History of medical practice in Illinois - Bushnell Historical Society

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242 History of Medical Practice in Illinoisled to a fatal outcome. Gangrene of the extremities was rarely encountered,but suppurative cervical adenitis was a common complication. Thus,patients who survived scarlet fever were sometimes left with damaged heartsor kidneys and not infrequently with defective hearing.Treatment of scarlet fever before 1900 was symptomatic. The necessityfor isolation or quarantine was recognized. Although terminal fumigationof the premises was required, there was no uniform period for such regulations.The time usually varied from 4 to 6 weeks in Illinois. When a placardwas posted on a home to indicate quarantine, it was one of the rules inChicago, even after 1900, that desquamation must be complete before thatwarning sign could be removed. Many believed that scarlet fever was mostcontagious during the peeling stage and failed to recognize that the chiefreservoirs of infection were the nose and throat.After isolation or quarantine procedures for scarlet fever, diet receivedmost consideration. Often the first question asked by the mother of apatient was: "What can I give him to eat?" Almost invariably the physician'sreply would be: "Nothing but milk." This advice was in keeping withOsier's teaching before 1900, the purpose of the diet being to lessen thelikelihood of a complicating nephritis, which was so generally feared. Inreality, it was not a prophylactic for any such purpose, as was proved someyears later.Prior to 1870, fatality rates for scarlet fever were often 10 per cent orhigher, but since that year there has been a progressive decline. 2 Thereseems to be no doubt that nutritional gains in the general population,pasteurization of milk, advancement of sanitary measures and progress inpreventive medicine all have played an important part in the suppressionof scarlet fever and other streptococcic infections. Only the future can tellwhether there will be another wave of virulent streptococci to account fora malignant type of scarlet fever, such as has occurred in the past. A greatperiod of depression with less nourishing food, lower standards of sanitationand a marked lowering of the scale of living in general could contributeto such a misfortune.While the first epidemic of poliomyelitis was reported in this country inLouisiana in 1843, the disease does not seem to have occurred on a largescale in Illinois prior to 1900. It is quite likely that many cases were notreported and others were unrecognized.It was not until 1882 that the tubercle bacillus was discovered by Kochand an intensive war on tuberculosis in this country did not get under way2In this connection it may be mentioned that during the first quarter of the 20thcentury, there was a reduction in the death rate for scarlet fever in the United Statesof more than 60 per cent. This improvement took place before sera, sulfonamidesor antibiotics were available.—Editor
Contagious Diseases 243until well after igoo. In the meantime, in Illinois as elsewhere, manypatent medicines—often at one dollar a bottle—were offered ascures forthis disease, and the United States Pure Food and Drug Bureau had notyet come into existence to curb such quackery.In some areas of Illinois, typhoid fever and malaria ran rampant. Thehigh incidence of typhoid fever was due largely to inadequate sanitarymeasures. Out-houses and contaminated water supplies accounted for mostcases. Unpasteurized milk and carriers often contributed to the spread ofthe disease in cities, although the water supply was often at fault. An exampleof the havoc wrought by typhoid fever generally in those times is prominentin the records of the Spanish-American War (1898) when therewere 20,000 cases among our troops in contrast to 350 battle casualties.Antityphoid vaccine was not developed by Wright until 1896, but it wasnot applied in the above mentioned war.All forms of meningitis were almost invariably fatal during this period.Regardless of the causative agent, the disease was usually referred to ascerebrospinal fever, for Weichselbaum did not discover the meningococcusuntil 1887. Moreover, there was no specific treatment until after Kolle andWassermann (1905) and Joachim (1906) developed their antibacterialsera, which Flexner improved in 1907.It has been estimated that in the larger communities, about 44 per centof children have whooping cough before they reach the age of five years.While this fact establishes the infection as one of importance, there areother reasons. Whooping cough differs from most of the common contagiousdiseases in that the infant may be attacked at any time after birth.Because of the insignificance formerly attached to whooping cough, comparativelyfew cases were reported and, if pneumonia developed as acomplication and death ensued, it was likely that no record of pertussiswas disclosed. Therefore, the statistics in regard to the prevalence andmortality of this disease are incomplete and unreliable.The etiology of whooping cough was a matter of dispute for many years.Some believed that it was a neurologic disorder or possibly of viral origin;others thought that an ulcer beneath the tongue was responsible for theparoxysms. In 1905 Bordet-Gengou discovered the Hemophilus pertussisas the specific etiologic agent.A multitude of remedies was used for treatment of the condition, andeven continued to be prescribed after the true nature of this disease wasscientifically determined. Although a prodigious variety of cough mixtureswas considered beneficial, quinine seems to have led the field in the choiceof drugs prior to 1900, and some physicians seemed to look upon thisremedy as specific. In spite of all claims, actually little of value was doneeither to prevent or treat pertussis during the 19th century.
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HISTORY OFMEDICAL PRACTICEIN ILLINO
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PREFACEVARIOUS members of the Illin
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Prefaceixall of its local health de
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PrefacexiDr. E. A. Piszczek, Chicag
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THEEDITOR'S FOREWORDperiod 1850 to
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Editor's Forewordxvand 650 he comme
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xviiiXVIII.XIX.Medical Bacteriology
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CHAPTER IINTRODUCTIONBy DAVID J.DAV
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Introduction 5Smillie 3 wrote on ep
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CHAPTER IIMEDICAL GEOGRAPHY OF ILLI
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Medical Geography of Illinois 9geol
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Medical Geography of Illinois 15had
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Medical Geography of Illinois 17of
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Fig. i. Places and regions in Illin
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Medical Geography of Illinois 21ref
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Medical Geography of Illinois 23Cha
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i„r»-l ll'urlnllli• A i!.n»Ut
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CHAPTER IIITHE HARDY PIONEER:HOW HE
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CHAPTER IVORGANIZATION OF THE ILLIN
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CHAPTER VIIINTERNAL MEDICINEBy GEOR
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114 History of Jiledical Practice i
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CHAPTER XIVDERMATOLOGYBy B.BARKER B
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CHAPTER XVNEUROPSYCHIATRYBy OSCAR H
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CHAPTER XXIVMEDICAL JOURNALISM IN I
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APPENDIXMISCELLANEOUS NOTESAddition
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5ioIndexAntifebrin, 138, 139Antipyr
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5 1 * Index159, 163, 190, 284; Amer
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5HCollege of Medicine, University o
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516 IndexEpidemics, 5, 507Epileptic
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15 i8 IndexHarris, Dr. J. O., 115Ha
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5 2 ° IndexJacobson, Dr. Daniel Si
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522Index456, 457; Privately Endowed
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524IndexParkes, Dr. Charles T., 181
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3526IndexReed, Dr. Carlos I., 403Re
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5 s8 IndexStrong, Dr. R. M., Histor
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