Selected writings of A. Jackson Howe.
Not often did Professor Howe step over into the field of the general practitioner of medicine in his editorials. The article selected is a fair sample of the way he noted diagnoses and the manner of treatment employed by him. His criticisms on the use of quinine are in accord with the views of most Eclectics since his day. In fact, quinine has oftener proved damaging than beneficial in la grippe, and particularly where head-pains were among the most prominent symptoms. Only when specifically indicated should quinine or any other remedy find a place in the treatment of this treacherous malady. Periodicity, soft pulse, moist skin and tongue, and lack of nervous irritation are the direct indications for quinine.—Ed. Gleaner.
LA GRIPPE.—Two years ago this country was the victim of a specific respiratory catarrh, which, having no nosological name, was known by the French term La Grippe. The epidemic spores impressed the respiratory organs of almost everybody. The morbid onset was sudden, and generally profound. There would be sneezing, headache, chilliness, coughing, and great mental depression. After about ten days' duration the symptoms became milder in type, and a state of convalescence was observable. The average case produced great discomfort, but did not seem to be dangerous to life. The aged and the feeble succumbed to severe attacks, or became the victims of albuminuria. While very few died of the disease, the death-rate was decidedly increased by the presence of the specific influenza. The morbid action aggravated other diseased conditions.
Without warning the same morbid influence returned, and in as intense a form as at the first visitation. The second invasion as often hit those who suffered before as the then exempt. The disease spread rapidly over the country, manifesting its presence over wide expanses of country on the same day. Watery eyes were to be seen everywhere, and coughs and sneezes were everywhere heard. The fever was hard to bear, as well as muscular pains. The pituitary discharge was profuse, compelling the victim to use a handkerchief almost constantly. Frontal headache was a sure complication. The function of olfaction was totally suppressed for several days, and the appetite was poor. The temperature of the body sometimes reached 103 or 104°, yet only at times. The usual temperature was from 100 to 103°. Not infrequently pneumonia was a sequence or complication, and the heat attained 104 or 105°. Such a high range was dangerous; and the patient was lestless. In some instances the bowels were disturbed, nausea and diarrhoea supervening. Paroxysms of coughing were attended with distress, the tough mucus refusing to leave the air-passages. The cough was largely bronchial. In the feeble there would be sweating turns, which seemed to exhaust the patient.
The treatment varied according to the prescribed fancy. No two physicians treated cases alike. In fact each practitioner experimented largely. Quinine was the sheet-anchor of the non-professional. Women shopping would stop at the drugstore and swallow quinine in capsules. But, so far as my observations extended, quinine proved no more of a specific than antipyrine, or any other of the antithermics. I thought that cold sage-tea benefited more than any other drug. I pushed pilocarpine for several days, yet could not say with any better success than when I prescribed phenacetine. Veratrum behaved well, and I gave it to more patients than I did any other remedy. I put dynamyne upon the head when it ached, and upon the chest when pleuritic pains existed. I prescribed chloralamide to those who could not sleep; and found that the agent produced its usual effects. Lemon juice was agreeable;
and hot lemonade became popular among the unprofessional. In la grippe there was an excellent chance to prescribe for symptoms to the neglect of nosological names. The Homoeopathist found indications for aconite, as he does in most febrile states; but as the disease was largely of the respiratory organs, veratrum better filled the indications.— HOWE, Eclectic Medical Journal, 1893.