“Diseases” Due to Physical Agents and Intoxications

ANAPHYLAXIS

Definition: This is the highbrow term for serum poisoning or protein poisoning. Any protein introduced into the body through other channels than the digestive tract is a rank poison. All serums and vaccines are foreign proteins and therefore poisonous. Anaphylaxis follows every use of all serums.

Symptoms: These may be mild or severe. In its mildest form there may be only restlessness, feverishness and aching in the limbs, or there may be a mild urticarial rash.
Various skin manifestations follow the use of serums. Although these are chiefly urticarial (nettle rash) in character, they may resemble almost any form of skin rash. Often successive crops of eruptions will follow each other, these usually polymorphic (presenting many or different forms) in character. The skin eruptions, and all other symptoms are in direct proportion to the amount of serum injected. Sometimes the eruptions are large, like boils. Serum injections produce malaise (uneasiness and discomfort), fever, skin eruptions, enlargement of lymph glands (glandular inflammation), leucopenia (a diminution of the number of white blood cells), swelling, pain, fever, and stiffness in the joints, edema (accumulation of serum in the cellular tissues), albumenuria, (albumen in the urine), generalized itching, convulsions followed by opisthonosis (a spasmodic rigidity of the body in which the trunk is thrown backward and arched upward), cyanosis (blueness due to circulatory impairment), dyspnea (difficult breathing), complete respiratory failure, nausea, vomiting, coughing, choking, fainting, dilation of the pupils, paralysis, insanity, inflammation of the heart, frequently permanent impairment of the heart, collapse, death. Death sometimes occurs instantaneously, at other times, a few minutes to a few hours to a few days after inoculation.
Large vesicles filled with clear liquid may follow intense inflammations over and around the sight of injection. “Alarming collapse” and immediate death are not infrequent. Local edema and, eventually, local necrosis sometimes occur. In animals, where these things have been exhaustively studied, the blood is greatly altered. The blood loses much of its coagulability, sometimes almost all power of coagulation being lost. There is a fall in blood pressure, anemia of the brain, involuntary voiding of urine, and feces, great muscular weakness, and a diminution of white cells and polynuclear cells in the blood. Hemorrhages occur under the membranes of the stomach, duodenum, colon and bladder. Inflammation of the intestinal mucous membrane, with excretion into the intestine of much mucous mixed with blood, is seen in dogs. Distention of the lungs, due to closing of the bronchial tubes and the subsequent efforts to breathe, occurs in some animals. In others, the trouble develops in the liver or heart. These things are all evidences of a profound injury to the organs and tissues of the body, the injuries to the most vital organs only having been studied.

Etiology: Serum sickness, serum poisoning, anaphylactic shock, anaphylactic reaction, anaphylaxis, protein-poisoning — these are all terms for the same thing — follows the use of serums and vaccines given to prevent or “cure” “disease.” Mild forms of protein poisoning are seen in individuals who are “sensitive” (allergic) to certain proteins. One dose of serum is often fatal. One dose renders the victim more “sensitive” to subsequent doses. All serum treatment is criminal as well as futile.

Prognosis: Recovery is the rule, though this may require considerable time. Many are left with permanent damages.

Care of the Patient: The best care is prevention. The vaccine and serum practice should be destroyed forever.
Otherwise care for the victim of this fanaticism and commercialism as you would any other acute poisoning — fasting, rest, warmth — until all acute symptoms have subsided.

ARSENICAL POISONING

Definition: Acute or chronic poisoning by arsenic.

Symptoms: Nausea, vomiting, diarrhea, skin eruptions, or pigmentations, dry throat, edema of the eyelids, sometimes coryza, falling of the hair, paralysis of the arms and legs with ataxia, atrophy and numbness, but little pain. The legs are most affected, causing steppage gait. Optic atrophy with blindness may also develop. Notice how much this condition resembles the descriptions given for “syphilis”, of which arsenic is the most approved “remedy.”

Etiology: Acute poisoning is caused by ingestion of paris green or rat or insect poisoning, usually with suicidal intent. Chronic poisoning may result from inhalation of arsenic from dyes in wall-paper, carpets, etc., or by ingestion by mouth in handling dyed paper, artificial flowers, etc., by eating sprayed fruits and vegetables, or, and most commonly, by taking repeated doses of the poison as medicine, as in so-called “syphilis.”

Care of the Patient: First get rid of the source of poisoning. Give a fast for elimination of the drug; or a fruit and vegetable diet will do the same. Paralysis should be cared for as described in Vol. IV of this series.

IVY POISONING

Definition: A dermatitis produced by the sap of poison ivy, poison oak and various other species of rhus.

Symptoms: Intense itching and the formation of watery blisters (blebs) at the seat of poisoning are the chief symptoms.

Etiology: The dermatitis is produced by absorption into the skin of the poisonous sap of the plant. Some individuals are peculiarly susceptible to the poisoning while others are very resistant. Perhaps many things help to constitute resistance or the lack of it — texture of the skin, much or little toxemia and the state of nutrition are perhaps involved.
Recently efforts have been made to show that people “allergic” to ivy poisoning are suffering from vitamin C deficiency. Since, however, vitamin C deficiency may mean many things, this is hardly an explanation of susceptibility. It is claimed that a diet rich in citrus fruits and their juices prevent skin troubles of an “allergic nature.” This is in line with my own experience: the only thing I have found that appears to hasten recovery is a diet of orange juice.

Prognosis: Recovery occurs in all cases.

Care of the Patient: Cleanliness, scratching; and a diet of orange juice are all that are required.

LEAD POISONING

Definition: Plumbism or saturnism, as this is called, is poisoning by absorption of lead. It may be either acute or chronic.

Symptoms: Acute: In the acute form the symptoms — rapidly progressing anemia, with acute neuritis, epilepsy, convulsions, or delirium or with severe gastro-intestinal symptoms — develop rapidly from continued contact with lead. Painter’s colic is a familiar example of the acute type.

Chronic: In chronic cases the chief symptoms are anemia, a blue-black line of lead sulphide (lead line) in the gums near the teeth; colic preceded and accompanied by obstinate constipation and resembling severe intestinal colic, often vomiting; cerebral symptoms, such as hysteria, convulsions, delirium with hallucinations, epilepsy, and optic neuritis; paralysis which may involve almost any part of the body; and, very commonly hardening of the arteries, chronic inflammation of the kidneys and gout.

Etiology: Lead may be swallowed in food and drink or absorbed through the skin and lungs. Lead smelters and grinders, painters, glazers, and plumbers who fail to wash their hands before eating may take it in with their food. It is ingested in drinking water, cider, etc., in new lead pipes, or absorbed from hair dyes and cosmetics.

Care of the Patient: It is first essential to remove the patient from contact with his or her source of poisoning. Thereafter, until the most pronounced symptoms have subsided, a diet of lemon juice or lemon juice and orange juice should be fed. A fruit and vegetable diet and exercise are essential after the lead has been eliminated.

DRUG ADDICTIONS

Below we shall consider the most common drug addictions in alphabetical order. The reader should understand that, though we have not considered it, caffeinism, as represented in coffee, and tea using and in the use of the Cola drinks, is as much a drug addiction as alcoholism or morphinism.

ALCOHOLISM (Inebriety)

Definition: Alcoholic poisoning may be either acute or chronic.

Symptoms: Acute alcoholic poisoning is due to taking large quantities of alcohol. Its symptoms are flushing of the face, mental excitement, increased pulse and respiration; then incoherent speech, delirium, dilated pupils, loss of muscular coordination, subnormal temperature, vomiting, and, finally, stupor and coma. Not infrequently the coma is interrupted by convulsive seizures. In most cases, if the dose has not been too large, recovery follows in a day or two. In some cases death results. After recovery there is usually a lack of appetite for several days.
Chronic alcoholism is characterized by disturbed sleep, mental impairment, fine tremors, redness of the nose, injection of the eyes, and gastro-intestinal catarrh. If long continued the use of alcohol results in degenerative and cirrhotic (hardening) changes in the heart, blood-vessels, liver, kidneys, brain and cord.
A common result of chronic alcoholism is delirium tremens. This is usually excited by temporary use of unaccustomed amounts of alcohol, by injury or by some “intercurrent disease,” especially pneumonia. It is characterized by great mental excitement, insomnia, incoherent speech, tremors, disordered intellect, and terrifying hallucinations of sight or hearing, the proverbial “snakes in the boots” and “pink elephants on the wall.” There are rapid, feeble pulse, anorexia, constipation, and slight fever. In “favorable” cases, convalescence begins in a few days, but in many cases symptoms of the “typhoid state” develop and the patient sinks into a semi-coma lasting several days or even weeks (“Wet brain”).

Sequelae: Most prominent among the many sequels of chronic alcoholism are pneumonia, chronic meningitis, cirrhosis of the liver, arteriosclerosis, multiple neuritis, amblyopia, (dimness of vision), epilepsy, dementia, and cancer of the throat or stomach.

Etiology: Ignorance, weakness, low mentality, and the use of alcohol as medicine are the chief causes of the alcohol habit. Its use is a “social” habit and few seem able to resist the “pull” of the crowd.
Prognosis: Dr. Cabot says, “it is not much torture to stop alcoholism, and when we once have stopped, it is comparatively easy to go back to it.” Perhaps the influence of friends, or the nagging of a wife, or the weakness that makes us afraid to face troubles plunges one back into the foul embrace of this product of fermentation.

CHRONIC OPIUM POISONING (Morphinomania)

Definition: Chronic morphinism is poisoning due to the habitual use of opium and its derivatives — morphine, heroin.

Symptoms: Disturbed sleep, mental depression, irritability, tremors, a characteristic propensity for lying and deceiving, loss of flesh and strength, anemia a peculiar sallow complexion, anorexia, deranged digestion, tendency to diarrhea, and an “irresistible craving” for the drug, are the chief symptoms of the habitual use of opium. The “craving” is probably no more than a desire to experience relief from the suffering felt when the nerves are no longer under its narcotic influence.

Etiology: Dr. Alexander Lambert states in Osler’s Modern Medicine, that eighty per cent of the people of this country who have acquired the morphine habit have acquired it from doctors, that is, because of drugs given them by physicians. Dr. Richard Cabot, says in his Handbook of Medicine that “a considerable portion of the remaining twenty per cent are doctors themselves. The profession which figures most numerously in the list of occupations of those who get morphinism is the medical profession.”
Many hundreds of drug addicts can trace their addiction to the use of nostrums to relieve them of headache or “nervousness” or sleeplessness. Morphine given for some time after, an operation may build addiction. All others who foster the drug habit are bounded by state and federal authorities and, when caught, are severely punished. Why make an exception of the physician?

Prognosis: Doctor Cabot says, “with morphine it is torture to stop and comparatively easy to stay ‘stopped’.” In truth only those of sound stamina of character and an interest in life to hold them away from the drug, stay stopped. Prostitutes, criminals and degenerates commonly return to the drug.

CHLORALISM

Definition: Chloralism is the habitual use of the hypnotic and anodyne, chloral: also its poisonous effects.

Symptoms: Following slight primary “exhilaration,” mental and physical depression, skin eruptions, bad breath, spongy gums, poor appetite, indigestion, malnutrition, permanent dilatation of the blood-vessels in the skin, intermittent pulse, blunting of the higher mental qualities, restlessness, sleeplessness, irritability, sensory and motor disturbances, and sometimes, dementia, develop. Habit seems to establish little tolerance for the poison.

Etiology: The choral habit grows out of the use of the drug to relieve pain or to overcome sleeplessness. Note that its ultimate effect is to produce sleeplessness.

COCAINISM

Definition: This is the morbid results of the habitual use of cocaine. The habit is comparatively rare, few cases existing except those complicating the ‘morphine and alcohol habits. The habit is seen chiefly in those of low grade mentality — prostitutes and jailbird types are most frequent users. It is taken generally as snuff or as a nasal spray; sometimes hypodermically. It is commonly called “snow” and its users, “snow birds.”
Dr. Cabot says: “One wants to be always on one’s guard against sprays and other throat and nose remedies which relieve very markedly and at once. They generally contain cocaine, and are always dangerous for that reason.”

Symptoms: Large doses occasion great excitement, sometimes convulsions, followed by weakness of respiration and heart action, general prostration, convulsions and coma. The cocaine habit results in emaciation, anemia, digestive disturbances, disordered heart action, physical and mental weakness, nervousness and great depravity.

NICOTINISM

Definition: This is the term applied to nicotine (tobacco) poisoning. It may be both acute or chronic.
No space will be devoted to a description of the symptoms of acute and chronic nicotine poisoning at this place for the reasons that they are very generally known and we have discussed them elsewhere in these volumes, especially in Vol. VI.

Care of the Patient: Curable cases of addiction can get well without dope and they cannot be cured with it. “Curing” dope habits with more dope is a monstrous voodoo program. All poison habits are to be cared for alike. The tea and coffee habit (caffein habit) and all other drug habits hold their victims by the suffering they cause. So long as they are used they continue to cause suffering. Therefore the first thing necessary in all habits is the abrupt and complete withdrawal of the poison. No “tapering off” process will succeed and no success can attend the effort to substitute one poison habit for another.
Dr. Dewey was the first to use fasting in alcoholism. His success is described in his little book on the subject. The fast is equally as effective in nicotinism, morphinism, and all other poison habits. The following from Dr. Weger is to the point:
“Prior to 1923, we had the privilege of supervising the treatment of eight or ten alcohol and drug addicts of the most confirmed type. Food was withheld. The reactions during the first week of fasting were as a rule violent. Hot baths were the only measures used for relaxation. In about one week the mental state cleared sufficiently to permit the patients to realize their condition and cooperate actively thereafter. In four or five weeks they were apparently normal though keenly alive to the ordeal they had just been through. No evil effects ensued and all seemed happy and grateful. The desire for alcohol or drugs did not return and excellent reports of permanency were received from about one-half of these cases several years after treatment. Such permanent cures are the exception rather than the rule in cases treated by gradual withdrawal of the liquor or drug or by substituting palliative drugs during the course of treatment.”

HEAT STROKE

Definition: Called also heat exhaustion, insolation, sunstroke, siriasis, and thermic fever, heat stroke is a profound enervation (shock) due to prolonged exposure to high temperature. Two forms are recognized as follow:

Heat Exhaustion is caused by continued exposure to high temperature, either natural or artificial, while working hard.

Symptoms: These are prostration with cool skin, temperature often subnormal, pulse small and frequent, sometimes restlessness and delirium.

Prognosis: This is usually favorable.

Sunstroke (thermic fever): is caused by severe exertion while exposed directly to the sun or to high temperature.

Symptoms: In severe cases, where exposed to intense heat as in forced marches, the victim falls unconscious and death follows at once, or after a few hours of coma with difficult breathing and heart weakness. In ordinary cases there may be a sudden arrest of perspiration, premonitory headache, dizziness, sometimes nausea and vomiting, colored or indistinct vision, then unconsciousness, which may be temporary or increased to deep coma. The face is flushed, skin dry and hot, pupils temporarily dilated, then usually greatly contracted, muscular relaxation, sometimes muscular spasms or convulsions, temperature rises to 107 to 110 or higher, pulse is frequent and full, respiration is deep and labored, or stertorous.
In fatal cases the coma deepens, the pulse becomes frequent and feeble, respiration rapid, irregular and shallow, or of Cheyne-Stokes type, and death follows in twenty-four to thirty-six hours. In other cases consciousness returns, the temperature falls, pulse and respiration become normal and recovery is complete or with sequelae.

Sequelae: The victim may recover predisposed to subsequent “strokes” or suffer from physical weakness, impaired memory or power of mental concentration, or headache and mental disturbance whenever the weather is warm. Tilden says: “Various disorders may persist after a recovery from heat-stroke; namely, neuralgia, headache, and sometimes strange ideas or notions. These troubles, however, result as much from wrong daily life as from the previous sickness; indeed, such cases can be cured of these relics of former sickness if the patient will follow the proper style of living.

Etiology: It is appropriate to consider the cause of heat-stroke and sunstroke together, for they are practically identical. Lowered vitality, fatigue and alcoholism are important predisposing factors. Excess water drinking and overeating also predispose. The excessive heat exhausts the nervous system and disturbs the heat-regulating centers, or the vasomotor centers of the brain. Certain types, like blondes and red heads offer less resistance to the sun’s rays.
The deaths from heat stroke recorded every summer over most of the country, especially in the cities, occur chiefly among those who are dissipated. It is doubtful if any succumb who are not toxic. In fact heat prostrations are confined almost entirely to those who gormandize in hot weather. Over-eating, eating much sugar and taking considerable quantities of salt and the use of alcohol are man’s greatest enemies in hot weather.
Salt eating causes excessive intake of water and this causes excessive perspiration. Those who eat and drink normally do not perspire excessively. A relaxed and wet surface of the body has indigestion, caused by imprudent eating, behind it.
There is no danger of being overheated or sun struck when eating is what it should be. Nature guides her wild creatures to eat lots of grass, fresh herbs and juicy fruits in summer — man continues to eat concentrated foods. People who overeat on such foods are made very uncomfortable, their bodies are greatly overworked by the excess of food and water, and these are the. ones who meet with prostration and sun stroke.
A normal person will sleep as well in hot weather as in cool. He will not be forced to seek a cool place or have an electric fan stirring the air over his bed. The normal individual will lie down and sleep anywhere. The gourmand — full of food, salt, water, iced-tea — will be so uncomfortable he will not sleep anywhere.
Dry heat is more endurable than moist heat. A humid atmosphere is enervating. Heat strokes are rare in dry climates.
Oswald says: “Sun-strokes can be obviated by a simple and very inexpensive precaution — temporary abstinence from animal food. A refrigerating diet (vegetables, fruit, etc.) counteracts the effect of a high atmospheric temperature, but the caloric influence of meat and fat, combined with solar beat and bodily exertion, overcome the organic power of resistance, the pyretic blood-changes produce congestion of the brain and sometimes instant death. I venture the assertion that in nineteen out of twenty cases of comatose sun-stroke it will be found that the victims were persons who had gone to work in the hot sun after a meal of greasy viands. One to two P.M. is the sun-stroke hour.” — Physical Education, p. 112.

Prognosis: There is a high mortality in extreme cases, especially in alcoholics. Sequelae are common.

Care of the Patient: Dr. Weger says “the few cases of heat exhaustion treated have made quick recoveries after complete rest, average nursing care and restricted diet.” It is our opinion that many of the deaths from heatstroke and sunstroke are due to ice-water bathing, ice-cap to the head, heart “stimulants,” bleeding, ice-water enemas, and other mad-cap endeavors to “sustain” and cure the patient. Rest and reaction are impossible under such treatment. It amounts to treating shock with shock.