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Formerly Assistant to Government Institute for Infectious Diseases; Lecturer on General
Pathology and Oral Surgery to Tokio Dental College; Resident Physician
to Surgeon-General Prof. Satow's General Hospital, Tokio.


The skin of the Japanese is of light yellow, which, on the one hand transits into an European white, while on the other hand it goes down into deep yellow or light brown. Exceptionally, it is light bronze colored as if they came from Ceylon.

Skin of Upper Classes.—The people of the upper class are mostly lighter in color than those of the lower stratum. Some Japanese are not distinguishable from Caucasians in color, and apparently lighter than many of the Spaniards or Italians. The northern Japanese people are lighter in color than those of southern Japan, where they resemble somewhat the Malayans in color. Differences between sex is very slight. It is caused by the difference of the mode of life. Japanese men are more exposed to weather and sunshine than the women, half of whose lives are lived inside of the house.

Skin of Children.—Children are not lighter than the adults, and toward their teeth-changing age they become somewhat flushed with red color.

Babies.—A new-born baby is called akambo in Japanese, which means "red baby." It is remarkably red compared with that of the white race, but the redness does not continue longer than a few days after birth. Babies of higher class people are also lighter in color than the lower, while in other respects infants coming from robust mothers are frequently lightly rose-colored in the cheek, and are not as beautiful as the lighter child for European eyes.


Skin Pigments.—The yellow color of the skin of Oriental people depends upon the presence of pigment particles within the skin stratum. So we find yellow or brown pigments in these people while it is black in the negro. But by careful examination of the lighter-colored skin of the Japanese there is a very small amount of pigment, though it may be larger in amount according to the intensity of the color. Of course the amount of the pigment found in Japanese differs only quantitatively, not qualitatively. In children just born, or in foetus, the distribution is very uneven and the amount is also scarce.

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Mixed Breeds.—Mix breeds of European and Japanese are mostly very beautiful, their skin resembling north Europeans, or sometimes the inhabitants along Mediterranean sea.

Skin of the Abdomen.—Local pigmentation is not without interest. The pigmentation of the middle line of the abdomen is oftentimes noticed in yet young maids who have no relation to pregnancy at all, whereas European women have it only during their pregnancy. In rare cases we meet with pigmentation of male subjects.

Nipples.—Nipples of unmarried girls are darker than those of the blonde European women, which in the latter must be gently rose-color before marriage.

Lips.—Lips and eye-balls are generally about the same as Europeans are, but sometimes there are some who have circumscribed blueish-grey coloration along the conjunction of external skin and mucous membrane.

Tatooing.—Beside these congenital characteristics, Japanese did tattooing in greater extent. But tattooing on the skin is not accepted by the higher class or educated people, it is controlled exclusively by the lower layer of the people, such as coolies or the same. Under the law these barbarous customs were already forbidden and now we see them very seldom among the old coolies.


Japanese Cleanliness.—Japanese are strict lovers of individual cleanliness. Every family has a bath-room, whether in the city or the village cottage, from the wealthy to the poorer classes. Those who have no bath-rooms of their own may find everywhere public baths, which are scattered throughout the cities or towns. These public baths stand under inspection of the sanitary police.

Daily Baths.—Above the middle-class people, Japanese take baths every day; even the laborers never omit baths over three days at longest.

Change of Clothing.—Underwear, stockings or other clothes are sent once a week to laundries, while well-to-do families take more frequent care of the clothing. Japanese women are more careful than the men, so if any woman omits a bath over two days she is spoken of as dirty by the others.

Bath Temperatures.—The temperature of the bath is generally very high in the city, while it is about the same as in other lands in the country.


Types of Hair.—Speaking generally, Japanese have the same features of hair as the other folks of the Malayo-Mongolian race. There are, however, at least two kinds of Japanese distinguishable by their hair, one is of the thin hair type, with long face; another is of the thick hair type, which reminds us of resemblance of the Albino race. In this latter type we observe pretty coarse hair on various parts of the body.


Color of Hair.—Development of hair of Japanese is thick and strong The color of the hair is seemingly dark, but absolute black is very seldom seen. If we examine the hair carefully it is darkish-brown, or frequently red-brown; true blonde hair being seen rarely in the Japanese, it being somewhat abnormal, as the hair of the Albino is among Europeans.

Hair of Children.—The hair of children is far lighter in color than that of adults. Under four years the children have rarely dark hair.

Women's Hair.—The hair of women appears a more brilliant black than that of the men. The length of the hair is preserved pretty long, for aesthetic purposes, and some reaches to the heel, when they untie their pompadours. The thickness of the hair is about equal to that of European women. Japanese women's hair is generally straight. Curling is seldom seen. Japanese women detest curled hair, and unmarried girls are quite unhappy when they have curled hair.


The beard of the Japanese is very thin and scarce. It makes its appearance comparatively later in life than with the Europeans. The color is generally dark-brown to red-brown, and sometimes lighter brown.


Pompadours.—No woman in the world, from admirable society ladies to the negresses in a wild part of Africa; from ancient Egyptians to the present Hottentots, have failed to take care of their precious hair. So it is also the case with Japanese women. As you read and see, the Japanese women form very peculiar pompadours with great earnestness and skill.

Perfumes.—They use some perfuming oily materials to make the hair fragrant and brilliant.

Hats.—The European hat is never used by Japanese women. They use an oblong square piece of various cloth. In a short walk they use no cover except a handy parasol. On the other hand, most of the laboring class women use cloth covers over their heads.


Nose Peculiarities.—One glance is enough to judge what nationality is in question, when anybody notices the nose and eyes of the Japanese. The difference of the nose of Japanese from Caucasian lies in the anatomical difference as to the attaching point of the root of the nose to the frontal bone. Where the Caucasian's stretches out directly from the same plain in front the Japanese nose starts from far deeper portion of the frontal bone. This peculiarity gives a further characteristic appearance to the face of disagreeable flatness. Exceptions to this common character are frequently seen.

The Eyes.—Japanese eyes, are very different from those of the European, as the latter have the depression between the orbital arch and lidrim, while the former lack this depression and have folds in the lid-rim and inner-angle of the eyes. The opening also is narrower in Japanese. All these differences depend upon the position of the eye-balls. The European has eye-balls situated more forward.

Color of the Eyes.—Japanese have dark eyes; among one hundred, ninety-five being brown, five black. But in Japan true black eyes are rarer than in Southern Europe. New-born infants have bluish-black to greenish-black colored eyes, which after several months become gradually a brown color.

Eyebrows generally grow very thick and broad and of black color.

Ears.—Ears are not built shapely in many cases as we notice in Europeans.

Cheek.—The cheek is also pretty prominent, which represents an Asiatic characteristic. This is only remarkable in one type of Japanese; while in another the long-faced type is not much noticeable.


The mouth of fine type is usually small, and the lips fasten shapely; while the lower type has a comparatively wider opening, which is disagreeable to look at. Teeth are of good quality when grown normally. In the lower class, however, there is a more prognatic mouth, owing apparently to the ignorance about the proper care of the children during their second dentition. Dental diseases seem to be rarer than in this country. Oral hygiene is regarded as important by the Japanese, and children are taught to get a regular habit of cleaning the mouth at home as well as at school.


Measles (Mashin or Hashika).—Preventive measures are taken strictly. Isolation of the sick children from healthy. When one of a family falls a victim, all dejecta of the sick child is mixed with antiseptica, Such as five per cent. carbolic acid, or one one-thousandth corrosive sublimate lotion, and so forth. For the disease itself, baths, packs—especially carbol ointment, milk, eggs, expectorants and sometimes antipyretics.

Scarlet Fever (Shiokownetz).—Preventive measures are the same in all infectious cases. Baths, douches, packs, gargles, lemonade, stimulants and symptomatics. In Japan no epidemic of this disease has been experienced, and I have treated only one case. Some authors believe that Japanese are immune to scarlatina.

Small-Pox (Howsow).—Before the introduction of Jenner's vaccination, small-pox was regarded as if a life-tax which everybody born in Japan must pay once in a lifetime.

Vaccination.—Since vaccination has been imported people believe in it unanimously, and thirty years ago the government put forth vaccination laws. It is compulsory, every three or seven years. The treatment is by baths, symptomatics, stimulants, prophylactics.

Chicken-Pox (Futow).—Children suffer only slightly, and unless complications follow the physician is not usually called in. But medical officers of health notify the case.

Mumps (Zikasenin).—Generally mercuric ointment rubbing is enough. If the case is grave, the leech, purgatives, light diet and incision are resorted to.

Whooping-Cough (Hiakunichigai).—Isolation of children from patient. Change of air; much out-of-door life; moist packs; cold ablution. Each fit attended with vomiting should be followed immediately by the administration of nourishment (milk, egg, broth, and so forth). Bromoform from three to ten drops, sometimes beneficial. Internally, some narcotics, such as bromide or belladonna. There are many children who become true patients from imitating their comrade-patients. Parents lack care when such a comic accident occurs.

Cholera Nostra (Kakuran).—This is much dreaded by parents, and also in adults in the summer months.

Treatment.—Opium, calomel, bismuth, astringent wine, soup, poultices, stimulants.

Dysentery (Sekiri).—Japan was losing her inhabitants at a dreadful rate annually, and the cause was discovered by Dr. Shiga, who started his serum-therapy treatment about three years ago in behalf of the government. The result of this special treatment decidedly diminished the mortality. Dr. Flexulo, professor in University of Pennsylvania, discovered the same cause in his expedition to the Philippines.

General Treatment.—Besides this special treatment, castor-oil, calomel, opium, suppositories, saline infusions, mucilaginous enemata, concentrated liquid diet, stimulants, hot packs, isolation, notification, disinfection, and so forth.

Canine Rabies (Kiokenbio).—Preventive inoculation, or commonly spoken of as Pasteur's treatment. Cauterization of wound, narcotics (chloral, morphine), stimulants.

The Plague (Pest or Kokushibio).—The recent invasion of plague gave Japan a severe blow, and government as well as people were in utmost alarm, and every effort was made to subdue this obstinate disease. At present no case in Japan. The preventive measure is very strict; burning down infected places, ships and trains quarantined, house-hunting and arrests in suspicious cases.

Special Treatment.—For special treatment, Yersin's healing and preventive inoculation; Kitasato's serum therapy; Oiher's symptomatic treatments.

Yellow Fever (Ohnetz).—No cases in Japan.

The Rheumatic Diseases (Riumatisu).—Salicylic acid and its salts, salophen, salol, colchicum. Wet packs, baths (iodine, bog-mud), massage, and so forth.

Croupous Pneumonia (Haiin).—Ice-bag, cold drinks; diet with milk and eggs; cold packs, mustard-plaster, digitalis and stimulants.

Epidemic Cerebro-Spinal Meningitis (Riu-kow-sei Now-sekizuimaku-in).— Occurs seldom in Japan.

Treatment.—Best, cold pack, ice-bag, blood-letting from mastoid region, calomel, cantharoidal blister to the nape of the neck, mercurial inunction, antipyretica and narcotica.

Erysipelas (Tandoku).—Serum therapy in first place, and then ordinary symptomatic treatments, such as poultices, sustained nourishment, cold baths, stimulants, injection of 3 per cent. carbolic acid to surrounding inflammation.

Relapsing Fever (Kaikinetz).—Quinine or other antipyretica stimulants and tonics. This disease was introduced by soldiers at the end of China-Japanese war, but no cases at present.

Malarial Fever (Kwanketsunetz).—Quinine sulphate in various doses before the expected attack—usually six hours. In protracted cases, arsenic and iron administered, and baths directed.


Pulmonary Tuberculosis (Hai-kekkaku).—Digestible diet (milk chiefly recommended, eggs, soft-boiled rice, cod-liver oil, young poultry), cool rubbing of skin, open-air life, country residence, treatment in sanatorium; arsenic, creosote, guayocole, myrtol, solveol, and so forth; mineral waters. Expectorants (pectoral tea, senega, apomorphine, chloride, and so forth). For cough—codeine, opium, belladonna, morphine. For night-sweats—atropine, agaricine, and so forth. For hemorrhages—rest, ergotine, morphine, ice-bag, lead acetate. For marasmic fever—antipyretics. Individual spittoon, disinfection of linens, encouragement of the patient.

Sanatorium Treatment.—Beside these ordinary treatments in Japan a special serum therapy is in popular favor, or new-tuberculin injection in sanatorium, where patients are provided with free air, sports in various styles and medical attendance.

Glandular Tuberculosis (Rui reki).—Cod-liver oil with lime, iron, iodide, arsenic, nutrition; sometimes surgical operation. Japanese believe that glandular tuberculosis is a forerunner of pulmonal tuberculosis, and they come to get it extirpated by surgeon.

Intestinal Tuberculosis (Cho kekkaku).—Opium, poultices, bismuth, astringents, mucilagenous drinks, decoction of salep or Colombo.

Tuberculous Peritonitis (Fukumaku-kekkaku).—Beside symptomatic treatments, laparotomy undertaken with brilliant results.

Typhoid Fever (Chotyphus).—Serum therapy is used as a special remedy with good results. Diet, milk, broth, eggs, beef juice or chicken. Calomel at onset. Cold baths at 20 degrees Centigrade, and antipyretica in febrile stage. Later, digitalis and stimulants. Prevent bed-sores by alcoholic applications or air bed.

Diphtheria and Croup (Dixteria Croopu).—Serum therapy in every case. As other methods for preventing complications, gargle or inhalation of dilute solution of carbolic acid (rarely used), iced milk, stimulants. In suffocating stages, emetics, intubation or tracheotomy. In such grave cases combination of antitoxin serum and surgical operation are preferred.

Grippe (Riu kow sei Kanbo).—Isolation and disinfection of the patients, but in widespread epidemic these preventive measures are scarcely to be carried out. For patient, rest in bed, good ventilation, lightly digestible food and medicaments. Among medicines, chinine is very effective, or antipyrine and salicylic acid are recommended for fever. Expectorants, gargles and stimulants according to the condition, of the patient.

Asiatic Cholera (Kolera).—Strict quarantine and disinfection. Cholera cadavers always cremated. *

Serum therapy against cholera was and is used by government institute, but we have not many cases to determine its real value. Calomel, opium, ice-pills, hot-packs, stimulants, infusion of saline solution are symptomatic medicines.

Leprosy (Rai-bio).—Preventive measure is the most important, inasmuch as we have no special treatment. In a plain, near Mountain Fuji, there is one lepra village under government expense, where any patient who desires to spend his poor life apart from the community is allowed to live, furnished with necessary staffs.

Among medicaments for leprosy, natrium salicylicum has good reputation and ointments of ichthyol, aristol and hydroxylamin are recommended.

Gonorrhea (Rinbio).—As preventive measure, strict inspection of public girls thrice a month by sanitary inspectors. Some use condoms and wash local part with 2 per cent. carbolic acid, after intercourse.

Medicinal Treatment.—Among medicines, sulphate of zinc followed by iodoform is most used; garbolmol came in general use quite recently. Internally, balsamum copaivae (0.6 in gelatine capsule, five ten times a day), balsamum peruvianum, balsamum. tolutanum, oleum terbenthinae, fructus cubebae, and so forth. Dietary care is very important, as light coffee, milk, tea, avoiding strong coffee, tea or spices. Patient must be confined to bed, no speaking, no pictures which may cause sexual excitement; against erection and pollution; early supper, many hours before sleep, and a pulver consisting of bromide potash, lupulin and camphor.

For annoying urination (repeated in short time) suppositories of opium or morphine used (but not belladonna).

For chronic gonorrhea we decline to meet urethral strictures, which want bougie treatment or surgical operation.

Tetanus (Hashofu).—Serum therapy used in general. Beside thorough incision and washing of the infected wound, if discovered. Among symptomatic remedies narcotics are the only medicines to lessen patient's trouble.

Chancre (Nansei-gekan).—When ulcers appear many abortive treatments offered, such as washing with concentrated nitrate silver, sulphate zinc, caustic potash, caustic paste or galvanic cauterization.

After these methods, application of thin layer of iodoform, aristol, calomel, bismuth, dermatol or europhine, and covered with fat-free cotton moistened with carbol vaseline. Liquors avoided, as well as sexual intercourse. For complications, often surgical treatment wanted.

Syphilis (Baidoku) or Acquired Syphilis (Kowten baidoku).—Prophylaxis, being the same as gonorrhea. When syphilitic patients may marry? It is considered as harmless if they marry after three years from their first infection. But this, of course, depends upon the patients, whether they had taken proper antisyphilitic treatment during that period or not. After marriage, they should consult physicians every two or three weeks for first six months whether any sign of return appears or not.

Syphilitic Stages.—If a man is infected with syphilis, the first symptom is hard chancre, which wants mercury treatment. From this primary stage to secondary period mercury cure is the chief treatment. The patient is forbidden to indulge in baccho et venere during this treatment. Cold is harmful for the patient taking inunction cure, so cold baths or douches not allowed. Dietary care is also important. Some physicians recommend combination of inunction and internal administration of iodide potash. For the broad condylomata on the external skin, washing with saline solution and calomel pulverization proves beneficial. When recidicive occurs, sometimes condylomatous eruptions appear in mouth. In such case internal use of mercuric preparation is prescribed.

Third Stage of Syphilis.—When syphilis proceeds to the third stage, iodide of potash is prescribed as a special remedy. By this treatment, if patient be persevering enough to maintain full effect, almost all of the syphilitic symptoms disappear.

Iodo preparations combined with iron serve as an effective remedy against subsequent cachexia and amyloid degeneration. Mineral baths (sulphur) are recommended also. Sometimes subcutaneous injection of mercuric preparations are directed.

If gummata affects various parts they are treated surgically.

Nose Syphilis.—When syphilis is located at nose, mercuric plaster is used for ulcerative part of skin. For the destruction of internal part of nose, we treat it with nose-douche, washing with carbolic acid (2 per cent), corrosive sublimate or thymol, followed by snuffing of calomel or iodoform. After the destructive process ceases to progress, the deformation is repaired by a plastic operation.

Other Syphilitic Forms.—Other forms of syphilis are treated under general antisyphilitic remedies and special methods according to the location.

For syphilitic affection of nervous system, electricity or massages are recommended sometimes beside general antisyphilitic cure.

Hereditary Syphilis (Senten baidoku).—Prophylactic measures are most important, so nobody should marry within the course of three years after infected with syphilis. If a woman becomes infected with syphilis during her pregnancy, a strict antisyphilitic remedy must be taken. If it was in the course of the latter half of pregnancy, the baby is expected to be born healthy. But in such a case, the baby is to be nourished with cow-milk or by a wet-nurse exclusively. But if syphilis had rooted deep in the parent before pregnancy, the baby also inherits the formidable virus with its life, and then the baby is preferably nourished with its mother's milk. But the mother is treated with iodide potash in order that the specific medicine may be secreted through mammalian glands into the milk. For the disease itself, use mercuric pills in favorable forms for the stomach.

Treatment of Mothers.—During treatment the mother should take care of cleaning oral cavity every day. Bath containing corrosive sublimate (3.0), 28 degrees Reaumur, is directed every day. In my country the bath-tub is made of wood generally, and it suits for the use of mercury bath.


Laryngeal Catarrh (Kowtow katarrh).—Priesneitz's pack around neck, hot milk, codeine for acute. Inhalation of saline water, tannin-alum solution; painting with nitrate silver (3-10 per cent.) for chronic. Baths are not recommended much.

Bronchitis (Kikwanshi katarrh).—For acute form, mineral water, milk and tea, wet packing, warm baths, codeine, expectorants. For chronic form, marine life or warm southern climate, wet packs, rubbing skin, expectorants. Inhalation of mineral water is especially recommended.

Asthma (Zensoku).—Treatment of eventual nose diseases, marine life. In paroxymata, iodide potash, morphine, inhalation of pyridin vapor, and so forth.

Pulmonal Emphysemata (Haikishi).—About same as asthma or bronchial catarrh. Iodide potash or digitalis, gymnastics of lungs, pneumatic chamber, compression of thorax, and so forth.

Pleurisy (Kiomaku-irr).—If the quantity of exudate reaches up to second intercostal space soon, it is drawn by puncture. But there must be several pauses during the whole operation, as it will cause cerebral anemia from sudden loss of blood-pressure. Before and after treatment of the operation must be strictly aseptical. Besides, contra-irritation, wet pack, ice-bag, diuretics, anti-rheumatics and morphine.


Endocarditis (Shinzonaimakuin).—Rest, ice-bag, salicylic preparation or eventually digitalis, strophantus.

Cardiac Insufficiency (Shinzo-benmaku-heisafuzen).—Digitalis infusion (0.8—1.2/00) is the chief remedy in meeting the disturbance. Other auxiliary medicaments are diuretics, stimulants, morphine.

For the hydropsy from heart disease: Calomel combined with digitalis, taking care of stomatitis at the same time. Then the diuretics such as acetate potash, diuretics, scilla, tartarus boraxatus, and so forth.

Treatment by Massage.—Massage, high position and enveloping of the swollen parts is recommended. Puncture for strong hydropsy is rare. During compensated stage care is directed not to use strong body moving or alcoholic beverages, while patient should take nourishing, assimilable food. Bath-cure (cold baths) is also advisable.

Nervous Palpitation (Shinkeisei Shinki-kowshin).—First affair is to improve patient's general condition; iron, quinine or strengthening diet for anemic subjects, while bitter waters or bath-cure prescribed for the full-blooded. Among internal remedies nervines or sometimes narcotics are used. Cold compression and ice-bags often act beneficially.

Angina Pectoris (Kyoshinsho).—Irritation of skin (mustard), application of hot or cold compression, morphine injection and other narcotics such as chloralamid, nitro-glycerine, and so forth.

Pericarditis (Shinnow-in).—Quiet, rest, digitalis, strophantus, ice-bags or mustard-paste. In large exudate, puncture with aspirator; in pus accumulation, surgical operation.

Aneurism of Aorta (Daidowmyakuriu).—Iodide of potassium, ergotine, compression, electric cauterization, and so forth. But no remedy proves effective.


Inflammation of the Mouth (Konai-iu).—Including various forms of stomatitis. Cleanliness, care of gums; gargle with tannin, alum, borax, and so forth, according to the condition, antiseptics also used such as hypermanganate of potassium (0.1 per cent. ), chloro-potash (2 per cent.), hydrogen dioxide solution (2 per cent.), tincture myrrh, tincture ratani, or lapis cauterization in grave cases.

Acute and Chronic Gastric Catarrh (Kuisei and Mansei-I-katarrh).— Treatment of the acute same as here. For chronic forms it depends upon the nature of the causal diseases. At first, treatment of causal diseases; regular dietary, avoiding fatty indigestible foods. Sometimes cold rubbing upon the stomach region, massage over stomach, regular evacuation (using oil or glycerine enema), sea-water baths, hot spring cures.

Gastric Ulcer (I-kwaiyo).—Bed-rest, warm poultice applied intermittently, fluid diet (milk, eggs, soups). Internally, administer sodium bicarbonate with bismuth, the latter used alone in large doses in some cases.

Cancer of the Stomach (I-gan).—Internally, only symptomatics, sometimes hydrochloric acid and extract of condurango used with good result. Eventually, when the cancer is located near the pylorus it is removed by surgical operation.

Dilatation of the Stomach (I-kakucho).—Regular washing of the stomach in evening daily; massages, electricity; cold rubbing over gastric region. Fluid diet, regular evacuation with purgatives or enema, morphine, chloral hydrate, and so forth. Surgically, early extirpation of the tumor.

Nervous Dyspepsia (Shinkeisei-shokafurio).—Cold rubbing, strengthening diet, massage, electricity, baths and mental therapy.

Intestinal Catarrh (Chokatarrh).—Dietary regulation, opium and tannin, tannigen, and so forth. For acute form, artificial Carlsbad salt, packs, massage, digestible food and regular evacuation. Alcoholic liquors forbidden.


1. Tape-Worm.—Extract filic maris 2.0 in capsules (in 5-6 pieces) taken in one-half hour. Three hours later one spoonful of castor oil given. Sometimes we use thymol, one-half grain, instead of extract filic, as the latter may eventually cause amaurosis. Chloroform is also used with success.

2. Ascarides (Round Worm).—Santonin, one grain several times a day.

3. Oxyuris (Seat Worm).—Naphthalin, 4 x 0.15—0.4; castor oil or calomel.

Ascites (Fukusui).—Treatment of causal diseases, digitalis, diuretics, calomel, puncture.

Jaundice (Oudan).—Artificial Carlsbad; dietary direction; no fat stuffs.

Biliary Calculi (Tanaeki).—For paroxysm apply cataplasm, narcotics internally or hypodermically. Carlsbad-cure, salicylic and bicarbonate sodium given later.

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Bandages saturated with ammonia, starting at the nerve centre indicated by 1 in the adjoining cut, and passing tightly over the head, are sure to relieve headache. See index—Headache.


Fits, spasms, convulsions are successfully treated with mustard, turpentine, or some similar application to the back of the neck, just below the spot indicated in the adjoining figure by 1. See index—Convulsions.


A favorite remedy for the pains of pleurisy consists in the application of heated salt, or similar heated or drawing applications, acting as counter-irritants, to the back beneath the shoulders, as Indicated by circle 2 in adjoining cut. See index—Pleurisy.


Many successful medical men treat ague both internally and externally. They find that external applications of stimulating oils to back and loins, as indicated by figure 3 of the adjoining figure, is very helpful to the internal treatment. See index— Chills and Fevers.

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A favorite relief for neuralgia is to apply to the temple, at the spot indicated by circle 1, a strong peppermint liniment or astringent, poultice. The same treatment applies to any nerve centre. See index—Neuralgia.


Many medical authorities advise an external application for diphtheria of turpentine, hot salt water, or petroleum, at the point indicated in the adjoining figure by circle 2. See index—Diphtheria.


Some specialists advise, in conjunction with the internal treatment for lockjaw, a powerful nicotine application externally, at the pit of the stomach, as indicated by circle 3. See index—Lockjaw.


A very effective treatment for indigestion is the outward application of the hot salt bag, or other heating means, to the stomach, as indicated by object 4 in adjoining cut.



The full details in the geographical distribution, etiology and symptom of the disease I do not here touch, but it will be of interest to mention a little but mysterious history of the disease in China and Japan.

In China we find in the medical writings about a thousand years ago the words "Ketsue or Set," meaning rabies of the dog; and in Japan we can say nothing else than that a hundred years ago there were physicians who wrote on the prevalence of rabies in dogs.

We had a prevalence of rabies in dogs at Tokyo, the capital of Japan, in 1870, and at Nagasaki harbor in 1893. The latter was the greater outbreak, and many of the people were victims of this disease. Since that time the disease has drawn medical attention, and thenceforth small outbreaks occurred every year within a limited area in the country.

Virus.—There are two theories, microorganism, and chemical toxin, but neither have a firm basis. It is very strange that when the virus is in a dry state, but not absolutely, it never causes the disease, if inoculation takes place in the human body, and has had too long an incubation. The former antagonizes the parasitic theory, and the latter the chemical toxic theory; but no doubt there is some unknown virus which has some affinity for the nervous system. Animal experiment shows that the virus localizes in the brain and spinal cord, especially the medulla oblongata, and also cerebro-spinal fluid, peripheral nerve, saliva, lacryma; suprarenal bodies, thymus, heart, and so forth, contain the virus; but not the liver, spleen and aqueous humor. In the urine and blood sometimes the virus is found, and sometimes not.

The transporter of virus is always saliva, but how this virus reaches to the nervous centre from the bitten wound is still a question. Some observers take the blood theory and others insist on the nerve fibrous theory.

Incubation.—It has several incubation periods, and it oscillates from three days to twenty-five years, but twenty to sixty days are most common, and when the bitten part is nearer to the nervous centre, the shorter the incubation, or vice versa. Intemperance hastens the establishment of the disease.

Prophylactic Treatment.—The dogs that have no masters must be killed, and the pets must be muzzled when they go out. But it is necessary to tax higher, as in Germany, where twenty marks is taxed per head. Preventive inoculation can hardly be performed by private practitioners; it is too expensive to prepare and keep the inoculating material; so then the local boards of health must always prepare the inoculation material for an emergency, because the later inoculation is always unsuccessful.

Inoculating Treatment.—When a man is bitten he must be sent to the inoculation department, and there the inoculation takes place; on the other hand the dog is sent to the institute or police station, and must be diagnosed by a veterinarian or bacteriologist; sometimes the suspected dog may be killed for diagnosis. The physician's duty is to advise the patient to get the inoculation, and it is in vain to treat with some caustic medicine or cautery. Indeed the old-fashioned practice often results in danger, because generally there has been a pause of time since the accident to call upon a physician, and some ignorant patients never intend to get the inoculation, thinking the caustic treatment to be sufficient. Now I have the opportunity to confess the carelessness which had occurred in my practice. About nine years ago a patient called on me who was bitten by a dog, and in this case only five minutes had passed since the accident. Then I excised the wound, situated at the right pulp of the thumb, and cauterized. When two months had passed, after he had called on me, the intensive hydrophobia had been established, and then he died. But nine years ago we had not any inoculating departments in Japan.

Since Pasteur began the inoculation in 1885, the first inoculation took place in Japan in 1893, by T. Kurimoto, and in 1897, by S. Kitasato. The method is as follows: First, make inoculation material from the brain of a rabid dog, rubbing in a bowl the mixture of the brain 0.5 grams, and 0.6 percentage saline solution 2.0 grams, then inoculate the rabbits, weight 1800.0 to 2000.0 grams. This inoculation takes place under the dura mata by trepanation, and one or two drops of the above mentioned virus will be injected with the Pravatz's syringe. Then the inoculated rabbits, after about two weeks show paralysis in the hind legs at first, then in the front legs, and die. After dissecting, the whole spinal cord is taken and cut into three pieces, tied with strings and hung in a glass bottle which contains caustic potassium in the bottom; this bottle is kept in a dark place.

Next, to make the preventive inoculation fluid, the cord in which the strength of the virus is lessened by drying is cut five milimeters thick and mixed with three grams bouillon and rubbed in the bowl. The virus is lessened in strength in ratio to the days of drying.

The whole manipulation is done aseptically if possible. To inoculate the human body, begin with the most attenuated virus; that is, the fourteen-day dried one. When it is dried fifteen days the virus is destroyed. And in second inoculation take a thirteen-day dried one; in third inoculation a twelve-day dried one, and so forth. At last two-day dried virus is inoculated; the limit of virus strength has no special value, and Koch limits to two-day dried one, and twenty to twenty-five times; but Kurimoto inoculates twenty to thirty times to a patient.

In Russia (St. Petersburg) they inoculate from six days to two days dried virus, and in Vienna twelve days to two days; in Budapest they inoculate fresh cord diluted with distilled water in ratio 1-10,000; this is called the diluted method and begins in 1-10,000 limited to 1-100.

The doses change by age: under ten years, 1.0 gram; ten to fifteen, 1.5 grams; fifteen to twenty, 2.0 grams; over twenty, 3.0 grams of the mixture. To show the result of the inoculation we mention here the mortality under inoculation treatment:

      Japan (Eurimoto) ............... 1.3 per cent., death.
      Prance (Pasteur Institute) ......0.8 per cent., death.
      Russia ...................... 3 to 4 per cent., death.
      Budapest ...................... 0.37 per cent., death.
      Whole of Europe (average)...... 1.49 per cent., death.

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Last Modified: Monday, 13-May-2013 15:31:47 EDT