diuretic, alterative, and stimulant 
 influence may usually be kept op by moderate 
 quantities steadily inhaled in ordinary breathing, 
 better than by occasional doses by the stomach or 
 bowels. From my own general and favorable expe- 
 rience therewith in the various scorbutic, necraemic, 
 septic, typhoid, infectious, and depressed states of 
 system, I firmly believe that the free and appropriate 
 use of the oil of turpentine in the adynamic and 
 hemorrhagic states of vellow fever, as well as in 
 cholera and allied diseases, will prove invaluable, 
 both as a preventive and curative of some of their 
 most dangerous symptoms and tendencies. I therefore, 
 strongly urge its free exhibition therein, both by the 
 lungs and stomach, or rectum, as may be required, 
 beginning usually with small quantities and gradually 
 increasing according to necessity, until the desired 
 effect is secured, this, rather than the quantity used 
 being the better guide, in every disease, always how- 
 ever, bearing in mind that in excess it irritates and 
 inflames internal organs with external tissues, as well 
 as intoxicates and enervates the nervous and general 
 system, or induces anesthesia, for which indeed, it 
 may be sometimes employed advantageously, while 
 exceptionally, as stated by Dr. Waring (Practical 
 Therapeutics), " In some persons, Turpentine, in any 
 form, or in any dose, produces very unpleasant effects: 
 coma, intoxication, violent strangury, eruption of the 
 skin, etc." 
 
 The beneficial iufluence of the oil of turpentine is 
 not, how T ever, thus limited exclusively to the patient, 
 for its general diffusion in the air destroys the infec- 
 tious principles therein, as well as prevents their 
 
150 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 development and thereby protects the attendants and 
 others exposed, against contagious miasms and dis- 
 eases, as in diphtheria, typhus, small-pox, scarlatina, 
 cholera, and others of a less virulent character, it 
 being a potent ozoniferer, disinfectant, and germicide, 
 as well as stimulant and restorative, but as it is 
 inflammable it must not be too freely disseminated in 
 the air where there is any danger of fire. 
 
 Other essential oils as of peppermint, cinnamon, 
 eucalyptus, with thymol and their analogues, singly 
 or combined with turpentine and other less pleasant 
 remedies, with the juice of alliaceous plants, as of 
 onion, garlic, etc., the activity of which depend upon 
 an essential oil, are also applicable in adynamic fevers 
 and conditions of system. These oils and cognate 
 agents may also be inhaled, taken by the mouth or 
 applied to the surface. One of the most common and 
 useful of this class is garlic, which may be employed 
 both as a condiment and medicine at the same time. 
 " When it is taken internally, the oil is speedily 
 absorbed, and pervading the system, becomes sensible 
 in the breath and various secretions. Even ex- 
 ternally applied, as to the soles of the feet, it imparts 
 its odor to the breath, urine, and perspiration, and, 
 according to some writers, may be tasted in the 
 mouth. Its effects on the system are those of a 
 general stimulant. It quickens the circulation, excites 
 the nervous system, promotes expectoration in debility 
 of the lungs, produces diaphoresis or diuresis accord- 
 ing as the patient is kept warm or cool, and acts upon 
 the stomach as a tonic and carminative. . . . Ap- 
 plied to the skin it is irritant and rubefacient, and 
 moreover, exercises in some degree its peculiar 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 151 
 
 influence upon the system, in consequence of absorp- 
 tion. . . . The juice is said sometimes to check 
 nervous vomiting, in the dose of a few drops. If 
 taken too largely, or in excited states of the system, 
 garlic is apt to occasion gastric irritation, flatulence, 
 hemorrhoids, headache and fever/' — U. S. Dispensa- 
 tory. Hence the use of the juice or oil of garlic is 
 indicated in cholera, and other atonic serous, hemor- 
 rhagic, catarrhal, albuminous and purulent defluxions, 
 as well as in congestive, malarial, and low fevers, 
 with scorbutic, collapsed, and depressed conditions 
 generally, both exhibited internally and applied to 
 the surface, and may be taken in food and medicine 
 for preventive as well as curative purposes. 
 
 In the more purely hygienic with the medicinal 
 treatment of typhus, yellow, malarial, puerperal, 
 enteric, and other asthenic fevers, with small-pox, 
 erysipelas, diphtheria, cholera, septic, infectious, 
 putrescent, and adynamic states of the system in 
 general, special effort should be made to insure the 
 proper oxygenation of the blood, haematosis, chemico- 
 organic metamorphosis, and depuration of the fluids, 
 organs, secretions, and entire system by a due supply 
 of pure air with other arterializing agents, of which 
 oxygen, peroxide of hydrogen, and nitrous oxide will 
 prove the most useful, though it is probable that 
 nitromuriatic acid owes some of its efficacy to the 
 oxygen as well as chlorine it supplies to the system, 
 besides its compound action as an acid. Of oxygen 
 itself little need be said, as it is well known and less 
 active in a free than nascent state, though quite use- 
 ful, but of the peroxide of hydrogen, which yields it 
 in this condition, much may be usefully expected. 
 
152 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 With regard to the physiological influence and 
 therapeutical effects of peroxide of hydrogen. " Dr. 
 B. W. Richardson, of London, found that to venous 
 blood, deprived of its fibrin, it imparts oxygen, with 
 an increase of heat, and a change of the color to red. 
 Fibrin and cellular tissue cause it to evolve oxygen. 
 Sugar and starch are decomposed by it, giving out 
 carbonic acid. Albumen, gelatin, urea, and cutaneous 
 tissue have no effect upon it. Injected into the left 
 cavities of the heart of an animal, it restores the 
 irritability of that organ, but has an opposite effect in 
 the right cavities. Thrown into the arteries imme- 
 diately after death, it restores for a time, the contrac- 
 tile power of the muscles, and suspends cadaveric 
 rigidity, while it counteracts the influence of various 
 medicinal substances that cause muscular spasm. Dr. 
 Richardson inferred from his experiments that the 
 peroxide might be found useful as an antidote to the 
 narcotic poisons, as a local application to gangrenous 
 ulcers, and as an internal remedy in low forms of 
 fevers." From numerous trials he found it of value 
 in various diseases, as rheumatism, whooping-cough, 
 scrofula, bronchitis, phthisis, etc. "Dr. Richardson 
 recommends that a solution of the peroxide should be 
 used charged with ten volumes of oxygen, the dose of 
 which may be from one to four fluid-drachms, freely 
 diluted with water. There are so many substances 
 which decompose the peroxide, that, as a general 
 rule, it is best given without addition; at least nothing 
 should be allowed to remain long in contact with it." 
 — (U. S. Dispensatory). 
 
 These properties render the peroxide of hydrogen 
 peculiarly appropriate in cases requiring oxygenation 
 and vitalization, with disinfection and depuration of 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 153 
 
 the blood and system in general, hence applicable in 
 typhus, yellow, malarial, bilious, enteric, puerperal, 
 and other asthenic fevers, with variola, choleraic, 
 toxsemic, septic, contagious, colliquative, atonic, and 
 depressed conditions generally, especially with gastric 
 and hepatic torpor, as according to Dr. Richardson, 
 "In Jaundice it exercises an excellent effect by im- 
 proving the digestion, and causing a free secretion 
 [of bile?]"— (Waring' s PracL Thera.). As it also 
 increases the secretion of urine, it is specially indi- 
 cated in cholera, albuminuric, uremic, with dropsical, 
 and correlative abnormities. It aflords a convenient 
 method of exhibiting oxygen, and will doubtless 
 prove useful in all cases requiring that vitalizing 
 agent. 
 
 Nitrous oxide, in some respects, is still better adapted 
 to the preventive and curative treatment of typhus, 
 yellow, and other low fevers, with choleraic, septic, 
 infectious, and malarial diseases, as well as adynamic 
 disorders generally, particularly in the prodromic chill 
 and concomitant depression in the acute stage, as well 
 as before the outbreak of the disease, though it is 
 applicable throughout in asthenia, to destroy the 
 morbific factors and counteract the pathological 
 tendency ab initio, and in convalescence to restore the 
 normal tonicity, as it is very active in oxygenating the 
 blood, promoting digestion and nutrition, increasing 
 the hepatic, renal, and other secretions, depurating the 
 body, stimulating the brain, nervous, muscular, and 
 general system, and breaking up the malarial cachexia, 
 with other baneful dyscrasia, promptly resolving their 
 concomitant abnormities, and restoring healthful vigor 
 of body and mind. Moreover, in all cases of sus- 
 pended animation, prostration, or sudden collapse, as 
 
 H 
 
154 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 in asphyxia, swooning, depression from exhaustion, 
 hemorrhage, serous and other defluxions, as well as 
 malarial and congestive chills, transudative affections, 
 with asthenic states and debility in general, nitrous 
 oxide is specially applicable as a powerful counter- 
 active, exhilerant, vitalizer, invigorant, and restorative. 
 In particular, it will doubtless prove more actively 
 efficient in rousing the system and exciting reaction 
 in the collapse of cholera, and all states of depression 
 than any other known remedy. Indeed, it is far 
 superior to oxygen and other agents as a stimulant, 
 tonic, resolvent, and corroborant in depressed condi- 
 tions. For stimulant purposes it should be given in 
 small and frequently repeated doses, or continuously 
 for a time in moderate exciting quantities by inhala- 
 tion or otherwise, exhilerating rather than anaesthetic 
 doses being required for the due invigoration of the 
 system in all forms of depression. In fact, the prompt 
 and powerful revivifying, exhilerating, and invigor- 
 ating influence of nitrous oxide upon the animal 
 economy is so decided as to render it applicable for 
 more varied and extensive sanitary and medicinal 
 purposes than almost any other known agent, a specific 
 detail of which I hope to present ere long in a special 
 work upon the subject. 
 
 Besides these and the oxymuriatic and chlorinated 
 preparations, with the usual alteratives, antiperiodics, 
 and tonics, there are other agents more or less applicable 
 in ship, yellow, malarial, and septic fevers, infectious, 
 colliquative, and correlative diseases, as carbolic, sul- 
 phurous, and salicylic acids, with their compounds of 
 soda more particularly, from their general neutraliz- 
 ing, febrifuge, disinfectant, antiseptic, antizymotic, 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 155 
 
 and depurative effects. From its mildness and effi- 
 ciency as a febrifuge, antiperiodic, and tonic, and its 
 conversion in the system into salicylous acid, Salicin 
 is likewise appropriate in yellow fever as in cognate 
 maladies. Iodine and bromine with some of their 
 compounds judiciously administered, are also applica- 
 cable therein, particularly the hydrobromic acid in 
 the active febrile stage to allay thirst, quiet the 
 stomach, and for its general soothing, antipyretic, 
 antalkaline, disinfectant, and resolvent effects. In 
 fact, it promises to be a most efficient and valuable 
 febrifuge, antizymotic, antiseptic, nervine, and anti- 
 phlogistic in all acute and sthenic fevers, contagious 
 diseases, superexcitable, and inflamanatory conditions 
 of system, both singly and in conjunction with 
 other antipyretic, anodyne, disinfectant and resolvent 
 measures. 
 
 When the bowels, which are so apt to be constipated 
 in yellow, bilious, malarious, and other varieties of 
 fever, do not respond sufficiently to the acid medica- 
 tion and regimen, with the varied incidental measures, 
 they may be relieved with small doses of citrate of 
 magnesia or phosphate of soda, which latter may be 
 given like common salt in broth and other food; or, 
 perhaps better still in general, when there is much 
 local gastro-intestinal irritation, with the more con- 
 servative laxatives of ox-gall, raw eggs beaten up in 
 water with salt added, or the chloride of sodium 
 separately, yeast, glycerine, olive and castor oil, and 
 similar nutrient and emollient defecants; while in 
 torpidity, the more active cholagogues and purgatives 
 are applicable, as podophyllin, iridin, aloin, etc., and 
 even croton oil, that may be readily taken in pill with 
 little disturbance of the stomach, though free purga- 
 
156 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 tion, and hydragogue catharsis especially, is usually 
 objectionable in these affections from being too debili- 
 tating. Yet, croton oil is said to be quite efficient in 
 yellow, bilious, and malarious fevers, in improving 
 the secretion, and unloading the gall-bladder of large 
 quantities of dark bile, though its general effect is 
 hydragogue and energetic, but, "When its action is 
 excessive, a draught of Lime or Lemon juice affords 
 almost immediate relief. . . . In the Bilious Re- 
 mittent Fevers of India, Dr. McGregor regards Croton 
 Oil as one of the most efficacious remedies we possess. 
 . . He found it succeed in procuring the evacua- 
 tion of vitiated bile when Calomel, Jalap, and other 
 purgatives had failed/' ( Waring' s Pract. Therapeutics.) 
 But to avoid hypercatharsis therefrom, croton oil 
 should be given in small doses of half a drop or less, 
 alone or with other remedies occasionally until a 
 moderate action is secured. When a more direct 
 cholagogue effect is required small doses of ^'chloride 
 of mercury may be exhibited, calomel being danger- 
 ous in conjunction with other preparations of chlorine, 
 though perhaps podophyllin and its analogues would 
 sometimes be preferable. The bichloride, aloin, and 
 others of a like character, with the more stimulant 
 secernants and tonics, as pilocarpin for diaphoresis, 
 quinia, strychnia, etc., may also be introduced sub- 
 cutaneously, as well as by the gastro-intestinal canal, 
 bat this brings us to the consideration of surface 
 medication. 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 157 
 
 IV. 
 
 EXTERNAL TREATMENT. 
 
 The direct application of remedies to the abdomen 
 and general surface of the body is also a very efficient 
 method of medication, especially applicable when the 
 administration of drugs by the alimentary canal is 
 objectionable. Thus the application to the abdomen 
 of aloin, croton, castor, and other oils* hydrarg, 
 ftichloride, and other cathartics aud medicaments 
 properly diluted, may be sufficient to keep up a 
 soluble state of the bowels and favorably influence 
 the system in- general in times of emergency. The 
 application of the mineral and vegetal acids to the 
 surface is especially efficacious both for their local 
 internal and constitutional effects as well as disinfect- 
 ant purposes in infectious diseases, hepatitis, jaundice, 
 bilious and malarial fevers, with torpor of liver and 
 bowels, ascites, and other disorders, and is particularly 
 indicated in yellow and allied fevers, in which their 
 free application by frequent lavements or the bath, 
 would doubtless materially help to overcome the 
 disease and restore the patient as in corresponding 
 disorders, in which the nitric and hydrochloric acids, 
 or nitro-hydrochloric acid are thus so very efficient. 
 
 " Nitromuriatic acid was first brought to the notice 
 of the profession, in consequence of the favorable 
 report of its efficacy as an external remedy in hepa- 
 titis, made by Dr. Scott, formerly of Bombay. When 
 thus employed, it produces a tingling sensation of the 
 skin, thirst, peculiar taste in the mouth, and occasional 
 soreness of the gums and plentiful ptyalism ; and at 
 
158 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 the same time stimulates the liver, as is evinced by 
 an increased flow of bile. It is used either by spong- 
 ing, or in the form of a local or general bath. When 
 applied by sponging, the acid is first diluted so as to 
 have the sourness of strong vinegar. When used as 
 a foot-bath, three gallons of water, contained in a 
 deep narrow wooden tub, may be acidulated with six 
 fluidounces of the acid. In this the feet and legs are 
 to be immersed for twenty minutes or half an hour. 
 The bath may be employed at first daily and the 
 sponging may be used at the same time. The bath is 
 said to be effective in promoting the passage of biliary 
 calculi. The solution prepared for a bath is acidu- 
 lated with two fluid-drachms of the acid, to make up 
 for the waste by evaporation. The bath should have 
 a temperature of about 97°, which may be attained by 
 heating part of the acid solution and throwing it back 
 into the remainder." — {U. S. Dispensatory). 
 
 " In Chronic Hepatitis, and in Acute Hepatitis when 
 the acute symptoms have been subdued by depletion and 
 other antiphlogistic measures, Nitromuriatic Acid 
 both internally and externally, has been used with 
 great advantage, Mr, Annesley, who employed it 
 extensively, placed great reliance on it, and Sir J. 
 McGricor observes, after employing it in about 200 
 cases, ' one fact we are clear and decided in, that the 
 injury to the constitution is infinitely less from the 
 acid than from the mercurial ointment, and that men 
 are not half the time convalescent from the first as 
 they are from the last remedy.' It is in the form of a 
 bath that it is most used and proves most serviceable. 
 . . . In urgent cases a general bath to envelope 
 the whole body may be used. If the acid-bath create 
 much irritation of the skin the quantity of the acid 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 159 
 
 may be diminished. . . . In Dropsy from disease 
 of the Liver or Spleen, much service will accrue from 
 the Nitromuriatic Acid bath, or from sponging the 
 surface of the hypochondria, night and morning, with 
 a warm lotion containing these acids or from the 
 internal use of them. (Copland)." — Waring' s Practi- 
 cal Therapeutics), 
 
 Sponging and bathing the body with dilute vinegar, 
 as well as its internal use is also very serviceable in 
 the prevention and treatment of fevers, in infectious, 
 septic, and scorbutic diseases. "Diluted vinegar 
 forms an excellent lotion for sponging the body in 
 fevers; under the same circumstances, it is an agree- 
 able refrigerant drink, when properly sweetened; 
 sprinkled about a sick room, it is extremely refresh- 
 ing; and the vapor is useful in many affections of the 
 throat." — [Ibid). Also in strong solution alone or 
 with chloride of sodium is excellent as a gargle in 
 diphtheria and other anginose affections. " The re- 
 frigerant influence of diluted vinegar on the surface 
 is undoubted, it not only diminishes heat, but allays 
 pain. In Hcemorrhagic affections the cold feeling which 
 it produces on the skin is extended to the whole 
 system, hence the benefit derived from it in internal 
 haemorrhages, and in inflammation of the cavities. 
 . . . In general fever, sponging the body with 
 vinegar and water is applicable in every case in which 
 the skin is preternaturally hot, when no idiosyncrasy 
 stands in the way." — (Ibid). 
 
 Vinegar is also a direct styptic and antiphlogistic, 
 with disinfectant properties, and has long been used 
 as a prophylactive against infectious and epidemic 
 diseases, but it is far inferior to the mineral nitric and 
 hydrochloric acids or their compound nitro-hydro- 
 
160 BASIC PATHOLOGY AND SPECIFIC TBEATMBNT OF 
 
 chloric acid. Solutions of chlorine, chlorinated soda, 
 and their analogues are also efficient both for external 
 and internal use for disinfecting, preventive and cura- 
 tive purposes, as likewise carbolic, sulphurous, and 
 salicylic acid, with solutions of thymol, eucalyptus, 
 tar, and similar agents in infectious diseases as 
 specially indicated. But as " prevention is better 
 than cure," we will briefly consider the most appro- 
 priate means therefor relating more directly to per- 
 sonal purification and protection than general sanita- 
 tion, which is usually thought to be all sufficient, yet 
 is really only partially so, as it removes merely some 
 of the extraneous, without at all touching the intrinsic 
 and systemic sources of diseases, the most imme- 
 diately active and prolific causes thereof in general. 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 161 
 
 V. 
 
 PREVENTION. 
 
 Much diversity of opinion exists respecting the 
 origin, contagiousness, and transmissibility of yellow 
 fever, diphtheria, typhoid, and other diseases of a 
 varied zymotic, septic, and infectious character, on 
 the border line or intermediate between the markedly 
 contagious and benign diseases, but which, like their 
 analogue — erysipelas, vary in degree of contagiousness 
 according to the energy of morbific force, or intensity 
 of disease, conditions of system, and other favoring 
 circumstances, hence ranging from the least innocuous 
 to the most infectious, in every grade of activity, one 
 being converted into the other according to the power 
 of either or both special intrinsic and extraneous 
 pathogenic agencies. Moreover, there is much differ- 
 ence of opinion with regard to the spontaneous or 
 secondary origin of such maladies, yet, this need not 
 be, for in accord with the laws of nature, there is no 
 valid reason why all the most malignant and contagious 
 diseases may not originate spontaneously as well at one 
 time as another, coeter is paribus, the same as innocuous 
 disorders, their occurrence being but a matter of con- 
 ditions, or intensity of morbific influences, and not of 
 time, as exhibited in the spontaneous origin of puer- 
 peral fever, erysipelas, and gonorrhoea, which arise 
 de novo at all times alike whenever the pathogenic 
 factors are brought together, and may be secondarily 
 transmitted ad infinitum. Hence, it is most probable, 
 that disease of all kinds, the most malignant and con- 
 tagious as well as the less infectious and benign, 
 
162 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 originate spontaneously whenever the morbific factors 
 and concurring circumstances are present without 
 regard to time, person, or place, as in the beginning, 
 this being as well in the present as at any former 
 period, just the same as in the case of spontaneous 
 combustion that will occur at any time or place, and 
 the resulting fire spread indefinitely if sufficient com- 
 bustible material be present, unless repressed by a 
 counteracting power. Indeed, like combustible matter, 
 the principal factors of the most malignant disease 
 may co-exist, and yet, in the absence of a slight acces- 
 sion or additional factor, may remain quiescent and 
 innocuous or become active by accretion, as in the 
 case of a proximate, extending into an exciting cause 
 of disease, and just as gunpowder or dynamite may be 
 all perfect for action up to the very verge of explosion, 
 yet in the deficiency of an adequate degree of heat or 
 concussion may remain inoperative and harmless 
 though dangerous, instead of becoming explosive and 
 destructive from the slightest increment of tempera- 
 ture or force. 
 
 Thus, as certain forms of contagious with all benign 
 diseases originate spontaneously according to the 
 presence and activity of special pathogenic factors, why 
 should not all varieties of disease from the least in- 
 fectious to the most malignant, in like manner develop 
 de novo, and even life itself, whenever the specific con- 
 ditions required therefor co-exist? as the same elements, 
 forces and laws, that originally produced them still 
 exist and act as formerly. Because life or one form of 
 disease does not originate in certain ways it does not 
 follow that they do not arise in other ways, any more 
 than spontaneous combustion is impossible because it 
 does not occur in some special mode. Necessarily for 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 163 
 
 the spontaneous origin of fire, disease, and life, certain 
 special factors are required, and without all of which 
 no perfect evolution in either direction can result, yet 
 with them specific action is certain. The spontaneous 
 development of fire, life, and disease, is hence a matter 
 of definite conditions, which may occur at any time in 
 the present and future, as in the past. The same 
 matter, force, and laws exist and act now as in the 
 beginning, and the operation of the same influences 
 or factors will produce the same result as well at one 
 time as at another. Indeed, as observed elsewhere,* it 
 is more than probable that if all fire, disease, and life, 
 were instantly and absolutely extinguished, the latter 
 as well as the former would again reappear in the 
 natural order of things, in accordance with the force 
 and laws or omnipotent power that originally produced 
 and continues them and the universe in operation, as 
 the laws of nature are uniform and immutable, and 
 matter and force the same always and forever, while 
 the same agencies will produce the same effects at all 
 times alike. 
 
 Thus, as the development of fire, disease, and life, 
 is purely a matter of conditions the elements and forces 
 which originated them at one period, can in like 
 manner produce them spontaneously as well at any 
 time, as amply demonstrated in the former, by the 
 unquestionable frequent occurrence de novo of fire and 
 disease — both benign and contagious and doubtless 
 also of life itself, though this is not so manifest, yet, 
 presumably just as positive. Therefore, as it is evident 
 that all diseases, epidemic and contagious, specific and 
 malignant, as well as benign, may originate sponta- 
 neously at any time, anywhere, whenever concurrent 
 
 * Natural Laws of Marriage. 
 
164 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 conditions are favorable, it is the part of wisdom and 
 common sense to recognize the fact,- and try to dis- 
 cover and remove the active morbific factors or pro- 
 ducing causes thereof, to prevent their inception, as 
 well as seek the means of cure and extinction after their 
 development. While this is true of all disease, it is 
 of special importance in pestilential, epidemic, and 
 contagious maladies, of which small-pox, diphtheria, 
 typhus, yellow fever, and cholera, are types, all of 
 which may be prevented by due attention to personal 
 hygiene, and avoidance of their extraneous as well as 
 intrinsic causes, some of which are well known and 
 preventable, while others may be neutralized or de- 
 stroyed, though not fully determined. Thus, there is 
 no question but that malarial disease spontaneously 
 originates from certain baneful conditions of soil, air, 
 and habitat, or filth, that may be avoided or subverted. 
 Yellow fever partakes of the same nature and is 
 spontaneously developed in a similar manner from 
 local impurities as manifested in its occurrence de novo 
 on ships, as well as in certain places constantly as the 
 pestiferous conditions of its origin accumulate, the active 
 extraneous as well as systemic causes of which may 
 be prevented, removed, or destroyed the same as of 
 
 ordinarv malarial disease. Cholera is in the same 
 
 1/ 
 
 category, though in its various forms, with typhus, 
 diphtheria, and correlative maladies are dependent 
 more directly upon avoidable morbific personal condi- 
 tions, as well as extraneous agencies of filth, foul air, 
 bad ingesta, etc. It is the height of folly therefore, 
 to be looking outside and abroad or elsewhere for the 
 sources of disease which exist and originate so freely 
 within and around our own bodies, in our organiza- 
 tion, ingesta, habits and environment. 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 165 
 
 But, in whatever way such diseases originate, the 
 genera] system of prevention and protection may be 
 sammed up in the one word of cleanliness or purity 
 of person and surroundings, of which personal hygiene is 
 more directly essential than public sanitation, though 
 the former is measurably dependent upon the latter, 
 but for the greatest healthi'ulness all forms of pub- 
 lication are required, general and individual, 
 extraneous and intrinsic, molecular and systemic. 
 To this end it is not essential to know all 
 the factors of disease to be able to counteract 
 and obliterate them, although desirable for more cer- 
 tain and specific action, any more than to know the 
 stinkin. incuts of a pile of filth to disinfect, or 
 
 remove and get rid of the whole offensive mass at 
 one Yet, when there is obscurity and doubt, all the 
 probable morbific factors should be carefully guarded 
 against, intrinsic as well as extraneous. It is not enough 
 that all the usual general measures of sanitation have 
 been adopted for the removal and disinfection of all 
 kinds of tilth and extraneous sources of disease, as 
 there are potent causes thereof depending upon the 
 alimentation, personal habits, and modes of living, as 
 well as tb ial organization of the vital economy, 
 
 and which within themselves, are often sufficient to 
 engender more or less serious disorder of the system, 
 and without which the former would prove partially if 
 not entirely innocuous, but with both together are 
 very destructive of health and life. Hence there must 
 be due regard paid to proper alimentation, habits and 
 modes of living, with personal cleanliness and purity 
 of the entire economy, or interior and molecular, as well 
 as exterior of the body, to insure healthy nutrition, 
 depuration, tonicity, and protection of the general 
 
166 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 system. Any person or organism surcharged with 
 effete and noxious matter must have a depraved 
 blood, and all the organs, functions, and secretions 
 more or less disordered, and rendered unduly suscepti- 
 ble to zymotic, septic, infectious, and other grave 
 diseases, especially to such pestilential maladies as 
 typhus, ship, yellow, congestive, puerperal and like 
 fevers, with small-pox, erysipelas, diphtheria, cholera 
 in all its forms, and similar plagues, as well as a host 
 of the minor ills of life, and all preventable. 
 
 Personal habits, ingesta, and modes of life in all 
 climes, times, and conditions, on both sea and land, 
 have often more to do with the predisposition to and 
 the inception of these with other diseases, and espe- 
 cially in hot weather, seasons, and climates, than 
 extraneous agencies, these latter being more or less 
 inoperative without the former, while both combined 
 will produce the maximum of disease and death. 
 This is exemplified everywhere in the history of sea- 
 men, soldiers, travellers, individuals and communities, 
 in fact human beings in every phase and state of 
 existence, who by various irregularities of exposure, 
 bad or improper, defective, inappropriate, or excessive 
 ingesta, vicious courses, and otherwise, induce morbid 
 conditions not only dangerous within themselves, but 
 actively promotive of epidemic and other forms of 
 disease. 
 
 Prominent among the most general and actively 
 predisposing and exciting causes of pestilential with 
 other diseases, are those twin curses of humanity — 
 tobacco and alcohol, the use of which is especially 
 noxious in hot weather and climates in producing an 
 ammoniacal, superalkaline, toxic and corrupt con- 
 dition of the blood and atonic state of the system 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 167 
 
 directly promotive of the development of typhus, ship, 
 yellow, congestive, and other low fevers, with 
 choleraic, septic, and adynamic disorders generally. 
 We have shown how tobacco produces a superalka- 
 line, scorbutic, and morbid state of the blood, both 
 from its ammonia and nicotia, and other baneful ingre- 
 dients, with depression of the nervous system and 
 general vital energies, that renders those who use it, 
 or are exposed to its pernicious influence specially 
 liable to neeramiic, infectious, pestilential, and ady- 
 namic diseases, thus not only of contagious, septic, and 
 mephitic diseases, but choleraic, albuminous, hemor- 
 rhagic, and serous deiluxions of all kinds, with 
 inanition, marasmus, consumption, paralysis, and 
 atonic affections in general. The use of all forms of 
 * alcoholic liquors also induce a scorbutic, depraved, 
 and poisoned condition of the blood, both directly and 
 from consequent retention of effete matters, with 
 malnutrition, mal-disintegration, aberrant innerva- 
 tion, with superalkalinity, morbidity, and debasement 
 of the entire system, that render it very susceptible to 
 epidemic, septic, contagious, and other maladies, 
 alcoholics everywhere being the first and foremost to 
 succumb to pestilence, as well as disease and death 
 from ordinary causes thereof. In the case of yellow 
 fever " Dr. Car tw right, of iSfew Orleans, says that in 
 one season in that city five thousand drinking men 
 died with yellow fever before it touched a sober 
 man." — (Alcohol and Hygiene, by J. Colman). But, 
 assume that this was a mistake, and that only one- 
 fifth or one thousand so died, that would still be a 
 terrible mortality and unnecessary sacrifice of life, to 
 say nothing of the concomitant suffering and misery 
 from both the alcoholism and plague. Yet, how 
 
168 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 much the greater must be the debasement with de- 
 struction of health and life when the baneful action of 
 these two noxions agents — tobacco and alcohol, are 
 combined, as is so generally the case even ordinarily, 
 and so much the more in conjunction with the pestif- 
 erous influence of yellow fever, typhus, cholera, and 
 other malignant maladies, as well as the minor ills of 
 life. 
 
 The blood and body of every one charged with 
 alcohol, ammonia, nicotia, colludine, and other poison- 
 ous agents in spirituous liquors and tobacco, as well 
 as other noxious matter introduced from without, 
 with the abnormal products engendered within, and 
 retained excrementitious materials from their per- 
 nicious action upon the system, cannot fail to be 
 disordered to such a degree as to render them un- 
 usually vulnerable to pestilential diseases and morbific 
 influences generally. It is obvious therefore, that the 
 use of these two potent agents of infectious, with 
 ordinary disease, as of evil effects in general upon the 
 physical, mental, and moral nature of mankind, 
 should be avoided altogether, but as few will be 
 induced to adopt this most effective and radical mode 
 of protection, the many must necessarily bear the 
 consequences of indulgence therein, in the concomi- 
 tant illness, suffering, and degeneration, with prema- 
 ture and often sudden termination of existence there- 
 from, as well as the increased susceptibility to the usual 
 diseases and devastating epidemics which they would 
 otherwise escape. 
 
 The pernicious effects of these baneful agents — 
 tobacco and alcohol, are not however, limited so ex- 
 clusively to those who use them, but extend to inno- 
 cent persons and abstainers therefrom, especially those 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 169 
 
 of tobacco more directly by the vicious habit of smok- 
 ing, which fills the air with a poisonous miasma that 
 people are obliged to breathe and pollute their blood 
 and bodies with, to their more or less serious injury, 
 juch susceptible persons are not only thus directly 
 sickened and enfeebled thereby, but rendered more 
 than usually liable to the various contagious and 
 epidemic diseases, as well as the ordinary afflictions of 
 life. But, smokers diould not be allowed to thus 
 outrage, endamage the health, and imperil the lives of 
 others by inflicting upon them this deleterious tobacco 
 smoke any more than the poisonous fames of chloro- 
 form or other noxious substance. It is amazing that 
 while so much effort is made to destroy other forms of 
 malaria, this pernicious and all-pervading tobacco 
 miasm is permitted to be engendered and diffused 
 almost ad libitum everywhere, to the detriment of 
 many persons, especially sickly and sensitive men, 
 women, and children, who suffer greatly yet cannot 
 escape therefrom. No other form of poisonous vapor 
 would be allowed to be engendered and diffused so 
 freely and indiscriminately as is the noxious fumes of 
 tobacco, and as the world becomes sufficiently civilized 
 it will be put under the ban of the law the same as 
 other poisons. The infliction of tobacco smoke upon 
 any one without special permission, will then, as it 
 ought now, be treated as a criminal offense against 
 personal right, and individual and public health, the 
 same as the infliction of nicotia alone, or other baneful 
 constituent of tobacco, and chloroform, prussic acid, 
 opium, arsenic, and other poisons, either in solid, 
 liquid, or gaseous form, is now justly treated as a 
 crime. But, in the present state of barbarism in this 
 respect, people must protect themselves with the young 
 
170 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 and helpless as best they can against these smoking 
 poisoners and the congeries of potent poisons em- 
 bodied in the vapor and smoke of tobacco, as they 
 would defend themselves and others from any one of 
 them, and all other pestiferous agents. Moreover, 
 while endeavoring to stay the production and diffusion 
 of this all pervading tobacco miasm, they must also 
 adopt the best means to overcome its pernicious effects, 
 both immediate and remote, as well as otherwise pro- 
 tect against the inception of such destructive maladies 
 as typhus, ship, yellow, bilious, enteric, puerperal, and 
 other fevers, with diphtheria, erysipelas, cholera in all 
 its forms, and all other toxemic, septic, infectious, 
 scorbutic, and adynamic diseases serologically con- 
 nected therewith, as well as decomposing organic 
 matter, and specific contagia, with the noxious 
 materials engendered within the body from its baneful 
 action, vicious habits and bad modes of living generally. 
 
 There is not only a natural endosepsis and exosepsis, 
 but also a voluntary artificial autosepsis or self-poison- 
 ing from the wilful ingestion of these noxious agents 
 — tobacco and alcohol, as well as enforced involun- 
 tary toxicosis, sickness, suffering, and death from the 
 baneful miasm of the former engendered by smokers, 
 all of which is unnecessary, inhuman, and avoidable 
 by simple abstinence therefrom. 
 
 Hence the vital necessity for personal with general 
 sanitation, and especially for purity and depuration of 
 the interior with the exterior of the body, as well as 
 disinfection of clothing, ships, docks, houses, barracks, 
 and other places, which are usually, though erroneously, 
 considered all sufficient, for toxic, and contagious 
 material may be spontaneously engendered within, as 
 well as be introduced from outside the living organism, 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 171 
 
 and be communicated to others, without the infected 
 person or producer being sick, as manifested in 
 vagrants, prisoners, nomads, pilgrims, and uncleanly 
 people generally, particularly in hordes, crowded and 
 close places, who by the offensive exhalations from 
 their bodies, often infect others without being ill 
 themselves, striking examples of which are afforded 
 in the origin and spread of epidemics in the East and 
 elsewhere, with other marked instances as in the Black 
 Assizes of England, etc. The same condition of things 
 exist in lower animals, as for instance, in the produc- 
 tion and transmission pf the so-called Texas fever in 
 cattle, and in the sickening emanations from pigs and 
 other animals. Even cleanly persons may have their 
 bodies charged with infectious and noxious matter 
 sufficiently to transfer to others while unaffected them- 
 selves, as is sometimes the case with the contagium 
 of small-pox, scarlatina, diphtheria, puerperal fever, 
 erysipelas, and other pestiferous and offensive agents, 
 markedly with the effluvia of hospitals, dead-houses, and 
 dissecting rooms, and the more common use of garlic, 
 onions, tohacco, and alcoholic liquors, enough to 
 sicken some who may be obliged to inhale the 
 noxious and disgusting emanations from the lungs 
 and bodies of persons surcharged therewith. A 
 decided instance of the former is afforded in the gesta- 
 tive woman who may have her blood so charged with 
 the contagium of small-pox and other diseases as to 
 infect her child in ittero without herself being affected, 
 as shown in the birth of living as well as dead children 
 with the disease. The foetus in utero is doubtless thus 
 subject to all infectious and noxious agencies that may 
 be absorbed into, as well as those produced within the 
 mother's blood and body, while they may also with 
 
172 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 those engendered by herself, be given out freely 
 enough to affect others. Indeed, it is most probable 
 by some offensive emanation from a pregnant woman 
 that causes the occasional so-called sympathetic sick- 
 ness of stomach in the husband, similar to noxious 
 exhalations in other cases which induce nausea, 
 emesis, and more serious illness in many persons. 
 
 Thus in the prevention of disease, especially of con- 
 tagious and infectious maladies, while due attention 
 should be given to general sanitation to remove or 
 destroy all the extraneous sources thereof so far as 
 possible, special effort must be made to disinfect, 
 purify, and protect the human or animal body itself 
 in its entirety, by internal as well as external depura- 
 tion, for every organ, blood-corpuscle, cell, molecule, 
 and particle of the economy must be freed and kept 
 free from noxious matter to insure the greatest safety 
 from intrinsic as well as extraneous morbific agencies. 
 People must be taught as well as compelled to avoid 
 the internal with the external causes of disease, to 
 disinfect and depurate themselves, and purify every 
 organ and atom of their bodies inside and outside, so 
 as not to become factories of infection and veritable 
 walking pestilences, sources of affliction, disease^ and 
 death to others, which they have no more right to be, 
 than to poison, infect, or destroy them outright. In 
 general, this personal and systemic purity and protec- 
 tion may be largely effected by abstinence from tobacco 
 and spirituous liquors with all other deleterious 
 agents and debasing habits, by correct modes of 
 living, with appropriate alimentation, and especially 
 the free use of acid drinks, fruits, and food, specified 
 elsewhere, supplemented if necessary by the more 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 173 
 
 active mineral acids, particularly the nitric, hydro- 
 chloric, or nitro-hydrochloric, the most simple, agree- 
 able, and potent disinfectants and antiseptics, that 
 will neutralize the superalkalinity, and correct the 
 scorbutic, toxic, septic, and infectious condition of the 
 blood, refresh and purify the body, destroy contagious 
 and morbific matter, with the parasitical microzymes 
 and vermes, promote digestion, nutrition, secretion, 
 and depuration, and invigorate the system in general. 
 Phosphoric acid, coffee, allium, coca (Erythroxylon), 
 quinia, oxygen with its analogues, and like antalkalies, 
 stimulants, disinfectants, antiperiodics, and tonics, 
 are also preventive as well as curative of asthenic 
 fevers and conditions of system. Their permanent 
 stimulant, protective, and remedial influence is in 
 marked contrast with the morbid excitement and 
 noxious effects of spirituous liquors of all kinds so 
 much relied on for protective as well as curative 
 purposes, but which really disorder the stomach, 
 liver, nutrient and vital processes, fill the blood and 
 body with impurities, depress the nervous and 
 sy>temic energies, and induce as well as promote 
 congestive, inflammatory, septic, infectious, and ady- 
 namic diseases, especially in hot weather and climes, 
 and during epidemics, hence should be entirely dis- 
 carded. 
 
 But, the most potent and essential agent of personal 
 with general sanitation for the preservation and restora- 
 tion of health under all circumstances, is an abundance 
 of pure unadulterated atmospheric air, the most indis- 
 pensable of all forms of food and tonics, supplemented 
 when deficient by its active constituent — oxygen, or 
 congeners — peroxide of hydrogen, and nitrous oxide. 
 Oxygen, the active constituent of these compounds 
 
174 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 being the most powerful disinfectant and purifier in 
 nature, as well as supporter of life- and promoter of 
 health. Hence, without pure air, or its equivalent 
 oxygen in an available form, it is of little use to resort 
 to extraneous means of systemic disinfection, for they 
 must all prove more or less nugatory in the absence of 
 the most essential element of life, health, and purity — 
 fresh, uncontaminated, vitalizing atmospheric air. Pure 
 water is next in importance to atmospheric air as an 
 aliment, diluent, depurant, invigorant, and restorative, 
 essential for solution, circulation, nutrition, internal 
 purification and expurgation, as well as external de- 
 puration, which are powerful safeguards against infec- 
 tious, epidemic, and septic maladies particularly, with 
 fevers and diseases generally. 
 
 Thus, premising a due supply of these essentia of 
 life and health, to avert the occurrence and during 
 the prevalence of typhus, ship, yellow, malarial, puer- 
 peral, typhoid, and other fevers, with variola, scarla- 
 tina, diphtheria, erysipelas, scurvy, cholera, and other 
 zymotic, septic, infectious, and allied diseases, with 
 general sanitation, special efforts should be made to 
 disinfect and depurate the blood and bodies of seamen, 
 travellers, soldiers, prisoners, pregnant women, chil- 
 dren, and people generally, exposed or subject thereto. 
 But this systemic purification should be actively from 
 the interior as well as exterior of the body, and, while 
 it may be induced by personal effort, could be most 
 perfectly effected under medical supervision, by the 
 free use of vegetal, animal, and mineral acids, with 
 corresponding antalkalies, disinfectants, antiseptics, 
 and alimentation, and other appropriate sanitation, in 
 an abundance of pure air uncontaminated with the 
 tobacco miasm or other form of malaria, and water 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 175 
 
 free from impurities, with the usual personal and ex- 
 traneous purification, especially in ships, quarantine, 
 barracks, prisons, hospitals, and other places where 
 authority prevails, though generally there would be 
 little objection to the acid regimen and treatment, as 
 the method is simple, safe, economical, agreeable, and 
 efficient. Thus, with the other adjuncts, by the liberal 
 administration of the mineral acids, the hydrochloric 
 and nitric particularly, or better still the dilute nitro- 
 hydrochloric acid in plain water or lemonade in the 
 proportion of from x-xv njj to the juice of one lemon 
 in a goblet of water sweetened to taste, and taken 
 through a glass or other non-corrosive tube, every 
 two or three hours, more or less frequently according 
 to necessity, a marked disinfection of the blood and 
 body may be soon effected. In conjunction therewith, 
 acid drinks, fruit, and other food, with as much sugar 
 as desired to reduce their sharpness and as an aliment 
 and antiseptic, may be taken ad libitum, as the juice of 
 limes, lemons, oranges, etc., with ripe tart apples, 
 peaches, grapes, and other pulpy acid fruit that may 
 be suitable, as likewise stewed apples, cherries, cran- 
 berries, prunes, tomatoes, culinary rhubarb, and other 
 appropriate acid vegetals as indicated. The stimulant 
 and antiseptic juice of onions, garlic, and like articles 
 of diet are also useful in the more atonic conditions 
 of system. Sour buttermilk, cottage cheese, with 
 or without sugar as fancied, soused pig's feet and other 
 nitrogenized food acidulated with vinegar, or like com- 
 patible acids as desired, may also be taken at pleasure, 
 as likewise sauer kraut or its juice and similar anti- 
 scorbutic articles so long as they are suitable and 
 agree. For the milder scorbutic, and septic condi- 
 tions of the system, the lime and lemon juice, with 
 
176 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 sour buttermilk, and the ordinary acid fruits and 
 food, may be sufficient to neutralize the ammoniacal 
 condition and superalkalinity of the blood, disinfect, 
 and purify the body, and counteract the mephitic and 
 infectious diathesis, without the stronger mineral acids, 
 though these alone, or in conjunction therewith are 
 so much the more decided, prompt, and efficient, and 
 particularly applicable on ships, in quarantine, and 
 times of danger. 
 
 This acid alimentation and medication is usually 
 very agreeable, and may be continued more or less 
 freely until the scorbutic, superalkaline, mephitic, 
 infectious, and pestiferous condition is entirely over- 
 come, and the entire system disinfected and depu- 
 rated, which is usually indicated by persons loosing 
 the desire for acids which is generally active in such 
 scorbutic, toxic, and infectious states of system, as 
 well as by the marked change in the tongue, blood, 
 and complexion, indicative of purification and health. 
 Besides, further evidence is afforded by the disappear- 
 ance of the jaundiced hue, and offensive exhalations 
 from the lungs and skin with regularity or tendency 
 to looseness of the bowels; bilious, muddled and 
 dirty aspect, with torpid liver, offensive breath, foetid 
 odor and constipation, being usual in such scorbutic, 
 febrile, septic, and contagious conditions. In case, 
 however, of exposure or tendency to typhoid fever, 
 cholera, and similar disorders, with undue laxity of 
 the bowels and diarrhoea, as before indicated, the more 
 astringent disinfectants, acids, and remedies, with 
 corresponding binding fruit juices, food, and general 
 hygienic measures are most appropriate and useful. 
 
 The basic pathogenic factor of cholera is an am- 
 moniacal or superalkaline state of the fluids and solids 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 177 
 
 of the system, the same as with all the other zymotic, 
 infectious, and epidemic diseases, and may likewise 
 originate at any time, anywhere, spontaneously, 
 whenever the essential morbific conditions are 
 present, or the excessive production, retention, or 
 introduction of ammonia in the system with exosmotic 
 action of the blood and bowels, such as heat, moisture, 
 filth, close, confined, and poisoned air, with tobacco 
 fumes or other malaria, the nicotian miasm itself 
 being sufficient to induce, both as predisposing and 
 exciting cause, all forms of choleraic clefluxions, as it 
 surcharges the blood and body with ammonia, and 
 other alkaline and toxic matters, enervates and de- 
 presses the nervous and general system, diorders the 
 stomach, liver, and bowels — causing dyspepsia and 
 constipation, with alternations of diarrhoea, and nau- 
 sea, vomiting, and purging, or cholera morbus, and 
 doubtless also cholera infantum, with the most severe 
 form of malignant cholera, independent of all micro- 
 organisms or concomitant agencies, being in itself an 
 active materies morbi and cause of intestinal defluxions 
 w r ith other colliquative affections, and especially 
 pernicious and energetic when a tendency thereto 
 exists, even in those habituated to its use, and so 
 much the more in those unaccustomed to it, with th e 
 many who cannot endure its baneful effects at all, and 
 are readily depressed, nauseated, sickened, vomited 
 and purged, or afflicted with choleraic and other ady- 
 namic disorders thereby. A most potent predisposing 
 and exciting cause of all such choleraic and correlative 
 scorbutic, zymotic, septic, infectious, and colliquative 
 diseases, is thus in general use in the form of tobacco, 
 while its pernicious miasmatic smoke is almost uni- 
 versally engendered and diffused everywhere to the 
 
178 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 detriment of the innocent with the guilty, so that 
 while seeking to discover and exterminate collateral 
 malaria and morbific agencies, this omnipresent and 
 powerful one should not be overlooked or disre- 
 garded, but effectually extinguished or suppressed, at 
 least so far as to protect the guiltless against its 
 noxious influence. 
 
 Though microbes may be found connected with 
 cholera, it is not very probable they are the primal 
 etiological factor of the disease, being rather merely 
 concomitant or secondary products. As Dr. C. C. 
 Vanderbeck justly observes [Medical Bulletin), " The 
 weight of authority is against its being bacteria or 
 microscopic life. Finding bacteria in cholera ejections 
 does not prove them to be the cause of the disease, 
 any more than finding skippers in cheese proves them 
 to be the cause of cheese degeneration. We must 
 not forget that dirt is favorite soil for low forms of 
 organic life, and suitable food for disease germs, and 
 that bacteria and disease germs may be, very likely 
 are, different things, existing in the same suitable 
 medium for their development. 
 
 Now the basic element of dirt and pabulum for the 
 development and support of microzoa is ammonia, and 
 as a superalkaline condition of the system is the ser- 
 ological substratum of cholera with all other cognate 
 diseases, it is most probable that it is the primal and 
 superinducing morbific factor thereof when in excess, 
 without any specific poison or microzyme, but merely 
 any general influence that will induce irritation, 
 congestion, and defluxion in the bowels superadded 
 as in ordinary diarrhoea. Thus, in fact, merely the 
 ordinary causes of diarrhoea intensified, in conjunction 
 with the ammoniacal and superalkaline dyscrasia, are 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 179 
 
 doubtless sufficient to develop malignant cholera as 
 well as cholera morbus, cholera infantum, and diar- 
 rhoea, or different degrees of choleraic defluxion, as it 
 often occurs sporadically in different parts of the 
 world, and may become infectious and epidemic when 
 this superalkaline predisposition exists in many per- 
 sons to a sufficient degree for the secondary as well as 
 primary development of the infecting principle and 
 microzymes, which may then find lodgment in such 
 suitable alkaline bodies and soils for propagation and 
 activity, in the absence of which they would either be 
 undeveloped, inert, or die out, the cholera or hsemic 
 and intestinal flux being an active conservative pro- 
 cess to rid the blood and bowels, and eliminate from 
 the system, the excessive alkaline, poisonous, and 
 infections, or irritant matter therein, though the ex- 
 purgatorial action is apt to become so excessive as to 
 seriously disorganize the blood, depress the vital 
 energies, and often speedily destroy life, all of which 
 may be prevented by subverting the basic superalka- 
 linity and primal morbific cause of this with allied 
 diseases by acidulous and antalkaline alimentation 
 and medication, and correct modes of living. 
 
 The alkaline basis of cholera has been recognized, 
 but apparently merely in a general way, the more 
 specific causative influence of the volatile organic 
 alkali — Ammonia — being overlooked as the prime 
 underlying morbific factor and direct basic pabulum 
 vit;e for the development and activity of the infecting 
 poison and microzymes or secondary pathogenic 
 agencies thereof with correlative diseases. 
 
 Thus, recently among other conclusions from a 
 study of "a vast mass of accumulative evidence" 
 upon the subject, Dr. Frank W. Reilly, while he 
 
180 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 admits and limits the spontaneous origin of the 
 cholera poison and disease to India "only," though it 
 is obvious they may develop anywhere whenever the 
 essential factors therefor are present and as proven by 
 the occasional occurrence de novo of sporadic and 
 epidemic cholera in different parts of the world, says 
 in a report to the Surgeon-General of the U. S. Marine 
 Hospital Service (Jour. Amer. Med. Assoc, Sept. 22, 
 1883) : " To set up anew the action of the poison 
 alkaline moisture and a decomposing temperature are 
 required, fluid of decided alkaline reaction hastening 
 the process, the reverse retarding. Favorable con- 
 ditions for the growth of the poison are presented (1), 
 in ordinary water containing nitrogenous organic 
 impurities, alkaline carbonates, etc.; (2) in decompos- 
 ing animal and vegetable matter with an alkaline 
 reaction ; (3) in the alkaline contents of the intestinal 
 portion of the alimentary canal. 
 
 " A cholera ejection, or material containing such, is 
 harmless, both before the appearance and after the 
 disappearance of bacteria, but is actively poisonous 
 during their presence." Yet this may be in conse- 
 quence of the presence of their ammoniacal pabulum 
 and toxic concomitant, in the absence of which they 
 are undeveloped, or starve. 
 
 u The poison is destroyed naturally either by the 
 process of growth or by contact with acids; (1) in 
 water or soil ; (2) acid gases in the atmosphere ; (3) 
 the acid secretion of the stomach. 
 
 " It may be destroyed artificially (1) by treating the 
 cholera ejections or material with acids; (2) by such 
 acid (gaseous) treatment of contaminated atmosphere; 
 (3) by establishing an acid diathesis of the system." 
 From these propositions he is convinced " that the 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 181 
 
 mineral acids may be relied upon as a certain means of 
 preventing the spread of Asiatic cholera." 
 
 In reviewing the subject Dr. Vanderbeck remarks 
 (ante): " For the purpose of disinfection, nitrous-acid 
 fumes and burning sulphur are indicated. As to the 
 acid medication, it has received the indorsement of all 
 the best observers and practitioners having experience 
 in cholera epidemics. It is particularly insisted upon 
 as a preventive. If the disease should break out on 
 ^hip-board, besides isolating the patient, and acidulat- 
 ing all his discharges and surroundings, the crew and 
 passengers should be placed on sulphuric acid lemon- 
 ade. This rule can be applied to army hygiene, and 
 to city and dwelling sanitation." It is also of universal 
 application in personal and public sanitation. 
 
 With other sanitarians the same writer enforces the 
 necessity for cleanliness. "With many diseases dirt 
 seems to favor the vitality of their germs and it is 
 without the shadow of a doubt the case in the disease 
 under consideration. What is the inevitable conclu- 
 sion then ? to starve out the poison is to be clean — 
 cleanliness in the strictest sense, clean persons and 
 clothing, clean houses, cellars, and drains, clean sewers, 
 streets and rivers, clean food and drink. Cleanliness, 
 ever the sheet anchor of hygiene, is preeminently so 
 in cholera seasons and epidemics." 
 
 Moreover, not only to subvert cholera, but all other 
 pestilential as well as ordinary innocuous disease, is 
 cleanliness of primal and supreme importance, and 
 above all clean air and purity of the blood and body, 
 or personal sanitation in its entirety. Yet, how can 
 this be secured when the air is freely contaminated 
 with the noxious tobacco miasm that so actively alka- 
 lizes and poisons the fluids and tissues of the living 
 
182 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 economy, depresses the nervous and vital energies, 
 promotes mal-nutrition, ansematosis, corrupt meta- 
 morphosis, and toxic condition of the system, with 
 purpuric, hemorrhagic, serous, and intestinal fluxes, 
 and specially predisposes to, and excites disorder of 
 the stomach, liver, and bowels, diarrhoea, cholera 
 morbus, cholera infantum, and malignant cholera, with 
 other pernicious maladies, as well as many minor ab- 
 normities. Hence, it is vitally important to discard 
 and avoid this poisonous tobacco miasm with all other 
 forms of malaria and toxic agencies, or causes of 
 diseases, while to counteract the superalkalinity of the 
 system and tendency to cholera with allied intestinal 
 and other affections, astringent and tonic acids with 
 corresponding neutralizing, disinfecting corroborants 
 and regimen are required. 
 
 Thus, it is apparent that an ammoniacal and alka- 
 line dyscrasia develops the pathogenic causes and 
 microbes of cholera with other diseases. Even for the 
 support of the claimed cholera bacillus, Koch found 
 that it requires an alkaline medium, and is readily 
 destroyed by heat, dryness, and acids. But, it has 
 been ascertained that the so-called comma-bacillus is 
 not peculiar to cholera at all, or even to disease, as a 
 similar or indistinguishable spirillum exists in the 
 mouths of healthy people. Thus it is stated by Dr. 
 H. Raymond Rogers {Jour. Amer. Med. Assoc, Oct. 18, 
 1884) that the so-called cholera microbe of Koch is 
 now found where cholera does not exist, and, too, as Dr. 
 Koch informs us, in other epidemic diseases. All diag- 
 nostic or therapeutic significance is removed from this 
 microscopic object. a Besides, Surgeon Major Timo- 
 thy Richard Lewis, M. B., Assistant Prof, of Pathology 
 in the Army Med. School (Netley), states in the 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 183 
 
 Lancet, Sept. 20, that comma-like bacilli identical in 
 size, form, and in their reactions with aniline dyes, 
 with those found in choleraic dejections, are ordinarily 
 present in the mouths of perfectly healthy persons." 
 
 From his experiments on animals, which are detailed 
 in the Indian Med. Gaz., April, 1884, the Lancet states, 
 (Jour. Amer. Med. Assoc), that Mr. Vincent Richards 
 found that " Decomposing choleraic discharges had no 
 effect on pigs, but as in other instances, the administra- 
 tion of recently-passed stools proved more or less 
 rapidly fatal, with symptoms of asphyxia. Mr. Richards 
 concludes that the alvine discharges at certain stages 
 of cholera contains a powerful poison, whose chief 
 action is to enfeeble and destroy the function of 
 respiration. The rapidity of its action excludes it 
 from being an organism, and he thinks that it is a 
 chemical compound, probably of albuminoid nature. 
 It remains for chemistry to isolate the body, and for 
 experiment to determine accurately its physiological 
 action; but Mr. Richards thinks that it will probably 
 be found to be easy to disinfect the evacuations by 
 permanganate of potash." 
 
 It is thus most probable that the contagia of cholera 
 with all correlative affections are of a specific chemico- 
 organic nature evolved from nitrogenous and ammo- 
 niacal matter both within and without the vital 
 economy, and partaking of the character of the toxic 
 ptomaines, which may be engendered or introduced 
 in the circulation and gastro-intestinal canal, the 
 choleraic tendency being apparently superinduced by 
 some poisonous agent in the blood as well as bowels. 
 Hence this cholera poison may be of the same nature 
 as the toxic ptomaines, which Prof. R. N. Wolfenden 
 says (Ibid) "are developed in the body, post-mortem," 
 
184 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 and which are of "an alkaloidal character, and can be 
 obtained also by decomposition of albumen, peptone, 
 casein, muscle, brain, etc. Moreover they seem to be 
 present in some normal secretions (saliva and urine). 
 Probably the production of ptomaines within the living 
 body may be the pathological cause of many obscure 
 conditions, especially those following on poisoning by 
 bad blood, such as stale fish, etc." 
 
 Stale and tainted meat, fish, shell-fish, and other 
 decayed food, are very apt to cause gastro-enteric 
 disorder with vomiting and purging, cholera morbus, 
 diarrhoea, or choleraic and other affections, which may 
 be dependent upon such occult poisons, as well as 
 their indigestible character. 
 
 They may doubtless also be introduced through the 
 lungs, as these poisonous alkaloidal ptomaines are 
 volatile and allied with ammonia, and are neutralized 
 and destroyed by acids, for according to the same 
 authority " they are often amorphous in form and 
 alkaline in reaction, for the most part volatile and 
 easily alterable, forming chrystalline salts with acids 
 as a rule. The addition of acids to them usually 
 changes them, with the production of pleasant odors 
 like orange flower, musk, etc., allowed to oxidize by 
 contact with atmospheric air, they emit disagreeable 
 cadaveric or urinous odors." As they originate from 
 nitrogenous and ammoniacal matter, they may be 
 re-converted into ammonia and like it volatilize and 
 decompose when exposed. 
 
 Furthermore, as bearing upon this subject, Dr. G. 
 V. Black, of Jacksonville, 111., has presented the in- 
 genious view {Jour. Amer. Med. Assoc, Sept. 13, 
 1883), that microphytes develop poisonous morbific 
 matter like mushrooms and other macroscopic plants, 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 185 
 
 thus, " pathogenic micro-organisms by their re-molecu- 
 lization of matter, form poisons of the nature of the 
 alkaloids, which are the active agents in the produc- 
 tion of disease." But, for this purpose these 
 microbes must have nitrogenized matter of which the 
 elements of ammonia are the basis, hence both 
 directly and indirectly, micro-organisms, toxic pto- 
 maines, contagia, septic, and other poisonous prin- 
 ciples, are all dependent upon ammonia as the basic 
 forts et origo mall, whenever it is sufficiently abundant 
 to supply the necessary pabulum, and stimulus for 
 their spontaneous or secondary development and 
 transmission. 
 
 Thus, with all other zymotic and infectious diseases, 
 whether cholera is dependent upon an ammoniacal or 
 superalkaline state of the blood, gastro-intestinal 
 canal, and general system, a specific contagium, toxic 
 ptomaine, organic or chemical poison, or special 
 bacillus, or all together, as they are apparently in- 
 timately connected, the basic and specific acid and 
 antalkaline treatment is indicated and has empirically 
 proven most efficient both for prophylactive and 
 curative purposes therein. Hence, in cholera and 
 like gastro-intestinal disorders, astringent acidulous 
 drinks and medicanlents are thus most effective, 
 especially phosphoric acid and its compounds of iron 
 and lime, and plain or aromatic sulphuric acid, which 
 is one of the most useful both. chemically and clinic- 
 ally as an antalkaline, astringent, germicide, antisep- 
 tic, and tonic. This, with other acids being destruc- 
 tive of microzymes and subversive of their basic 
 pabulum — ammonia, and its toxic concomitants, as 
 well as counteractive of their morbific effects. It is 
 especially corrective of choleraic affections and has 
 
186 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 been employed to purify the drinking water particu- 
 larly, but also exerts a beneficial antidotal, detergent, 
 and protective effect upon the system. For instance, 
 as stated {Philadelphia Ledger) this was put in use at 
 the Philadelphia Gas Works in 1849, by direction of 
 Dr. C. M. Cresson. The workmen employed at the 
 Gas Works were directed to add to each pint of 
 Schuylkill water one or two drops of sulphuric acid, 
 which was furnished them for the purpose. " So far 
 as my knowledge goes,' 5 Dr. Cresson says, in a pam- 
 phlet on Drinking Water, published in 1875, "and I 
 was constantly at the Gas Works during that summer, 
 not a single case of cholera occurred among them, 
 although the employment, location, and habits of the 
 men predisposed them and favored an attack of the 
 epidemic, of which they were in the midst." 
 
 Plain or aromatic sulphuric acid may often be ad- 
 vantageously added in appropriate doses, to common 
 tea, without milk, duly sweetened. Tea alone being 
 an exhilarating and constipating beverage, and with 
 the acid forms a pleasant antalkaline, antizymotic, 
 antitoxic, astringent, and tonic drink, acceptable to 
 children as well as adults, that may be taken more or 
 less freely according to desire and necessity, with due 
 regard to the protection of the teeth, both for 
 preventive and curative purposes in diarrhoea, cholera 
 infantum, cholera, and other gastro-intestinal defluxi- 
 ons, serous, hemorrhagic, catarrhal, or purulent, as in 
 typhoid fever, dysentery, enteric and other profluvia 
 of phthisis, with analogous fluxes from the genito- 
 urinary and other organs. When a more stimulant 
 effect is required phosphoric acid and its compounds 
 of iron and lime are applicable, with other constring- 
 ing tonics as indicated, where there is a tendency to 
 looseness of the bowels, or diarrhoea and cholerine. 
 
DIPHTHEKIA, TYPHOID, AND ALLIED DISEASES. 187 
 
 Vinegar is also a useful astringent acid, antalkaline, 
 germicide, antiseptic, diuretic, and sanitive, applicable 
 both as a preventive with the food and drink, and 
 remedy in choleraic defluxious. In sweetened, plain, 
 barley, or other water it forms a pleasant, antalkaline, 
 and prophylactive drink, and as a condiment with the 
 food aids digestion, and promotes normal action of the 
 stomach, liver, and bowels. As a remedy for diarrhoea 
 it is said to be quite efficient by Dr. T. E. Stellwagen, 
 [Med. and Surg. Reporter) in the form of cider vinegar 
 preferably, in the dose of about two ounces undiluted 
 for an adult. It may also be given to infants, in the 
 dose of a teaspoonful of moderately diluted vinegar to 
 a babe a year old. " Its effect is to check pain, tenes- 
 mus, and tormina, at once, to relieve the chilliness and 
 cramps, when present, and to disseminate a feeling of 
 warmth and comfort over the body." Hence may 
 prove restorative as well as preventive in cholera. 
 Aromatic, and camphorated vinegar are also indicated 
 therein. Dilute acetic acid or perhaps better its im- 
 pure form of pyroligneous acid, as it contains creosote, 
 with carbolic acid and its analogues, will doubtless 
 prove useful in cholera with other gastro-intestinal 
 fluxes and disorders of the alimentary canal and general 
 system. In general, astringent acids particularly, are 
 very efficient in scorbutic, superalkaline, and bilious 
 diarrhoeas. 
 
 For the active flow of diarrhoea and choleraic fluxes 
 with collateral states, I have found the following 
 very efficacious in arresting the profluvia and correct- 
 ing the intestinal disorder: Plumb, acetas, gr. iss, 
 camphor gr. j, opium and carbolic acid (cryst.) each 
 one quarter of a grain, combined in one pill, (to which 
 may be added calomel, if desired,) and taken every 
 
188 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 hour or more or less frequently according to necessity, 
 with sometimes in conjunction therewith a suppository 
 of three grs. of acetate of lead to one half gr. of 
 opium combined with five or more grs. of cacao 
 butter, introduced into the rectum after each discharge 
 until it is checked, yet, if used too freely they will 
 contract the bowels unduly, and produce discomfort 
 and general sedation. 
 
 To prevent and overcome the depression and other 
 concomitants of gastro-intestinal fluxes, with choleraic 
 and allied affections the more or less free voluntary 
 inhalation of the oil of turpentine is also very useful 
 in connection therewith. It is highly probable that 
 in cholera, as well as other depressed conditions, the 
 active inhalation of the oil of turpentine will be 
 decidedly efficient, as it thus directly enters the blood, 
 acts promptly and generally as a potent stimulant to 
 the heart, circulation, and nervous system, subverts 
 congestion, disorganization, and effusion of the serum 
 of the blood, promotes the secretions and especially of 
 the skin and kidneys usually suppressed in that dis- 
 ease, increases the heat, tendency to the surface, and 
 energy of the body, and will doubtless act effectively 
 in creating a diversion from the gastro-intestinal 
 canal, counteracting the systemic depression, torpor, 
 and typhoid tendency, and rousing a sufficient degree 
 of vital power to excite reaction and overcome the 
 disease altogether, though of course, it may be ex- 
 hibited by the mouth and rectum, as well as by 
 external application directly and in hot baths, and be 
 aided by other appropriate remedies. 
 
 " In Cholera, the Spirit of Turpentine applied by 
 means of hot flannels, and by diligent friction over 
 the abdomen, is one of the best external applications 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 189 
 
 which can be resorted to. It may also be administered 
 in the form of enema; thus employed it has proved in 
 many instances highly serviceable, stimulating the 
 system, allaying the vomiting, and causing a degree 
 of reaction which other remedies fail to produce. I 
 would also strongly advise its internal exhibition in 
 the manner and doses advised in haemorrhage. In the 
 stage of collapse, its external application should never 
 be neglected." — (Waring 9 s PracL Thera.) 
 
 Nitrous oxide is also strongly indicated both for 
 preventive and curative purposes in cholera as in 
 allied abnormities, to preserve and restore the in- 
 tegrity of the blood, oxygenation, haematosis, calori- 
 faction, and circulation, increase the tonicity of the 
 heart, nervous and muscular system, subvert abnormal 
 defluxion from the blood and bowels, promote normal 
 secretion of the liver and kidneys especially, and 
 stimulate and invigorate all the functions of life. It 
 will no doubt prove as actively efficient as an exhilar- 
 ant, tonic, revivifier, reactive and restorative in 
 cholera, as in correlative depressed and collapsed 
 conditions, and adynamic diseases, given in frequent 
 small and stimulant doses and continued so long as 
 required. Oxygen is likewise useful for the same 
 purposes, but is not so stimulant and active as nitrous 
 oxide. Peroxide of hydrogen will doubtless also 
 prove useful in cholera with cognate diseases. 
 
 These more purely physiological means of protec- 
 tion and restoration in cholera with all correlative 
 diseases are especially indicated therein, as they are 
 potent disinfectants, stimulants, resolvents, tonics, and 
 restoratives, of general application, with appropriate 
 alimentation, also of prime importance. Thus, for 
 instance, in gastro-enteric affections particularly as 
 
190 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 typhoid fever, cholera, diarrhceal, and similar disorders, 
 such acidulous, astringent and constipating fruit juices, 
 jellies, and food, as oranges, peaches, bananas, per- 
 simmons, quince, blackberry, and like acid and con- 
 stringent vegetals, with gum arabic, rice, barley, etc., 
 in infusion and more consistent form, strong tea 
 plain or acidulated, and still better milk, usually hot 
 and peptonized, though it may be taken at any 
 temperature desired, with lime water or sulphite of 
 lime, bicarbonate or bisulphite of soda, in small 
 quantities at a time, and other albuminous and amyla- 
 ceous diet of a binding nature, are best, laxative fruit, 
 food, and other substances being contraindicated in 
 such intestinal. profluvia. 
 
 Wearing a thick flannel bandage around the abdo- 
 men, or better, warm woolen underclothing is pre- 
 ventive and corrective of diarrhoea and choleraic deflux- 
 ions, during the existence of which a recumbent position 
 is all important, the upright position being dangerous 
 and sometimes causing sudden death. In the collapsed 
 state of cholera elevating the lower part of the body so 
 as by gravitation to increase the quantity of blood and 
 stimulus to the heart and brain, is recommended by 
 Dr. H. Kaymond Rogers, of Dunkirk, N. Y. As the 
 inverted position with the head lower than the body 
 and limbs, is so very useful in depression from anaes- 
 thesia, haemorrhage, and otherwise, it will doubtless 
 prove beneficial in the collapse of cholera with all 
 other forms of syncope. Artificial heat to preserve 
 and restore the normal temperature of the body is also 
 often necessary by warm dry air, hot and stimulant 
 applications to the surface, massage, etc. 
 
 In the preventive and restorative treatment of 
 cholera with allied zymotic, septic, and infectious 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 191 
 
 maladies, the more volatile antalkalies, acids, disin- 
 fectants, and germicides, as chlorine, phenic, sulphur- 
 ous, and sulpho-carbolic acid, with thymol, eucalyptus, 
 and other essential oils are also applicable both 
 internally and externally. They may be readily 
 diffused in the air and thus more or less freely inhaled 
 as potent antiseptics, counteractives, depurants, and 
 destroyers of both extraneous and internal microzy- 
 mes, alkaline, toxic, and infectious matter. The 
 diffusion of turpentine with other essential oils in the 
 air, will also engender ozone, a most powerful disin- 
 fectant, germicide, and nullifier of noxious and con- 
 tagious principles. 
 
 With the internal oxygenation, antisepsis, and de- 
 puration, external disinfection and purification of the 
 surface of the body is also important in all cases and 
 times, by the usual bathing in fresh, or often better, 
 medicated water, as sponging or baths of salt or sea- 
 water, solutions of the various mineral and vegetal 
 acids, and other agents as chlorine, chlorinated, or 
 sulpho-carbolate of soda, tar, turpentine, etc., properly 
 diluted. 
 
 This basic acid and antalkaline medication and 
 regimen with their allied agencies are thus applicable 
 in the prevention and treatment of yellow fever and 
 cholera as in ship, typhus, remittent and malarious, 
 bilious, enteric, puerperal, scarlet, and other fevers, 
 with small-pox, diphtheria, measles, erysipelas, car- 
 bunculoid, gangrenous, and mephitic conditions 
 generally, they being very efficient in all such 
 zymotic, septic, infectious, scorbutic, and putrescent 
 diseases according to my experience with that of 
 others previously indicated, and will doubtless prove 
 as specific in the former as in the latter, when properly 
 
192 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 adapted thereto, for while in general, this acid and 
 antalkaline treatment is basic and specific in all such 
 maladies, as before noted, it requires to be modified 
 and supplemented to meet the varied indications in 
 the special phazes and complications of these am- 
 moniacal, superalkaline, infectious and malignant 
 diseases, in accordance with their specific character, 
 morbid manifestations, and complexities, without, 
 however, changing its fundamental nature and appli- 
 cations thereto. 
 
 Thus, by the general adoption of the sanitary and 
 medicinal measures herein presented for preventing 
 and destroying the immediate personal as well as re- 
 mote causes — internal and extraneous, and counter- 
 acting the active basic predisposing and exciting 
 ammoniacal, superalkaline, and concomitant toxic, 
 malignant, and microbic conditions of all z} T motic, 
 septic, contagious, pestilential, putrescent, and ady- 
 namic diseases, much unnecessary sickness, suffering, 
 and sacrifice of life, with their concomitant evils 
 throughout the world may be prevented, w T hile 
 individual and public health will be promoted, and 
 human energy, activity, happiness, prosperity, pro- 
 gress, and civilization, proportionately increased. 
 But to this desirable end every one must be self- 
 helpful by avoiding all deleterious agents and vicious 
 habits, and by continuous and adequate disinfection 
 of their entire system — inside and outside — so as to 
 depurate and purify most effectually every blood-cor- 
 puscle, cell, part and particle of their bodies, as well 
 as to preserve the purity of the air they breathe, the 
 water they drink, the food and other ingesta they 
 take, with clothing, ships, habitations, and surround- 
 ings generally. Thus by correct modes of living, 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 193 
 
 appropriate alimentation, aeration or oxygenation and 
 purification of their own bodies and environments, 
 people can largely protect themselves from these 
 destructive scorbutic, contagious, epidemic, malig- 
 nant, and mortiferous diseases with the minor ills of 
 life, and realize most fully the truth of the old Saler- 
 nian oracle that he 
 
 <l Who guards his health, his life in turn makes sure, 
 Prevention far surpasses any cure." 
 
 Ondroneaux's Trans. Exhortatio Sanitalis. 
 
194 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 VI. 
 
 CONCLUSIONS. 
 
 Having thus presented a very general outline of the 
 basic aetiology, pathology, and treatment — both pre- 
 ventive and curative, of typhus, ship, yellow, remittent, 
 bilious, puerperal, enteric, and other fevers, with 
 cholera, diphtheria, scarlatina, small-pox, purpura, 
 scurvy, erysipelas, gangrenous, carbunculoid, and scor- 
 butic, zymotic, septic, infectious, pestilential, malarial, 
 mephitic, putrescent, and cognate diseases generally — 
 the most virulent maladies that afflict and destroy 
 mankind and the lower creatures, for a more specific 
 and systematic exposition of the subject I add the 
 following summary of my conclusions thereon. 
 
 I. That the living organism is composed of various 
 chemical elements, prominent among which are the 
 fixed alkaline bases and metals, — calcium, sodium, and 
 potassium, an excess or deficiency of which results in 
 abnormal states or disease that is variously manifested 
 and complicated. 
 
 II. That, besides the metallic oxides or fixed alkalies 
 — calcia, soda, and potassa, which are always introduced 
 from without the body in various forms and combina- 
 tions, there is another prominent alkali — Ammonia, 
 differing materially from the others in being unstable, 
 volatile, and organic, that is both engendered within 
 and introduced from without the living organism. 
 
 III. That, in excess in the -vital economy, these 
 alkaline substances induce various abnormal condi- 
 tions primarily manifested in a morbid crasis or dys- 
 crasia of the blood and body, which for brevity and 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 195 
 
 convenience may be termed in general, superalkalcemia, 
 of which there are several varieties corresponding to 
 the special alkalies, that may be respectively designated 
 thus, from an excess of lime — Calccemia; of sodium — 
 Nalricemia ; of potassium — Kalicemia in conformity 
 with that of ammonia — Ammonce?nia, and others of a 
 like tenor. 
 
 IV. That, each one of these forms of superalka- 
 laemia, though with the same general basis of superal- 
 kalinity, is attended with distinctive constitutional and 
 local manifestations and complications of disease, as 
 of lime or Calcemia, in diminished secretion, consoli- 
 dation of tissue, calcariou3 and osseous degeneration; 
 of sodium and Natriremia, in concretions and arthritic 
 deposits of urate of soda or chalk stones, with second- 
 ary inflammation and neuroses, as in gout, etc., though 
 sodium is primarily liquefacient and scorbutic but 
 not to the same degree, as potassium in excess, or 
 Kaliaemia, which causes solution and increased fluidity, 
 with degeneration, and passive defluxion of the blood, 
 and scurvy, purpura, and similar disorders of a non- 
 febrile and non-inflammatory character but disorganiz- 
 ing and asthenic tendency. While an excess of 
 ammonia or Ammon8emia,also induces undue solvency, 
 fluidity, and scorbutic deterioration of blood with a 
 disposition to active serous, hemorrhagic, febrile, in- 
 flammatory, and dissolutive conditions, both general 
 and local, of a toxic, septic, contagious and primal 
 sthenic, but ultimate and general adynamic type. 
 
 V. That, these respective dyscrasia may be produced 
 at will by the free administration of these alkalies, 
 and are often induced fortuitously in the over-indul- 
 gence of ingesta containing them, as impure water 
 with ammoniacal or organic contaminations, and 
 
196 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 saline waters, liquors, and food, with much lime, soda, 
 and potash, as in mineral waters, wine, salted meat, 
 with tobacco in its various forms, as well as the undue 
 use of the former medicinally, and all of which may 
 be variously combined, thus giving rise to diverse and 
 complex forms of disease — acute and chronic, of 
 various types and degrees of intensity, though of a 
 general asthenic character. 
 
 VI. That the most noxious of these alkalies are 
 potassa and ammonia, which though in general 
 similar in their basic acrid and liquefacient action 
 upon the blood and tissues, differ widely in their 
 special effects and morbific manifestations on the 
 system. Potash being solvent and sedative, in excess, 
 depressing to the heart, circulation, nervous, muscu- 
 lar, and general system, hence induces passive necree- 
 mia, congestions, haemorrhages, defluxions, disorgani- 
 zation, and enervation, with corresponding diseases of 
 a low grade, as scorbutic and purpuric affections 
 without much if any, fever or excitement. While 
 Ammonia with like solvent effects upon the blood 
 and tissues is stimulant, in excess, irritant, inflamma- 
 tory, disorganizing, and prostrating, exciting, and 
 irritating the heart, blood-vessels, circulation, organs 
 and system generally, hence causes active congestions, 
 serous effusions, haemorrhages, inflammations, fevers, 
 and defluxions of every variety and degree, with a 
 mixed form of sthenic and asthenic disease, the latter 
 preponderating from its diffluent and disorganizing 
 effects upon the fluids and solids of the body. The 
 baneful action of both these alkalies are often com- 
 bined from bad habits and modes of living, as well 
 as accidentally, with corresponding complexity of 
 disease. 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 197 
 
 VII. That, while the fixed alkalies are introduced 
 only from without the body exclusively in the ingesta, 
 Ammonia being an organic volatile alkali formed by 
 the direct union of its gaseous constituents in the 
 normal chemico-organic reactions of the elements of 
 the body is largely generated and retained within the 
 vital economy as well as more or less freely introduced 
 from without the system, especially in such noxious 
 ingesta as tobacco with its vapor and smoke, impure 
 water and air or malaria from extraneous decomposing 
 and other matter, or even by its re-inspiration after 
 exhalation in close places. Hence ammonia is more 
 apt to accrue in excess within the body and rapidly 
 and frequently cause disease than other alkalies, 
 particularly in hot weather, seasons, and climates, or 
 undue exposure to artificial heat, both dry and with 
 moisture, and periods of overactivity of system, impure 
 air in confined places, defective alimentation, and bad 
 habits and modes of living at any time and place. 
 
 VIII. That when Ammonia accumulates to a cer- 
 tain extent in the body, whether from undue chemico- 
 organic evolution or retention within, or extraneous 
 introduction from without the economy, or all 
 together, it causes a diffluent disorganizing, and 
 pyrexial condition of the blood and tissues, with 
 a scorbutic, toxic, necrsemic, phlegmonous, febrile, 
 pyemic, septic, infectious, mephitic, and colliquative 
 state of system in various degrees of intensity and 
 activity, excites with minor disorders, congestive and 
 inflammatory action in different organs and parts of the 
 body with fever of a stheno-asthenic type as mani- 
 fested in various eruptions, anthrax and carbunculoid 
 affections, serous, albuminous, and hemorrhagic de- 
 fluxions, as anasarca, diarrhoea, cholera, albuminuria, 
 
198 BASIC PATHOLOGY AND SPECIFIC TKEATMENT OF 
 
 leucorrhcea, bronchorrhoea, epistaxis, haemoptysis, 
 hematuria, haematemesis, and haemorrhage from the 
 gums, bronchia, bowels, uterus, ami skin, and into 
 the internal tissues with apoplexies of lungs, brain, 
 and other parts, or scurvy, purpuric, haemorrheal, 
 purulent, and colliquative diathesis, and such abnormi- 
 ties as lithaemia, uraemia, erysipelas, diphtheria, in- 
 flammation of stomach, liver, and other organs, with 
 gastric, bilious, remittent, puerperal, enteric, and the 
 more malignant congestive, typhus, ship, yellowy and 
 allied fevers, with typhoid, contagious, mephitic, 
 pestilential, and scorbutic diseases generally, all of 
 which result more or less speedily and intensely from 
 heat, moisture, filth, impure air and water, with other 
 baneful ingesta and conditions that largely increase 
 the evolution, retention, and increment of ammonia 
 within the vital economy, especially in close and 
 crowded places, as strikingly exemplified in the rapid 
 development of ammonaemia, septicaemia, and conta- 
 gium in the surviving prisoners of the infamous 
 " Black Hole of Calcutta," who after escaping speedy 
 death from suffocation, were immediately attacked 
 with a malignant typhus fever. Besides the property 
 of ammonia to induce a scorbutic, solvent, and 
 necraemic condition of the blood and typhoid state 
 has been observed by many and experimentally 
 demonstrated by its artificial introduction into the 
 animal system by forced inhalation and swallowing 
 by Dr. B. W. Richardson. — {Waring' 's PracL Thera.) 
 
 IX. That, Ammonia is the basic agent and principal 
 morbific factor of all the varied scorbutic, zymotic, 
 septic, infectious, necraemic, pestilential, and putres- 
 cent maladies, with mephitic, choleraic, and cognate 
 diseases in general, local as well as systemic, its 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 199 
 
 resultant ammonaemia and concomitant purpuric, 
 typhoheemic, and septicemic dyscraia, being the sole 
 cause of many, and the underlying chemico-toxic 
 condition upon which the infecting principle and 
 malignancy of all depends, from the slightest ab- 
 normity to the most contagious malady, in every 
 degree of activity, intensity, and complication, 
 according to its quantity, rapidity of evolution, reten- 
 tion, and susceptibility to its noxious influence, 
 abnormal tendencies, and concurring morbific agencies 
 of heat, moisture, malaria, contagia, climate, weather, 
 exposure, defective dietary, bad habits and modes of 
 living. 
 
 X. That, besides the natural internal systemic and 
 extraneous sources thereof from organic transforma- 
 tion and decomposition Ammonia is largely artificially 
 engendered and introduced into the body in the per- 
 nicious juice, vapor and smoke of tobacco with its 
 other noxious ingredients, which produce a special 
 form of blood-poisoning and toxicosis from the 
 separate and combined action of its baneful constitu- 
 ents that are both of an irritant and depressing or 
 acro-narcotic character, thus causing and helping to 
 induce a superalkaline, toxic, and perverted condition 
 of the fluids and solids of the economy, with general 
 inanition and adynamia, productive and promotive of 
 scorbutic, purpuric, necrsemic, septic, mephitic, infec- 
 tious, and other corrupt and asthenic states of system, 
 
 XL That, in general, in various ways, chemically 
 by adding ammonia, nicotia, and other noxious 
 matter to, alkalizing, poisoning, preventing the oxy- 
 genation, and polluting the blood, irritating the lips, 
 mouth, throat, air-passages, lungs, heart, and genito- 
 urinary organs, debilitating the gastro-intestinal canal 
 
200 BASIC PATHOLOGY AND SPECIFIC TREATMENT OP 
 
 and chylopoietic viscera; and, dynamically depres- 
 sing the brain, nervous, muscular, and general system, 
 tobacco disorders every organ and function of the 
 economy, and acts as a powerful predisposing and 
 exciting cause of local and constitutional, physical 
 and mental disease, as manifested in ptyalism, can- 
 cerous affections of lip, tongue, and nares, ulcerations 
 of mouth and throat, diphtheria, cynanche maligna, 
 laryngeal and pulmonary phthisis, dyspepsia, torpid 
 liver and bowels, biliousness, piles, nausea and vomit- 
 ing, constipation and diarrhoea alternately, cholera 
 morbus, cholera infantum, and doubtless also malig- 
 nant cholera, mal-nutrition, marasmus, mal-disinte- 
 gration, neuralgia and paralysis of face and heart, 
 angina pectoris, adynamia of brain and nervous 
 system, neurasthenia, melancholy, insanity, dementia, 
 blindness, deafness, and paralysis of ganglionic and 
 sensori-motor functions generally, with bronchorrhcea, 
 leucorrhcea, albuminuria, and Bright's disease, abnor- 
 mal production and retention of excrementitious 
 matters in the system, toxaemia, lithaemia, uraemia, 
 superalkalaemia, and scorbutic condition of the blood, 
 promotive of purpura, typhus, ship, yellow, congestive, 
 puerperal, enteric, and other asthenic fevers, with 
 haernaturia, haemoptysis, haematemesis, and hemor- 
 rhagic, septic, mephitic, choleraic, infectious, and 
 adynamic affections generally, particularly when there 
 is a special epidemic tendency thereto. 
 
 XII. That, tobacco is particularly dangerous to 
 sickly and sensitive people, children, and pregnant 
 women, as it induces and intensifies both organic and 
 functional diseases and tends to entail a degenerate 
 organism upon children of nicotized parents, as well 
 as to destroy them before and after birth, for the vapor 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 201 
 
 and smoke of tobacco directly enters the blood of 
 pregnant and nursing women as of others, and causes 
 uraemia, sickness of stomach, miscarriage, uterine 
 haemorrhage, puerperal eclampsia and fever, with 
 other abnormities, as seen in the maladies and fre- 
 quent abortions, and post partum sickness and death 
 of the offspring of women who work in tobacco 
 factories. Besides, how can children whose bodies 
 are charged with this potent, tobacco poison both 
 before and after birth from their mother's nicotized 
 blood and milk, as well as directly from nicotized air, 
 be properly organized or live, and normally develop 
 when exposed to such a noxious agent that sickens 
 and destroys adult human beings with the lower forms 
 of life? Would pregnant or nursing cows with their 
 calves be thus exposed to the pernicious fumes of this 
 powerful poison, and are human beings of less im- 
 portance than cattle? 
 
 XIII. That, thus in various modes, tobacco pro- 
 duces functional and organic, hereditary and acquired, 
 acute and chronic asthenic diseases of the blood and 
 body, undermines both physical and mental health, de- 
 stroys the tone and stamina of body and mind, and 
 saps the very foundations of life, inducing a state of 
 toxicosis or Nicotism analogous to alcoholism, and 
 often of itself suddenly as well as slowly terminates 
 the existence of those who use or are exposed to it, 
 there being little doubt but that some at least, of the 
 many sudden deaths attributed to rheumatism, disease 
 or paralysis of the heart, syncope, apoplexy, palsy, 
 collapse, etc., are the direct result of nicotism, of the 
 heart, blood, brain, nervous and general system, and 
 either slow or speedy, a species of suicide or homicide, 
 or both, according to whether inflicted upon self alone 
 .i 
 
202 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 or others combined, hence the use of this potent 
 poison should be entirely discarded. 
 
 XIV. That, nicotism of the heart, stomach, kidneys, 
 brain, nervous, and general system, with its concomi- 
 tant nicotaemia and general extraneous sources of 
 alkaline, poisonous, and depressing agents inhaled 
 and otherwise ingested in the body, superadded to the 
 internal organic development of arnmonaemia, toxaemia, 
 and septicaemia, from the undue production and reten- 
 tion of ammonia, with other noxious and excremen 
 titious matter in the economy, proportionately in- 
 crease the tendency to, and promote the inception of 
 all other forms of blood-poisoning and adynamia, and 
 favor the production and intensify the operation of 
 specific contagia or infection of all kinds, with corres- 
 ponding zymotic, septic, scorbutic, necraemic, putres- 
 cent, mephitic, lithiasic, and other dyscrasic and 
 asthenic diseases, manifested in various forms, de- 
 grees, and complications of acute and chronic, 
 functional and organic, general and local disorders of 
 body and mind, according to varying circumstances of 
 habits, weather, season, climate, and other morbific 
 causes. 
 
 XV. That, as the volatile organic alkali — Am- 
 monia is so freely engendered and retained in the 
 vital economy from excessive exertion, heat, moisture, 
 alcoholic liquors and other noxious ingesta, defective 
 oxygenation, alimentation, depuration, and elimina- 
 tion, as well as introduced from without in tobacco 
 smoke and other forms of malaria from decomposing 
 organic matter, impure water, and otherwise, while it 
 is solvent, acrimonous, irritant, disorganizing, and 
 induces a typhohaernia or putrid dyscrasia, it is very apt 
 to accumulate in excess in the blood and body and 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 203 
 
 become the basis, source and origin of the toxemic 
 and infectious crasis of all scorbutic, necraernic, 
 zymotic, septic, contagious, malignant, putrescent, 
 mephitic, and allied diseases, especially of scurvy, 
 typhus, typhoid, ship, yellow, congestive, bilious, 
 remittent, malarial, puerperal, and other fevers, with 
 cerebro-spinal meningitis, small-pox, scarlatina, 
 measles, diphtheria, cynanche maligna, erysipelas, 
 anthrax, carbunculoid affections, and gangrenous 
 sloughing, and phagedenic wounds, ulcers, and similar 
 foul conditions generally, with hsemorrhcBal, catarrhal, 
 lymphoidal, serous, purulent, and other extravasations, 
 as anasarca, haemoptysis, haematemesis, hematuria, 
 purpura, bronchorrhcea, leucorrhcea, albuminuria, 
 diarrhoea, cholera in its various forms, and other deflux- 
 ions, while it engenders an infectious type of an 
 ordinarily innocuous disease, ae pneumonia, or pleuro- 
 pneumonia, dysentery, metritis, and other occasional 
 septic varieties of usually non-contagious affections, 
 as well as complicates and intensifies consumption, 
 pertussis, gout, rheumatism, eczematous, and all other 
 diseases — local and general, from the most insignifi- 
 cant and benign to the most malignant. 
 
 XVI. That, excess of ammonia in the blood and 
 system is thus the basic, predominant, and prolific 
 cause of the most corrupt, contagious, pestilential, 
 putrescent, and destructive diseases that afflict man- 
 kind and the lower animals, and without which they 
 would not develop, or become malignant and infect- 
 ious, and that all diseases, benign and contagious, 
 local and general may be superimposed upon, or com- 
 plicated with, this ammoniacal dyscrasia, according to 
 special morbific factors or immediate causes, as for 
 instance, the extraneous influences of heat, filth, con- 
 
204 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 fined or impure air, and malaria in the production of 
 superalkalinity of system, congestive, typhus, yellow, 
 remittent, enteric, and other fevers; of gestation in 
 evolving the diathesis and parturition in exciting puer- 
 peral eclampsia and fever; of wounds, bruises, or 
 irritations of any kind in arousing erysipelas as well 
 as its spontaneous occurrence from the intensity of the 
 superalkaline dyscrasia; or of cold and moisture, with 
 like general influences, or local irritation of the 
 pharynx and air-passages from tobacco and other 
 causes in developing diphtheria, cynanche maligna, 
 and similar diseases; with the more occult evolution 
 of the actively contagious exanthemata — variola, scar- 
 latina, and their pestiferous correlatives; besides the 
 various intercurrent necrsemic, toxsemic, litheemic, 
 uremic, choleraic, and transudative disorders; and 
 the more limited local carbunculoid affections and 
 grangrenous conditions, — internal and external, the 
 septic crasis, disorganizing tendencies and malignancy 
 of all which are proportionate to the degree of ammo- 
 nsemia. Some of these are entirely, and others in- 
 directly dependent upon, and complicated with, this 
 basic superalkaline cachexia, the removal of which 
 more or less completely subverts the whole disease, 
 while its absence prevents the inception thereof. 
 
 XVII. That, as the amrnoniacal basis and infectious 
 poison of these zymotic, septic, contagious, pestilential, 
 and scorbutic diseases, are largely generated sponta- 
 neously within, as well as introduced from without the 
 living body special effort should be made to prevent 
 the development, neutralize and destroy these primary 
 morbific factors with their coexisting and complicating 
 specific contagia, as well as subvert and resolve their 
 concomitant maladies, and, as they are mainly of 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 205 
 
 an alkaline character, both theory and experience point 
 to Acids, antalkaline, and antiseptic substances as the 
 specific counteragents and remedies therefor. It 
 matters not what the special type of the superalka- 
 linity and septicity of the blood, the basic and specific 
 treatment is essentially the same in being antalkaline, 
 and antiseptic, hence the necessity for acids and their 
 correlative antalkaline neutralizing and disinfecting 
 agents, the particular form or nature of which will 
 depend somewhat upon the special variety of the 
 superalkalaMnia, toxaemia, and septicemia, though in 
 general the same, and as the acids and their cognates 
 are inherently antizymotic, antiseptic, antipyretic, 
 disinfectant, resolvent, and depurant, as well as antal- 
 kaline, they subserve the various other essential pur- 
 poses for the prevention and successful treatment of 
 these varied scorbutic, zymotic, septic, contagious, and 
 mephitic diseases. 
 
 XVIII. That, in general the most potent antalka- 
 line, antizymotic, antiseptic, counteractive, resolving, 
 and disinfecting agents to most effectually neutralize 
 this superalkalinity of the blood and ammonaemia, 
 with their concomitant toxaemia, and poisons, destroy 
 the specific contagia and microzymes, subvert their 
 morbific effects, depurate the blood and S3 T stem, 
 frustrate and resolve such malignant and adynamic 
 maladies, are the mineral, vegetal, and animal acids, 
 with some of their basic elements and compounds, as 
 nitric, hydrochloric, nitro-hydrochloric, phosphoric, 
 hydrobromic, sulphuric and sulphurous, carbolic, 
 salicylic, lactic, citric, acetic and other vegetal acids, 
 with their corresponding bases and compounds, as 
 chlorine, chlorides, and chlorates, or chlorine combina- 
 tions of iron, soda, and lime more exclusively, and to 
 
206 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 a certain extent, bromine and bromides, iodine and 
 iodides of the same, sulphur, .sulphites, and sulpho- 
 carbolates, of soda, salicin and salicylate of soda and 
 bismuth, with the juice of limes, lemons, and other 
 acid fruits and food, as sour buttermilk, and acid 
 albuminoids, usually comprised in an antiscorbutic 
 dietary and hygienic regimen. Of these in general, 
 the hydrochloric, nitro-hydrochloric, phosphoric, lactic, 
 and citric acids, with correlative acid principles and 
 aliment, and corresponding bases and compounds 
 indicated, are ordinarily the most appropriate and 
 specific for the prevention and resolution of these 
 septic, contagious, pestilential, mephitic, putrescent, 
 and adynamic diseases, both constitutional and local, 
 though in some of the latter complications the milder 
 and more astringent sulphuric, sulphurous, acetic, 
 hydrobromic, sulphocarbolic, and like acids with their 
 compounds are most applicable. 
 
 XIX. That, for the general superalkaline, scorbutic, 
 septic, toxsemic, infectious, and mephitic dyscrasia, as 
 of scurvy, purpura, necrsemia, typhus, ship, remittent, 
 and other fevers, and adynamic diseases, with a putrid 
 crasis or tendency, even with marked local manifesta- 
 tions and complications, as in small-pox, scarlatina, 
 diphtheria, typhoid and puerperal fever, erysipelas, 
 carbunculoid, gangrenous, and other afiections of a 
 like character, the mineral, animal, and vegetal acids, 
 especially the nitric, hydrochloric, nitro-hydrochloric, 
 phosphoric, sulphuric, citric, lactic, and acetic acids, 
 with their equivalent acid compounds, juices, fruits, 
 and food, are basic and specific remedies in neutralizing 
 the superalkalinity or ammonsemia and toxaemia, 
 destroying the specific virus and contagium, toxic, and 
 mephitic principles, and underlying cause, drying up 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 207 
 
 the sources, blighting the concomitant poisons, micro- 
 zymes, and abnormities, disinfecting the blood and 
 body, and resolving the disease altogether. 
 
 XX. That, the neutralization of this ammoniacal 
 and superalkaline dyscrasia, by the basic acid and 
 antalkaline treatment removes the underlying patho- 
 genic cause and resolves the general disorder with the 
 concomitant local lesions, whereas without the sub- 
 version of the former, the treatment of the latter is 
 usually of little or no avail, the local manifestation 
 with the constitutional malady running their destruc- 
 tive course and becoming intensified and complicated 
 according to concurring morbific circumstances, as 
 exemplified in septic and adynamic fevers and condi- 
 tions generally, with local affections, injuries, and 
 ulcerations, the slightest lesion tending to a malignant 
 type, heuce the frequent failures of surgical operations, 
 and paramount necessity to correct this superalkaline 
 dyscrasia by appropriate acid medication and regimen, 
 antalkalies, antiscorbutics, and corroborants before, as 
 as well as after, to insure the success of operative 
 procedures, with the resolution and healing of wounds, 
 and local lesions of all kinds. 
 
 XXI. That, while in general, the various acids — 
 mineral, animal, and vegetal, with their correlatives, 
 are the basic and specific remedies for the primal 
 underlying morbific causes and pathological conditions 
 of these septic, malignant, contagious, and adynamic 
 diseases, in the more complicated inflammatory cases 
 thereof they sometimes require to be supplemented 
 by more active resolvents as potassium and sodium 
 chlorate or their analogues, though guardedly, and 
 the elements and compounds, other than ammonia, of 
 iodine, bromine, sulphur, as well as chlorine, with in 
 
208 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 the more asthenic states, the addition of such stimu- 
 lants and tonics as oil of turpentine, iron, quinia, 
 strychnia, oxygen, peroxide of hydrogen, nitrous 
 oxide, and other energetic corroborants. 
 
 XXII. That, in diphtheria, for instance, while the 
 acids alone are often sufficient to abort and resolve the 
 disease altogether, in the early stage especially, yet, 
 from the complex pathology of the malady, a com- 
 pound treatment with them as a basis, is usually most 
 certain and reliable to overcome the combined abnor- 
 mities of the blood, pharynx, and nervous system, con- 
 stituting the disease. Thus to neutralize the amnion- 
 aemia and toxaemia, destroy the septic and infectious 
 matter with the micrococci, disinfect the throat and 
 blood, subvert the formation and dissolve the mem- 
 branous exudate, and depurate and invigorate the 
 entire system at the same time, nitric, hydrochloric, 
 or nitro-hydrochloric, with citric, lactic, and phosphoric 
 acids are the most useful, though other acids may be 
 exhibited in conjunction therewith, or separately as 
 their absence and necessity requires. In addition, if 
 the exudative tendency is great, the resolvents potas- 
 sium and sodium chlorate are efficient adjuvants 
 carefully employed in small quantities. For the 
 depression and as a haematic, tonic, and antiparalytic, 
 muriate of iron, quinia, and strychnia, or the still 
 more stimulant phosphoric acid and phosphates or 
 lacto-phosphates of the same, may be used in conjunc- 
 tion or alternated with the former. To counteract the 
 typhoid condition, and for general disinfectant, anti- 
 septic, germicidal, stimulant, and other purposes, the 
 oil of turpentine is most efficient, exhibited more or 
 less freely as indicated by diffusion in the air and more 
 direct inhalation, or by the gastro-intestinal canal, as 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. r 209 
 
 well as moderately applied externally to the neck and 
 chest if necessary. In conjunction with this treatment 
 a corresponding acid regimen should also be adopted 
 of lemonade, the juice of limes, lemons, grapes, and 
 other acid fruits, with stewed fruit and jellies as 
 cranberry, cherries, plums, apples, or apple butter, 
 and other tart antiscorbutic vegetals, with such 
 corresponding animal food as sour buttermilk, all 
 sweetened to taste and taken ad libitum. Indeed, sour 
 buttermilk of itself forms a very agreeable, substantial, 
 and reliable aliment, as well as efficient solvent and 
 medicament through its lactic acid, both locally and 
 constitutionally, though cottage cheese, with acidulated 
 oysters, eggs, and other albuminoids with vinegar, are 
 also applicable, and generally palatable until the 
 disease is resolved and health restored. This basic 
 acid and correlative treatment, according to my 
 experience, most effectually aborts and subdues 
 diphtheria with cognate diseases, as it meets all the 
 varied indications therein and is prompt and positive 
 in both prevention and cure. 
 
 XXIII. That, for the milder diphtheroidal types of 
 cynanche, characterized by slight fever, headache, 
 loss of appetite, lassitude, depression, congested and 
 ulcerated sore throat, scorbutic blood, and general 
 malaise, the acid treatment alone with nitro-hydro- 
 chloric acid, lemonade, and corresponding acid regi- 
 men, is usually very prompt and effective, and will 
 often gratify both patient and physician at the speedy 
 relief and recovery therefrom, the response thereto 
 being too direct and decided to admit of the idea that 
 the disease resolved spontaneously. 
 
 XXIV. That, to prevent the further infection, in- 
 ception, and extension of diphtheria whenever it 
 
210 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 appears, the same acid regimen and medication should 
 be adopted by all exposed thereto, the former alone or 
 with nitro-hydrochloric acid in sweetened water or 
 lemonade being prophylactive, and applicable at all 
 times to subvert its development, which largely occurs 
 from the neglect of appropriate acid alimentation with 
 adequate sanitation to remove and avoid all the causes 
 of diphtheria, not the least of which is that ever- 
 present artificially engendered baneful miasm — tobacco 
 smoke, that alkalizes and poisons the blood, irritates 
 and inflames the nares, throat, and air-passages, 
 depresses the nervous, muscular, and general system 
 disorders the nutritive and vital processes, and acts as 
 an actively exciting as well as predisposing cause of 
 diphtheria with many other abnormities, both local 
 and constitutional, and should be suppressed by all 
 moral and legal means as a potent cause of disease and 
 death in various ways, both directly and indirectly. 
 
 XXV. That, both pathologically and clinically 
 diphtheria and croup are distinct diseases though often 
 complicated and merging with each other in every 
 degree, hence termed diphtheritic croup, the extremes 
 being well marked, from the more purely innocuous 
 spasmodic, congestive, inflammatory, and membran- 
 ous form of the latter to the most malignant and 
 infectious variety of the former, requiring in general 
 opposite modes of treatment. Thus, in diphtheria, 
 mainly by acids, antalkalies, disinfectants, and tonics ; 
 in croup, mostly alkalies, antispasmodics, and seda- 
 tives, the bromides of sodium and potassium, or, even 
 in some cases, ammonium, and iodoform, being 
 specially indicated therein, as well as in whooping 
 cough, with their analogues, from their local and 
 general anaesthetic, antispasmodic, and resolvent 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 211 
 
 effects; while hydrobromic acid is better adapted to 
 the sthenic types of the complex varieties, which 
 necessitate a mixed treatment with the sedative or 
 tonic acids, neutral salts and corresponding remedies, 
 according to the special sthenic or asthenic character, 
 tendency, and complications of the local and constitu- 
 tional affections. 
 
 XXVI. That, the same general acid and correlative 
 basic and specific remedies, principles of treatment, 
 and prophylaxis apply in all allied diseases with diph- 
 theria, as in the acute stage and active phlegmonous 
 form of cynanche, and scarlatina, the mineral, and 
 vegetal acids, with potassium and sodium chlorate, or 
 their analogues, are more exclusively applicable, while 
 in the adynamic and putrid stages or varieties of 
 anginose and other affections, it is better to omit or 
 reduce to a minimum the latter according to the 
 degree of local inflammation and exudation, and add 
 the muriates of iron, quinia, and strychnia, alternating 
 with the phosphates or lacto-phosphates of the same, 
 with ol. terebinth, more or less freely according to 
 necessity, acidulated coffee, and other non-alcoholic 
 stimulants as being far better in these and other 
 diseases than spiritous liquors. In the active febrile 
 and inflammatory stage of small-pox, the hydrochloric 
 and nitro-hydrochloric, with the animal and vegetal 
 acids are also the basic remedies, aided by the chlorates 
 or citrates of potassium and sodium or other salines, 
 as indicated, but which should be withdrawn as the 
 sthenic condition declines, and be combined with, or 
 substituted by the muriates of iron and quinia, or 
 strychnia with the acids, in conjunction alternately 
 with phosphoric acid and its compounds of the same 
 with lime in the adynamic conditions, and with sul- 
 
212 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 phuric acid and its analogues, and oil of turpentine 
 freely in the typhoid and haemorrhagic states. The 
 same general treatment is applicable in all the exan- 
 themata. In septicaemia and puerperal fever, active 
 support is required from the beginning, hence the 
 nitromuriatic acid in water or lemonade, and muriatic 
 acid with muriates of iron and quinia, with moderate 
 doses of potassium and sodium chlorate combined, 
 and free stimulation with oil of turpentine, strong 
 acidulated coffee, and other non-alcoholic corroborants, 
 are most appropriate. While in its analogue, — 
 erysipelas, the same nitro-hydrochloric acid, and 
 hydrochloric acid with the chlorides of iron and 
 quinia, and ol. terebinth, are also markedly efficient, 
 the saline resolvents not being usually required therein 
 except in the more phlegmonous form. In carbuncu- 
 loid affections the acids and chlorates in the more in- 
 flammatory states, with the tonic chlorides in the 
 adynamic conditions are actively resolvent and re- 
 storative. In typhus, ship, remittent or malarial, and 
 other asthenic fevers without severe local complica- 
 tions, the nitric, muriatic and nitromuriatic, phospho- 
 ric, citric, and other acids are actively efficient, though 
 the concomitant adynamia may be more readily 
 overcome by the additional stimulus of quinia, strych- 
 nia, oil of turpentine, acidulated or plain coffee, and 
 other non-alcoholic corroborant and tonic agents. In 
 all septic, infectious, and mephitic conditions, Tax 
 water forms a mild stimulant, disinfectant, alterative 
 menstruum for the stronger remedies, while lemonade 
 and sour buttermilk are generally useful as antalkaline, 
 antiseptic, antipyretic, refreshing, nutrient and restora- 
 tive drinks. In the more sthenic stages or varieties of 
 these with other diseases, it is probable that hydro- 
 bromic acid will be very efficient, especially in irritable 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 213 
 
 and inflammatory anginose and gastro-intestinal affec- 
 tions or complications, as in scarlet and yellow fever, 
 and gastro-enteritis, phlegmonous, traumatic, and other 
 fevers, with cognate abnormities, though its anaesthetic 
 and sedative properties contraindicate and limit its 
 application in diseases essentially asthenic or with an 
 adynamic tendency. In all such diseases correspond- 
 ing appropriate local and external applications are 
 useful adjuvants to the general treatment. Thus, 
 with all diseases of this same general class, the mineral, 
 animal, and vegetal acids, or the acid medication and 
 regimen form the specific treatment, to be pushed ad 
 saturandum in all cases to overcome the basic superalka- 
 linity and concomitants, specially adapted and supple- 
 mented by other remedies as indicated by the varied 
 conditions and complications thereof. 
 
 XXVII. That, when stimulants and tonics are 
 required in these and other diseases, phosphoric acid, 
 oil of turpentine, valerian, coffee, tea, coca, oxygen, 
 peroxide of hydrogen, nitrous oxide, quinia, strychnia, 
 and their correlatives, are far better than spirituous 
 liquors in any form. The oil of turpentine is espe- 
 cially efficient as a substitute for alcohol, being 
 superior thereto in many respects, and as a rapid, 
 diffusible, and more permanent stimulant, to the 
 heart, circulation, and system in general, as well as 
 a potent, antizymotic, antiseptic, haemostatic, discu- 
 tient, alterative, secernant, diaphoretic, diuretic, 
 laxative, disinfectant, depurant', and restorative, while 
 it can be readily and freely exhibited by involuntary 
 inhalation, without dosing the stomach or risking the 
 acquisition of bibulous habits. Besides, by its diffusion 
 in the air it engenders ozone, and acts as a general 
 disinfectant and germicide, protective of those exposed 
 
214 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 to malarious and contagious influences. It may also 
 be required by the stomach and bowels, and should 
 be freely used to disguise the taste and smell of 
 alcoholic liquors whenever they are employed, which 
 should be as seldom as possible. Coffee is also a 
 valuable disinfectant, antiperiodic, antiseptic, febri- 
 fuge, digestive, cholagogue, stimulant, and tonic, 
 useful in malarial and low fevers, infectious and ady- 
 namic conditions, and as a counteractive to the 
 depression from, and a substitute for, alcohol. Be- 
 sides, it forms an excellent menstruum for disguising 
 the taste of quinia and other nauseous drugs, while 
 with lemon juice and other acids it is actively reme- 
 dial and restorative in scorbutic, malarial, septic, 
 contagious, and other diseases, and with milk and 
 sugar a pleasant nutrient supporting drink, that in 
 various forms and combinations may often be medici- 
 nally employed with advantage in lieu of more 
 dangerous and expensive remedies. Oxygen, per- 
 oxide of hydrogen, nitrous oxide, and other invigorat- 
 ing agents indicated are also far better than alcohol 
 in all essential respects without any of its obnoxious 
 effects. 
 
 XXVIII. That, at the best, alcohol is but a tem- 
 porary stimulant in very small doses for a brief period, 
 and permanent sedative, inebriant, narcotic, and 
 stupefacient, depressing, relaxing, and paralyzing in 
 large or frequent small doses, the very opposite of 
 tonicity and invigoration as amply demonstrated in 
 the familiar phenomena of intoxication or poisoning 
 therewith. In the former period of excitement it thus 
 affords but temporary reactive excitation that soon 
 subsides and requires its frequent repetition in dimin- 
 ishing doses to continue its excitable effects, rather 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 215 
 
 than in increasing and sedative quantities, to thus 
 avoid exhausting or overpowering the inherent vital 
 excitability upon which its stimulant effects depend, 
 as it gives nothing to the system and stimulates only 
 by exciting vital reactive effort to throw it off and 
 resist its poisonous influence, so frequently exhibited 
 in drunkenness. Hence, alcohol in every form is 
 inadequate as a permanent stimulant in any case 
 requiring prolonged stimulation and support, and is 
 only adapted in small doses for the treatment of 
 temporary states of depression, rather than for severe 
 and prolonged illness, and not at all in the treatment 
 of chronic disease in which permanent stimulants and 
 tonics are required, while it is not preventive but 
 productive of disease in general, and has no property 
 or application whatever as a food or beverage. 
 
 XXIX. That, as in common with all other zymotic, 
 septic, and allied diseases, ammonaemia and super- 
 alkalinity of the body is the basis of that destructive 
 pestilence of tropical climes — yellow fever, the acid 
 treatment and regimen with the mineral, animal, and 
 vegetal acids, the nitric, hydrochloric, nitro-hydro- 
 chloric, phosphoric, citric, lactic, and acetic acids 
 more particularly, with phenic, sulphurous, sulpho- 
 carbolic, and salicylic acids, and their cognates, 
 chlorine, chlorides, and chlorates, hydrarg. bichlorid, 
 chlorinated soda, bromides, sulpho-carbolates, salicy- 
 lates, other than ammonia, lime and lemon juice, 
 vinegar, sour buttermilk, and the acid fruit and food 
 generally, with the oil of turpentine, and the more 
 vitalizing oxygen, peroxide of hydrogen, nitrous 
 oxide, and other non-alcoholic stimulants, alteratives, 
 resolvents, and restoratives, as specially indicated, 
 promise to prove specific therefor as in all correlative 
 diseases. 
 
216 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 XXX. That, as supplementary to this general acid 
 medication in all scorbutic, zymotic, septic, infectious, 
 mephitic, and cognate diseases — both local and 
 systemic, there should be a corresponding acid dietary 
 with the juice of limes, lemons, oranges and other 
 acidulous fruit, jellies of cranberries and similar acid 
 berries, stewed cherries, apples, plums, prunes, 
 tomatoes, and like antiscorbutic vegetals, with ripe, 
 pulpy, succulent, juicy, tart fruit, like peaches, pears, 
 apricots, grapes, tamarinds, etc., and the more sub- 
 stantial nitrogenized drink and food presented in 
 sour buttermilk and its analogues, all sweetened to 
 taste. Acidulated oysters, eggs, and other concen- 
 trated nitrogenous food with vinegar, lemon juice, and 
 like acids, pickled tripe, soused pig's feet, and other 
 acid albuminoids, and peptonized food are also most 
 applicable and nutritious therein. 
 
 XXXI. That, as in general this acid medication 
 and alimentation is too secernant and laxative in those 
 cases in which there is undue secretion and defluxion 
 from the bowels and other parts, as in diuresis, 
 diarrhoea, typhoid fever, cholera, and like affections, 
 the more astringent acids, bases, compounds, and 
 regimen, are most appropriate according to special 
 indications, as muriatic, phosphoric, plain or aromatic 
 sulphuric acid, sulphurous, carbolic, acetic, and other 
 constringing acids, with chloride, bromide, or phos- 
 phate of iron and lime, or sulphate of iron, sulpho- 
 carbolate of soda, and like compounds, with corres- 
 ponding acidulous fruit juices, and food, as quince, 
 banana, etc., and such astringent, tonic, nutrient 
 drinks as tea with milk and sugar, cold as well as 
 hot tea being very grateful and restorative in diar- 
 rhoea and choleraic affections. Milk with lime water 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 217 
 
 or sulphite of lime, bicarbonate or bisulphite of soda, 
 or peptonized milk and other food, are still more 
 nutrient, emollient, germicidal, and tonic therein. 
 Tea and milk at any temperature, separately or 
 together are specially indicated in intestinal fluxes 
 and cholera, as they are refreshing, nutrient, consti- 
 pating, supporting, promotive of absorption and 
 restitution of the lost fluid, while they may be taken 
 as freely and frequently as desired, though small 
 quantities at a time are preferable, being far more 
 remedial and nourishing than cold water alone, which 
 is so beneficial in choleraic affections, though hot 
 drinks are usually most applicable, particularly in the 
 collapsed conditions. Tea sweetened and without 
 milk, is a useful vehicle for, and adjuvant of plain or 
 aromatic sulphuric, acetic, and other astringent acids, 
 especially applicable in enteric fever, cholera infan- 
 tum, cholera, serous, hemorrhagic, and other pro- 
 fluvia, in which these constringing acids are very 
 efficacious. Also, as indicated, in depression and 
 defluxions, other stimulants and astringents may be 
 added to, or given separately and followed with a 
 draught of tea, as capsicum, krameria, valerian, 
 compt. tinct. of cinchona, sulphuric ether, spirits of 
 camphor, turpentine, etc., to restrain the flow and 
 excite reaction, especially in prostration and collapse 
 from choleraic and other drains. 
 
 XXXII. That, in diarrhoea, cholerine, and choleraic 
 defluxions, the astringent acids and their compounds 
 as plain or aromatic sulphuric acid, phosphoric acid 
 with its compounds of iron and lime, siaiple, aro- 
 matized or camphorated vinegar, or a combination of 
 acetate of lead, opium, camphor, and carbolic acid in 
 pill by the stomach, and plumbi acetas with opium in 
 
218 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 suppository by the rectum, in doses before stated, 
 with corresponding antalkaline, antizymotic, cons- 
 tringing acidulous drinks, remedies, and regimen 
 elsewhere specified are in general very efficient in 
 correcting the systemic and gastro-intestinal disorder 
 and arresting the profluvia. 
 
 XXXIII. That, in the depression, collapse, and 
 typhoid condition of enteric fever, cholera, and all 
 other diseases, the oil of turpentine by free inhalation 
 as well as by the mouth and rectum, and externally, 
 is powerfully stimulant in exciting reaction and 
 restoration. Nitrous oxide is a still more potent 
 stimulant, revivifier, and tonic, and will doubtless 
 excite reaction as promptly in cholera as in other 
 asphyxiated and collapsed conditions, as well as 
 counteract the disease in general. Oxygen and peroxide 
 of hydrogen are also applicable for the same purpose, 
 but are not so stimulant as nitrous oxide, which is a 
 superior exhilarant, invigorant, and restorative that 
 will no doubt prove most efficacious in cholera as in 
 other adynamic disorders. Hypodermic injections of 
 camphorated ether, strychnia, and other reactives, with 
 sub-cutaneous or intravenous injections of artificial 
 serum, and transfusion of blood, are valuable restora- 
 tives. Warm clothing, and stimulant applications to the 
 surface of turpentine, allium, capsicum, heat, and 
 other exciting agents are also beneficial. 
 
 XXXIV. That, in general, in all zymotic, septic, 
 infectious, febrile, mephitic, and cognate diseases, 
 with the internal medication external application 
 of acidulous and disinfecting agents are also important, 
 as nitro-hydrochloric, muriatic, carbolic, salicylic, 
 and other acids, or vinegar, with chlorine water, 
 chlorinated soda, etc., properly diluted, and applied 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 219 
 
 to the surface, are very useful in malignant and con- 
 tagious fevers, malarial, infectious, and mephitic con- 
 ditions, varying according to the special type of the 
 disease, as chlorine water, disinfecting baths, or solu- 
 tions of chlorinated soda and lime, sulphurous or 
 carbolic acid, or sulphocarbolate of soda, vinegar, etc., 
 in small-pox, scarlatina, and other exanthemata, while 
 the nitric, hydrochloric, nitro-muriatic, and cognate 
 acids are better in bilious, typhus, yellow, and other 
 fevers and mephitic states, applied either in general 
 bathing, foot or sponge baths, simple lavements, or 
 stronger direct applications, according to the character 
 of the disease, and emergency of treatment; such 
 agents as oil of turpentine, capsicum, allium, mustard, 
 and like excitants with heat particularly, being more 
 applicable in cholera and similar adynamic conditions. 
 XXXV. That, matter, force, and natural law, are 
 the same always and forever, and life and disease, like 
 fire, are dependent upon definite primal conditions, and 
 originate spontaneously at all times and places alike 
 whenever the essential factors or concurring circum- 
 stances are present. Hence, the most malignant and 
 contagious, as well as the less infectious, with all 
 innocuous diseases, originate de novo at any time, 
 anywhere, whenever the pathogenic factors are favor- 
 able for their development, which are dependent upon 
 special conditions peculiar to each disease, and not 
 upon time or place, and will thus originate sponta- 
 neously at any time, anywhere, whenever the necessary 
 morbific elements or conditions are sufficiently active, 
 the specific nature of which it is the duty and should 
 be the object of scientists to discover, avert, neutral- 
 ize, decompose and destroy. 
 
220 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 XXXYI. That, contagious with non-infectious 
 diseases are primarily of a chemico-organic and 
 bio-dynamic, rather than microzymic origin, micro- 
 organisms or the so-called germs being concomitants 
 and sequential, or of secondary development, their 
 evolution and vigor being dependent upon an ammo- 
 niacal, corrupt, and degenerate state of the fluids and 
 solids of the vital economy, carbonic acid, water, and 
 ammonia, being the primal essentials for their origin, 
 development, and activity, filth, and decomposing 
 organic matter or putrefaction, breeding them as well 
 as engendering contagia, ptomaines, with other toxic 
 agents, and giving out septic poisons and mephitic 
 miasms within, as well as without the living organism. 
 
 XXXVII. That, as Ammonia dissolves and decom- 
 poses the corpuscles of the blood and plastic compo- 
 nents of the vital tissues, induces a state of superalka- 
 laemia, toxaemia, septicaemia and corruption, and 
 engenders micro-organisms with various poisonous 
 and infectious principles within the living economy, 
 it is the basic pathogenic material and morbific factor 
 in causing scorbutic, necraemic, zymotic, septic, con- 
 tagious, pestilential, mephitic, colliquative, and allied 
 diseases, and that by its prevention, subversion, 
 neutralization, removal, or destruction, the primal 
 source of these toxic, infectious, and morbific agents, 
 maladies, and microzymes, is overcome, and the whole 
 train of pestiferous sequelae counteracted and destroyed, 
 which can be most effectually accomplished by the 
 acid antalkaline, antiscorbutic, antizymotic, antiseptic, 
 disinfectant, depurant, resolvent, stimulant, tonic, and 
 sanative medication and alimentation previously 
 specified. 
 
DIPHTHERIA, TYPHOID, AKD ALLIED DISEASES. 221 
 
 XXXVIII. That for the most perfect protection 
 against disease of all kinds, whether casual, endemic, 
 epidemic, infectious, contagious, or innocuous, besides 
 the purification of surroundings, and avoidance of 
 pernicious ingesta, particularly of those baneful 
 agents — tobacco and alcohol, with vicious habits and 
 practices, efficient means should be adopted to insure 
 personal cleanliness, purity, and healthful vigor of the 
 whole system, as essential to guard against the spon- 
 taneous origin, as well as acquisition and communica- 
 tion of contagious, with the development of all other 
 diseases. This personal sanitation should be compulsory 
 wherever possible, as well as voluntary, so as to 
 disinfect, depurate, and purify every molecule, cell, 
 part and particle of the entire economy, interior and 
 exterior, the mere purification of the surface of the 
 body being as insufficient as the cleansing of the outside 
 of a fount of corruption steadily generating within, 
 and sending forth through every pore pestiferous 
 poison. So likewise, the living organism engenders 
 and exhales poisonous and morbific effluvia, that 
 necessitates its constant depuration within, throughout, 
 and from the entire system, to prevent the development 
 or retention, and destroy ab initio the internal produc- 
 tion of toxic, infectious, and mephitic matter, which 
 uncontrolled is apt to prove a bodily source and fons 
 et origo of corruption, disease, pestilence, and death 
 to the individual and community. 
 
 XXXIX. That, in quarantine, barracks, prisons, 
 hospitals, and elsewhere, wherever authority prevails, 
 this personal disinfection and purification of the blood 
 and body or entire vital economy inside and outside, 
 should be enforced at all times as well as during 
 epidemics, exposure, and -special periods of danger, 
 
222 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 particularly of filthy people and those coming from 
 infected places, or exposed to extraneous contagion, 
 by this acid antalkaline, disinfectant, antiseptic, anti- 
 zymotic, and corroborant regimen and medication, as 
 the most positive safeguard in general against con- 
 tagious and pestilential, with ordinary diseases. But 
 for the greatest success in this bodily purification and 
 prophylaxis against disease, special adaptation of the 
 various disinfecting and sanitary agents, especially of 
 aliment, must be made according to the particular 
 type and tendency of the infection or epidemic, with 
 personal peculiarities and conditions, in unison with 
 the varied character, tendency, and complication of 
 these diverse maladies, which though depending upon 
 the same basic superalkaline dyscrasia, yet need varied 
 special acidulous, antalkaline, antitoxic, neutralizing, 
 disinfectant, depurative, remedial, and dietetic treat- 
 ment as before specified. 
 
 XL. That, as most essential to insure the greatest 
 vigor, purification and protection of the vital economy 
 from impurity, contagia and disease of all kinds, 
 with other essentia of alimentation, there must be 
 perfect purity of the inspired air, the atmosphere being 
 the great reservoir of the supreme vitalizer, invigor- 
 ant, disinfectant, tonic, and restorative — oxygen, that 
 constantly penetrates, enlivens, transforms, and 
 animates, as well as disintegrates and depurates, every 
 blood-corpuscle, cell, and fibre of the living organism, 
 any interference with this primal process of aeration, 
 necessarily proportionately induces asphyxia, toxico- 
 sis, disease, decline, and death. Hence, as indispens- 
 able for the preservation and restoration of health, the 
 use of, or exposure to, all noxious agents that pollute 
 the atmosphere, or malaria, in every form, must be 
 carefully avoided, particularly the poisonous vapor 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 223 
 
 and smoke of tobacco, obnoxious at all times and 
 especially dangerous during epidemics of diphtheria, 
 cholera, typhus, yellow fever, typhoid and cognate 
 diseases, even to those accustomed to it, and so much 
 the more to the many unaccustomed and supersuscep- 
 tible to its noxious effects. What folly it is then to 
 prate about the danger and ill effects of malaria, with 
 the necessity for ventilation, pure air and cleanliness, 
 while befouling and permitting the atmosphere almost 
 everywhere to be corrupted by this pernicious mias- 
 matic tobacco smoke that poisons the blood and bodies, 
 and saps the vital power of all who inhale it. What can 
 be expected of the ignorant masses with regard to sani- 
 tation in this respect, when even their sanitary 
 guardians and the professed teachers of hygiene (?) 
 themselves thus actively engender this poisonous 
 miasm and pollute the air with this potent nicotian 
 enemy of health and life ? Well may we parody the 
 despairing cry of the perishing mariner on the sea, of 
 " Water, water everywhere, but none to drink," by the 
 corresponding one of Air, air everywhere, but none to 
 breathe, uncontaminated with the noxious tobacco 
 miasm, though the latter cannot be rejected like the 
 former, but must perforce be inhaled nolens volens 
 with all its pestiferous adulterants, thus coercively 
 taking with it into the lungs, blood, and system, this 
 baneful compound miasm of degradation, disease, 
 pestilence, and death to the innocent as well as guilty. 
 To parody Goldsmith, it may be truly said 
 
 111 fares that land to nicotian miasm a prey, 
 Where tobacco blights and human beings decay. 
 
 Hence avoidance of all deleterious agents and habits, 
 
 with purification of the air, purification of the body in 
 
 its entirety— internal and external, are basic essentia of 
 
 health and life, while common sense, decency, equity, 
 
224 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 
 
 and self-preservation, instigate to the suppression of 
 this poisonous artificial tobacco, with all natural 
 miasmata, as far better than trying to subvert their 
 evil effects, which, with the consequent waste of time, 
 means, and vital energy, degeneration, suffering, and 
 destruction of health and life, would be entirely 
 averted if the former were duly obviated. 
 
 XLL That, finally, as the facts and principles herein 
 presented, are based upon, and in direct accord with, 
 chemistry, physiology, aetiology, pathology, hygiene 
 and therapeutics, they are believed to be correct in 
 science and truth, and if properly applied cannot fail 
 to largely prevent, subvert, resolve and cure these 
 formidable pestilential, zymotic, septic, infectious, 
 contagious, malarial, mephitic, putrescent, and colli- 
 quative maladies, with the minor scorbutic, necrsemic, 
 and adynamic disorders and complications, that pre- 
 vail so extensively throughout the world and afflict 
 and destroy mankind with the lower forms of life, 
 and consequently, save from unnecessary sickness, 
 suffering, and premature death, with all their con- 
 comitant misery, thousands of human beings and 
 inferior animals — for they are interminably interlinked, 
 who would otherwise suffer and perish therefrom. 
 Therefore, to this desirable end, it is hoped that these 
 views will be subjected to the severest practical test 
 in the prevention and treatment of all such diseases, 
 in quarantine, hospitals, and elsewhere, in public and 
 private — human and veterinary — practice, to most 
 fully determine their true value and extend their 
 benefits as widely as possible to both mankind and 
 the inferior creatures, for ammonaemia and superalka- 
 linity with their toxemic, contagious, colliquative, 
 and pestilential concomitants occur, and acid, antal- 
 kaline, antiscorbutic, antiseptic, and disinfectant 
 
DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 225 
 
 measures are required in all for the preservation and 
 restoration of health. This is exemplified in the 
 varied forms and degrees of typhoid, necraemic, 
 toxsemic, contagious, colliquative, pestilential, gan- 
 grenous, putrescent, and allied diseases — constitu- 
 tional and local, both in man and the lower organisms, 
 all of which are of the same general nature, though 
 variously manifested and complicated by t special 
 modifying circumstances and specific contagia, yet 
 originate from, and dependent upon, the same general 
 basic ammoniacal or superalkaline condition, and 
 scorbutic, septic, and corrupt dyscrasia, with the same 
 general process of disorganization of the blood and 
 body decomposition and rottenness, with their con- 
 comitant mephites, poisons, infection, and micro- 
 organisms, and which, from their general similitude 
 and predominant symptoms in some of the more 
 malignant varieties, have been aptly termed the 
 plague, malaria, black jaundice, black vomit, black 
 tongue, black measles, black small-pox, black disease, 
 black death, cholera, and otherwise designated as 
 indicative of a like general typhohsemia, disorganiza- 
 tion, and dissolution, from one common solvent 
 decomposing alkaline agent — Ammonia, of intrinsic 
 and extraneous origin, superinduced by and compli- 
 cated with, various systemic and adventitious causes 
 previously indicated, with often lack of fresh, succu- 
 lent, acidulous, antalkaline, antiscorbutic, antiseptic, 
 counteracting food, so common with mankind and the 
 inferior creatures, as they are closely affiliated patho- 
 logically and therapeutically, as well as physiologically 
 and hygienically, the general laws of life, health, 
 disease, and death, being the same throughout the 
 entire animated creation.