1920 Journal of the American Medical Association (JAMA)  
cause a recurrence of the infection. The teeth should be cleansed daily and a mouth wash used at frequent intervals. Excessive use of tobacco should be avoided as well as other predisposing causes enumerated else¬ where. The author desires to emphasize strongly the value of the use of arsphenamin locally in the form of a 10 per cent, solution in glycerin or, for practical purposes, 0.6 gm. of arsphenamin dissolved in 2 fluidrams of glycerin. It does not seem to disintegrate in this way, and if
more » ... n this way, and if dissolved in sterile water or salt solution and neutralized with sodium hydroxid, the preparation will become useless in a short while after being prepared. The author believes also that it is better to mix all the powder with the glycerin at one time rather than to dissolve just enough for the particular application ; there is no serious objection to this method. The parts to be treated should be thoroughly cleansed and dried, and then the arsphenamin solution applied by a small cotton swab and the material thoroughly rubbed into the lesions. It is surprising tò see the good results by applying this treatment twice a day. The duration of the disease is shortened materially, and it seems also to lessen the pain associated, which is particularly prev¬ alent when the gums are involved. It is also indicated in those cases in which the gums are primarily involved and there is infection about the teeth, such as pyorrhea, as the author has found that about 90 per cent, of such cases show fusiform bacilli and spirochetes resembling Vincent's organism. The next substance that gave good results was 2 per cent, solution of chromic acid applied in the same man¬ ner or sprayed on with an atomizer. Some observers have used tincture of iodin, colloidal silver, flavine, and a mixture composed of vinum ipecacuanhae, one-half ounce, glycerin, 1 ounce and liquor arsenicalis, 1 ounce ; also powdered méthylène blue; but in the author's experience, none has given such good results as the solution of arsphenamin. CONCLUSIONS 1. It seems to be definitely proved that the fusi¬ form bacillis and the accompanying spirochete are one and the same, the latter being an evolutionary form of the former but always present with the bacillus. 2. The author believes that Vincent's angina is much more common than is at present realized, and that it is not recognized because of the failure to take a smear, and that furthermore it is frequently mistaken for diphtheria and syphilitic ulcers. 3. It is also probable that the considerable use of candy or proteins with the subsequent lack of oral cleanliness predisposes markedly to this infection ; like¬ wise, that poor teeth harbor the organism and that it will manifest itself in its characteristic lesions when¬ ever a suitable opportunity is given. It seems to be more frequent during the winter months. 4. The use of arsphenamin dissolved in glycerin is strongly advised in the treatment of Vincent's angina and infections in which the fusiform bacilli and spiro¬ chetes resembling Vincent's organism are found. 220 Kelker Street. Human Engineering. -To this new specialty, usually termed "Industrial Medicine," I prefer to give another name, one that more clearly defines the real scope and possibilities of what the work offers, the name of "Human Engineering," for it clearly covers fields usually thought to be far removed from that of medicine.
doi:10.1001/jama.1920.02620500018006 fatcat:dg4xvh6ux5bkpbeerfroxfkd7a