Some Cases of Interest and Value

A. C. HEWETT, M. D., CHICAGO, ILLINOIS

Echafolta—Cocain

Nine days since in crossing Randolph Street I fell so suddenly that my head struck the granite pavement with such an impact that the cartilage of my nose was torn from its bony attachments, a gash 3-4 of an inch long was cut to the right cheek bone, and the front and right side of my upper jaw along a line of the roots of the superior teeth was fractured, and my upper lip was cut from inside to the outer skin. I was taken to my office in the Masonic Temple. The blood-flow was staunched, and I was stimulated to a hazy consciousness, with sense sufficient to enable me to adjust and press home the cartilage to the bone, and bite to close contact, the crepitating edges of the broken jaw, and hold them in situ. A good courageous friend brought me seven miles away, from my office to my home and to bed, in which I took a semi-sitting posture to avoid blood pressure to my head.

Pain in the nose, in the jaws and in the caput had become intense; because, and to be rid of it I took echafolta dr. i2, water ozs. iv, mixed. Dose a teaspoonful each 15 minutes for the first hour—then every half hour (two doses) and thence on, a dose every hour, until the pain ceased, and I fell asleep. I also bathed the roof of my mouth, the bridge of my nose, the lip and cheek with a 4 per cent solution of cocain in the above dilution of echafolta, and wet pats of absorbent cotton in it and laid them on the wounds. By the time I had taken the sixth dose pain had ceased and the nervousness abated, and as the time for the seventh dose came I was "drowsing toward sleep."

The next day I took the echafolta in the same way. The third day I took a similar dilution every fourth hour, and thence on till healing was complete. I kept the surface wounds moist with the dilution, but discontinued it internally. Instead I applied to the arch of the mouth a 2 per cent solution of cocain in a mixture of echafolta, oil of cloves, specific cactus grand., each 6 drs., carbolic acid (crystals) grs. 10; glycerine (pure), q. s. to make 1 oz. This latter application held the pain in check in the region of the nose and jaw-fractures except that from actual pressure of my teeth. Of course I could not and cannot yet masticate solid food. No septic symptoms have supervened. The lip and the cut in the cheek healed by first intention. The cheek shows only a red line, and the lip only a little thickening beyond normal.

A dull semi-pain with a suggestion of soreness, pervaded the upper and frontal portions of my head during waking hours till the sixth day.

This, the ninth day, finds me up, dressed and doing; strength nearly normal, my (yet slightly enlarged) nose frontally in line, jaw quiescent, (no biting allowed) but my face! Rainbow hued, and stunning. I'll have bushels of fun tomorrow, weather permitting, going to, at, and returning from my office and business. My years are 80, May prox.

Charcoal in Food Poisoning

I recently received a "hurry call" to attend Mrs. H.—"very sick." The patient, a woman in good circumstances aged about fifty years, was found to be in fact very ill; pale-gray in the face, forehead and limbs covered with a clammy perspiration, pulse so small and rapid that counting was next to impossible, suffering severe gastric and abdominal pain, "had been vomiting copiously till nothing but a stringy mucus could be ejected." Asked what she had eaten; I was told coffee, cross buns and canned boneless chicken; I at once diagnosed ptomain toxins, and gave charcoal, prepared as per the following Rx:

Calcined willow charcoal and wheaten flour two heaping tablespoonfuls each; common table salt a level teaspoonful; warm water four ounces. The charcoal, flour and salt were first well mixed. Water was added little by little for convenience and speedy result.

Dosage, a brimming tablespoonful every ten minutes regardless of recurrent vomitings. The first dose was partly ejected. The second retained in spite of attempts to vomit. After taking the third spoonful, pain and nausea gradually subsided. Of course a hot water bag and bottles were put to her feet, warmed flannels wrapped around her knees and a hot water bottle placed in her hands, which she smilingly and soon, nested upon her stomach.

Cardiac action called for attention and I placed atropin and strophanthin a sixtieth of a grain each, well back upon her tongue, the bitter and stimuli of which soon induced increased surface capillary and peripheral nerve action and a quiet "beauty nap." I directed continuance of hourly doses of the charcoal mixture till all should be taken. An uneventful and rapid recovery ensued.

Not long after I attended another patient similarly but not so severely affected. She was much younger; had "lunched," taking coffee, doughnuts and canned salmon. The charcoal mixture (sans the cardiac remedies) and applied heat, brought similar result, and the admonition to use charcoal in food poisoning.

La Grippe

Our apartments janitor, his wife, and a daughter of about eight years, and a sister of eighteen live in the building. They are typical Georgia colored persons but educated (?).

About two months since, near six p. m. I was called to see the wife "She berry sick." (An argument could be made here that physicians should not be allowed to try to write in fake dialect—although this is written by the same tough 80-year-old coot that set his own jaw and nose, so perhaps a little leeway is warranted—MM) She was about 30 years old. I found her abed, in a high fever, pulse above 100, temperature 103 and nervously on the verge of clonic spasms. She was in a mild delirium though her attention could be arrested and briefly held. Her head was thrown as far back as the neck would flex and she seemed intent on burrowing a hole through her pillows. Her husband said, "Docta! She has 'Minin Gesus' jus' a yea befo! We fraid she done got it egin."

Without waiting to give a name, I saw a condition. I ordered hot pepper-water foot bath, and played nurse in making a singing sinapism, broad and long, of mustard moistened with tabasco sauce, the condiment of which the Adirondack hunter said "small bore, well loaded, shoots true;" and applied to the back of the neck and over the upper spine. I made a dilution as per Rx

Mix. Sig.:

Teaspoonful every 15 minutes, four doses, the same every 30 minutes, two doses; and thence on a teaspoonful every hour of waking time.

Late in the evening I called again. I was told "De musted bun so, hit was done took oph!" The spasmodic symptoms had entirely abated. Moaning and "pillow drilling." had ceased and she seemed quietly, tiredly sleepy.

I saw her next morning about 7 o'clock, she said, "I slep mos ob de night. Doctah, you cued me." I replied "By no means are you cured. You will not get out of bed today or tomorrow and you are to take the medicine I leave (Rx above) just as I directed at first, or I'll do nothing more for you." I also directed the three others to take a teaspoonful every four hours of day time. "We will," they chorused. As I left the husband said; "Doctah, I tie her in baid if she doan min you."

That ended, and prevented (apparently) "La Grippe," "Influenza" or whatever name is given, in "Our Africa;" notwithstanding the wife and sister have been efficiently active in clearing walks of drifts and loads of snow, slush and sleet, long stretches of which are under the care of the "master of shovel and broom."

Eucalyptol—Prophylaxis

Mr. B. was "Our Next-door Neighbor." A wife and three children were his. The youngest near five years of age became ill and I was asked to "see" and "advise." I, at once diagnosed diphtheria, and said, "Send at once for your physician." They did so. Within an hour the doctor came. He was a man worthy of trust and bore an excellent reputation.

The little one grew steadily worse, and on the third day died. The doctor certified, "Angina Maligna." The home had been "placarded" and not a neighbor beside my wife and myself would dare to go and help.

The doctor had from his first visit pronounced the case fatal. The little one was its "Father's Darling" and a sufferer from the first; and the father was reckless in his disregard of caution against contagion. When death was imminent, he repeatedly pressed his lips against her foam covered ones, till at the last I dragged him away from the bed by force and into another room.

Though careless of his safety, he yet willingly took thrice daily five drops of eucalyptol (not the turpentine of the wood Eucalyptus Globulus) but the volatile oil of the leaf, of which I took, and gave to him, to my wife, Mrs. B. and the two other children; continuing the prophylactic treatment for nearly a week.

The doctor named it a "sporadic" invasion. No other cases following it, and no exposure traced. There was no "fumigation" of the placarded house, and I took no other cautionary measures.

Rhus Tox Poisoning—Echafolta

Related entry: ElTh-Jan1908 (quinin) - ElTh-Jan1908 (ammonium chloride) - ElTh-Feb1908 (quinin) - ElTh-Mar1908 (nitrous ether) - ElTh-Apr1908 (echafolta)
Other tomes: Ellingwood - King's

"Trixy," a much petted fox terrier owned and loved by the childless wife of Mr. D., at whose home my family and myself were boarding, was brought to me with nose, lips and eyelids red, swollen and evidently painful in the extreme. The pet was a sorry looking canine and I took pity on the "doggie", got my echafolta bottle, diluted some of the specific, one part to four of water, and told the madame to sponge the swollen face two or three times during the day. I soon left for my office and did not see "Trixy" till the next morning.

On going next day to breakfast, a young lady boarder said to me "Dr., I wish you would look at Trixy." I answered "I prescribed for him yesterday and if madame washed his face as I bade her he should be well or nearly so." She blushing flamingly, replied, "Yes, I know. His face is well but—but you must look—look him all over" and rushed to the dining room. Puzzled I went on the porch and called the patient; he came at my call and I "looked him over." The dog had been poison-ivied "all over" where the hair was short. His scrotum and sheath were fearfully swollen.

A very large bed of ivy, one of the most virulently toxic of the more than a hundred species known, was growing lush green and tender just back of Mr. D.'s home. Trixy had evidently been there. I prepared another dilution and told Mr. D. that an "all over" application should be made of the one to four mixture and also ordered that one dram of echafolta to four ounces of water be shut in with the pet so that he should have it as his only drink for the next two days. The second day thereafter the swelling had entirely abated, the redness faded and he was pronounced cured, save that from nose, lips, eyelids and "all over" there supervened a complete desquamation of the poisoned cutis.

This is the only case of quadruped poisoning that ever came under my observation. All "bipeds" that have come to me for treatment for "rhus poisoning" have responded to echafolta treatment even sooner than did Trixy. One prescription has been sufficient to cure in every case I can remember. I apply the echafolta full strength to the irritated part in child or adult, as long and as often as needful to subdue and hold the burning and smarting in abeyance. At the same time I give internally a dilution: echafolta ½ drs/ to 8 ozs. of water for a child, a teaspoonful four times daily for a week or more. For an adult the same internally echafolta 2 drs., water 4 drs., same dosage and time.

So far as I have known, each person (and the brute) so treated, have been immune from rhus poisoning thereafter.

Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.