HEROIC DRUG THERAPY OF PNEUMONIA IN CHILDHOOD RECOMMENDED BY JACOBI IN 1917

Abstract

Abraham Jacobi (1830-1919), the first professor of pediatrics in America, and the first president of the American Pediatric Society, did more than any other physician to place pediatrics in America on a firm and lasting basis. Nonetheless, his treatment of pneumonia in childhood, even as late as 1917, was as heroic, and as unscientific, as that practiced by physicians in the mid 1800s. He wrote:

I rarely treated a child pneumonia without digitalis. American practitioners have gradually ceased to be cowardly. If faint-heartedly you wait for changes or chances to turn up, you lose your patient. Pneumonias have no stomach for waiting. In treating pneumonia some American doctors have learned to know that hearts lose strength by the hour, unless they are stimulated at once and persistently. Small doses are insufficient; big ones are demanded, and they must be reliable drugs. Digitalis alone may not be sufficient. Spartein sulphate should accompany it in good doses. The modern American pharmacopeia is no guide for you or your patients. Ignorance of apothecaries has been presiding over it. I read in it that ⅙ grain of spartein sulphate is proclaimed to be the dose for an adult. But very rarely ⅙ or ¼ is sufficient as a baby's dose, provided you want it to be efficient; and you want it repeated frequently. Caffein is one of the efficient drugs, that means 4 or 6 or more grains a day for a baby. Camphor has been neglected by us. A year old baby may require 2 or 4 or 8 or 10 grains a day.