Chapter 12
Improved Medication
In Biblical days, the lepers sat outside the city gates and begged for alms. They were not allowed within the city, nor were they looked upon with any degree of pleasure, only fear and distrust. It must have been revolting to see the poor things in all degrees of repulsive deformities, and knowing so little about leprosy, the citizens were naturally fearful of personal contact. To them the lepers were unclean and untouchable.
Now we have lepers better understood and under better control. For years they were treated with chalmoogra oil and kept in colonies at Carrville, Louisiana and on the island of Molokai, in Hawaii. The treatment was slow, and progress was questioned, but the condition was arrested. At this time there is a far better drug, one of the sulfas with which they are kept better controlled and even improved. The deformities of older days are now unheard of. They can have more visitors, and some are given more freedom. The condition is now called Hansen’s Disease, which has less connotation of unpleasantness.
Lobar pneumonia was a disease to be dreaded in the thirties and prior to that. If a patient developed pneumonia, he was treated with prayer and cough syrup up until the time the pneumonia germs were classified and serum was given. It was helpful but now with our new antibiotic drugs, pneumonia does not often develop and when it does, it can be treated very successfully.
In February 1965 there was not single case of lobar pneumonia in the University of Illinois Hospital to use to teach medical students. However, there were several cancer of the lung cases.
Erysipelas is a disease almost unheard of now, but it was horrible to observe in early days. It is a streptococcic disease of the skin, which spreads with alarming rapidity. When it involves the area around the eye it can spread behind the eye, abscess there and push the eye out. It was previously impossible to stop. Doctors used to paint the skin with tincture of iodine and bathe the area with hot water, all to no avail. Now with our new drugs—penicillin, sulfas, and antibiotics—we can stop it over night.
Diphtheria used to be endemic in areas of the Midwest and South. It was easy to control by inoculation but hard to stop or cure once it got started in those who failed for some reason to be inoculated. After a successful cure, there was the danger of failure of the heart due to the effect of the toxin on the muscle. Now there are only sporadic cases of diphtheria, for physicians are ever alert to preventive medicine.
Another malady that was dreaded was poliomyelitis. Until very recently it occurred in various parts of the world, and especially in these United States. In 1933 there was a severe epidemic in Los Angeles in which several of the nurses at the General Hospital were involved and it affected the minds of some to the extent that they became quite incompetent. Even in my practice I had mothers bring children into my office who required only a glance to make the diagnosis. They were sent to the General Hospital at once.
Now that is all changed. The crippling effects need not occur, and the Kinney treatment is no longer needed. The vaccine is very effective and should not be neglected. Poliomyelitis, in our new scientific world, need be no more. What a blessing this is for our youngsters!
Typhoid fever is another disease that has gone by the wayside. It is easily prevented by sanitary methods and need not be endemic in any areas where care is exercised. In the days when it was endemic, there would be many cases of it every summer. I have seen six or seven cases in one small community in a summer and it was extremely difficult to treat. If the patient’s Peyer’s patches held up, and didn’t rupture to cause peritonitis, he had a good chance to overcome the disease, but he would be too weak to do much work for months. Now, we have a specific remedy, chloromycetin, which clears it promptly. This is one of the marvels of the new age.
Tuberculosis is well known to everyone, for we donate to the tuberculosis fund every year. But we don’t hear of so many people having it now-a-days. In New England, in the early days, we read of women relatives of famous men dying of tuberculosis at an early age. Even in the thirties, the greatest cause of death in women from sixteen to thirty-five years of age was tuberculosis, but that has changed now. Wonders of the scientific age have produced PAS, INH and streptomycin. There are very few sanatoria for tuberculosis patients because it is so well controlled, but let us not relax too much, for it is still with us. Several cases are still found among prisoners, heroin addicts, and in the ghettos.
Another interesting mystery which has been solved is the cause and treatment of pellagra. It was a stubborn condition manifested by diarrhea, dermatitis, and dementia. For years it was a puzzle to doctors, especially in the South where it was endemic. It was found to be due to lack of Vitamin B. The people who had pellagra ate corn bread and sow bosom and were short of Vitamin B and all its complexities. It was strictly an avitaminosis and could only benefit from vitamins or good nutrition. Really, we would be surprised how many peop1e suffered from lack of vitamins due to poor nutrition. The welfare and food stamps should relieve that condition.
Everyone knows about smallpox, and how it has been controlled by vaccination. Although frequent scares do occur in various parts of the world, the Health Department, by requiring vaccination in order to return to this country from a trip, has kept us relatively free from smallpox.
The improvement in the treatment of syphilis requires some thought. Prior to penicillin therapy, which clears it in a few days, there were two years of long drawn out treatments with bismuth and neo-salversan. It was given weekly or semiweekly, a series of bismuth injections, then a series of neo-salversan into the veins. It was a long treatment, and the patient often tired of it and quit before the treatment was finished. Then it was possible for tabes dorsalis to develop. This was a condition in which the spinal cord was involved, resulting in erratic walking, first with one cane, then with two. At other times the syphilis settled in the brain, causing paresis. As late as the early forties, syphilis of the brain was responsible for about half the elderly people in mental institutions. But all that is changed now that we have penicillin treatment. Syphilis is on the increase again, mainly because the doctors are not syphilis conscious, or are not reporting it.
It is very obvious that medicine has come a long way. Yellow fever, malaria, diabetes, and many other conditions are more easily prevented and alleviated than ever before. This is the result of untiring efforts of research departments of drug firms and doctors to prolong life, and essentially to improve health. With the research on cancer, multiple sclerosis, cystic fibrosis and some of the even rarer diseases, we may have many more of them controlled in the near future. Our debt of thanks goes to the untiring scientists who are dedicating their lives to the prevention and cure of these diseases.