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Old 02-22-2012, 03:32 PM
 
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I just watched the HBO miniseries Mildred Pierce (2011) and also re-read the book (from 1941). The miniseries was MUCH closer to the book than the original movie from 1945 was. It's a work of fiction, but includes a lot of minute detail about how things were in the 30s (the depression, prohibition & repeal, how divorcees were viewed, etc).

Anyway, in the book and the miniseries, the little girl dies, almost unbelievably, from an infection of a pimple on her upper lip. The doctor has a little band-aid on it, and tell the mother they took a swab of the pimple to check for infection, because "any infection occuring from the mouth up, drains into the lateral sinus, and that means the brain..."

I'm no physician, but huh???

First, I know antibiotics were relatively new in the early 30s, when this happened. We all know penicillin was discovered by Fleming in 1928, but sulfa drugs were already out at that time to fight infections. So it seemed odd that they didn't treat her with an early antibiotic. I know it's a work of fiction, but Cain, the author, was so meticulous in his details of everything else from the time period, it seems strange he'd be so off on this point.

Second, the little girl had a high fever, a very high pulse, she was almost totally unconscious, and mostly delirious from the high fever. Could this kind of deadly infection really happen as the result of an infected pimple? I read somewhere that before penicillin, people lived with the fear that any little cut or scratch could get infected and eventually result in death. Was this an exaggeration? It seems strange that Cain would use this mode of death as just a dramatic literary device, when there were so many other more believable ways of killing the character off. This "draining into the lateral sinus" thing sounds weird too. Is there any medical validity to that?

Third, they tried giving the girl a transfusion, but rather than bringing in a bag or bottle of blood, they brought in a big strong man with his sleeves rolled up, who was a professional blood donor. They hooked the patient right up to the donor. Is this really how they did transfusions back then? Right out of one person and into another? I know the Depression was pretty tough, but did people really make a living donating their blood, in person, to hospital patients? Evidently the guy charged so much, it was more than most families could afford. I know nowadays we hear of desperate people "donating" blood for cash, but it's small amounts of blood, small amounts of cash, and it goes into a bag, not right into a person. Anyone know if this was really done in the 30s? Where might I read more about this--I find it really interesting.

The 1945 Joan Crawford version of the movie didn't seem to even want to cover this, so they just had the little girl die of pneumonia.

Anyway, I love all kinds of historical fiction, and I like to look up the factual history that's presented, to learn more, and get a more detailed context for the story. But this pimple thing really got me.
Thanks.
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Old 02-22-2012, 04:18 PM
 
Location: Mostly in my head
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There was a famous case that my parents warned me about in the late 40s-early 50s about a teen?child? who was the son of someone famous and the teen died from a brain infection caused by a pimple on the nose, near the nostril. Can't remember exactly but he might have been the son of a Supreme Court Justice. My father was a physician and the message was NEVER mess with a pimple on your nose.
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Old 02-22-2012, 04:28 PM
 
Location: zone 5
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In the 70's I saw a magazine article that referred to the area from the corners of the lips to top of the bridge of the nose as "the triangle of death", because an infected pimple there could spread quickly to the brain. I laughed it off. A few years later someone I knew ignored a badly swollen pimple there, went to sleep and woke up with one whole side of the face swollen. He spent several days in the hospital, the first day unconscious, getting pumped full of antibiotics. If he'd slept longer, they said he would have died. So I guess it could have progressed to the point where the antibiotics they had available wouldn't help, although she'd have looked worse than having a little bandaid.
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Old 02-22-2012, 04:31 PM
 
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Yes, it's possible to do a blood transfusion person to person. My guess is that, at that time, it would have been more likely in a rural, poor, or emergency situation. Those circumstances also could influence the lack of early antibiotics in your first question. So it seems consistent to couple the lack of newly specialized medicines with less modern transfusion methods.

An infection that can kill can start in a myriad of ways - many seemingly or typically insignificant. That's true to this day. Think of MRSA or infections caused by bowel obstructions that cause sepsis and, potentially, death.
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Old 02-22-2012, 05:02 PM
ino
 
Location: Way beyond the black stump.
680 posts, read 2,131,150 times
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Quote:
Originally Posted by SouthernBelleInUtah View Post
There was a famous case that my parents warned me about in the late 40s-early 50s about a teen?child? who was the son of someone famous and the teen died from a brain infection caused by a pimple on the nose, near the nostril. Can't remember exactly but he might have been the son of a Supreme Court Justice. My father was a physician and the message was NEVER mess with a pimple on your nose.
Well, it seems you aren't overly familiar with that so called "famous case" so I have to wonder why even mention it? Could it be that your involvement/relationship with medicinal practitioner/s taints your view on things?

However, leaving that aside, I can't see any problem with popping that pimple, no matter where it is from the neck up as I have done throughout my entire life when the need arose/arises, and then dabbing...is it iodine, that old liquid that turned skin yellow? or metho, plus a miriad other substances that could be used, immediately afterwards.

This just shows how mainstream will not deviate from the dictate of modern medicine teachings.

Statistically, from the odd few which may have some unpleasant outcome to the simple act of popping a pimple as compared to the millions around the world who would do the same thing, this is not an argument for NOT popping pimples, just an argument that SOMEONE may have an issue with doing same. That holds true for most everything in life, that doesn't constitute an argument for NOT doing something.
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Old 02-22-2012, 05:27 PM
 
Location: Georgia, USA
21,497 posts, read 26,089,700 times
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Default It's true

Facing up to the Triangle of Death | The Dr. Oz Show

Sulfa:

Amazon.com: The First Miracle Drugs: How the Sulfa Drugs Transformed Medicine (9780195187755): John E. Lesch: Books

The sulfonamide Prontosil became available to doctors in April, 1935.

So it would depend on the year in which the incident with the little girl happened.

Penicillin was discovered by Fleming in 1928 but only became commercially available in 1945.
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Old 02-22-2012, 05:34 PM
 
Location: Georgia, USA
21,497 posts, read 26,089,700 times
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Quote:
Originally Posted by ino View Post
Well, it seems you aren't overly familiar with that so called "famous case" so I have to wonder why even mention it? Could it be that your involvement/relationship with medicinal practitioner/s taints your view on things?

However, leaving that aside, I can't see any problem with popping that pimple, no matter where it is from the neck up as I have done throughout my entire life when the need arose/arises, and then dabbing...is it iodine, that old liquid that turned skin yellow? or metho, plus a miriad other substances that could be used, immediately afterwards.

This just shows how mainstream will not deviate from the dictate of modern medicine teachings.

Statistically, from the odd few which may have some unpleasant outcome to the simple act of popping a pimple as compared to the millions around the world who would do the same thing, this is not an argument for NOT popping pimples, just an argument that SOMEONE may have an issue with doing same. That holds true for most everything in life, that doesn't constitute an argument for NOT doing something.
The problem with indiscriminately popping pimples is that you massage bacteria deeper into the skin.

A pimple is like a tiny abscess. If you try to pop it when it is just a red bump, you will not do anything to help make it any better. Just applying a topical antibiotic may help it heal faster.

If it has gotten soft and clearly has pus in it, then draining it with a sterile needle and applying a topical antibiotic is an option. It would be a good idea to ask your doc to show you how to do it.

If you get a lot of pimples, see a dermatologist. There are topical medications that can help.
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Old 02-22-2012, 05:53 PM
ino
 
Location: Way beyond the black stump.
680 posts, read 2,131,150 times
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Quote:
Originally Posted by suzy_q2010 View Post
The problem with indiscriminately popping pimples is that you massage bacteria deeper into the skin.

A pimple is like a tiny abscess. If you try to pop it when it is just a red bump, you will not do anything to help make it any better. Just applying a topical antibiotic may help it heal faster.

If it has gotten soft and clearly has pus in it, then draining it with a sterile needle and applying a topical antibiotic is an option. It would be a good idea to ask your doc to show you how to do it.

If you get a lot of pimples, see a dermatologist. There are topical medications that can help.
Thanks for that, but no Thanks. I don't have an acne issue, but like most I am still susceptible to the odd volcano occasionally, and I don't need to see a doc to rectify it I've been fixing it on my own, unassisted, all my life

Besides, I've got my own 'topical medication'
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Old 02-22-2012, 06:16 PM
 
Location: Georgia, USA
21,497 posts, read 26,089,700 times
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Regarding the blood transfusion thing.

My Dad worked at the Georgia Warm Springs Foundation --- FDR's polio foundation --- before WWII. I know he was the donor for at least one such transfusion to a polio patient.

So the direct donation thing was being done as late as that.
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Old 02-22-2012, 07:34 PM
 
9,209 posts, read 18,049,326 times
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Hunh, so there really can be a killer pimple!

The book took place in Los Angeles and in suburbs just outside of LA, so this wasn't an isolated rural area. I guess the person to person transfusions may have also taken place in more urban areas too, if the book has any credibility. I wonder if this was because refrigeration wasn't widely available, and when it was, it was somewhat unreliable.

I didn't know penicillin wasn't commercially available until the 40s. I guess I figured once it was discovered everyone would realize overnight how valuable it was and it would be everywhere quickly, like today (and they didn't even have all the FDA hoops to jump through.) Thanks for the info.

Just a little hobby I have: when I read any historical fiction, I end up researching and reading a lot more than the actual book, as I like to check out all the factual info.

Should have seen when I read Wolf Hall--I did enough research to probably get half-a-Master's on the history of Tudor England
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