Dr. Jean Jarricot, MD
Director-Founder of the Dispensaire René Quinton de Lyon
Marine Plasma (Quinton Plasma or Ocean Plasma) in Therapy of Nurslings
(The Marine Dispensary)
Extract from: Dr J. Jarricot, Le dispensaire marin, Paris, Masson 1924
Translated from the French by the Ocean Plasma Team
THE EXAMINATION METHODS, OF SURVEILLANCE AND CONTROL AT THE MARINE DISPENSARY
Without wanting to limit the immensely vast subject of the Marine Plasma action, the main interests of the Marine Dispensary, the pediatric nursing organism I head, are the following:
- Chronic or acute nutritional problems of nurslings; retardation of growth (hypotrophia, dysthrepsia), stoppage of development (atrophy, athrepsia).
- Chronic or acute problems of the gastro-intestinal tract (enteritis, dyspepsia) and their cortege of vomiting and diarrhea, as well as intestinal hyperacute catarrh (infantile cholera).
- Specific cachexic patients; ganglionic manifestations, such as those of bone and skin tuberculosis; skin diseases in general and eczema of infants in particular.
Very numerous diseases have now been treated with Marine Plasma (Ocean Plasma), in a systematic fashion and with excellent results. Of these we can cite mainly: anemia, lymphoid diseases and scrofula, skin diseases, various kinds of tuberculosis, nervous system affectations and chronic gastro-intestinal afflictions.
Related to anemic, lymphatic, scrofulous and tubercular (bone and skin) disorders, Jovane and Pagano have observed many rapid and lasting healing results. Bourganel and de La Prabe have confirmed these results. I too, have observed cases of old and fistulous adenoids heal without recurrence.
In the domain of skin diseases, Vartor and Quinton have reported to the Academy of Medicine many striking observations and method of treatment for eczema. Psoriasis, and we all know the tenacity of this disease, can be healed half of the time. Regarding the nervous system, Marie and Pelletier, Robert Simon and Quinton, Plantier and numerous other authors have recorded their best effects in [cases of] paralysis, neurasthenia, gynalgia, etc. As far as pulmonary tuberculosis is concerned, the opinions are split: but is this not the case with all active medicaments? One thing that is sure is that, from 1905 on, the remarkable successes that were obtained by Quinton and Robert Simon have been presented to the Academy of Medicine by Chauffard and that, since then, numerous works [research] have confirmed these results, notably those of Fournel, Mathieu, Jovane, l'Agano, Carles, Védy, Fomou, etc. The observations of Robert Simon and Quinton, as well as Bourganel and d'Amyot, leave no doubt whatsoever concerning the efficacy of the Marine Method in cases of enteritis, muco-membranous colitis such as chronic constipation. For injections, I do not recommend the use of pure seawater. Such injections are painful and provoke unwanted violent reactions. However, I do utilize two seawater dilutions just about indiscriminately (except in eczema cases, or intrarachidian injections or in cases of massive doses):
- One is isotonic (2 parts seawater to 5 parts pure [spring] water - this is the Quinton Plasma [also known as Marine Plasma or Ocean Plasma].
- [The other is hypertonic - pure seawater, cold sterilized]
First of all, [pure] seawater can be given to a vomiting nursling to drink [in tiny quantities of course], notably in cases where there is choleriform enteritis or where one can observe, at the start of the Marine Treatment, an absolute intolerance for milk, however, under the influence of the Marine Treatment, this intolerance is only transitory.
I have administered seawater to nurslings by an intra-rectal infusion, drop-by-drop like Murphy's method. The rate of administration is 13 drops every 15 seconds or 50 grams in 15 minutes. This method should not be neglected in a case where injections cannot be carried out; however, this is not the choice process [of administration].
The process of choice to administrate seawater is either by intra-tissular injection, hypodermic injection or intra-muscular injection - whatever is easier.
The Marine Method demand that one adopts, at least at the start of the treatment, the following regimens:
1) Nursling eczema - very weak and spaced-out doses
2) Chronic constipation of enteritis cases - weak but more closely spaced and increasing doses
The marine method demands average doses and relatively defined doses in the treatment of common diarrhea of young children, even in massive hypersecretional cases, but without choleric complications. To the contrary, the method demands very elevated doses (more than 200 times the dose of eczema) in cases of acute intestinal catarrh of nurslings; when one observes the zones, i.e. the border, the breath, the folds and characteristic stomach. The Method gives these dosage indications as formal posology, as necessary prescriptions, as outcome of experience, definitely established.
The premature interruption of the treatment is almost always a decision that is determined by [the condition of] the child. Sometimes, a very short treatment suffices. Everything happens, in certain cases, as if the injected seawater doses had imprinted upon the child's development a favorable and definitive momentum. In most cases, it does not happen this way. To decide the opportune moment in time when to suspend a treatment is often, in my opinion, one of the most delicate operations. The most diligent attention is required at that time.
Practice of the Marine Method
A child, even when facing the final moments of his life, with pronounced muscular resolution, non-perceptible pulse, widely spaced breathing movements (32, 28, 24, 18, 16), non-existent corneal reflex, when the child is injected with Marine Plasma, it comes back to live in 92% of the cases.
Choleriform enteritis, the most serious disease of a child's digestive tract follows right away or suddenly declares itself during a common gastro-enteritis. This happens mostly to subjects younger than two years but also strikes sometimes children of 27 to 28 months of age. If this is mis diagnosed, four to eight days suffice to see death ensue.
Choleriform enteritis of nurslings demands two sub-cutaneous Marine Plasma injections per day, one in the morning and one in the evening, of 200 grams each, for ten days running. After ten days, if all goes well, one needs to inject 200 grams once every 24 hours for 8 days more. One can then suspend the intensive treatment, while being on standby to resume treatment in case of an alert.
«With children that are close to the extreme phase (with ocular mucosities, vitreous eyes, corneal depression, attenuation or disappearance of corneal reflex, muscular resolution, difficult-to-measure pulse, slowing of respiration) one has to inject two doses of 300 or even 400 grams each during the first 24 hours. Once this has been accomplished, one should come down to the usual doses of 200 gr. In every case, it would be indispensible to administrate two injections per day during the first eight days independently of the apparent condition of the child after the first few injections. An interruption or a slowdown in treatment is invariably followed by a serious relapse. The 200 gr injection usually lasts for 12 hours. It is enough not to renew this injection to see all the gastro-enteritis phenomena that were attenuated by the Plasma, reappear.
The regimen that is prescribed to the child is of utmost importance and should be rigorously followed. Generally, within two hours, the marine injection re-establishes the lost faculty of digestion. In [relatively] rare cases (15%), digestive intolerance persists after the first injection or reappears during the treatment. Usually, this intolerance diminishes with the next injection. If it [still] persists, one should feed the child with Plasma for about 12 or 24 hours with 1/3 water added. The Plasma is remarkably well accepted. Thereafter, one comes back to the original regimen.
If, because of the injection, the temperature rises to 40°C or less, one does not need to have recourse to baths. Any reactionary temperature never presents any danger.
2. COMMON ENTERITIS
By common enteritis I mean all the affectations of the digestive tract of nurslings other than choleriform enteritis. These are characterized by a beginning that is less sudden but
generally quite insidious and take the child to the brink of athrepsia or atrophy. The Marine Method can in this case be summarized with two words: inject and nourish, inject the necessary dose and feed the child sufficiently [and appropriately].
As with choleriform enteritis, milk and starches (flour) should be of excellent quality. [Note: A more modern approach would substitute puréed ripe fruit for starches and assure that mother's milk is available instead of cow's milk. If mother's milk is not readily available, then diluted certified cow's milk would suffice. Formula liquids should be avoided if at all possible].
POSOLOGY OF THE INJECTED SEAWATER
- Dry Enteritis (constipation)
With common dry enteritis (constipation), the first doses should always be weak. Constipation has this characteristic in the sense that strong doses would tend to aggravate it; Therefore, one should always start with several injections of 10 cubic cm (3 or 6) and not increase these to higher doses (30, 50 100 cubic cm) unless those weak doses do not bring about the desired change. Once the active dose is reached, one needs to remain there and not go any higher unless this active dose becomes ineffective, in the long run. When an athreptic or atrophic child is constipated, and its general condition is very low, one should try to improve the general condition and act accordingly by stronger doses (i.e. 30, 50, 100 cubic cm).
In most cases, doses that work are as follows: six initial injections of 30 cubic cm at the rate of three injections per week. Then 50 cubic cm at the same interval. The treatment should not comprise less than 15 injections, even if there is improvement or seeming healing following the first injection. This should be continued beyond the 15 injections if the condition persists and even for several months if it is a case of athrepsia or a deep organic wasting. In about 20% of the cases, [even] doses 30 and 50 cubic cm are insufficient. Know that there is a simple way to know. One principle governs the doses. When a dose is insufficient, one must increase it until the desired results have been attained. However, one should make sure that the lack of success is really due to the insufficiency of the dosage and not due to an incorrect regimen [diet], due to an inappropriate adjunctive treatment or any other cause. If, for example, the stool does not improve, if the vomiting continues, if the nursling does not nurse, the subject remains anorexic and stationary in terms of weight, and if all these different morbid manifestations are not there due to a technical shortcoming, then one should augment the dosage and, if necessary, shorten the intervals, until one give even daily injections, [by default].
In really serious cases, just before dying, following a common diarrhea, then one must resort to doses of 200, 400 and, if necessary 600 cubic centimeters per day, by means of two injections spaced about 12 hours apart, and then come back to the doses of 100, 50 and even 30 cubic centimeters three times a week, as soon as the clinical condition has improved. At any rate, the handling of dosages is really quite simple; it can be summarized in the following manner: 10 cubic centimeters with constipated patients; 30 and 50 cubic centimeters with diarrhetic patients; 100 to 200 cubic centimeters as needed in extreme cases. The intervals should be two or three days between injections. In extreme cases, daily injections and even twice daily at 200, 400 and 600 cubic centimeters per day, according to the gravity of the situation and the age and the weight.
3. LACTOSE INTOLERANCE
Use of seawater in the case of vomiting
Five minutes before each meal, one should give one soup spoon of isotonic [here Jarricot probably means hypertonic and not isotonic] pure seawater or diluted to 1/3 with ordinary boiled water. If the anti-emetic effect is insufficient, i.e. if the vomiting are relentless or very voluminous, one should replace, during two or three days, alternating between a milk feeding and a Plasma feeding (two parts plasma and one part water). Avoid to alternate with subsequent feedings. One should give Plasma instead of milk only if the preceding feeding had been vomited.
Doses of seawater to inject
According to the form that characterizes the intestinal problems (diarrhea or constipation), one should chose the prescribed treatment dose for simple enteritis patients, at least at the beginning of the treatment. One should also take into consideration the fact that, in the case of a child's lacto-intolerance, doses can manifestly be multiplied. The age of the child should not matter here. Except for cases of severe constipation, it is altogether safe to increase the dose [of injection] to 200 grams of plasma every 24 hours, even in the absence of aqueous diarrhea, but certainly in the presence of of general phenomena, such as wild vomiting and the important symptoms of gastro-intestinal hyperaesthesia, justifying an intensive treatment; and for everything else, and above all for forms that resemble spasmodic disease, one would be wise to give, right before the two daily injections, a hot and prolonged bath.
4. GENERAL CASES OF MALNUTRITION OF NURSLINGS: HYPOTROPHIA, DYSTHREPSIA, ATHREPSIA, ATROPHY
Malnutrition exists when there is insufficient assimilation or excessive nutrient losses [or where there is lack of nutrition].
Treatment of child malnutrition
One needs to apply the prescribed dosages as per the protocol of common enteritis and that of lactose intolerance, i.e. the usual doses of 30 to 50 grams (cc's) of Quinton Plasma [Marine Plasma or Ocean Plasma], three times a week. With children that have very low weight or profound malnutrition, it would be best to start with daily injections of 10 cubic centimeters of Plasma, during at least 20 days. At any rate, if the improvement is not prompt and evident, then even in these cases one would raise the dosage to 30 gr, 50 gr, 100 gr and even higher. Finally, in cases of extreme cachexia, imminent death, one should ignore the age or weight and immediately inject a strong dose, i.e. 100 grams of Plasma or more, in two equal but divided doses 24 apart, except in the case of edema.
In all these cases, the general rule is to reduce the intervals and augment the doses of the results are not satisfactory. One never runs any risk to inject a strong dose; however, one sometimes observes, after the first or second injection, a few hours of fever or agitation and we have already explained that such a reaction is always without danger. In all conditions of malnutrition that result from general diseases and that accompany the diseases or that cause morbid complication, the therapeutic prescription is always the same as far as the Marine Method is concerned, except if one is faced with a case of choleriform enteritis, tuberculosis, syphilis and, in some ways, eczema. By referring to the appropriate headings of this chapter, where these cases are illustrated, one can find indications and references exposed that show what this Method implies. With all other diseases one needs to remember that the Marine Treatment in no way conflicts with any medication and consequently one can always have recourse to specific serotherapies, to general treatments of infectious diseases such as colloidotherapy, etc. - in other words, to general therapeutic resources that come to mind and that could be complementary to the Marine Method.
5. NURSLING TUBERCULOSIS
In every case where a tubercular terrain is diagnosed (tubercular child or tubercular heredity), the treatment should start with weak doses of 10 cc of Plasma, three times a week. However, one should keep in mind that for all non-visceral tuberculosis cases, one should normally resort to average doses of 30 and of 50 gr of Plasma, three times a week, in order to obtain sufficient improvement; for example, in case of pseudo-athrepsic tubercular cases. One should also know that in these same nosological cases, the strong doses of 100 to 200 grams are well tolerated and often necessary to realize the desired Marine Method effect.
In all non-visceral tubercular cases, the effect of the Marine Method is remarkable. This an incontestable fact. One sees, for example, tubercular skin ulcerations resolve with such rapidity that one can see, in three week's time, complete scarring of the ulcerations that covered a surface area of a Franc [large coin]. In the case of osseous tuberculosis r peripheral ganglionic tuberculosis, the effect is also often quite rapid. An adjunctive treatment that can be recommended would be that of deep washing of the fistulas, with isotonic Marine Plasma. The Marine Treatment effect is often perfect chosen in uncomplicated visceral lesion cases of latent forms of infantile tuberculosis (dyspeptic type as in the anemic type).
In cases of visceral tuberculosis one needs to draw certain distinctions. Quinton thinks that the Marine Method is capable of giving impressive results in all cases, even pulmonary tuberculosis. It is not only the most serious of juvenile tubercular conditions that could benefit from seawater. Of course, in the most ravishing forms such as broncho-pneumonia as well malaria, one cannot hope for much from a Marine Treatment; there, everything comes to a checkmate. But, with pulmonary tuberculosis, tracheo-bronchial adeno afflictions, and wasting diseases, seawater is a great aid. As far as I am concerned, I am proud to say that I have employed seawater in these grave cases and to have been able to conserve the life of children whose death was certain in conditions that I have observed, such as: fever, cough, weight loss, positive intradermic reactions with nursling only a few months old. However, I would not pass judgement on the use of the Marine Treatment as the only treatment, to the exclusion of any other, as far as those very grave tuberculosis cases are concerned. But there is no doubt for me that seawater provides unfailing aid to these infected tubercular nurslings, debilitated by disease and failing. In summary, I am favorably inclined to the employ of seawater, even in serious infantile tubercular diseases. As a rule, in these cases, and I emphasize, is to start with weak doses of 10 cubic centimeters, three times a week and not to augment these doses, as the case demands, unless the temperature allows it, i.e. if the injection is not followed, within 8 hours, by a febrile reaction, regardless whether the treated form was apyretic or not before the injections were given.
6. GENERAL SYPHILIS
All by itself, and to the exclusion of any other treatment, the Marine Treatment can give first class results to the syphilitically challenged nursling. By means of its unique influence, ulcerations, if they exist, diminish rapidly; the drained appearance disappears, and right from the very first injection, the scarring process appears. With those specific nurslings that have weight retardation, as with those afflicted with commonplace hypotrophia due to undernourishment, the weight rises right away, in almost all cases. Weight improvement, however, does not always have the usual intensity. In 25% of syphilis cases, the weight increase is only 400 to 600 gr per month; at least the weight rises right away, even if it had been stagnant for a long time. At the same time as the weight picks up, we also see the height increase, as well as the frontal and parietal venous ectasia diminish. It is normal that the hydrocephalia continues its evolution during the first weeks of the Marine Treatment; but this too invariably moderates itself, as is proven by successive cranial measurements (total perimeter, biparietal diameter and antero-posterior).
The syphilitic nursling should be treated with the Marine Treatment for at least six months to a year. Conducted with regularity, this treatment progressively leads the child to a state of visceral perfection that is simply astonishing when later one looks for the taints and stigmata and when one sees how vast the extent of benefit this Marine Action really is. Infantile syphilis can be accommodated by ordinary doses of 30 to 50 grams of Marine Plasma, three times a week. Nevertheless, strong doses (100 grams of Plasma, three times a week) could be necessary. The weight increase remains the criterium of the posology.
It is possible to inspect numerous observations of specific nurslings with whom all the morbid phenomena have disappeared with one single use of seawater. But that does not mean that the Marine Method is oblivious to failure in the treatment of syphilis. In certain cases, we had only checkmates.
The eczema lesions of children, as is the case with those of adults, respond very well to Marine Treatment. In the majority of cases (60%), the first injection of Plasma responds with an immediate but temporary aggravation of the lesion that suppurates and weeps abundantly for one or two days, sometimes three, only to dry up and diminish thereafter. The next injections follow the same pattern, a little less obviously in general, until complete disappearance of the weeping with following erythema. This definite disappearance of the morbid symptoms happens, in certain cases, at about the eighth or tenth injection, sometimes a little later; and there are some tenacious cases as well.
With nurslings, the six first injections should be practiced at a volume of 10 cubic centimeters. Stronger doses provoke sudden reactions that are too severe. These sudden reactions are without inconvenience if the eczema is located elsewhere than on the face. It is preferable to avoid these if the cheeks, the eyelids and frontal region are invaded by the lesions. The abundant weeping that can happen could reach the eyes and cause conjunctivitis. This is usually without consequence. It is better to avoid the reaction by using weak doses and by plenty of humid dressings. Keep the latter in place on forehead and cheeks.
In 40% of cases, the improvement comes right away, and without any reactional upsurge. One can see the erythema (redness) diminish, primitive weeping reduce, the lesions dry up and become like dry leaves, then pale and disappear. If, by contrast, the doses of 10 cc are not succeeded by neither an improvement nor a reaction, it would be best to proceed right away to doses of 30 cc and, if needed to 50 cc so as to promote a regression of the lesions without an acute reaction even though a reaction is always a sign of healing. In all cases, one should repeat the injection three times a week. The humid dressings should be done with boiled water and applied to the areas affected by the eczema. In every case it would be advantageous to replace the use of water by Ocean Plasma (Marine Plasma), especially on the raw lesions.
When children's eczema is accompanied by serious gastro-enteritis phenomena (i.e. choleriform enteritis or summer aqueous enteritis), one needs to hurry; one needs to ignore the eczema and apply the treatment, with massive doses to address the diarrhea and dehydration while simply dress the eczema lesions with humid dressings. One can see, in the majority of cases, that the eczema improves with astonishing rapidity. I insist on the point that the weak doses that are recommended by Quinton in the treatment of eczema have but one purpose, and that is to limit the reactional worsening of healing symptoms for facial eczema. Do not have any apprehension to apply stronger doses; their effect is more energetic and faster; one should employ these higher doses whenever there is slow improvement in acute cases or also when eczema is generally dry. The rule is to push the doses until the lesions weep under the influence of the Plasma injections; improvements can only happen under those circumstances. Quinton and Variot did just the same recommend 30 cc doses and more. Quinton only recommended the 10 cc doses later, in order to avoid the slight visual complication that can happen with children having facial eczema.
Broncho-pneumonia of the nursling is an affection for which the Marine Treatment seems fail; but seawater remains an interesting adjunctive remedy, particularly when the child is dehydrated by aqueous stools. I happen to have combined a special broncho-pneumonia-specific treatment to the Marine Treatment. This cannot be explained in these pages; but after one year of experience, I cannot remain silent on the remarkable success rate that the Marine Treatment has given me. Neither can one deny the fantastic effect that seawater has with children with broncho-pneumonia. When we see that the children continue feeding, even with fever, despite the most pessimistic clinical signs and finally heal without any significant loss of weight.
9. NERVOUS SYSTEM AFFLICTIONS
I think that, in the near future, it will be possible to show what immense services that seawater can provide to patients that are afflicted with diseases of the nervous system. Today, it would be premature to talk about definite assertions such as to define the limits of action that seawater might have in the vast domain of neuro-pathology. But it is possible to already state a few general facts, even if somewhat disconnected.
In all meningitis cases, seawater is certainly capable of favorable action. First of all, seawater upholds the patient's strength, his appetite, his general state. One assists, by injecting the tubercular meningitis patients with such unexpected results that, in general, happen where one would have predicted with certitude a continual and intense loss of weight. The child succumbs to the nervous debilitation, among the usual signs, but without losing any weight, without stopping to feed himself as long as swallowing is possible [this sentence is convoluted in French and possibly inadequately rendered in the English language by the translator - sorry]. One can image what kind of help can be provided for all the non-tubercular meningitis patients where one can add to a specific or general infection medication an adjunctive therapeutic agent with such power.
But there is more. The Marine Action is not limited to an eutrophic effect. Seawater has neurotrophic properties that are quite evident if one judges by the good effects that are obtained with adults in cases of neuralgia, neuritis and paralysis, as well as with sciatic neuralgia (Jarricot), with alcoholic neuritis (Plantiel), with children of all ages having enuresis [involuntary discharge of urine] (Plantier, Jarricot), and even with all those stubborn cases on which all kinds of other treatment had been tried.
In this way, we also see seawater proving itself with favorable action in cases of infantile paralysis where one can sometimes see a unilateral action, or at least a predominance that is attested by the circumferential measurement of the atrophied member and the return of mobility in those cases where function seems to be compromized forever. I can cite results of the same kind that were obtained with familiar amyotrophia, myatonia and chorea. I know of no contraindication that would prompt one to abstain [from using this treatment] due to scepticism.
And finally, how can one doubt the efficacy of this seawater action on the nervous system when one observes with one's own eyes, and in a relatively short time, the head of a nursling modify itself; hydrocephalia, for instance, to become more moderate; isocephalia cede to a shaping of the face; the entire head to stop swelling while the height continues to augment; or, by contrast, a microcephalia with a prognostic of death to improve; the brain to develop and, at the same time, the intelligence to awaken, speech to appear, and the whole psychic life to blossom?
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