Champagne and Strychnin in Chest Troubles 
of the Aged. 
Read in the Section on Practice of Medicine, at the Forty-fifth Annual 
Meeting of the American Medical Association, held at San 
Francisco, June 5-8. 1894. 
BY G. EDWARD BUXTON, M.D. 
NATIONAL CITY, C AL. 
REPRINTED FROM 
THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 
JULY 28, 189i. 
CHICAGO: 
PRINTED AT THE OFFICE OF THE JOURNAL OF THE ASSOCIATION. 
1894. CHAMPAGNE AND STRYCHNIN IN CHEST 
TROUBLES OF THE AGED. 
From these few remarks, which shall be presented 
briefly, do not conclude that my dependence upon 
the vis medicatrix naturae is sublime, and faith in the 
medicinal value of drugs microscopic. 
It is true my graduating thesis was upon the action 
of mind in medicine, but that was nearly a score of 
years ago, before the faith cure fad and, as the years 
increase so does my confidence in medicine intelli- 
gently administered; when failure comes, as fre- 
quently it does, it is because the situation has not 
been fully grasped or the vital forces have ceased 
to act. 
A physician living on the shores of San Diego Bay 
sees many invalids from east of the Mississippi, a 
large proportion of whom come from the Atlantic 
seaboard; and among them are many advanced in 
years who come expecting to find in our perfect 
climate the perennial spring of youth and by par- 
taking of its waters live forever. 
While the tendency of this equable climate is to 
prolong life and, in some instances to an astonishing 
degree, as has been shown by Dr. P. C. Remondino 
in his researches in this direction, still the aged 
come to us sick, and here the aged sometimes die. 
It has always seemed to me important that the sick, 
the feeble and advanced in years, should make the 
long journey across this entire continent, not in a 
few days as is now customary-from the Atlantic to 
the Mississippi, from the plains of Kansas to the 
high altitudes of the Rockies, and then drop down 
again to the sea-but on the other hand, that they 2 
should come in slow stages from point to point, oc- 
cupying weeks or months in covering this great 
distance. 
I have myself witnessed great distress on the 
trains bringing invalids, due to these changes ; and 
patients have repeatedly told me of their sufferings 
on the way, especially in the higher altitudes. 
In former times when the journey was made by 
team from the Missouri, west, the change came grad- 
ually, and when this "golden shore,'' was finally 
reached the health seeker was in full harmony with 
environment and likely long to outlive the time limit 
set by Holy Writ. 
We do not see in the region about San Diego Bay 
the same good old pneumonia, double and otherwise, 
that we used to treat, for instance, in Boston or 
Pittsburg. 
There is pneumonia and pneumonia; and this 
probably in some measure accounts for the great va- 
riety of treatment which has been and still is in 
vogue; why should we follow the authority recom- 
mending phlebotomy who wrote fifty years ago, and 
of patients living in the humid, insular climate of 
England, and about the disease as seen among those 
malt liquor drinkers-those roast-beef and plum- 
pudding eaters? Why should such medical experi- 
ence be taken as the guide to proper treatment of 
cases in the high altitudes of the upper Missouri 
Valley, or among the corn- and hog-fed malarial 
dyspeptics of the lower Mississippi Valley, or 
how can we reasonably follow treatment appropri- 
ate to the sturdy young farmers of New England, 
and apply the same remedies in cases among the 
closely confined factory operatives? Or how ap- 
ply any one of these methods, successfully, to the 
health seekers coming, physically bankrupt, from 
the Eastern States, to our land of perpetual sunshine, 
fruits and flowers ; here where he may freely partake 
with no restrictions, of ozone from nature's vast 
laboratory reaching thousands of miles to westward 3 
and from which, wafted by the gentle Pacific zephyrs, 
it comes to these Californian shores. 
There being then chest troubles-pneumonia is 
the name which like the broad mantle of charity 
covers so much-manifesting their symptoms under 
such a variety of conditions in the old, the young, 
the feeble and the strong, it does seem to me impos- 
sible to settle upon any one plan of treatment which 
shall be appropriate to all cases and fit all alike well; 
and so I have used for my theme not pneumonia, but 
chest troubles, that the range might be sufficiently 
wide to still embrace a treatment applicable. 
I am ready to believe that all the methods of 
treatment recommended by men of large experience 
have been appropriate and helpful in many cases to 
which theypvere suited. 
But -IF is,to the condition of the lungs, alone or 
mainly, that we are to look for guidance in our treat- 
or, rather, shall it not be in a large proportion 
of these cases to a tired and worn out heart, which if 
not relieved gives up the struggle ; thus rendering all 
treatment useless and the end fatal. 
"Find out the cause of this effect, 
Or rather, say the cause of this defect, 
For this effect, defective, comes by cause." 
Bartholow says : "The mortality from pneumonia 
has been and continues to be a subject of warm dis- 
cussion on the part of those who advocate some 
special plan of treatment. Accurracy in diagnosis 
and skill in treatment are such uncertain elements in 
the statistics of mortality, under different plans of 
treatment, that but little reliance can be placed on 
the statistical method as applied to therapeutic ques- 
tions. In determining a fatal result in pneumonia 
so much depends upon the condition of the individ- 
ual attacked, or the diathesis with which his system 
is tinctured, that no comparison of systems of 
treatment can be accurate that does not take note of 
them. 
"Death is usually due to collapse-that is, cardiac 4 
failure, and obtunding of the nervous centers. This 
state is not necessarily caused by purulent transform- 
ation-it may be due to failure of heart, and lungs 
and brain, before the end of the stage of red hepati- 
zation. The effects of the pulmonary changes are 
enhanced by the stasis in the cerebral veins and 
ischemia of the arteries and by cardiac paresis." 
It is surprising how little breathing capacity will 
suffice to carry on the functions of existence, as wit- 
ness the model fashion plate for instance, or the "one 
lungers" in Southern California; which reminds me 
of the inspector on the boundary line who stopped 
three Chinamen trying to steal across to the United 
States; their names suggested Lung, and having 
lived some time in a health resort he entered them 
on his report as One Lung, Two Lung, and Three 
Lung. 
While we do not see any patients of the three-lung 
variety in San Diego County we do have many with 
but one, and often those with less than a whole one; 
and while these individuals do not, perhaps, consider 
themselves as strong as ever, still well enough to 
dispense with the doctor and able to attend to their 
daily duties. 
And so in many of these pneumonias the lung ca- 
pacity would seem sufficient to prolong life, but the 
blow falls upon the heart; it labors to force blood 
through choked channels and obstructions; the 
blood is impoverished by deposits of important ele- 
ments; the heart muscles and others involved in the 
circulatory process weakened ; the stimulating pres- 
ence of oxygen in the blood current to encourage the 
over-worked organ absent, but, on the other hand, 
unusual quantities of carbonic acid present with its 
enervating influence on nerve and brain. And just 
here is the indication for the treatment mentioned; 
champagne and strychnin. 
I am not going to tell you just how these do good- 
presenting this, that the other theory with which 
you are all familiar; maintain that the alcohol is a 5 
food, or that it prevents rapid metamorphosis, con- 
serves force, soothes and anesthetizes irritable nerve 
centers and satisfies a complaining stomach; but I 
simply say they do good and recommend, if you do 
not already use them often, to hereafter use them 
oftener. The strychnin as a tonic to the heart and 
muscles involved, seems to back up and sustain the 
good work begun by the champagne. 
Whisky does not act as favorably when given in 
these cases and the benefit, I conclude, does not de- 
pend solely on the alcohol administered. 
Do not ask me what particular brand of champagne 
I recommend, for no fee having yet been paid by 
the proprietors, and having before my eyes the recent 
and awful warning of Hart's Apollinaria water and 
Hammond's testicular juice I forbear to name the 
mark. I do not say California champagne is the best 
in the world-it is unnecessary, for the doctors are 
on the ground, and they will test the matter for 
themselves aad so be able to determine. 
In 1884, while practicing in the city of Pawtucket, R. I., 
I was called in consultation to an aged lady of 74 years ; she 
had been sick a week with pneumonia; both lungs badly 
involved; temperature 105 degrees; pulse 140, weak and 
irregular; respiration rapid; expectoration of prune juice 
character; delirium of a low muttering type; mouth open, 
tongue dry and dark brown ; with picking at the bed clothes 
and involuntary evacuations. The case seemed altogether 
hopeless. 
I suggested champagne and strychnin, and her attendant 
requested me to carry out that line of treatment and 
assured me he would esteem it as a great personal favor if I 
would assume the entire care and take charge of the case, 
for he frankly admitted he believed the patient would 
surely die. 
Hypodermics of strychnin, 1-60 grain each, were given 
until the system manifested an increase of the reflexes 
especially of the lower extremities, every two or three hours 
at first, then at longer intervals and, as matters mended, 
granules of the same strength were administered by the 
mouth twice or three times a day; and a tablespoonful or 
two of meat juice was given hours, followed with 
pepsin and washed down with twodor four tablespoonfuis of 
champagne. 6 
Within twenty-four hours there was improvement; the 
heart steadier and less rapid, pulse fuller, the muttering 
ceased, the muscular agitation was quieted and the bed-pan 
called for when needed ; additions were made to the nour- 
ishment, of hot milk and Vichy water ; the champagne was 
given in larger quantities but less frequently, and in a few 
days the old lady was convalescent. 
No cast-iron rules are given to regulate the admin- 
istration of these remedies; every case will be a law 
to itself, and the amount required will vary-give 
here, as always, remedies for results-give until the 
pulse steadies, becomes slower and fuller, until the 
heart does its work better, and then be governed by 
the subsequent needs of the particular case. 
Under our heading, "chest troubles," we may speak 
of cases following la grippe: when the acute symp- 
toms have subsided and that state supervened of 
prostration, with general collapse threatening, and 
the weight falling upon heart and lungs, with 
impeded circulation and the lungs in an edematous 
or hydrostatic condition; then, champagne and 
strychnin is appropriate treatment, and with suita- 
ble nourishment become ministering angels to restore 
and lead back to better things. 
Quite recently an aged lady came to our city from Phila- 
delphia; her family physician had carried her through an 
attack of la grippe and sent her here to Southern California, 
hoping she might more rapidly gain strength ; but, in cross- 
ing the mountains by train she had taken what she called 
"a fresh cold," and reached her destination seriously ill; 
and when I saw her,soon after,she had a pneumonic deposit 
in the lower lobes on both sides. 
She passed her eightieth birthday delirious with fever, 
rapid respiration and brick-dust expectoration; and the 
consulting physician did not help quiet the now thoroughly 
alarmed family by saying she would die; but she got her 
strychnin, champagne, meat juice and milk regularly, and 
in quantities which to my judgment seemed necessary to 
meet the indications; and she made a good recovery not- 
withstanding her last will had been made and her friends 
had said good bye. 
In continued fevers, especially of that type which 
in Kansas City in the old days we called typho- 
malarial, this treatment is of great value; when the 7 
heart and lungs are distressed it arouses nature to 
make this supreme effort, and thus free the patient 
from those depressing influences which if not relieved 
would end in death. 
In these days when the coal tar products are so 
recklessly administered, the warning voice can not 
be too often raised, and a heart stimulating rather 
than a depressing course advised. 
These few thoughts are presented rather as sug- 
gestions and not as dogmas; having no pet theory 
to promulgate and sustain at all hazards, no long 
list of cases and statistics has been made out, with 
quotations and extracts from an exhaustive roll of 
writers and authorities. 
Some one has said: "The bibliography has become 
what the bearskin is to the British grenadier-it 
makes him look tall and imposing. 
"You may be excused for being abashed in the 
presence of one who reels off a list of twenty pages 
long of authorities consulted; unless he remind you 
of certain persons who make it a point of parading 
before you the names of all the eminent men with 
whom they have a bowing acquaintance." 
My experience with this line of treatment during 
the past dozen years has not been invariably success- 
ful-what man saves all? But in a large number of 
cases, both in my own practice and coming to my 
knowledge, under the care of confreres, the results 
have been highly satisfactory; and suchthat 
when compared with other methods have recom- 
mended this to more general use. 
And while I do not expect to carry universal con- 
viction by premises somewhat narrowly drawn, still 
I may expect this treatment or some modification of 
it in chest troubles of the aged, not only to maintain 
an excellent reputation but to increase in favor on 
closer acquaintance.