MEDICAL NOTES.

Auckland Star, Volume LXV, Issue 285, 1 December 1934, Page 9 (Supplement)

MEDICAL NOTES.

UNDULANT FEVER. INFECTION FROM COWS DOCTORS' MANNERS.

(By PERITUS.)

Several years ago a farmers' journal I refused an article of mine because "in | every herd of dairy cows there was sometimes contagious abortion, and why alarm the public?" The editor did not know, as I did, that the infection of brucelle abortus produced undulant fever in man, and although less common than tuberculosis, could liavo fatal results. Both tubercle arid brucella infect milk, and milk from any but healthy cows is therefore dangerous. A death from undulant fever has taken place in Christchurch, and others have been reported. No honest dairy man sells milk known to bo infected, but all dairymen and the general public should know that the danger exists. Undulant fever hau befcn treated as influenza, as mild typhoid, and as remittent fever, for the symptoms are indefinite, except in severe cases, and in previously healthy people the body is strongly resistant, the infection causing no more marked symptoms than a loss of strength, feeling of weariness, •_ and constipation. The fact that there is 110 antidote and no directly useful treatment defeats tfyi doctor when he is sure of his diagnosis. Young persons arc ] more frequently affected tlian others, but , it does not appear in infants. There lua > bo sleeplessness and headaches, ot appetite, nausea, and a heavy feeling about the stomach. The spleen and liver are tender on pressure. Sometimes there is a slight cough, and almost invariably, free perspiration. The appearance of the patient is natural, but languid. There is no rash, but the temperature rises irregularly, and there is pain (like rheumatism) in ankles, wrists, and knees. The convalescence is tedious. The whole period of sickness to recovery may be one hundred days or more. The .?} cases are rare, but the extent of mild sickness and general discomfort, due-to infected milk, must be great, if, as I am informed, milk is sold from cows affected by abortion under I the impression that it is harmless.

Blood and Food. It is commonly believed that if a cow has a healthy udder, the milk is ■ " s » fe - The fact is that milk is altered blood. Food is converted into blood, and the blood is converted into all bodily materials, including milk. Therefore if an animal has any general abnormal condition the milk may be affected. There are many biological substances beyond analysis, beyond tests and microscope, and only known to exist by results in living creatures. Contagious abortion is not a hiddeh or secret disease. The dairyman knows it, and now, should know also that brucella is communicable to man by milk. For hundreds of years doctors have been dealing with results to the neglect of origins. As the years have passed we have been made increasingly aware how intimate are our relations with lower forms of life, and how frequently our lives are endangered by the assault of microbic creatures attacking us in the food and drink we consume and the air we breathe. The battle for life must be fought by incessant demand for pure air, pure food, and refinement of sanitation. A careless or ignorant man may cause the infection of a community, and widespread enlightenment is the best protection. One by one diseases at ono time mysterious have been tracked down, reduced to a minimum or almost entirely abolished. Smallpox, scrofula, tuberculosis, malaria and others have been ic-, duced by the knowledge of a few men being conveyed to many. Now cancer, rheumatism, the common cold, influenza can be banished only by new knowledge, gained by research, and then broadcast to the multitude. The assistance of everyone is needed in lessening infection and checking preventible disease. It is true that we grow old and all must die, but ill-health is seldom a .gift at birth, and even if it is, may be improved later. Speed of movement and increase in machinery have moro than quadrupled accidental i' jury, which has been largely met by advances in surgery, but the bacterial invasions have been left almost untouched, except where sera, used experimentally, have stimulated natural resistance. Diphtheria still takes toll of life; pneumonia and septicaemia have) no certain definite, reliable specific, and the physician (whilst laughing at the homeopatliist) is always treating symptoms. The text books say, try this, try that, and "standard remedies" are for experiment more often than not. Therefore cow fever is not much less well provided for than many other diseases.

The Surgeon's Manner. Several times I have heard complaints of the "abrupt," "sharp" manner and speech of eminent surgeons. There is a method assumed by some, of cultivating a rude, uncultured method of speech, which impresses the groundlings, and is only permissible in men who have become eminent. It means nothing, and does not indicate bad temper. I quote one instance. The interview between patient and consulting surgeon was ended. The former was a quiet, reserved little man in bad health. "I am paying liberally for your advice," ho said to the surgeon, "and have every reason to believe it to be worth the money, but I did not come here to be barked at. I could purchase such rudeness for less." The surgeon happened to be a gentleman. "I am sorry," he said instantly. "I did not mean to be unkind." An unfortunate thing about this manner is that'it is catching. Juniors get it, and make it ridiculous. Theatre sisters get it, and scare young nurses nearly to death. It is, in the beginning of hospital groyvtli, known and acccpted by the whole profession, and now that I have told you, I trust you not to express amusement unless it is illegitimately assumed. There is a definite pomposity of manner in the "great" physician, but his hall-mark is a quiet, bland, soapy smoothness, coldly aloof, but offering a sort of chilly comfort to the sick.