Skin creams and salves

Wednesday, January 23, 2013

eskimo

From the Journal of the American Medical Association, Volume 45, 1905~

"Medical Affairs in the Heart of the Arctics"', by N. Senn, MD


The geographic distribution of disease, the study of primitive races, of their climatic conditions, customs, habits and manner of living as etiologic influences, their methods employed in combatting disease and their resources in the treatment of accidents are subjects which can not fail to interest physicians who are concerned in the progress of their profession and the welfare of humanity the world over.

Greenland, image source, wiki
My vacation trip this summer brought me in touch with, and afforded me an excellent opportunity to study, one of the most interesting peoples in the world, the Eskimos of the far north, in the very heart of the Arctic region. These people are scattered in small settlements along the northern part of the west coast of Greenland, extending from Upernavik to Etah, a distance of about 600 miles. Etah is the most northern habitation of the Eskimos. It is in latitude 78° 40' N. and is less than 700 miles from the North Pole. It is in the heart of the Arctic region, where so many fearless explorers have spent their long, dark winter night preliminary to the dash for the North Pole on foot and sledges over ice and hummocks of ice. It is here where so many hopes were shattered, where so much suffering was endured and where not a few brave sailors have found a premature grave.


Peary in Arctic furs, image source, wiki
This unusual opportunity to visit the headquarters, the starting point of the Arctic explorers and the interesting people who live in this remote part of the inhabited world was presented to me through the courtesy of Commander Robert E. Peary, U. S. Navy, the famous explorer of the far North. Dr. Frederick Sohon of Washington, D. C, and myself were the only passengers on the Erik, which sailed from Sydney, Nova Scotia, Monday, July 17, with a cargo of coal for the Peary Arctic expedition now under way to the much-soughtfor pole. Commander Peary and his crew sailed later from the same port on the Roosevelt, and it was understood that we should meet in North Star Bay on or before August 10. The Roosevelt met us in that place August 9, and proceeded at once to Etah. Commander Peary came on board the Erik to conduct the walrus hunt which was to take place in Murchison's Sound, between the two stations, and to pick up along the coast the Eskimos who were to form a part of the expedition. This trip, as well as the few days at Etah with the two ships lying side by side, gave rise to a good opportunity to become well acquainted with Commander Peary and to receive from him much valuable information concerning the Arctic region and its scanty population of Eskimos. Many of the members of the crews of both vessels were familiar with Arctic conditions and the customs and habits of the Eskimos. From these sources and the results of my own observations I have collected the material incorporated in this paper.

Cape York, image source, wiki
The real Eskimos inhabit the west coast of Greenland, north of the Danish colonies, beyond the limits of civilization. The Eskimos of the Cape York settlement were taken on board the Roosevelt. The Erik called at all the other settlements and the commander selected his material for the native part of the expedition as we went along, so that practically all of these came under my observation. The final weeding out of the undesirable took place at Etah before the Roosevelt sailed for the farthest North, at 3 a. m., Thursday, August 17. Twenty-one persons were left here to establish their winter quarters and to form the base of the expedition. The Erik left Etah Wednesday, August 23, with orders to call at Godhavn on the return voyage to St. Johns, Newfoundland, where we arrived September 5.

THE REAL ESKIMOS.

an eskimo of mixed race
The Eskimos within the limits of civilization, that is, those living in the Danish colonies and settlements, in Baffin Land and Labrador, have lost their original type and have largely abandoned their primitive way of living. Intermarriage with Europeans and Americans for more than a century has resulted in a mixture of races which has either completely effaced the typical Eskimo physiognomy or has, at any rate, modified it so much that it has become almost unrecognizable (Fig. 1). Many of the Eskimos in Danish Greenland would be taken anywhere for Danes or Scandinavians, so far as their appearance is concerned, rather than for natives of the Arctics. The round, full, flat face has, in the course of many generations, been moulded into a face characteristic of the people inhabiting the countries of North Europe. Blond hair and blue eyes, something never seen in a genuine Eskimo, are by no means uncommon here. In Labrador and Baffin Sound similar changes have occurred in consequence of race mixture. The Eskimos, like other primitive races when brought in contact with foreigners, have a longing to adopt their dress and manner of life, hence those who have lived among them have adopted habits and customs entirely different from those of the untutored, genuine Eskimos.

pure-blood Eskimos 
The real Eskimos are now only to be found in the heart of the Arctic region along the strip of the coast of Greenland that I have indicated. These people live in isolation and what little communication they have with the outside world through polar expeditions has made little if any impression on their manner of living (Fig. 2).

Commander Peary has been among these people a good deal of his time for the last 14 years. He knows them well, can call them by their names and has their unlimited confidence. He knows the history of all of them who are more than 2 years of age. He speaks their language and is perfectly familiar with their habits of life and the few diseases to which they have been subject since he first visited them. He is a very careful observer and his statements can be relied on.





eskimo woman
Although the Eskimo race is a distinct one and has little in common with the Indians of North and South America, there can be no doubt of its Asiatic origin. The Eskimos are below average size, thick-set, legs short, face flat, malar bones and cheeks very prominent, well-shaped nose, although in many of them the bridge is somewhat depressed; eyes universally brown, lower jaw well developed, teeth regular, pearly white and in perfect condition; hair straight, coal-black; beard scanty, as well as the eyebrows and eyelashes; eye slit slightly narrowed, not oblique; forehead full and only slightly receding, mouth large, lips thin and fine-cut, color of skin dusky, cheeks florid with a copper tinge, hands and feet small, even delicate. The women are much smaller than the men, many of them being not more than four feet in height. Their garments are made of fur—bearskin for trousers, which are made long for men, short for women; the former wear short, the latter long sealskin boots (Figs. 2 and 3). The coat, with hood, is made of seal or foxskin, the former for summer and the latter for winter wear. Bird skins and the fur of the Arctic hare are worn for underclothing. The native dress is admirably adapted for the climate in which these people live, and Commander Peary has adopted it for himself and wears it summer and winter.                                                

The Eskimos are the filthiest people in the world. They never wash, not even the face and hands. The smell of the fur clothing and secretions of the skin are productive of a stench about their persons and especially in their igloos and tents that is characteristic and at first very obnoxious to the uninitiated. During winter these people live in huts (igloos) (Figs. 4 and 5). of stone or ice; in summer in tents of sealskin. Furs are used for the common family bed and each occupant, from father to babe, strips completely before retiring. They do not marry in the sense in which we use this word, but mate like animals for convenient periods of time, which may be for life, for a year, or only for a hunting trip of a few days. Exchange of mates for an indefinite time is of common occurrence.

stone igloo


These people are all children, contented, peaceable, honest and hospitable; they are without a ruler and without any ambition for fame or power—an ideal socialistic community where property is held in common, politics unknown, and where all are on the same social plane.

They subsist almost exclusively on a raw animal diet, which explains the absence of a number of diseases that are common among the civilized people. Salt water contains iodin, and all animals living in it and all animals which live on sea food absorb more or less of this fickle chemical substance. None of these people has ever suffered from scurvy, which was such a common affection among the crews of the early polar expeditions and which occasionally afflicts the Eskimos who consume more cooked than raw animal food. Peary has profited by this observation, and places great importance in supplying his crew with fresh meat, and has never seen a case of scurvy among them. He has found by experience that lime juice, which formerly enjoyed such an enviable reputation as an antiscorbutic, is not only useless but harmful. Taken in the Arctic region, it acts as a cathartic and becomes distasteful to those who have used it.

eskimo man and woman in a kayak
The iodized raw animal food also explains satisfactorily the absence of enlarged tonsils, cervical lymphatic glands and goiter. I examined the throats and necks of many Eskimos and found the tonsils and thyroid glands in all of these in a markedly atrophic condition, and in none of them, except in two syphilitics, were there any palpable cervical lymphatics. The perfect, splendid teeth and strong lower jaw are the anatomic points of the carnivorous diet. I examined the mouths of several persons between 60 and 70 years of age and found every tooth in place and firm but ground away by long usage almost to the level of the healthy gums. The vocation of the Eskimos, both men and women, requires very little use of the legs, consequently they have suffered in length while, on the other hand, paddling of the kayak (Fig. 6), throwing of the harpoon and lance and handling of the dog-whip have resulted in the course of centuries in an unusual development of arms and chest.

Although I have no positive information on the subject, I am satisfied that the exclusion of all vegetable food from the diet has shortened the gastrointestinal canal, that the appendix, if present at all, is in the most rudimentary form and that the glands concerned in the digestion of starchy food have become atrophic, while those whose secretion is needed for the digestion of meat and the emulsification of the fats are hypertrophic. The stomach digestion of these people is something wonderful. Indigestion is about as infrequent as in the dog— in fact I believe there is the closest analogy between the anatomy and physiology of the organs of digestion of the Eskimo and the only domestic animal with which he is familiar, the dog. Commander Peary and a number of the men of both crews, who have seen much of Eskimo life, can not remember of ever having seen a case of chronic indigestion, peritonitis, or intestinal obstruction. Hair and fragments of bone taken with the food by the dog occasionally produce peritonitis in this animal, but these mechanical causes for such affections of the intestinal canal are excluded from the diet of the Eskimo. We would naturally conclude that an exclusive animal diet would cause constipation and a uric acid diathesis with a long train of their remote consequences —headache, insomnia, skin eruptions, gout, rheumatism, etc.—but this is not the case. The large percentage of oil contained in their diet acts as a gentle laxative and protects them against a multitude of ailments which form the major part of the diseases with which the general practitioner has to deal. The Eskimo can eat with relish and without any ill consequences old, stinking blubber that would turn the stomach of a crow and that if eaten by a white man, if he could retain it, would kill him by producing ptomain poisoning.

The skin of the Eskimo, covered with filth and vermin, is remarkable for its smoothness and immunity to skin diseases. The only skin eruptions I have seen among the large number of Eskimos of all ages I examined was a patch of psoriasis over the posterior surface of the elbow of a syphilitic, and a small pustular eruption affecting one ala of the nose in an infant suffering from a nasal catarrh. The very fact that these people fear and avoid the external use of water may account for their freedom from diseases of the skin. The exposure of the hair to the midnight sun for more than throe months of the year and the wearing of a loose hood of fur during the winter favors hair growth. Baldness is unknown here and even Time finds it difficult to bleach the coal-black hair and beard. Men and women of 6O and more years show only here and there a gray streak in the luxuriant hair never touched by the comb.

The special senses, except that of smell, are very keen and old age appears to have little if any influence in diminishing the acuteness of sight and hearing. The acuteness of vision for near and distant objects of these people is something that will astonish the visitor. I became aware of this on my hunting trips under the guidance of Eskimos. They could see a hare or a bird far beyond the reach of my vision and could calculate the distance with an infallible accuracy, something no one is capable of doing who is not habituated to the rarity of the atmosphere of the Arctic region.

DISEASES.

It would take much less space to enumerate the diseases to which the Eskimos are subject than to name those to which they appear to be almost immune so long as they live in their own climate and do not deviate from their customary habits of life.

Tuberculosis in any form is unknown among the Eskimos in the heart of the Arctic region. I heard no phthisical cough, saw no emaciated forms nor hectic flush; no cases of lupus, glandular, joint or bone tuberculosis and no cripples except the man who lost part of one foot from frost bite. Experience, however, has shown that as soon as these people are brought to the United States they contract pulmonary tuberculosis of the most virulent form and succumb to the disease in a few months. Of six persons brought to the American Museum of Natural History in New York all contracted the disease and in less than six months four of them were dead, one returned and recovered and one remained in New York still suffering from a more lingering form of the disease. The one who returned to his Arctic home and resumed his former manner of living made a very speedy and permanent recovery, a strong argument in favor of the Arctic region as a summer resort for tubercular patients. The focus of infection created by this patient in the settlement to which he came and where he has since lived has proved harmless during the eight years that have expired since his return.

Rheumatism is one of the most prevalent diseases among the Eskimos. At the North Star Bay settlement I found a man about 35 years of age in one of the tents completely crippled by this disease which, according to Peary, commenced twelve years before. He was lying helpless on his reindeer skin, with every large joint of all the limbs contracted and stiff. The left elbow was swollen, painful and exquisitely tender to the slightest touch. He was smoking and appeared to be not in the least concerned about his helpless condition, as, according to the prevailing custom among the natives, the tribe provided him and his family with food and clothing. Lumbago and sciatica frequently affect in this climate the crews of expeditions and whalers.

Venereal diseases were introduced here by the whites and have become widely diffused throughout the native population, owing to the unrestrained, promiscuous intercourse practiced everywhere. Syphilis pursues a very mild course in the natives. None of the terrible ravages of the tertiary form of this disease, with which we are so familiar, are seen here. I have no doubt that the iodin contained in their food furnishes a satisfactory explanation for this. A well-known Eskimo is known to have contracted the disease eight years ago. He has had no treatment of any kind and is now in perfect health and the father of several healthy, vigorous children. I examined a boy about 15 years of age who was then the subject of secondary lesions. I found mucus patches on the inner surface of the lower lip, general lymphatic hyperplasia but no cutaneous eruptions. The severest case of tertiary syphilis I have seen was in the case of a man about 50 years of age whose woman was infected by a member of an Arctic crew some eight or ten years ago. One of her children of a corresponding age, a girl, is a half-caste, pale and delicate. This man bore all the marks of a syphilitic cachexia; his arteries were atheromatous, a patch of psoriasis affected the posterior aspect of one of the elbow joints and the cervical and epitrochlear glands were very much enlarged. I did not see a single case of saddle-nose, of gumma, periostitis, Hutchinson's teeth or syphilitic alopecia. These facts prove conclusively that syphilis among these people pursues an unusually benign course, for which we must give credit to Iheir liberally iodized sea food. Gonorrhea seems to follow the same benign course. Careful inquiry and abundant testimony from reliable sources combine to show that stricture, orchitis and cystitis do not exist. I questioned Commander Peary and Mr. Henson, his main man, who have spent seven winters among these natives, with special reference to the existence of urinary difficulties among old men. From their accounts it appears that prostatic obstruction does not exist, as they have seen many of the men urinate, and noticed that the stream was large and strong. The sexual life of these people and the iodized food may account for the absence of senile prostatic hypertrophy and its consequences, urinary obstruction and eventually renal disease. I saw one case of gonorrheal ophthalmia of a mild form in an adult and complete corneal opacity of one eye in the case of a young girl, caused undoubtedly by this disease. One man and a woman had each lost an eye from traumatic causes.

Marie Peary, born 1893. aaaawwwww:)
Winter Anemia.—The long winter, with its attendant darkness and long confinement in the small, badly-ventilatcd huts, to which is often added a lack of sufficient food, is productive of anemia and its results, debility, insomnia and nervousness. Commander Peary anticipated this change in the conditions of the blood and the defective nutrition and guards against them by keeping his crew and the Eskimos as much as possible out of doors and busy, and supplying them with an abundance of fresh meat. He has found this prophylactic treatment equally effective with both contingents of his expedition. The general lack of nutrition during the long winter night is best shown in the case of his little daughter. She was born in Bowdoin Bay, an-arm of lnglefield Gulf, in September. Her weight and size remained the same until the sun made his appearance and she was taken out daily in the open air in a dog sledge, when she commenced to grow rapidly and the blush of health and vigor appeared in her face. Nature takes a long rest in the Arctic region and this affects animal as well as vegetable life; the former comes to a standstill, the latter, for the time being, completely suspended. With the appearance of the sun reanimation takes place, which reaches its maximum during the long and uninterrupted reign of the midnight sun. The effect of the midnight sun on vegetation in the Arctic region is remarkable. What takes place in plant growth with us in months is accomplished here in as many weeks. In four to six weeks the flowering plants bud, blossom and mature their seed.
 Animal life during this time receives the same stimulating benefit from the sun.

Affections of the Nervous System.—Insanity among the Eskimos is unknown. As these people have never been given an opportunity to indulge in alcoholic drinks they are free from all affections due to alcoholism. Smoking is a new vice with them which crept in a few years ago, but as the supply of tobacco is irregular and most of the time scanty or entirely lacking, it has so far produced no ill results. The natives, howrever, have a strong liking for the weed and when the supply of tobacco warrants it, young and old enjoy the pipe, which makes its rounds if only one is at their disposal. I have seen children on their mothers' backs do their good share in burning up the contents of a pipe. The same causes which combine in the causation of winter anemia result occasionally in producing a nervous condition closely allied to, if not identical with, hysteria. Peary in 1900, on his trip to the northeast coast of Greenland, witnessed this condition and describes it as follows: "When we were drinking our tea one of the younger Eskimos fell in a fit and the others became hysterical. I felt a peculiar dizzy sensation myself. Recognizing the effect of our alcohol cooker in the close atmosphere of the igloo, with every aperture sealed by the newly-fallen snow, I hurriedly kicked out the door and a portion of the front wall. This relieved matters, and I sent three of the Eskimos outside to get the benefit of the fresh air, while I took the two worst ones in hand personally, and finally succeeded in quieting them down. After this they were 'ankooting' all day. The open water ahead of as, the groaning pack beside us, the bad weather and the, to them, mysterious attack of the morning, had combined to put them all in a very timid and unsteady frame of mind" (McClure's Magazine).

It is well known that the long winter, with its depressing effects on body and mind, often disturbs the equilibrium of the otherwise well-balanced nervous system of the natives. But the nervousness, or call it hysteria, never becomes chronic, and disappears under more favorable climatic or dietetic conditions. A similar train of nervous symptoms has not infrequently been observed in members of Arctic expeditions who wintered here and the depression in one or two cases has been so grave as to induce the poor sufferers to seek relief by committing suicide. I could not learn of a single case of epilepsy, chorea or apoplexy.

Peary in 1909, image source, wiki commons



Sunday, January 20, 2013

Iodine- the good soldier

A public service advertisement courtesy of Dow Chemical, Saturday Evening Post, 1950. Text enlarged below...



Monday, January 7, 2013

Iodine as counter-irritant, World War I

world war I veterans in hospital at Youngstown, Ohio


another snippet on counter-irritation with iodine for pain relief~

Another interesting class was the convalescent gassed patients, many of whom had the effort syndrome but the majority of whom were, especially the mustard gas cases, subject to a peculiar type of pain. They would report at sick call with a history of being unable to sleep because of a pain variously described as dull, short, lancillating, migratory, etc., somewhere in the neighborhood of the heart. It would be localized in various places from the left mid-axillary line to the right nipple line and from the clavicle to the level of the umbilicus but always radiating from the heart. No cause for this pain was ever found on physical examination, but the men were too positive in their statements for one to doubt that it was a real thing to them. Numerous remedies were tried but the only real results achieved were from generous counter-irritation with iodine applied over the whole pro-cardiac area, accompanied by the assurance that this pain was only a temporary affair which would soon disappear. We could never find that this pain in any way interfered with the man's work, but it was certainly a constant cause of complaint and quite trying to the sick call officer until the above treatment was instituted.

source:

published 1919



Sunday, December 2, 2012

Iodine for Beauty!

I found a fabulous magazine on ebay, "The Body Beautiful", published in 1937. It's an early health magazine for women. It was published by "Beauty Publications Company" based in Chicago, Il. From the advertisements in the magazine for various vitamin and mineral supplements, I am guessing that this publication was devised as a vehicle to sell those supplements.



 I purchased this magazine because "iodine baths" was listed as one of the subjects. There are a couple of photos of iodine beauty treatments in an article entitled "A Woman's Heart Never Wrinkles", ...but... the article is strange for a few reasons., the first being that with the exception of the subject lines below the pictures, the word "iodine" is not to be found in the article. The article consists of wisdom gleaned from a mysterious Professor Bela____ from Budapest(how exotic!).

bathing the breasts in Budapest! The iodine bath
From the article: "It is in Budapest where women are loveliest and most feminine. It is in Budapest where men retain their masculinity and agility the longest. That now famous poem "The Breast of a Lady in Budapest" was written to a woman artist and sculptress over fifty years of age."  Famous that poem may have been, but it now appears to have been lost to time..

And there are vague allusions to a mysterious serum, "The wonderful neo-serum has been tried and proved in rejuvenation. Glandular therapy has lured back the youth cells into the bodies of slipping men and women. Where a few years ago only the extremely wealthy could be rejuvenated by transplantation processes, today men and women of moderate means, without injections, without the knife, can rebuild themselves in their own homes. The heart can show it's youth again when it can express through a rejuvenated body."


The mysterious Dr Bela _____ states: "I have become anything but popular in the eyes of other surgeons because of my emphatic statements that proper feeding, rebuilding and drugless methods can rejuvenate."

the iodine soap mask! daily???? yikes!
So there it is- the article never states what, exactly, this wonderful therapy is with the exception of references to the "neo-serum" . I will suppose that the "glandular therapy"', "neo-serum", etc., contained iodine in some form as well as thyroid hormone.


If we are to take the photos accompanying the article as a hint then bathing in iodine and swathing the face in an iodine mask were also important components of the Budapest Beauty Ritual.

I have seen iodine baths referenced in other old writings, most notable M. Lugol's pioneering use of the "ioduretted bath". Iodine baths are also suggested usually as a means of weight loss(accompanied by massage), and as a means of clearing up skin afflictions in old beauty manuals. 

I was hoping for more from this article. Hey, the pics are good though, and there are also many ads in the magazine for iodine-containing supplements. The article is poorly written and vague, perhaps it was a teaser to whet the appetite for the forth-coming "neo-serum" supplement.

This is a valuable piece of iodine history, in my opinion. Please note in the clips below, the "irradiated" iodine. Radiation was, at that time, one of the new miracles of medicine. The ads vary between the irradiated iodine supplements and iodine from the sea. At least the health-giving properties of iodine were known at this time!















Sunday, November 4, 2012

Iodine gets the lead out



Unusual Case of Lead Poisoning.—Three months before the onset of foot drop, the patient had suffered an attack of lobar pneumonia and had been very ill. Many years previous to this, he had had occasional attacks of "rheumatism.'' With the exception of the rheumatism he had not been ill for 16 years. This sickness had been an unusually severe attack of lead poisoning which he had developed while working "in a sheet lead factory" where he had been foreman. After repeated attempts to continue his work there he had been obliged to resign a very lucrative position and discontinue this kind of work. He had had "colic" so severely that the physician in charge had despaired of his life and had expected him to die. Recovery had been tedious and he had never been well since. Still in the last years he had not shown symptoms of lead poisoning and had considered his ill health clue to rheumatism.

It was difficult to imagine this present foot drop to be directly clue to "leading" sixteen years ago, and the history of his past illness was again reviewed. Special inquiry was made of the attack of pneumonia, which condition the present trouble has so closely followed. Apparently he had had a frank attack of lobar pneumonia but said that the physician in charge thought the lung had not returned to its normal erudition, and that he had taken medicine for some time after he was up and about. He was asked to describe this medicine which he did as follows: "The medicine was bitter drops, made my nose run as though I had the hay fever, and I took ten drops after each meal. The medicine formed a white scum over the neck of the bottle and turned the label brown." The explanation of the case seemed clear to Lazell. The lead deposited sixteen years before in some insoluble form in the bones, had been thrown into solution by the iodids given for an unresolved pneumonia and acute lead poisoning had resulted. The patient was given a good prognosis, saturated with sodium iodide and made a complete recovery. 1

____________________


In many forms of chronic rheumatism, and in certain affections of the osseous system, due to a syphilitic taint, iodide of potassium is of the greatest service; and its value in the treatment of chronic lead-poisoning is not so generally known, even in the medical profession, as it deserves to be. The iodide of potassium dissolves the compounds of lead with albumen, fibrine, fcc, which abound in the body in chronic lead-poisoning; and these dissolved compounds are excreted by the kidneys. In these cases, lead may often be detected in the urine, almost immediately after the administration of the iodide. This salt has a similar action in chronic mercurial poisoning, and cases are recorded of mercurial salivation having come on during the use of iodide of potassium, in consequence of the liberation of mercury, which had been previously fixed in the system. 2



The Journal of the American Medical Association. Volume 55, 1910

2  Chambers's Encyclopaedia, Volume V, 1931

Friday, September 7, 2012

Iodine as counter-irritant, part 2

More on the use of iodine as a counter-irritant. Follow the link for more information including a lot of case histories, I have copied the intro and a few plates, with instructions. The take-home point is that the counter-irritant must be applied AWAY from the area of local inflammation, over the next "vascular territory".

The Treatment of Surgical Inflammations by a New Method ~ 1870

Other means of counter-irritation are discussed in the book, I focus on IODINE.

An introduction to the concept can be found here:

 http://iodinehistory.blogspot.com/2012/09/iodin-as-counter-irritant-artificial.html


KEY POINT~ What are the principal conditions which are needed for the prosperous beginning and progress of an inflammation? An inflamed part must have increased space —more room for swelling, it must have more blood, it is all the better for perpetual unrest. There must be no other inflammation near to interfere with it—two inflammations do not flourish together.

In the following pages I assume (and the results recorded hereafter justify the assumption) that the- inflammatory process is one and the same process wherever it- may occur, and that the best remedies for any inflammation are the best in all. That drugs have, for certain purposes, great utility I do not deny. Putting aside, however, specific inflammations I know no drug, or combination of drugs, that can cure an inflammation. Counter-irritation can unquestionably cure inflammations. Let me cite one fact among many. An inflamed patellar bursa, before chronic thickening sets in, can be most certainly cured by a ring of blister placed around it, when every other remedy fails. Seeing that counter-irritation could do what no other remedy could, I put a ring of counter-irritation around abscesses, carbuncles, cellulitis, and other inflammations, and discovered striking and rapid results. I next sought to find out the most favourable localities for counter-irritation in every inflammation.

It appeared to me that it should always be established over the next, or another, vessel or vascular territory.

I knew that even and gentle pressure could rapidly arrest some, especially chronic, inflammations. For removing the products of inflammation I knew no remedy to be compared with it. I used it, therefore, in all accessible inflammations.

The best mode of using the best remedies (counter-irritation, pressure, rest, and a few others) in every inflammation is not a routine treatment. Take counter-irritation alone; there is endless scope for individual and independent judgment in the determination of its best localities, best degrees of intensity, best extent and configuration of area, and best modes of production. It is the same with the other remedies advocated in these pages.

One of the greatest advantages of counterirritation is this—it immediately and efficiently relieves inflammatory pain. Most patients are eager to exchange a continuous, dull, wearing, inflammatory pain for a temporary smarting.

The cases are very briefly reported, as they are intended simply to illustrate the effects of treatment.


The following diagrams are mostly drawn from actual cases. The dotted lines show the extent of counterirritation, of a moderate character, as effected by iodine pigment. Unless otherwise indicated, the whole circumference of the limb is irritated.

PLATE I.
Fig. 1.—Extent of counter-irritation in a large abscess of the fore-arm. If the first application of iodine is efficient, the relief of pain is striking and immediate. See Mr. Hodges's case of Mammary Abscess, and Mr. Turton's cases of Carbuncle.

Fig. 2.—Shows singular appearance, after twenty-four hours of counter-irritation, in removing inflammation, and circumscribing pus. I have several times seen this tumourlike collection of pus removed in a few days by continued counter-irritation.

Fig. 3.—Extent of counter-irritation (iodine) in abscess of popliteal space. An iodine paint is applied to the whole circumference of the limb within the dotted lines.








PLATE V.

Fig. 1.—Counter-irritation in carbuncle. A mild form should be more extensive, as in next fig. also.

Fig. 2.—Counter-irritation in a single boil, and in a cluster of boils.


















Figs. 1 & 2.—Show extent of moderately vigorous (iodine pigment) counter-irritation in synovitis and early articular ostitis of knee and ankle.


Fig. 3.—Is intended to show use of actual cautery in severe articular ostitis of shoulder. One stripe is at the front, one at the back of the joint, and one midway between the two.












PLATE XIV.


Fig. 1.—Shows mode of using counter-irritation (acetum lyttao in severest, iodine liniment in less severe cases) in purulent inflammations, especially gonorrheal, of conjunctiva. Where counter-irritation must be repeated or kept up, two horseshoe shapes, one within the other, are useful.


Fig. 2.—Shows sharp counter-irritation in the more acute laryngeal inflammations.


Fig. 3.—A milder counter-irritation in the less acute inflammations.








Wednesday, September 5, 2012

iodin as counter-irritant~ "artificial hyperemia", part 1

An introduction to the concept of "artificial hyperemia" and the usefulness of iodine as a counter-irritant.

text source: Dental materia medica and therapeutics  1920


"the blood must continue to circulate—there must never be a stasis of the blood." 




blood circulation~ wiki images

...Within recent years a new remedial measure has been introduced into therapeutics for the purpose of combating infectious diseases which is so surprisingly simple, and yet so very definite in its final result, that one can only wonder why it was not discovered a long time ago. The object of the treatment consists in the increased utilization of the natural resources which the body possesses in the fight against local infection, and is known at present as the hyperemic treatment of Bier. Bier founded his conception of this treatment on observations which he had made in the clinic of Rokitansky in Vienna. He had repeatedly pointed out that a lung with a chronic obstructive hyperemia resulting from some valvular insufficiency of the heart would not, in the great majority of cases, be attacked by tuberculosis. On logical reasoning Bier applied the same principle with surprisingly good results in the treatment of chronic infections of the joints. In due time the technic of this treatment, depending largely upon the construction of suitable apparatus, had to undergo many modifications; but, even with the remarkable increase of the scope of its utilization it is still employed by comparatively few practitioners...

...the aim of Bier's hyperemic treatment is to bring about "the increase of the beneficial inflammatory hyperemia resulting from the fight of the living body against invasion," and the most important principle underlying this treatment is that "the blood must continue to circulate—there must never be a stasis of the blood." ...

...At present it is generally conceded that inflammation is not a disease, but that it is the local defense of the tissues against an injury, manifesting itself by more or less pronounced symptoms— as redness, heat, swelling, pain, and impaired function. The most important changes occur in the blood vessels, which are distended by an increased influx of blood that is very quickly displaced by a retarded afflux. The white corpuscles conglomerate in bunches near the vessel wall, especially in the veins and capillaries, while the red blood corpuscles keep more to the center of the blood stream. The leucocytes and the lymphocytes now pass between the endothelial cells through the vessel walls of the veins and of the capillaries, but not of the arteries. This wandering of the white corpuscles—diapedesis—is accompanied by the transudation of blood serum, which fills the surrounding tissues, causing an edematous swelling. Later on the red blood corpuscles follow, but they migrate in very much smaller quantities... 

Whenever living tissue is injured—whether by mechanical, thermal, or chemic means—the system at once tries to protect itself against the invading foe by an increased rush of blood into the injured area, resulting either in a victorious fight—complete resolution, or in a surrender to the enemy—necrosis.



According to the conception of the older practitioners, irritants were employed for the purpose of depleting the "malignant humors" from the diseased part into the immediate neighborhood. Such irritants were known as derivants, while revulsives were used to disseminate these humors into the farther situated parts. In many instances irritants are applied to the healthy tissue somewhat distant from the primary seat of disturbance, with the intention of diverting the deep-seated congestion into a new direction, or, as our forefathers expressed it, "to leave a way for the escape of the humors." Proof for this supposition has never been furnished. Medicaments applied for these purposes are known as counterirritants. If strong irritants are applied to a circumscribed area of tissue, an exudation of small globules of serum occurs; the latter soon coalesce and raise the epidermis of the true skin, thereby forming a blister...

...At present it is generally recognized that the milder irritants produce the preliminary stages of inflammation—hyperemia. An increased influx and a retarded afflux of blood in the irritated tissue is the sequence of the irritation, and not, as it has been generally supposed, a diversion of the blood stream. Depending on the nature of the irritant, the congestion may be superficial, or it may reach to quite a depth. Hyperemia, in the sense of Bier (see Artificial Hyperemia), is one of the most important functions which nature possesses in overcoming morbid processes. Tissues which are richly supplied with blood possess a very pronounced restorative power, and there is no doubt that artificial hyperemia exercises a distinct beneficial influence on the reparative processes. This is partially the reason why wounds in the oral cavity heal so much quicker than in other parts of the body. Pain in deepseated structures is often mitigated by applying an irritant. By counterirritation of a sensory surface located somewhat distant from the primary seat of irritation, we may be able to divert the pain to this newly excited focus. Such applications are usually employed in the many forms of ill-defined pericemental disturbances. Some of the substances employed as irritants act by reflex action—that is, after their primary action they produce socalled reflexes, which have a beneficial influence on pathologic disturbances.

It should be remembered that the same irritant produces different effects on tissues of different resistance. The more delicate mucous membrane of the mouth requires naturally less severe irritation to produce definite results than the thick and horny layers of the skin.

Counterirritation is sometimes referred to as depletion. Depletives (to empty) are means which were very frequently used in former years for the purpose of locally abstracting blood or serum from the tissues in general or from the point of disease. Dry and wet cupping, scarification, and leeching were the usual methods employed for such purposes. Local depiction by physical means is rarely practiced at present. General depletion of the system by artificially increased perspiration or by abstracting fluids from the body through the bowel by salines or hydragogues are referred to under Cathartics and Diaphoretics.

Iodin in aqueous or in alcoholic solution occupies an important place among the irritants. It possesses a powerful and penetrating action. 

iodine molecule- wiki images


Iodin; Iodum, U. S. P., B. P.; I; Iode, F.; Jod, G.

Source And Character.—Iodin (from the Greek ioeides, violet-colored) was discovered by Courtois in 1811, and named iodin by Gay-Lussac on account of its violet-colored vapors. Iodin is prepared from crude iodin, which is obtained from kelp, but principally from the mother liquors of Chile saltpeter of South America. It forms heavy, bluish-black, friable crystals, having a characteristic odor and a sharp and acrid taste. It is soluble in 5,000 parts of water, 10 parts of alcohol, freely soluble in ether, chloroform, and in the solution of the iodids of the alkalies. Its alcoholic solution has a reddish-brown color, while, when dissolved in chloroform or carbon disulphid, it exhibits a violet tint. It volatilizes at ordinary temperature and fuses at about 239° F. (115° C). It is incompatible with starch, tannin, vegetable colors, etc.

Average Dose.—1/10 grain (0.005 Gm.).

Medical Properties.—Antiseptic, caustic, and alterative.

Therapeutics.—Iodin, in concentrated solution, acts as a caustic; in diluted solution, applied locally, it produces only irritant effects. Iodin has a peculiar action on the vessel walls, as it increases their penetrability. It produces typical fibrinous inflammation of the serous membranes. After the destruction of their epithelial coat, these serous membranes show a pronounced tendency to stick together and to heal by first intention. For this reason iodin is successfully employed in the treatment of fistulous tracts, etc. Painted on the skin, iodin quickly penetrates into the structures, and produces sensible irritation, thereby relieving pain which may be present in the deep-seated tissues. Incidentally it enlarges the walls of the various vessels, promotes absorption, and by reflex action produces venous hyperemia, which involves all the tissues within the affected area. The favorable influence of this artificially produced hyperemia on the diseased tissues is more fully discussed under Physical Therapeutics. (See Artificial Hyperemia.) Iodin is very freely employed in an alcoholic solution (tincture of iodin), and as the milder acting Lugol's solution. In using the tincture of iodin the alcoholic component of the latter must be accredited with a certain share of its action.

To promote the more ready absorption of iodin, various solutions have been recently introduced. Iodipin, an iodized sesame oil, containing respectively 10 and 25 per cent of iodin, and iothion, a glycerinated solution, containing 77 per cent of iodin, are the more important representatives of this group. Both preparations are almost colorless and odorless, and are used as substitutes for the tincture for external and internal purposes.


Preparations.—

Tincture of Iodin; Tinctura Iodi, II. S. P., B. P. It contains 7 per cent (2.5 per cent, B. P.) of iodin dissolved in alcohol. The U. S. P. tincture contains in addition 5 per cent of potassium iodin, which increases its therapeutic effect and stability.
Compound Solution of Iodin; Liquor Iodi Compositus, U. S. P.; Lugol's Solution. It contains 5 per cent of iodin dissolved in a 10 per cent aqueous solution of potassium iodid.

Iodin Liniment; Liquor Iodi Fords, B. P. It contains about 14 per cent of iodin.

Therapeutics.—Tincture of iodin is universally employed as a counterirritant in pericemental disturbances. Its beneficial influence is based on three principal functions of iodin—to act as a derivant by sensory irritation, to produce artificial hyperemia, and to promote absorption. Its antiseptic properties are of less importance in this connection. If a definite iodin action is desired in the mouth, the ordinary tincture is not well suited for this purpose. Its alcoholic component causes superficial coagulation of the delicate mucous membrane, and in reality very little iodin is absorbed from this weak solution. If the tincture is repeatedly applied at short intervals, the caustic effect of the alcohol destroys the mucous lining, and a painful excoriated surface is the result. The irritating effect of the alcohol is probably as much responsible for the apparent results attributed to the tincture as its iodin component. Liquid iodin preparation for dental purposes should be concentrated solutions in water, preferably in the form of Talbot's iodo-glycerol. (See page 206.) A colorless tincture of iodin is occasionally demanded; ammonia water added to the tincture will quickly destroy its color. If higher concentrated iodin solutions are wanted, Carson's or Churchill's iodin paint is serviceable, but these compounds should not be used indiscriminately on the mucous surfaces of the mouth...