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UNIVERSITY OF CALIFORNIA 

SAN FRANCISCO MEDICAL CENTER 

LIBRARY 




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The 

iMedical World. 

VOLUME XV., 
1897. 



C. F. Taylor, M. D., Editor. 



THE MEDICAL WORLD, 
1520 Chestnut Street, 

PHILADELPHIA, PA. 

*■" Digitized by VjOOQlC 



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YEARLY INDEX 



FOR 



THE MEDICAL WORLD 



VOLUME XV, 1397. 



PAOB 

Abdominal Plethora 18t 

Abortion, Charge of 148 

AoetaniUd in Malaria 08 

Aone 801, 814 

Aconite Poisoning 187 

Active Principles 476 

**Ager" 386 

A Hint ... 84 

Albuminuria, Arbutus for ... . 108 
Alcohol a Depressant. 45* 

Alcohol. Fearing Op .am, yet play* 
in* with . . 347 

Alcohol, The Giving of 8J1 

Alcoholism . . 149 

Alcoholism,'* "Strychnin© Cure of 84 
American Medical Association, 
The Bemi-Centennial Meeting 
ofths ... .211 

Anatomical or Surgical ? ... 88 
An Active Campaign Ahead . 897 
Anti-Tubercle Serum, Experience 

with . . 163 

Antl-VivisectionistB, Questions 

for .... 810 

A oesthesia t Atropine in . 109 

anesthesia, Earliest Record of ■ 84 

Safe 1(1, 88S 

Anesthetics in Labor . . . . 338, 39S 

Antitoxin 13, 381 

in Group Ill 

Diphtheria 339 

" In Diphtheria 

7, 8, 9, 10, 11, 115, 180, 188, 291 

Dosage 390 

" in Membranous Croup 188 

Meditations on . . 141 

*' in Private Practice . . 89 

Aphonia 311 

Apoplexy . 4 

r - a Very Short Talk on 6 
Appendicitis, According to the 
Authorities, The 
Treatment of 313 
" Complicated with 

Pregnancy . 601 

" Complicating Preg- 

nancy . 158 

" Grape Seeds and . 169 

? Was it .... 304 
Arbutus for Albuminuria .... 106 

Aspidospermine 185 

Asthma . . 49, 300 

Caused by Uric Add . . 114 
" Por Hay Fever and 816 

" Whiskey and Salt Treat- 

meat for 80 

Ataxia, Vacuum Treatment of . 119 



PAGE 

Atropia Combination, The Mor- 
phia and . 191 
" Do More Harm than Good 
When Given with Mor- 
ohia? Does Not .... 99 

" Morphia and 144 

Atropine and Morphine 185 

Atropine in Anesthesia 109 

Atypical (Typhoid Malarial) 

Fever 899 

Auto-toxemia 350 

Ayer's Cherry Pectoral 476 

"Ayer's Hair Vigor" 128 

Baby's Bath, The 846 

Bateman's Pectoral Drops ... 531 
Belladonna Poisoning 419 

Bell's- Palsy (PadalParalysis) . 8» 
Bengal College of Physicians and 

Surgeons 55 

Beta-Naphthol as a Summer 

Remedy 376 

44 Bilious Colic." . . 9* 

That Case of • 163 
Biological Laboratory, An Inspec- 
tion of Parke, Davis & Co. 's . . 126 
Bismuth, Proper Doses of . . . -831 
Black Byes . ..... 887, 859 

** Eye, For 481 

Boschee's German Syrup .... 476 
Bowel, Impaction of . • . 300 

" Troubles of Children, For 841 
Bowels, Due to Intussusception, 

Gangrene of 94 

*' Emptying the ... 93 

" Inflammation of the . . 380 

•• Obstruction of 18 

* 4 or Congestion of the 
Stomach, Which? Ob- 
struction of 197 

Brain Trouble 517 

Braying Brayton 487 

Breasts, Supernumerary 801 

Brlght's Disease 108, 871 

•* %i Pregnanoyin . 75 

BronohiUine ... 523 

Bronchitis 491 

'* The Cause of .... 445 
Brown's Bronchial Troches ... 476 

Bubonic Fever 55 

Buckler's Croup Mixture .... 476 

Bull's Cough Syrup . . 476 

Burns, and How I Treat Them . 189 

by Gas in Coal Mines . 128 

•• Caused by Gas 137 

" Oreolin for H>7 



FAGB 

Burns, Dressing for 103 

** Treatment of ... 189, 189 
Business Methods, A Word About 486 
" Side, An Episode From 

the 883 

" Side, The 411 

Calcium Sulphide • 838, 836, 877, 508 
Observations on 834 

44 of 878 

44 4i or Heper Sul- 

phuru . . .836 
California. Southern .98 

Cancer, Bloodless Treatment of 133 
" Cure, Arsenious Add 

Again Brought out as a 893 
44 Cures . . . .186 

Cancerous Growths, Removal of 168 
Cancer with Marsden's Paste, 

Treatment of 301 

Catarrhal Powder, Blrney's ... 523 

Catarrh. Snuff for 808 

Cerebral Hemorrhage 66 

Cerebral Anemia 419 

Change of Life and Grip .... 808 
Childbirth, Death in . . . 395 

" Obscure Death Twen- 
ty-four hours after 335 
Children's Diseases, Points in 

Treatment of 841 

Child's Cough Mixture 478 

Chloroform in Labor 114 

On the Use of. . .458 

Cholera Infantum 374, 886 

Cold Water 
Treatment for 278 
44 A Successful 

Treatment of 375 
44 Morbus, Saline Solution 

Suboutaneously for 438 

Chorea 888, 878 

Cinnamon as a Disinfectant, Oil 

of . 81, 119 

as a Dressing, Solu- 
tion of Oil of. ... 187 

44 in Surgery 118 

Water as a Dressing . 438 
Circumcision, A Plea for .... 134 

Class-Room Notes 

40,88,136,168,318, 356 
Clavicle in Position, How to Re- 
tain a Fractured ... 6 
" Treatment of Fractured 35 
deary's Asthma Powder .... 477 

Clergyman's Views, A 75 

Clubbing Department 188 

Cocaine Addiction 178 



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FAG* 

Cocaine for Tetanus .... I j\\ lftl* 
Coldness of the Extremities int I . 

Women ••• 1M* 

Colds, Treatment for . ... 448, 601 
Oold Surface . . 128 

Oold Weather, Notes on Diseases 

Incident to .... 446 

Collect a BUI, One Way to . 434 

Collections and Hard Times for 

the Doctor, anent .870 

Collections, Concerning .... 409 
CoUeotlonsr How Are . . . 514 
Oolleotionsr How are Your 

800,844,411,618 
Collective Investigation of Infan- 
tile Scurry 481 
Conception be Legitimately Pre- 
vented t How May, 106 
Conception Justifiable T When is 

the Prevention of 47 

Conception, Means of Preventing 151 
Conception , Prevention of 

21, 51, 105, 107. 128, 188 
Oonoeption.The Classes Who Pre- 
vent 104 

Consecrate Your Work 845 

Constipation . 485 

Consultations. The Ethics and 

Amenities of 285 

Consumption . . . 158, 158 

Consumption, Cured of ... 485 

* Treatment 488 

Convulsions in Children, Cool 

Sponging for 287 

Convulsions, Puerperal. See 

Puerperal. 512 

Copulation Through the Urethra 240 

Cornea, Ulceration of 878 

Corpus Cavernosum, Induration 

in .... .121 

Correction 82,121.885, 472 

Ctorysa .480 

Cough, For . . 120 

Cough Mixture Wheelock's ... 523 
Coughs and Colds 448 

Coughs and Colds, Treatment for 481 
Coughs. For . . 54 

Cough Syrup, White's . . 521 
Craigh Colony for Epileptics 45 

Oreasote for Tuberculosis, The 

Vapor of . 885 

Criminals be put to Death ? How 

Shall ... 46 

Crying in Children, Cure for .. 125 
Croup, Antitoxin in 115 

Croup.Antitoxin in Membranous 188 
Croup, Diphtheria? Is Membran- 
ous 117 
Croup, Membranous 

108, 220, 205, 458. 458, 504, 510 
Croup? What About Antitoxin 
in Membranous U 



Delicate Subjects Cannot be Dis- 
cussed Publiclr. ... 107 
Dellenbaugh's Cough Cure ... 477 
Dementia. ... 101 
Dengue, not Yellow Fever ... 487 

Depilatory 620 

Diabetes Mellltus 205 

Diabetic Patient, Pain in Feet 

in a . 517 

Diarrhea be Inherited? Can.. . 17 
•• can be Inherited .... 240 
" chronic ...... 207, 411 

" for Chronic 255 

•• in Children 278 

" Inherited 284 

" in the Aged 150 
The Discharges in In- 
fantile 880 
" Therapeutics of 282 
Diarrheas, Dosimetric Treat- 
ment of Summer 278 

Diarrheas of Children . ... 871 

Diphtheria 205 

Diphtheria Antitoxin 220 

Diphtheria, Antitoxin in . . 

7. 8,0, 10. 11, 116, 180, 188, 201 
Diphtheria, A Trial of Antitoxin 

in 71 

Diphtheria ? Is Membranous 

Croup 117 

Diphtheria Mortality 12 



• . r4>®*« 

•DJdhthsTia, My^perVpoyWift : v 
t Sulpnnr ami Cha r poa U n Tieai-- ' • 

•'trig* ^^' .-?•'* 200 

Diphtheria. The Sulphur and 

Charcoal Treatment of . . .181 
Diploma Mill Again. Wisconsin. 50 
41 AWisoonsin ... 80 
Diploma Mills, War on .... 57 
Dirt Bater, A Two Year Old ... 277 
" Eating . . 821 

Disinfectant, Oil of Cinnamon 

asa 81, 110 

Doctor's Wife, From Another 00 

" Doctor's * lfe," More from a 151 
"Doctor's Wife." More Pointed 

Hematics from a 12 

Doctors' Wives . .... 881 

Don't's 484 

D j* i metric Practice, Ten Years of 

105, 287, 287, 824. 878 
Dosimetric Treatment of Summer 

Diarrheas 278 

Dropsy by Removal of Ovarian 

Cyst, Cure of 245 

Drop«y Cured by Salivation 57 

Dropsy, Epsom Salts Cures Two 

Cases of 186 

Drug Habit, The ..... ill 

Dysentery 205, 282 

Dilatation of Anus for 254 

For 878 

Dyspnea 80 

Remedy for 186 

Ear Ache . , 274 

Ectoplo Fetation In the Lower 

Animals 150 

Ecsema 204, 410 

u of the Feet 814,888 

44 of the Feet, Chronic . 808 

Ointments for ... 888 

Palmar . 210 

Edema, Rapid Reduction of . 454 

Elbow Joints, Examination of . 428 

Electricity, On the Use of . . 82 

Emphysema, Pulmonary .... 100 

Enteilc Fever . 451 

Enterocolitis, So-called "Summer 

Complaint" 270 

Epilepsy . . 200, 258, 861 

44 Ear Trouble the Cause 

of . 68 

44 Tobacco as a Cause of 62 
Epileptics, Colony Management 

ror 45 

Bpileptoid Convulsions 888 

Epistaxis. Periodic 410 

Erections, Treatment for Nightly 462 
Erysipelas of the Face 482 

44 Treated by Turpen- 

tine, Facial ... 147 

Ether in Obstetrics .148 

Ethical Questions. Some . .... 810 
Ethics, b reach Co«ie of 255 

Examinations, Questions from 

West Virginia 618 

Expectorant, Stokes' 521 

• 4 Extro-Cardla" .40,187 

Eye Two Years— Its Removal. 

Foreign Body in an 150 

Eyes by Gunshot Wound Without 
External Deformity, Destruc- 
tion of Both 407 

Facts, Worn-out 488 

Fecal Abscess 455 

44 Impaction . . 250 

Femur and Humerus of Child, 

Fracture of 101 

Fevers, An Aid In the Treatment 

of 145 

Fever, That Curious 66, 158 

Fireside, By the .448 

Florida Climate for Tuberculosis 64 

Fly Paper, Sticky 804 

For 44 A Tough Case" ... 72 

Formulas of Patent Medicines 888 

Formulas 476, 520 

Frenum, Short 807 

Call Stone, A Large 26 

Gestro-intestinal Catarrh ... 18. 48 

General Debility 416 

Glands, Enlarged 804 



Gleet . 28 

Gombault's Caustic Balaam ... 610 

Gonorrhea, Oreasote in 886 

Methyl Salicylate in 
the Treatment of . ~" 



Obstinate . . 801, 

Goiter ... 448, 

44 Wanted, Treatment for . 

Gooche's Mexican Cough Syrup 

<*ood Samaritan Cough Syrup . 

Gout Specific. Reynold's . . 

Grandmother's Own Cough Rem- 
edy . . 

44 Grip." Camphor for . . . 

Growths in His Penis ... 

Guaiaool Locally as an Antipy- 
retic 

Gull's Cough Mixture . . . 

Gunshot wound of the Abdomen 
Without Wounding the Intes- 
tines 

Gunshot Wound, Remarkable . . 



814 



477 
477 
521 

4T7 
01 



102 
477 



207 
287 



Hair, For the . . .... 800 

44 Removal of Superfluous 78 
44 Renewer, HalTs Vegetable 

Sicilian 804 

Hall'* Oatarih Cure . . 477 

Hay Fever . 800, 814, 848, 877 

44 Fever and Asthma, For . . . 816 

Headache 814 

Cure for .... 888 

Elixir, Non-depressant 481 

44 Severe 802 

Health, Going off for 814 

4 'The Big Four" Route 

to 265 

Heart on the Outside 25, 128 

Helskell's Tetter Ointment . . 478 
Hematocele. Hernia Pudendi, 

Complicated b* . . 512 

Hemorrhage Due to Quinine . . 6 

44 From the Kidney 185 

in Labor? Does 

Quinine Favor . . 872 

44 Post Partem . . 210 

Hemorrhoids 168, 486 

Hepatitis, Acute Suppurative . . 208 

Hernia, Infection Cure of . . 887 

44 Pudendi, Complicated by 

Hematocele 612 

Hernia, The Injection Treatment 

for the Relief and Cure of . . . 467 

Hiccup 290 

Hiccups. Persistent 106 

HodKklns Disease 165 

Homeopathic Indications .... 818 
Hospital Association, The Fifty 

Cent Co-operative . . 108 

Hot Air Treatment, The Local . 2 
Hour Glass Contraction .... 118 
How Are You Doing It? What 

Are You Doing? and . . 486 
44 are Your Collections?. . . 

800, 855, 887, 412, 518 
44 to Retain a Fractured Clavi- 
cle in Position .... 6 
Hydrophobia. Coucerning 402 
Hyper-seositiveness and Meagre 

Ability 177 

Hypnotic Suggestion ... 86 
Hypnotism as a Cure for Short- 
ness of Breath 267 

Hypnotism, Cases Cured by .167 

Hysteria 888 

and Neurasthenia ... 201 

44 For 872 

Treatment of 221 

44 [ohthysote" 888 

Impetigo, Contagious 170 

Impotence . 165, 507 

Incontinence of Urine .... 162, 818 

Index Book 206 

Individualization ... . . 81 

Infancy, Unnecessary Medication 

in . ! 164 

Inflamed Tonsils 886 

Influenza? Is This a Form of . 108 
44 Insomnia Habit" and Its Treat- 
ment by Natural Methods, The 187 

Insult and Plagiarism 808 

Insured ? Are You 87 



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PAGE 

Intestinal Antiseptics 868 

Itching After a Born Has Healed C 
•* After a Burn Has Healed, 

for 71 

Ivy. Poison 886 

Jackson's Ooogh Syrup . ... 40% 
Jasj, Beet Treatment for a .... 875 

Jaxteway's Pills 484 

Jaundice 160 

Jayne's Expectorant . . . 477 

Journalistic Brethren 968 

Justice, Not Charity, but . . . . 176 



448 

Kidney, Hemorrhage from . . 99, 191 

" Trouble, Remedy for . 840 

Knee Joint Trouble 193 

Labor, Anesthetic* in 838 

Case of Painless .... 88 

" Chloroform in 114 

Ergot in 801 

M Quinine In 802 

La Grippe .... 866 

Laws in Different States, Meaioal 811 
•• of the States, the Medical 478 
Legal Decisions Affecting: Physi- 
cians .... 136 
Legislation, Medical .... 188 
Legislatures, Physicians Elected 

to .8 

Legitimate Medical Journalism . 465 
** Let Beason Reign and Passion 

Serve'' 848 

Liniments, Cheap . . 76 
Liver and Stomach on the Out- 
side 169 

Lodge Practice Evil, The .... 80 

o. Dry Cups for 210 

Quick Belief for ... 164 
Quick Remedy for . . 78 
r, Worm Coughed from the • 8*9 
Lupus Treated with Sunlight . . 397 

Malaria, Aeetauilide in 68 

The Specific Action of 

Quinine in . 891 

Malarial Paroxsyma, Cause of . . 476 

Malpractice. Slander and .... 149 

Mark, Port Wine 98 

Marriage, foetal Purity and 864 

Question, Tne 166,831 

Masturbation 888, 8t0, 430, 448. 467 
44 bya Married 

Woman 480 

Materia Medica, Restudy the . . 611 
Measles Treated with Sulphide of 

Calcium 78 

Medical Dictionary ? Best . . 88 
'* Examining and Licens- 
ing Boards 320 

" Medical Index*' .... 161 

Medical Journals Should Not be 

Lent to Lay Readers 107 

Medicine, Natural Aptitude for . 306 

" The Trend of ... 881 

Melbom's Pectoral Balsam ... 478 

Membranous Croup 108 

Menstruation .... 39 

Absence of .... 944 

Migraine 416 

Mifk Can, The Omnipresent . . . 841 

** Condensed 866 

44 Given to Nurslings. The 
Temperature of .... 843 
Mineral Spring Practice at Home 1T6 
Mistakes, How to Avoid Medical 984 

Mistletoe Poisoning 876 

Morphia and Atropia ... .144 
" « " Combina- 
tion, The 191 

Morphine Poisoning 144 

M To Prevent Nausea 
Following Adminis- 
tration of 191 

Treatment, A Brief 

Report on 74 

** Users 431 

Morphinists, Treatment of Incur- 
able .4 
Mortality in 1896 in Thirty-two 
Large Cities, Rates of 893 



PAGB 

Mountain Fever, A Peculiar . . 463 
Mucus Membra ue, Exfoliation of 

Lingual and Buoal 81 

Municipal Aid in the Diagnosis 

of Typhoid ,131 

Nasal Ulcer 361 

Need of the Times 474 

Needs, Some of Our 1(8 

Neuralgia 74 

Neurasthenia 108 

44 Hysteria and ... 201 
Nitro-Glyoerin in ^right's Dis- 
ease 418 

Normal Saline Solution 88 

Nose Bleed 888 

NumbaeasAll Over -888 
and Prickling Sensa- 
tions 208 

Nutmeg Liver 164 



Obstetrics With Syncope, and 

Later Sapremia, A Case in . . 836 
Opium.Tet Playing with Alco- 
hol, Fearing 347 

Orange Blossom 310 

Organization 319 

Oeteo-Malacia . . . . 397 

Otitis Media Supurati va Chronica 97 

Otalgia, For 608 

Otorrhea 386 

Our Library Table . . . 489, 482, 637 

Our Monthly Talk 

41, 8L 137, 170, 314, 368. 804. 847, 

891, 484, 479, 633 
Over-Fatness, Treatment for . . 843 



Pain in Bight Side, Obscure . . 868 

Paralysis 160 

" Central 146 

Paresthesiae .... 360 

Parturition Mitigated by " Squaw 

Root," Pains of 246 

Patella, Fracture of the 138 

Peekskill's Cough Syrup . . 478 

Pension Examining Surgeons . 868 
Periodic Epistaxis ... 419 

Permangauate of Potassium in 
Scarlet Fever and other Poisons 289 

.Petit Mel . 197 

Pharyngitis, Chronlo .... 386 

Phthisical Patients' Diet .... 6 

Phthiei 78 

Physical Improvement of the 

Race 76 

Physicians Elect 1 d to Legisla- 
tures 8 

Physiol 4n's Relation s to the Gen- 
eral Public, The 70 

Pin Worms ... 838, 869, 463 

Piso's Cure for Consumption . . 478 

Placenta, Adhereut 86 

4 ' " Dr. Clloe's 

Case of 76 

Plagiarism and Insult . . . . 898 

PlaoenjkPervia 148 

Played-out Men and Women . . 88 

Pleasant Chat 61 

Pneumonia 60, 62, 140, 141, 161, 306 
A Peculiar Case of . 601 
44 Antlseptio Treat- 
ment, of 283 

" Discussion, An Out- 

sider's Comment on 
the ... Ill 

44 following Grip, Sub- 

normal Tre tmeut 
In ... 192 

" Recent Expressions 

of M d rn Views of 166 
" Sub-normal Temper- 
ature in 189 

14 Treatment of 61 
Poisoning by Native Plants, Simi- 
lar to Be- ladonna Poisoning . 466 
Post Mortem Examinations, Im- 
portance of 876 

PostMortems 457 494 

Post Partum Hemorrhace, Pre 

vention of .... 619 



PAGB 

Post Partum Hemorrhage, To 

Prevent 368. 296 

Practical Points . 896, 441, 4*8, 628 
Practicing, Requirements for . . 444 
Pregnancy, Appendicitis Com- 
plicating . ' 168, 601 
44 Diagnosis of .... 186 

44 Estra Uterine . . 604 

44 For Vomiting of . 469 

44 in Bright's Disease 76 

44 in the Lower Ani- 

. m mals, Extra- Uteri i e 169 

* " That Twelve Months 1 290 

Pregnant. One Year 96 

Prescription Points 227 

Presidents. Burial Places and 

Causes of Death of Our .... 488 
Privacy Disappearing t Is ... 211 

Procidentia Recti 878 

Professional Liberality 4*2 

"Prosperity" in Canton, O. . . . 472 

Prostatic Irritation 428 

Prostatis 466 

Protection to Legs when Riding 

Horseback 368 

Pruritus 361 

Pruritus Ani . . . 49, 194, 250, 261, 595 
Psoriasis gyrate ... ... 236 

Puerperal Convulsions . . . 512 
K at Six 

Months 800 
44 4 ' Veratrnm 

Vlrldein 421 
Eclampsia . . 66. 101 
Cases of . . 64 
44 4i Yeratrum 

Vlride Hypodermi- 

oallyin 296 

8epsis 298 

Pulmonary Emphysema .... 100 
44 Tuberculosis/Tobacco 

a Preventive of . . 228 

Pulsatilla 84 

Pulse. Slow ... 244 
Punishment to Fit the Crime . . 891 
Purpura Hemorrhagica .... 88 
Purpuric Case 60 

Quebracho 185 

Questions 300 

Quinine— Treatment of Typbo- 
Malarial Ferer, Substitute for . 262 



Recognition of Diplomas .... 860 

Red Star Cough Cure 478 

Reform . . ,. 4 

Removing the Drink Crave, Ac- 
tion in 448 

Renal Calculi 429 

Reply to Doctor Lookhart . . . . 1E0 
Requirements for Practising . . 444 
Rewards in the Approval of Con- 
science . . 482 

Rheumatic Ointment 621 

Rheumatism 206 

Rhinitis ... 236 

Rhus Poisoning, Permanganate 

Potass for 244 

Rhus Toxicodendron 84, 76 

Rotheln . . 496 

Royal Catarrh Cure ... 476 
Rutland Aided Medical Legis- 
lation 220 



Saddle Lamps and Rug . . .283 
Samaritan Nervine, Dr. Rich- 
mond's .... ... 520 

Scalp Diseases, New Hats May 

Spread 348 

Scarlatina 306 

Soarlet Fever and other Poisons, 

Permanganate of Potassium in 289 
Schenck's Pulmonic Syrup . . . 631 
Scrofula .... . . 82 

Scrotum an Indication of Illness 

in a Male Infant, A Pendulous 19t 
Scrotum, Pendulous or Relaxed . 248 
Seasonable Therapeutic Points, 

Some 490 

Self-Prescribing Ill 



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nam 

Sending Patients Aw»? from 
Home. Some Thoughts Relative 

to 108 

Sexology. Neglect of 103 

Sexual Neurasthenia 007 

Sexual Weakness and Diseases 

of the Urethra 604 

Bicklv Women Marryinjt .... 186 
Slander and Malpractice . . .140 
Bleep Walking, Sure Cure for . . 4U 
Smell In Diagnosis, The Sense of 190 
Smith Bros.' Oough Drops . . * 478 
Snake venom. Experiments with 148 
Sobering a Drunken Man . . . 810 
Social Purity and Marriage ... 264 
Sodium Chloride (NaCL.) .... 610 

Southern California 489 

Specialists Comment* 2t0 

specialist. The 06 

Special Organs, How to Act on . 76 
Spelling, Improved . . 264 

" Squaw Boot." Pains of Parturi- 
tion Mitigated by .... 245 
8qu*wRoot Tea Anything to do 

with it? Had 02 

Steps in 

Stirpiculture 21 

Stomatitis, Catarrhal 40 

Ulcerative 81 

Stricture 12i 

btryoania Poisoning, Veratrum 

for 284,2*1, 884 

Strychnia Poisoning with Re- 
covery ... ... 61 

Strychnia. Safe Way to give . . 481 

Study up Your Oases 268 

Suggestion. Belief by 71 

Sulphide of Calcium . . . 204, 826 
Measles 

Treated with 78 
Sulphide of Calcium— dee Cal- 
cium. 

Sulphooarbolates 851, 408 

Summer Complaints . . . 281, 818, 8 JO 
•» Summer Complaint," Drainage 

and Antisepsis in . . 205 

Summer Complaint, Hygiene vs. 

Drugs in . 273 
44 In Califor- 

nia. No . 278 
14 In Children 

277,288 
44 In Indian 

Territory . 810 
Diarrhea . . 272 8 10 

in Children 
Under Two 
Years of 
Age ... 272 
Diarrheas of Children 

360.270,275,316 
** Diseases 268, 271 

** '* of Children . 278 

41 Bemedy, Beta-Naphthol 

asa . . . 276 

Troubles 820 

Suppositories. Convenient and In- 
expensive . . . 206 

Syphilis 880 

Treatment of . . . . 81, 287 



Tabulate Interesting Articles 

How do your 78 

Tachycardia .79, W 

Talk with Our Readers 8 

Tapeworm in a Rabbit . . 122 

" New Treatment for . 81 

' " Vomited a . . . . 8J8, 428 

Taxing Physicians 846 

Tel-el-Keblr ... 66 

Temperature in Pneumonia fol- 
lowing Grip, Sub- 
normal . ... 102 
44 1 u Pneumonia, Sub- 
normal .... 110 
" Sub-normal . . 286, 821 
Testicles had never descended in- 
to Scrotum 878 

Tetanus 140, 508 

A Case of 500 

" Cocaine for 151 

Thioslnamine 87 

Thorn's Cough Mixture .... 478 
Thyroid Therapeutics, Tenative . 170 



PaOB 

TicDoloureux 78 

Tight Lacing 482 

Tinnitus 85 

Tobacco 205 

and Tuberculosis ... 424 
'* as a Cause of Epilepsy . 62 
Kvilsof . . ... 202 
44 Habit and of Tuberculo- 
sis, Theory and Ther- 
apy of 464 

44 in Tuberculosis . . .8*0 
Tongue, Coat d. Long Continued 26 
Tongue Coated, of Singular Ob- 
stinacy ... ... 40 

Tonic, An Anti-Malarial .... 465 

44 Celery Compound .... 484 

Torpid Liver, For 421 

To the Members of the Medical 

Ptofession 20 

Tough Csse, A 84 

Tremor 187 

Tremor of Hand 124 

Triplet*. 198 

Truth from Everywhere • . 486 

Tuberculosis, Florida Climate For 64 
'* The Climate of 

Southwest Texas 

for 416 

44 Theory and Ther- 

apy of Tobacco 
Habit and of . . 464 
44 The Vapor of Orea- 

sote for 880 

44 Tobacco and ... 421 

44 Tobacco tu • 880 

44 Serum and Pilocar- 

pine, Hypoderm- 
ieally for . . 405 
Turpentine, Pure OU of . ... 846 
Twelve Months' Pregnancy . • 184 
Twins in Uterus, Djath of . . 08 
4 * With Locked Heads ... 101 
Typhoid, Certain Test for ... . 79 
Typhoid Fever, 205, 809. 867. 861, 866 
875, 800, 404. 405. 40T, 411. 418 
44 " An Earnest Ex- 

pression on . 410 
44 44 Diagnosis and 

Treatment of. . 861 
44 " Have You Changed 

Your Treatment 

of? 865 

44 •• One Hundred 

Oases of . . 800 

" " Prevention of . . 407 

44 " Resembling ... 60 

44 Treatment for .. 400 

4% 44 Two Items in . . 440 

44 Variously Treated 460 

44 u Woodbridge on 880 

Typboid? Is it 868,408 

The Palms in . 604 

44 Municipal Aid in the 

Diagnosis of . . . 181 
44 or a Fever Resem- 
bling Typhoid, in 
Kentucky and Ten- 
nessee 57 

Typhoid or Enteric Fever . . 864 
Typho- Malarial Fever. Substi- 
tutes for Quinine Treatmenffef. 252 



Ulcer 168 

Ulcer of Leg. 122 

Ulcer of the Leg, Treatment, of . 186 
Uioers, Leg ... 184 

•• Old Leg 186 

Umbilical Cord Sir Feet Long . 128 

Union 181 

Urethra, Hairpin In 10 

Urethra, Neoplasms in the 20 

44 Sexual Weakness and 

Diseases of the 604 

Urethral Trouble . . ... 161 

Uric Add. Asthma Caused by . . 114 
Urinary Tract, For Irritation of 

the 80 

44 4i Hemorrhage from 165 

Urine. Incontinence of . . . .' 800 

Urticaria .... ... 28, 49 

Urticaria? Why do Strawberries 

Cause 801 

Uterine Trouble 82, 50 



PAOB 

Uterus, Calcareous Degeneration 

in the 4043 

4 * of a Cow, Amputation of loO 



Vacuum Treatment Ml 

Vaginal Douche, DireetJ ana for . 891 
Suppository . . . 190 

Value 481 

Various Topics 117 

Venery, Excessive 281 

" Treatment for Excessive 83* 
Venomons Snake Bites . . 877 
Veratrum for Strychnia Poison- 
ing 884 

44 Hypodermieally for 

Convulsions .... 872 
44 in Strychnia Poisoning 291 
44 in Strychnia Poisoning 

and In Eclampsia 877 
Vlride Hypodermieally 
in Puerperal Eclamp- 

ala 205 

▼ iride in Puerperal 
Convulsions. . 481 
44 Viride.Norwood's Tinc- 
ture of 852 

Veterinary Requirements o f 

Country Doctors 848 

Viburnum vs. Ergot 878, 418 

Vomiting In Pregnancy 828 

of Pregnancy, For . . 480 
Vulture" Must Go, The "North 
American 808 

Warty Growths of the Genitals, 

The Treatment of 88 

Water . . 81 

44 A Clinical Hint About . . 480 
What Are You Dot og? And How 

Are You Doing It? 485 

Whooping Cough 808 

44 , For . . . 446, 520 

Wife, A Business 488 

Winter Remedies, Some .... 445 
Wit and Wisdom, . . 

48, 87, 172, 217. 261, 808, 852 
Women, Examination of Unmar- 
ried 185 

Woodbridge on Typhoid Fever 880 
Treatment, Success 

of the 87 

Worms in Children 520 

(Lumbriooid) For .... 520 

Worn-out Facts 486 

Writer's Cramp T8 

Yellow Fever 458 

44 Dengue Not ... 407 
41 4 * Faroe at Galves- 

ton, Texas, The 600 



INDEX OF AUTHOR* AND OON- 
TBIBUTOBS TO VOLUME XV. 



Abbott, E. W 86 

4 * W.0 475 

Aikens. N HO 

Acton, Thomas 25 

Allen, L.B 140,208,881,411 

Anderson, J, T 52, 206, 6512 

Andrus, A. P. 70 

Apgar, F. A. 401 

Armstrong, Jas 952 

AspinwalT, W. B. 618 

Atkinson, Joseph 407 

Aylesworth. Geo. M 840 

Badger, F.D 4S0 

Baggott, J. F 118, 187 

Baggot. J. P. 81 

Ball, W. F. 425, 462 

Barker, I.N 152 

Barnett J. T. 168, 286, 873 

Baylor, R. H 415 



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PAGB 

BftTD60, Geo. A 434 

Boll, M. C. 266 

Benedict, Fordyce H 449 

P. W 181 

Benhun, F. A. 63 

Bennett, H. O. 376, 448 

J.S 71 

Betto, Geo. 1 78 

Bishop. Francis M. 86 

«eckm«r. R. 198 

Blake, J. D 31 

Hlsrokemeyer, H. H 881 

Htash, A. T-. 862, 8? 9 

Boawell, D. 872, 614 

Bowen, Berry 496 

" R.J 138 

Bowers. JM. F 800,481, 578 

Bowman, A. R. 161, 376 

•• L. D 36 

Boynton, o. B 164, 439, 615 

Briets, a J. V? 480 

Brill, J. H. 396 

Brodnax, Ben. H. 189, 304 

Brown, O. A 34 

L. C. 388 

8. G. A 124 

Bruaner, Prank R. 191 

Bryan. Dr 76 

Bachmao, a A. 184 

ButUoek, E. 8. 364 

Boruham, WD. 66 

■kirk, J. D 109 

npbell, O. Fitz-Henry .... 78 

* J. C 148 

T B. 18 

Oarriek, A. J. . . . 76 

Oanon, J. Wen 803 

Caosldy, ftarsfleld 61 

OatheM, W. T 813 

Chambers, B. P 888 

Cbarbonnean, Lionel C 4(6 

Ohew Borer 8 55, 148 

Cleseil, J K 298 

CBaeon. B. 8 73 

Oli&e, W. S. ... 

84, 86, 54, 73, 76, 164, 278, 882, 899 

Cloyd, A. D 97, 370 

Cohen, I.N 311,495 

Coleman, W.L. 

195, 387, 287, 836, 878, 453, 497 

Collier, 0. S. . 138 

OollingB. O. P 428 

Oonley.O.W 76 

Cooper, 0.0 30 

Conover. 8 617 

Cooper, W. 368, 814, 483 

Corbett,J.W 144 

Comet, E, 834 

Oornwell, Alfred 188, 397 

«Jorry,0. T 56 

Corson, Charles B 802, 819 

Cothraa, L. 30 

Cowan, B. H. 388 

" W. H . .191 

Crowe, T.J 391 

Cullen.O.R. 388 

Cumnoings, J. 279 

Cunningham, R. B 887 

Cutter, Bphraim 838 

Cuzner, A. T. 70 

X>aland, Jadson 476 

I>alton. A. B 300, 873 

I>arneU. WE. 889 

Darla, B. *» 341 

** J.W 438 

I>earborn, J. J 4 . . 804 

J>e Resche, Job 397 

Dodge H. C. 78 

Dolbeek. G. Nelaon 165 

I>owalng. B. W. P 407 

I>reher,T. H 148 

Hrewry. R. BT 198 

Drnmmond, 8. O. \ . 428 

Dudley. Hnbert W. ... 145 

Duncan, T. 445 

Kdgar, w. «, 891 

JEdmondaon, W. J 482 

Kdson, Beni. . . Ill, 187, 285, 421, 491 

Bdwards, B. P. 301 

T. J 513 

KUiott, J. A. 76 

Brican, A. M. 107 

Brren, o 80 

Brskine, Edward 328, 419 

Bverta, Dr 362 



PAGV 

Ewing, W. G 467 

Fairbanks, Carl 830 

Field, FT 414 

Plelds, B. H 504 

Folsom. JamesE 311 

Flower, Sidney • . 36, 367 

Francis, Willard Oyril . . 119,341, 244 

Priedlander. M 269 

Friend, P. Milton 34 

Frost, R. 8 888 

Gattis. R. L 83 

Gibson, J. W 11, 375 

Gilbert, Luther L. 347 

Gllmore, E. B 141 

"ottheii, W 88, 170 

Gould, Geo. M 29 

Gray, W. B 168 

nreenfield, P. G 63 , 228 

Grin n* 11, Fordyce 108 

Groton, W. D. 509 

Gruioe, W. W 246 

Gulnn, Ernest B. SOI 

Guas, H. T 868 

Hale.*. B. 497 

Ha nllton. J. D. 281 

Hammond, J. S 287 

Hanklns.T 138 

Hannah, Alexander 28 

Hard, A. D. 3*8 

Harden, John H ► 189 

Haring, I. O. 878 

Harrington, J. F 325 

Harris, Ohas. H 899 

'• Dr 448, 451 

Hatch, A. D 808 

Haslett, H. Poster J 08 

" J. 115, §01 

Hemy, G. W 239, 395, 338 

Henry, J. A 138 

Hersbey. J. A 310, (19 

Hill, P. Bf 886 

Hlne. L. 8 87 

Hinton, R. L 879 

Honker, H. H 473 

Hosetter,A. H 801 

House, * . B 130 

Howard, R.L. . 880 

Howell, W. H. . . 109, 197 

Howland H. 98 

Hulme. Thos. D 165 

Hunt, A. J 10, 181, 291 

Irwin, T.J 514 

Iuen,P.J 116 

Jameson. G. M 102, 189, 378 

James, William F 884 

Jackson, F. P 34 

Jennett, J. G 206 

Jennings, Geo. N 396 

Johns, Jacob R. 510 

Jones, G. F 464 

" John 240 

" W.Thomson 888 

Judson W. H 86, 187 

Juetner. Otto 430 

Kelley.F, L 04 

"KM... 344 
Kellogg, A. O* ". '. " '. ". ". ! " '. *. 149 

Kelly, J. L 867 

Kendlg. B. V 407 

Kendr?ck,0 117 

Kennedy, J.W 115 

Kernodle, J. D 207 

Ketchum, N 76 

Kidder. W. W 40* 

King, J. H.O 79 

Koebler, H. F 839 

Lancaster T. A 221 

Landers, J R .386 

Landry, A. P 31 

Latta, M. M 161, 88*1 

Lawrence. V. E 10 

LeOrone T. W 145 

Le Grand, G. F 327 

Leslie. M. 8 877 

Liggitt John J 181 

L«ne, T. H 99, 800 

Dink, W. E 67, 246 

Leuf, A. H. P 384 

Lewis, A. T 227 

" P.N 64 

Lookhart,J.W 

12, 67, 141, 186, 229, 865 
Lomerson, Prank . . 249, 276, 436, 445 

Long, J. I. T 31, 8*8, 408 

Love, I. N 81, 365 



PA«E 

Lowder. W . 83 

Luiton, R. M 82 

McOabe, Chares P 196 

McCluney, J P 199 

McCormick, H . » 890 

MoCrscy, D. Orestus 300 

McOreight. 8. L 150 

McDavTtt, Virgil 331 

McDonouih, J. P 118 

Mackenzie, N. 8. 800 

Markley. L. R 278, 439 

Martin, J 8 834 

H.T 471 

14 R 8 423 

Mason, R. Osgood 167 

Matchette, A. 387,415 

Mauser, W. H 198 

Mayer. Dr 68 

Mel!ck, P. A 96, 290 

Meyers, L. E. 208 

Mlddlebrooks, J. D 456 

Milslead, W. T 388 

Mitchell, A. W 1C5 

O. P 304 

Monroe. H. P 22, 120 

Moore, E. D 409, 418 

" J. Nott 121 

u M. 8 165, 887 

Morris, N. K 382 

Muenid, J. A 69 

Musgrove, Thomas W 371, 331 

Neiberger, W. D 213 

Newlon, W. 8 132 

Ntwth. O. H 405 

Nioodemua.J.D. &16 

Oehme, FTg. 825, 453 

Olmstead.D.G 133 

Oppermann, A 168, 818, 413 

Ormsby, George F 74 

Paquin, Paul 49* 

Parks, N.O'D 308 

Park yn, Herbert A 187 

Parvin, rheophllus 225 

Patoben, O C. ... 146, 378, 833, §68 

Patterson, E. L 864. 

O. M. 425 

B. L 316, 446 

Patton, Charles 377, 452 

Patton, W. B 376 

Pearoe.J.H 389 

Pendleton, Eugene 99 194 

Pickerel. J. F. 94 

Pickeret, Joseph 801 

Pitser, George 506 

Playter, Edward 1'9 

Poe, 496 

Pons. L. J 351, 284 

Powell, Preston 71. 272 

Preston. Edgar D 410, 508 

Price, M. G 828, 511 

Purvis, Myles 248 

Qninn, B. E. 450 

Bawls, Garln 192 

Raymond, E. I. ■ 45? 

Reed, J. Fleetwood 109 

Register, E. O. 89' 

Rencurret, Manuel E. . . .804 

Rew, P. A 62,74,245, 877 

Rice and Rice, Drs. 278 

" H. . . 30 

Rick, J. B 19 

Ridley, R. O. 471 

Robertson, Jr , W. 8 244 

Byron 391, 494 

EH 128 

J. Owen 888 

Rockwell, H. 194 

Rodgers, D. W 86 

Rogers. W. F 875 

Boney. DO 189 

Boot, 8 E 79 

Rose, D. •• 105, 385, 817 

Ross. A. 8 825 

Rotter. Oscar 151 

Sabal.E. F 310 

Sanborn, E. A. ... 158, 165, 204 

8auls, J. A 803 

Saunders, H. A *0 

H. P 80 

8cates, D. W 404 

Schafer, H 888 

Schmidt, G 9* 

•• Herman .... 387, 378, 519 

Schoennmann. O. W 503 

Schwartz, W. D 166 



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PAOB 

Coott, Chas. B SIS, 871 

" B. Challen 434, 464 

8eafuse,8 M 200 

8eay,B.W. 283 

Seiple, W. G. M 617 

Sclera, J. O 881 

8engtteoken, J 101 

Shafer. W. W 149 

Shaffer, P. T. B 26 

Sharp. J. H SO 

Bbauweoker, 8 108 

Shemwell. J. W. 160 

Sherman, W. N 27i 

Shirk, P. M 460 

Short, Robert W 164 

Silvern. E. B 78, 114, 102 

Simmons, D. G 67, 804, 882 

Simpson, J. B 188 

-Martin J. M 114 

Slicer, J. B 78 

Smith, B. M. 486 

•• R.J 801 

M W. O. 289, J80 

Sneed, B. M 180, 888, 820 

Soper, F 428 

Sonder, O. Fletcher 467 

Spradllng, Lewis W 810 

Spohn, J. C 608 

Squire. W. B. 618 

Stearns. B. If 194 

Stewart, B.L. 138 

Slid worthy, D. B 70 

Strangways, W. F. . 848 

Swain. J. B. 016 

Bwlneburne, E B, . . . .188 

Tassell, W. H. 861 

Taylor, K 160 

• 4 B. A 14 

Thomas, J. H 800 

Thornton, G. G. ... 64, 107, 801, 468 

Torbett, J. Walter 400 

Torrance, J. M 617 

Townsend. O. W 188 

Tonitall.E. L 186 

Turbln.L.M 462 

Usher, J. D 210 

Van Dyke, F. H 620 

Walker, L G 341 

Wailing, Wm. H 887, 607 

Walton, A. L. 420 



PAoa 

Walton, P. E. 162 

Ward, W. D. F 810, 888 

•' W. W 888 

Waring, B.P 8 

Warner, W. A 87 

Washburn, IB 288, 887 

WassanvA. II 800 

Waters, W. T .188 

Watt, J. M. 378 

•• J. 8. . 81,288,818 

Weugh, Wm. F 

4,47,02, 184, 178, 840, 811. 887. 418, 

486, 488 

Wesson, LA- 488, 478 

Westeott,J B 816 

West. G. W 60 

Whitley, James D 

Whitney, A. B 888 

WiUonghby. Emily Oapron . . 887 
Wilson, O.G. . . . . . 838 

u O. L. . . , 888 

Wioslow, O. H 448 

Withers, Bassell 888 

Witney. O. ... .70 

Wolford.M.L. 7 

Woodbridge, J . B 8* 

Woodruff, A. J 08, 163 

Wm. .... 73 

Worcester, O. B 480 

Yager, B J. .77. 101, 130, 160, 80S, 886 

Yarbrough. H. J 8*0 

Young, T.E 473 



INDEX OF REVIEWS. 



A Daughter of Humanity .... 807 
Anomalies and Cariosities of 

Medicine 178 

A System of Gynecology .... 480 



A Text-book of Diseases of 
Women. By Charles B. Pen- 
rose, M.D 480 

A Textbcok of the Pi actio© of 
Medicine. By J. M. Anders, 
M.D 608 

A Treatise on Appendicitis. By 
John B Dearer, M D. . . 888 

Betay Gasklns (Dimlcrat) .... 480 

Don't Worry * 886 

Essentials of Bacteriology. By 
M V. BaU, M. D. . . 887 

Essentials of Physical Diagnosis 
of the Thorax . 178 

1 1 ebrtety ; Its Source, Prevention 
and Cure 488 

Kareasa ; Etnlcs of Marriage 480 

Lectures on Appendicitis and 
Motes on Other Subjects. By 
Boot. T.Morris, A. M„M. D. . 887 

Letter to a Prospective Bride 448 

Manual of Static Electricity in X 
Bay and Therapeutic Uses. By 
8. H.Monell M.D 488 

Pathological Technique 687 

Premature Baldness and Dyspep- 
sia . . 480 

Secret Nostrums and Systems of 
Medicine . . . 488 

Static E'ectrioity as a Therapeutlo 

Tethered " Truants. ' By W." 6. 
Cooper, M. D 887 

The American Year Book of Med- 
icine and 8urgery 178 

The International Medical An- 
nual for 1807 488 

The Practice of Medicine. By 
James Tyson, M. D. . . . 480 

The Treatment of the Sick; a 
System of Applied Therapeu- 
tics ay Wm. F Wsogh ... 480 

Treatment of Uterine Fibroids . 688 

Tuberculosis of the Genito Unl- 
nary Organs, Male aid Female. 
By N. Senn, M. D., Ph. D., 
LLD. 488 

Typhoid Fever and Its Abortive 
Treatment. By J. B. Wood- 
bridge, M.D 888 




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The Medical World 

The knowledge that a man can use is the only real knowledge ; the only knowledge 

that has life and growth in it and converts itself into practical power. The rest 

hangs like dust about the drain, or dries like raindrops off the stones.— Froudb. 



The Medical World. 



C. F. TAYLOR, M.D., 

Editor and Publisher. 



Subscription to any part of the United States and Canada, 
Owe Dollar per year. To England and the British 
Colonies, Five Shillings per year. Postage free. 
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We cannot always supply back numbers. Should a num- 
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Fay no money to agents for this journal unless publisher's 
receipt is given. 

Address all Communications to 

"THE MEDICAL WORLD," 

15*0 Chestnut Street, 

Philadelphia, Pa. 



Vol. XV. 



Januajly, 1897. 



No. 1. 




1897. 

It is well that we have a time for a re- 
view of the past, and of resolve for the 
future. This time with most people is 
at the end of the old year, or the begin- 
ning of the new year. Retrospection is 
a good thing to indulge in, at least once 
a year. If we do it discriminatingly we 
get the full value of our experience. 
Mistakes made in the past are valueless 
to us unless we make them help us to 
avoid similar mistakes in the future. 
Successes are incomplete unless we make 



stepping stones of them to lead us to 
greater victories. 

Introspection is as important, and it 
should be done far oftener than once 
a year. By looking inward we learn to 
know ourselves ; and everyone should 
know himself as well as possible. It not 
only leads to a modest estimate of one's 
self, but it helps to strengthen weak 
points in our character. Vanity lodges 
in the breast of only him who knows not 
himself; vigorous and oft-repeated in- 
trospection is a sure cure for it, for none 
of us have much to be vain over. On 
the brink of the ocean of truth, all 
we finite mortals can hope to do is to 
gather a few pebbles along the shore. 
In comparison with what there is to be 
known, and what should be done, what 
we can ever hope to know and do can 
never make us vain. But yet we need not 
take a hopeless view. While an in- 
dividual can do very little, yet many in- 
dividuals striving earnestly and patiently 
can do mnch — have done much. Think 
of the changes in the practice of medi- 
cine since you entered the profession ! 
Think of the improvements in the last 
ten years. Now, please, review in your 
mind all that you have learned during 
the year just closing. If you have 
striven earnestly, you will find some* 
thing to think about. Yes, and why not 
write about it? Would it not be well to 
send the fruits of this yearly retro- 
spection to The World, so that all may 
have the benefit of the experience of 
each ? But retrospection should be se- 



THE MEDICAL WORLD. 



vere, else it does but little good. Be as 
severe on yourself as possible, and you 
will be benefited all the more, and your 
experience will be all the greater inter- 
est and benefit to The World family. 
Send us the mistakes you have made, as 
well as the successes yon have achieved. 
Let our sanctum be your confessional ; 
your name and address will be held in 
the strictest confidence when desired. 

Introspection is more of a private mat- 
ter. It is a study of your inner self, 
while retrospection is more of a review 
of things, and usually of your relation 
to them. Now is the time for both. 

Let us first know ourselves thorough- 
ly, then grasp the fruits of the past, and 
go forth to meet the coming year with a 
resolve to do better work, to be better 
men, to make 1897 better than 1896 or 
any year previous. This is the only 
way we can progress. Life is short, and 
as a wag once said, " We will be dead 
along time." We can live but once, 
and there is enough to do in our short 
span. Shall we do it, or leave it for 
those who will follow? There is only 
one opportunity for each to do his part. 
That opportunity is in the " to-day" of 
each one's life. It must be decided and 
done during that " to-day." What has 
1896 contributed ? What will 1897 con- 
tribute ? 

We are nearing the grand time of re- 
trospection — the end of a century. These 
closing years are the " home stretch" of 
the most remarkable century that the 
world has ever seen. To-day may seem 
like yesterday ; this year may seem much 
like last year; but when we measure 
by centuries the difference is vast ! This 
vast difference is the result of daily, 
patient efforts. You can contribute 
something to it during 1897. Will you 
doit? It will soon be too late to con- 
tribute anything further to the nine- 
teenth century. As remarkable as this 
century i has been, these closing years 



will be filled with stirring events and re- 
markable achievements. This is not a 
time for mental drowsiness and slothful 
inactivity. Let each and every one do 
his part with vigor and fidelity. 

The Local Hot Air Treatment. 

The result of the hot air treatment by 
the Tallerman-Scheflield apparatus in 
this city have thus far been as follows : 
The case of lumbago, not chronic, treated 
before the Philadelphia Medical Society, 
was cured by that one treatment The 
other case treated before the society, 
gouty feet, received one additional treat- 
ment and has been greatly benefited. 
One case of gonorrheal rheumatism re- 
ceived two treatments without benefit. 
Five cases of chronic fibrous rheumatism 
received one treatment each and all were 
greatly benefited. The benefit received 
by this treatment seems to be perma- 
nent 

This apparatus is patented both in 
this country and in Europe; the appara- 
tus is not for sale, but it is leased to phy- 
sicians for a term of ten years for $500, 
payable $50 per year, with the agreement 
that it will only be used in the private 
practice of the physician holding the 
lease. These conditions will seem rather 
hard to the average physician. We do 
not wish any harm to the patentees, but 
we do hope that American ingenuity 
will find a way to apply dry heat of the 
requisite temperature without infringing 
upon the patent, and thus give the 
benefit without restrictions to suffering 
humanity. We gave a description of the 
apparatus in the last issue. 

Friends, don't forget to write specially 
on the diseases of the season. Some dis- 
eases, as typhoid fever, have no special 
season, or rather (unfortunately) all sea- 
sons are theirs. But many troubles have 
distinct seasons, and The World should 
be your constant and reliable companion 
at all times. Th^g^an^c^^^^geach 



THE MEDICAL WORLD. 



doing his part to make it so. We all owe 
more than we can ever pay to the pro- 
fession. During January write your ex- 
perience with pneumonia. What do you 
<io for coughs ? What do you, yourself, 
take when you have a troublesome cough, 
arising from cold? Have you a good 
reliable mixture without opiates? Write 
soon, in order to be in time for the Feb- 
ruary World. Then for March — what 
do you look for chiefly then ? Rheuma- 
tism — and what else ? You know we 
are speaking over a wide territory — from 
ocean to ocean, and from the Gulf to 
Hudson's Bay. Some things are the 
same everywhere, while others differ 
greatly with the locality. Write Feb- 
ruary ist to be in time for March issue. 



Physicians Elected to Legislatures. 

We learn with satisfaction that there 
are twelve physicians in the newly elected 
Legislature of Indiana. Also that about 
as many more were candidates, but were 
defeated. This shows a commendable 
interest in public affairs by physicians. 
It also indicates that the people are look- 
ing to the medical profession for leaders. 
Let us prove that our profession is worthy 
of this confidence. This can only be 
done by studying the true interests of the 
masses of the people, and championing 
the same. The physician's work is the up- 
lifting of humanity. We have been doing 
this patiently during all these years, in a 
medical and sanitary way, with the most 
brilliant and beneficent results. But we 
find that the politicians (the so-called 
u statesmen ") have made such a miser- 
able failure of government that we must 
come to the rescue. The body politic is 
sick, and it is our duty to offer remedies, 
and to aspire to official positions wherein 
we can successfully apply the remedies. 
We would rather not ; we would prefer 
to continue to give our undivided atten- 
tion to science ; but in times like these 
we must do our full duty as citizens. 
We see what Indiana has done. What 
have other States done ? 



Do vou notice any improvement in 
this issue ? We hope to make The World 
more valuable than ever to our readers 
during 1897. Instead of giving our 



own opinions, or waiting for our 
readers to give their opinions the follow- 
ing month, we have long thought of sub- 
mitting queries, puzzling cases, etc., to 
eminent physicians, and publishing their 
opinions in the same issue. You will 
notice that this is begun in this issne, 
but we expect to work up this feature and 
make each issue of The Medical World a 
consultation with eminent physicians. 
We want to make The World a positive 
necessity to every practicing physician. 



A Talk with Our Readers. 

This season of the year always brings 
us in close relations with our readers, and 
we always welcome it While not a 
single day of the year passes without 
bringing subscriptions to us, yet during 
this season they come in floods, and 
many take occasion to express themselves 
privately to the editor. We have just 
looked over a large pile of letters saved 
out for us, and if we were inclined 
toward vanity our " tail feathers would 
be spread like those of a peacock." But 
it is not praise that we want ; we would 
rather have criticism when there is 
occasion for it, for that is more helpful 
than praise. However, we wish to thank 
all those who have expressed them- 
selves. 

There has been a very large expres- 
sion on the subject of the proper time to 
stop sending a paper to a subscriber. 
The unanimous opinion is that it is both 
proper and desirable that a publisher 
should stop sending a paper when the 
time paid for expires. Did we say 
unanimous? No, there is one ex- 
ception. This exception is a pleasant 
and a carefully typewritten letter, con- 
taining the following: U I think The 
World is about as good as it can be made. 
I arrived at this conclusion by com- 
paring it with other journals." Yet 
this is the one letter that did not 
contain a renewal ! But perhaps it is be- 
cause of recent removal from Ohio to the 
Pacific coast, and possible uncertainty 
about remaining. The Doctor thinks that 
the subscriber often fails to give the mat- 
ter of renewal attention on account of in- 
convenience, or being very busy ; and he 
loses a good thing while we lose a sub- 
scriber. Yes, perhaps that is sometimes 

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THE MEDICAL WORLD. 



true ; but the notice of expiration should 
be kept prominently upon your desk, 
always in sight, so that it can be at- 
tended to at the earliest convenience. 
As we do not wish any who want The 
World to miss a copy, we will send this 
January issue to some who have failed as 
yet to send in their renewal, thus giving 
them plenty of time. But it will not be 
continued further. While we want all 
who really want it to have it, it will not 
be forced upon anyone. While many 
say that they cannot get rid of some 
publications if they once subscribe, you 
will not find it hard to get rid of The 
Medical World, if you want to. You 
pay us once a year, and we will work for 
you all the year. This is a business re- 
lation in which you have by far the 
easiest part 

A word as to how to subscribe for a 
medical journal. Some write on a postal 
card : " Please enter my name on your 
subscription list for 1897. " Others write 
a letter saying : " Please continue my 
subscription to The Medical World," 
but fail to inclose the subscription price. 
It is said that some publishers are glad 
to'get any excuse to put a new name on 
their list, and that they continue the 
paper from year to year without au- 
thority, and, finally, put the accumu- 
lated account into the hands of a col- 
lection agency, and begin a process of 
44 hounding " the doctor. Well, we don't 
do that We sgy, if you want The 
Medical World, pay for it when you 
order it That is the only business way. 
And when your subscription expires, 
renew it by sending the price again if 
you want it continued. We can't live 
on used postal cards, and we don't want 
accounts of #1.00 each scattered all over 
the country, and you don't want such 
accounts against you. 

Our mission is to benefit the medi- 
cal profession. It sadly needs 
benefit in a business way. If we 
can inculcate the habit of paying 
cash, we will be doing much for 
the profession. On the other hand, 
make prompt collections from your pa- 
trons. They will respect you all the 
more for it. We now have our readers 
so trained that we get very few postal 
card subscriptions; but we don't want 
any. 



Original Communications. 



Short articles on the treatment of diseases, and experience 
with new remedies, are solicited from the profession for 
this department ; also difficult cases for diagnosis ami 
treatment 

Articles accepted must be contributed to this journal only. 
The editors are not responsible for views expressed by 
contributors. 

Copy must be received on or before the twelfth of the- 
month for publication in the next month. Unused 
" manuscript cannot be returned. 

Certainly it is excellent discipline for an author to feel that he 
must so* alt he has to say in the fewest possible words, or 
his reader is sure to skip them; and in the plainest possible 
words, or his reader will certainly misunderstand them. 
Generally, also, a downright fact may be told in a plain* 
way; and we want downright/acts at present more thaw 
anything tto.~RusKni. 

READ. REFLECT. COMPARE. RECORD. 



Treatment of Incurable Morphinists.— Notes. 
— Apoplexy .—Reform. 

Editor Medical World : — How many 
of us have had the opportunity q( seeing 
the latter days of an incurable morphine 
user ? For there are incurable cases, in 
spite of the sure cures and guaranteed 
fakes. Victims of incurable disease 
like cancer ought not to be subjected to 
the useless torture of attempts at impos- 
sible cures. And in a certain number of 
cases the bodily functions have been so 
long accustomed to perform their duties 
under the influences of morphine that 
they have forgotten how to do without 
it. Perhaps they may re-learn the lesson > 
perhaps not. And if prolonged trials 
show that life is impossible without the 
drug, it must be restored. 

The question will then come up, of 
how best to regulate the life as to secure 
the longest period, free from sufferings 
with the greatest amount of productive 
labor. In other words, when it is evi- 
dent that a man cannot be cured, but 
that morphine and he are to be com- 
panions for the rest of his life, he should 
not dissipate his remaining property and 
squander his remaining vitality in the 
vain search for a cure, but rather seek 
how to manage the drug so as to secure 
the most benefit and the least harm from/ 
it 

First comes the stereotyped " thorough 
examination." The organs are to be ex- 
amined seriatim, the excretions scruti- 
nized closely. The general physique, 
disease tendencies, probable sources of 
danger, the capacity for improvement,. 



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THE MEDICAL WORLD. 



the mental condition, especially as to the 
power of comprehending instructions 
and the willingness to carry them out 
efficiently, are to be weighed with judg- 
ment. The habits as to eating, drink- 
ing, sleeping, bathing, clothing and 
exercise, are all of importance. It is 
surprising how very good doctors neglect 
their own health, or are ignorant of the 
existence in themselves of vicious habits 
they would quickly enough detect in 
others. What a complicated task is this ! 
And then comes the important work — 
how to reduce the daily dose of mor- 
phine to its lowest point by removing 
the causes that induce a larger one, and 
by finding the best form of the drug, 
and the best synergists, to render a little 
dose as useful as the big one. 

Does he take morphine for insomnia ? 
Then see if a hot bath, a bowl of hot 
clam broth and twenty grains of. trional 
every third night will not enable him to 
do as well with half the dose. You thus 
lessen much more than half the injurious 
effect of the drug. Is it neuralgia or 
some other pain that renders life without 
morphine impossible? But atropine 
greatly increases the analgesic effect of 
morphine ; so does chloroform water 
(by hypodermic). Strychnine, caffeine, 
spartein and cactus all synergize the sus- 
taining, comforting effect of morphine; 
while cicutine is a potent auxiliary in 
cancer, chorea, and many manifestations 
of the neurotic diathesis. In fact, it is 
not very uncommon for persons who 
begin treatment with the idea of render- 
ing the drug-taking as harmless as pos- 
sible, to find to their amazement that 
the habit has been cured ; the treatment 
having completely relieved them of the 
necessity for morphine. 

There is one more curious fact in con- 
nection with these cases, and that is that 
a habitue will rarely make a real effort to 
be cured until he is on the eve of a general 
breakdown. It is our usual conclusion 
that when a man is really roused up to 
the point of seeking relief he is in such 
a condition that his life would not have 
been long if he had not made the effort. 
Men will go on thinking they would 
like to be cured, but making no effort to 
do so uutil symptoms of approaching 
dementia, failure of the kidneys or of the 
digestive organs, absolute inabilty to 



sleep even with double doses, difficulty 
in keeping the attention fixed on any 
subject, horrible nightmares, with 
spasms of the glottis or of the diaphragm, 
or a realization that the interest in and 
love for family, profession or those 
things in which one's soul has taken 
deligljt are rapidly fading out, come as 
warnings that the end is near if some- 
thing is not done, 

I have not enumerated the failure of 
the sexual function, because its relations 
are peculiar. Some women cannot nurse 
their infants, although the mothers are 
strong, fat and plethoric. They seem to 
have so strong an affinity for nutritive 
material that they cannot loosen their 
hold on it, even to nourish the babe at 
the breast, although they want to do 
this anxiously. So some men seem to 
cling to the sexual function, sacrificing 
everything for it I believe that the 
procreative instinct or rather proclivity, 
is so powerful that every mental func- 
tion would be lost in dementia before 
the capacity for sexual congress were 
lost. So that I look upon the impotence 
of the morphinist as one of those rather 
pitiful attempts of nature to protect us 
from the effects of the abuse of our 
bodies which our reason ought to have 
prevented. 

This same conservation of force is 
seen in the lessening of sexual desire in 
elderly men, and in those who are en- 
grossed in the cares and worries of any 
occupation calling for unusually arduous 
and prolonged mental effort. Even 
severe physical exertion has the same 
effect, and our athletes are often feeble 
in sexual power and desire, while the 
alcoholism that seems inevitable to suc- 
cessful pugilists is said to have its origin 
in the desire to acquit themselves man- 
fully with the legions of women who are 
known to besiege these men with their 
amorous solicitations. 

Heyne said : ' c While my children were 
coming I produced few books." The 
vital force cannot be depleted heavily in 
more than one direction at once without 
injury. At any rate I have learned to 
judge unfavorably of the condition of 
the confirmed drug-habitue whose sexual 
force is unaffected. 

An awful ending to a morphinisms 
career came to my notice recently. An 

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THE MEDICAL WORLD. 



old doctor, who had a little pharmacy, 
was fold out for debt He was a victim 
of morphine, poor and friendless. A 
short time after the sale he was seen out 
on the lake in a boat, lying at full length 
in the vessel, but refused to talk to those 
who found him. The word was passed 
around that he was trying to screw his 
courage up to the point of suicide. To- 
wards evening he came in, got a supply 
of whisky, and again went out in his 
boat Nobody interfered, no one sought 
to dissuade him. I believe bets were in 
order as to whether he would get his 
courage up or not The general opinion 
seemed to be that it was the best thing 
he could do. And a week later his body 
came ashore. 

The most shocking thing about it was 
the callousness with which every one 
who knew of the affair looked on it 
What must have that forlorn wretch's 
thoughts have been during those last 
hours when he was nerving himself up 
for that awful plunge into the unknown ! 
No hope in the hereafter, no loving hand 
to smooth the pillow of death, a mis- 
spent life behind, and what before ? 

Is morphine worth this much ? What 
is all the suffering one could possibly 
endure in the struggle for freedom be- 
side such a death as this ? If only the 
last spark of manliness remained, I 
should think it would impel a man to 
feel that he would rather die in a death 
struggle with his enemy than go into 
the grave with the consciousness of cow- 
ardice. 

Dr. Wade has had a case of hemor- 
rhage due to quinine. I reported one 
years ago, in which cocaine solution ap- 
plied locally checked the bleeding at 
once. It is a pity we cannot ascertain 
why quinine acts in this wav in some 
instances and not in others. My patient 
was stout, and of a gouty family, but 
otherwise in perfect health. Was Dr. 
Wade's case gouty, rheumatic, diabetic 
or malarial? Dr. Gilliland relates a 
curious case of monstrosity, and raises 
the question of maternal impressions. 
On this I will quote a passage from Dar- 
win's " Animals and Plants under Do- 
mestication," vol. ii, p. 251 : "Dr. Wil- 
liam Hunter, in the last century, told 
my father that during many years every 
woman in a large London lying-in hos- 



pital was asked before her confinement 
whether anything had specially affected 
her mind, and the answer was written 
down; and it so happened that in no 
instance could a coincidence be detected 
between the woman's answer and any 
abnormal structure ; but when she knew 
the nature of the structure she frequently 
suggested some fresh cause. The belief 
in the power of the mother's imagina- 
tion may, perhaps, have arisen from the 
children of a second marriage resembling 
the previous father, as certainly some- 
times occurs." 

I have never known a case where the 
mother "called her shot" before the 
birth of a marked or deformed child, 
though after the birth explanations are 
easy. 

Here is a suggestion for phthisical 
patients' diet : Instead of creamery butter 
let them use butterine, which contains 
a large proportion of marrow. Bone 
marrow is recommended as a peculiarly 
valuable food, from the influence of mar- 
row on blood-making, and now that 
butterine is recognized to be a whole- 
some, cleanly Article, its use should be 
tested therapeutically. 

Dr. Rutherford asks how to retain a 
fractured clavicle in position. An easy 
matter according to Hogarth, who cari- 
catured the doctor for inventing compli- 
cated machinery to perform two very 
simple operations — to draw a cork and set 
a broken clavicle. But, in truth, to put 
the fragments in place and keep them 
there, is anything but easy. Perhaps 
there is no better way for most cases 
than to apply a Velpeau's bandage, 
which is described in every surgical 
work. 

Itching after a burn has healed (page 
477). Try painting with tincture of 
benzoin ; a paste of salicylic acid in 
starch, 1 to 8 ; losophan in benzoated 
lard, 1 to 40 ; hypodermic injecti^*\ of 
pilocarpin, gr. y&> in the center of the 
itching area, and meanwhileytlse mass- 
age with hot camphor linimej^t every day 
for fifteen minutes at a timj 

A very short talk on aroplexy : Pre- 
vent it by avoiding anger/over-exertion, 
over-eating or drinklbg, aid by treating 
atheroma, hypertrophy of the heart, ple- 
thora, gout or any Iktlrer predisposing 
cause of apoplexy. 

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THE MEDICAL WORLD. 



**- 



If an attack is impending, bleed, give 
^laterine, gr. 1-13, or aconitine, gr. 1- 
*34> every half hour or oftener, accord- 
ing to th< * 

If the a 
dication i 
lessening 
by bleedin 
gogue cat! 
well suit 
which is d; 
rest and q 
cessary. 

When th 
formed, the 




xigency 01 tne case. 

occurjed, the first in- 
check thyhemorrhage by 
the circulation, 
itine and hydra- 
'eratrum is not so 
y cause vomiting, 
The most absolute 
the sick-room are ne- 



^ has ceased and the clot 
Fesulting inflammation re- 
quires aconite, saline cathartics, low diet 
with little fluids, and above all, rest and 
quiet 

The fever gone, the next step is the 
absorption of the clot and the other debris 
from the injury. The iodide of sodium, 
gr. xxx a day, with mercury in some 
cases, and the same low, dry diet, rest 
and quiet, are our best remedies. 

Absorption accomplished, the nerves 
may not at once resume their activity 
unless strychnine and galvanism are em- 
ployed to arouse them. Faradization and 
massage should be employed after the 
first month, to keeprup the nutrition and 
flexibility of the muscles and tendon^^ 
I ; If anyone else than the editor of the 
World had written the page of " talk" 
{page 478), I would speak of it with a 
warmer appreciation than the editor 
would allow. But I wish every doctor 
who has interested himself in the late 
election would read it and consider the 
objects presented. Revolutionary reforms 
are rarely successful, and usually induce 
counter revolutions ; but the good cause 
is best helped along by the steady growth 
of public sentiment in the right direc- 
tion. Let the medical profession, as 
leaders in the world's civilization, once 
appreciate the benefits of government 
ownership of the telegraph, express, sav- 
ings banks and other public utilities, 
and let each of us begin to educate that 
portion of the public that comes under 
our immediate influence up to the same 
point. In good time the measures will be 
Forced upon the legislators by the irresis- 
tible pressure of public sentiment. It is 
not so brilliant a way of doing things, 
but it is the natural way, and the only 
successful one. It is not necessary that 



a man should swallow " Looking Back* 
ward " at a singfe gulp, but we will be 
content if he goes a little way with us irf 
advocating the reform most of us agree 
lipomas especially needed. . The success 
of onisuch change will pofot the way 
for the next; and thus we reaclvout for 
the perfection for which we strive, but 
can nearer reach. 

/ William F Waugh, M. D. 

103 State St., Chicago. 



Antitoxla It-Diphtheria. 

Editor Medical WotTd^My personal 
experience in the use IW* 'antitoxin 
is limited to the following cases, in two 
of which I was called as consultant, 
therein advising the use of antitoxin, 
and to a number in the practice of other 
physicians in which I was asked for an 
opinion as to diagnosis : 

Case 1. J. H., boy 14 years of age, 
was first seen August 13, 1895, by an- 
other physician about noon, who diag- 
nosed the case as one of diphtheria. I 
was called to see the patient, the follow- 
ing day and assumed charge of the pa- 
tient and concurred in the diagnosis and 
advised the use of antitoxin. The local 
supply being exhausted, I' ordered at 
once from Philadelphia, but* could not 
secure it until Friday, a. m., and admin- 
istered it Oibout 10 a. m. 

There was an extensive membrane on 
both tonsils and on the posterior surface 
of the uvula to its tip ; both tonsils and 
uvula were enormously swollen and 
there was general faucial inflammation. 
Patient could not swallow, even liquids, 
the uvula closing the intertonsillar 
space, and, as a consequence was much 
distressed^ 

10 C. C. Behring's solution was in- 
jected. 

At the evening visit the patient was 
much brighter and better. On Satur- 
day morning there was marked improve- 
ment The voice, which had been 
muffled, was now distinct and the patient 
expressed himself as feeling better. I 
found him eating grapes and peaches, 
and was informed that on the evening of 
Friday he had partaken of bread and 
milk. 

The improvement setting in so 
promptly, I did not repeat the injection. 



THE MBDICAL WORLD. 



With larger experience I would not rely 
on one injection, but would repeat at 
least once. 

From this on I gave strych. sulph. 
gr. bV> four times daily, which com- 
prised nearly all the medical treatment, 
except local, in which hydrogen diox- 
ide was used. Recovery prompt and 
complete, with no sequelae. 

Case 2. S. C, boy, 7 years of age, 
was first seen Sunday, October 6, 1895. 
Diagnosis : Tonsilitis, and treated it ac- 
cordingly. On Monday, case much bet- 
ter ; in fact, the patient was at table 
eating, when I called. The throat was 
clean and patient feeling well. I was 
again called Wednesday noon, when I 
discovered decided membrane on both 
tonsils and pronounced the case one of 
diphtheria. At 4 p. m. I saw the patient 
with twootherphysicians, who concurred 
in the diagnosis. I injected 10 C. C. of 
Gibier's solution. Thursday a. m. re- 
peated the injection. At this time there 
was some detachment of the membrane 
apparent and slight amount of bleeding 
from the margin. 

Locally I applied hydrogen dioxide ; 
internally hydrarg. bichlor. and tinct 
Ferri chlor. 

Recovery was rapid, with no sequelae. 
Case 3. I was called in consultation 
to see a girl 5 years of age, a strong and 
robust child previously. A brother had 
died on the same day of laryngeal diph- 
theria, and this proved to be of the same 
character. There was complete aphonia 
and the respiration seriously impeded. 
Not much membrane was apparent, but 
the throat was very red. 

I gave 10 C. C. of Gibier's solution 
about 7.30 p. m., and advised its repeti- 
tion in the morning by the attending 
physician, which was done. Tne patient 
was very ill, but made a good, though 
somewhat tedious recovery. From being 
a skeptic, the attending physician, a close 
observer, became an enthusiast in its use. 
Case 4. A boy, 6 years of age, was seen 
in consultation in a country district A 
number of deaths had occurred in the 
neighborhood, two within a few hun- 
dred yards of patient's residence. This 
patient, apparently, was not very ill, 
but the attending physician said his 
other cases that died were apparently 
no worse than he. Injected 10 C. C. 



Gibier's solution, which was repeated 
the following day. Recovery. 

Case 5. Anna I*, 4 years. First saw 
the patient Sunday, September 6, 1896, 
at 6.30 a. m. The face was flushed, the 
skin hot and dry, the pulse very rapid, 
with marked constitutional disturbance. 
A small patch of membrane on the left 
tonsil was observed, which increased dur- 
ing the day, with invasion of the right 
tonsil Diagnosis of diphtheria con- 
firmed by another physician. At 5.30 
p. m. injected 5 C. C. Mulford's anti- 
toxin (potent), and repeated it at 10.30 the 
same night 

At the morning visit there was a 
marked improvement ; the temperature 
was normal and the heart's action much 
better. The internal treatment was the 
same as in preceding cases. The mem- 
brane disappeared in five days. Recov- 
ery was prompt and complete. 

Aside from these case?, I saw a num- 
ber in which antitoxin gave very satis- 
factory results, but, as they were not 
under my care, could not give their his^ 
tory. 

As to the value of antitoxin. 

So far as my limited experience ex- 
tends, I have to say that no other treat- 
ment has afforded me the same results; 
nor has recovery, in cases in which it was 
not used, been so prompt and free from 
sequelae. While I do not regard it as a 
specific, I do believe that no other treat- 
ment with which I am familiar offers 
the same hope to the patient or promises 
as prompt results to the physiciai^ as 
antitoxin, and, until I am shown " a 
better way," I shall continue its use. 
M. L. Wolford, M. D. 

Harrisburg, Pa. 

Editor Medical World:— On September 
1 I received a communication from you 
asking me to contribute to your Novem- 
ber number on antitoxin, as I have used 
it very largely in this and adjoining cities. 
I was taken down about September 
12th, or 15th, with a bad case of inflam- 
matory rheumatism, and have been con- 
fined to my bed ever since. I am sitting 
up to-day and am away from my office, 
and cannot give you exact date or full 
description of cases, and may ask ex- 
cuses for my communication on account 
of my illness. Digitizedby GoCM 



THE MEDICAL WORLD. 



In the winter oi 1893 I had been 
Health Officer of Kansas City since 1890, 
-and continued in that capacity until the 
spring of '96. As we had an epidemic 
of diphtheria in the city in * 93 I bought, 
through the city authorities, a supply of 
antitoxin. The Jackson County Medi- 
cal Society, at my request, appointed 
a committee to observe its use and make 
cultures from the throats of children 
in cases observed. During the winter 
we used antitoxine on about forty-five 
cases out of 150 reported. All recovered 
except five, and these were bad cases and 
and the serum was used late, about the 
fifth or sixth day. We also used it in 
about ten cases of membranous croup 
that winter, with four deaths — the deaths 
were in cases moribund when used, and 
died in less than twenty-four hours after 
its use. 

In the winter of 1894 we used it in 
about 60 cases out of 120 reported. 
Where cases were doubtful yre had 
cultures made before using it ; if cultures 
did not confirm diagnosis we did not use 
it We found in 1894, as in 1893, ^ at 
physicians would try to cure their cases 
without it, and when they found the 
child getting worse they would fly to 
antitoxin, and our mortality of cases in 
1894 was greater than in 1893 — about 12 
or 15 per cent. 

The epidemic of 1895 was a very 
severe one in Kansas City ; and we had 
reported to the Board of Health about 
200 cases. The same holding back ot 
physicians occurred, and the serum was 
used only in about 80 cases. The mor- 
tality, where it was used in both early 
and late cases, was about 15 per cent ; 
where it was not used the very mild 
cases (that were probably not diphtheria) 
recovered, and the severe cases, where 
serum was not used, mortality showed 
about 50 to 60 per cent. 

In the winter of 1896 we had few 
cases, and used antitoxin on about one- 
half of the bad cases, with a mortality of 
12 to 15 per cent, in both early and late 
cases, and in bad cases, where not used, 
mortality showed about 50 per cent 

This communication would be too 
long were I to give many of these cases 
in detail, but as Health Officer, with the 
death records before me every day, and 
nearly all of the antitoxin used in 1893 



and 1894 passing through my hands, 
I have knowledge of all the cases, many 
of which I saw personally, especially in 
1893, 1894, 1895, and can give my evi- 
dence favorably to the use of antitoxin 
in all the cases where true diphtheria or 
membranous croup is present. 

Altogether, the extent of my ex- 
perience and in consultation with other 
physicians has been in about 200 cases, 
and I want to most unqualifiedly en- 
dorse antitoxin for many reasons, ^es- 
pecially as the remedy has never, in my 
hands, done any harm, and favorable 
symptoms are shown in 12 hours ; and if 
enough is used, in 24 hours and 48 
hours there is marked improvement all 
along the line, except in moribund cases 
within 24 hours of death, or where sepsis 
has already begun. I think the remedy 
should be used promptly after diagnosis, 
and repeated in 10 or 24 hours, according 
to indications. 

The main trouble seems to be that the 
physicians try to cure the cases them- 
selves ; and after five or six days, when 
the poison is absorbed in the system and 
the patient gets suddenly worse, they fly 
to antitoxin to find out it is too late. 
When used early it will cure. When 
used late it is doubtful, but in bad cases 
or late cases I think the double anti- 
toxin should be used. I have used en- 
tirely Gibier's antitoxin, made at the 
Pasteur Institute in New York. 

Dr. R. P. Waring. 
Kansas City, Mo. 



Editor Medical World: — My use of 
this remedy has been confined to ten 
cases. The diagnosis of all of them had 
been confirmed by microscopical exami- 
nation, not by the culture method, but 
by a more direct and shorter way. I 
take a bit of the membrane from the 
throat and thoroughly rub the surface 
of a clean cover glass with the inside of 
the membrane ; then color in the usual 
way ; mount in balsam and examine ; 
all of which can be done in fifteen 
minutes time, instead of twelve to fifteen 
hours by the culture method. By the 
above short plan I have never failed to 
find the Klebs-Loeffler bacilli, and in 
sufficient numbers to warrant a diagnosis 
of diphtheria. 

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In the treatment of all my cases, I 
usually resort to the medicinal treatment, 
watching them carefully until I become 
satisfied that they are going from bad to 
worse ; then I use the serum. The 
beneficial effects of the serum treatment 
is quite manifest in from eight to twelve 
hours. After a lapse of twelve hours, if 
the improvement is not well marked, I 
repeat the dose. In the ten cases I have 
only used a second dose in three of them ; 
they were desperate cases, and all re- 
covered. The two cases, of the ten, which 
died, I saw in consultation, and they 
were practically dead when the serum 
was used. t 

I have never had any untoward results 
from the use of the serum, but on the 
contrary improvement has been rapid ; 
convalescense established much sooner 
than in mild cases which recover after 
medical treatment, and sequelae, if any, 
have been very light. 

The serum used in the first four cases 
was prepared by the New York Pasteur 
Institute ; the remainder of the cases 
were treated by the H. K. Mulford 
(Philadelphia) preparation, because I 
could obtain it more readily. 

From my experience with this won- 
derful discovery I am forced to the fol- 
lowing conclusions : 

i. Diphtheria antitoxin will not re- 
store those dead from diphtheria. 

2. It is more a specific for diphtheria 
than we have in medicine for any 
ailment. 

3. Severe cases treated medicinally 
almost invariably result fatally, whereas 
in all these cases, if the serum be used 
early, recovery may confidently be ex- 
pected. 

4. Serum properly prepared is as harm- 
less as any remedy known. 

5. A physician withholding this remedy 
from his patients, and permitting them 
to die from diphtheria, should have his 
license revoked for criminal negligence. 

James D. Whitley, M.D. 
Petersburg, Illinois. 

Editor Medical World : — A month ago 
I was called to see a boy aged 4 years. 
He had been sick with diphtheria two 
weeks; it involved the larnyx. His 
physician told the parents that he could 
do nothing more for the child, and would 



not return/ Parents sent to town and 
had photographer come to take ante- 
mortem photograph. The artist in- 
duced them to send for me. I found 
child coughing and laboring to jjet 
breath. I immediately gave P., D. & 
Co.'s antitoxin. This was at 10 p. m. 
Next morning patient was much better,, 
and I discharged him in three or four 
days, cured. Three injections were used. 
"The medical journals which are oppos- 
ing antitoxin are responsible for the 
death of many children. 

V. E. Lawrence, M. D. 
Ottawa, Kan. 



Editor Medical World. — I report two 
cases of diphtheria treated with anti- 
toxin. This is all the cases I have had 
a chance to treat, as diphtheria is, for- 
tunately, a rare disease in this section. 

March 23^ 1895, was called at 10 p. m.> 
to see W. W M aged 30. He had lost a 
child with diphtheria about two weeks 
before, treated by another practitioner. 

I found him prostrated, pulse 108, 
rapid and feeble. Temp. 103 2-5, mem- 
brane over entire throat Ordered cor- 
rosive sublimate, gr. 1-50, every three 
hours, and throat sprayed with H % O r 

March 24, a. m. , worse ; glands much 
swollen, throat very sore. Marked pros- 
tration. Albumen in urine. Tr. ferri 
chlorid added to treatment. 

March 25, 4 p. m., gave injection ot 
10 c c (one bottle) of antitoxin. Temp, 
before injection 103 . Throat still 
sprayed with H t 2 . At 11 p. m., temp. 
100 3-5°, pulse not so rapid, 

March 24, a. m., temp. 99 1-5 . Even- 
ing rise to 100 2-5 . 

March 26, a. m., temp, normal. Even- 
ing rise to 99 . Membrane expector- 
ated in one piece, leaving perfectly 
healthy tissue. 

March 27, a. m., temp- 97 2-5°, Even- 
ing rise to normal. 

Subsequent treatment tonics and re* 
stricted diet Heart seemed very weak 
as the temperature fell. To combat this 
strych. sulph. and digitalis were freely 
used. 

We see that patient was seriously ill 
only four days, and his recovery was due 
to antitoxin, as all other treatment was 
discontinued except spraying the throat 
with H 2 Oj. 

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Case No. 2. The two-year-old 
daughter of Case No. 1. 

Was called Sunday, April 7, 1895, at 9 
a. m. Found pulse at 196, temp. 104 . 
Inspection showed a small patch on side 
of fauces. Tenderness under jaw, but 
gland not enlarged. 



gr. isa 

gr. * 
gr. ii 



Ordered Hygrarg chlor. mit 
Sodii bicarb 
Phenacetin 
M. Divide in chart no. xii. 
S. One every 2 hours. Throat sprayed 
with H 2 O* 

4 p. m., patch extending, pulse 200, 
full and rapid ; temp. 104 . I diagnosed 
it as diphtheria. Family desiring a con- 
sultation, Dr. B. was called, and confirm- 
ed diagnosis. Patient about the same as 
before. 

Monday,8 a. m., temperature had raised 
from 103 2-5 to 104 2-5 , since last visit ; 
pulse quite rapid. Gave an injection of 
1-3 of bottle of 10 cc. of antitoxin, discon- 
tinuing medical treatment, but still 
spraying with H 2 O* 

5 p. m., temp, about 100 2-5 ; pulse 
less rapid ; membrane not so prominent 

Tuesday, 7 a. m., temperature station- 
ary at 100 all night , pulse same as pre- 
ceding evening ; less membrane. Gave 
an injection of another 1-3 of bottle ; 
spraying with H 2 O t continued. 

Wednesday, a. m., temperature normal, 
and had been subnormal previous even- 
ing ; pulse normal and strong. 

Thursday, a. m., temperature and 
pulse normal, no membrane. A very 
easy convalescense followed. Being a 
little careless in the use of the syringe, 
blood was drawn. The wound festered 
and a lump formed. This disappeared 
in 36 hours, and produced no constitu- 
tional disturbance. 

This case was seriously ill for a day or 
two, and owes her recovery to antitoxin. 

I used Behring's antitoxin, imported 
from Germany. The vials I used con- 
tained 10 cc, 1000 antitoxin normal 
units. 

I wish to call attention to the great 
heartf weakness in case No. 1, also the 
fell of temperature produced by the two 
injections of antitoxin. There was a 
slight rise in temperature immediately 
after injection of antitoxin. 

I think a good plan would be to have 



the temperature taken every hour or so. 
If it continues to fall, enough antitoxin 
has been used ; when it remains station- 
ary, give more antitoxin. Give antitoxin 
early to get best results. Don't think it 
will cure every case. That is impossible. 
A. I. Hunt, M. D. 
Hamilton Square, N. J. 



What About Antitoxin in Membranous Croup? 

Editor Medical World : — I have been 
interested in the recent discussions on 
the antitoxin treatment of diphtheria in 
the November and December numbers 
of The World. I have passed through 
some severe epidemics of diphtheria in 
its very worst form while in the north- 
west, and with success. I had a com- 
paratively low mortality consideringthe 
malignant form of the disease. This 
was before antitoxin was ever heard o£ 
My treatment of diphtheria was as fol- 
lows: In the first place, and for its 
alterative and constitutional effects, mer- 
cury was jjiven, usually the gray powder, 
but sometimes calomel, every two hours, 
and a wash of permanganate of potash of 
suitable strength, not too strong, was used 
every two hours, with a swab, or as a 
gargle, if the child was old enough ; also 
the tincture of the chloride of iron used 
as a wash or gargle and internally every 
six hours. If debility or marked anemia, 
quinine and stimulants according to the 
case, with inhalations of steam from 
eucalyptus, or carbolic acid, or a com- 
bination if necessary. 

This treatment, if persisted in day 
and night with variations to suit each 
individual case, together with a careful 
use of a solution of the bichloride of 
mercury with a spray between the gargles 
of the permanganate of potash until the 
patient is under the influence of the mer- 
cury, I have found successful. I know 
from experience that it will save nine 
out often cases, take them as they come. 

If I had a case of diphtheria now I 
would use the treatment outlined above 
with antitoxin. 

I am positive that diphtheria and 
membranous croup are distinct diseases, 
and require a distinct and different treat- 
ment from any I have been using. I 
never saved a case of membranous croup; 



12 



THE MEDICAL WORLD. 



have lost several cases of membranous 
croup in the last few years, and I would 
like to know if any of the readers of The 
World ever tried antitoxin in mem* 
branous croup, and with what result ? 

I have, after dutf consideration, made 
up my mind that I will try it in my next 
case of membranous croup. I believe 
from what I have read that it will be 
the remedy in this disease. As I 
said before, I have not been unsuccessful 
in the treatment of membranous croup 
with the usual remedies, but have been 
ynusually successful in the treatment of 
diphtheria. 

I have been in this part of Illinois four 
years, and I don't think there has been 
any diphtheria in this vicinity, although 
some of the physicians in the neighbor- 
ing towns claim they have had cases of 
it. 

They would only have one case in a 
family of several children, and that case 
would die. None of the rest of the 
family would have it, and they would 
use no immunizing doses of antitoxin, 
neither would they use the usual anti- 
septics or disinfectants. From their de- 
scriptions of the cases there is no doubt 
in my mind that they were membranous 
croup. 

I rely a great deal on the hereditary pre- 
disposition of certain families to be sub- 
ject to membranous croup, and am a firm 
believer in the prophylactic treatment 
of it before the membranes begin to form. 
I think I have saved cases that would 
have terminated in that way if I had not 
used preventive measures, judging only 
from the family history and the case 
treated. 

Harvel, 111. J. W. Gibson, M.D. 

[The question of whether or not mem- 
branous croup and diphtheria are iden- 
tical has been long and earnestly dis- 
cussed; and, Doctor, the concensus of 
opinion and the weight of authority are 
now strongly inclined to the belief that 
they are identical. Yes, by all means 
use antitoxin in your next case of mem- 
branous croup. It is used, and with 
success, in these cases, on the theory 
j^at membranous croup is laryngeal 
w £>htheria. The success of this treat- 
p^nt seems to be an additional proof 
£ £ membranous croup and diphtheria 
> .he same. — Ed.] 



Diphtheria Mortality— Antitoxin. 

Editor Medical World :— I am particu- 
larly glad to note your level-headed edi- 
torial on the relation of diphtheria anti- 
toxin to statistics. By all means let tts 
have reliable statistics, for in no other 
way can the value of new therapeutic 
measures be calculated. The inflated 
statistics with which the advocates of 
antitoxin rushed into print were enough 
to stagger any thinking man and well 
calculated to make him suspect a " nig- 
ger in the wood pile." They compelled 
many conservative physicians to believe 
that financial rather than therapeutic re- 
sults were the chief end and object of the 
heralds of antitoxin. All that has been 
said in favor of antitoxin has not ena- 
bled me to divest myself of that idea. 
I may be wrong, and hope I am. No one 
would welcome with louder plaudits than 
I a better treatment for diphtheria. Not 
that the treatment which I have used, 
arid which was outlined in a recent issue 
of The World, has been unsuccessful in 
my hands, but that the medical profes- 
sion seem to be so entirely unsettled and 
at sea as to any rational plan of treat- 
ment for this disease. 

Since the name "diphtheria" was 
given to this particular angina by Bre- 
toneau, of Tours, in 1834, hundreds of 
therapeutic agents of more or less renown 
have been used in its treatment, and 
many have been proclaimed almost if not 
quite specific. Many writers have 
claimed for their method of treatment 
results not less successful, and, in some 
instances, more so, than is generally 
claimed for antitoxin. But, then, until 
recently, diphtheria was not claimed to 
be such a fatal disease, except in epi- 
demics of the malignant form, where 
death frequently occurred in a few hours 
after the first symptoms of the disease 
became noticeable, and where the fatal 
membrane was often found in the 
heart cavities, stomach, lungs, or intes- 
tines, as well as in the throat. In such 
cases ordinary remedies have frequently 
no time to act, and the mortality is large. 
I have not heard, and I believe it is not 
written, that antitoxin has proved suc- 
cessful beyond measure in one of these 
malignant epidemics of diphtheria, and 
until it is honestly so written all diph- 
theria statistics that claim a very low 

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THE MEDICAX WORLD. 



13 



death-rate for antitoxin and a very high 
death-rate for all other methods of treat- 
ment must be taken cnm grano salis. 
The literature of the subject which I 
have been able to read would, I think, 
justify an estimate of less than ten per 
cent, of malignant cases treated with 
antitoxin, and over ninety per cent of 
bacterial and non-malignant cases so 
treated. If this estimate is nearly cor- 
rect, it follows that, unless the friends of 
the serum therapy cannot show a death- 
rate of less than ten per cent., or that 
diphtheria is a much more fatal disease 
now than formerly, they utterly fail to 
establish its boasted therapeutic value. 

As long ago as 1874, Dr. Hartshorn 
said : u Simple diphtheria is not very dan- 
gerous to life. The croupous (tracheal) 
form is decidedly so, and the malignant is 
fatal in a large majority of cases." 

Gerhard Tweedie, 1842 says : " If the 
system can be speedily brought under 
the influence of mercury, the issue will 
generally be successful. If the pellicle 
has formed in the air passages, very little 
expectation of recovery can be enter- 
tained." 

Watson, by Condie, 1858, says: 
" Diphtheria proves fatal (when it does 
prove fatal) by the extension of the in- 
iammation into the air passages." 

Wood, 1858, said: "Except in the 
malignant form, or when it occurs in 
constitutions much enfeebled, or assumes 
the character of pseudo-membranous 
croup, the prognosis is favorable." 

In 1880 Dr. J. Solis Cohen dissented 
somewhat from the above opinions. He 
said : "It is impossible to predict safety 
even in mild cases, while recovery may 
follow the most unpromising manifesta- 
tions." 

In 1894 Dr. Hughes, of Philadelphia, 
said: "The mortality from this disease 
is about ten per cent" 

Dr. Callam, in the proceedings of the 
Finland practitioners, claims to have 
treated 150 cas$5 without a single death. 

Dr. Geo. Guttmann reported 66 cases, 
treated from April, 1879, to July, 1880, 
33 of which were severe, without a 
single death. He used the pilocarpin 
treatment 

Dr. Condie, in 1868, said : " When the 
disease is confined to the soft palate, 
isthmus of the fauces and pharnyx, it is 



seldom attended with much danger. 
When the inflammation is of little ex- 
tent it may disappear spontaneously in a 
few days. When, however, the disease 
extends into the larnyx it is very fre- 
quently fatal." • 

Dr. Bluebaum, in Inter. Nat. Med. 
Mag., reported 39 cases out of 40 
cured by galvano cautery to the false 
membrane. 

Dr. H. C. Harkness, in Med. Sum., 
1871, says: " In a series of 35 cases in 
which I used turpentine but two deaths 
occurred." 

Dr. J. Hirsch, in a pamphlet on diph- 
theria, claims to have not lost a single 
case of diphtheria in nine years practice, 
during which he used the acetic acid 
treatment 

From the last year's discussion of the 
subject, this list might be extended in- 
definitely ; but with the recent literature 
on the subject the profession is ac- 
quainted, so I need not jog their memo- 
ries. Nor am I unmindful of the fact 
that the more modern devotees of mush- 
room science and hot-house therapeusis 
are apt to curl the lip a little, if not 
more, when the venerable fathers of 
rational medicine are called upon the 
witness stand. I only claim that their 
evidence is good for the times in which 
they lived and wrote. 

The evidence seems to justify the con- 
clusion that until the beginning of the 
antitoxin craze, diphtheria was not con- 
sidered a very dangerous or fatal disease, 
except in the malignant or tracheal 
forms, which constitute less than ten per 
cent, of all cases ; that the death rate 
was less rather than more than ten per 
cent It is my opinion, based largely on 
observation and experience, that when " 
any physician loses more than twelve or 
fifteen per cent of his diphtheria cases 
in private practice in a senes of years, he 
should turn his diploma's face to the 
wall and pull down his " shingle." His 
practice is a menace to the lives, health 
and safety of the community. I would 
like to express my disgust with those 
physicians who are now not only con- 
fessing, but parading the fact that under 
any but the antitoxin treatment they 
lost from twenty-five to fifty per cent of 
their diphtheria patients in private and 
hospital practice igfesStJ fear the terms ' I 



14 



THE MEDICAL WORLD. 



would look cold and stiff like so many of 
their patients. 

In the current number, of The World, 
Dr. Rosenthal gives us a list of 86 faucial 
and 55 laryngeal cases, with only 6 
deaths ; but he sajfc nothing at all about 
the number of these cases that could 
never be recognized as diphtheria without 
a microscope. It may be possible that 
only the 55 laryngeal cases could have 
been diagnosed as diphtheria without a 
bacterial examination, and that his real 
mortality was nearly 12 per cent The 
doctor tells us that before antitoxin he in- 
tubated 100 cases with a mortality of 62 
per cent. ; but he don't tell us why he 
intubated when other means would more 
successfully relieve any case in which the 
pseudo-membrane does not extend into 
the trachea or bronchia. Nor does he 
tell us anything of the value of intuba- 
tion or antitoxin in cases where the false 
membrane does extend beyond the 
larynx. His statistics are absolutely 
worthless. Then we are told of over 600 
cases immunized (bamboozled would be 
more correct), not one of which showed 
symptoms ot the disease. Well, well, I 
could tell of more than 600 cases not im- 
munized, many of which were exposed to 
the contagion, if diphtheria is contagious, 
actually living, sleeping, eating and 
drinking in the same room with diph- 
theretic patients, yet showing no signs 
of the disease. It is an unquestioned fact 
that only a very small per cent of those 
exposed to the contagion, supposed or 
real, of diphtheria ever contract the 
disease ; and until immunization can be 
proved to have reduced or obliterated 
that very small per cent, it can have no 
claim for professional recognition. It is 
simply an experiment, well calculated to 
fill the coffers of those who can experi- 
ment wholesale with their clientele with- 
out danger to their practice. 

I may yet be a convert to the serum 
therapy, but before that can happen some 
things must be made so plain " that he 
who runs may read." If the Klebs- 
hoeAer bacilli are the cause of diphtheria, 
and the antitoxin destroys the "bug" 
as well as its product, why not apply the 
serum directly to the false membrane and 
the passages through which the bacillus 
enter the system ? If given by the mouth 
would not the serum be digested just as 



other animal substances are ? If so does 
such digestion destroy its antitoxin 
properties? And if not, why not? Being 
a purely animal product, why do not the 
functions of assimilation and elimination 
and the various glands have the same 
effect upon this as upon ordinary serum 
when used hypodermatically ? To the 
wise these questions may indicate great 
ignorance ; but the writer is not above 
learning. 

One manufacturer of antitoxin wrote 
me that the use of his preparation of 
serum would have prevented death in my 
reported case of diphtheria, but he ven- 
tured no explanation of the large 
number of such sudden deaths following 
the use of antitoxin. 

Dr. J. W. Lockhart. 

St John, Wash. 

[From the evidence now in, we believe 
that antitoxin has great and positive 
value in diphtheria. Nevertheless, we 
admire Dr. Lockhart's article. Such 
vigorous skepticism puts any new treat- 
ment to a severer test, and in the end 
serves the interests of truth. The chief 
reason that we admire the doctor's 
skepticism is because it is coupled with 
an expressed desire to learn. This is the 
difference between opinion and prejudice. 
We hope that the doctor will add ex- 
perience with antitoxin to his qualifica- 
tions, and then we will be glad to hear 
what further he has to say. Antitoxin 
is making large and important claims, 
and we all want to know the truth. — Ed. J 

Dr. R. A. Taylor, of Otisville, N. Y., 
writes that he has a record of 76 cases of 
diphtheria treated medicinally, with only 
one death. He thinks this is a very 
good record for a country practitioner, 
which we will all grant. Finally he bad 
a case in which all medicinal treatment 
was inadequate. He had studied the 
subject of antitoxin carefully and finally 
concluded to use it in this case. The re- 
sults were so satisfactory that he has used 
it ever since, having freated 18 cases 
with it with no death. He says of the 
treatment, " it is so much easier, less 
anxiety, and will do ho harm.' 1 He uses 
Mulford's antitoxin. 



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IS 



More Pointed Remarks from "A Doctor's 
Wife." 

Editor Medical World : — It is even as 
Dr. Mayer anticipated, I am not yet satis- 
fied that anesthetics are dangerous and 
useless in obstetrical practice, and why 
should I be ? Have I not the brightest 
stars and some of the leading lights of 
the medical profession, both of the new 
world and the old, on my side of the 
question ? It is. strange, but true, that 
there are always some who believe the 
old way is best, and who try to build a 
great wall of prejudice against any- 
thing, whether justifiable or not, that is 
just not exactly according to their way 
of thinking. I have, however, not come 
to attempt a discussion of this subject 
A number of physicians have answered 
the objections offered far better than I 
could have done ; and I also realize the 
fact, quoting Dr. Mayer's own words, 
that " arguments as well as facts will not 
convince a certain class of people." I 
wished, though, to write again to thank 
the editor of this journal for kindly pub- 
lishing my articles, and also to return my 
gratitude to that noble array of phy- 
sicians who so kindly, truly, and con- 
siderately answered my queries. Happy, 
indeed, are the women who are fortunate 
enough to fall under your care in this 
their great hour of trial. Your words 
strengthened me in the belief that the 
wall of prejudice, which in many places 
surround the use of an (anesthetic in 
labor, is destined soon to melt away, 
even as the winter snow before the noon- 
day sun. I want also to assure Dr. 
Church that in the cases spoken of in a 
former article the presentations were all 
normal, and that the difference in the 
suffering in the last two was due to the 
soothing influence of chloroform. And 
I believe that the more speedy delivery 
was due to the fact, that as the pains 
were rendered more bearable, greater ex- 

? filing force was brought into action, 
his is exactly opposite to the view ad- 
vanced by Dr. Church, that an anes- 
thetic will not do in breech presentations 
because the expelling force of the mother 
is needed. Ask any woman who has 
used an anesthetic if she could not be 
induced to exert herself more with it 
than without it, and I think she will 
answer yes. I think all who read Dr. 



Church's article will agree with me that 
there are some fallacies in his reasoning. 
We were not talking about complete 
anesthesia, nor were we advising its use 
where persons were physically incapaci- 
tated to take it I believe, however, 
that there has been one objection for not 
using it advanced that there is really 
something in. I refer to the prejudice 
against its use existing in some com- 
munities, together with that of surround- 
ing physicians. I am aware a physician 
is running some risk in giving it in such 
neighborhoods, for should anything 
wrong occur from any cause, however 
remote, it would more than likely be 
attributed by the family to the anes- 
thetic, and in all probability this view 
* would be encouraged by the anti-anes- 
thetic physicians. 

I would say that it is not to this class 
of physicians that I have been addressing 
my remarks, but to that class who are 

Srejudiced themselves, and want every* 
ody else to be. And 1 might say right 
here that any husband who refuses to 
let his wife have the benefit of this price- 
less boon to her should be labelled, 
"tyrant;" for such he is, indeed. I 
quite agree with the physician who said 
in the November number, that if nature 
has to take its course, an old woman 
would answer the purpose as well as an 
M. D. in the majority of cases. It is 
manifest that there are a great many 
people who think that to bear children 
is what a woman is made for; and 
that she who dares to utter a protest 
should be condemned in the severest 
possible manner. One physician sarcas- 
tically remarks that "it is so nice to 
become a mother without suffering." 
No doubt, if he is a father, that thought 
has occurred to him before with regard 
to becoming a father. We, unfor- 
tunately, do not hope to attain to entire 
immunity from suffering, but we do pro- 
pose in the near future to have what 
relief we are entitled to from our medical 
advisers. We are as justly entitled to 
the benefits of modern anesthesia as any 
other class of people, and ere long the 
physician who refuses it will have to 
practice in some department of medicine 
other than obstetrics for his living. 

But now for another question. I had 
hoped that the one who asked a ques- 

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16 



THE MEDICAL WORLD. 



tion in the November World, on page 
431, and signed himself G., would nave 
a respectful hearing before that learned 
body, the readers of The Medical World. 
It is a question that I do not know that 
the medical fraternity can solve so that 
it would suit every case, nor do I think 
that they are much, if any, more respon- 
sible for the existing state of things than 
any other class of men. Still, I think 
the question was more worthy of your 
consideration than ridicule. When I 
read the signature to the article to which 
I refer in the December number I 
felt like exclaiming " et tu Brute !" I 
hold Dr. Waugh in the highest esteem, 
and have been thinking of sending him 
some flower-seeds for his garden ; but if 
that is his opinion of a woman I will 
wait until I hear from him again. Per- 
haps when his shoulder gets well he will 
not be so harsh in his judgment ; but, 
really, I do not think that even a lame 
shoulder is sufficient apology for his 
radical views on the subject The only 
apology I can find for him is that his 
practice must be confined to the wealthy, 
indolent class of women, who love their 
own ease above everything else. He 
manifestly does not take into considera- 
tion that class who have themselves to 
support, and husbands, too. Say what 
you will, this is a question that is agitat- 
ing the minds of thousands of the women 
of our land to-day. Good women, too, 
and not the frivolous kind who want to 
shirk responsibility. 

No true woman would attempt to de- 
stroy the fetus after once conception has 
taken place, except for grave reasons ; 
but the prevention of it is quite another 
question. I most heartily pity the wife 
who bears no children, for they are the 
light of our homes and the tie that binds 
husband and wife in a more indissoluable 
union than anything else can ; but I pity 
more the woman who is so overburdened 
with child-bearing that she would gladly 
lay down in her grave to rest, if it were 
not for the children she already has, and 
who sees no relief except old age or 
death. Do not smile. There are many 
such. 

From what Dr. Waugh says, one would 
think he would encourage a man to give 
his wife a divorce if she had the courage 
to think she had borne enough children. 



Perhaps No. 2, after she has been ini- 
tiated into the mysteries of child-bear- 
ing, will also reach a point when she 
shall think she has done enough in that 
line. In that case would you advise a 
man to go on ad infinitum, or until he 
got one that could wear him out ? Haw 
many young and lovely girls fall into 
this trap of marriage as innocently as a 
mouse walks into a trap, and finds, too, 
like the mouse, that her captor has no 
mercy. Do not understand me that I 
am opposed to marriage. A good, con- 
siderate husband is God's best earthly 
gift to woman ; but who can describe the 
unhappiness and misery of one who fails 
to get a good one. A woman does not 
always get the sympathies of her husband 
' in her troubles. I know one man who, 
it is said, would not speak to his wife for 
some time, because she bore him a child 
late in life ; and another who was very 
angry because his wife did not succeed 
in destroying the life embryo, and up- 
braided her with not trying to. These 
were not ignorant men. One is a prom- 
inent lawyer and the other a druggist I 
know still another whbse wife had very 
bad times in labor, and her children 
came in such quick succession that she 
ventured to complain; whereupon she 
was consolingly informed by her hus- 
band that 4 c it was on account of women's 
sins that they suffered so. ' ' Tied to such 
men as these shall a woman go on bear- 
ing children for them just for a support? 
The women who are free and wash from 
house to house for a living get it easier. 
Is it any wonder that so many girls, see- 
ing the trap into which, perhaps, their 
sisters or friends have fallen, are seeking 
other means of support than marriage ? 
The cases I have mentioned are not iso- 
lated ones, but parallels to them are to 
be found in every community. Perhaps, 
if you understood women better you 
would find that it is not always from 
these so-called selfish reasons that she 
does not want to have more children, but 
it maybe her interest in her posterity. 
Take, for instance, the woman who has 
been reared in refinement. Perhaps she 
has married a drunkard or worthless 
character, and she does not want to have 
a large family to bring up in poverty 
and ignorance. And, again, from her 
own physical weakness she may not be 

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able to transmit to her child the ele- 
ments of health, and is unwilling to keep 
on bearing children who are doomed to 
a life of ill health and an early grave. 

The majority of the women with 
whom I am acquainted do quite as much 
in their way as their husbands toward 
the support, as a husband often finds to 
bis sorrow when he loses a good wife. 
In view of all these facts, I claim (though 
I may be wrong) that a woman has a 
perfect right to say when she thinks she 
has borne enough children. I don't 
know at what point this article will be 
attacked, but since Dr. Church intimates 
that woman's need of an anesthetic in 
labor exists in her mind, I think, most 
likely, that some of my critics will con- 
clude that there is something ^abnormal 
about my mind ; or that I am a hopeless 
dyspeptic, or have liver disease, or more 
likely than all, that I am subject to 
hysterics. Anticipating this, I will take 
this opportunity to assure them that 
nothing of the kind exists. And if I 
have not enumerated all of the ills com- 
monly ascribed to a woman who is not 
pleased with everything just as she finds 
it, I will say further that I have a pleas- 
ant home, interesting children, and a 
kind and devoted husband, and have, in 
fact, nothing to sour me with life except 
women's woes. It is not my own wrongs 
that I am thus parading before the pub- 
lic, but my own good fortune has not 
blinded me to the trials and sorrows of 
some other women with whom I often 
meet And I am persuaded that these 
conditions are not confined alone to my 
narrow scope of vision, but that they ex- 
ist all over this so-called free country of 
ours. 

A Doctor's Wife. 

[The Editor discreetly refrains from 
comments upon this article. The reason 
is obvious — the lady has a sharp pen and 
wields it with vigor. He will, however, 
venture this remark : Doctors are men — 
that is, the majority of us are ; and it 
is a good thing for us, occasionally, to 
see ourselves as feminine eyes see us. 
" A Doctor's Wife " holds up the mirror 
and gives us this opportunity. It is just 
possible that some might suspect that 
tl A Doctor's Wife" is a "fake" indi- 
vidual, and that these articles are gotten 



up by a professional writer, perhaps in 
the editorial sanctum. To any that may 
have had such a thought, we wish to say 
that they are entirely wrong. She is the 
wife of one oi our regular subscribers in 
a distant State. This suggests the ques- 
tion, does your wife read The World? 
It will pay you to encourage your wife 
to take an interest in the profession and 
its work. Her value to you as a com- 
panion and helper will be vastly in- 
creased. Usually not much encourage- 
ment is required ; the opportunity is 
sufficient. Try it and report] 

Can Diarrhea be Inherited ? 

[The following is told so well that we 
allow it to go in without cutting down. 
It may bring out some useful facts. — 
Ed.] 

Her name was. Julia Ann Johnson. 
Indiana was the home of her flesh — some 
hundred and seventy pounds of it — but 
her soul still lingered in the blue hills of 
her native State, u Ole Carliny." 

As we have already intimated, she was 
heavy. She was also shapeless and in- 
clined -to be sluggish. The style of her 
calico dresses, and she affected no other, 
was never altered except as to sleeves. 
They were up-to-date. But the plain 
waist and full skirt, garnished with a 
bright gingham apron, were sacred fix- 
tures. 

Her iron-gray hair was parted exactly 
in the middle, and drawn smoothly into 
a concentrated knot at the back. Most 
of her front teeth had taken an indefinite 
leave of absence. Still she was not 
ugly. Her broad, almost expressionless 
face was very fair and clean-looking. 
Her "speaking eyes " had but one story 
to tell, and that was simply, "I am a 
woman of sorrows." 

She was coming. Her familiar form 
was approaching by the " back road." 
There was little chance of mistaking her 
identity. Even her walk betrayed her. 
The children called it " Indian fashion," 
each foot being swung around so that it 
would come down directly in front of the 
foot behind it. For the lithe and wil- 
lowy Indian that was all well enough, 
but for a woman of Mrs. Johnson's age 
and dimensions such a walk was an of- 
fence to grace. It was an established 
fact that the path of a Johnson could be 

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distinguished from all others, as far down 
as the third and fourth generations. 

She had reached the stairs, and was 
stumbling to the top. Mrs. Clark sighed 
as she looked toward the door, and a 
childish voice said 44 Here's mamma," 
and Julia Ann was ushered into her 
presence. 

44 Good morning, Mrs. Johnson ; have 
a chair." And she offered the caller a 
delicate rattan rocker. 

u Mornin', Miss Clark," she responded, 
softly, as she sought the seat cautiously, 
and, losing her grip in mid-air, landed 
with a thrilling thump. 

44 Won't you take off your bonnet ?" 

44 Allowing " she would, the flappy ar- 
ticle in question was removed and laid in 
an ample lap, and two fat white hands 
crossed and carefully deposited upon the 
crown. The 44 speaking eyes" then 
sought the hostess' face with a 44 help- 
me-Cassius-or-I-sink " look that went 
straight to the little woman's soul. 

44 Are you in trouble, Mrs. Johnson ? 
Can I help you in any way ?" 

44 Well, I just come to see if you 
could do anything, Miss Clark," and the 
voice alone would have been irresistible, 
44 but you've helped us so much, I was 
jist ashamed to come again." She could 
get no further. 

44 There is nothing to be ashamed of, 
Mrs. Johnson. Speak right up. Has 
anything dreadful happened?" urged 
Mrs. Clark. 

44 It's about Ruth, my little gran'daugh- 
ter." 

Mrs. Clark looked puzzled. The 
grandchildren in the house of Johnson 
were legion. 

44 Why, don't you mind Ruth, the 
curly-headed one — the one you give the 
Shelly dress to, and — ?" 

44 Oh, yes ; I do remember now. She 
is the frail little tot" 

"Yes'in. I— I thought you'd mind 
her, and that's jist what I come to see you 
about." And the old lady sailed smoothly 
out upon her sea of trouble. 44 Now, lit- 
tle Ruth, she ain't well. She ain't never 
been well in her life. She's been afflicted 
like with a — a runnin' off ever sence she 
was born, and she's three year old, a-goin' 
on four. She'll be four this harvest." 

44 What have you given her for it, 
Mrs. Johnson ? Anything ?" 



44 Oh, law, yes, Miss Clark; wdtae 
tried every di-ree medicine fur and near, 
and none of it don't appear to do no 
good, only fur a day or two." 

4 4 That is a strange case." Mrs. Clark: 
was not a physician, but she had the 
name of being 44 powerful clever in dis- 
eases." 

44 A very strange case," she repeated. 
4 4 But the £rst thing for us to do is to get 
at the cause of—" 

44 No, Miss Clark," interrupted the 
grandmother; 44 that's too fur back. 
Ruth's pa, ye know, was a soldier, and 
he took a runnin' off in camp, and lie 
has had it ever sence, and we allowed" 
— she lowered her voice — 44 and we al- 
lowed that she must of inhaled this di- 
ree from her pa, and I come to ask if you 
knowed of a cure for a di-ree that was 
inhaled" 

And Mrs. Clark appeals to the medical 
fraternity for an answer. A. M. T. 



Qastro-Intestlnal Catarrh -Obstruction off 
Bowels. 

Editor Medical World : — I have a case 
of gastro-intestinal catarrh in an un- 
married lady 28 years old. She has been 
suffering from the disease some three or 
four years. The symptoms are frequent 
nausea, flatulence and sour eructations, 
griping pains and diarrhea, with fre- 
quent discharges of large quantities of 
tough coagulated mucous. Pain and 
tenesmus frequently occurs just after 
eating, with urgent desire to go to stool, 
when discharge will be as^ above de- 
scribed. She has had a variety of treat- 
ment from other good physicians as well 
as myself. I have exhausted my knowl- 
edge of the materia medica for such cases, 
with the result of some benefit and tem- 
porary relief, but far from approaching a 
cure. Have given Fowler's solution of 
arsenic in two-drop doses before meals, 
which has slightly benefited case at 
times. She has had laxatives followed 
by arsenate of copper, sulpho-carbolate 
of zinc, nitrate of silver in quarter grain 
doses continued for a month at a time, 
large doses of sub. nit. bismuth, beta- 
napthol, subgallate of bismuth ; the latter 
does some good in controlling eructations 
and flatulence. She has also had copious 
injections of from two to four quarts of 

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fluid medicated with different substances, 
as bichloride of mercury, boracic acid, 
creoline, carbolic acid, etc. She has also 
had a good tonic treatment, as strychnine, 
quinia and iron, also pepsin, pancreatine, 
maltine, etc Two quarts of hot water 
with a teaspoonful of salt will stop pains 
and diarrhea temporarily, - I will be 
greatly obliged for suggestions from the 
editor or the readers of The World. 

And now I will report a case that may 
do somebody some good. About a month 
ago I was called to see a 14-year-old boy 
who, four days before, while at school in 
the country, was riding on a board being 
dragged over rough ground and roots by 
other boys in a grove adjoining the 
school-house. He suddenly felt severe 
pain in abdomen, and on attempting to 
rise found that the pain was so great that 
he could not straighten the body. He 
went home complaining greatly, but the 
parents were careless until they found 
that his bowels had not moved for four 
days, except slightly, just after the acci- 
dent I found him on a couch, limbs 
and body flexed, and suffering great pain. 
On examination I discovered a hard 
tumor the size of my fist a little below 
and to the right of the umbilicus, from 
which I concluded that probably the only 
hope of relief would be in a surgical 
operation. However, as I had a good 
fountain syringe with me, I concluded to 
try that first, and after preparing a gallon 
of soap-suds, elevated the hips and com- 
menced operations . But the patient was 
very irritable and complained fearfully ; 
would not retain more than a pint or a 
quart of the fluid until it would be forced 
out, the patient complaining of great 
pain. 

I then placed him under chloroform, 
and after forcing in more than three 
quarts of fluid, I heard a gurgling sound, 
when I withdrew the tube and placed the 
boy over a bed-pan. The water was dis- 
charged with large quantities of gas and 
fecal matter. The tumor had disap- 
peared, patient was very sore over abdo- 
men and had fever ranging as high as 
104 P. for nearly a week, but at the end 
of that time was convalescent and made 
a perfect recovery. 

T. B. Campbell, M. D. 

West Lebanon, Ind. 

[You seem to have done all that medi- 



cine can do for your case of gastrointes- 
tinal catarrh. You must now rely, first, 
on cleansing the membrane. It seems 
that the fluid that you mention having 
used was used per rectum. This is all 
right as far as it goes, and the patient has 
been benefited. She should drink a pint 
of hot water an hour before each meal. 
The effect will be improved by adding a 
little soda ; that will make it more cleans- 
ing; be sure to have it hot. Next, make 
the diet very simple, and at first quite 
sparing ; not because she should be re- 
duced, but because her digestive appara- 
tus needs rest as well as cleansing^ The 
breakfast should be simple and sparing ; 
the dinner more substantial, but very 
simple, avo iding all de sserts ; the supper 
simple, but "rather more plentiful than 
the breakfast Avoid tea, coffee and 
s pices. Avoid all drink with meals and 
fortwb hours after. Bowels should move 
regularly and freely. Massage over ab- 
domen night and morning will favor this, 
and perhaps be a general benefit In- 
deed, a general massage at night would 
be a benefit. The habits of life should 
not be sedentary, but active within the 
patient's strength, and in the open air in 
fine weather. Bicycling would perhaps 
be a great benefit. Doctor, discard all 
medicine and try the above faithfully 
and report Allow more food as the 
appetite and digestion improve, but still 
simple and nutrituxft. We should cure 
this patient, but' her habits of life must 
be changed to something like the above. 
Report details of all that you do, and re- 
sults.— Ed.] 



Hairpin in Urethra. 

Editor Medical World : — A young 
woman called at my office to have a hair- 
pin removed from her urethra. Upon 
questioning my patient I learned that it 
was inserted by herself, the bent end 
'foremost, and was beyond touch with the 
finger. She said she was subject to 
dysmenorrhea, and had been advised by 
a lady friend to introduce a hairpin 
to dilate the orifice and thus relieve 
the difficulty. Neither she nor her 
friend had any knowledge of anatomy. 
In attempting to carry out this advice 
she inserted the hairpin by holding the 
prongs between her thumb and finger. 

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Having it well introduced in this man- 
ner it accidentally slipped from her grasp, 
the prongs expanding, and was beyond 
recovery by her. An examination re- 
vealed the fact that the object had made 
its way into the bladder (undoubtedly 
through her unsuccessful attempts to 
remove it), and would be difficult to 
remove. 

After dilating the urethra, with a great 
deal of perseverance I managed to grasp 
one of the prongs of the hairpin with a 
small dressing forceps. 

I now introduced the forefinger of my 
left hand well up into the rectum, and 
by this method I discovered that the 
forceps had grasped the prong about 
midway between the free end and the 
curve. 

By careful manipulation I succeeded in 
making a new curve, and to some extent 
straightening out the original curve in 
the hairpin. By now making traction 
upon the forceps, my finger still in the 
rectum attending to the curvature of the 
object to facilitate its removal, I suc- 
ceeded in removing the hairpin, and the 
young miss left the office both wiser and 
happier. 

Larrabee, Wis! J. B. Rick, M. D. 

Query : Had she been trying to " pin 
up her water-fall ? n 



Neoplasms in the Urethra— Gleet. 

Editor Medical World : — In two cases 
of urethral diseases I have adopted a 
new and successful method of treating 
gonorrhea and neoplasm in the urethra. 
One case of obstinate neoplasm, caused 
possibly more from strong and deep in- 
jections than anything else, and which 
was so deep I could not get satisfactory 
results, and which would not yield to 
" taking medicine," I resolved on a new 
and novel plan, and if it is not* original 
with me both the method, as well as the 
solution used, I am not aware of its ever 
being used by another. 

The treatment consisted of taking a 
linen male catheter, of about number 
twelve, oil it, introduce it into the 
urethra until the neoplasm comes in the 
fenestra (which can be easily known by 
placing the fingers on the under side of 
the penis, as the catheter is slipped in) ; 
after in place a piece of rubber tubing 



should be, or has been, fitted over the 
other end of the catheter, about two 
inches long, and to this rubber tube the 
apex of a small funnel is attached, and 
into this funnel pour a solution made 
from stick caustic and water. The 
strength of the solution should be a ligh 
milk color. Pill the catheter and turn 
and draw it up and down. Continue for 
three minutes, and the treatment is 
finished. It causes no pain, and the 
patient can treat himself as well as you 
can. He needs hardly ever any other 
treatment, and in from a week to ten 
days the cure is effected. The catheter 
fitting tight, as it does in the urethra, 
prevents the solution from going deeper 
than you want it I also used the same 
solution on a sore of the size of a dollar 
on a child's chin, the cause being from 
the stomach, first starting from the cor- 
ner of the mouth. A cure was effected 
in this case in about four days. 

Gleet, as is generally known, is the 
result of stricture, and to get rid of the 
gleet you must break up the stricture, 
and to break up the stricture you must 
use a cutting instrument or a bougie. I 
approve of the latter method, as in my 
experience a recurrence is not so apt to 
follow, but I do not approve of too large 
an instrument, so large as to cause a 
tearing any other place but the stricture. 
All urethras are not of the same size. A 
suitable size should be selected for each 
case. Keep the urine alkaline and you 
will cure your patient. 

Rolla, Mo. C. C. Cooper. 



The Lodge Practice Evil. 

In cities, physicians complain that the 
free dispensary evil cuts seriously into 
their income, as many patients are treated 
who are amply able to employ and pay a 
private physican. There is a different 
evil which applies to smaller places, and 
concerning which the physicians of Santa 
Clara County, California, have taken a 
stand. Dr. L,. Cothran, the secretary, 
writes as follows : 

41 Investigation shows that medical 
compensation for lodge work averages 
about 15 cents on the dollar. Even re- 
spectable lodge physicians feel a sense of 
degradation in giving their services for 
15 cents on the dollar, and the ever-in- 

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creasing spread of these charitable insti- 
tutions is absolutely destructive to the 
business of other physicians. 

44 The main incentive of the persons 
who band themselves together in lodges 
is to get cheap doctoring ; they are will- 
ing to take, but not to give. They be- 
long to protective unions, and the same 
xij*ht should not be denied physicians. 
Ninety-nine per cent of these people are 
able to pay reasonable fees to physicians, 
but will not do so as long as a few doctors 
in every community for the sake of im- 
mediate gain can be induced to stand as 
driven guys to the lodge politicians. 
No preacher or lawyer would give his 
services to these people for fifteen cents 
on the dollar. No grocery store or mer- 
chandise firm would contract to supply 
these lodges with goods at fifteen cents 
on the dollar of actual worth. Where 
one doctor temporarily profits by con- 
tract work, the business and ethical rights 
of fifty others are violated." 

The following are the resolutions 
adopted by the physicians of Santa Clara 
County, California : 

Whereas, Rendering professional 
services at a stipulated fee per capita per 
annum is derogatory to the dignity of the 
medical profession, we, the undersigned 
physicians and surgeons of Santa Clara 
Connty, California, enter into the follow- 
ing agreement : 

First. — We mutually, jointly, and in- 
dividually pledge our word of honor not 
to enter into any contract or agreement, 
or renew any existing contract or agree- 
ment, either written, verbal or implied, 
to render medical or surgical services to 
any lodge, society, association or organi- 
zation. 

Second. — We will not render medical 
or surgical services to the members of 
the above-mentioned bodies for less com- 
pensation than we charge the general 
public for similar services. 

Third. — This agreement shall not be. 
construed to affect existing contracts be- 
tween physicians and surgeons and the 
above-mentioned bodies. 

Fourth — These pledges shall take 
effect and be in force for a term of three 
(3) years from and after May 22, 1896. 

This agreement shall not apply to 
hospitals and purely public charitable 
institutions. 



Then follows a long list of signatures, 
and a standing committee whose duty is 
4 'to interview new coming physicians, 
etc, and, in general, to carry out the 
purposes of the agreement." 



Stirpicutture— Exfoliation of Lingual and Buc- 
cal riucus Membrane. 

Editor Medical World:— To shoot 
directly at the mark, it is very evident 
that Doctor Waugh is not a stirpicul- 
turist His remarks in December World 
in reference to the prevention of concep- 
tion compel this conclusion. 

It seems to me that Dr. Waugh has 
taken untenable ground and spoken 
without due consideration. The posi- 
tion he has assumed with respect to this 
matter renders it necessary for him to 
maintain that it is right, proper and 
advisable to continue to multiply weak- 
ness, pain, deformity, grief and sorrow, 
ad infinitum. It would seem that he 
fails to appreciate the importance and 
disirability of lessening disease and 
sorrow, deformity and depravity, by pre- 
vention. An ounce of prevention is 
worth as much in this case, in my hum- 
ble opinion, as in any other. 

How one can look over our land upon 
the well-nigh countless number of weak, 
afflicted, diseased, deformed, depraved 
and suffering persons without a sigh for 
an effective remedy, and contemplate 
perpetuation and mutiplication without 
earnest prayer for deliverance, is incom- 
prehensible to me and suggestive of 
stoicism. 

Consider the number of sick, weak, 
afflicted and deformed through heredity ; 
consider the number ot over-burdened, 
breaking-down mothers being actually 
consumed by excessive child-bearing ; 
consider the number of men and women 
unfit to procreate ; consider the number 
of doctors, drug-stores, hospitals and 
medical schools, and then answer the 
question : Is this a desirable state of 
affairs ? 

From the standpoint of the altruist, 
philanthropisit, philosopher, economist 
and stirpicultist, prudent and timely 
advice on the line of prevention is de- 
sirable and commendable, as it seems to 
me. 



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In conclusion I have a case I wish to 
present to The World household for 
diagnosis and treatment. The case ap- 
pears simple, and yet it is obstinate. 
The case is that of a woman of 55 in good 
health, family history good. The trouble 
is confined to the tongue and inner side 
of the cheeks. The tongue presents the 
appearance of a superficial scald in 
patches with exfoliation of whitish 
rolls and flakes of membrane, thin and 
small. The same condition and appear- 
ance are observable upon the inner side 
of each cheek, the buccal membrane 
undergoing like exfoliation. The ex- 
posed surface of deeper structure looks a 
little angry. Considerable of each cheek 
is involved, but there is no appearance 
of malignancy. Trouble seems super- 
ficial. This process of reproduction and 
exfoliation of the membrane has been 
going on for two years or more, with 
little change of aspect. There is very 
little pain, except when hot fluids or 
other irritants are taken. 

Treatment so far has only been pal- 
liative. Nothing seems to be curative. 

Please diagnose and suggest treat- 
ment. Potas. chlorates, carbolic acid, 
silver nitrate, tihct iodine, Seller's 
tablets, and innumerable preparations 
have failed. What shall I do with it ? 
Is it a form of eczema, and what will cure 
it? J. I. T. Long, M. D. 

Allen, Md. 

[Yes, doctor, you are right — and 
wrong. There are two sides to this 
question; indeed there are many sides 
to this most vexed question. In the 
present moral condition of the race the 
great danger is the abuse of preventive 
measures. There can be no question 
that they would be beneficent if only 
used in proper cases ; but there is always 
the danger of giving free reign to license, 
and the wholesale avoidance of parental 
duties and responsibilities. Dr. Waugh 
takes his position largely on moral 
grounds, and this is absolutely necessary 
in the present condition of humanity. 
Your remarks also suggest a different 
line of thought that I fear does not occur 
to physicians as frequently as it ought. 
You speak of multiplying weakness, 
pain and deformity. How about our 
child labor and woman labor in our mad 
and irresponsible rush for gain ? and the 



thousands maimed by our railroads every 
year ! These things are as preventable 
as procreation by the unfit And, more, 
if all our children were born perfect ; 
and of healthy parents, our industrial 
system would dwarf, weaken, maim and 
deform them. I am not a revolutionist^ 
but I am an evolutionist, and there are 
many things that must be speedily 
evolved. Shall our * civilization be for 
the man or the dollar ? The dollar is 
now the standard, and as long as dol- 
lars grow dearer and men grow cheaper > 
the children of men will be sacrificed to 
mammon, however perfectly they may 
be born. We may be far from the mines, 
the factories, the sweatshops and the 
slums; but in that "great day" we will 
find that we will have to bear our share 
of the responsibility for them. We burn 
the coal and get the products of the fac- 
tories at as low a price as possible. As 
physicians we see many sad things, and 
our duty is to raise humanity, both 
physically and morally ; as citizens we 
are a part of a complex civilization in 
which many systems are harbored that 
deform, debase and degrade. We have 
duties there, too. 

Your case of mouth trouble is likely to 
be difficult to cure. Two thoughts sug* 
gest themselves ; reflex irritation and 
malignancy. Examine for any evidences 
of ulcerative condition from esophagus 
to anus, from which reflex irritation 
could come. That failing, submit some 
of the exfoliation to a pathologist — Ed.] 



Prevention of Conception. 

Editor Medical World: — The article on 
page 39° of October World, and on 
page 431 of November World under the 
caption of " How May Conception be 
Legitimately Prevented," are both time- 
ly and to the point so far as they go ; but 
neither of them suggest a remedy. 

I shall not enter into a discussion of 
the legitimacy of preventing conception. 
Suffice it to say that almost every phy- 
sician has in his charge women to whom 
further child bearing would be at great 
risk of their lives, or if their lives were 
spared their future would be unalloyed 
torment. In such cases no question 
arises in my mind as to my duty. 



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23 



cent, of 
amount ot 
tories shoij 
dram eact 
before cojj 
isintrodt 
well up 



My remedy is as follows : I mi 
vaginal suppository of cocoa but^ 
which I incorporate from 6 JJo 10 per 
racic acid an^rthe same 
tannic acid. ^Jrnese supposi- 
dram to one 
From Jlffee to five minutes 
of these suppositories 
:o.t&e vagina, and pushed 
the cervix. The cocoa 
butter having melted and set the boracic 
and tannic acids free, they act as an 
effectual germicide, thus destroying the 
spermatozoa. 

The use of these suppositories causes 
no discomfort of any kind, but on the 
contrary they do great good in cases of 
cervical or vaginal inflamation. 

If the suppositories are too slow in • 
dissolving you can incorporate a little 
olive oil, and they will dissolve quite 
readily. 

I have tested this mode of preventing 
conception for more than six years with 
quite a number of women, all of whom 
had been bringing children into the 
world as fast as the laws of nature would 
permit, but since they began the use of 
this remedy not one of them has ever 
been pregnant, and all of them are en- 
joying the best of health. 

Therefore I am persuaded that the 
remedy is an effectual one when prop- 
erly used, and at the same time is harm- 
less. 

But let me caution you never to write 
a prescription fof this remedy. The 
knowledge of Jthese remedies should not 
become public property, for few women 
would ever consent to endure the pangs 
of child birth if they were in possession 
of the knowledge of so simple and yet 
so effective a remedy. 

H. P. Monroe, M. D. 

Harris, Kansas. 

[We wish to emphasize the last para- 
graph of the above. The physician 
should not only be thoroughly convinced 
that it is extremely important from a 
medical point of view that his patient 
should not become pregnant, but he 
should consult his conscience long and 
seriously before allowing himself to take 
a hand in this kind of business, and 
when he does so, the patient should not 
know how or where to get the prepara- 
tion except through him. — Ed.] 



Editor Medical World: I notice in 
October and November numbers of The 
World, several little articles relative to 
how conception may be legitimately pre- 
vented, but am inclined to think from 
the way the brothers are taking this 
question up, that they da not intend to 
have much to say on this subject I am 
positively in favor of any thing legiti- 
mate that will prevent conception when 
it is not for the best to bring up a family 
of children. I also believe there are 
numbers of ways to prevent conception 
if our learned brothers will give them 
out to the poor suffering women who al- 
wayst have to stand the suffering of 
giving birth to children, when they are 
not in condition to do so without long 
continued suffering before and after 
birth of the children. I believe it is the 
duty and should be the aim of every man 
and woman that enters the marriage 
state, to bring up a small family of two 
or three children, if they are physically 
and financially able to do so ; but I think 
it is a sin against the laws of God and 
society for poor or weakly parents to 
bring into the world families that they 
are not able to bring up and raise prop- 
erly, and in a large number of cases, 
leave for the cold world or some chil- 
dren's asylum or home to bring up. 

Men and women will marry as long as 
the laws are such that they can, and as 
long as there are no laws to prevent the 
marriage of weakly and sickly men and 
women, and as long as they marry they 
will undoubtedly enjoy the, or rather 
one of the, main enjoyments that they 
are permitted to enjoy — sexual inter- 
course. As long as they enjoy this 
privilege there will always be concep- 
tion. It has resolved itself down to one 
thing, then, and that is, what shall be 
done to prevent conception without 
injury to the woman's health. Now, to 
get the brothers interested in this dis- 
cussion, I will suggest the following 
(which is not original with me), which I 
do not guarantee to answer the purpose 
fully, but will start discussion, and we 
will no doubt strike upon the proper 
remedy before we are through with the 
discussion. I would suggest sulphate of 
zinc, one spoonful in a pint of warm 
water, as an injection into the vagina 
immediately after intercourse, using irri- 

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THE MEDICAL WORLD. 



gating or long tnbe of an Alpha " D " 
or " E" syringe. No waiting, but must 
be used immediately after intercourse. 
Now, brothers, be men, and let us hear 
from you on this subject, which is one 
of such importance to women. 

u One who thinks women are one of 
God's noblest creations. " 

[In part of the above contribution not 
printed the writer seems to think that 
we should "let it be known 1 ' for the 
benefit of suffering women. We must 
insist all the time that this is a subject 
that should engage the physician's most 
careful and conscientious attention in 
any given case, and that to gi^ out 
general information upon this subject is 
not to be thought of. How many men 
and women in your practice would shirk 
the duties of parenthood if they knew 
how, and thus miss the greatest joys of 
life? How many children would there 
be in your community if only those that 
are wanted would come ? Far too many 
married people would procrastinate, 
saying "No, not 'yet," until the best 
time to procreate, or the ability to pro- 
create, had gone. Then would come a 
lonely old age after a desolate life. N0, 
doctors, don't have any hand in this 
business unless for the most important 
reasons, the leading one being such mal- 
formation of the pelvis as to render de- 
livery impossible. — Ed.] 



Editor Medical World : — There is no 
law, written or unwritten, human or di- 
vine, that forbids the prevention of con- 
ception when any valid reason exists for 
the prevention ; and we are asked what 
we advise when such reason exists. 

The mechanical means usually em- 
ployed are objectionable from a hygenic 
and ethical point of view. 

The condom is effectual, but it is an 
abomination, as it diminishes sensation 
in both male and female, and sometimes 
breaks. 

The use of the hood, or " French Pes- 
saire," for the female, requires too much 
skill in its adjustment, so that many 
times it fails to accomplish its purpose. 

In the method of withdrawal, there is 
more room for unpleasant effects than from 
emission in a sheath ; and as the sexual 
act is not completed, I believe it to be in- 



jurious, to the female at least, as it always 
leaves her unsatisfied, and for esthetic 
reasons is unpleasant to both parties. 

The douche has a certain value, pro- 
vided it is resorted to immediately after 
the sexual act, and if impregnated with 
carbolic acid or astringents in order 
to destroy the spermatozoa. Sperma- 
tozoa travel one inch in seven and one 
half minutes ; and when conjugal rela- 
tions are strong, mutual, normal and 
complete, the sequel is beyond the reach 
of an injection. 

The aluminum button, to be placed 
in the os uteri, is of more recent origin. 
The objection to this is it can only be 
used when the uterus is perfectly free 
from all discharge. 

Kleinwachter prescribes a cocoa but- 
ter suppository containing 10 per cent 
boracic acid to be introduced high up in 
the vagina. They dissolve and the 
liberated acid destroys the spermatozoa. 
With this it is not necessary to follow 
the sexual act with a douche. This 
method I know to be effectual with a few. 

The article I have to offer is effective, 
free from hygienic, ethical, moral or 
physical objection. It is a soft silk 
sponge, shaped in the form of a ball, of 
sufficient size, which will average as a 
rule, one and one-half cubic inches or a 
trifle more. A silk thread should be 
passed through it so it will not tear out 
and the two ends tied together, leaving 
them seven or eight inches long. That 
is the article complete. 

No skill is required to adjust it It is 
simply moistened and inserted a little way 
into the vagina, and at the needed time it 
will be carried forward, shielding and cov- 
ering the os uteri, while the seminal fluid 
is caught and held in its meshes. 

It is not necessary that it should be 
removed before morning, but it might 
be well to take this extra precaution. 

het this be as much a part of the 
wife's night attire as her robe, and I feel 
safe in promising her that the conjugal 
embrace will not mean the possibility of 
pregnancy. 

I think it worth consideration whether 
or not controlling the quantity would 
not enhance the quality of the product 
F. F. Jackson, M. D. 

379 Van Biiren street, Chicago, 111. 

[While the above is a good review of 

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25 



methods in use, yet there is nothing new 
here presented ; nor do we think the 
method specially advocated is absolutely 
certain. 

We have avoided and resisted the dis- 
cussion of this subject in these columns 
for a number of years. That the use of 
this knowledge has a legitimate place in 
the practice of medicine, there can be no 
doubt Yet we wish to impress the 
importance of making the application of 
it the subject of maturest judgment and 
deepest conscience. We will further 
ask that this issue of The Medical World 
be specially guarded from the hands of 
the lay public. — Ed.] 



Heart on the Outside. 



Editor Medical World : — I had a curi- 
ous malformation lately. On November 
20th, 1896, 1 was called to see Mrs. D., a 
primipara 25 years old, who had had a 
miscarriage two years before. After usual 
labor, delivered a child perfectly devel- 
oped save that the heart was on the out- 
side of the chest ; perfect in every re- 
spect except the pericardium was want- 
ing. The sternal end of the fourth and 
fifth ribs was absent, leaving an opening 
into the chest cavity, through which the 
aorta, vena cava superior and pulmonary 
artery and veins entered. The heart 
beat for two hours, during which time I 
tried artificial respiration, but without 
success. I should like to know if any of 
my brethren have had anything similar. 
L. D. Bowman, M. D. 

Tionesta, Pa. 

[The above is unique as far as we know, 
and we hope the doctor was able to pre- 
serve it — Ed.] 



Treatment of Fractured Clavicle. 

Editor Medical World : — The function 
of the clavicle is to brace the shoulder. 
In its fracture the shoulder drops down 
and forward. Bring the shoulder up and 
back until the end of scapular section 
is in nice coaptation with the end of 
sternal section, and keep the shoulder 
thus by using figure of eight bandage 
comfortably tight. Use starch paste or 
plaster of Paris with each turn of band- 



age. Use carbolized absorbent cotton 
next to the skin. 

You will notice carefully that the end 
of scapular section is in perfect coaptation 
with end of sternal section; and if so 
you will be well pleased with your work. 
Now place a pad under the flexed arm and 
bandage the same to the body. 

Thomas Aiton, M. D. 

Creedmor, Texas. 

v- 

Coated Tongue Long Continued. 

Editor Medical World :— =-1 wish to re- 
port »to you a case which may be of 
interest and use to your numerous read- 
ers — one which, though I have practiced 
now twenty years, gave me so much 
trouble, puzzled me so much that I was 
several times on the verge of despair. 
More than that, the gentleman had gone 
the rounds among some of the best men 
without relief. Two years ago I treated 
him for about three months and ex- 
hausted all the remedies suggested to 
me for the trouble. I finally told him I 
could do no more for him, and that he 
might try other and better experience. 
However, after that interval he came to 
me again with the same trouble, exactly 
as two years ago. The history is as fol- 
lows : Mr. C , a well-developed mus- 
cular man weighing at least 160 pounds,, 
and about 55 years of age, who seldom 
for years missed a meal or lost a day's 
work, has had, " as long as he can re- 
member," a dirty brown thickly-coated 
tongue, thickest on centre and back, 
leaving only a very narrow margin near 
point and edges clean. To my inquiries, 
repeated and extensive, all symptoms 
were more or less negative; but those 
that I gathered during this long course 
of treatment, were as follows : More or 
less sluggishness of bowels, a drowsy 
stupid feeling, so that when in company 
or church he was overcome with tendency 
to sleep ; a dead, cold feeling of left leg 
from hip down, with prickly itching 
feeling at times. His pulse, at weekly 
examinations, was variable and peculiar 
in so far that while at one time it had 
the normal beat of 72 beats to the min- 
ute, at the next visit was down to 60 or 
66 ; but had one unchangeable quality — 
fullness and regularity — not intermittent. 

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In appearance be was dark, bronzed in 
countenance, and there seemed to me at 
times more whiteness of eye and a slight 
tinge of greenishness. Taking all these 
symptoms together, I diagnosed his 
trouble to be chronic g^stro-hepatic ca- 



tarrh : and from this 



g^stro; 
Infcve: 



er varied in 



opinion except that my treatment adopted 
for its cure seemed a failure. During 
one of his last visits he mentioned that 
there was a large amou nt of slimy mu- 
cous, or greasy disch arge wi ft i the feces, 
and I determinSTTo treat that by anti- 
septics and correctives for the catarrh. 
At once there was a change tor the better. 
My treatment then was as follows : 

R Pulv. rhei dr. ij 

Sod. bicarb., ... dr. iss 

Aq menth. pip., . . . ad oz. vi 

M. Sig. — Two teaspoonfuls in hot water 
after each regular meal. 



Beta-naphthol, . 

Bismuth subnit, 
M. Put into 16 capsules. 
Sig. — One morning and evening. 



dr. S8 

dr. i 



To my delight the change for better 
was at once apparent ; the tongue be- 
came moist and threw off the fur more or 
less in one week, a remarkable result 
when you consider that I had tried nearly 
every corrective for liver and stomach 
sluggishness combined with catarrh, such 
as sod. phos., amon. mur., mag. sulph., 
combined with fld. ext. taraxicum, ess. 
pepsin fphenolated), and bitter tonics. 
We had, at various times, discussed the 
advisability of washing out the stomach 
repeatedly, but it always struck me that 
whilst a good temporary result might 
have been attained, it could not have 
been permanent, since it would not have 
removed the cause. Though the patient 
was very anxious to have it done, I so 
told him. 

The question I would ask, and which 
is not clear to me is, was the sluggish- 
ness and stupidity of mind, combined 
with the drowsiness and tendency to 
sleep, so marked in his case, and also 
the slow, full, regular pulse, the result 
of stasis of the bile in the biliary tubules 
owing to swelling from catarrhal inflam- 
mation? or was it owing to imperfect 
separation from the blood of biliary mat- 
ters owing to the sluggishness of the 
liver ? 



I forgot to state, in speaking of treat- 
ment, that he took, during all time of 
treatment, the calomel, sod. bicarb, and 
ipecac tabule, of Mulford & Co., night 
and morning. 

G. Schmidt, M. D. 

Milwaukee, Wis. 



A Large Gall Stone. 



Editor Medical World: — On March 
9th I was called to see Mrs. J. R., 
aet. 65 years. She gave a history of 
frequent gastric disturbances, accom- 
panied by vomiting of bilious matter ; 
bowels usually constipated. At this 
time suffering severe gastric pain upon 
taking any food or drink, with no relief 
until the ingesta is discharged either by 
emesis or catharsis. Gave some alkaline 
remedies which seemed to afford great 
relief, but after a few days was again 
called and the alkalies again relieved 
her, but in a less degree than on preced- 
ing occasion. The trouble grew more 
persistent and refused to yield to any- 
thing that I prescribed. She vomited 
enormous quantities of bile, amounting 
to gallons in a single day ! There was 
obstruction in the bowel which I could 
not satisfactorily locate. The green 
vomit changed to a brown fecal vomit, 
the vomitings being succeeded by a 
respite from pain. Death ended the 
scene on April 13th. 

An autopsy was held, and a calculus as 
large as an ordinary chicken's egg was 
found in the ileum. It measured six and 
four and a half inches in circumference, 
and weighed fifteen drachms. On 
analysis it was found to consist of 60 per 
cent, cholestrin, 10 per cent, bile, and 
30 per cent, insoluble in ether, alcohol or 
water. Although found some sixteen or 
eighteen inches from the ileo cecal valve, 
it had doubtless acted as a ball valve, at 
times running back from the cecum and 
allowing fecal matter to pass around it, 
and find egress. 
Elizabeth, Pa. P. T. B. Shaffer. 



Hypnotic Suggestion. 

Editor Medical World : — According to 
the popular idea, a man must be both un- 
conscious of his actions, and a mere tool or 

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27 



automaton in the hands of the hypnotist, 
before he can be said to be hypnotized. 
But, according to our modern conception 
of the state of hypnosis, Mr. Moody, the 
evangelist, who is at present doing some 
interesting revival work in New York, 
and who is attaining his effects by the 
forceful suggestions which he showers 
upon his listeners from the pulpit and 
the platform, is simply a very successful 
hypnotist. By ' 'successful" I do not mean 
that Mr. Moody is looking particularly 
for worldly prosperity, but that he is 
successful in his work. His listeners are 
in a state of light hypnosis ; they are by 
no means unconscious of what is passing 
around them ; they are not under the 
control of the speaker ; they could not, 
by suggestion, be made to accept sense- 
delusions in the same manner as the 
active somnambulist 

I suppose none would be more horrified 
than Mr. Moody himself if it were hinted 
to him that the only point of difference 
between his methods and those of the 
public hypnotist was that he sought to 
spiritually elevate his subjects, while the 
latter is content to permit them to make 
sport for an audience. 

But there is no doubt that a revival 
meeting is practically an exhibition of 
the effect of hypnosis. Not an injurious 
effect — far from it In some cases the 
suggestions given are both instant and 
permanent in their effect upon the trend 
of thought of the listener, changing his 
preconceived ideas of his duty to his 
neighbor, his God, and himself, and 
establishing in his mind a better pur- 
pose, a fuller sense of responsibility, an 
eagerness to live aright, to live anew ; 
to be more spiritual, to be less sordid. 
Yes, in some cases the lesson sticks : but 
for the great majority the revival is, as 
its name exactly indicates — a revival ; a 
renewing of a fire that has always smol- 
dered, deep down in the heart of each 
listener ; and this fire, though it may 
give out a very perceptible warmth 
while Mr. Moody is assiduously applying 
the bellows, will die away again for 
want' of both draught and fuel, as soon 
as the revivalist takes his departure to 
another city. 

In this lack of permanence in the sug- 
gestion given lies the great point of 
similarity in all forms of mental treat- 



ment. It seems, indeed, as if to keep 
watch and ward constantly were a neces- 
sity ; as if the work were never done. Ap- 
parently the only means by which the 
thought or suggestion can be made 
permanent is to keep hammering it in — to 
keep on ; to keep at it The driving-in 
process is a necessity, if not by the cler- 
gyman, or physician, teacher, hypnotist, 
or friend, then by the person himself. 
The gospel of Christian science is the 
gospel of perpetual and positive asser- 
tion, or the suggesting to oneself that 
something is not which to our senses it 
appears to be. Can you differentiate 
between this and hypnotic suggestion? 
To me all these things seem plainly to 
be as the branches of one tree ; and the 
bark which enwraps both trunk and limbs 
is hypnotism. 

It is not difficult to see how favorable 
the conditions surrounding the revival 
meeting are to the induction of the hyp- 
notic state. There are the sense of 
physical rest, the music, the singing, the 
point of concentration, i. s. y the speak- 
er's face ; his sympathetic personality, 
and lastly, the oneness and emotional 
co-operation of the listeners with the ex- 
pressed thought of the speaker. It is not 
unnatural, surely, that there should be 
found in such gatherings a general cere- 
bral receptivity to suggestion which is 
supposed to be identical with the condi- 
tion of the brain in hypnosis. To their 
religious ecstasy of enthusiastic accord 
with the speaker the listeners to a great 
extent surrender the reasoning faculty 
and follow whither he leads. He is for 
the time positive, they are for the time 
negative. Then is brought about that 
condition of faith and trust which is as 
far removed from the objective condition 
of inductive reasoning as the north 
pole from the south. Then it is that 
the spoken word falls on ground pre- 
pared to receive it, and according to the 
repetition of the teaching, to the nature 
of the individual, to his intelligence, to 
his training, to his environment, to the 
power of his auto-suggestion, or to his 
instability, will the thought implanted 
become an ideo-dynamicforce, orbeon the 
other hand soon forgotten. 

Sydney Flower, 

Editor of "The Hypnotic Magazine," 

Chicago, 111. 

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Urticaria. 

Editor Medical World : — This disease 
is also known as nettle-rash and hives. 
It is an acute eruption, accompanied by 
tingling, burning and itching. It shows 
itself by a sudden formation ofwheals 
upon the skin, of different sizes, shapes 
and colors. The wheal is the character- 
istic feature of the affection. The typi- 
cal form of this eruption is a broad, flat, 
slightly elevated p apu le, with a b right 
red center. The size of the eruption de- 

?mdT upon the amount of exudation, 
o the touch they may be firm or soft 
Itching and b urningare the character- 
istic sym ptoms ofTB S dise ase. Some- 
times it gives but little annoyance ; again 
it may cause the most intense suffering. 
They may appear in any part of the 
body and suddenly disappear, to present 
themselves in another locality. Chil- 
dren are more susceptible than adults, 
but the trouble may appear at any 
period of life. 

Causes : — The causes may be divided 
to external and internal. 

The external causes are the irritating 
influences of pla nts o f the nettl e fa mil y T 
and the bitq^FcSrtaininsects, asJice, 
fleas, mosqu itos and ~becl-bug s : and in 
some cases scratchi^prjriction of the 
skin. In children it is very frequently 
caused by the b ites pf -fleas, lice or bed- 
bugs. The internal causes afeTthe most 
frequent, generally being due to some 
gastric or intes tinal irritation. Certain 
articles^bf food, such as Jish, clams, 
lobsters', cheese, etc., frequently give 
rise to" this trouble. In some individuals 
who are susceptible, cer feiji drugs 
will very frequently cause it Among 
them are iodi4£_lgf potassium, tur- 
pentine, cojiaihaj- cub ebs _ and sali- 
cylic acid. In children it is often 
caused by intestltial worms ; in females 
by some uterin^3jfficulty. It is inti- 
mately connect ed w ith the nervous sys- 
tem. In realitylfTs caused by an irri- 
tation of thengrves that supply the skin. 
Anything that disturbs the nervous sys- 
tem may produce it. 

The prognosis is favorable so far as 
life is concerned. If the cause can be 
removed the trouble will rapidly disap- 
pear. Frequently it becomes chronic, 
either from non-recognition of the cause, 
or because the latter cannot be removed. 



The diagnosts is easy. Simply re- 
member the characteristic lesion and the 
subjective symptoms, viz., itching and 
burning. The discovery of tEe cause is 
the most difficult, as a rule. 

Treatment : — The therapeutics of the 
affection are very unsatisfactory. If 
possible find the cause and remove it If 
it is due to some irritating ingesta 
in the stomach or intestinal canal, an 
emetic or brjsk-purge will in most cases 
promptly relieve the trouble. Make the 
diet as simple as possible; %void all 
stimulating food and alcoholic oTTnalt 
lifluqrjr If there is an acid stomach, 
give ten grains of bic&rbon£le 01 soda 
before each meal, or a little lime-water. 
If due to sotee" irrit ating underwear, 
promptly remove it. Keep the bowels 
open with sal ines . The clothing should 
not be too heavy through the day, and 
the bed-covering at night should be 
light See that the sleeping-room is 
well ventilated. Sponge the body with 
vinegar and wate r. Salt water-baths , 
are frequentiy^valliable. • 

When the disease has become chronic 
it will give both the patient and the 
physician a great deal of trouble. Lo- 
cate the cause and remove it if possible. 
Regulate thebowels, stimulate the action 
of the livef*tfnecessary, and carefully 
revise th e die C Examine the urine 
carefully "^RkT if abnormal correct it if 
possible. Salines and" diuretics will be 
of service hefe. 

Salicylates^ sodium, 20 gr. doses 
three times daily, may prove of great 
value. Atropine, gr. 1-60, may be of 
some use. Local applications should 
also be used, such&s-sol. carbolic acid, 
% per cent., or black wash. 

Alexander Hannah, M. D. 

Sardis, W. Va. 

[The question of the treatment ot 
obstinate chronic cases of urticaria 
was submitted to Dr. S. Solis- Cohen, 
of this city. He believes this to 
be a nervous disease, depending upon 
irritation, either direct or reflex. 
The irritation may be chamical, 
mechanical, thermal or .egjptiorial ; from 
witETn or without. The cure is to re- 
move the cause. Emetics, cathartics, 
removal of any external irritation, etc, 
at once suggest themselves. Intestinal 
parasites, rather difficult to dislodge, 

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29 



may be the existing cause. Uric acid in 
the blood is a very frequent cause. He 
treats this condition by regulation of 
diet, exercise, etc. , and by giving alkalies 
— but not sodium. — Ed.] 



To the Members off the Medical Profession. 

I would be pleased to have an ex- 
pression from you, either personally or 
through some medical journal, as to the 
relations of the lay-publishing firms of 
medicals journals and the profession. 
The request is suggested by the fact that 
Messrs. Wm. Wood & Co., of New York, 
refuse to permit the editors of u The 
American Year-Book of Medicine and 
Surgery " to use in our abstracts of Medi- 
cal Progress articles and illustrations first 
printed in the Medical Record and the 
American Journal of Obstetrics. 

This decision seems to me to be wrong 
for the following reasons : — 

1. It prevents the dissemination of 
medical knowledge. The Year-Book 
condenses, systemizes, and criticises the 
year's medical work in a shorter space and 
more permanent manner than the jour- 
nals, and has thousands of readers no sin- 
gle journal can claim, or hope to reach. 
Every physician writes and publishes 
articles in order that every member of the 
profession may, if possible learn of his 
work, and that science and progress may 
thus be furthered and humanity benefited. 
To intefere with such dissemination of 
our literature in reputable publications 
is, I think, discourteous and unjust to the 
profession and an injury to medical 
science. 

2. This injustice and injury to medicine 
become all the more striking when phy- 
sicians do not receive a cent of pay for 
contributions, from the publication of 
which the lay-publisher is supposed to 
make considerable financial profit 

3. No others in the world, not even 
those who pay their authors for their 
contributions, have in the least objected 
to our reproductions of quotations, 
abstracts and illustrations from their 
journals. 

Do you wish to limit the dissemina- 
tion of your contributions to medical 
science by such an exclusion of them 
from reputable publications? Is this 



literature the property of yourself and of 
the profession, or is it not? Does your 
gift of it to a journal make it the private 
property of the publishers of that journal? 
Is it not a rather a loan for temporary use 
only? 

Will you not hereafter demand that 
there be printed with your article a state- 
ment that the right of abstracting the 
text or reproducing illustrating is 
guaranteed ? Sincerely yours, 
119 S. 17th Street, Geo. M. Gould. 
Phila., Pa., Dec. 1896. 

[We heartly indorse Dr. Gould's posi- 
tion, as given above. We do not believe 
in monopoly, nor any attempt at mono- 
ply, in medical literature. It is contrary 
to the traditions and the spirit of the 
medical profession. — Ed. M. W.] 



rienstruation. 

Editor Medical World : — Is not men- 
struation unnatural to women ? Is it not 
the result of the moral law not comply- 
ing with natural law? Is not menstrua- 
tion in all its forms, simply so many 
abortions? — sometimes of a nonimpreg- 
nated, dead ovum, sometimes of an 
impregnated dead ovum, and sometimes 
of an impregnated living ovum, this last 
instituted in error, and kept up by 
habits ? 

Some years ago, a marriage was fol- 
lowed (in due time) by the birth of a 
healthy, girl baby. Mother and child 
did well for a month, when I was sent 
for (a very cold morning). I found the 
babe had been smothered between the 
two parents. I gave directions for dry- 
ing up the milk, and returning to the 
normal non-nursing condition. 

Some weeks after this I was called 
again, and found the patient with all the 
pains of dysmenorrhea. I tried for months 
to cure her, but could not. 

I then told the husband that I wanted 
him and his wife to have no sexual 
communication — for— two moifths." I 
thought that would cure her. He told 
me that both he and she would do any- 
thing to get clear of those dreadful pains. 
I believe they kept the promise. The 
first term after separation was like the 
former, very painful; the second was 
easier, and the next quite easy, what we 

"Digitized by VjOOQLC 



30 



THE MEDICAL WORLD. 



call normal, followed by conception and 
a babe, now twenty months old. 

Had she been afflicted with monthly 
abortion of a living impregneted ovum ? 
J. H. Sharp, M. D. 

San Augustine, Texas.- 



Dyspnea. 

Editor Medical World: — I used to 
have the most desperate kind of dyspep- 
tic asthma, which brought me South 
twenty years ago, before I understood 
its management. Having another attack 
when encamped on the Florida beach, I 
sent to Key West for the following pre- 
scription, which seemed to make a radi- 
cal cure, for I never had a suspicion of 
the complaint for many years afterward : 

R Iodide Potoss. 

Tr. lobelia. aa. 2% dr. 

Tr. sanguinaria 40 m. 

Syr. tolu . ad. 4 oz. 

Dose — Teaspoonful before dinner, supper 
and at bedtime. 

As I have known what appear to be 
permanent cures made by lobelia, it 
would appear to be a specific, whatever 
may be said to the contrary, as it is also 
the oldest asthma remedy. I have since 
seen the above combination in a medical 
journal, and it has been introduced 
into Potter's " Mat Med., Phar. and 
Therap.," which ought to be a good en- 
dorsement. 

For instantaneous relief of the "asthma 
of heart complaint" (dyspnea of thoracic 
hydrops), when the patient is at the last 
gasp, can't get his breath down a quarter 
of an inch by lung ^ction, and blue in 
the face, iust tell him to Ijold hiiTnose 
and swallow all '(He air ne^Tan, as if 
drinking wateh While- doing this the 
involuntary rythmic contractions of the 
diaphragm will belaoliped ; then let him 
hold his breath -aud strain. He may 
think he hasn't time for such an experi- 
ment, as every breath missed is worth 
$10 to him ; but he will find that it 
strains the water out of the lungs, and 
the relief from his misery is immediate 
and complete. This is the way I caught 
on to this little wrinkle : I had sat up 
three nights, many years ago, in mortal 
agony, when I felt a tremendous sneeze 
approaching, which frightened me as 1 
thought it would be the "last straw;" 



but obtaining relief instead, I set to 
reasoning, and the above discovery was 
the result 

Arcadia, Fla. H. Rice. 

[Doctor, your results may have been 
all right, but we do not think your rea- 
soning is, nor your diagnosis. Your 
thorax could not have been filled with 
water and disappear so quickly. The 
cause was nervous. Your immediate 
and complete relief suggests snuff, or 
anything that will cause a sneeze, as a 
remedy in similar pases. Your descrip- 
tion is graphic. One who has u been 
there" can describe it better than those 
who have only seen others suffer. — Ed.} 



For Irritation of the Urinary Tract. 

Dr. H. P. Saunders, of Alfred, N. Y. y 
with his renewal for 1897, and after 

!>raising The World, gives the following 
or irritation of the urinary tract : 

R. Populin (Keith's) . grs. xxiv 
Sulph. codeia . grs. ij 

Tinct. contharides. . gtt. v 
Water . . . oz. iij 
M. A teaspoonful every fifteen minutes till 
relieved, then every half hour to two hours as- 
needed. Shake before using. 

The following he finds to be a very- 
useful antiseptic, soothing and healing: 
emollient for burns, sores, contusions, 
etc.: 



Campho-Phenique 
Petrolatum 



one part 
three parts 



He says that, though having been in 
the practice forty-four years, he keeps^ 
his eyes open for "a better way." 
Whenever a better way is discovered, it 
should be given to all through The 
World 

Whiskey and Salt Treatment for Asthma. 

Editor Medical World : — In October 
issue Dr. Martin asks if anybody ever 
heard of the use of whiskey and Salt in* 
the treatment of asthma. 

I have before me a brochure or pamph- 
let, printed in 1840 in the Swedish lan- 
guage, relating to the use of whiskey 
and salt in a number of diseases, as in- 
termittent fever, -gout, rheumatism, 
pneumonia, asthma, enteritis, diseases 
of skin and nervous system, and a num- 
ber of other troubles. 

The originator of this remedy was one 

Digitized by VjOOQiC 



THE MEDICAL WORLD. 



3i 



William Lee, of Leeds, England, a 
wealthy land owner, who, so the little 
pamphlet says, gave away annually 
about sixty gallons of the remedy to the 
suffering poor. 
Here is the formula ; 

R Liverpool salt, oz. iii 

Best whiskey, pt. i 

M. Shake for ten minutes, then set away for 
twenty minutes, when it is ready for use. (In- 
ternally and externally.) 

Has Dr. Buillis eve* used belladonna 
with calomel ? 

It is said to prevent not only ptyalism, 
but also diarrhea. C. Erren, M. D. 
^Rush City, Minn. 



D. A. P. Landry, of Nova Scotia, 
suggests that the earliest record of anes- 
thesia is the biblical description of God 
casting a " deep sleep " upon Adam, be- 
fore removal of the rib from which to 
make Eve. We suppose that few, if any, 
physicians take this story seriously ; but 
the fact is interesting that the sugges- 
tion of a "deep sleep," different from 
the ordinary sleep, during which an 
operation could be performed without 
pain, has been before the race all these 
centuries, yet it was not until the present 
century that we were able to produce it 
This story suggests hypnotism as well as 
nesth esia. 



Individualization. 

Editor Medical World : — Nearly every 
number of The World contains requests 
for treatment for certain diseases. The 
inquirers are frequently rewarded by val- 
uable aid. But much more frequently, 
I fear, failure results, through the practi- 
tioner following the teachings of classi- 
cal authors or the intensely practical 
hints given by the editor of The World 
and his galaxy of contributors. Why? Be- 
cause there is no specific treatment for 
any disease according to our accepted sys- 
tem of nosology. 

^ We must study the individual pecu- 
liarity of each patient. The nosological 
name of Smith's disease may be the same 
as that which afflicts Brown and Jones ; 
but the treatment must be different in 
each case, because the patients differ from 
each other. 



In the eye of the discriminating thera- 
peutist the difference between individ- 
uals is of greater importance than the 
difference between the so-called diseases 
of the nosologist. When we begin to 
study individuality we cease curing dis- 
eases and commence curing sick people. 

Bellevue, Kan. J. S. Watt, M. D. 



Ulcerative Stomatitis. 

Editor Medical World :— Dr. Hilliard, 
of Tarpon Springs, Fla. , asks for treat- 
ment of ulcerative stomatitis. I will 
suggest to him 4rhat I consider an infal- 
lible cure. Gi\4 patient chalk mercury 
tablets, one-half grain each ; one three , 
times a day, fcr four or five days, 
addition, have ler to place in her mc 
one-half grain tablet of sulpho-cariplate 
of zinc. Ha^l her hold the tapet^on 
the ulcers unnl it is dissolved^ianging 
from one ulcyr to another. iJcher swal- 
low the dissolved tablet. ^Repeat four 
times a dayluntil her mrah is entirely 
well. It t thought bjfsome that this 
form of stcpatitis is tlm result of defect- 
ive nutritAn, causinj^in ulcer at the end 
of nerves similaj^to herpes; in fact, 
some call It hemreof the mouth. 

Palmyra^^S. J. D. Blake, M. D. 



Oil of Cinnamon as a Disinfectant. 

Editor Medical World :— I think I 
ought to say in some of the medical 
journals, before it is too late, that of 
the numerous disinfectants and deodor- 
ants which I have used in forty years' 
work, oil of cinnamon stands pre-eminent 
As a vaginal douche; where a douche is 
necessary, add three or four drops to a 
quart of water and use. Don't often 
have to repeat For surgical work, where 
necrosis of bone or soft tissues require 
disinfection, this is the best agent of 
which I know — better than the advertised 
preparations. No time to write an ex- 
tended article, nor is any needed. 

J. P. Baggot, M. D. 

Bamberg, S. C. 

[The oil would not dissolve thoroughly 
in the water. Why not use. a strong 
tincture in quantity to represent the 
same amount of oil, and which would 
diffuse readily in the water ? Doctor, 
please give details of your manner of 
using as a surgical dressing. — Ed.] 



32 



THE MEDICAL WORLD. 



Quiz Department. 



Questions are solicited for this column. Conununlostloas 
not accompanied by the proper name and address of the 
writer (not necessarily for publication) will not be 
noticed. 

The great number of requests for private answers, for the 
information and benefit of the writer, makes it neces- 
sary for us to charge a fee for the time required. This 
fee will be from one to five dollars* according to the 
amount of research and writing required. 

Correction. 

November World, page 441, first col- 
umn, last line should read m. x., instead 
of oz. x. Please take a pencil and make 
this correction now, while you have it in 
mind. 



Uterine Trouble. 

Editor Medical World :— The follow- 
ing case is very obstinate: A married 
lady, no children, been married eight 
years, menstruated regularly since fifteen. 
Her periods are about normal, except 
that she suffers very much with her 
head and back. Suffering continues 
most all the period. Digital examination 
finds the uterus anteflexed and a large 
cervix. She suffers some slight pains in 
lower part of bowels, but not constant 
Some leucorrhea. She is sparely built 
but has the average amount of flesh. Her 
greatest trouble seems to be loss of 
strength. When she lies about fora few 
days she gets to feeling all right and 
well ; but a few minutes' exercise will 
cause her back and head to hurt, and she 
gets weak and nervous. Therefore, she 
is in bed the most of the time, but has a 
good appetite and color. What is the 
probable cause of her trouble and the 
proper treatment ? 

R. L. Gattis, M. D. 

Belle Noir, N. C. 

[The difficulty of treating a patient at 
a distance, without ever having seen the 
patient, must be realized. We submitted 
the above to Dr. Theophilus Parvin, the 
eminent teacher of, and authority upon, 
obstetrics and gynecology, of Jefferson 
Medical College, who recommends as 
follows : Dilate the cervix under ether. 
Apply glycerine tampon daily to reduce 
size of cervix, also paint cervix with 
Churchill's tinGtuigofiodine every three 
or four days. Thinksftrere is a lrysterical 
element; perhaps caused by the local 
condition.— Ed. J 



Scrofula. 

Editor Medical World:— A girl, age 
6 years, weight 32 pounds, complex- 
ion light Family history, so far as 
we can learn, is good, and parents 
appear to be healthy ; the father weigh- 
ing 240 pounds, the mother 130 
pounds. Parents say the child was born 
during the seventh month of pregnancy, 
and she has never been healthy. When 
about three years old an abscess formed 
under her arm about the size of half a 
walnut ; since then she has had seven or 
eight such, either on her forehead or under 
the arms, and two more are now form- 
ing, one on the posterior surface of each 
arm just below the elbow. To the touch 
they are solid, and when lanced are found 
to be filled with a 4t hard pus" (this is the 
best way I know to express it), which 
seems to burrow into the tissues. These 
abscesses are about two months forming, 
and, after being lanced, are about three 
months in healing. 

The bones of both forearms and left 
tibia are considerably enlarged, but not 
tender. Appetite good and bowels regu- 
lar. Deciduous teeth were small, and 
dropped out in a few months. Perma- 
nent teeth are beginning to emerge, but 
are small and irregular. 

She took syr. iron iodide for several 
months, about a year ago, and her gen- 
eral health improved ; but the abscesses 
came oftener. 

Any information regarding this case 
will be thankfully received. 

Ledyard, Iowa. W. Lowder, M. D. 

[This case was submitted to Dr. T. J. 
Mays, member of the faculty of the 
Philadelphia Polyclinic. He diagnoses 
it as scrofula, with probably a specific 
basis. The specific basis is suggested by 
the enlarged tibia and bones of the fore- 
arms. He suggests the following treat- 
ment : io gr. cor. chlor. of mercury four 
times a day, after eating. Also, one-half 
teaspoonful of each of the following four 
times a day, after eating : 

Syr. hypophos. comp. (Hostelley). 

Syr. hydriodic acid (Hostelley). 

These may be combined and given to- 
gether, but perhaps the mercurial would 
better be given separately, either in solu- 
tion or pill. All to be given after eating ; 
after breakfast, dinner and supper, and 
before retiring, giving something to eat 



THE MEDICAL WORLD. 



33 



first ; but if the child retires early, soon 
after supper, a "piece" can be given 
about the middle of the afternoon, after 
which the medicine should be given. 
Nutritious food, open air, no exhaustive 
exercise. This treatment must be con- 
tinued for a long time. Report occa- 
sionally. — Ed.] 



Editor Medical World :— I shall feel 
grateful to any brother, who has had ex- 
perience in treating locomotor ataxia to 
give me his best treatment through the 
columns of The Medical World. 

Ataxia. 



Editor Medical World : — I wish to hear 
the opinion of you or some of the best 
M. D.'s whether the following question 
is an anatomical or a surgical one, if 
given at an examination. 

The question is .: 

Describe Scarpa's triangle, the muscles 
and their relation to vessels and nerves 
within the triangle. 

This question was given as a surgical 
question before a State board of medical 
examiners. 

Also, I wish to know if the expression 
" nutmeg liver " is ever used in medical 
books, or is this only a local appellation ? 
In the many books I have I cannot find 
it Medic. 

[This is an anatomical question, but 
its relation to surgery is so close that we 
see no impropriety in an examiner on 
surgery asking it 

Nutmeg liver is an expression that has 
found its way into medical literature. 
You can find it in Gould's Medical Dic- 
tionary, page 880, top of second column. 
—Ed. J 

Editor Medical World :— I wish you 
and the many readers of The World to 
give me any information you can on the 
treatment of a case of purpura hemor- 
rhagica. 

My patient is a lady 27 years old, 
weighs 170 pounds, dark hair and eyes, 
very nervous temperament, mother of 
two children 8 and 10 years old, and has 
been a widow for several years. Appe- 
tite fine, digestion good, but she some- 
times suffers from constipation, which, 



however, I have about relieved. The 
purple spots are not very numerous, but 
can generally be found. This trouble 
began three years ago, and hemorrhage 
from the nose and gums for two years 
was a very troublesome symptom, but 
now the trouble is uterine hemorrhage. 
She menstruates regularly when I am 
successful in stopping the flow at all. It 
sometimes continues for several months 
without ceasing ; not very profuse, how- 
ever, at any time. 

My treatment has been tonics of 
various kinds, principally Blaud's pills, 
iron, quinine and strychnine, arom. 
sulph. and galic acids, and, when needed, 
tr. of digitalis. Locally, hot or cold 
douches with astringents in jthe vagina, 
and sometimes inter-uterine douches. 
By this treatment she has frequently 
been able to leave her bed two or three 
days after the passage of her " regular 
period. n There has been, no rise of tem- 
perature attending the attack. The in- 
jections used have been medicated, some- 
times with carbolic acid, boracic acid, 
tannic acid or nit silver. I have also 
used tampons with astringents. I have 
given also ergot, viburnum, etc. Her 
diet is nutritious, but not stimulating. 
She craves pickles, lemons and other 
fruits, and uses them freely. Results of 
treatment sometimes very fine ; at other 
times nil. Practitioner. 

[Are you sure that no uterine polypus 
is present?— -Ed.] 



Editor Medical World :— I wish to ask 
what is the best medical dictionary ? 

Also, the best remedy to excite the 
animal passions. I have extensive in- 
quiries by played-out men and women. 

Auburn, N. Y. Dr. . 

[We find Gould's Dictionary of Medi- 
cine the most useful. 

The best treatment for " played-out 
men and women " is good food, temper- 
ate habits, plenty of exercise, good hy- 
gienics and good morals. The last is 
the most important. Doctors should not 
"stimulate the animal passions." That 
is not what we are for. Our duty is to 
make people better, not help them to be- 
come worse. We would not deserve the 
high position we hold in society if we 
prostituted our powers. "Played-out 



34 



THE MEDICAL WORLD 



men and women " should become better 
men and women ; then they will "play 
in " again ; but we hope for a higher 
purpose than the gratification of animal 
passions. — Ed.] 



A Tough Case. 

Editor Medical World :— Will you be 
so kind as to ask help for me ? I am 32 
years of age, spare built, weight about 
143 pounds ; have had very fair health 
until 3 years ago, when I had a long 
spell of chills, followed by a hard spell 
of typhoid pneumonia. It was thought 
by three physicians that I would die. 
However, I seem to have entirely recov- 
ered, with the exception of polyuria. I 
made an analysis of my urine several 
times during a few months, but could 
find nothing abnormal except excessive 
quantity. After a few months this did 
not trouble me so much. About two 
months ago I made another analysis and 
found to my horror albumen 60 per cent. 
I then remembered that I had been easily 
fatigued for the past eight or ten 
months, and that urination had become 
more frequent, especially at night 

I have a good appetite ana good di- 

Srestion ; very slight edema at times ot 
ace and left instep and ankle. I neg- 
lected to state that I had gonorrhea 
about eight years ago that lasted five 
months. I had a very high temperature 
for three or four weeks in the beginning, 
with one or two relapses. My urine 
showed 50 per cent albumen then. I 
practiced masturbation in early youth 
and manhood excessively, also indulged 
in sexual intercourse very freely after 
marriage, about four years ago. Taken 
all around, I have been pretty tough. I 
would rather not have my name pub- 
lished, but will sign Dr. A. I* D. 

Arkansas. 

P. S. — Of course I know I have Bright' s 
disease, and that it is incurable ; but I 
want to prolong my life as long as possi- 
ble, especially as I am in debt. I would 
be glad to hear from yourself as well as 
The World readers in regard to the best 
treatment. 

[Doctor, your habits must now be as 
correct as they have been " tough" 



heretofore. Even after the mistakes of 
youth, many who should know better 
make man iage a perpetual debauch. Phy- 
sically the results are just the same as 
though the marriage ceremony had not 
been pronounced ; morally it is just the 
same,except the cloak of legality is thrown 
over it. You see your mistakes now, and 
your desire to live long enough to get 
out of debt is very laudable. The only 
medicine we will suggest for the present 
is the tincture of iron. Our readers may 
suggest other remedies if they wish. 
Take frequent hot baths or vapor baths 
to keep the skin acting freely and thus 
relieve the kidneys. Keep your bowels 
open and lead an exemplary life, avoid- 
ing fatigue and securing plenty of sleep. 
—Ed.] 

A Hint. 

Dr. W. S. Cline, of Woodstock, Va., 
writes : " I hate to write for The World, 
as so many doctors write to me and fail 
to inclose postage." Please take this 
hint. The feast part of the cost of a let- 
ter is the postage ; and that is the part 
that you can pay yourself when asking 
further information from a distant bro- 
ther. Better make it a rule to inclose 
several stamps, to make up for past neg- 
lect and for others who are thoughtless 
as you have been. Keep plenty of 
stamps on hand all the time ; get them 
by the dollar's worth. 

Editor Medical World: — Will you 
please give me the formula in which you 
use Pulsatilla ? I have a case in which I 
wish to use it, and I can get very little 
information in my books as to the form- 
ula used, dose, etc. C. A. Brown. 

Rincom, N. Mex. 

[A drop of the tincture every half hour 
is a good way to give it It is better 
used alone. — Ed. ] 

Editor Medical World : — Can you ? or 
some other member of the fraternity, 
give the formula of Dr. Kennedy's 
Rheumatic and Neuralgia Dissolvent, 
and oblige an old subscriber? 

Comments— Rhus Tox. 

Editor Medical World : — November 
World, page 441, " Strychnine Cure of 
Alcoholism." DiJBLed J^kjC^C strych. nit 



THE MEDICAL WORLD. 



35 



gr. u> atrpph. sulph. gr. ,oo, aq. desk m. 
x. Inj. t i. d. This would seem to 
mean hypodermic. R. No. 2, strych. 
nit. gr. i, atroph. sulph. gr. 200, aq. oz. 
x. Inject t. i. d'. The amount of water 
in the latter would lead me to think that 
the injection should be rectal, and yet 
the dose is less than No. 1. The line of 
therapy, as completed in R. Nos. 4 
and 5 leads me to think well of the 
methodus medendi, but I wish to see the 
oz. x. removed or confirmed. Why not 
use both sulphates ? Is not A gr. large 
for hypodermatic use ? or does this class 
of patients bear large doses of strychnia 
*ell? 

Lower half of page 445 seems to me to 
be wasted, which is not of usual occur- 
rence in The World. It is too much like 
the boy emptying his shotgun into a 
thicket after a rabbit he had lost sight 
of. * 

Page 391, October number, query for 
use of rhus. tox., or poison oak. As I 
run through November number I fail to 
find an answer. I do not use it for 
names, but for conditions. Given, local 
sharp burning pain, bright redness of 
surface, sharp stroke of pulse, and espe- 
cially it is indicated by a condition which 
gives small bright red spots on tip of 
tongue. It is an anti-zymodic, and cor- 
rects special lesions of the circulation by 
its action on nerve centers. Given the 
above conditions in a case of rhus tox. 
poisoning, and I will cure the case with 
sp. rhus gtt v., aa. oz. iv., m. s. dr. j\, 
every hour. Now don't label me homeo- 
pathic. I am only delving after facts, 
and believe that a doctor should profit 
by all of the best brought to light in the 
past history of medicine, and relegate 
pathics and isms to the past. 

On same page I note the question of 
Dr. J., of Texas, regarding permanganate 
of potass., and would suggest that he try 
Upjohn's yi gr. pills, one before break- 
fast, and increase the dose as the stomach 
bears it. 

F. Milton Friend, M. D. 

Lamar, Colo., 11, 15, '96. 

[See correction in another column. It 
should be m. x., instead of oz. x. Sorry 
for error, but we are all human, you 
know. If others are as discriminating as 
you, they would not use this formula 
until put right. Yes, we, too, think that 



both salts should be sulphates, or both 
nitrates. 

As to lower part of page 445, we think 
it one of the most valuable things in the 
issue. Are you ever bothered with per- 
sistent coughs, and wonder what next to 
give ? It may be that you don't have 
them in Colorado, but in most other 
places we have them. Well, here are the 
results of 24 remedies tested in coughs, 
and all in one half pagfe I In the lan- 
guage of the stieet urchin, " what more 
do you want?" — Ed.] 



Adherent Placenta. 

Dear Dr. Taylor : — In January I at- 
tended a lady in confinemeut and had a 
complete attachment of the afterbirth. I 
took away what I could, and used a solu- 
tion of Setter's antiseptic tablets as an 
injection every four hours. In Decem- 
ber, I attended the same lady with hour- 
glass contraction and a complete attach- 
ment. I had the best doctor in the 
county called, but with same results. 
Patient doing well. Did I do the best ? 
Hemorrhage great in both cases. 

Woodstock, Va. W. S. Cline, M. D. 

[Doctor, your results in January are an 
emphatic endorsement of your treatment 
We suppose your treatment was sub- 
stantially the same in December, and we 
hope that your results will be as good. 
A college professor would have curetted 
the uterus if necessary to get all the 
placenta away —a very proper procedure, 
but you have shown that it is not always 
necessary.— Ed.] 



Tinnitus. 

Dear Editor:— Will you publish this 
query in the World ? 

Last winter my wife had nervous pros- 
tration, commencing with an acute or an 
execerbation of a chronic nephritis ; albu- 
men casts, granular casts (broken down) 
found with the microscope ; later on her 
urine became normal, although during 
the whole time she was in bed the room 
was permeated with a uriniferous smell. 
After being confined to her bed six 
months, she is up, around, and quite 
well, except her head. 

When first taken she had terrible 
noises in her head, and they have never 
left her. Sometimes^^gi^^he 



3* 



THE MEDICAL WORLD. 



will become insane from the roaring and 
buzzing. No one of the consulting 
physicians has offered any help for the 
noises. Can any of the readers of this 
journal give a hint that will help her and 
relieve a suffering mortal ? 

W. H. Judson, M. D. 
Danielson, Conn. 

[The first thing is to thoroughly clear 
the external auditory meatus. We sup* 
pose this has been done, although it is 
sometimes neglected. This being done, 
and the symptoms remaining, the trouble 
must be in the internal ear. At this 
stage we submitted the case to Dr. E. B. 
Gleason, 41 S. 19th Street, a very able 
ear specialist, who says as follows: " A 
minute quantity of cerumen, a hair, or a 
single flake of epithelium, resting on the 
drum-head, is sufficient to cause the 
symptoms. However, tinnitus is more 
frequently the result of some abnormal 
condition of the middle ear. This may 
consist of closure of the Eustachian 
tube, contraction of the ossicular liga- 
ments, or the intratympanic muscles. 
In a certain number of ear cases the tin- 
nitus is due to a disturbance of the con- 
tents of the labyrinth, as the result of 
congestion, anemia, or inflammation. 
Treatment is suggested by the condition 
found to be present. Middle ear or laby- 
rinthine troubles require the attention of 
a specialist" — Ed.] 

May I ask you to inform me where the 
Craig Colony for Epileptics is located ? 
Any information which you may be able 
to give me in regard to conditions of ad- 
mittance in the institution will be ap- 
preciated. 

Francis M. Bishop, M. D. 

Newark Valley, N. Y. 

[Who can supply this information? 
We have heard of this institution, but 
have forgotten its location. An article 
describing this colony by some one 
familiar with it would be interesting. 
—Ed.] 

Editor Medical World : — Young man, 
35 years, good habits, fair general health. 
At the beach last summer, very hot day, 
suffered with the heat. 

The next morning, on awaking, found 
he had lost control of upper and lower 
lips on right side ; soon found he could 



not open eyelids on right side, jior move 
muscles on forehead, cheek or chin. 

There has been no pain; can feel 
touch on face as usual. Blisters have 
been used on face, above the ear and 
back of neck; also electricity, inter- 
rupted faradic current. 

Is this a case of paralysis of motor ttoot 
of fifth nerve? Very little medication 
has been tried. 

Will any of your numerous readers 
suggest any help ? 

E. W. Abbott, M. D. 

Concord, N. H. 

[Concerning the above we consulted 
Dr. F. X. Dercum, specialist in nervous 
diseases, who spoke of it as Bell's palsy 
(facial paralysis). The most usual cause 
is cold. Perhaps the young man lay on 
the ground awhile, or otherwise exposed 
himself to cold that warm night Ex- 
amine ear, as middle ear trouble some- 
times causes paralysis of facial nerve. 
In that event, the middle ear trouble is 
probably the result of cold, and the 
paralysis the result of the ear trouble. 
Examine facial muscles electrically, to 
determine reaction of degeneration. The 
prognosis will be indicated by the reac- 
tion. Treatment : Electricity, the form 
depending on the reaction of the mus- 
cles. Internally, try salicylate of sodium ; 
that failing, give iodide of potassium for 
a long time. — Ed.] 



Editor Medical World : — I have read 
with interest an article in the October 
World, page 396, on the use of thiosi- 
namine,and was particularly impressed 
with the reference made in regard to the 
absorption of cicatricial tissue. Now, 
in my specialty I frequently meet with 
old cases of lateral laceration of the 
cervix, with a bulky cicatrix in either 
side of the cervix, causing an unnatural 
gapping of the os. From the informa- 
tion you are in possession of in regard 
the use of thiosinamine, would I be justi- 
fied in injecting the remedy in small 
doses into the tissues of the cervix, with 
a view of softning and reducing those 
cicatrices sufficiently to avoid the use of 
the knife? 

Where can I obtain the remedy and 
what does it cost ? 

I take great^leasure in perusing the 



THE MEDICAL WORLD. 



37 



pages of The Medical World ; they are 
instructive and edifying. 

Dr. D. W. Rodgers, 

Union City, Mich. 

[The above was submitted to Dr. 
Sam'l G. Dixon, the distinguished Pres- 
ident of the Phila. Acad, of Nat Sci., 
who originated this treatment- He says : 
"The action of thiosinamine is sys- 
temic It should not be injected into the 
tissues of the cervix. If the doctor be- 
lieves it worth trying in the cases men- 
tioned, it should be injected into the arm 
or back." 

Messrs Lehn & Fink, importers of rare 
drugs, 128 William street, New York, N. 
Y., can perhaps supply it — Ed.] 



If you can will you kindly give me 
your diagnosis and treatment of the fol- 
lowing case, in your next issue ? I am 
very anxious to get something to relieve 
the patient Two elderly physicianss 
have tried and failed, just as I have. 

Mrs. G., age 48, weight 235, ill since 
July 5, or confined to bed since then. 

Had an abdominal abscess in region 
of left ovary 15 years ago, good recovery. 
Fell, April 25, and injured same side. 
Soon after the fall the muscles of left 
leg and side, also neck, were very sore, 
the head could not be turned without 
assistance. The left leg had to be drawn 
up ; part of the time the cords beneath 
the knee were very tense ; just above the 
elbow on outside of arm was a lump the 
size of a small hen egg. , Pain just be- 
neath the ribs in both sides is severe, 
also between the ribs on side over the 
heart Temperature normal. For a 
time perspiration was profuse, not much 
now. Appetite small ; feet bloated a 
little; also ankles. Pulse 78 to 94, at 
times quite irregular, also intermittent 
At times a hacking cough distresses her. 
Bowels inclined to be constipated. Urine 
in July scanty, 16 oz. in 24 hours. Sp. 
gr. 1.034 ; sugar none ; albumen, small 
amount; phosphates profuse; quite 
strongly acid. Now urine is 38 oz. in 
24 hours. Sp. gr. 1.022, other points 
the same. The patient is lifted from the 
bed to a reclining chair occasionally. 
She can not bear any weight on the left 
limb. Once when she sat up everthing 
turned black to her. 



As to treatment : 

Diuretics are used freely. Spring 
water (Colfax, Iowa), potass acetate, 
digitalis, oil juniper, etc. Sodii phosp., 
tonics, nitric acid, protonuclin, pepten- 
gyme, bismuth, lactopeptine and calo- 
mel ; malt extract, beef ^eptonoids, sul- 
fonal, solophen, phenacetine, antipyrine, 
phytotaca, nitro-glycerine, blisters and 
electricity were used. As sedatives, we 
used, chloral, croton chloral, papine and 
a little morphine. The stomach is quite 
sensitive and it has cause to be. Still, 
none of the medicine has been used 
strong. The family have used three or 
four proprietary articles. 

If you could give me a little aid in this 
case, it will be a favor. One doctor 
diagnosed the case lithemia ; another, 
neuralgia. 

There is no sign of an abdominal 
tumor nor abscess. A cousin of the 
patient was afflicted in the same manner. 
W. A. Warner, M. D. 

Lafayette, 111. 

[We wrote the Doctor that it may be 
spinal trouble due to fall ; to examine 
spine for tenderness ; to note altered 
areas of sensation and motor changes and 
report further. A case like this must be 
managed on the broadest general princi- 
ples ; and don't give so much medicine, 
and so many kinds. Make up your mind 
as to a line of treatment, and stick to that 
line without deviation until you have 
reason to change. Considering the age 
and weight of the patient, she cannot 
expect a rapid recovery. She must be 
patient, and is she not a little hysterical? 
Look to the circulation. Don't try to 
diagnose such a case as this as a "dis- 
ease;" she is suffering from rather a 
complicated condition. Gentle massage, 
increased from day to day, might help 
the left limb.— Ed.] 



Are You Insured? 

Editor Medical World : — These discus- 
sions on industrial economics I consider 
of incomparable value to the profession in 
directing our attention to the weak points 
of the present system, which is constantly 
operating against the livelihood and busi- 
ness interests of the hard-working physi- 
cian. 

And because of your noble efforts in 



38 



THE MEDICAL WORLD. 



this line of educating our profession in 
the all-important business of taking care 
of themselves and their families, I accord 
a hearty preference for The World to all 
other medical journals I have ever seen, 

I will have these articles published in 
the " Southern Mercury," the greatest 
reform paper published in Texas. 

You speak of an insurance provision 
in the last World — a most wise and 
excellent suggestion, and a policy I 
heartily endorse ; but here, again, I am 
bluffed off by the gigantic insurance 
monopoly of private corporations, where- 
in we see that there are millions upon 
millions of dollars vested in the hands 
of some few stockholders, who are thus 
enabled, through the power of such vast 
capital, to oppress and rob their cus- 
tomers in taxing upon them extortionate 
policy rates. I am willing, and more than 
willing, to take out a policy of insur- 
ance on the co-operative plan, in which 
all the insured are stockholders ; the 
business to be run on the assessment plan 
in paying death claims or indemnity 
sickness claims. 

In co-operative insurance I feel satis- 
fied that all moneys paid into the concern 
go directly to the support of the needy 
ones, without contest or vexatious litiga- 
tion, while most of the old line compa- 
nies are demanding an enormous profit 
out of the insured for the enrichment of 
a few private stockholders. Hence I am 
not insured, and, therefore, guilty of 
neglecting the all-important business of 
making a provision for the widow and 
orphans, chiefly on account of my an- 
tipathy to the oppressive extortions of 
private corporations. I do not feel like 
upholding a system of business that robs 
and levies an unjust tax upon the masses, 
in order to enrich a few individuals at 
the expense of the many. 

But, changing the subject, can you in- 
form me through the columns of The 
World in regard to the normal saline 
solution, its exact specific gravity and 
exact proportions and best method of pre- 
paring the same for transfusion into the 
vein direct, or by the rectum indirectly ? 

Oakalla, Tex. L. S. Hine, M. D. 

[Normal* saline solution is 75 parts 
of sodium chloride to 10,000 parts of 
water. 

State insurance would suit you, Doctor. 



They have it in New Zealand, the 
u star of the southern seas" ; but we 
can't hope for it for a long time, for 
Uncle Sam is an old fogy, and allows 
other countries to get ahead of him in 
so many ways. Getting rich is his 
hobby, and he cares much more for the 
rich than for the poor. If the 
doctors don't look out, one-tenth of the 
profession will have the patronage of the 
rich and live pretty fat, while nine-tenths 
of us will have to serve the poor for 
nothing, for there will be so many poor, 
and they will be so poor that they cannot 
pay us. 

Thanks for what you say about my 
efforts. I have realized for a long time 
that the doctors must be educated on the 
principles of industrial economics, and 
that they, in turn, must educate the 
people, so we can hope to get something 
better. But I got a discouraging com- 
munication a few days ago. An old 
reader, while renewing his subscription, 
said that while my articles on these sub- 
jects were interesting, he did not see that 
they were practical ; that there was no 
data from experience to prove that gov- 
ernment telegraph and railroads would 
be a success, and that such a proceeding 
would place entirely too much power in 
the hands of the party in power. Mercy ! 
Have I been writing in vain ? I hope 
the doctor will read up the back num- 
bers. In every civilized country on the 
globe except Bolivia, Cyprus, Honduras, 
Cuba, Hawaii, and the United States 
the telegraph is owned and operated by 
the government as a part of the postal 
system, and with entire success. Many 
leading countries, as Germany, Hungary, 
etc., own and operate the railroads, and 
they would not think of returning to the 
private corporation system. And this 
doctor lives in California, under the 
many abuses and extortions of the 
Southern Pacific ! I thought all Cali- 
fornia doctors were particularly well 
posted on these subjects. As to in- 
creasing the patronage of the party in 
power, the merit system of civil service 
has decreased this patronage to about 
one-tenth of what it was twenty years 
ago. If the telegraph and railroads were 
to come under government control, of 
course the merit system, and not the 
partisan or spoils system, would be ap- 



THE MEDICAL WORLD. 



39 



plied. It might be well to give a hint 
as to how such things would benefit the 
masses. A government telegraph system 
would opei* an office in nearly every post- 
office, employ about four times the 
present number of operators, at about 
double the present wages, and give 
telegraph service to the people at 
less than half the present cost. Yes, 
the immense profits of the Gould 
family from that source, would be cut 
off, but haven't they preyed upon the 
American public long enough ? Gov- 
ernment railroads would serve the daily 
interests of the people, particularly the 
farmers, to a much greater degree. We 
must educate or our patrons will con- 
tinue growing poorer every year. — Ed.] 



Whbn giving cases for our "Quiz" department, 
be sore to exhaust your own resources first. Read 
up carefully ; study each case as dilligently as law- 
yers are said to study their cases. Great lawyers 
are said to study every case laboriously and ex- 
haustively ; that is why they are great Don't send 
to this department until you have read and studied, 
examined and reflected, until you have exhausted 
ail your resources. Then send us a clear statement 
of the case, briefly giving every important point, 
but no unnecessary details. Dr. R. L. Gattis' case 
in this issue seems to be a good example. Give all 
treatment tried, and the results of the same. 



To our regret we find that some very inter- 
esting articles, now in type, will have to be 
carried over till next month. 

T Yes, we still send World and Medical Coun- 
cil both for $1.75 per year. Also World and 
Alkaloidal Clinic for $1.75 ; all three for $2.75. 
New subscribers to Clinic get a nine vial 
pocket case, filled, as a premium. 

Dr. G. A. Smith, of Clinton, Iowa, has used 
The Medical World Visiting List (in sections) 
for eight years, and says he could not get 
along without them. He writes : '• I recently 
had occasion to sue a corporation for a profes- 
sional account, amounting to nearly $1,000, 
and the little sections, as original books of 
entry, were unassailable, and I won my case." 

If you want The World during 1897, don't 
procrastinate, but send immediately. There is 
no time like the present. Don't send a postal 
card. We can 't live on second hand postal 
cards. Send a letter (no difference how short — 
the shorter the better), containing the subscrip- 
tion price. Or just enclose $i,with your card 
or printed stationery. No letter necessary. 
We will know that you mean it for The World 
for 1897. 



Current Medical Thought 

Antitoxin In Private Practice. 

Reported by Maud Josephine Frye, M.D, clini- 
cal instructor in the diseases of children, Medical 
Department, University of Buffalo. 

As a supplement to the number ot 
July 1, 1896, Pediatrics publishes the 
report of committee appointed by the 
American Pediatric Society to investi- 
gate this subject The committee, con- 
sisting of Drs. D Emmett Holt, W. P. 
North rup, Joseph O'Dwyer and Samuel 
S. Adams, submitted to the society, at 
its eight annual meeting at Montreal in 
May, a report, of which the following is 
a summary : 

1. The report includes returns from 
615 physicians. Of this number more 
than 600 have pronounced themselves 
as strongly in favor of the serum treat- 
ment, the great majority being enthu- 
siastic in its advocacy. 

2. The cases included have been 
drawn from localities widely separated 
from each other, so that any peculiarity 
of local conditions, to which might be 
ascribed the favorable reports, must be 
excluded. 

3. The report includes the record of 
every case returned, except those in 
which the evidence of diphtheria was 
clearly questionable. It will be noted 
that doubtful cases which recovered 
have been excluded, while doubtful 
cases' which were fatal have been in- 
cluded. 

4. No new cases of sudden death 
immediately after injection have been 
returned. 

5. The number of cases injected 
reasonably early, in which the serum 
appeared not to influence the progress of 
the disease, was but nineteen, these 
being made up of nine cases of some- 
what doubtful diagnosis, four cases of 
diphtheria complicating measles, and 
three malignant cases in which the 
progress was so rapid that the cases had 
passed beyond any reasonable prospect 
of recovery before the serum was used. 
In two of these the serum was of un- 
certain strength and of doubtful value. 

6. The number of cases in which the 
patients appeared to have been made 
worse by serum were three, and among 

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THE MEDICAL WORLD. 



these there is only one new case in 
which the result may fairly be attributed 
to the injection. 

7. The general mortality in the 5,794 
cases reported was 12.3 per cent. ; ex- 
cluding the cases moribund at the time 
of injection or dying within twenty-four 
hours, it was 8. 8 per cent. 

8. The most striking improvement 
was seen in the cases injected during the 
first three days. Of 4,120 such cases the 
morality was 7.3 per cent; excluding 
cases moribund at the time of injection 
or dying within twenty-four hours, it 
was 4.8 per cent. 

9. The mortality of 1,448 cases injected 
on or after the fourth day was 27 per 
cent 

10. The most convincing argument, 
and to the minds of the committee an 
absolutely unanswerable one, in favor of 
serum therapy is found in the results 
obtained in the 1,256 laryngeal cases 
(membranous croup). In one-half of 
these recovery took place without opera- 
tion, in a large proportion of which the 
spmptoms of stenosis were severe. Of 
the 533 cases in which intubation was 
performed the mortality was 25.9 per 
cent, or less than half as great as has 
ever been reported by any other method 
of treatment. 

1 1. The proportion of cases of broncho- 
pneumonia — 5.9 per cent. — is very small 
and in striking contrast to results pub- 
lished from hospital sources. 

12. As against the two or three in- 
stances iin which the serum is believed 
to have acted unfavorably upon the 
heart, might be cited a large number in 
which there was a distinct improvement 
in the heart's action after the serum was 
injected. 

13. There is very little, if any, evi- 
dence to show that nephritis was caused 
in any case by the injection of serum. 
The number of cases of genuine nephritis 
is remarkably small, the deaths from 
that source numbering but fifteen. 

14. The effect of the serum on the 
nervous system is less marked than upon 
any other part of the body ; paralytic 
sequelae being recorded in 9. 7 per cent of 
the cases, the reports going to show that 
the protection afforded by the serum is 
not great unless injections are made very 
early. 



ACTION OF THK SOCIETY UPON THE REPORT. 

At the close of its presentation, the 
society voted to accept the report of the 
committee, and after a full discussion it 
was decided to embody its conclusions in 
the following resolutions : 

1. Dosage.— For a child over two years 
old, the dosage of antitoxin should be in 
all laryngeal cases with stenosis, and in all 
other severe cases, 1,5000 to 2,000 units 
for the first injection, to be repeated in 
from eighteen to twenty-four hours if 
there is no improvement ; a third dose 
after a similar interval, if necessary. For 
severe cases in children under two years 
old, and for mild cases over that age, the 
initial dose should be 1,000 units, to be 
repeated as above if necessary ; a second 
dose is not usually required. The dosage 
should always be estimated in antitoxin 
amits, and not of the amount of serum. 

2. Quality of Antitoxin.— The most 
concentrated strength of an obsolutely 
reliable preparation. 

3. Time of Administration.— Anti- 
toxin should be administered as early as 
possible on a clinical diagnosis, not wait- 
ing for a bacteriological culture. How- 
ever late the first observation is made, 
an injection should be given, unless the 
progress of the case is favorable and 
satisfactory. 

The committee was appointed to con- 
tinue its work for another year, and was 
requested to issue another circular asking 
for the further co- operation of the pro- 
fession, this circular to be sent out as 
soon as possible, in order that the 
physicians may record their cases as they 
occur through the coming year .—Buffalo 
Med. Jour. 

Class- Room Notes. 

(From Dunglison's College and Clinical Record.) 

Ichthyol (one-third) and carbolized 
vaseline is a good ointment applied over 
an Erysipelatous Area. — Keen. 

Small euemata of ice water are of great 
value in relieving the Peristalsis so dan- 
gerous in certain complications of ty- 
phoid fever. — J. C. Wilson. 

To wash out a sinus arising from Sep- 
ticemia, Prof. Keen recommends a solu- 
tion of sulphuric acid, one part to 30. 
Peroxide of hydrogen may also be used 
effectually. 

An ice-pack applied to the abdomen in 

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THE MEDICAL WORLD. 



41 



Peritonitis often affords much mo re relief 
than the stupes nf t erpent ine, etc.— J. C. 
Wilson. —7 

Hemorrhage in Typhoid Fever is best 
treated by restricting the indigestion of 
fluids, and by the use of opium odminis- 
tered until its physiological effect is 
obtained. The opium may be given 
either by mouth or by suppository.— J. 
C. Wilson. 

In simple Impotigo the lesions may be 
incised, the contents pressed out, and a 
simple protective dressing ofcarbonized 
zinc oxide ointment ylrfpplied. — Stel- 
wagon. 

In the expulsion o^a Tapeworm, all 
food lAthheld forVtwelye hours, and a 
drachmlpf the edje£g aTextr act of male 
fern in I mucilaginous emulsion given 
every tmee lyirs ~pfov es a mast Useful 
procedunL-T^ C, T Wilson. 

The edema of the lower limbs in preg- 
nant women is best tr eated by bandaging 
the affecte^jjart ; a hot bgtlL (95 ) and 
immediate wrapping in blankets with 
copious draughts of hot J^ajer or hot 
milk, is also good t reatmen t.— Parvin. 

Our Monthly Talk. 

Concerning the express business, I have 
gotten some "eye-opening" facts from a re- 
cently published book. The following letter 
will explain : 

Philadelphia, Pa., Nov. 25, 1896. 
United States Postmaster General, Washing- 
ton, D. C. 

Dear Sir : — I inclose an article which ap- 
peared in The Medical World for November, 
' advocating an extension of the Postal Service 
in the direction of "Parcel Post," so as to 
practically perform the service now performed 
by the express companies. 
I have gotten a number of letters in reply to 
1 this article, all favorable to the suggestion. 
The Imperial Grantun Co., of New Haven, 
Conn., suggests that the merchandise postal 
I rate be reduced from 16 cents to 4 cents, or 
at most 8 cents (same as books) per pound. 
; This seems a reasonable suggestion. But I 
j read in a book entitled "A General Freight 
and Passenger Post," by J. L. Cowles, pub- 
> lished by G. P. Putnam Sons, N. Y., on page 
^ 7 : •' Our express companies carry all sorts of 
. parcels from the domicile in New York to the 
' station, thence by rail a thousand miles to 
Chicago, and deliver at tbe domicile in that 
I city, at a rate of $3 per hundred pounds ; but 
the railways tax the government 8 cents a 
pound, $8 a hundred, $160 a ton for the trans- 



portation of its mail bags for an average haul 
of not over 442 miles." And on page 17 : 
* ' Our railways are post-roads ; they can carry, 
and they should be made to carry, merchandise 
for the post-office as cheaply as they now do it 
for the express companies." 

Will you kindly inform me as to the accu- 
racy of the statement that the railroads carry 
for the express companies so much cheaper 
than for the post-office ? If this is true, the 
merchandise postal rate cannot be reduced 
until the railroads charge a more reasonable 
rate for carrying for the post-office. 

I would be obliged for information concern- 
ing, and your views upon, the same. It is not 
idle curiosity on my part, but I am inquiring 
on behalf of over 25,000 physicians in all parte 
of the country who read The Medical World, 
and who are interested in having instruments 
and samples of new medicines carried to them 
at a reasonable cost for the service — preferably 
by the Post-office Department. 
Very truly, 

C. F. Taylor. 

In reply I received an intricate table, giving 
charges per year per mile. As private parties 
do not get their transportation service in that 
way, I sent the table to Mr. Cowles to inter- 
pret and simplify. We will follow this up, 
and see if this injustice cannot be remedied. 
The price of Mr. Cowles' book is 75 cents. I 
advise that it be read and circulated. 

Later : As this goes to press I get further 
information directly from Mr. Cowles. Will 
follow this matter up next month. It is im- 
portant to every physician, In»the meantime 
get the book and read it. The editor of the 
New England Magazine says that it is the 
most important book that has appeared since 
Lloyd's "Wealth Against Commonwealth." 
Send directly to Hon J. L Cowles, 384 Crown 
St., New Haven, Conn., for the book. Price, 
only 75c 

How many have done as directed in the 
following letter? 

Editor Medical World. — I took your advice 
as given in October World, page 395, and sent 
for the book by Dr. W. H. Smith, of St. Clair, 
Mich., "The Effects of the Gold Standard, 
published by Chas. H. Kerr A Co., 56 Fifth 
Avenue, Chicago (price, 25 cents), and I wish 
to say that it explains the question fully and 
clearly. I wish to ask every physician to read 
this book, and talk bimetalism until we get 
relief. I would be pleased to hear from those 
who do this. J. W. Shemmell, M. D. 

Bumpus Mills, Tenn. 

We were deeply in earnest in our advocacy 
of silver, believing it to be for the true interests 
of the masses of the people, and consequently 
of the medical profession. We were proud 
that one of the very best books on the subject 
came from one of our own profession. What 
was true in principle a few months ago is just 



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42 



THE MEDICAL WORLD. 



as true now; but we have had an election 
since then, and for our sentiments concerning 
the same, see December World, page 478. 
There are many who believe that President 
McKinley will see, or be forced by conditions 
to see, the light and adjust himself to it. He 
and his friends wish his administration to be 
a success, and we sincerely hope it will be, for 
it can only be by prosperity to the masses of 
the people, and this is what we want. The 
object is not partisan victory, nor partisan 
success ; but prosperity to the masses of the 
people, and hence to the niedical profession. 
We must work and educate until we get this. 
Many think the silver question was settled by 
the last election ; but that remains to be tested 
by the condition of the times under a higher 
tariff and a continuation of the gold standard. 
If the times continue bad and grow worse un- 
der the incoming administration, the whole 
question will be opened again, and we and our 
people must be ready for it. Therefore, take 
the doctor's advice, and read and circulate this 
book. Another book should be spoken of in 
this connection ; we were not aware of its ex- 
cellence until after the election. It is " If not 
Silver, What?" by Hon. J. W. Bookwalter, of 
Springfield, O. It is published by Messrs. 
Claypool <fc Co., Springfield, O., price, 20 
cents. It is scholarly, broad, and judicial. 
We strongly recommend its reading. We sin- 
cerely believe the exclusive gold standard to 
be unjust and prejudicial to the producing 
classes of this, or any other country. Those 
who believe that anything different would be 
4 ' dishonesty, repudiation, etc.," do not under- 
stand the question ; and it is they, particularly, 
who should read the above-mentioned books. 

While the above are our sincere sentiments, 
yet we know that the remonitization of silver, 
while much better than the single gold 
standard, will not be a final solution of our 
money question. We will endeavor to make 
room for some remarks on something better 
than silver in a month or two. 

But what do you think of this for non-appre- 
ciation and ingratitude? A subscriber (we 
will not give his name but Indiana in his 
State) writes that he does not believe in "bal- 
loon dollars, and cannot renew his subscrip- 
tion to the Medical World' until 1900, by which 
time he expects silver to be remonetized. If 
all our subscribers would do this, they would 
kill the only medical magazine committed to 
this side of the question. Is this the way to 
atttain an object ? Is it not like trying to get 
rich by killing the goose that lays the golden 
€ g£ s ? Capital, monopolies, trusts, etc., pros- 
per by sticking together; and they will con- 
tinue to bleed the people until the people learn 
the value of sticking together. 

I have infinite patience with sincere gold 
standard men (who are not bigoted, and I try 
not to be bigoted in my opinions), and I suppose 
there are many thousands such who are readers 
of The Medical World. I feel it my duty to show 
them that the gold monopoly is the greatest 



monoply in the world ; that it is world-wide 
and all powerful ; that as gold rises (demands 
more products per ounce) every other product, 
including silver and humanity itself, is de- 
based ; that humanity sighs and cries for 
relief; that our profession is a part of that 
humanity, and feels the impoverishing effect 
of some unseen power. At the same time I 
freely admit that a similar silver monoply, or 
monopoly of both silver and gold, might be 
possible and become oppressive, in which 
event I would oppose it just as I now oppose 
the gold monopoly. 

But with the silver man who now wishes to 
desert his only friend in medical journalism, 
we have no patience. However, we will say to 
any who fear that the effects of the gold 
standard will rob them of their favorite medical 
magazine, if they cannot send the regular 
price, a personal letter to the editor (brevity 
desired) with three quarters or half the regular 
price, will secure continuance. 

Later: — I wrote briefly to the doctor and 
sent him reprints of articles from The World 
on economic subjects, which so many of you 
have had reprinted in your local papers. I 
am a 4< Hoosier boy, " having been born on the 
romantic Wabash; and I have always been 
proud of my native state until I received the 
letter above referred to. But promptly in reply 
came a renewal and an apology. The follow- 
ing is a part of his letter : 

** I beg your pardon, as I thought your jour- 
nal was in favor of the gold standard, and I 
made up my mind to not send any money East, 
but had sent my dollar to the St. Louis 'Medi- 
cal Brief. * After investigating your literature, 
I at once find my error, and gladly acknowl- 
edge my mistake. I will have our county 
paper publish as much of your literature as 
possible. " 

And the reputation of Indiana for gratitude 
is saved! — I have always been modest, and 
put these special articles in smaller type. You 
must read everything in The World, or you 
might miss just what you do not wish to miss- 
I have found the East, particularly scholarly 
Philadelphia, very congenial ; but I left my 
heart among the striving, aspiring people of 
the Great West. The charge, freely made a 
few months ago, that what they advocate is 
"dishonesty, repudiation," etc., is a calumny. 
But, friends, while gold and silver together as 
a money standard is more just and more 
honest than gold alone, don 't allow * ' silver " 
to eclipse your view of other questions. It is 
not even all of the money question. I will 
try to make that clear in a short time when I 
will present to your attention "something 
better than silver.'* 

I make these remarks in these pages because 
the gold monopoly and many other monopolies 
are impoverishing our profession by impover- 
ishing the masses of the people ; and The 
Medical World is devoted to the financial 
interests of the profession as well as to its 
scientific interests. — C. F. T. 



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THE MEDICAL WORLD. 



43 



"THE KEY NOTE; SUBSTITUTE HON- 
EST MONEY FOR FICTITIOUS CREDIT. " 
An appeal for genuine money from a Repub- 
lican standpoint. By Albert Griffin. Pub- 
lished by S. L. Griffin & Co., 119 South 
4th street, Philadelphia. Price, in paper, 
50 cents ; bound in cloth, $1. 

This is a well printed book of 448 pages. On 
the back are the following words : Bimetalism — 
Protection — Republicanism. This would natur- 
ally invite Republican readers, and repel Demo- 
cratic and Populist readers. But let me say 
that a member of any party can read this book 
with profit. I enjoy a very pleasant acquaint- 
ance with Mr. Griffin, who has been a staunch 
Republican for forty years. My many years' 
study of the financial question led me to think 
that I had a pretty good knowledge of it ; and 
when Mr. Griffin's book came I thought I 
could get the leading points in it in half an 
hour. But I soon found myself reading every 
line and every word carefully, page after page ; 
and instead of half an hour, I have spent many 
hours very profitably with this book. So do 
not be misled, as I was, with the thought that 
you are well posted on this question, but get 
this book and see a phase of the subject not 
presented by the ordinary book on the money 
question. It is large value, both in quantity 
and quality, for its price. 



Blakiston's Physicians' Visiting List is the 
oldest as well as one of the best published. 
While it has long been before the medical pub- 
lic, it is constantly revised and improved. 



Wit and Wisdom. 



The physical examination was almost com- 
plete, when the physician began inquiries into 
the family history. " What did your father 
and mother die of ? " * * I don ' t exactly remem- 
ber, sir ; but it wasn't anything serious. ' ' 

Has not every doctor a troublesome case of 
eczema? See advertisement of Noitol, and 
send for sample. 

Do you live in the country ? If so, you 
have open space. Poultry raising is not only 
interesting, but very profitable The Reliable 
In-ubator and Brooder Company, of Quincy, 
111., have sent us a beautiful 168 page cata- 
logue full of information. The postage on it 
was 4 cents. We feel certain that they will 
send you one if you will send postage, and 
! mention this notice. 

The Cough and Constituent Tablets acted 
i beautifully in a severe case of phthisis pulmo- 
nalis. Shall order more soon. The Freligh's 
Tonic is everything it is recommended to be. I 
have never used the remedy for rheumatism. 
Shall be glad to give it a trial. 
I . Scottsburgh, ya. H. C.Beckett, M. D. ' 



Mr Greeley was busy that morning and 
didn't want to be annoyed. The minister was 
persistent, and thought he must have a con- 
tribution for his pet society. Finally he said 
in rather a loud tone and an impressive man- 
ner : • ' Mr. Greeley, I want you to contribute to 
this society to prevent people from going to 
hell!" "Go along," said Mr. Greeley. "I 
won't give you a cent. There are not half 
enough people going to hell now ! " 

Messrs. McKessons & Robbins have many 
good preparations and much good literature, 
but they have never advertised in our pages. 
Write and ask them for pamphlet on treatment 
of upper air passages. Also, they may spare 
you a copy of their book, "The Newer Reme- 
dies. " Tell them your opinion of The Medical 
World. 

Tri-Elixiria is a new remedy advertised with 
us this month. See advertising notice formula, 
and send for literature. Please don't neglect 
this. 

Apenta is one of those remarkable Hunga- 
rian waters. You can judge of it by the fol- 
lowing formula : 

Grns per Gal. 

Magnesia sulphate . . 14742 

Magnesia carbonate . . 12.8 

Magnesia bromide . 085 

Sodic sulphate . . . 13079 

Calcic sulphate . . . 184.31 

Potassic sulphate . . . 5.92 

Lithic sulphate . . . 531 

Sodic chloride . . . 123.80 

Fluorine .... traces. 

Sodic carbonate . . . 33-47 

Calcic carbonate . . . 8 20 

Ferrous carbonate . . 5 42 
Ammonis (free and albuminoid) traces o 004 

It is one of the finest purgative waters 
known. See address on page facing editorial, 
and send for literature. 

Caroid comes on our front page this time. 
Those comparisons appeal directly to the eye 
and the reason. Write for further information. 
Try it for dyspepsia in which pepsin has 
failed. 

What do your patients wear next to the 
skin this cold weather? Would you be sur- 
prised if linen were suggested ? We are told 
that in Northern Russia all classes wear pure 
linen underwear, instead of wool. Write for 
literature and sample to Dennel Linen- Mesh 
System Co., 409 Pearl street, New York, N. Y. 

Have you sent for that sample of Resinol ? 
Do it to-day. See advertisement first leaf over 
from contents. 

Have you still that obstinate case of anemia ? 
Why did you not put her on liquid hemofer- 
rum ? It is not too late yet. See advertisement 
of F. Stearns & Co., and send for literature 
and samples. 



44 



THE MEDICAL WORLD. 



The Doctor — "Mrs. Brown has sent for me 
to go and see her boy, and I must go at once." 
His Wife— "What is the matter with the 
boy?" The Doctor—" I don't know; but 
Mrs. Brown has a book on * What to Do Be- 
fore the Doctor Comes, ' and I must hurry up 
before she does it." — Household Words. 

Do you give your babies, feeble children and 
old people the advantage of that royal food, 
imperial granum ?• If not, why ? If you are 
not acquainted with it, see advertisement just 
over from contents, and write for a sample. 

"Free to our doctor friends, Warner's Visit- 
ing Records and Prescription Blanks." This 
is quoted from advertisement of William R. 
Warner & Co., which see. You won't get 
them unless you write for them. 

Mr. Upjohn is an original and earnest man. 
We have talked with him on other subjects 
besides pharmacy. When such a man comes 
into pharmacy it is for a purpose, and that 
purpose is being rapidly accomplished. When 
his friable pills came out they created a sensa- 
tion. He once told us he had never seen an 
old fashioned pill machine. He did not want 
to know the old way. He came with a new 
way. You use his pills, don't you ? See in- 
side, last cover. 

There seems to be no limit to the enterprise 
and originality of the Antikamnia Chemical 
Company, of St. Louis. We have just re- 
ceived from them the most unique and inter- 
esting calendar for 1897 that we ever saw. No 
wonder Antikamnia is such a success. A 
good thing to start with, and such brains 
behind it. These men would not put so much 
thought and expense into Antikamnia unless 
it were a good thing. 

Do you use campho-phenique powder? If 
not, send 4 cents for postage, and write to 
Phenique Chemical Company, St. Louis, Mo., 
and mention this notice, and you will receive 
half-ounce package; as it sells for 50 cents 
per ounce ; this will pay you, and you will be- 
come acquainted with a good thing. 

See atttractive advertisement, page 5, and 
send for literature. 

Nervous Prostration. — My son aged 12, had 
been growing nervous over the shock of his 
brother's death, and seemed to derive no bene- 
fit from any remedies used in his case. Had 
him to the sea shore, change of surroundings 
and everything that could be done for his 
benefit ; he still grew thinner and worse all the 
time I put him on Celerina, and had marked 
benefit before the first bottle was used, and he 
has almost entirely gotten over it with the 
help of another bottle I got for him. I con- 
sider it a very nice and efficient nervine, just 
the thing for the children and nervous and 
delicate persons, where there is great prostra- 
tion. I shall use it freely. — N. P. Frassoni, 
M. D., Moosic, Pa. 



She was the tallest woman on record. Sh< 
was so tall that when she got her feet wet in 
March she didn't have a cold in the head untx 
the following December. 

Just drop a postal card to Messrs. Parke, 
Davis & Co., of Detroit, Mich., for their com- 
plete price list Very handy to refer to. 

When you are puzzled, it is safe to give 
Fellows' hypophosphites, for it is one of the 
best tonics known. 

Samples of uterine wafers will be sent to yon 
by Messrs. Micajah <fc Co., of Warren, Pa., if 
you are not acquainted with them. 

Mulford's antitoxine is pure, safe and effi- 
cient. See testimony inside first cover. It 
has been used by over ten thousand physicians, 
in 40,000 cases, with less than 5 per cent, of 
deaths ! Send for pamphlet. 

Opposite Contents you will find what two 
physicians say about Mercer's Pill Vita. 

Peace and comfort for the babies - r yes, and 
for "itchy" grown people, too. That is what 
Dr. Fehr's compound talcum powder does ; 
and if you don 't give your patients this com- 
fort they should employ some other doctor. 

" Something new; just out; get it." See 
advertisement of Cloride of Silver Dry Cell 
Battery Company, and see what it is and how 
to get it. 

Have your patients to get elastic stockings 
that won't pull apart ; that is, the •• Master" 
stockings. Catalogue free. Pomeroy A Co., 
15th street and Broadway, New York, N. Y. 

Send for enlarged and revised manual (free) 
to Messrs. B. Keith <fc Co., 75 William street, 
New York, N. Y. 

We believe Allison's operating tables and 
chairs to be superior. See their advertisement 
and write for further information. 

We have a new malt and a good one in this, 
time. See advertisement of Long Island 
Bottling Company. The malt is superior and 
fine, and the price is reasonable. 

Elixir Six Iodides. Does that appeal to you T 
Turn to Walker-Green's advertisement and 
read about them. 

Dr. Willis H. Davis thinks he is the oldest 
advertiser we have. He is slightly mistaken, 
as Messrs. William R. Warner <fc Co , are our 
oldest, having been with us continuously since 
1883. Perhaps Dr. Davis comes next. He 
has two quarter pages in this month. The 
World must be a good thing for him, or he 
wouldn't stick to it so long; and his goods 
must please our readers, or they wouldn't con 
tinue to patronize him. 

When writing to advertisers, always men* 
tion The Medical World. Not only that, but 
give your opinion of it as well. This will in* 
terest advertisers. 



^^^^y^yerog^e 



The Medical World 

The knowledge that a man can use is the only real knowledge ; the only knowledge that has 

life and growth in it and converts itself into practical power. The rest hangs 

like dust about the brain, or dries like raindrops off the stones. — Froude. 



The Medical World. 



F. TAYLOR, M.D., 

Editor and Publisher. 



Subscription to any part of the United States and Canada, 
Onb Dollar per year. To England and the British 
Colonies, Five Shillings per year. Postage free. 
Single copies, Ten Cents. These rates must be paid 
invariably in advance. 

We cannot always supply back numbers. Should a num- 
ber fail to reach a subscriber, we will supply another, 
if notified before the end of the month. 

Pay no money to agents for this journal unless publisher's 
receipt is given. 

Add&bss all Communications to 

"THE MEDICAL WORLD/ 9 

1530 Chestnut Street, 

Philadelphia, Pa. 



Vol. XV. 



February, 1897. 



No. 2. 




Colony Management for Epileptics. 

A number of replies to the Quiz on 
page 36, January World, asking for the 
location of Craig Colony for Epileptics, 
liave been received. Its location is Son- 
yea, Livingston Co., N. Y. It is a State 
institution, the establishment of which 
was inspired by the colony at Bielefield, 
Westphalia, Germany. The Craig Col- 
ony will be a year old February 1st, of 
this year, and it has already become a 
decided success. A number of facts con- 
cerning it appeared in December World, 
page 483. 

Among the replies to the Quiz 



came some interesting literature on 
the subject from Dr. Frederick Peterson, 
of New York City, President of the 
Board of Managers of Craig Colony. 
This literature shows that we are enter- 
ing upon a new era in the management 
of epileptics. 

Statistics show that epilepsy afflicts 
from one to two in each thousand of 
population. Taking the lesser ratio, a 
very simple calculation shows that in 
our 70,000,000 population there are 
about 70,000 epileptics, and we fear this 
calculation is too low. A very impor- 
tant question is, what sTiall be done with 
this large and unfortunate class? In 
the past the indigent ones have been 
sent to almshouses, there to live a hope- 
less life of neglect, associating with 
paupers. Those whose relatives can 
keep out of the poor house are almost as 
miserable, as they are debarred from 
society and occupation, shunned by all, 
and a burden to their relatives. 

Colony life is the star of hope in the 
lives of these unfortunates. The mem- 
bers are bound together by a common 
affliction ; and each one can feel the equal 
of his associates. No more disheartening 
shunning and dismal isolation. The 
affliction of these people disables them 
for only a few minutes each day, week or 
month. All the rest of the time they are 
capable, both mentally and physically, 
as a rule. Colony life opens up to them 
occupation, education, amusement, asso- 
ciation, etc. — all that is worth living for. 
This alone has already done more for 

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THE MEDICAL WORLD. 



Craig Colony epileptics than medicine 
could ever hope to do. This makes a 
good basis for medical treatment, the 
former disheartening condition having 
been a heavy handicap to therapeutics. 

An important feature of colony life is 
that they become almost self-supporting. 
At Craig Colony those who are able are 
put to work at something congenial, 
farm and garden work occupying the 
majority ; and it is found that the prod- 
ucts already pay about one-half the cost 
of maintenance, and it is hoped that 
finally the colony will become entirely 
self-supporting. 

It is gratifying to know that a number 
of States are preparing to follow the 
example set by New York in the man- 
agement of epileptics. We hope that 
in a few years all the poor houses will 
be cleared of their epileptics, and that 
they will be enjoying colony life, con- 
tributing to their own support by their 
labor. This will result in a much greater 
number of cures,' and a much less per- 
centage of insanity from epilesy. 

Only the indigent class has as yet been 
provided for. We suppose that a " pay " 
department, or private institutions pat- 
terned on these lines, will be an early 
development, for those who are able to 
pay. 

A chemical analyst says that fully 
half of the specimens of urine that come 
to him for examination, come in beer 
bottles. It is a happy (?) thought that 
in time these same bottles will Appear on 
the table of the beer drinker, filled with 
his favorite beverage. The moral is, 
either don't drink beer, or don't use beer 
bottles for such repugnant purposes. 

Wheat is one of the few articles that 
will sustain life indefinitely ; but bread, 
made from white flour, will not Why ? 
Because the white flour customarily used 
does not contain the most desirable 
parts of wheat Bread made from flour 



which includes the entire grain, except 
the outside hull, is a complete food. If 
children were raised on this kind of 
bread, instead of white bread, neither 
the dentist nor the doctor would be 
needed so often, and the bones, brains 
and muscles of those growing up would 
be better stuff. 



How Shall Criminals be put to Death? 

Over a year ago the Allegheny County 
Medical Society (Pittsburgh, Pa.), ap- 
pointed a committee to make an exhaus- 
tive investigation of the present methods 
of executing condemned criminals and 
recommend a substitute for hanging or 
electrocution. Dr. J. V. Chessrown, 
physician of the Allegheny county jail, 
chairman of the committee, says that the 
committee is about ready to report and 
will give the result of its investigation at 
the next meeting of the Medical Society. 
The committee will recommend that gas 
be substituted for the rope and electric 
chair. Dr. Chessrown says condemned 
prisoners could be painlessly put to death 
during their last night's sleep. The 
Medical Society will draft a bill for pres- 
entation to the Legislature this winter 
providing for the change. 

Capital punishment rests upon two 
theories. One is for punishment, and 
the other to deter others from committing 
similar crimes. Punishment with death 
is not punishment in the ordinary sense, 
for the subject being dead cannot reform 
his ways. This is revenge rather than 
punishment If this must be, it should 
be as humane as possible. We have often 
thought that a toxic dose of morphine, 
either by mouth or by hypodermic in- 
jection, would be a good plan. Asphyxia- 
tion with gas is about as humane, but 
not so convenient. Those who believe 
that the value of capital punishment is 
to deter others from committing crimes 
might think these methods too easy — 
not sufficiently horrible 1 Will not some 
future age look back on the legal murder 
of criminais as a feature of a barbaric 
age ? Can nothing better be done with 
them ? Conscience and intelligence will 
answer this question some time. 

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47 



Original Communications. 

r 

Short article* on the treatment of diseases, and experience 
with new remedies, are solicited from the profession for 
this department; also difficult cases for diagnosis and 
treatment. 

Articles accepted must be contributed to this journal only. 
The editors are not responsible for views exp re ss ed by 
contributors. 

Copy must be received on or before the twelfth of the 
month for publication in the next month. Unused 
manuscript cannot be returned. 

Certainly it is excellent discipline for an author to feel that he 
must say all he has to say in the fewest possible words f or 
his reader is sure to ship them; and in the plainest possible 
words, or his reader will certainly misunderstand them. 
Generally \ also, a downright fact may be told in a plain 
wav; and we want downright facts at present more than 
anything «/w.— Ruskiw. 

BEAD. REFLECT. COMPARE. RECORD. 

When is the Prevention of Conception Justi- 
fiable ?— Comments. 

Editor Medical World :— I want to 
say something to the lady signing her- 
self 44 A Doctor's Wife," and to all the 
other ladies who read The World ; and 
this is, that The World is not a society 
iournal, but a strictly scientific publica- 
tion, and that the hyperbolical language 
of compliment so general in speaking of 
your sex is out of place here. We are 
discussing scientific topics here, and this 
can only be done in the terms of scien- 
tific truth. When I hear a man speak 
of women as angels, I smile apprecia- 
tively, for I know he is simply express- 
ing extravagantly that sentiment of 
respectful admiration I also feel towards 
the sex. But when we talk as doctors 
about women, as we alone see them, we 
know that they are very, very human. 
And, if I add, still endeavoring to keep 
within the limits of scientific truth, that 
the woman as she is (human, with just 
enough of the angel to arouse in man 
aspirations to a nobler life than he could 
reach without her), is as good as she 
possibly could be without parting com- 
pany with man. I think my position 
on this question cannot be misunder- 
stood. 

Now, as to the prevention of concep- 
tion. Bach of the many readers of this 
journal has his own personal experience. 
If we put it all together we • get a good 
idea of the whole truth, many-sided as 
it is. But each must faithfully draw his 
part of the picture. 

The women alluded to by our lady 



contributor rarely apply to me for this 

{mrpose. A baby more or less makes 
ittle difference in a houseful; the 
rearing of infants seems to become 
a habit ; and such women will scarcely 
take the simplest precautions to prevent 
conception. If the woman has to sup- 
port her husband, it is another good rea- 
son for her applying for divorce; but 
how often does she do it? No. She 
will scrub and wash, while he sits behind 
the stove and smokes, and takes credit to 
himself that he only gets drunk and 
beats her occasionally ; and if you sug- 
gest that she ought to leave him, you 
will probably get her mop about your 
ears. Now, understand that, our lady 
opponent would advise the woman who 
has to support her husband to avoid 
child-bearing, so that she could give 
more of her earnings to her husband. I 
would say, get a divorce and marry a 
man who does not care to live on his 
wife's earnings, or stay single. And the 
same holds good for ever}' case she has 
cited — for the fool, the brute, the selfish 
and the drunken husband. Take away 
the wifely support and let them drop— 
the harder the better. But just why 
their evil propensities should be encour- 
aged by the prevention of conception is 
a bit of logic I cannot comprehend. 
Better load him with responsibilities 
until his manhood is roused ; let him see 
his children ragged and hungry ; and if 
this does not make a man of him, he 
surely is not worth a good woman wast- 
ing her life upon him. 

There are a few women who ought not 
to bear children, on account of their 
health. This class is divisible into two 
— those whose ill-health preceded mar- 
riage, and those who became sickly 
after it • 

For the first we have simply to say 
that they had no right to take upon 
themselves the obligations of matrimony 
when physically unfit Is it nothing at 
all that the longing of a man for off- 
spring should be disregarded? Is it 
wrong that a man should look with 
eagerness to the day when he can hold 
in his arms the pledge of his dear one's 
love, his child and hers? We hear a 
good deal of mother-love, but very little 
of father-love. And so many millions of 
us toil in workshop, mine or office, our 

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lives through, that our wives may be 
lapped in comforts, our children fed, 
clothed, reared and educated in the best 
way we can attain to. What else do we 
live for if it is not our children ? But to 
hear these people talk, one would 
imagine that we never have an idea 
beyond the primary desire for sexual 
congress. The man who desires father- 
hood is better for the wish. It is the 
man's right, his privilege; and the 
woman who marries, knowing herself 
physically unfit for maternity, is guilty 
of a crime that deprives her of all claim 
for sympathy. 

But as to the wife who, after marriage, 
becomes physically incapable of mater- 
nity. It is questionable if such a woman 
is not equally incapable of cohabitation 
— in many cases she is no more able to 
satisfy the sexual desires of a healthy 
man than she is to bear him children. 
So that this class is narrowed down to an 
exceedingly limited number. And with 
them there should be a choice, for hus- 
band and wife, whether each prefers to 
live together in their childless residence 
(not home), or separate. In each case 
the circumstances must govern our 
advice. If they chose to live together, 
and the woman is not too ill for cohabi- 
tation, the prevention of conception is 
simple. Insert a pledget of absorbent 
cotton, saturated with vaseline, before 
intercourse, and use a hot douche after- 
wards, and the result is certain. The 
vaseline effectually prevents the migra- 
tions of the spermatozoa. 

But the vast majority of the women 
who wish to avoid maternity have no 
such excuse. They simply do not want 
the trouble. They are perfectly will- 
ing to preside over the husband's house- 
hold, to spend his earnings ton dress, 
society and amusements, and even to 
gratify his needs ; but they do not care 
to have their own pleasures interfered 
with by children. 

Let us just glance at what civilization 
has done for women. In the earliest 
days, when a man wanted a wife, he lay 
in wait for her, entrapped her like any 
other wild beast, and enslaved her. This 
condition is illustrated by the way an 
old Sioux lived in Dakota. He had a 
little shed buift, on which he sat, with 
his pipe and gun, keeping his wives at 



work on his corn patches around him. 
A step in advance, and we find men and 
women working together, each doing the 
duty at hand. Next, the labor is divided, 
the wife taking the work done under the 
shelter of the house, while the man takes 
the fields and the hurft. As they get 
richer, she is supplied with servants, 
who do more and more of the work, 
leaving her the supervision and also the 
education of the children. Still higher 
up the grade, we find education under- 
taken by the State, many branches of 
domestic work performed for communi- 
ties and paid for in cash ; the superin- 
tendence of the home delegated to a 
housekeeper, and the woman's duties 
finally restricted to that of child-bearing 
and her society. Finally, did I say? 
No. The demand is now that the woman, 
who has "social duties" to monopolize 
her time, must be relieved of the child- 
bearing burden. This done, there re- 
mains but one step possible. 5?fce last 
relfc of her whilom slavery & the obli- 
gation to gratify her husband's sexual 
needs, and in the rise of that glorious 
word, alimony, we the final triumph of 
woman's emancipation ; when she re- 
ceives her full share of her husband's 
earnings, and gives absolutely nothing 
in return. To this haven some fortun- 
ate ones have already attained, and many 
look longingly towards it. 

As for her company, women in society 
have little time to wait on their hus- 
bands, except when they want more 
money. 

How far is this true ? Thank God, not 
yery much. It has been my unpleasant 
experience to meet some women of the 
selfish type, whose husbands are neg- 
lected, lonely men ; even some who dis- 
creetly closed their eyes on the existence 
of a real home, with bastard children to 
love him, as long as their own pecuniary 
supplies were not curtailed thereby. But 
these, also, are exceptional cases ; and to 
judge of woman by them would be as 
gross an injustice as it would be to judge 
the majority of women who apply for 
instructions in preventing conception by 
the few whg have a real excuse for doing 
so. 

On page 18, Dr. Campbell asks for 
suggestions for a case ofgastr o-intestifl al 
catarrh. Doctor, you "nave" usecl too 

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THE MEDICAL WORLD. 



-*a- 






't^t-i a 



;/ 



4* 



many good medicines. Take one and 
stick to it. I Put her o n an ab solute mi 
diet, half agl assful, hot, skimmed,, 
a little saltAvery Tour hours ; tMfeilk 
to be eatenf not drank, and fift«L min- 
utes to be Iccupied in takin^lch dose. 
When shf gets really huijffy, give a 
piece of Jpell-toasted staWbread or a 
toasted cmcker, each tim^and only very 
graduallf come back t^ull diet Mean- 
while £ire this a tria 

f carbonate,^^ - - - dr. i 

[ sulpho-cajpolate, - dr. i 

le of ipecwianha, - dr. i 

(tare o^Kydratis, - dr. vi 

atic^yrup of rhubarb, oz. vii 

It : A tablespoonful half an 

"each meal in a tumbler of hot 

She will get well promptly. 

Dr. Long (page 22) would let degene- 
rates marry and then prevent conception. 
I would forbid them marrying, and, in 
the case of criminals, castrate them, j/ 

His case of catarrhal stomatitis may 
be due to teeth that need the dentist's 
attention. The cause is mechanical, 
chemical or vital. The latter require 
the persistent use of antiseptics. I would 
suggest a mouth wash of chlorinated 
soda and chewing pellitory root as a 
means of increasing the vitality of the 
tissues. Perhaps hydrastis would prove 
more useful. 

Dr. Bowman's case of "extro-cardia" 
is very interesting, but not quite unique. 
About six years ago I received a descrip- 
tion of a similar case from Paris. In an 
old Spanish work on anatomy, also, I 
found plates depicting another case. The 
Doctor surely must have preserved this 
remarkable specimen for the museum. 

Dr. Schmidt (p. 25), has a case of 
coated tongue of singular obstinacy, 
whicKpafter resisting all treatment for 
years, finally succumbed to intest inal 
antisep sis. The symptoms noted, drow- 
siness, paresthesia, etc., were caused by 
the absorption of toxic substances from 
the intestinal canal. This is a key to so 
many morbid conditions that I must be 
pardoned for alluding to it in so many 
of my letters. * 

The best method to relieve urticaria 
was not mentioned, either by Dr. Han- 
nah or , by Dr. J. Solis-Cohen (p. 28). 
This is a mustard b ath. A friend, prac- 



Ig in Iowa, tells me he has employed 
It in the pruritic affection common in 
that state, and probably the same as 
that known farther south as "Texas 
scratches." 

In Dr. Rice's prescription for asthma 
(p. 30), he gives the credit to lobelia; 
but neither the iodide nor the sanguin- 
aria is inactive. Lobelia stimulates secre- 
tion, and by its relaxing effects 
unlocks the spasm. Sanguinaria is a 
powerful stimulant to the respiratory 
apparatus, and would seem to be contra- 
indicated in a spasmodic condition^ But 
this drug is a u vital inciter ; n/ it in- 
oreases the afflux of nervous energy to 
the lungs, and thus strengthens the tissues 
up to the point where they are enabled to 
throw off the disease. I have recently 
been able to test this agent in influenza, 
and in a little epidemic of common colds, 
nasal, laryngeal and bronchial. With 
some persons the old-fashioned sweating 
process is of very little use, besides being 
tedious and uncomfortable. Atropine is 
great with some, breaking up the attack 
handily ; but with others the only effect 
is a temporary drying-up of the secre- 
tions of nose, mouth and throat, very 
annoying ^hile it lasts and followed by 
the reappearance of the symptoms as 
soon as the effect wears off. Now, in 
these cases, where nose, throat, larynx 
and bronchi were involved in one great 
tremendous cold, with shivering, aching 
head and bones and profound depression, 
I gave sanguinarine nitrate, three gran- 
ules, of gr. 1-67 each, every hour. The 
effect has been simply remarkable. The 
attacks were broken up by five or six 
doses, so that next day my patient could 
get about with smaller doses quite com- 
fortably. I feel like asking my readers 
to try this treatment and let us see what 
there is in sanguinarine^ in acute respira- 
tory disease. Heretofore, I have known 
this drug simply as a powerful stimulant 
in the latter stages of phthisis, when the 
pulmonary sensibility is low and prod- 
ucts are not coughed out. 

And I have a new combination for that 
exasperating malady, prurjtis ani. It is 
camph£]>heni<jue, one dram, loso- 
phan^ 20 grains, and cosjuoline, one 
ounce." Apply every night or morning, 
continuing until the ♦disease is cured, 
and for a week longer. There is a 

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THE MEDICAL WORLD. 



peculiar form of balani tis for which the 
same mixture is c urativ e. The mucous 
surface of the prepuSJ becomes red, 
swollen, velvety, and itches intensely. 
The smegma is secreted so freely that 
one washing a day is not enough, and 
the cutaneous surface of the prepuce be- 
comes chapped, smarting on contact with 
the clothes or urine. 

On page 32, Dr. Gattis describes a case 
of uterine trouble, which seems to be of 
the anemic order, rather than the con- 
gestive. Sometime ago I described a 
similar case, which recovered when I fed 
the pelvic tissues with tampons saturated 
with cod-liver oil and bo vi ni ne. This is. 
good treatment when ioaitae increases 
the pain. Give internally the arseniates 
of strychaJBe, irgn^and qui nine, with 
hyposcyamine and helonin. 

I think " Practitioner " page 33, would 
better give his purpuric case the arsenite 
of copper, hamamelis and the lacto phos- 
phate of lime, with hydrastis as a hemo- 
static during the attacks. Also, plenty 
of fruit juices, lemons, pickles, etc 

William F. Waugh, M. D. 

103 State st, Chicago, 111. 

Pneumonia. 

Editor Medical World: — Time and 
space will not permit me to deal with 
pneumonia in general, therefore I will 
direct my thoughts to that most frequent 
and death-dealing variety, known as 
croupous pneumonia, which is an acute 
inflammation, of the lung involving the 
alveoli, and characterized by an effusion 
of plastic material into these breathing 
cells, thereby destroying their function, 
for a time at least. We will not follow 
the text-books mechanically, but will 
endeavor to study the morbid conditions 
present 

It is generally conceded that pneu- 
monia is a germ disease, and that these 
germs have a special affinity for the 
lungs, but are by no means exclusively 
confined to that organ. Death from 
pneumonia is almost invariably the re- 
sult of heart failure, either from exten- 
sive primary inflammation, or later, from 
ptomaines in the blood, depressing the 
nervous system, paralyzing the heart, 
producing a hypernbrinated condition of 
the blood and destroying the chlorides. 

In view of this extreme depressed con- 



dition, all remedies that have a tendency 
to weaken the heart or lessen the vital 
forces should be avoided, viz : aconite, 
veratrum, acetanilid, etc. If the physi- 
ological action of a drug be the true guide 
to its administration in disease, we fail 
to see why digitalis should be given at 
all in pneumonia, except where the 
heart's action becomes irregular. If it 
acts in any way, it can only increase the 
heart's power, and at the same time in- 
crease the resistance in front by con- 
tracting the arterioles and dilating the 
venules, throwing more blood to the in- 
ternal organs, thereby increasing the 
work of the heart and exhausting its 
power. It produces just the condition 
that we are striving to prevent, viz : en- 
gorgment of the venous circulation. A 
perfect circulation is one that empties 
the veins and fills the arteries ; and this 
must be imitated in the rational treat- 
ment of venous engorgement. 

Bleeding seems to me to be the most 
positive, powerful and prompt of any 
remedy at our hands. Bftt those who 
oppose this time-honored relic of antiquity 
may find great satisfaction from the 
hypodermic administration of glonoin, 
which also can be administered after 
bleeding and tends to prevent a necessity 
for its repetition, which, by the way, is 
one of the main objections to the use ot 
the lancet in pneumonia. One of the 
greatest advantages of bleeding is that it 
relieves the system at once of an amount 
of toxic poison commensurate with the 
quantity of blood taken, and the result is 
instantly seen in the condition of the 
patient. The extreme prostration of the 
vital forces is undoubtedly the result of 
this toxic principle in the blood, and any 
means that will tend to relieve it without 
compromising safety should be sought by 
all who study the best interests of their 
patients. 

Strychnine and alcohol are the most 
satisfactory remedies with which to com- 
bat the condition of shock and depression, 
and their administration should be 
pushed, especially the former. Alcohol 
can not be given to advantage beyond 
the point of ifs free elimination by the 
breath. There is a very marked con- 
dition of the blood that I have never seen 
mentioned in the text-books, yiz : an 
excess of fibrin and deficiency of chlo- 

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5i 



rides. It has been thought for a long 
time that there was a principle in the 
blood that was opposed to the invasion 
of germs, referred to as the * 'antiseptic 
properties of the blood," and since there 
is a deficiency of chlorides, we may infer 
that a subcutaneous injection of a solu- 
tion of sodium chloride, dr. iss to the 
pint, would be the most direct route to 
relief. This may be done just after the 
bleeding, and can be repeated twice or 
three times per day, but always with 
extreme asepis. 

I beleive the continued administration 
of the coal tar products for reduction of 
high temperature is a pernicious practice. 
Cold applications in some form will soon 
be the only admissible antipyretic in 
pneumonia. It is not only free from the 
depressing effects of the above class of 
remedies, but is highly stimulating and 
positive in its action. The mode of 
application must be governed by one's 
experience ; since the remedy is power- 
ful, the mildest application that will 
successfully reduce the temperature 
should be employed in each individual 
case. 

The atmosphere of the room should 
be pure and of an even temperature. The 
patient should be allowed plenty of nour- 
ishing food easy of digestion, and the 
excretions as well as the secretions should 
be constantly looked after. 

Malaria complicates almost every dis- 
ease in this region. Therefore, as a rou- 
tine practice, quinine should be given to 
eliminate this element 

There are many things concerning the 
treatment of pneumonia that I have 
avoided saying ; but, from what has been 
said, we may conclude : Firsts That pneu- 
monia is a germ disease. Second, There 
is a poisonous principle resulting from 
these germs that rapidly depresses the 
vital forces. Third, That depressing 
remedies should be avoided. Fourth, 
That stimulating remedies should be used 
in their stead . Fifth, That for the en- 
gorged and livid condition the lancet is 
the remedy par excellence, and should 
be supplemented by transfusion of sodium 
chloride solution. Sixth* That hydro- 
therapy is the only admissible remedy 
for relief of high temperature. 

Eufaula, I. Ty. G* W. West. 

[Dr. T. J. Mays, a prominent teacher 



and practitioner of this city, and special- 
ist in diseases of the chest, uses cold baths 
extensively in pneumonia, and strongly 
recommends their use. — Ed.] 

Treatment of Pneumonia— Prevention of Con- 
ception. 

Editor Medical World : — In pneu- 
monia I always begin my tieatment with 
an ipecac emetic. I give one-half drachm 
of fl. ext. ipecac (P. D., & Co.) every 20 
minutes until I get free and copious 
emesis. I prefer this to the ordinary 
custom of starting the secretions by cal- 
omel or saline. The ipecac accomplishes 
the following desired results: 1st It 
unloads the always over-abundant 
amount of bile that is in the stomach 
and duodenum, thereby relieving the 
nausea, and preventing the absorption 
of bile into the system. 2d. It relieves 
congestion of the lungs by equalizing 
the circulation; it promotes expectora- 
tion and lessens the diapedesis of blood 
into the air cells. 3d. It arouses the 
nervous system. 4th. It produces dia- 
phoresis. Ipecac is harmless and does 
not produce depression, as some may 
imagine. It can be used in the young 
and the aged with perfect safety. Of 
course it must be used early in the case 
to be of service. If used early, it will 
put the patient in better condition, and 
in many instances abridge the attack 
considerably. 

After the stomach settles (which will 
be in one or two hours) I place my 
patient on the following formula : 
R Ammonii chloridi . . . dr. ij 

Potassii iodidi . . . . dr. iss 
Ammonii bromidi . . dr. iij 
Tinct. aconiti .... gtt. xxx 

Aquae font oz. iv 

M. Sig — Teaspoonful well diluted every 
three hours. 

For excessive coughing, codeia X to % 
grain. 

On the fourth day of the disease (some- 
times before), I begin strychnine /<> of a 
gr. every three hours, and keep it up regu- 
larly until convalescence is fully estab- 
lished. In conclusion I will add that I 
blister with cantharides plaster every case 
that complains of severe pain in the lung. 
Instantaneous relief follows. There is no 
depression from a blister, as some 
authors would have u$ believe. I have 
blistered all fig* ^8351?* "V 



52 



THE MEDICAL WORLD. 



harm come from it, but have seen much 
good, and I recommend it as good 
practice. 

As to the prevention of conception, I 
fail to see why it should not be practiced. 
I do not see the justness or the righteous- 
ness of a couple marrying and having a 
whole litter of children whom they can 
not possibly educate or start out in the 
world properly equipped to cope with the 
many hard conditions in this cold world. 
The method I prescribe has never failed 
me when carried out properly. I have 
the lady to introduce a rubber cup over 
neck of womb (the French supporter) just 
before intercourse, (I explain to her the 
neck of womb, and how I want it to fit). 
After intercourse, I tell the lady to get 
out of bed immediately, and to inject 
one quart of warm water into the va- 
gina with a hand and ball rubber 
syringe (do not fool with a toy vaginal 
syringe). Then remove the rubber cup, 
and inject one pint of warm salt water 
high up in the vagina; then have a 
small ball of absorbent cotton with string 
attached, saturate with boro-glyceride, 
and introduced high up in the vagina. 
Leave this cotton in eight or ten hours, 
then she can remove it. This method is 
certain and harmless. 

Dr. J. T. Anderson. 

Cornelia, Mo. 

[See January World for the Editor's 
sentiments on the propriety of this pro- 
cedure. A great many differ from the 
Editor, insisting that, in cases like that 
above cited, for example, it is advisable 
and proper to limit the number of chil- 
dren. This question must be left to the 
judgment and conscience of each practi- 
tioner in each particular case. But we 
insist that instructions and moral (or im- 
moral) encouragement should not be 
given out indiscriminately. — Ed.] 

Pneumonia. 

Editor Medical World : — While I 
have nothing original to offer, I have 
something which experience has proven 
too valuable to keep, and I believe it 
will please others as it has me and my 
patients. Without discussing the mooted 
point as to whether the pneumo-bacillis 
is always present in pneumonia or not, 
it is not disputed that often there is a 
mixed infection, preceded by symptoms 



of a cold or grippe, and as a predisposing 
cause something that greatly depresses 
the vital forces. Suffice it to say that of 
late years most of my cases have had 
symptoms of grippe, and, believing in the 
germ theory, I have based my thera- 
peautics upon supportive, eliminativeand 
bactericidal treatment. 

If the patient is seen at the commence- 
ment, with a high fever and a full, 
strong pulse, pilocarpine is used in 
small, frequent doses (every 15 minutes), 
in a large amount of hot water, to pro- 
duce free diaphoresis, and a heart tonic 
to counteract its depressing effect, with 
the hope of modifying the course of the 
disease. 

I will not take your time in reviewing 
the usual form of treatment as laid down 
in the text-books, such as nourishment, 
cupping, mustard, cold applications, 
fresh air, etc., for they are well under- 
stood. The abortive plan, as advised by 
many of the medical journals a few 
years ago, by giving heroic doses ol 
digitalis, especially to the weak and 
aged, is not a safe one, for I have known 
sudden and unexpected dfeath to follow 
such use of the drug immediately after 
the patient raised the head. Neither is 
the indiscriminate use of the newer anti- 
pyretics advisable, except, perhaps, in 
small doses, for the relief of neuralgia, 
and then should be combined with a 
heart stimulant, such as caffeine. As 
with the modern gynecologist after a 
laporotomy, it seems to me opiates are 
contra-indicated in every case, with the 
exception of the occasional use of small 
doses of codea. 

For the relief of an irritable cough, 
after trying everything new I have read 
of, nothing has given me better satisfac- 
tion, especially in common cold and 
grippe, than the following inhalation, 
which I always use in pneumonia, be- 
lieving it to be, in the majority of cases, 
a mixed infection and involving the 
bronchial tubes more or less. 

R Beech- wood creosoti, (Merck's); 

Creolin 

Spt. camphor . . aa. dr. ij 

Menthol dr. ss 

M. sig. Ten or fifteen drops to be inhaled 

with steam every two hours or oftener. 

To depend upon a patent inhaler is 
impractical in tne country ; so one like 



THE MEDICAL WORLD 



53 



the following can be made in any 
house. Fit tightly over a tin fruit-can 
a paper cone with a small opening at the 
top ; this answers every purpose. Pour 
some water and the drops into the can 
and heat as hot as the vapor can be used 
by holding the cone in the mouth. An 
oil stove is best to heat'it on, but a brick 
heated in the stove very hot, or a kettle 
of hot ashes, or two nails laid across the 
top of a lamp-chimney to prevent 
smoking, or, still better, a wire frame 
fastened to the top of the chimney, will 
do. By the way, this or the use of a 
good atomizer with the following beats 
all the cough syrups ever made for a 
common cough. In the atomizer either 
use a solution of ichthyol, or Dr. Murray 
McFarlane's plasma nasal tablets, one 
to two ounces of warm, soft water, with 
one drop of creosote in alcohol. 

If there be dullness and other symp- 
toms of pneumonia, and especially a 
thick tenacious expectoration, give the 
following : 

R Calcii chloridi . . .dr. iij 
Aquae q. s. to dissolve ; 
syrup simp. q. s. . ad fl. oz iv 

Sig. — A teaspoonful every two hours. Alter- 
nate with — 

R Tr. aconiti (German green) gtt x 

Tr. gelsemii (green root) gtt xr 

Ext. belladona . gtt x 

Aquae . '. . . . oz. iv 
Sig. — Teaspoonful every two hours. If 
there is much pain in the side, use bryonia 
instead of belladona. The latter formula is 
only used during the first stage. 

At the commencement of the second 
stage, in place of sedatives, give the fol- 
lowing : 
R Beech- wood creosote (Merck's) . oz. ss 

01. morrhuse q. s oz. iij 

01. menth. pip. q. 8. 
Sig. — Half a teaspoonful with milk before 
and after, every two hours, increasing the 
dose gradually to a teaspoonful. 

Heart tonics, such as caffeine and 
strychnine, with glonoin when indicated, 
are used to tone up the nervous system 
and relieve the circulation. The calcium 
chloride is not the common chloride of 
lime of the shops, which is only chlori- 
nated lime ana not soluble in water ; 
but the chemically pure salt, which is 
freely soluble, and which has given me 
every reason to praise it in the highest 
terms when indicated ; but the time 
may come when it seems to have lost its 



usefulness, and is no longer indicated by 
the absence of acute symptoms, when it 
may be profitably replaced by 
R Strychnice sulph. pulv. . gr. j 
Calcii hypophos, vel sodii 

hypophos . . dr. iss 

Syrup simp.; aquae, spt. 

menthse pip. aaq. s. ad . oz. vi 
Sig. — A teaspoonful alternated every three 
hours with the oil and creosote. 

If the expectoration is abundant, the 
lime is preferred, if not the soda salt If 
after all acute symptoms have abated, 
there is a free mucfo-purulent expectora- 
tion, five drops of a solution of clear 
resin powdered and dissolved in warm 
turpentine to the consistence of molasses, 
every three hours on sugar, will arrest it 
if not tubercular. Sometimes I add 
eucalyptol to it and it makes an excel- 
lent cough balsam for a chronic or sub- 
acute cough. If the dullness of the 
lung does not clear up as promptly as it 
should, then the dose of creosote is in- 
creased to fifteen or twenty minims 
gradually, if the stomach will bear it ; 
but if not, as large a dose as it will 
tolerate, and in addition ten to twenty 
drops of creasotal are given on sugar to 
make up the deficiency of creosote. 
Patients may complain that they cannot 
take the oil and creosote, in which case 
give creasotal, and later commence with 
small doses of creosote gradually in- 
creased, and as a rule they will learn to 
tolerate it well when at first it is dis- 
couraging. The creasotal has the ad- 
vantage of being easy to take and not 
irritating to the stomach ; but a serious 
objection to many is the price, while its 
therapeutic advantage is nothing if an 
equal amount of creosote can be taken. 
Often the oil disagrees because it is 
rancid ; but that can be remedied by 
buying only the best fresh oil and imme- 
diately adding enough creosote to pre- 
serve it perfectly, which will not hurt it 
for any future use. 

It is a serious error to drop these cases 
of pneumonia (and grippe) too soon arid 
to let them out of bed too early. They 
should be more carefully watched and 
given larger doses of creosote and for a 
longer period of time, and larger doses ot 
strychnine and hypophosphites, and I 
believe there would be less phthisis fol- 
lowing these troubles. 

I omitted to mention that protonuclein 



54 



THE MEDICAL WORLD. 



in some cases has been useful, and that 
syrup hydriodic acid added to the oil 
and creosote has hastened resolution. 
F. G. Greenfield. 
Edinboro, Pa. 



aa. 



oz. lj 
oz. iij 

oz. j 



For Coughs. 

The. Editor asks "What do you take 
yourself for coughs ?" I will give two 
R's; either will relieve a cough. . Have 
used them for years, and wish no better. 

no. t. 
R Fl. ext. licorice 
Tr. opii. camph. 
Vini antimony ) 
41 ipecac j 
Spts. nitre oz. ij 

Sach. alba. oz. xx 

Mix and add water to make i qt. 
Sig.— Teaspoonful every hour when cough 
is troublesome. 

NO. 2. 

R Fl. ex. wild cherry oz. ij 

Rock candy . oz. iv 

Rye whiskey O ss 

M. Teaspoonful to tablespoonfnl every hour 

two. 

If you desire, in No. i you can put 5 to 
10 grs. muriate of ammonia to the dose. 

If you use either you can expect good 
results. 

Woodstock, Va. W. S. Cline. 



Florida Climate for Tuberculosis. 

Editor Medical World :— Since the 
appearance of Dr. Waugh's article in 
the October World, "Is Tuberculous 
Phthisis Curable ?" which I read with 
great interest, and I trust with profit, I 
have thought of writing you a short 
article setting forth some of the claims of 
Florida as a situation peculiarly adapted 
to invalids, especially those suffering 
from pulmonary tuberculosis ; although 
it is equally beneficial in many forms of 
nervous and stomach derangements and 
rheumatism. I will premise by saying 
that a private letter from Prof. Waugh 
finally decided me to write this. 

Having had a fairly extensive experi- 
ence in pulmonary diseases during a 
practice of twenty- four years in Ohio and 
Michigan, where, in common with nearly 
all physicians of that section, I felt the 
need of some suitable locality in a mild 
climate, where consumptives could be 



sent to escape the rigors of our Northern 
winters, I determined on coming to 
Florida to give the subject as careful 
study as circumstances would permit 
And now, after eleven years' residence in 
the State, having visited a large part of 
South Florida^ and having conversed on 
the subject with many intelligent phy- 
sicians, and having watched and treated 
many cases, I feel myself reasonably 
qualified to judge of its suitability for 
such cases. What these patients need, 
as hinted above, is a mild, equable, mod- 
erately dry climate, where they can spend 
much time out of doors. 

There are many places in the interior 
of South Florida which fulfil the above 
indications, and yet, which are so near 
the ocean on one side and the Gulf of 
Mexico on the other, that they have 
practically the same atmosphere as the 
ocean resorts, but robbed of much of* its 
dampness by its passage through our im- 
mense pine forests, and yet with a much 
larger proportion of ozone than in most 
localities away from the coast. Then the 
ordinary variation in temperature with 
us does not exceed io° in the twenty- 
four hours, while 20 is rare, and 30 is 
very unusual, seldom occurring more 
than once or twice a year. 

Then, while winter in many warm 
climates is the wet season, with us it is 
the reverse, and there is rarely a day 
when an invalid cannot spend some time 
out of doors, and most days much of the 
time can be spent in the open air. There 
is a common impression in the North 
that Florida is low and flat. This is 
erroneous. While we have no mountains 
and no hills of great height, there are 
many places which rise to a height of 
100 to 200 feet above sea level, and some 
that have an elevation of 300 feet 

The high pine lands, which are the ap- 
propriate home of the tuberculous, are 
generally quite rolling. 

As to the dampness, I have in these 
same pine woods seen ladies go out in 
slippers within two or three hours after 
a hard rain, without wetting their feet, 
or even moistening the soles of their 
shoes. 

The pine forests, with their balsamic 
odors and delightful breezes, are an im- 
portant factor in connection with the 
climate in the curative treatment of the 



THE MEDICAL WORLD 



55 



diseases under consideration. There are 
many localities in South Florida where 
consumptives do well. But not every 
place, even in this favored land, is 
adapted to this class of cases. 

We have many people in our midst 
who came here to die, but who have been 
living in comfort for years ; yet the death 
rate of our State is much increased by 
those who came here too late, very much 
to their own and our disadvantage. 

Notwithstanding this, our death rate 
is lower than nearly any other State in 
the union. 

Were not this article not already of 
sufficient length, I would like to tell you 
where and when those seeking relief from 
pulmonary disease should come and what 
they should do, having come. To-day 
is a beautiful, bright day, with the mer- 
cury at 78 , and there has not been a day 
this fall when we have not sat on the 
verandah, nor have we yet had a fire in 
the house, except for cooking. 

F. N. Lewis, M. D. 

Kissimmee, Fla., Nov. 21, 1896. 

From the Sunny East. 

Editor Medical World: — Small is- 
sues oft lead to grand results. But for a 
laughing hyena that threw the camp at 
Kassassin into wild disorder by raising a 
false alarm, and thereby delaying the 
memorable battle of Tel-el-Kebir by 
thirty-eight hours, the British would 
have had to encounter the wild rush of 
35,000 savage Bedouin Arabs in addition 
to the Egyptian forces entrenched behind 
Tel-el-Kebir, and, instead of being vic- 
torious, would have been vanquished. 
Procastination is considered the thief of 
time ; but in this instance it proved the 
salvation of over 14,000 Christian lives, 
as on the night preceding the English 
attack on Tel-el-Kebir, 35,000 Bedouin 
horsemen deserted the Egyptian camp, 
and on the morning of the 13th of Sep- 
tember, 1882, we had to face a few thou- 
sands of fellaheen, who, instead of being 
ready to fight us tooth and nail, were too 
disheartened by the desertion of their 
previous day's comrades to make any- 
thing like a. stubborn resistance. The 
hyena episode was not without salutary 
effects, since it taught the troops to dis- 
tinguish between the demoniac ha ! ha I ! 
ha ! ! 1 of the carrion brute and the wild, 



weird laughter of the fanatical dervishes 
of Africa. 

As in Egypt with human foe, so in 
Calcutta we had microbic and gaseous 
enemies by the million, ready to ally 
themselves to any invading epidemic 
Bubonic fever declared war with Bom- 
bay and began its deadly work; but Cal- 
cutta would not budge an inch to clear 
herself of her tons of removable filth. In 
vain^did the health officer and police 
commissioner try to rouse the commis- 
sioners to taking precautions to repel the 
invaders, should they elect to rush to this 
city. The condition was something 
beastly, and nothing was done till a man 
came from Bombay suffering from a 
syphilitic bubo, which brought on sym- 
pathetic fever, for which he was admit- 
ted into the Howcah hospital, where he 
was examined by two medical officers, 
who declared he had the bubonic plague. 
Then an ordinary case of mumps was 
similarly diagnosed by the health au- 
thorities, and this startled the commis- 
sioners into such active life that double 
gangs of the sweeper brigade were turned 
out for work at 2 instead 0f4.30a.rn *to clear 
the streets, and regular flushing relays 
were appointed, so that the streets and 
drains got such a thorough cleaning and 
scouring as they had not for the last ten 
years together. So that the plague, 
should it visit the capital of Bengal, 
would have to depend on its own re- 
sources in place of expecting reinforce- 
ments from the city's filth. 

The Bengal College of Physicians and 
Surgeons, which is the only medical in- 
stitution in this country unaided by the 
government with either professors or 
funds, and is the outcome of the effort of 
purely non-official practitioners to estab- 
lish themselves and disseminate their 
professional knowledge, has just com- 
pleted its first anniversary. It has a cor- 
poration exceeding one hundred fully 
qualified medical men, many of whom 
have attained high prominence in public 
estimation, and while it has 99 students 
being educated in a commodious building 
that it purchased for 79,000 rupees (t. e. y 
$22,570.00) hard cash, it has a splendid 
equipment and a reserve capital exceed- 
ing 30,000 rupees (t. e. y $8,540), together 
with a complete staff of teachers. It bids 
fair to become very popular, as it offers 



56 



THE MEDICAL WORLD 



a higher curriculum than generally ob- 
tains. 

There is a good deal of disaffection re- 
garding the new warrant which, chang- 
ing the title of assistant apothecary into 
assistant surgeon, leads to confusion that 
confounds the non- diploma' d with the 
diplomat practitioner, since the term 
assistant surgeon hitherto embraced a 
class of men who, undergoing the full 
curriculum, had to pass the L. M. S. and 
Arts examination. They still have to do 
so, whereas the assistant apothecary, 'or 
military assistant surgeon, as he is now 
called, is recruited from school without 
passing the F. A. test, and then receives 
a three years' course, which only em- 
braces anatomy, physiology, materia 
medica, chemistry, midwifery, hygiene, 
pathology, jurisprudence and dentistry, 
and excludes the other eight subjects 
necessary for a full medical training and 
entitlement to that place on the general 
medical register, which can not be denied 
to the assistant surgeon proper, who is 
an Indian official created for civil duties 
with the Indian medical service, whereas 
the military assistant surgeon is intended 
for duty with the army medical service, 
where he is seldom or never supposed 
(except in extremities) to exert his own 
professional discretion ; but is expected 
to obey orders given him by the doctor- 
in- charge for the treatment of soldiers 
and their families ; or, in other words, he 
is the " hands" and the army surgeon 
the "brain" in the " body" of hospital 
routine. 

Judging from the way that prices of 
cereals are running up, owing to the 
want of rain in the agricultural dis- 
tricts, there is every prospect of an ugly 
famine, which will act disastrously in 
India. Even water-logged Bengal is 
complaining of a scarcity of water and 
the want of funds, preventing hundreds 
of " ryots" from putting their land 
under cultivation. The consequent. dis- 
tress in some of the outlying districts 
is heartrending, indeed. So far, the 
Northwestern provinces are feeling the 
strain most, and the outlook is growing 
worse and worse, while the police have 
had their hands full in quelling grain 
riots by the starving poor. A few phil- 
anthropic men have come forward buy- 

ug up grain with a view to retailing it 



at a price within the reach of the poorer 
classes; but as independent effort has as 
much influence towards actual relief as a 
drop of water would towards making the 
Sea overflow its banks, the Government 
should step in with stringent laws com- 
pelling bunnias (*.<?., grain merchants) to 
sell at a fixed rate within reach of every 
one, and thus prevent a Jew persons 
from making immense fortunes at the 
sacrifice of the lives of hundreds and 
thousands of men, women and children. 
Roger S. Chew, M.D., G.M., M.S.C., 
Editof Indian Journal of Pharmacy. 

Late Chemical and Sanitary Analyst to the Cor- 
poration of Calcutta, India. 

•• That Curious Fever." 

Editor Medical World -.—Replying 
to Dr. B. Phillips, in The World of No- 
vember, page 430, allow me to say, that 
the disease in question is, without doubt, 
the same that we have so much of in this 
section. It is called here "the fever," 
typhoid fever (by most physicians), typho- 
malarial, continued malarial, and many 
other names, which leads to the suspicion 
that there is something wrong, either 
with the disease, or with the doctors. I 
do not doubt that it is the same disorder 
which, in Colorado, is called u mountain 
fever." It resembles typhoid more than 
anything else, but it lacks the essential 
symptoms of that fever. The normal 
course is about three weeks, but may 
spin out to six months. Relapses are 
not infrequent, and hemorrhages from 
the bowels may occur. The mortality is 
about the same as in typhoid, and except 
in the very first stage is as little benefited 
by active treatment. 

All this looks like typhoid, but after a 
practical experience of twenty years'with 
typhoid fever in the north, where this 
trouble is unknown, I am convinced that 
they are not the same. 

As to treatment, I think that full doses 
of calomel, with a general eliminant plan 
will, in many cases, if seen early, abort 
it; but after it is established, such at- 
tempts will lead to trouble and dis- 
appointment A conservative treatment 



gives the best results, and the doctor who 

does not attempt to " "•*** ; * " ™ 11 
u ^„^ m t h e most cases# 



cure it," will 



does not attempt to 

cure' 

Do not give anti-pyretics. Do not 
even paint the skin with guiacol to reduce 



THE MEDICAL WORLD. 



57 



the temperature. Cold baths and spong- 
ing do less harm and are sufficient. Do 
not give quinine ; it will prolong the 
case and add to its gravity, in proportion 
as it is pushed. 

This is the disease which DaCosta, 
many years ago, called "that curious 
fever which so many soldiers brought 
with them from the swamps of the Chick- 
ahominy." By the way, "that curious 
fever ", is still a good name for it. In 
this section it does not often occur in 
those who are broken down and poisoned 
with malaria, for we have very little 
malarm. 

The most common sequel is milk leg. 
As to the nature of the trouble, I can 
only say that my study of, and experi- 
ence with it, leads me to believe that it 
is a specific fever, which has not yet been 
generally recognized as such, and prop- 
erly named. It is probably caused by 
emanations from the soil, as it is most 
frequent and severe where the soil has 
been recently disturbed to some depth. 

There is no evidence that it is con- 
tagious ; and it is nearly as common in 
this climate in May as in October. Turn 
on the light 

C. T. Corry, M. D. 

Harriman, Tenn. 

Typhoid, or a Fever Resembling Typhoid, in 

Kentucky and Tennessee. -Success of 

the Woodbridge Treatment. 

Editor Medical World:— Be it un- 
derstood in the premises that the fever 
to which I shall allude in this paper 
is not the typical typhoid fever de- 
scribed in text-books and exemplified in 
large cities and city hospitals. It has 
the same anatomical lesions, the same 
tendency to intestinal hemorrhage, ulcera- 
tion and perforation, and frequently a 
great many other symptoms in common 
with that typical form of fever, and is, 
like that fever, not amenable to the anti- 
malarial treatment; but the typical tem- 
perature curve, the bronchial cough, 
diarrhea, tympanitis, subsultus tendi- 
num, rose spots, delirium, etc., so com- 
mon in the typical form, are more 
frequently absent in the fever under 
consideration, though each one of them, 
or a combination of several of them, may 
frequently be seen. 

It is called by some typhoid fever 



(possibly for want of a better name), by 
others typho-malarial fever, continued 
intermittent and continued remittent 
fever, etc 

The question has long been asked, and 
is still constantly arising, " Is it, can it 
be genuine typhoid fever ?" Opinions 
vary on this subject Without consuming 
your time adducing my reasons for so 
thinking, I assume that it is essentially 
a genuine typhoid fever, modified by 
habits of life, environment, systemic 
poisoning by malarious influences, etc. 

It is not necessary to refer to the 
nature, cause and symptoms of this fever, 
as all are thoroughly conversant with 
them as far as they have been deter- 
mined. 

The symptoms and course of this fever 
were identically the same forty or fifty 
years ago as seen to-day. Any difference 
in the rate of mortality, duration and 
predominance of ataxic and adynamic 
symptoms as seen then, was, I think, 
entirely attributable to the too heroic 
treatment at that time. 

About forty years ago " Wood's Prac- 
tice of Medicine " was the source from 
which most doctors drew their medical 
inspiration. He was one of the chief 
apostles of the antiphlogistic treatment 
of all diseases. This consisted in deplet- 
ing the system by bleeding, mercurial 
salivation, diaphoretics, diuretics, eme- 
tics, blisters, setons, etc. The use of 
these agents, together with cinchona, 
iron, vegetable bitters and turpentine, 
constituted the treatment of the modified 
typhoid fever about that time. Some of 
these remedies were fearfully abused. 
Bleeding was frequently practiced time 
and again, till the patient's lips were as 
pale as his face. Mercury was given in 
immense doses, and if a cure didn't 
speedily follow it was repeated until 
most mischievous salivation was induced. 
So it was with the other remedies used 
in connection with them. 

The very excesses to which this de- 
pleting system was carried naturally in 
the process of time produced a reaction, 
and the pendulum then swung about as 
far in the opposite direction. 

The expectant plan of treating dis- 
eases was next in order, and was the le- 
gitimate fruit arising from excesses in 
antiphlogistics. In this system of treat- 



5» 



THE MEDICAL WORLD. 



merit, doctors merely resolved themselves 
into trained nurses, and stood around 
and waited for nature to do, or fail to do, 
the desired work unaided, or aided only 
by supplying the patient with all the 
food he could possibly assimilate, and 
sometimes much more than was good for 
him. The stuffing process was carried 
still further by using a great abundance 
of stimulants in the form of egg-nog, 
milk punch, whisky straight, spiced 
wines, etc., in place of the depletion 
practiced by the antiphlogistic process. 
The doctor who could concoct the best 
and greatest variety of inviting drinks 
was at a premium. 

I do not now know the rate of mortal- 
ity attending the practice of these sys- 
tems respectively, but I know it was 
high. However, some practical princi- 

f>les, destined to live, were crystallized 
irom each of these radical measures. 

About this time the germ theory of 
disease began to fasten itself on the 
vitals of investigators. The beneficial 
effects of antiseptics, internally as well 
as externally used, were recognized. 
Carbolic acid, salicylic acid, boric acid, 
and their salts, found a much larger field 
of usefulness. Additional virtues were 
discovered in both the bichloride and 
mild chloride of mercury. There was 
found no disease, perhaps, to derive more 
signal benefit from antiseptics adminis- 
tered internally than typhoid fever, 
which was fed, aggravated and kept 
aflame by the anto-toxemia produced 
from septic matters absorbed. 

It was gradually ascertained that by 
the judicious internal use of antiseptics 
intestinal hemorrhage was less frequently 
seen, perforation was very rare, tympan- 
itis was usually absent, delirium and the 
symptoms of adynamia were almost uni- 
formly absent 

Among those general practitioners of 
medicine who confined themselves most 
exclusively to the maintenance of intes- 
tinal antisepsis in the treatment of ty- 
phoid fever, . Dr. Woodbridge, of Ohio, 
seems to have crystallized the most effec- 
tive system. In a paper read before the 
American Medical Association in 1894, 
he made some most startling assertions 
relative to the good results of his treat- 
ment. This claim of curing all his ty- 
phoid fever patients did not strike me as 



very unusual or remarkable, for, strange 
to say, every new treatment that had 
ever been promulgated did about the 
same thing. This was rather to be ex- 
pected. Medical statistics sometimes cut 
some queer capers. Some sarcastic skep- 
tic once remarked that there is nothing 
more uncertain than figures, save, per- 
haps, facts. 

However, as the treatment proposed 
by him was directly in the trend of the 
most modern and universally accepted 
treatment of-so many other diseased con- 
ditions, I found myself ready to test its 
merits, and determined that I would do 
so during the summer and autumn of 
this year. 

This .season has been prolific of an 
abundant crop of continued fevers, as 
well as of purely malarial fevers, in my 
territory, and some of them very malig- 
nant. 

Before making allusion to the cases ot 
typhoid fever treated this season, to 
which I wish to refer later on, I desire 
to emphasize this fact, viz. : The symp- 
toms presented by all our fevers are dur- 
ing the first few days so nearly identical 
that we find it difficult and sometimes 
impossible to differentiate cases of 
typhoid fever from the purely malarial 
forms of fever; consequently, in the 
treatment of all the cases of fever here 
reported they were treated for the first 
three to six days as purely malarial fe- 
vers. This proving futile, the Wood- 
bridge system of intestinal antisepsis was 
then adopted. 

After the commencement of this treat- 
ment, amelioration in all the symptoms 
was apparent in from two to four days in 
every case save one, and a steady and 
speedy progress was made towards re- 
covery. 

From June until the present time my 
son and myself have treated eighteen 
cases of typhoid fever by this method 
without a death, and with an average 
treatment under this plan of eight and 
one-ninth days, at which time all fever 
had subsided and they were dismissed as 
convalescent. These cases were of all 
ages, ranging from infancy to fifty years. 
They presented the usual variety of vio- 
lence, complications and adverse symp- 
toms. One case aborted at the third 
month while unde^the antimalarial treat- 



THE MEDICAL WORLD. 



59 



ment, and through the pig-headed reck- 
lessness of the patient, came near bleed- 
ing to death. Another had a violent 
meningeal complication, and was wildly 
delirious and violent until the Wood- 
bridge treatment had been in use two 
days, when all these symptoms subsided 
gradually and he was dismissed in eleven 
days. 

In all these cases the temperature was 
irregular, and during the first few days 
ranged from normal to 104 and 105 . 
One case was remarkably stupid — slept 
almost constantly. One had a violent 
sore throat, with a curdy form of excre- 
tion, simulating diphtheria. Some cases, 
after obstinately resisting the antima- 
larial treatment and constantly growing 
worse under it, steadily improved under 
the Woodbridge plan until a regular 
periodicity was developed ; then hung 
fire till quinine was freely administered, 
when convalescence was speedily estab- 
lished, although, as before said, these 
same cases had obstinately resisted this 
same treatment at first. 

Two cases of malarious fever not in- 
cluded in the above list were treated from 
the start by this plan on account of their 
not being able to use quinine from a 
family idiosyncrasy, and they were at 
work in five days. 

It was a notable fact in all these cases 
save one, that if subsultus, tympanites, 
delirium, or any adynamic symptoms 
were present prior to the use of the 
Woodbridge plan, they invariably sub- 
sided shortly after its adoption. 

Although epistaxis was frequently seen 
during the early stages, there has not 
been a single instance thus far of intes- 
tinal hemorrhage. 

The patients always seemed to make 
much more rapid improvement when the 
bowels were passing from four to seven 
liquid discharges daily. 

During the treatment any excessively 
high temperature was controlled, either 
by a modification of the Brandt system 
of cold baths when cold applications were 
well borne by the patient, or just a suf- 
ficiency of acetanihd to reduce the tem- 
perature from 103 or more down to 
about ioo° to 101 . This could be done 
without depressing the heart or vital 
forces. The modified Brandt applica- 
tion of cold, above alludecTto^ consists 



in the application of a sheet folded just 
the proper size to co ver the abdomen and 
chest, andTwet withwater at about 8o° 
temperature an d fea frplied every half 
hour. This was covered with a dry 
towel to protect the clot hing. This local 
application of cold can be practiced with- 



out disturbing 



patient, and as it 



covers all the viscgra except the brain, 
it succeeds very effectually in reducing 
the excessiveji$at down to a point com- 
patible with safety within two or three 
hours. But there were some cases who 
shivered and complained dreadfully of 
the cold, especially small children , and 
in those cases the use of the acetanilid, 
as above described, usually acted very 
satisfactorily. 

The Woodbridge plan is a combina- 
tion of purgatives and antiseptics in small 
doses, administered at first at short inter- 
vals, and later on, when the bowels be- 
come quite active, at longer intervals. 
We used exclusively his formula No. 2 
at intervals of one hour at first, and later, 
two hours or three hours. The No. 2 R 
is as follows : 

Podophyllum resin, .... 1-960 gr. 

Mercurous chloride, mild, . i-t6 gr. 

Guaiacol carbonate, . . . 1-4 gr. 

Menthol, 1-16 gr. 

Thymol, 1-16 gr. 

Eucalyptol qs. 

His formulas, four in number, are all 
put up in a very eligible form of tab- 
lets by Parke, Davis & Co., and when 
used, should be washed down with large 
draughts of water. 

In some cases the treatment was con- 
fined to the Woodbridge plan alone, 
aided by proper nourishment. In other 
cases aditional remedies were used, either 
from complications existing or from fail- 
ure of some of the functions to respond 
to that plan alone. 

The diet was of a liquid character al- 
most exclusively, mostly cow's milk, 
with eggs beaten up with it sometimes ; 
at others a small quantity of brandy was 
added. 

• It is not intended to be implied that 
this treatment includes everything which 
might be necessary in all cases of typhoid 
fever, but I would regard it as a very 
valuable combination to be added to the 
doctor's armament in such cases. I think 
the thanks of profession are justly 



6o 



THE MEDICAL WORLD. 



due to Dr. Woodbridge, for his persistent 
efforts to establish the utility of inter- 
nal antisepsis in fevers; the more so, 
since it was done in the face of strong 
opposition in high places. 

Guaiacol alone, of his No. 2 formula, 
has been used very effectually in fevers 
by other physicians, and I had myself 
used salol for its intestinal antiseptic 
properties in the treatment of typhoid 
fever several years previous to the adop- 
tion of the Woodbridge plan. Probably 
this plan may be improved on by further 
observation, but I think the principle of 
intestinal antisepsis has come to stay, not 
only in typhoid fever, but in all other 
anto-toxemias. D. G. Simmons, M.D., 
Adairville, Ky. 

[The most striking expression in 
this interesting paper is, " In all these 
cases the temperature was irregular, 
and during the first few days from 
normal to 104 or 105. " This would 
seem to take them out of the regular 
typhoid category, as the gradual climb 
of temperature from day to day, with 
only about one degree between morn- 
ing and evening, is characteristic of 
typhoid fever. The sudden development 
of from four to seven degrees of tempera- 
ture in twenty-four hours does not belong 
to typhoid as we usually understand it. 
How would it do to always use the 
Woodbridge treatment from the first in 
such cases, either with or without the 
anti-malarial treatment? The two cases 
so treated did well. However, the success 
of the Woodbridge treatment does not con- 
firm a diagnosis of typhoid, as it would be of 
use in any. febrile condition accompanied 
by sepsis in the alimentary tract. — Ed.] 

Resembling Typhoid Fever. 

Editor Medical World :— In accord- 
ance with Dr. Phillips' request (page 430), 
I will report the following cases : Mr. B., 
age 25, American born, worked the first 
part of the summer in a limestone quarry. 
Previous health and habits good. In 
June, while traveling, was taken with 
u cramps," followed by a severe diarrhea. 
After consulting several physicians with- 
out favorable results, he came home, and 
was prescribed for by a long-haired doc- 
tor, and after about one month I was 
called. 

Symptoms: Face presented all the 



symptoms of high fever ; eyes bright 
and glassy ; tongue broad, thick, small 
fissures, white coat with clean center ; 
skin dry, hot, no rash, no petechiae ; ab- 
dominal distention not great ; no gurgles 
or tenderness, except in the epigastric 
region ; stools dark and mixed with 
mucus, no odor, and from eighteen to 
twenty-four per day, which changed in 
about a week to pure bile and mucus. 
Anorexia: Pulse ran from 72 to no, 
and varied with temperature. 

I append temperature chart for two 
weeks after I had taken the case. 
Morning— 104°, 104 , 104 , 103 , 104 , 

103°, 103 , io2#°, 103°, 102 , 102 , 

I02°, IOI°, IOO#°, IOO 5 . 

Evening;— 104^°, 105 , 106 , 105 , 
104 K*, 104 , 103^°, 103 , 103 , 103 , 

I02 #°, I02>^ , I02°, 102°, IOO#°. 

The diarrhea came down to three stools 
a day, and became natural in color and 
consistency, and the temperature reached 
98 #°, and remained three days. He ate 
some canned grapes, and temperature 
reached 104 , where it remained two 
days, when it dropped to 97 in six 
hours. The skin was bathed with trans- 

Eiration, and, despite strychnia and alco- 
ol, continued twelve hours, when I used 
tr. belladonna five drops, then two drops 
every hour till physiological effect was 
shown. This rise occurred three times, 
at intervals of five days. Patient at no 
time had any of the following symptoms: 
Nose-bleed, headache, gurgles, tenderness 
in right iliac region, offensive stools, dry, 
dark, fissured tongue, mental symptoms. 

Case 2. Miss C, aged 16, lived on low 
ground, passed through a light attack of 
typhoid. The following symptoms were 
absent: Mental symptoms, petechiae, 
gurgles ; liad a strawberry tongue. Had 
two slight hemorrhages from the bowels. 

Since writing the above I saw a case 
in consultation with no symptoms of 
typhoid except meteorism, until a severe 
hemorrhage put the physician on his 
guard. Patient had chills every other 
day during this sickness. 

I have taken a great interest in the 
discussion caused by "A Doctor's Wife." 
Will some of the brothers give us an ar- 
ticle on eczema in artificially-fed chil- 
dren? H. A. Saunders. 

Swea City, Iowa. 

[Pew cases of an^iseas^^the 



THE MEDICAL WORLD. 



61 



symptoms present This is particularly 
true of typhoid fever. Some cases spend 
their force chiefly upon the bowels, leav- 
ing the brain and skin comparatively 
free ; in other cases the brain symptoms 
will be most prominent The tempera- 
ture range is the best basis for a diagno- 
sis. If the temperature rises gradually 
from day to day and persists, with only 
about one degree between the evening 
and morning temperature, the case is in 
all probability typhoid.— Ed.] 



Strychnia Poisoning With Recovery. 

Editor Medical World :— Yesterday 
I was called to the police station to 
attend a domestic servant who was 
reported to have taken strychnine. On 
arrival I found the would-be suicide 
composed and calm, and in the presence 
of the inspector of police and wife of the 
sergeant in charge she most solemnly 
stated that she had not taken poison, and 
that her first statement was simply the 
outcome of grief and worry. A most 
careful examination of the house revealed 
no trace of poison of any kind, and it 
being certain that no poison could be 
about without the knowledge of the lady 
of the place or the sergeant in charge, 
and the would-be suicide again affirming 
her statement that she had not taken 
poison, we believed her, and concluded 
that no poison was taken. Twenty min- 
utes after I noticed a peculiar convulsive 
twitching about the face, and again beg- 
ging the unfortunate girl to state the truth, 
shedeclaredshehadtakenstrychnine,that 
she was feeling very ill and was going 
to die. Without further inquiry I gave 
her 5 grs. of tannic acid, and apomor- 
phine hypodermically, loosening the 
clothes about the chest and neck, and 
then ran for assistance. The twitching 
continuing on return, I gave 10 grs. 
chloral hydrate, and was getting the 
stomach pump ready when she rolled off 
the chair, exclaiming she was dying, 
and was in a violent convulsion. She 
slowly rallied from this. There was no 
sign of vomiting. I again determined 
to use the pump and was forcing it down 
when a convulsion came on and I had to 
take it away without doing any service. 
The convulsions were now on fully five 
or seven minutes, increasing in severity, 



when a terrible one seemed to finish 
everything. She was completely cyan- 
osed, reflexes gone, and no evidence of 
life. With the assistance of the nurse 
and inspector of police, artificial respira- 
tion was kept up for ten minutes. Pres- 
sure over the heart, harmonizing with 
its beat was continued until gone. It 
was impossible to get the tongue as the 
mouth was closed so tight. I considered 
her dead, but, lifting her suddenly, 
throwing her on her side, and giving her 
a sharp Mow between the shoulders, I 
determined trying again. Signs of life 
again appearing, the artificial respiration 
was continued, and another 10 grs. of 
chloral hydrate given and continued 
at regular intervals. The convulsions 
continued seven hours. In the intervals 
she was conscious. The last convul- 
sion was very severe and we almost 
despaired of saving her, but it was the 
finish, and from that time the danger 
was over. We had the chest bathed 
nearly all the time with alcohol. It was 
impossible to use the pump. She did 
not vomit for fully five hours. She is 
now fully recovered and sorry she 
deceived lis. 

Moral : Don't believe would-be sui- 
cides. 

Sarsfield Cassidy, M. D. 

Government Medical Officer. 
Adaminaby, New South Wales, Aus. 



Pleasant Chat. 

Editor Medical World : — The Med- 
ical World for January, 1897, is a 
beauty, "so say we all of us." By the 
way, do the brothers realize that this 
year begins the twentieth century ? Ac- 
cording to our best chronology, Christ 
was born four years before the beginning 
of the Christian era ; so that nineteen 
full centuries have already passed since 
His birth, and we are now entering upon 
the twentieth. Shall we rise to the oc- 
casion, and " acquit ourselves like men ?" 
Read, digest and apply the editors 
New Year's greeting, and The World 
will be benefited by the results. Each 
of, us has learned something oi great 
importance during the past year ; send 
the results of your observations to the 
editor for general distribution. 

Let every physician raise his hat when 

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u a doctor's wife " passes. How can we 
ever hope to pay the debt we owe 
to woman ? Of course, sometimes she is 
uncertain, coy and hard to please ; some- 
times she is wrong, but means well. 
However, with all her faults, we love 
her still. 

Many thanks to the editor for his 
manly stand against the rage to prevent 
conception. There can be no excuse 
for deliberate murder, and prevention is 
only a short step removed. Overproduc- 
tion may be an evil ; but to sow broad- 
cast over this country, in its present 
state of morality, alleged means to pre- 
vent it, would be a much greater evil. 
It is a moral wrong to inform the laity. 
Dr. Watt, page 31, strikes the keynote 
of success in practice. Ponder it well. 

I cannot imagine what Dr. Baggart, 
page 3i,qjjeans by speaking of oil of cinna- 
mon u before it is too late." Has he 
been keeping it secret for forty years? 
When I was a child, my mother " kept 
in stock" a jar of oil of cinnamon in 
mutton tallow, and she regarded it as a 
specific for the many cuts, bruises and 
scratches which fell to the lot of the 
numerous children in the neighborhood. 
It is, indeed, a most excellent surgical 
dressing ; also for local use in diphtheria. 
Use simple cerate, alcohol, glycerine, 
fixed oils, or any other desired men- 
struum. In the treatment of the funis, 
apply the ointment and prevent all un- 
pleasant smells. But the principal use of 
the oil is in checking hemorrhages, espe- 
cially post partum, or in too long con- 
tinued menstruation ; also hemorrhages 
from the lungs or kidneys. Five or ten 
drops on sugar, p. r. n., is the usual dose. 
It is a splendid remedy, and, I supposed, 
was generally known. The Editor's 
criticism, that it will not mix in water, 
is all true; but it does the work just the 
same. My practice is to make a tincture 
in alcohol, two drachms to the pint, an«i 
add the tincture to the water. 

I^et Dr. A. L,. D., page 34, use rhus 
aromatica, and he will be able to pay all 
his debts. 

Dr. Brown, page 34, should have de- 
scribed the case in which he wishes to 
use Pulsatilla. Drop doses of the tinc- 
ture every half hour, is too heroic for one 
to use who is not familiar with the action 
of the remedy. I may add that there is 



a great deal of tincture and fluid extract 
of Pulsatilla on the market that is abso- 
lutely inert It should be made from the 
fresh herbs. It has a very positive action 
in diseases of the reproductive organs of 
both sexes. It lesse ns sexua rexcitement, 
but, like hyoscyamus, gives more 
power, by relieving irritation. In orchi- 
tis and ovaritis, its action is decidedly 
marked. It relieves nervou sness, and is 
valuable in spermatorrhea and dysmenor- 
rhea. I add five to ten drops (usually 
five drops), to hal£$iSfyftmce of water, and 
give a teaspoonful every two, four or six 
hours. I use the specific tincture or a 
reliable fluid extract. 

The remarks of Dr. Cline (p. 35), re- 
mind me of a case in my own practice. 
A midwife attended a lady in confine- 
ment, and, in her efforts to remove the 
placenta, tore the funis from its attach - 
.ment to the placenta. I saw the case 
twenty-four hours after. The lady had 
suffered so much from the manipulations 
of the midwife, and was so sore y that she 
would not permit me to use instruments, 
neither would she submit to an anes- 
thetic. I was compelled to leave the 
secundines in the uterus. Her recovery 
was prompt and complete. I gave her 
baptisia, potassium chlorate, potassium 
sulphide, etc., with frequent antiseptic 
vaginal douches. Since then I have 
frequently been compelled to leave por- 
tions of adherent placenta in the womb 
and have never had any trouble with 
them. A country doctor cannot always 
use a curette on account of the objec- 
tions of the patient or husband. 

I^et us all, in our County and State 
Medical Societies, use our influence 
against " the lodge practice evil;" and 
also use our best efforts to work up pub- 
lic opinion in favor of the government 
ownership of express, telegraph, tele- 
phone, etc. When the people demand 
it, it will be done, and the medical pro- 
fession would be a potent factor in the 
work of shaping public opinion. 

Lebanon, Mo. F. A. Rew, M. D. 



Tobacco as a Cause off Epilepsy 

Editor Medical World: — I have a 
case of tobacco habit under treatment, one 
who has used tobacco for thirty-six years. 
Without any cause whatever that can 
be discovered, hereditary, traumatic or 

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otherwise, two years ago epileptic seiz- 
ures developed, and continued. When 
lie came to me, after looking over the 
history of the case, I decided that the 
tobacco habit was sufficient cause, and of 
course that habit must be abandoned be- 
fore a cure could be hoped for. He has 
not tasted tobacco since. He is doing 
well, and. I doubt not, as soon as the 
nervous system is relieved from the ef- 
fects of that tobacco cyclone, he will be 
all right. 

Elkhart, Ind. F. A. Benham. 

[During the war Dr. C. D. Pearson, of 
Indiana, now deceased, made extensive 
investigations concerning the prevalence 
of epilepsy in the various States. He 
was surprised to find it most prevalent 
in the tobacco States, which suggested 
tobacco a possible cause of epilepsy. — 
Ed.] 

Bar Trouble the Cause of Epilepsy.— Acetani- 
lide in Malaria, etc. 

Editor Medical World :— Patient, 
female ; age, eleven years ; of German 
family ; well grown for her age ; of 
healthy appearance ; was subject to epi- 
leptic attacks for three years. First 
attack occurred while at school ; no 
known cause for same, as the girl was of 
good health previously. Second attack 
came on one week after the first, and for 
several months she had those fits at reg- 
ular intervals of seven days. Then they 
came on twice a week for five or six 
months. During that period attacks oc- 
curred always during the day, mostly in 
the afternoon ; finally they occurred daily, 
or rather nightly, shortly after going to 
bed. About the time she would fall 
asleep she would start with a shriek, 
body bending backwards, legs and arms 
jerking ana stiffening, frothing at the 
mouth, etc. After fifteen or twenty min- 
utes she would relax, begin to sob, and 
fall asleep with no disturbance any 
more for that night. Complained of 
nothing in the morning except a little 
nervousness ; no pain or distress any- 
where. 

Received treatment for two years from 
two of the best physicians in my neigh- 
borhood ; no results. Parents were finally 
told that nothing more could be done for 
the present, and that the girl would get 
all right as soon as her menses would 



excuse, when one comes to the end of 
his string ; but a very poor excuse.) So 
the treatment was discontinued for nearly 
one year. 

Had her " fit " every evening, but slept 
well after ; went to school in day time, 
and assisted in housework, never com- 
plaining of anything. Was as usual 
until last spring, when I was consulted 
for an earache which she suddenly com- 
plained of. After soothing applications, 
the ear would begin to discharge pro- 
fusely, yellow and green pus mixed, for 
about nine or ten days, when, after 
repeated antiseptic douches, the ear got 
well, with hearing unimpaired, as before. 
Strange to say, since that night, when 
that earache came on, till this day, she 
ha£ never had another epileptic attack. 
Now, was the sole cause for the epilepsy 
to be found in that ear? And why did 
she never complain of any trouble there 
before ? 

As to acetanilid in malaria, I think 
Dr. Broadnax is on the right track. 
Giving it, as he does, together with his 
14 acid iron tonic," it does splendid work. 
Have had recently three cases of ma- 
arial fever, one ot the quotidian, the 
other two of the tertian type. All three 
had taken quinine with purgatives very 
freely for several days, but chills would 
return faithfully. The first two cases 
were in the hands of a neighboring 
physician for five days, when I was called 
in his place. Acetanilid grs. v, plus capsi- 
cum grs. J^, given about one hour before 
the chill was due, one other dose in aboi^t 
one hour, then during the day the acid 
iron tonic only, has cured those three 
cases promptly, much to the chagrin of 
my neighbor. I prefer the capsicum to 
strychnia, in combination with acetan- 
ilid, in malarial complaints. But I 
would not abandon quinine altogether, 
for there are cases of malaria where it is 
the remedy par excellence. 

It is quite a significant fact in medical 
progress (or pessimism — which ?), to see 
some of the best men in our profession 
declare war against many of the time- 
tried weapons in medicine, without 
which no regular practitioner could have 
practiced only ten or fifteen years ago — 
weapons such as alcohol, opium, quinine, 
ergot, pot iodide, etc. Is it because they 
were powerful agents for evil, as well as 



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appear. ( By the way, a very common 
good, that they should be displaced by 
other more harmless remedies that are 
more pleasant to the eye and taste, "and 
will do no harm if they do no good?" 
That would be a nice thing, indeed, 
for the mentally lazy and inexperienced 
in our ranks, and would considerably 
reduce the possibility of being "doc- 
tored to death." It is such a nice thing, 
and simple, too, to prescribe antikam- 
mia, bromidia, sanmetto, tongaline and 
other numerous creations of the modern 
pharmacist that will promise anything 
and everything in the way of cure. But 
let us stop occasionally, and compare 
results in a general way. Are the advo- 
cates of these new things really latisfied 
with them ? Is it not amusing to see 
some of them, after a succession of 
"wonderful cures," fall back on just a 
wee bit of opium, quinine or calomel ? 
It is not long ago since I wrote an arti- 
ticle for this journal on ergot in obstet- 
rics, having found a wonderful substi- 
tute for the same, which answered well 
in many cases, but worked havoc in a 
recent case of mine. 

Ergot stopped a severe post partum 
hemorrhage for my patient, after I had 
exhausted, and I say it reluctantly, all 
other means at my command. Now I 
hear Dr. Broadnax laugh out loud. But 
never mind ; my patient is alive and 
well. 

As to that inquiry in the January 
World for an excitant of the animal 
passions, The World Editor has given 
most excellent advice. I do not wish to 
improve upon it, but only wish to add 
that to give excitants to "played out" 
sinners is a most vicious practice, and 
can only result in great harm. Does the 
inquirer know anything of pathology ? 
If so, why does he want to chase out the 
last spark of life and vitality that yet 
remain in such patients? 

To give aphrodisiacs in such cases is 
like whipping a tired horse to death. 
Does the whip impart strength to a tired 
animal, or does it cause only one last 
desperate effort, before the beast breaks 
down altogether? Yes, good food, good 
morals and good hygienics will redeem 
such patients, if anything will ; this I 
can say from experience. 

As to those admirable monthly talks 



by the Editor, I shall have them re- 
printed in our county paper shortly. 

Lorton, Neb. Dr. Mayer. 

[The " creations of the modern phar- 
macist " do not claim to entirely do away 
with such standard drugs as opium, 
quinine and calomel. All of these things 
have their proper place and uses. No 
doctor would think of trying to do with- 
out opium, quinine and calomel ; neither 
ought he to neglect the " creations of 
the modern pharmacist." — Ed.] 



Ca*es of Puerperal Eclampsia. 

Editor Medical World : — During 
1896 I have attended over 50 full-term 
labors, and have had two cases of puer- 
peral convulsions, one in which the con- 
vulsions began after delivery, and one in 
which they began before and ended with 
delivery. With the permission of our 
ever kind and humanitarian editor, I will 
report the indicationsand management ol 
both, which perchance may meet some 
country doctor's eye, and be his beacon 
light when no other help is to be had. 

Mrs. C, aged 27, white, primipara, 
lived a distance of eight miles from me, 
and I had never seen her before. I ar- 
rived in answer to a summons at about 
5 P. M. on the evening of the 25th of 
July, and found that the baby had ar- 
rived something like an hour before I 
did, though the cord had not been cut 
nor tied. This I proceeded to do, and 
then delivered the placenta with less 
than the usual amount of hemorrhage, 
I noticed that her face was somewhat 
swollen, and, on examination, I found 
her lower extremities badly swollen. She 
had been suffering from headache for 
several days, and was still suffering from it. 
Her pulse was about 96, full and bound- 
ing, with every other beat less distinct 

I immediately gave her 20 grs. chloral 
hydrate, and when I left she was feeling 
better and inclined to sleep. I told her 
husband that I feared convulsions, and 
if her head continued to pain her much 
to give her 15 grs. of chloral every hour 
till two more doses were given, or till 
her head was relieved, and then give not 
oftener than four hours, or as indicated 
by the head symptoms. I also instructed 
him to give her a gopd d gsep f s^lts next 
morning, as he r bow els w ere cons '* 
Soon after I had left, of in about 2]4 

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hours after the baby was born and after 
she had taker 35 grs. of chloral, she had 
a convulsion, and continued to have them 
at the rate of about every 20 minutes till I 
arrived at midnight and found her uncon- 
scious, having had eleven, and being in 
such a profound stupor that it was impos- 
sible to give her anything by the stomach. 
Before I had examined her pulse a con- 
vulsion came on (at 12) and another at 
ia. 20 a. m. and 1.05 and 2.40 and 4.30 
a. m., making in all 17 convulsions. I 
immediately gave % gr. sulp. morphia 
1-100 sulp. atropia hypodermically, and 
followed this by 20 grs. chloral dissolved 
in two teaspoonfuls of warm water, given 
the same way ; and, as she had another 
convnlsion 2.40 A. M., I gave 16 grs. 
more of chloral and ]/i gr. morphia and 
1-200 gr. atropia. I now felt that I had 
about all the medicine in that I could 
risk, and, as the convulsions, though 
farther apart, were harder, I tried the 
old standby of our forefathers, viz., 
bleeding, just after she had the last con- 
vulsion at 4.30, taking about two pints 
of blood from a vei n at the elbow. I 
remained with her till 8 o'clock a. m., 
and, as she showed no further indica- 
tions of convulsions, as a precautionary 
measure, I gave another hypodermic of 
% gr. sulp*jnorphia and i-iQO_gr. sulp. 
atropia. She remained unconscious till 
the next day, a while before I saw her, 
when she gradually became rational, but 
was never able to remember anything that 
happened the day her babe was born. I 
must not fail to mention also that during 
all the time before I bled her I was en- 
deavoring by the use of chloroform to 
stop or mitigate the severityof her par- 
oxysms. To show that she was par- 
ticularly susceptible to the influence 
which produced convulsions, I will say 
that when a child she had chorea, and 
has had in the last three years three 
epileptic seizures. Her father is an 
epileptic of several years' standing, and 
she has a sister that is an epileptic. So 
it will be readily observed that the neu- 
rotic tendency is great. 

Case 2. Mrs. S., aged 17, colored, 
primipara, had had seven convulsions 
when I arrived, and was supposed to be 
about eight months pregnant, and was 
semi-conscious. Convulsions were about 
30 minutes apart. I made an examina- 



tion, and found vertex presenting and 
the os dilatable. I gave ten drops of tr. 
yeratrum and % gr. morpfiia s"urp., 1-100 
gr. sulp. atropia; and" tried to stimulate 
contractions by digital irritation of the os 
uteri, which I succeeded to some extent 
in doing. After an hour, and seeing her 
have two convulsions, I determined to 
use forceps, which I did without a great 
deal of difficulty, delivering her in half 
an hour of a living but very delicate baby, 
which died in a few hours. The woman 
never had another convulsion, and made 
a speedy recovery. 

I have been practicing ten years, and 
have had five cases, all of which recov- 
ered, two of them beginning before de* 
livery and three after delivery. 

I have used m orphin e and atropia in 
all of the cases, pilocarpine in some, 
bleeding in pne , where I felt sure it did 
more good than all the remedies I had 
used before combined ; chloral hydrate 
hypodermically in all the cases where 
unconsciousness rendered it impossible to 
give it by the mouth ; rfrlnroform i n all 
th e cas es, and veratrumjn some. T """""~ 

rain perfectly sure that this is a dis- 
ease in which many remedies are useful, 
and that it will not do to pin our faith to 
any one line of treatment. The indica- 
tions are such as to justify heroic doses 
and measures, and we should not hesitate 
to use them ; always, however, keeping 
safely within bounds of reason, and not 
doing more harm by medicine to control 
convulsions than they would have done 
themselves. From my experience, when 
there is a full, bounding pulse, I would 
not rely long on other remedies before I 
resorted to blood-letting, which, like all 
the other remedies, has its indications 
and limitations. I am fully aware of the 
fact that some may criticise the use of 
chloral hypodermically, and say that it . 
should be used by the rectum. To these 
I would say that we can always be sure 
of what we are doing when we give it 
hypodermically, and a sore arm amounts 
to little when life is at stake. 

G. G. Thornton, M. D, 

Gravel Switch, Ky. 

[Would it not have been well, in the 
first case, to have emptied the bowels 
immediately by enema, and given the 
" good dose of salts " without delay ? — 
Ed "I - ~ 

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Puerperal Eclampsia 

Editor Medical World : — I have 
lately had what was to me a very inter- 
esting obstetric case. It seemed that 
. from the beginning of the pregnancy, 
which was her first (her age was about 
thirty) the stomach derangement and 
other disagreeable symptoms were un- 
usually severe. At about seven months 
I was sent for, the messenger saying they 
thought she was in labor. I found her 
suffering extremely with cramping pains 
in the stomach, sometimes extending to 
other portions of the body. The most 
powerful sedatives seemed to have no 
effect, except for the time she would be 
in a stupor from their effect. An exami- 
nation found the anterior lower portion 
ot the uterus displaced downward, the 
cervix high up, very small, elongated 
and displaced so that it lay against the 
left side of the pelvis. No opening in it 
that I could discover. Examination ot 
the urine found it about ten per cent 
albumen. I thought the trouble was in 
part due to uremic poisoning, and in part 
due to the uterine displacement and 
closure of the cervical canal. She im- 
proved after twenty-four hours so I could 
leave. By taking a course of blue mass 
and ipecac in small doses at intervals of 
a few days, and Hayden's viburnum 
compound continually, she got along 
without many serious symptoms till 
about two weeks before her expected 
confinement, when I was sent for, the 
messenger saying she was in labor and 
having fits. I found her with the same 
cramping, etc., as two months before, 
with the addition that the spasm ex- 
tended to all parts of the body, the 
patient becoming insensible. Purga- 
tives, diuretics and sedatives were liber- 
ally used, the first having all the effect 
desired, the sedatives none. After forty- 
eight hours, ergot and gossyppium were 
administered, which in twenty-four hours 
had the effect of lowering the uteris till 
it was easier to reach the cervix. After 
long effort I forced my finger into the 
cervix, finding the first half of the canal 
very tight. After forcing my finger 
through it, proving to me that it had 
been closed by adhesive inflammation, I 
continued the effort till the os was di- 
lated to the size of a quarter, and the 
presentation diagnosed. After the dila- 



tation there was not another convulsion. 
The labor was not completed till thirty 
hours afterward, owing to inefficient 
pains, and not being allowed by the 
family to use forceps. The child, 
though small, was well formed and liv- 
ing. The recovery of the mother was 
uneventful. Of course, many things 
were tried from first to last besides the 
drugs mentioned, but these are what 
seemed to do most good. Venesection 
made the convulsions more mild, but 
did not stop them. If any of the brethren 
have any criticisms to offer, I will be 
glad to hear from them. 
Tenn. C 

[Adhesive inflammation of the os uteri 
very rarely occurs. If the convulsions 
had not occurred, and the case gone to 
full term, it is not likely that anything 
unusual would have been noticed about 
the os. To bring on labor as you did 
was proper. At that stage of pregnancy 
the os is, and should be, very firmly con- 
tracted. Application of belladonna oint- 
ment would have aided in the dilatation. 
We consulted Dr. W. S. Stewart, ex- 
prof, of obstetrics in the Medico-Chi- 
rurgical College, about this case, and 
he says he has found that one dram of 
chloral injected into the rectum will 
control the convulsions one hour and a 
halfL He controls puerperal convulsions 
in this way, and also by giving chloral 
by mouth, when the patient can swallow, 
and chloroform by ihhalation. For 
album inuria' du ring pregnancy he gives 
Bashanrs mixture, salines and chloral at 
night, irnecessaxyjo produce sleep, and it 
also tends toward off convulsions. — Ed.] 



Cerebral Hemorrhage. 

Editor Medical World:— V. B. P., 
Company U H," 55th Regiment, O. V. 
Inft, age 54 years. 

Had been in good health until about 
9 A. M., December 27, 1896, when he 
expressed himself as not being very well. 
In a short time he went to his room and 
lay down upon his bed. At noon he said 
that " he did not care for any dinner, so 
would keep quiet where he was." 

About half an hour later, when his 
room-mates returned, they found him 
lying upon the floor in a half conscious 
condition. 

I was immediately summoned, and 



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67 



found patient's pulse no, weak and 
irregular ; respiration 24 ; temperature 
99 F.; head turned toward the right 
side; eyes also turned toward the right, 
and pupils dilated ; left side of face 
flabby, and mouth very much distorted, 
with inability to protrude the tongue. 
The left hand and arm were completely 
paralyzed ; the left leg and foot partially 
so. 

He was immediately removed to the 
hospital, and hot- water bags were placed 
to his f^et, legs and s ides , and an ice cap 
to his head. He was then given fluia 
extract oFergot, o ne-ha lf dr. with sodium 
bromid e grs. x , everyTwo hours. 

At five p. fla., patient was delirious and 
talked incessantly, though the greater 
part was unintelligible ; the paralysis had 
advanced until there was complete left 
hemiplegia ; the other symptoms were 
about as when taken before. 

At nine p. m., patient was quiet and 
had been sleeping about one hour. 
Directions were given to continue hot 
water and ice, though not to awaken 
patient tojjiye medicine. 

At nine o'clock the next morning I 
was much surprised to find my patient 
walking about the ward, the only re- 
maining symptoms of the previous trou- 
ble being a marked weakness of the leg 
and arm, and a partial paralysis of the 
tongue and face. 

Paralysis of various forms is a common 
affection among the inmates of this insti- 
tution, but this is the first case on our 
records where a man has so completely 
recovered, in one night 

The man has always been sober, indus- 
trious and not addicted to any excesses. 
W. D. Burnham, Ass't Surg., 
Ohio Soldiers' and Sailors' Home. 

Sandusky, O. 

Dropsy Cured by Salivation. 

Editor Medical World :— I attended 
a negro woman for la grippe two years 
ago. After recovery sne was attacked 
with what I thought was heart trouble — 
shortness of breath, with feet and legs 
swelling up to above the knees. I put 
her on the usual remedies for the heart 
— calomels-di gitalis, e tc. She continued 
to grow worse every week, until she 
could not lie down day or night. After 
reading an article in some journal I put 



her on small doses of calomel for three 
days. I told her *atx5ut her eating, but 
she drank some sour milk, by which she 
was terribly salivated ; tongue swelled so 
she could scarcely speak or swallow. I 
put her on Fgwler's solution of arsenic, 
five or six drqpsTlhree times daily. She 
soon recovereafrom the salivation, and 
was entirely relieved from all trouble, 
and has been well ever since. 

Link, S. C. W. E. Link. 

[The heart was not the cause of - the 
trouble, except that a weakened action 
might have contributed to the dropsy. 
Either the kidneys or a fault of assimi- 
lation was the cause. The calomel, by 
its action on the liver, or in some other 
way (we do not yet understand the won- 
derful action of mercurials), corrected 
the fault of assimilation, and the case 
was. cured. This case illustrates the 
fact that, in the olden days, mercuriali- 
zation really did some wonderful things, 
but also some terrible things. If we 
were able to discriminate, and use this 
powerful weapon for good, and not for 
harm, we would be better off. Kidney 
trouble rarely irises per se. It is usually 
caused by the kidney being compelled 
to excrete substances not normal to its 
function. Back of this, then, lies a 
difficulty of assimilation — the real 
difficulty. Many cures of so-called kid- 
ney trouble are cures of the cause re- 
mote from the kidneys, relieving the 
kidneys of their extra and abnormal 
work, and, presto, the kidney trouble 
vanishes, provided no structural damage 
has been done by the extra and abnormal 
work. I hope we will understand these 
things better some time. — Ed.] 

War on Diploma mils. 

Editor Medical World : — I would 
like to express my appreciation of Dr. 
Mayer's righteous indignation expressed 
against a certain diploma mill. I am 
with the doctor heartily. I have no 
use for diploma mills or their product. I 
hope the doctor has no particular spite at 
this particular "mill," so that he can be 
liberal and broad-minded enough to in- 
clude the more pretentious "mills" 
in his sweeping denunciations. The 
country is surfeited with these " mills" 
masquerading under the pretensions of 
being first-class medical colleges, and 



68 



THE MEDICAL WORLD 



filled with half-baked M. D.'s, whose 
only recommendation or evidence of 
ability to treat disease successfully is 
their diploma. True, it costs a mint of 
money to get one of their diplomas, but 
the cost of a diploma is no index to the 
ability of its possessor. The best way to 
down all such diploma mills is to esti- 
mate all diplomas at their true value. In- 
stead of teaching the public the untruth 
that a diploma is a sure index of profes- 
sional ability, teach that the moral char- 
acter of the man is the most important 
thing for them to consider ; that a man, 
dishonest in any other line of business, 
is more than likely to be dishonest in the 
practice of medicine. Teach the great 
truth that the medico-political lobbyists 
of some States have by false pretenses in- 
duced some State Legislatures to place fic- 
titious values upon the diplomas from the 
"recognized" medical trust colleges. 
Teach them that, if possible, State ex- 
amining boards are worse tfcan diploma 
mills ;' that Dr. Alexander Wilder and 
hosts of other men high in professional 
ranks are unalterably opposed to medical 
legislation, and believe that the best in- 
terest of medical science would be ad- 
vanced by the repeal of all such legisla- 
tion; that medical legislation is tyr- 
anny intensified, un-American, unconsti- 
tutional, and class legislation of the 
most sinister kind. If the general pub- 
lic was once set right on this matter, 
Fred Rutland's diplomas would not sell 
for a dollar apiece, and would be worth 
less than that to their owners. Nor is 
that all ; a great many of the more pre- 
tentious "mills," if they did not lean 
upon the strong arm of the law for ex- 
istence and students, would soon become 
more practical in their methods and 
teachings — a "consummation devoutly 
to be wished." 

Does Dr. Mayer know anything about 
the history of medical legislation in Ne- 
braska and the organization of the two 
medical colleges in that State, one of 
which has for its dean and lecturer on 
the theory and practice of medicine a 
young man twenty- four years of age and 
less than two years' practical experience ? 
If he does, I hope he will write it up for 
the readers of The World. It would 
be interesting reading. The doctor 
might also tell how these same profes- 



sors (?) obtained a decision from the 
State Supreme Court compelling a 
physician licensed in Nebraska, but re- 
moved from the State, to again gradu- 
ate from the State medical examining 
board before he could resume practice 
in that State. 

In Br ice's "American Commonwealth' 7 
we find that the liberty to practice medi- 
cine is practically unrestricted in Eng- 
land. The only restriction being that 
none but registered physicians can col- 
lect their bills by legal process, or hold 
office by appointment under the govern- 
ment. Under the more despotic State 
government of Washington and some 
other States any person may practice 
medicine, but he may be subject to a 
fine and imprisonment for taking a fee 
for his medical services. Granny Good 
might save life where Dr. Drunk would 
be almost sure to kill ; yet for taking a 
fee for her kind offices Granny could be 
fined and imprisoned, while the law 
would enable the Doctor to collect a fee. 
It is a disgrace to American manhood 
that any person under the stars and 
stripes can be legally punished for taking 
pay for any act that results in good and 
good only. " The laborer is worthy of 
his hire " when he does his work well, 
is a principle ignored by medical legisla- 
tion. I believe in placing responsibility 
where it belongs, and nowhere else. 

Two years ago a farmer came for me 
in the middle of a cold, stormy night, 
asking that I come as quickly as possi- 
ble to attend his wife in confinement 
Being badly indisposed, threatened, as I 
thought, with peritonitis, I insisted that 
he get some one else. The man began to 
cry and exclaimed: "What shall I do ? It's 
twenty miles to Colfax, and before I can 
go there and back my wife will be dead." 
" Well," said I, " can't you get Mrs. B.? 
She can do as well as a doctor, if every- 
thing is all right" u Mrs. B. is there 
already," was the reply, "and an arm is 
born and she can't get it back ! " I went, 
and found an arm and funis extended 
from the vuvla. There were no pulsa- 
tions in the chord. I performed podalic 
version, and delivered. In forty minutes 
from the time I entered the house the 
woman was resting well, happy and 
thankful for what I had done for her. 
In the morning the husband, having 

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69 



business in town, rode with me six miles. 
He said " There ought to be a law to 
keep old women from taking such cases ;' * 
and if his wife had died Mrs. B. would 
have been responsible. " No, sir," said 
I, "that's a mistake; if ypur wife 
had died no one but yourself and possi- 
bly herself would have been responsible. 
Mrs. B. took the case at your request 
with the distinct understanding that she 
could * get along ' if everything was all 
right If everything was not all right 
you were to get a doctor, and if you de- 
layed too long the responsibility would 
be yours." Well, he had not thought 
about it that way before. In this coun- 
try of u magnificent distances " there are 
many cases of confinement where it is 
simply impossible to get a physician ; 
and I am glad there are some women in 
each community who can take charge of 
such cases. I believe that every woman 
should know what to do, and how to do 
it, in this class of emergencies. I have 
no quarrel with the mid wives. One of 
them who has, in her time, probably at- 
tended more cases of confinement than I 
have,made the remark that " since Dr. L. 
came to St. John's I haven't as much con- 
fidence in myself as I used to have ; he 
is a wonderful revelation to me." 

Let Dr. Mayer carry the war against 
the " diploma mills" into Egypt I 
will be with him under the shadow of 
the pyramids. J . W. Lockhart. 

St John, Wash. 

[Doctor, your communication is honest, 
earnest, and interesting ; but, you know, 
in these pages we meet for friendly inter- 
change of views, although we may not 
always agree. On the general proposi- 
tion, we believe in certain legal require- 
ments for those who wish to practice 
medicine. We agree with the sentiments 
and favor the plan given by Dr. R. S. 
Sutton in The World for last April. 
Intelligent and safe medical practice re- 
quires certain knowledge. A person 
practicing without this knowledge is a 
danger to the community. The law in 
most States requires that a pharmacist 
who dispenses poisons shall have certain 
qualifications, that he may be able to 
practice so dangerous a calling without 
undue risk to the lives of his patrons. 
And how about the doctor who orders 
these poisons ? Should he not also be 



required to have certain qualifications ? 
A pilot must know his business before 
he is permitted to take into his hands the 
lives of crew and passengers. Many 
other instances could be given. Now, 
the question is, who is to judge of the 
proper qualifications of pharmacist, phy- 
sician, pilot, etc. ? A person who stops 
in at a drug-store to make a purchase 
cannot go into the merits of the drug- 
gist's qualifications. Passengers upon a 
boat cannot judge as to the qualifications 
of the pilot to steer the boat safely to its 
destination . These things must be done 
by law. This is necessary for the safety 
of the public It is not a question of 
trusts or monopolies, except as certain 
States may abuse this necessity. To in- 
sure public safety, a pharmacist must be 
judged by his peers in order to decide his 
fitness to practice pharmacy ; so with the 
pilot, and those of many other callings 
involving risk and danger to the publie ; 
and these things must be done by law. 
We do not see why those who presume 
to be able to practice medicine should be 
excused from giving some evidence ot 
their qualifications for so responsible a 
calling. — Ed.] 



Wisconsin Diploma Mill Again. 

Editor Medical World: — About two 
years ago I received papers from an Eclec- 
tic institution or society, of Milwaukee, 
Wis., stating that diplomas would be 
issued by above-mentioned body without 
attending a college course. 

I threw the circular in the stove, after 
showing it to my son, a student in phar- 
macy, who laughed at the easy way 
to be made a doctor in the State of 
Wisconsin. But for my son's mock- 
ing the idea of issuing such diplomas 
I would have forgotten the matter by 
this time. 

To make the entire humbug (sanc- 
tioned by law) clear to my brethren of 
The World's family, I will give them 
to know what a great power medical so- 
cieties have in our State, and whether 
used for good or evil depends on the cen- 
sors of such societies. 

Medical societies are empowered to 
issue diplomas by Section 1,425, Revised 
Statutes. It gives power to the censors 
to grant a diploma to any whom they 

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THE MEDICAL WORLD. 



may deem worthy after an examination, 
and receive a fee of $10. Of course 
the examination may be whatever the 
censors choose to make it It all de- 
pends on the censors. 

J. A. Muenich, M. D. 
Jefferson, Wis. 



The Physician's Relations to the General 
Public. 

Editor Medical World: — As con- 
servators and guardians of the physical 
well-being of humanity in general, we 
are called upon to expound the laws of 
health. We must, therefore, of necessity 
be promoters of the cause of temperance 
as well as instructors of the laws of sani- 
tation and hygiene. To do this with 
success and credit, it is necessary that 
we receive a proper professional educa- 
tion, and a thorough training to fit us 
for our life work. 

As medical advisers, we become in- 
trusted with secrets that are of the most 
sacred nature. We are likewise sub- 
jected to greater temptations than 
most men, and our opportunities of 
wrong-doing are many. As a class, 
however, we are worthy of the great 
trusts reposed in us. 

How often are we called upon to treat 
the poor who cannot pay us for our ser- 
vices ! From time to time we are called 
upon to rise from our beds, facing the 
inclemencies of the weather, to attend 
some sick and suffering patient, with no 
expectations of pay or reward other than 
the consciousness of doing good. 

During the prevalence of epidemics, 
we stand-like Moses, between the people 
and the plague, risking and very often 
sacrificing our lives in their behalf. 

If we examine the records of our 
surrogates' offices in our principal cities, 
how few names do we find there of phy- 
sicians. One of the causes for this state 
of aftairs is, that we are denied what 
are called business methods. We cannot 
advertise our business as the merchant 
and tradesman do. We cannot claim 
greater advantages to be obtained by 
treatment received from us over that 
obtained from others. Neither can we 
claim to treat disease and administer 
medicine c * below cost ' ' 

As a rule, we are poor business men. 
We do not use proper diligence and 



method in obtaining a just remuneration 
for services rendeied. 

Our profession is a peculiar one, re- 
quiring great technical skill and ripe 
judgment. This technical knowledge 
and skill cannot be made available out- 
side of the profession ; yet quacks and 
charlatans are oftentimes far better re- 
munerated than the highly educated and 
qualified physician. This is due largely 
to the ignorance of the public in regard 
to medical subjects in general. The one 
who elbows his way to the front has an 
advantage over the one who patiently 
waits to be called there. 

Another reason why the physician 
does not meet with the recognition he 
deserves, nor is protected in the pursuit of 
his calling as other professional men are, 
is that he, as a rule, takes no active part 
in political affairs. He has patients from 
all parties, possessing various shades oi 
opinions. Besides this, his professional 
work calls for the utmost exertion of his 
abilities, so that he ordinarliy finds him- 
self unable to pay the proper attention to 
political subjects. 

The clergyman can preach politics 
from the pulpit, and take an active part 
in political work, and he is applauded 
for so doing. The religious journals are 
mainly supported, financially, by adver- 
tisements of quacks and charlatans, to 
the injury of the public in general, and 
certainly not to the advantage of the 
medical profession. If our medical 
journals were to admit into their adver- 
tising columns the advertisements antag- 
onizing and opposing the moral and 
religious efforts of the clerical profession, 
their papers would be filled with denun- 
ciations, and their pulpits would resound 
with anthemas against our profession. 

Seeing we occupy professionally such 
a unique position before the public, the 
question arises, ought we not to occupy 
a privileged position in society, and be 
accorded special privileges? Should we 
not also be protected from invasion of 
our rights from without ? Again, should 
we not be consulted, and our advice 
taken through our representatives, the 
medical societies, on all subjects relating 
to the general health and physical well- 
being of our communities ? 

Doubtless, if the profession in general 
would take more interest in % political 

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affairs, much more good would accrue to 
the communities. 

In conclusion : 

Let us in the future take more interest 
in political affairs. 

Consider what is best to be done with 
our habitual criminal class. Shall we 
continue to imprison them at a great 
expense to the communities, and no 
resulting abatement of crime, but rather 
the reverse ? 

Shall we continue to found in our 
State prisons, colleges of crime for. the 
graduation of perfected criminals ? 

Shall we consent to our perfected 
criminals marrying, and through their 
potentiality, giving birth to inherited 
tendencies to crime? I^et us consider 
our responsibilities, and so act that in 
the future we will have no cause for 
regret for unfulfilled duties. 

A. T. Cuzner, M. D. 

Gilmore, Fla. 



Relief by Suggestion. 

Editor Medical World:— The Lan- 
cet for November 25th contains an article 
giving the details of a case wherein an 
14 obstinate case of vomiting of pregnancy 
was cured by the application of elec- 
tricity, but it was discovered that the 
battery was not in working order at the 
time the electrodes were applied, so that 
it was purely by suggestion that the re- 
sult was accomplished." This case re- 
minds me of one which occurred in my 
own practice some three or four years 
ago. I was called hurriedly to see a 
patient, and upon arriving at the house 
was ushered into an up-stairs room, 
where I found a man rather beyond mid- 
dle age, who was rolling and tossing 
about on the bed in a perfect frenzy. He 
was crying and praying, and altogether 
appeared to be suffering terribly. I in- 
quired of the attendant (his wife) the 
cause of the trouble, and received a 
rather disjointed history of a wound re- 
ceived in the army, a bullet having 
lodged in the region of the left kidney, 
and still remaining there. She stated 
that he had several times complained 
just as he was doing at this time, but 
was always relieved by a hypodermic in- 
jection of morphin. 

I forthwith prepared my hypodermic 
for an injection of % gr. of the sulph. 



of morphin, and '150 of atropin, of 
which I had only one tablet remaining 
in my case ; but imagine my discom- 
fiture when I found the washer on the 
plunger had shrunken so that it could 
not be given. Not to be outdone by so 
small a thing as this, I caught up the 
skin between my thumb and finger, and 
inserting the needle, I pretended to in- 
ject the solution. I told him he would 
soon be relieved, and it was not two min- 
utes until he told me that he felt the 
medicine " going all over him," and in 
five minutes he declared the pain was 
entirely gone. 

I relate this because I feel confident 
that there are many cases where sugges- 
tion will relieve a patient, and I believe, 
often effect a cure. 

I will state, however, that before leav- 
ing this patient I stepped over to the 
druggist opposite and supplied myself 
with the necessary tablets, etc., and gave 
him the "second" injection. I called 
the next morning and found there had 
been no return of the trouble. 

J. S. Bennett, M. D. 

Todd's Point, Ky. 

[Why was the u second," the real in- 
jection, given if the suggestion had 
worked so nicely, and the patient free 
from pain? It seems probable that this 
patient was suffering from the passage of 
a calculus through the ureter, from the 
kidney to the bladder. This is suggested • 
by the location of the pain, the " frenzy* ' 
of pain, the patient rolling and tossing 
about, its sudden cessation, and the fact 
that it had occurred-before. It is likely to 
occur again unless the urine is examined 
and proper treatment instituted. — Ed.] 

A Trial of Antitoxin in Diphtheria. 

Editor Medical World: — In noting 
the pros and cons in the discussion of the 
use of antitoxin by the contributors of 
The World, it seems to me that there 
is a tendency on the part of some mem- 
bers of the profession to decide the ques- 
tion in their own minds, and then to 
make subsequent tests from the stand- 
point of their preconceived opinion. My 
preconceived opinion was that the anti- 
toxin furor was probably another fake in 
the interests of the pocketbook of the 
promoters, similar to several of the great 
(?) discoveries of which we are informed 

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THE MEDICAL WORLD. 



from time to time. But as most all of 
my diphtheria patients in whom laryn- 
geal symptoms developed seemed to gain 
little benefit from the usual endorsed 
treatment, I tried antitoxin, and tested 
it so far as my ability and limited num- 
ber of cases permitted. 

Between November 20 and Decem- 
ber 31, 1896, I treated 32 cases of 
diphtheria, 23 of which were of a type 
of enough severity to render the diagnosis 
beyond question. Of these 23 cases I 
wish to submit my report. They ranged 
in age from six weeks to 36 years, two 
being over 12 years of age and nine 
being two years of age or younger. 
Thirteen had the laryngeal complication 
with severity, and seven of the 13 were 
not seen until after the third day. 

One case only of the 23 died, and that 
one was beyond help when first seen, 
dying in six hours from the time of first 
visit 

Antitoxin was used in these cases in 
doses of from 500 to 1 ,000 units repeated 
when necessary in from eight to 24 hours, 
and in connection with the usual 
orthodox bichloride, per oxide, treat- 
ment. 

One patient developed a rash over the 
back of the trunk ; none had any of the 
other bad effects generally reported to 
follow the use of antitoxin. 

In three cases part of the antitoxin 
was injected hypodennically, and part 
was swallowed ; and so far as could be 
determined, when swallowed a larger 
dose was required, but the result other- 
wise was the same. - 

I gave no minimizing doses and 
regard the reports concerning them as 
not indicative of result, the proportion 
of population in a community contract- 
ing the disease being so small. Very 
few cases injected in the first and second 
days prove fatal, and it is hardly fair for 
a physician to put the whole community 
to the expense of minimization when 
he knows that the danger is so small. 

From the above experience, antitoxin 
is regarded by the writer as safe and 
w6rthy of confidence and fair trial. I 
do not believe it will cure every case, 
raise the dead or prevent errors of judg- 
ment ; but it will assist a perplexed 
physician very promptly in his bad cases. 
I have not thought it necessary to use it 



in every case, as many cases need littl* 
or no medicine of any kind. 

From my observation and reading ] 
think that some of the causes of advers< 
reports on antitoxin are the use of un 
reliable serum, use of old serum, use oi 
dirty needles or syringes, injection intc 
improper parts of the body. 

I feel confident that many of the 
cases reported above would have been 
fatal under any other treatment 

Menasha, Wis. Preston Powell. 



For " A Tough Case/ 



* 



Editor Medical World : — On page 
4, January number, in the case of 4< A 

ough Case," a number recover by 
following up these hard lines : 

Avoid the use of meat soups, meats, 
poultry, game, cheese, eggs, peas, beans, 
tomatoes, spirits, ales and onions. 

Take, milk, vegetable soups, bread, 
butter, farinacaeous foods, vegetables, 
fish, oysters aud fruits in moderation. 

Sweets and sweet fruits very sparingly. 

Wollen underwear at all times. 

Warm baths ; never a cold one. 

All the rest that can be had. 

Take gr. *V chloride of gold and 
iodine three times a day. 

If excess of urates in the urine, take a 
laxative quantity of sulphate of soda in 
hot water in the morning, and take one- 
half a pint of water an hour or two after 
meals. 

London, Ont. Wm. Woodruff. 



For Itching After a Burn Has Healed. 

Editor Medical World : — In reply to 
Dr. Smithson, page 477 of December 
World, allow me to state that in case of 
a deep and severe wound, the chances are 
that the terminal nerves are being caught 
and compressed by the contracting cica- 
trix, and that surgery alone will give 
relief. But the trouble and expense of 
doubtful experiments make the game 
hardly worth the powder, unless the pain 
be too great 

In case of a more superficial burn, gen- 
tle massage with some bland ointment 
ought to suffice. If the doctor will use 
resinol patiently and thoroughly, I think , 
he will be pleased with the result If he 
thinks favorably of this suggestion, he 
can learn all he needs to know of the 

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73 



virtues of the mentioned remedy by re- 
ferring to page xvi of the December 
World. R. S. Clason, M. D. 

Spokane, Wash, 

[Or page xiv of January or Februaj; 
World.— Ed.] 



^ Dr. W. S. Cline, of Woodsfc 
writes : u I have written 87 



Va., 
ters to 
all parts of the country since Ae quick 
remeayXfor lumbago appeara in The 
WoRLDyknd all say it sohdijls for them. 
If they Irill use the U. S^r. collodion 
and strolg ammonia, thewwill have no 
trouble.! My druggist «ll mail it to 
them atliS cents. It iyquicker than a 
morphiJe injection." 

The doctor's artic^ appeared in De- 
cember World, pagej^7. After suffering 
for threlweeks withJciatica and lumbago 
in spite If the usudT remedies, he found 
immediate relief J^ using a preparation 
he foundln Janmry World, 1892. The 
remedy is\jj^Bows : Tincture of iodine, 
aqua ammonia (strong) and collodion, 
equal parts. To be painted on the part,/ 

fteasles Treated with Sulphide of Cal^him. 

Editor Medical World: — A recent 
epidemic of measles has afforded me a 
fine opportunity to try the ameliorating, 
abortive and prophylactic powers of the 
sulphide of calcium. Its abortive prop- 
erties in furuncle are pretty well estab- 
lished. In a recent epidemic of measles 
I had an opportunity of testing it Many 
children in the same family had the dis- 
ease rendered mild and many did not 
take the disease when put under the in- 
fluence of this drug, In some cases of 
adults where the eruption was very dark, 
and typhoid symptoms present, by the use 
of one grain every two hours all the un- 
pleasant symptoms were easily controlled 
and speedy convalescence occurred. I 
have faith to believe that scarlet fever and 
even small pox can be rendered mild if 
not aborted by the early use of this 
remedy. Try it, reader, and let us hear 
horn you. E. B. Silvers, M. D. 

Rahway, N. J. 

How do you Tabulate Interesting Articles? 

Editor Medical World : — Won't you 
in next issue of your excellent journal 
suggest a form of blank-book, in which to 
note interesting articles in the monthly 



journals worthy W memory and future 
reference— t-a. soA of simple " index re- 
rum ? " By so opine you will confer a 
favor on. me and, doubtless, many other 
subscribers to The Medical World. 

I find * both useful and interesting to 
re-read tl>e old issues. 

n November World I must note pa^e 
44^ and highly commend Dr. Ervm 
Tucker's article, " Difficult and Prema- 
ture Delivering of a Very Large Child." ' 
Such clinical memoranda are highly in- 
structive, and especially so to those re- 
mote from the great medical and surgi- 
cal centers. I am getting old in the pro- 
fession now, but this article brings to 
mind Rob Lee's "Clinical Midwifery," 
which our good old Dr. Meigs, back in 
the 50's, used to urge his class to buy 
and take home with them. 

J. E. Slicer, M. D. 

St. Joseph, La. 

Removal off Superfluous Hair. 

Editor Medical World :— In the No- 
vember number, a subscriber " wishes to 
know the formula of a good liquid for 
removing superfluous hair. " Allow me 
to state there is absolutely none such, or 
any kind of a preparation that can by any 
possibility remove permanently super- 
fluous hair. All advertised preparations 
for this "are the veriest frauds and hum- 
bugs, and can only destroy the hair even 
with the outer surface of the epidermis. 
A razor will do this just as well, and with 
less trouble, expense, or damage to the 
skin. A brief study of the anatomy in- 
volved will convince you of the utter 
uselessness of any chemical action on the 
hair itself ; for, you may pull the hair 
completely out by the roots, and the 
system of follicles which produces and 
feeds the hair will proceed to make and 
send out a new hair. Therefore the only 
way to get rid of superfluous hairs is to 
destroy the follicle ; and no outward ap- 
plication will do this. The only success- 
ful way to do this work is by the insertion 
of the electric needle. This even is often 
unsuccessful, and always painful ; for, 
unless the needle finds the follicle and de- 
stroys it, the hair, though extracted, will 
be reproduced. I have made a specialty 
of this subject for years and speak from 
experience. Geo. I. Betts, 

Milwaukee, Wis. Electrotheropeutist. 



74 



THE MEDICAL WORLD. 



A Brief Report on Horphine Treatment. 

Editor of Medical World : — Besides 
psychical treatment, in morphinism, 
medicamentous substitution is practiced 
by physicians employed by the Temper- 
ance Reform League, in order to shorten 
and render tolerable the tortures of the 
period of abstinence. In the beginning of 
the treatment one of the customary even- 
ing injections of morphine is replaced 
by a dose (by mouth) of two or three 
centigrammes of codeine (in the form of 
its hydro-chlorate), combined, in very 
excitable patients, with 30 to 45 grains 
of sodium bromide, in solution. Later 
on, as the morphine is being steadily re- 
duced the dose of codeine maybe repeated 
three or four times in 24 hours. (1-6 
grain of morphine corresponds to 2-5 to 
1-2 grain of codeine.) As a rule 1 1-2 
grain a day suffice, never giving more 
than three grains in one day. 

As the abstinential symptoms improve, 
the dose of codeine in the solution or 
pill should be gradually and secretly re- 
duced, withont however, dispensing with 
the solution or reducing the number of 
pills taken. Meanwhile, mitigated half- 
baths at a temperature of 78.8—82.4 F, 
most frictions at 68 P, and, in diffuse 
pains or gastralgia, slight faradization of 
the affected parts, are of service. 
Temperance Reform League, 
c-o Geo. F. Ormsby, Xenia, Ohio. 



Neuralgia. 

Editor Medical World: — "Some 
men learn for the sake of edification." 
Only that knowledge which we retain and 
of which we make a proper use is benefic- 
ial to us. How much trouble and suffer 
ing we would avoid, could we remember 
all we learn. These reflections are sug- 
gested by a perusal of Dr. W. S. Cline's 
experience with sciatica and lumbago 
(page 477j Mepigai^Wgrld, December, 
1856). Five years ago Dr. Cline knew all 
about the application which proved such 
a blessing to him, but he had forgotten it. 
The Medical World has always been 
and will always be brimful of good things, 
and they should not and need not be for- 
gotten. Let every brother keep a vade 
mecum, properly indexed, and keep each 
volume of The Medical World proper 
ly bound, and it will be an easy matter to 
turn to any article which he may wish 



to recall. I have ten volumes of The 
Medical World thus treated, and my 
vade mecum is highly prized. Let me re- 
mark that the local application referred 
to need not be confined to cases of sci- 
atica and lumbago. Use it in all forms 
of neuralgia, especially trifacial ; apply 
it over the nasal forsae in " cold in the 
head," on the occiput in spinal menin- 
gitis, on the mastoid process and vicinity 
in earache in children, over the coccyx, 
over the painful joints in rheumatism 
and arthritis, in pleuritis; anywhere, 
everywhere when its influence is desired, 
but do not expect it to be a cure-all. 
Bach therapeutic agent has a specific 
action, and when the conditions are the 
same the effect will be the same. The 
term " neuralgia " is apt to mislead. All 
pain is in one sense neuralgia. Neural- 
gia should not be confounded with neu- 
ritis. The former may be the {gwlt of 
numerous pathologi cal c onditions. It 
ma^Be " tftgt ry of a starred nerve for 
prop er fo od ; " it may be the result of 
structural changes ju„ the nerve itself; 
inflammation. ofjfiie nerve oF oF neigh* 
boring parts^ caries, exostosis, tumors, 
affections of the^sexual organs, stomach, 
liver, kidneys, etcTplF is often reflex ; 
structural changes in the spinal cord, 
brain or membgne, morbid deposits in 
those tissues, metallic poisons, miasgjatic 
influence, constijgtiofi7 etc. So that in 
treating" a case ofoSstinate neuralgia the 
physician should diligently "search for 
the cause of the local pain, and not im- 
agine (hat the application referred to 
will cure all cases of sciatica and lum- 
bago, nor should he discard it as worth- 
less should it fail in a given case. Apis 
melifica,asclepiastuberosa,macroty'srac., 
Phytolacca dec, bryonia alba, rhus toxi- 
codendron, and many other similarly act- 
ing agents are prompt and efficient reme- 
dies in cases of neuralgia where they are 
indicated. That is, each remedy has a 
characteristic action, has a tendency to* 
remove a certain pathological condition, 
and whenever that peculiar pathological 
condition is the principal cause of the 
local pain, that agent will promptly cure. , 
We need a more careful study of our ma- 
teria medica, so as to understand the pre- 
cise action of the remedies which we use. 
Another important point is the size of the 



dose. A sma 



|Le^f06e or P h 



ine will 



•THE MEDICAL WORLD. 



75 



stimulate, a large dose will depress ; a 
small dose of rhubarb will often check a 
diarrhea ; a large one has the opposite 
effect The same may be said of every 
therapeutic agent. Therefore regulate 
the size of the dose by the effect which 
you desire to produce. I may have more 
to say on this subject in the future. 

Frederic A. Rew, M. D. 
Lebanon, Mo. 



A Clergyman's Views. 



A clergyman reader of The World, 
Rev. A. J. Carrick, of Cleveland, Minn., 
suggests that we open a Social Purity 
department. He makes this suggestion 
because physicians are more able to 
speak on this question than any other 
class. They have a greater knowledge 
of the amount of adultery, fornication, 
masturbation, etc., practiced, than any 
other class, and the sad consequences. 
He further says: "The various pro- 
fessions ought not to be divorced as they 
are. The ministry, medical, legal and 
all other professions ought by all means 
to be more in harmony than they are. 
All ought to work together for the sup- 
pression of crimes of whatever nature. 
This would necessitate the exchange of 
ideas, the throwing open of secret 
chambers. " 

This is a good suggestion. It is the 
duty of every profession to endeavor to 
uplift the race. The better each profes- 
sion understands the peculiar line of work 
of the other, the better each can co- 
operate with the others. 

A lay friend, a gentleman of high 
moral standard and great intellectual 
ability, happened to see a copy of January 
World. He thinks we have taken a 
much-needed step, and he takes the med- 
ical profession generally to task for not 
doing more for the physical improve- 
ment of the race. The following are 
quotations from the letter : 

u Some people should be saved from 
themselves, or in spite of themselves. 
The idea of syphilitics, consumptives 
and weak-minded people marrying and 
bringing new souls into existence, is dis- 
gusting, horrible ! And yet your profes- 
sion does not sound a warning note. The 
idea of clergymen uniting in marriage 



anything and everything that can pay a 
fee, is repellant, yet the cloth loses sight 
of the eternal fitness of things, relying in 
* divine approbation.' Sara Grand, in 
'The Heavenly Twins,' made a bold 
dash in suggesting that doctors do the 
marrying, instead of the preachers. It 
caused many people to think, for it is in 
the line of scientific development." 

" Anatomy and physiology as now 
taught taboo the most important organs 
of the body, and children are allowed to 
learn all they ever know of them from 
vicious associates. I contend that in 
every school there should be a school 
physician, paid as teachers are, he to look 
^fter the development of the physique, 
while the teacher trains the mind. He 
could instruct in mixed classes, in classes 
of one sex at a time, or individually, and 
in time the pupils would be thoroughly 
instructed on this very important subject, 
and they would no longer consider the 
noblest function of man — procreation — 
as something nasty! We teach them all 
about the propagation of flowers, birds, 
etc., but carefully hide from them any 
knowledge of human propagation. Why? 
My work on this line is bearing fruit 
The system is discussed and recommend- 
ed here, and I see a girls' school in 
Philadelphia now has a lady physician. 
You can see how the evils of self-abuse 
would be reduced to a minimum. Parents 
are no more fit to develop the body of a 
child than they are to develop the mind. " 



Pregnancy in Bright'* Disease. 

Editor Medical World: — Mrs. K. r 
a £ e 43 years, mother of ten children. 
Three years ago put under advisement 
for Bright' s disease. Conception ocur- 
red. Three weeks prior to confinement 
she had persistent hematuria, edema ot 
extremities and face, vision impaired, 
and tendency to mania. 

Delivery in due time, face and feet 
presenting. Child delivered under 
chloroform, a fully adherent placenta 
removed. Now three weeks after, mind 
clear, urine clear, sight improving. I 
omit all details of treatment, but would 
query : Did not this persistent hemor- 
rhage save this albuminous woman's 
life? 

San Saba, Tex. N Dig ^i 



7 6 



THE MEDICAL WORLD. 



Rhus Toxicodendron. 

Editor Medical World : — In reply to 
Dr. Planck's inquiry, October Medical 
World, page 391, 1 offer the following : 

Case I. Mr. P., aged 36, laborer ; 
sharp pain in heajLoyer left eye ; pointed 
tqjLgue, papillae prpminent on upper 
surfac e and tip! 

R. Specific rhus gtt x, aqua oz. iv; 
teaspoonful every hour. 

Case IL Mrs. S., aged 48 ; erythemat- 
ous blotches over entire body, extremely 
susceptible to no ise, bur gin^a nd itching 
of skin, to ngue pointed, papi llae_p romi- 
nent, pulse quick, pinched appearance 
about the eyes, pain in lefF frontal region. 

R. Specific rhus gtt x, aquae iv ; tea-, 
spoonful every hour. 

Case III. MissB., aged 3 years ; wakes 
startled in sleep, screams out, nervous ; 
complains of i tching and lining of 
skin ; pointed, strawberry tongue ; 
eruption of small vesi cles filled with 
watery fluid, shaffCsiroke of pulse, 
fissures behind ears, burning eyes. 

R. First decimal "effluxion rhus gtt x 
to dr. i, aquae oz. iv ; teaspoonful every 
hour. 

In fact I use rhus in almost all dis- 
eases of.skin r including erysipelas ; and 
with at>bve symptoms I have never been 
disappointed. I use Specific rhus manu- 
factured by Lloyd Bros., Cincinnatti, O. 

Upshur, O. C. W. Conley, M. D. 

Dr. Bryan, of New York city, sends 
the following u new" features : 

1. Eclectic medication. 

2. Treatment for gonorrhea. 

3. Economic co-operation, 

I. Did you ever think of the fact that 
every practicing physician is an eclectic ? 
Eclectic means to choose the best Every 

Eractitioner chooses the best in his 
nowledge, or should do so, for each par- 
ticular patient. The school called " Ec- 
lectic " has developed some very valuable 
facts, particularly in connection with the 
use of American plants in medicine. Yes, 
let us have some "eclectic medication.' ' 

II. The treatment of gonorrhea has 
never been satisfactory. We do hope 
that some one will do for this disease 
what Dr. Wood bridge seems to be doing 
for typhoid fever, and antitoxin for 
diphtheria. 

in. Economic co-operation. By all 



means. A nation is, or should be, a vast 
co-operative enterprise. We are yet in 
embryo. We are as yet working too much 
for self, on individual lines. We now 
have the army, navy (they are the na- 
tional police, just as each locality has its 
local police), the rendering of justice, 
highways (wagon roads, but not rail- 
roads), education, postal service, and 
many other things already on a co-opera- 
tive basis ; we want to add the tele- 
graph, all banking, railroads, etc., as 
rapidly as we can. We want our public 
concerns, as telegraph, banking, trans- 
portation, etc., operated for the public 
service at cost, and not for private profit 

Dr. CHne'5 Case off Adherent Placenta. 

The patient made a good recovery, and 
is up and out. Page 35, Jan. World. 
Woodstock, Va. W. S. Clink. 

Later. 

Dear Dr. Taylor : — My case of adherent 
placenta is out and around all the time. 
The attachment in the first confinement 
was so tight it seemed a part of the 
womb. I had to scratch out what I gpt 
away. The second was even worse, and 
having been criticised for not curetting 
after the first confinement, I asked for 
assistance in the second to show that 
I was correct In the same month of the 
first confinement a lady died from 
curetting. I desired to keep down in- 
flammation. I used four Seller's tablets 
to a quart of water, thrown into the 
womb every four hours. 

Woodstock, Va. W. S. Clink. 

How to Act on Special Organs- -Cheap Lini- 
ments, Etc. 

Editor Medical World: — In renew- 
ing my subscription, I have thought to 
write you an approval of your course in 
conducting the magazine, and more par- 
ticularly to lend my endorsement to your 
political articles, which I consider far 
better and more to the point than the 
articles of paid writers of our large 
dailies and weeklies, which endorse a 
party, no matter what becomes of a 
people, and only change when forced to 
it by public opinion. 

I also offer a suggestion or two. I<et 
the attention of the readers of your maga- 
zine be given to the best means to pro- 
duce results on special organs ; for ex- 
atnple, to check vot^^fo. produce 



THE MEDICAL WORLD. 



77 



vomiting ; to check the flow of water 
through the kidneys ; to produce a flow 
of water from the kidneys ; to move the 
bowels, as a whole ; to check, the bowels, 
as a whole ; to excite an action of the 
skin; to chfcck.an action of the skin, 
etc- For instance ; 

In a case o& obstinate vomiting in a 
woman with a Uterine disease and a low 
fever, after using a gre^it many remedies, 

R Bismuth subnit . gr. ij 

Cerium oxalate gr. ij 

Cocaine . ^. . gr. 1-12 

everjf hour, relieved in one day, and 
ultimately enabled enough medicines to 
be administered to cure. 

Sometimes the organs aire difficult to 
control, and all our most trusted agents 
fail. Then a list of what helped others 
becomes of value. For instance, obsti- 
nate night sweats, diarrheas of years* 
standing, etc. We have all had them, 
all cured them, all failed to cure. 

Let me give another instance. A 
child swollen all over the body — dropsy. 
No water passing for a week ; obstinate 
vomiting ; cause unknown ; perhaps 
scarlet fever in the blood, not developed ; 
or a sequala; diphtheria followed by 
nephritis. No matter what the cause, 
you must relieve it. 
R Calomel . 'gr. 1-10 

Soda gr. 1-10 

— i --f^girj^^j^"^ — *v_£ r 8l ° 

Every hour until nausea ceaseiTftrse 
larger doses if necessary. Follow with 
saturated solution of Epsom salts, every 
hour until bowels starT, nidiug b^jnjec- 
tions. Then diurgjics : junip er se ed, 
cblchicum seefl, squill, di gitali s, acetate 
of potas sa. ti nctured in gpirifs of nitre, 
given in doses to suit age of patient. 
Then repfcaF^the calom el powders and 
salts as before, wiflTTonics and stimu- 
lants ; or infusion of juniper seed used 
freely, and baths in inmSion of pine tops 
daily, where they "STR be obtained. 

Let everybody tliat knows a good, 
cheap remedy spread it abroad. The 
people are growing poorer and poorer 
every year ; the doctors, also. Reme- 
dies at one dollar or more per ounce, are 
out of reach of both patient and doctor. 
What shall we do to replace them ? Our 
protection laws pour money into the 
hands of a lot of foreigners at our ex- 
pense. For instance, phenacetine sells 



here at $1.40 per ounce. Canadian 

phenacetine sells in Buffalo at 40c. per 

ounce. " The foreigner pays the tax !" 

A good cheap, external application is : 

Camphor - - - - oz. i 

Oil rosemary - - - dr. iii 

Oil origanum dr. ii 

Aqua ammonia fort. - - oz. 1 

Tr. tobacco - pints i#. 

Mix. Belladonna leaves can be used in 
place of tobacco, and lard oil, or shaved 
oil soap will thicken. Another still 
cheaper is : 

Yolk of two eggs. - 
Mix. Bathe a swollen painful part in either 
of the above before a fire twice daily. 

J. A. Elliott, M. D. 

Northumberland, Pa. 

[Equal parts of coal oil, spirits of tur- 
pentine and spirits of camphor makes a 
good and cheap liniment for general 
use. 

The remedies in the above article are 
perhaps all right, but it is not well to 
take a superficial, symtomatic view of a 
case. Search deeply for the cause, and 
then you will feel that you have com- 
mand of the situation ; but do not allow 
thoughts on pathology to take your 
attention from pr actica l therap eutics. 
Some deep pathologists are poor practi- 
tioners. But you must be something of a 
pathologist, or you cannot be an intelli- 
gent practitioner. — Ed.] 

Dr. E. J. Yager, of Graysville, Md., 
wishes to congratulate Dr. Mayer upon 
his raid on " diploma mills," and thinks 
that none should be allowed to compete 
with us in the practice of medicine ex- 
cept those who have given their time and 
labor to study and research, just as we 
have. He also endorses Dr. Jones' re- 
marks on ergot in obstetrics. He says : 

"I have been in continuous practice 
for 20 years and have attended 600 women 
in lying-in room, and have not had a case 
either of puerperal fever or uterine dis- 
placement in my own practice. In all 
of these cases I have strictly avoided 
ergot during labor. I am a friend to 
ergot, but not in labor. I fear that in 
some cases the violent contractions in- 
duced by ergot has led to rupture of the 
uterus." 

He uses chloroform in labor, as well 



78 



THE MEDICAL WORLD. 



as in painful operations, and says : " I 
have but one index of safety in the ad- 
ministration of chloroform, and that is 
the pupil of the eye. So long as it ifc 
contracted there is no danger. At least 
this has been my experience." 

Figure-of-eight bandage and axillary 
ball are the best means he knows of for 
adjusting broken clavicle. 

A practitioner in full practice must 
take things as they come, which may re- 
quire skillful attention to a dozen or 
more distinct classes of cases per day. 
Therefore, a medical magazine should 
and usually does consist of reports upon 
various topics in medicine. Yet one's 
real progress in his profession is the re- 
sult of s pecial and ser ious attention to a 
single su bject a t a tim e. It is our policy 
to discuss as far as possible the diseases 
prevalent at the time of issue. For ex- 
ample, in last issue large attention was 
given to antitoxin in diphtheria (al- 
though, unfortunately, diphtheria is not 
confined to one season of the year), and 
in this issue pneumonia and typhoid 
fever are the predominant topics. For 
March issue let us have specially your 
thoughts on the troubles that you find 
most prevalent in early spring ; rheuma- 
tism will be one of these. 

But do not be deterred by the above 
from expressing yourself upon any topic 
upon which you really have something 
to say. By saying it through The 
World, you say it to the whole country. 



y Phthisis 




R^Mass petrolei 


oz. iv. 


Creasoti opt. 


dr. iiss 


Ovi vitellus 


ij. 


Syrup, simp. 


OZ. 188. 



Spiritus frumenti, to make Oss. 
M. Sig. : A dessertspoonful in a gill of sweet 
milk at 8, 12, 4 and 8 o'clock daily. — Dr. C. 
H. Wilkinson of Galveston, Texas, in the 
Texas Medical Journal. 

Yes, we still send World and Medical 
Council both for $1.75 per year. Also World 
and Alkaloidal Clinic for $1 75 ; World and 
Hypnotic Magazine with a book on Hypnotism 
as a premium for $1.75 ; any three for $2 75 ; 
all four for $3 75. New subscribers to Clinic 
get a nine vial pocket case, filled, as a premium. 



Quiz Department. 



Questions are solicited for this column. Communication 
not accompanied by the proper name and address of tht 
writer (not necessarily for publication) will not be 
noticed. 

The great number of requests for private answers, for the 
information and benefit of the writer, makes it neces- 
sary for us to charge a fee for the time required. This 
fee will be from one to five dollars, according to the 
amount of research and writing required. 



TIc-Douloureux. 

Editor Medical World:— Can you 
tell me what to do to alleviate or eradi- 
cate the cruel spasmodic pains of tic- 
douloureux ? Never had twinge of it till 
six years aro last December (age 52). It 
began gradually in my left cheek. At 
times the pain has been very severe, 
nearly driving me frantic. Eating, talk- 
ing or even touching my moustache 
would send the shooting, lacerating 
pains through my left cheek, eye and 
temple. Last season, from May to Sep- 
tember, I was entirely free from it for 
the first time since it appeared. Was in 
hopes the freedom would prove perma- 
nent It began slowly creeping on again 
in September. It has not been as severe 
this season as in some years in the past. 
Drug treatment has not brought the de- 
sired relief. It seems to yield to nothing 
excepting u old Father Time." I am 
aware the removal of the nerve some- 
time effects a permanent cure. I hesitate 
to resort to the knife. Perhaps you can 
suggest something that may relieve me. 

H. C. Dodge. 

West Medford, Mass. 

[This case was submitted to Dr. H. C 
Wood, of the University of Pennsylvania, 
who said at once: 
go to a warm, 

Southern California." Possibly, a hot 
climate may be necessary." He does 
not recommend the knife for this case. — 
Ed.] 



"The doctor should 
equable climate : as 



Writer's Cramp. 

Editor Medical World :— Can you, 
or any of your readers, suggest a reliable 
treatment for writer's cramp ? I have a 
case in the incipient stage, occurring in 
a young lady. 

C. Fitz-Henry Campbell. 

Spring Hill, N. S., Can. 

[Dr. H. C. Wood was consulted in re- 
gard to above, and says: u Nothing but 



THE MEDICAL WORLD. 



79 



rest will do any permanent good. You 
might as well try to cure a fractured leg 
with the man walking around, as to try 
to cure writer's cramp without rest 
Massage and electricity may do good 
temporarily, but rest is necessary to 
cure. ".] 

Tachycardia. 

Editor Medical World:— Will you 
allow me, through The World, to sub- 
mit for treatment a case of tachycardia ? 
The patient is otherwise healthy, is a 
strong, hard-working temperate man of 38 
years of age. Since he was 13 years old he 
has had attacks at intervals of from four 
months to two or three years, and lasting 
from three to ten hours, during which 
the heart beats so rapidly that it is 
almost impossible to count the pulse. 
The attacks appear suddenly without 
any known exciting cause, and are unat- 
tended by pain or very distressed breath- 
ing. I have tried inhalation of chloro- 
form, hypoxemic injection of morph. et 
atrop., ordinary cardiac remedies, cold 
water and strong coffee, without the least 
effect. Will some one tell me what I 
can do to relieve my patient during 
these attacks, or cure the case ? 

Ashland, Wis. A. P. Andrus. 



Editor Medical World:— The pre- 
scription of H. P. Monroe, M.D., on page 
23, January World, seems very indefinite. 
Does he mean by weight or by measure? 
From 6 to 10 per cent, of tannic acid 
would be more than double 6 to 10 per 
cent of boracic acid by weight, the former 
being much more bulky. Would not a 
very small quantity of permanganate of 
potassium improve the suppository ? as it 
has a very marked effect upon the germs 
of gonorrhea. Will Dr. M. give his pre- 
scription in drams and grains, making 
quantities definite ? So many drams of 
cocoa butter and so many grains of each 
acid to make one dozen supposotories. 
S. E. Root, M. D. 

Rochester, N. H. 

Editor Medical World :— Since the 
days of influenza (la grippe) has the wine 
juice or bloody sputa ceased to be pathog- 
nomonic of pneumonia? 
Amity, Ark. J. H. C. King, M. D. 

[I guess not. — Ed.] 



Would you kindly inform one in the 
Medical World the best way of remov- 
ing nevus, or wine mark, other than by 
electrolysis, as I have a case where the 
mark is too near the eye to use elec- 
tric needles ? C. Witney. 

Santa Cruz, Cal. 



I should like very much to hear from 
some of The World readers on obstruc- 
tion and invagination of the bowels in 
young children, as two such cases came 
under my observation during the past 
summer, both of which proved fatal. 

Homer, Neb. D. B. Stidworthy. 



Have you evef known or heard of a 
case of extra-interine pregnacy in the 
lower animals? It is thought that they 



never occur. 



Formula for " Ka-ton-ka" is asked 
for. Also for "Balard's Snow Lini- 
ment " 

y — 

Current Medical Thought 

Certain Test for Typhoid. 

Little is now spoken of in the realm 
of bacteriology as being impossible or 
beyond the reach of science, but the 
latest discovery in that branch of medi- 
cine has aroused the whole profession 
and set every important laboratory in the 
country at work. It is of far more in- 
terest to the world at large than most 
scientific discoveries seem, tor it is of im- 
mediate benefit to the public, and the 
new knowledge can at once be put to 
practical uses. What has been found in 
brief, is a test for the early diagnosing of 
typhoid fever, the disease that so fre- 
quently baffles physicians, and is often 
not recognized as typhoid until it is well 
advanced. 

The new test, known as the blood test, 
has never once failed in the hundreds of 
experiments made in this country and 
abroad, and now is an accepted scientific 
fact Within the last few days the bac- 
teriological laboratory of the Board of 
Health of this city has set the seal of 
confirmation on this new system of 
typhoid diagnosis by announcing that 
they have made this fall more than 160 
tests, and all with success. 

In all these experiments typhoid, if 



So 



THE MEDICAL WORLD. 



there be typhoid, shows out clearly and 
unmistakably. So far as this city is 
concerned, the practical advantages of 
the discovery are that the blood of any 
suspected typhoid case will be examined 
by bacteriologists of the Health Board, 
and a report on it made at once. The 
tests take only a few moments, and the 
matter has been so simplified that it is 
now possible for a doctor to send down a 
drop of dried blood on a card and have it 
examined. 

Doctors, for years past, have talked 
about "typhoid symptoms," and many 
treatises have been written explaining 
and expounding them. Many of these 
symptoms are so marked and so impor- 
tant that they have been called u charac- 
teristic^ But the entire medical pro- 
fession has always found that these 
symptoms were only of value when a 
great number of them were present at 
once. One, two or three might occur, 
and yet another and totally different dis- 
ease develop. 

For example, "rose spots" is one of 
the most important symptoms, but it is 
absent in fully thirty per cent, of typhoid 
cases, and seldom appears in any event 
until the eighth or the tenth day of the 
disease. Enlargement of the spleen is 
another symptom, but this exists also in 
malaria and miliary tuberculosis. 

And so the .symptoms run. Taken 
singly it will be seen they are of little 
value, and thus diagnosis and treatment 
have frequently had to be delayed day 
after day. 

The new test in detail is beautifully 
simple. From a complicated scientific 
process it is reduced to a few movements 
of the hand of an expert bacteriologist, 
and all is done. The drop of dried blood 
taken from the lobe of the ear or the tip 
of the finger of a suspected typhoid 
patient and sent to the laboratory on a 
card is mixed with sterilized water and a 
fraction of it put upon a microscopic 
slide. To this a drop or a portion of a 
drop, of pure typhoid culture is added. 
This typhoid culture is part and portion 
of a laboratory's outfit nowadays, and 
has been ever since this discovery was 
made. The slide is then put under the 
microscope. 

Now, as all these experiments have 
proved, one of two things will happen. 



Either the typhoid germ existed in that 
portion of the drop of blood mixed witlx 
the typhoid culture or it did not No 
ordinary microscopic investigatiop can 
tell anything conclusive about that droj> 
of blood unmixed. But — and this is one 
of the mysteries of science — as soon as 
the mixture on the slide is brought within 
the field of vision and the bacteriologist 
can distinctly see it, the bacilli of typhoid 
already existing in the typhoid culture 
either move about as before or there is a. 
cessation of the rush to and fro of these 
minute bodies and an agglutination or 
concentration of the organisms into large 
clusters. 

If the bacilli move and keep separate 
there is no typhoid in the blood of the 
person under examination. If the bacilli 
cluster and stay quiet typhoid exists, or 
else has existed in the system within six 
years, a matter which can be very easily 
learned from the patient himself. 

No febrile diseases, no malaria or any 
other malady in the blood will cause this 
concentration of bacilli. This the ex- 
periments have conclusively established. 
The test is therefore absolute. 

The discovery was originally made by 
Robert Pfeiffer, of Berlin, Koch's assist- 
ant, in the fall of 1894, but he kept the 
secret to himself for many months, and 
it was not until late in 1895 that other 
European scientists were working act- 
ively on it. Gruber and Durham, in 
Berlin, confirmed Pfeiffer, Gruber much 
simplifying the process. Widal, in Paris, 
made at the same time a series of impor- 
tant experiments, writing at length re- 
garding their success in the spring ot 
this year, and Bordet published an article 
retailing the history of what had been 
done. 

Widal's process was much simpler than 
either Pfeiffer' s or Gruber's, but it re- 
mained for a Canadian, Wyatt Johnson, 
of Montreal, bacteriologist to the Board 
of Health there, to devise a test along 
the same scientific lines, but so simple 
that it could readily be put into operation 
and results obtained quickly. 

This process he described in a paper 
read in October, and it is this that has 
been taken up so generally s^id speedily, 
and has just been described as being in 
use in New York and elsewhere. — N. V. 
Public Health Tour. 

Digitized by UOOQ LC 



THE MEDICAL WORLD 



81 



New Treatmen t for T apewor *" - 

Dr. Newington {Medical Times and 
JHospital Gazette), gave the following for 
another disorder and found that the 
patient passed a de ad tapeworm eleven 
feet long, of whose presence lie, as well 
the physician, was ignorant : 

R. Potass, hydriodat. . gr. xxxvi 
Iodi . . . . gr. vij 
Aquae . f. oz. 

Ten drops in water three times daily. 

The same combination was then tried 
in three cases in which the parisite was 
known to be present and in each case it 
acted equally well. In still another case, 
which had resisted all previous attempts, 
the patient passed a mass of dead tape- 
worm and for a year had no return.— 
Col. and Clin. Rec. 



Water. 

Drugs, drugs, drugs, seem to be the 
chief inspiration in the life-work of too 
many men. Hydropathy has been a 
wonderful service to humanity. We can 
appreciate the necessity of water when 
we remember that 75 per cent of our 
body is made up of water. It is just as 
important as the solids in life's condi- 
tions. The demands for water are affected 
by the amount of muscular exercise, and 
the degree of temperature to which the 
body is exposed. For a fl irrj fa ted 
Stomach or bi lious coli c no thing is su- 
perior to liberaF^tlinHfies of hot water. 
For " a night out " two or three cups of 
hot water along with a cup or two of hot 
coffee nothing us superior. It soothes 
the nervous system if you will abstain 
from food a few hours. 

We neSTwlfter for nutrition, but also 
as well, and more important, for a 
proper elimination. Water taken freely 
acts as a purifier of the system, both by 
flushing and by its solvent action. The 
majority of people drink too little water. 
I would highly advise training children 
to drink more water. It is a most im- 
portant agent in improving the complex- 
ion. Medicine should be given in large 
quantities of water. In typhfiifljever I 
insist upon free drin king of pu re water. 
No solvent will act^better tn removing 
uric acid from the system, "arid the only 
pure water is distilled water. 

Copious draughts of water for its 
stimulative effect or the reduction of 
temperature has been used in many 



years. The hot pack in convulsions of 
children is often misused. Better to 
begin with a tepid heat and add cold 
water gradually. Hot water locallv in 
inflammatory conditions is most ex- 
cellent 

Often I have thought the surgeon's 
knife might be laid aside if we knew 
how to use water. A large number of 
the cases of a ppendic itis, in my opinion, 
might be relieved By a thorough washing 
out of the bowel.— Dr. I. N. Love, in 
Col ClinTRec. 



Treatment of Syphilis. 

Abstract of Clinical Lectute Delivered at the 
New York School of Clinical Medicine, No- 
vember 2$, 1896. 

A careful consideration and trial of 
the various methods of treating the 
syphilodermata has led me to the fol- 
lowing conclusion : 

1. In the primary stage, when only the 
chancre is present, no general treatment ; 
calomel locally. 

2. As soon as the secondary period sets 
in, as shown by the general adenopathy, 
angina, and eruption, the internal treat- 
ment for mild cases should be ^to % of 
a grain of the piais-iodide of mercury, 
t. 1. d., continue d for ^three months, or 
unfiTlhe symptoffiscKsappear. In severer 
cases, with pustular eruptions, severe 
anginas, persistent headaches, etc., a 
course of six to ten intra- muscular injec- 
tions of 10 per cent, calomel-albolene 
suspension, 5 to 10 minims, at intervals 
of five to fifteen days, should be em- 
ployed. 

3. After completion of the course and 
cessation of the symptoms, employ 
tonics, etc., without specific treatment, 
for three months. 

4. Thereupon a second calomel course 
as above, plus a small dose (15 grains) of 
iodide of pot assium in milk-After- meals. 
This is to be given whether later sec- 
ondary symptoms of the skin and mucosae 
appear or not. 

Second Intermission of treatment, 



la£ 



la||ing three to six months, according to 
the presence or absence of symptoms. 

6. In the second year, if tertiary le- 
sions marked by deeper and more local- 
ized ulceration are present, give the 
iodide of potassium, increasing doses 60 
to 600 grains daily, as may be necessary. 

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THE MEDICAL WORLD. 



Combine with it occasional courses of 
calomel injections. If no lesions appear, 
give a mild course of both. 

The best local treatment of the syphil- 
odermata is with the mercurial plaster- 
mull. 

Condensed Facts for the General Practitioner. 

General practitioners desiring to use 
electricity in their practice, but posses- 
sing practically no knowledge of electro- 
therapeutics, will do well to read, study 
and learn the following points : 

The faradic or interrupted current 
cures disease mainly through physiologi- 
cal and mechanical processes, producing 
no appreciable chemical effect in the 
tissues. 

In each faradic battery there should 
be two coils — primary and secondary. 

The current from the primary coil has 
greater quantity and produces greater 
mechanical effects, but lacks penetrating 
power, and is more useful in superficial 
troubles, particularly where mechanical 
effects are desired. 

It is also of great service in internal 
treatments for many vaginal and uterine 
diseases. 

In the primary current there is some 
difference in polarity, the positive pole 
producing greater sedation and the nega- 
tive pole greater stimulation. 

The secondary coil produces a current 
having much greater penetrating power 
than the primary current 

It will more easily overcome resistance 
on account of its greater tension, and is 
to be preferred to the primary current in 
treating deeply-seated conditions. 

There is no appreciable difference in 
polarity in the current from the second- 
ary coil. 

The current from the secondary coil is 
much more pleasant in its effect, partic- 
ularly to nervous subjects. 

In the direct galvanic current there 
are no interruptions to the .current as in 
the faradic. 

The galvanic current produces chemi- 
cal effects in the tissues as well as physi- 
ological and mechanical effects. 

There is no sensation to the current 
beyond a feeling of numbness and burn- 
ing beneath the electrodes. 

In general terms, it may be stated that 
the faradic cunrfht is to be preferred in 



muscular troubles and the galvanic in 
nervous diseases. 

The galvanic current will produce a 
greater degree of sedation or stimulation. 

The galvanic current should be used 
to stimulate the absorbents, to remove 
effusions, morbid growths, callosities, 
tumors, facial blemishes, superfluous 
hairs, etc. In these conditions the fara- 
dic current is practually powerless. 

The positive pole of the galvanic cur- 
rent is much more sedative and the neg- 
ative pole much more irritating and 
stimulating. 

Electrolysis and cataphoresis can only 
be used with the galvanic current 

To produce the most pronounced seda- 
tive effect and allay irritability make 
stabile applications of the positive pole, 
galvanic current 

To produce the most marked irritation, 
use the negative pole of the galvanic 
battery or reverse the polarity frequently. 

Electricity has a decided,refreshingand 
soothing effect upon the entire nervous 
system, and is of great service in nearly 
all nervous diseases. 

Either faradic or galvanic current 'will 
equalize the circulation, increase the 
flow of blood to the surface and extremi- 
ties, and improve nutrition and assimil- 
ation. — Electro- Therapeutist. 

Case of Painless Labor. Had Squaw Root 
Tea Anything to do with It? 

Dr. R. M. Lutton, Grand Rapids, 
Mich., reports (Medical Counselor, No- 
vember, 1896), that he* was called at 
night to attend a case of labor. While 
getting ready to go, he asked the husband 
if his wife was having considerable pain. 
He replied she was in no pain whatever. 
After arriving at the residence, he found, 
on examination, a normal case — mem- 
branes ruptured and labor progessing 
nicely. In just twenty minutes the 
child was born ; the afterbirth came all 
right This was the patient's first born. 
But the remarkable feature of the case 
was that she had no pains nor pain from 
first to last — not the slightest. She stated 
that she had been drinking " squaw-root 
tea " for four or five months. She had 
gathered the fresh roots in the woods, 
and steeped them in water, and had taken 
a drink of this tea twice a day. — Va. 
Med. Semi-Mo. 

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THB MEDICAL WORLD. 



8i 



Class-Ropm Notes, 

(From Dunglison's College and Clinical Record.) 

In Iyeuoprrhea with accompanying 
anemia the ""following prescription is 
recommended by Prof. Hare : 

R. Acid arsenosi, - - gr. J 
Ferri redact! , - - gr. v 

Quininae sulph., - - dr.j. M. 
Ft. pil. xx. 

Sig.— One pill three times a day after meals 

A dusting powder of starch and boric 
and salicylic acids is useful in conditions 
of Increased Production of Sweat, as fol- 
lows: 

R. Pulv. acid, salicyliti, gr. x-xx 
Pulv. acid, borici, - dr. ij, 

Pulv. amyli, - - dr. vj. M. 
— Stelwagon. 
After Labor Co mpli cated with Pla- 
centa Eteyia, the tinctuie of the chloride 
of irotf in closes not exceeding ten drops, 
well diluted, may be given with advan- 
tage. The following is also a useful 
prescription : 

Tartrate of iron and potassium, gr. 60 
Extract nnx vomica, - gr. 3 

Scale pepsin, - - - gr. 30 
In 30 capsules, one four times daily, with 
food. 

— E. P. Davis. 
Diseases of the Cornea, especially ul- 
cerations, are apt to arise from faulty 
teeth, or from any diseased condition of 
the mucous membranes about the head 
Such conditions should be carefully ex- 
amined for. If the patient is strumous, 
cod-liY£X-&il and al lied tonics are indi- 
cated as constitutional treatment. — De 
Schweinitz. 

The following is a reliable antipruritic 
application : 

R. Acidi carbolici, • . dr. j-iij 
Glycerini, ... dr. ij 
Alcoholis, oz. ij 

Aquae, . . . q. s. ad Oj. M. 
— Stelwagon. 
In Mjjalgia, massage is always good 
treatmenT^The following may also be 
used, well rubbed in : 

R. Tine, belladonnae, . . dr. j 
Tine, aconiti, ... dr. ij 
Tine opii, . . t . dr. ij 
Liniment, saponis, q. s. adoz vj. M. 
Sig. — Poison. To be used externally only. 

« — Hare. 
In the treatment of Syphilitic Plastic 
Iritis, where quinine is desired in addi- 



tion to the specific treatment, the follow- 
ing is useful : 

Sulphate of quinine, . gr. 2 
Protodide of mercury, . gr. J-J 
Ext. of hyoscyamus, . gr. J. 

De Schweinitz. 
The subjective symptoms of Urticaria 
may be greatly relieve! by applytng"tne 
following as a lotion : 

R. Acidi carbolici, . dr. j-iij 

Acidi borici, . . . dr. iv 
Glycerini, . . . oz. ij 
Aquae, 0%. xiv. M. 

— Stelwagon. 
If a Burn is not very diffuse, a solution 
of the tincture of cantharides, one part 
to 40, upon a cloth, is said to relieve 
pain and aid in healing. But if the 
burn be extensive this treatment is con- 
traindicated because of its effect upon 
the kidneys, already overtaxed by the 
interference with the functions of the 
skin. 

— Hare. 

The Treatment of Warty Growths of the 
Genitals. 

William S. Gottheil, of New York, in 
a paper on Epithelioma of the Penis read 
before the Society for Medical Progress, 
November 14, 1896, concluded as fol- 
lows (International Journal of Surgery, 
January, 1897) : 

1. Warty growths of the genitals, 
more especially in the male, are always 
to be suspected of malignancy, no mat- 
ter how innocent they seem. 

2. They should be either left entirely 
alone, or be thoroughly removed by 
knife or cautery. 

3. Imperfect attempts at destruction, 
as with nitrate of silver, carbolic acid, 
etc., are especially to be avoided ; there 
being many cases recorded in which they 
have apparently stimulated a benign 
growth into malignant action. 

One of our subscribers writes that he takes 
23 medical journals, but likes The World 
best of all. Follow the Doctor's example, and 
take " lots " of journals. They are good and 
cheap. Don't let the trifling price stand in 
the way when you see what you want. Don't 
say you have too many already. Is there any- 
thing you buy that is as large value for the 
price as a yearly subscription to a magazine 
like The Medical World, for example? 
Don't try to «« skimp' 'or economize in this 
direction. It won 't pay. 

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?HE MEDICAL WORLD. 



Our Monthly Talk. 



One letter can change the meaning of an 
entire sentence; for example, on page 38 pf 
January World occurs this sentence: "In 
every civilized country on the globe, except 
Bolivia, Cyprus, Honduras, Cuba, Hawaii 
and the United States, the telegraph is owned 
and operated by the government as a part of 
the postal system, and with entire sucess. " 
In some of the first copies printed, before the 
error was corrected, it read •• If every civilized 
country, etc., " the use of f for n changing the 
entire meaning. If you received one of these 
copies, take a pencil and change the f to n. 

Gold is considered the most desirable pos- 
session in the world. The reason for this is 
plain. The English government says that a 
pound sterling shall consist of so many grains 
of gold ; and with these pounds* debts can be 
paid and any kind of property can be pur- 
-chased. So the English law gives to gold the 
•command of every kind of property and obli- 
gation. This is a high favor to give to any 
one product, but the English law does it, 
some other countries do it, and a certain class 
of citizens want this country to do the same. 
So, at present, gold is the most desirable mate- 
rial possession. But there are some things 
better than gold, and I received one of them 
to-day (Jan. 4). I received from Hon. Albert 
Griffin, of Topeka, Kan., a handsomly bound 
volume of his book " Bimetalism — Protection — 
Republicanism, " with the following inscrip- 
tion on one of the blank leaves in front : 

' ' Besides presenting this book to my highly 
esteemed personal friend, Dr. C. F. Taylor, 
•editor of The Medical World, Philadelphia, 
Pa., I wish to state that, in Kansas, no other 
educated class so generally supported Mr. 
Bryan for President as did the medical fra- 
ternity. Having noticed this fact early in the 
campaign, I therefore made special inquiry 
wherever I traveled, and found ample evidence 
that it was Dr. Taylor's able and fearlessly 
expressed articles on financial matters pub- 
lished in his magazine that had set them to 
thinking and nerved them to act. May he 
live long to bless his race. 

Albert Griffin. 

Topeka, Kan., Dec. 30, 1896. " 

The inscription is the part that is better 
than gold — or silver either. It makes me feel 
that I have been doing some good ; and it 
encourages me to push on with the good work. 
However, I do not measure the result by the 
number of votes cast for any particular man 
at any particular time, but by the greater fact 
that I am helping physicians to realize that in 
a government like ours they have a vital inter- 
est in the way it should be conducted. It is their 
duty to themselves, to their families and to the 
community, to study the principles of economic 
justice, and to instruct the people therein. 



To be a good physician is a great thing ; bvLt 
that alone is not enough. However accom- 
plished as a physician one may be, if he is not 
a good citizen he is not a complete man. By 
"good citizen " I mean one who takes a rea- 
sonably active part in the proper government: 
of his community, his State and Nation. It is 
absolutely necessary that the intelligent: 
classes do this, for, by neglect, we see what 
condition we have gotten into. A few thou- 
sand families own by far the greater part of 
the wealth of this country; corporations, 
trusts and monopolies rule with an iron hand, 
corrupting public officers and impoverishing 
the masses of the people ; and, when the 
massses are unable to pay for medical ser- 
vices, the physician's income is seriously 
impaired. This is the special reason why 
these questions are taken up in these pages. 

We have recently had a number of checks 
and drafts returned unpaid. Reason, bank 
broken. In these cases, of course, the sender 
has to pay a second time. If we had Govern- 
ment banks these losses would not occur. We 
have never known a dollar to be lost by the 
post office money-order system. In order to 
guarantee safety (a very reasonable require- 
ment), the editor of the Chicago Express, and 
Mr. Thos. E. Hill, author of Hill's Manual, 
suggest that banks give bonds to secure de- 
posits. If we cannot get Government banks, 
this is the next best thing to do. They sug- 
gest the following form of petition, to be pre- 
sented to the legislatures of all the States : 

A Petition. — To secure depositors, in banks, 
against loss. 
To the Honorable Members of the Senate and 

House of Representatives in Legislature As- 
sembled in the State of . 

It is a fact that bank failures cause a direct 
loss to depositors of money in banks of many 
millions of dollars in the United States every 
year. 

These numerous failures cause financial 
panics which result in the shutting down of 
business, throwing great multitudes of people 
into idleness, and compelling the sale of prop- 
erty at a great sacrifice. 

These immense losses to the common peo- 
ple, by bank failures, cause such distrust of 
banks as to induce the people generally to 
hide their money, thus withdrawing it from 
circulation, which results in scarcity of money, 
excessively high interest, and the suppression 
of business. 

The hiding of money on the person and 
about the home, through distrust of banks, 
makes continual temptation to footpads and 
robbers, and hence the era of crime in which 
no property or life is safe. 

As this crime, impoverishment and great 
distress come from losses through bank failures 
and consequent loss of confidence in monetary 
conditions, and as we believe some action 
should be taken to relieve the worthy bank of 

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THE MEDICAL WORLD. 



85 



suspicion, we, the undersigned, petition you 
to enact such law as will require that the 
banker give bond that people shall not lose 
the money which they deposit in banks. 

Better cut this out and send it to your 
representative in the Legislature of your State, 
and ask him to introduce a bill to this effect. 
See that your representative in the Legisla- 
ture also presents a bill for direct legislation 
in your State. We want government by the 
people direct. We are tired of government by 
the banks and banking interests. 

Mr. Edward T. Heyn, of New York City, 
contributes an exhaustive and convincing 
article to the November issue of the Annals of 
the American Academy of Political and Social 
Science on " Postal Savings Banks." The fol- 
lowing are a few of the facts cited : 

41 Hon. C. S. Fairchild, Assistant Secretary 
of the Treasury under President Harrison, said 
that while Attorney-General of New York he 
was compelled to wind up the affairs of twen- 
ty-two savings banks, with the loss to the de- 
positors of $4,000,000. He became convinced 
that the professed guardianship exercised by 
the State over these banks amounts to nothing. 
The depositors were really without protection 
against the dishonesty of the bank officers. 
Three out of every eight of the savings banks 
of Maine suspended between the years of 1872 
to 18^9, and in the State of New York twenty- 
two banks failed with a capital of $4,475,661. 
One hundred and seventeen banks, brokers, 
savings banks and trust companies failed dur- 
ing the year ending June 30, 1891, having 
liabilities of over $38,000,000 and assets of 
over $20,000,000. During the three years 
prior to January, 1891, the failure of State 
savings banks and private banks in twenty- 
three States numbered 210, with losses amount- 
ing to over $32,000,000. The losses in the 
same year in Ohio and Illinois, through the 
failure of State, savings and private banks, 
aggregated over $8,000,000; number of banks 
in existence in the last year was 12,666 ; the 
number of failures was seventy-nine, and the 
percentage of failures 0.62, with assets amount- 
ing to $6, 125, 189, and liabilities to $1 1,024,628. ' ' 

Postal savings banks have been established 
in nearly every leading country of the world 
except ours. In every instance they are highly 
successful and a boon to both the people and 
the Government. Rich men invest their money 
in United States bonds for safety and interest, 
and if a lew of them combine and establish a 
national bank, they can deposit their bonds with 
the Government (storage free, no insurance 
necessary) and get back 90 per cent, of the 
face value in national bank notes which they 
can loan out and still continue to draw interest 
on the bonds, thus getting double interest. If 
the Government does this for rich men, it 
should establish postal savings banks to pro- 
vide security for the savings of the poor. 
Write to your Congressman and United States 



Senators to favor this class of legislation. 
We, the people, must urge it or it will not be 
done. We must undo the causes that have 
led to the creation of the "masses and the 
classes' 1 — the privileged classes. 

It takes a long time to get a national law. 
Many state legislatures are now in session, 
and they can act much more quickly than Con- 
gress. Georgia has just enacted a stringent 
anti-trust law, and Indiana is about to do the 
same thing. Urge the physicians in your legis- 
lature to be on the alert. The national anti- 
trust law has been impotent in the hands of 
both a Republican (Harrison's) and a Demo- 
cratic (Cleveland's) administration. But Geor- 
gia's law is being put into effective operation, 
and the people are already being freed from 
the domination of trusts in that state. Let all 
the other states follow the example of Geor- 
gia. Also, a state can require that banks 
within its borders give ample bonds to secure 
depositors. See that your legislature be urged 
to do this immediately, and put a stop to this 
miserable robbing of the people by the break- 
ing of banks. This requirement is so reason- 
able, important and necessary that I do not 
see why it has not always been a part ot 
legitimate banking. 

In the annual flood of letters that come to 
us from every part of the Union, there are 
many expressions to the Editor, which are 
always welcome. The largest expression this 
year was upon the question of whether or not 
a periodical should be stopped when the time 
paid for expires. The unanimous expression 
was in the affirmative, with one exception, 
which was noted last month. 

The next to the largest expression was con- 
cerning * ' Our Monthly Talk. ' ' The enthusi- 
asm in favor of it, and the urgent requests that 
it be continued, were very gratifying to me. 
But there are two sides. I think about four 
wished that it be discontinued, and I must be 
fair with the minority, however small. By 
far ,the best letter on this side I here present : 

A SUGGESTION. 

Editor Medical World : — A few days ago 
I received a communication from you request- 
ing suggestions as to the improvement of The 
Medical World. In your journalistic life 
you have received many flattering encomiums 
which were, no doubt, well deserved ; but I 
take it that the highest and truest type of 
friendship is manifested by a kindly and judi- 
cious spirit of criticism. Not the carping, 
hypercritical sort, but the kind which endeavors 
to elevate and make more valuable that which 
already occupies a high altitude in our esteem. 

With this latter spirit as the animus, and in 
conformity with your request, allow me to sug- 
gest the expurgation of the department de- 
voted to politico-social topics from The 
World. It will be said these come in close 
touch with the physician's life, which is very 
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86 



THE MEDICAL WORLD. 



true, but many other topics might be classed 
in the same category and with equal propriety 
might be admitted. Then, were these hetero- 
geneous subjects admitted we would have a 
journal that would be really kaleidoscopic in 
the variety and diversity of its contents. 

If there be any who feel they have a self- 
imposed mission to perform in weaving into 
the complex social web of life the bright woof 
of Utopianism, let them promulgate their ideas 
through the many channels open solely for 
that purpose. 

Let the columns of our medical journals be 
richly freighted with the medical pabulum 
that enables the eater thereof to be virile and 
herculean in the battle with the common 
adversary of man. 

It certainly is a prostitution of one of the 
most noble and beneficent callings in which 
mankind is engaged to trail it through the 
slimy depths of politics. 

During the last six months learned and 
erudite writers have given us to satiety disser- 
tations upon capital, labor, monopolies and 
trusts, the gold and silver topics, and now 
that the election is over, let us gracefully 
accept the egis of the sovereign will of the 
people and allow the turbid political waters to 
settle. Can it not be that when we scan the 
pages of our favorite medical journal, we will 
be regaled solely with that which leads us to 
its perusal — a desire for medical truths ? There 
are many intricate and perplexing things that 
daily confront the physician, and the columns 
now filled with what is considered correlative, 
if otherwise filled, might furnish the solution 
to one confused subject. Let us turn on the 
search-light of strictly medical investigation 
and observation, and in this way devote all 
our energies to illumine the many dark path- 
ways in our medical pilgrimage. 

L. B. Allen, M. D. 
Humboldt, Neb., December 15,1896. 

I immediately wrote thanking the Doctor for 
his manly, frank and courteous letter, and 
promising that I would try to make room for 
it soon in this department. Justice demands 
that the minority or the opposition be given 
a fair and respectful hearing, and for this 
reason I publish the above letter. I tried to 
get it in last month, and had written about a 
page and a half in reply, but this I have decided 
not to publish. Is not this deparement itself 
a sufficient reply ? A few years ago I agreed 
with the Doctor entirely ; but these hard times 
have borne so heavily upon doctors that they 
cannot afford to be indifferent to remedies that 
they, as citizens, can greatly aid in bringing 
about. And whenever doctors are in need, 
Thb Medical World will be with them, try- 
ing to aid in every legitimate way. Don't 
spurn politics when good or bad policies deter- 
mine whether we shall have prosperity or 
adversity. If the " slimy depths of politics " 
are dirty, clean them. Doctors should be good 
at disinfecting. In his second paragraph I 



think the Doctor refers to the newspapers. If 
he knew to what extent they (particularly the 
metropolitan press) ape influenced by the in- 
terests of the "classes," he would better 
appreciate these few pages every month, 
devoted to strict economic justice to all. It 
this could be accomplished there would be no 
more hard times for intelligent, sober and in- 
dustrious physicians. 

Many were surprised at the calculation in 
my article entitled " An Honest Million, " in 
World for last May, showing that a man 
working every week day, beginning at the 
birth of Christ and continuing all these cen- 
turies, saving one dollar per day, would at the 
present time have only a little more than half 
a million of dollars. Now, let us put a dollar 
at work drawing interest at the same rate as 
our bonds, 4 per cent., interest payable quar- 
terly, and see what the result is. Prof. H. C. 
Whitaker, of this city, kindly worked out the 
problem for me and here is his answer : 

11 Had one dollar been loaned on the first day 
of January, A. D 1, interest being allowed 
at the rate of four per cent, per annum 
compounded quarterly, then 1896 years later — 
that is, on January 1st, 1896— the amount 
due would be $593, 333, 360,81 9, 160,830, - 
000,000,000,000,000, (593 nonillion dollars). 
If it were desired to pay this in gold 23 22 
grains to the dollar, then taking spheres of 
pure gold the size of the earth, it would 
require 51,858.3 of them to pay the amount. 
A single sphere of gold to pay the debt would 
have a diameter of 294, 957 miles. " 

Just think of it. Over fifty thousand worlds, 
all pure gold, to pay for that dollar ! Shall we 
now ask, which is accounted the most impor- 
tant in our civilization, the man or the dollar ? 

Here is the record of only one dollar, but it 
draws interest for a very long time. Now 
think of the many millons of our National 
bonded indebtedness, which, it seems, a 
certain class of people want to make perpetual. 
Further, our states, counties and municipali- 
ties have fallen into the bond habit. And, 
still further, our railroad bonds amount to 
more than all these combined, issued mostly on 
fictitious values, but the people have to pay 
interest on it all, in the form of exorbitant and 
ruinous transportation rates . The attempt has 
been made, and will be made again, to make 
all these payable in gold. In the light of the 
above calculation, the " goose that lays 
golden eggs" must retire to an insignificant 
place, and God must come forward and change 
the planets into gold to pay these bonds ! Let 
us place high upon our banner this motto : 
No More Bonds Forever! C. F. T. 



$&> In deference to the wishes of many subscribers, I have 
reprinted some of my articles on industrial and economic ques- 
tions, and will send them to physicians on receipt of three cents 
per set. It is understood that everyone receiving these will pass 
them around among his patrons, and make efforts to fume them 
published in the local paper. This last is specially important. 

C.F.T. 
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Wit and Wisdom. 



Can you afford to not have The Medical 
World come to your desk every month ? It 
is a capital pocket companion, for use when 
you are detained. Try it. 

Notice posted up in Swiss pass : " No Echo 

*»*o-day." The American tourist wonders if 

the operations of nature have gone on a strike. 

No, the fellow engaged to do the * ' echoing " 

was sick that day. 

We take pleasure in calling attention to a 
very handsome pamphlet, presenting some 
practical and interesting facts concerning 
tongaline and the different troubles for which 
that remedy is intended, namely : rheumatism, 
neuralgia, nervous headache, la grippe, gout, 
sciatica and lumbago. The brochure is ren- 
dered most attractive by being embellished 
with original drawings, and also handsome 
photogravures of a number of eminent mem- 
bers of the medical profession now deceased. 
It is the aim of the publishers to mail a copy 
to every physician in the country, but any 
who fail to receive such can obtain one by 
applying to the Mellier Drug Company, St. 
Ivouis. 

Have you patients who cannot take cod 
liver oil? Then go to the "marrow" of the 
problem by considering Carnogen (beneath 
Contents), which is made largely of marrow. 
Please do not neglect this. 

Is pepsin falling into disuse ? Is it because 
Caroid is so much better? Pepsin is applica- 
ble to only one class of foods, only in the 
stomach, and only in an acid medium. Caroid 
will digest all kinds of foods in all kinds of 
mediums; it begins its work as soon as it 
passes the lips, and continues all through the 
digestive tract as long as there is work to do. 
See title page, and write for further information. 

Have you patients that cannot take iron ? 
Or how about that chlorotic girl that the usual 
remedies fail to reach ? Turn to Contents, 
then turn leaf and look at bottom of left-hand 
page. That will help you out. 

What is Terraline ? It has now been before 
the profession seven years. A half-page ad- 
vertisement in this issue will tell you what it 
is. 

When they ask what tonic they shall take, 
Teutonic will be the proper answer in a large 
number of cases. See advertisement in this 
issue. 

Iris aquestion of clothes ? E. O. Thompson 
is your man. He will send you samples and 
illustrations free. See his offer. 

S. G. P. O. What does that mean? A 
column on another page will explain. 

A postal card will bring to your desk Frye's 
Bulletin of Instruments. Wiry not have it ? 
See his advertisement. 



"Physician as a Business " are still going 
at half price, 50 cents: When they are gone 
you will want one. Same way with Skin 
Chart, 15 cents. See Order Blank. 



If you have no suppository machine, get 
Gibbs' Hollow Suppositories. You can easily 
put in them whatever you want. 

It never irritates when given hypodermi- 
cally, nor nauseates when given by mouth. 
Sharp & Dohme's Ergotole. 

Some doctors are smart. They never look 
at the advertising pages. Don 't need to. Too 
smart ! Poor fellows ; they don't know what 
they miss. A good picture of Dr. Waugh 
appears in the advertising pages of this issue. 
Dr. Abbot is publishing his book, soon to 
appear, and gives us the Doctor's picture, and 
information concerning the book. 

Don't pay book-binder's bills. Get World 
Binder, only 35 cents (see Order Blank on page 
xx), equal to others sold at from 50 cents to 75 
cents. Our Binder takes each World as it 
comes, thus keeping them clean and all to- 
gether in regular order. 

We have spent a delightful half hour read- 
ing a biography of Sir Astley Cooper, just re- 
ceived. The anecdotes of his early life are 
very amusing, and the peep into life, both 
medical and general, in England a century 
ago, is very interesting. Send a postal card 
to the Norwich Pharmacal Company, Norwich, 
N. Y,, mentioning this notice, and you will 
receive the biography free. 

Freugh's Tablets, Cough and Constituent, 
fill a needed want. I myself took the sample 
sent, and received undoubted benefit." 

J. M. Thompson, M. D. 

Kansas City, Kans. 

In over 40,000 cases of diphtheria where 
Mulford's Antitoxin was employed there was 
a mortality of less than 5 per cent. Mulford's 
Antitoxic Serum has withstood all tests, and 
it now ranks as the foremost serum for strength 
and reliability. Most recent brochure on 
diphtheria treatment free. H. K. Mulford Co., 
Philadelphia. 

It is surprising that petroleum oil with its 
positive antiseptic power, stimulant, anti- 
spasmodic, diaphoretic and expectorant prop- 
erties, should not find more extensive use in 
medicine than is given to it. The great pop- 
ular reputation which it enjoys as a healing 
agent for both internal and external use is 
well known. Do you use Angler's Petroleum 
Emulsion ? If not, why not ? 

Refer your patients needing artificial limbs 
to Marks, the greatest in this line in the world. 
See adv. and send for catalogue. 

Yes, any kind of support you want for weak 
places. SeeFlavell's page. 

Are you satisfied with your visiting list ? 
Why not try World list? See Order Blank, 
page xx. 



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THE MEDICAL WORLD. 



Among the replies to an advertisement of a 
music committee for an organist and music 
teacher, was the following one : " Gentlemen, 
I notice your advertisement for an organist 
and music teacher, either lady or gentleman. 
Having been both for several years I offer my 
services." 

Charles Marchand did a great thing 
when he introduced peroxide of hydrogen to 
the medical profession. But his Hydrozoneis 
still better. Do you use it? See opposite 
editorial page. 

W. A. Ward, M. D., New Edinburg, Ark., 
says : I have used Aletris Cordial in threatened 
miscarriage, in several instances, with the best 
results ; one case in particular, the lady was 
nervous temperament and very easily excited, 
but by giving Celerina combined with 
Aletris Cordial for a short time, she passed 
over it safely. I am of the opinion that any 
physician prescribing Aletris Cordial, in such 
cases as it is indicated, will not be disap- 
pointed in the result. 

Mulford's Antitoxic Serum is preserved by 
the addition of 0.5 per cent, of Trickresol. 
This has proven by far the best preservative, 
creating no disturbances at the site of in- 
jection, and acting in no way as an irritant. 
Most recent brochure on diphtheria treatment 
free. H. K. Mulford Co., Philadelphia. 

On page 41, January World, in speaking 
of that remarkable Hungarian bitter water, 
Apenta, we used the word " formula " instead 
of " analysis." This is a natural water, and 
the word " formula" does not apply to it. 
The analysis in January issue showed grains 
of the various constituents per gallon. The 
following shows parts per 1,000 as analyzed 
by Professor Dr. L. Liebermann, the Director 
of the Royal Hungarian Imperial Chemical 
Institute (Ministry of Agriculture): 
Sulphate of magnesia . 24.4968 

Sulphate of soda . . . 15.4320 
Sulphate of lime .... 1.0989 

Chloride of sodium . 1.8720 

Bicarbonate of lime . 0.8843 

Bicarbonate of protoxide of iron . 0.0189 

Silicic acid 0,0100 

Besides these constituents, the water con- 
tains traces of lithia and potassia. The spe- 
cific gravity, at 15 C, amounts to 1.04 14. 

Battle 's Bromidia is better than any sim- 
ilar preparation that a local druggist can 
make. We once saw on Mr. Battle's desk a 
lot of attempted imitations by local and dis- 
honest druggists. A "hodge-podge" lot 
they were; all colors and consistencies. If 
you want certain and uniform results, you 
must have a reliable and uniform preparation. 
It pays to get the genuine. 

SEE McKesson A Robbin's quarter page 
advertisement this month. They have never 
been with us before. Let us give them a 
hearty welcome. 



An editor of a Western paper recMtlyJ 
printed this rather ambiguous announcement : 
"On account of lack of space, a number of 
deaths have been postponed." 

Dr. W. C. Abbott, editor of the Alkak>idal 
Clinic, writes : "I think the Medical Wo*m> 
method of keeping accounts is the very best 
that I have ever seen, and I have looked over 
many, and I heartily congratulate yon upon 
its conception. ' ' 

Always look on page v to see what Mean*. 
Schieffelin are offering. Send for their litera- 
ture. 

Have you sent a postal to Messrs. William 
R. Warner & Co. for their Visiting Records, 
etc., " free to their doctor friends "? See bot- 
tom of their page, facing last page of reading. 

Take an ordinary pill, place it on a soft pine 
board, and with a hammer you can drive it in 
the board like a bullet. Try it with one 
of Upjohn 's Pills. At the first light stroke it 
crushes to a powder. Pressure under your 
thumb will reduce it to powder. Try it. Does 
this fact suggest anything to your mind ? 
Which kind do you want to put into the stom- 
achs of your patients ? 

A fat baby or a lean baby, which ? If it is 
fed upon Imperial Granum it will be a fat baby. 

Bovinine has joined our pages again. Mr. 
H. T. Champney, the genial and courteous 
vice-president and manager, informs us that it 
has been greatly improved. Your pale patients 
will bless you if you make them ruddy again. 
You can do it with Bovinine. 

When in doubt, give Fellows' Hypophos- 
phites ; for it is one of the very best of tonics 
and reconstructives. 

Have you used Micajah's Uterine Wafers? 
A great many doctors must use them, for they 
continue their full page with us from year to 
year. Have you read it carefully ? 

Did you send, last month, for Keith's 
Revised Manual (free)? If not, send this 
month. See their page. 

Mr. Isaac Phillips has a page with us each 
alternate issue. This is his month. See 
what he has to say. 

Perhaps you have used preparations ' * some- 
thing like Listerine. ' ' Why not use Listerine 
itself? 

If you don 't find the kind of a medicine 
case you want in the adv. of Western Leather 
Manf. Co., this issue, send for their complete 
catalogue. 

Mellier Drug Co. has two half-pages with 
us this month — one in front and one in back. 
See if they are not interesting to you. 

Dr. Lawrence's treatment for acne pustu- 
losa: 

A young lady, Miss Lizzie F. , was having a 
constantly recurring eruption of acne vulgaris, 
which commenced with dark, red papules, 

{Continued over next leaf.) 



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The Medical World 

The knowledge that a man can use is the only real knowledge; the only knowledge that has 

life and growth in it and converts itself into practical power. The rest hangs 

like dust about the drain, or dries like raindrops off the stones.— IteouDZ. 



The Medical World. 



C. F. TAYLOR, M.D., 

Editor and Publisher. 



•ubscription to any part of the United States and Canada, 
Own Dollar per year. To England and the British 
Colonies, Frvn Shillings per year. Postage free. 
Single copies, Tnir Cents. These rates must be paid 

We cannot always supply back numbers. Should a num- 
ber fail to reach a subscriber, we will supply another, 
if notified before the end of the month. 



ffay no money to agents for this journal unle 
receipt is given. 

Addssss all ComrmriCATioifS to 



i publishers 



'THE MEDICAL WORLD," 

15*0 Chestnut Street, 

Philadelphia, Pa. 



Vol. XV. 



Mabch, 1897. 



No. 8. 



<HiK4SI -**1S2|sMS 



^%3BB&r 



A certain part of the machinery 
of the subscription department was 
not watched as closely as usual this 
month, which resulted in quite a 
number of our friends who had already 
renewed receiving "reminder cards M 
concerning their renewal. Kindly par- 
don. Each one has been answered per- 
sonally, and as we know what part of the 
" machine " is at fault, it will not occur 
again. 

A Wisconsin Diploma Mill. 

We have heard much lately about 
Wisconsin diploma mills. It seems that 
one of the most enterprising is endeavor- 
ing to get $35 from every druggist in the 



country— quite a lucrative undertaking ; 
for there are between 30,000 and 40,000 
druggists in the United States, and you 
can multiply and see the great financial 
possibilities. The following circular 
letter was received by a druggist in Cam- 
den, N. J. We purposely omit the 
address: 

" Always gire jour PUIX ADDRB88 every time yon write 

no matter how often it msy be." 
(Cut of tenute f*md. Rutland, If. D., Pres't. 
wrath in e*> A. N» v« Rutlaud, If. D., BeCy. 

tended hand.) Chablxs Podmoru, M. D. , Tress. 
Incorporated under the lews of the State of Wisconsin. 

Wisconsin Eclectic Medical College* 

Dear Sir: — 

If you have any aspirations to a pro- 
fession which runs side by side with that 
of pharmacy; if you desire to become a 
physician, and have the legal right to 
append M. D. to your name, then you 
are politely requested to carefully read 
and digest the contents of the inclosed 
prospectus. 

The plan, as outlined therein, gives to 
the pharmacists an open door to the 
legitimate practice of medicine, as an 
authorized physician. In these days* 
when the pharmacist is required by law 
to be as highly educated, as well read, as 
well versed in the various branches of 
medical knowledge, and to pass as rigid 
an examination (and in some States much 
more rigid) than is required of the phy- 
sician ; is there, we ask, any reason why 
the pharmacist should not avail himself 
of the opportunity (while he has it) to 
take yet another step on the ladder of 
life and become M. D.? 

The average pharmacist's knowledge of 
materia medica, therapeutics, anatomy, 
physiology, science and practice of medi- 
cine, obstetrics and surgery is usually 

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THE MEDICAL WORLD. 



just as good as the average physician, 
indeed many much better, for there are 
thousands of practising physicians who 
never had a diploma, never was asked a 
question on the subject; while every 
pharmacist has been through the fires 
Of inquisitorial examination. 

The diplomas of the Wisconsin Eclec- 
tic Medical College are perfectly good in 
law, binding and valid, and the total 
fees are exceedingly moderate, $35 all 
inclusive. We only ask your best 
thoughts on the matter. And in the 
meantime we shall be glad to hear from 
you, and to explain any point, or points, 
not made quite clear by the prospectus, 
or any which may arise in your mind. 

We are yours very sincerely, 
Wisconsin Eclectic Medical College, 

Fred. Rutland, Ph.D., M. D. 

Inclosed with the letter was a copy of 
the charter in due legal form, with cut 
of State House, etc The following is the 
wording : 

UNITED STATES OF AMERICA, 
The State of Wisconsin, 

Department of State. 
To all to whom these presents shall come: 

I Henry Casson, Secretary of State 
of the State of Wisconsin, do nereby cer- 
tify that there has been this day filed in 
this department an instrument in writing 
purporting to be articles of association 
with a view of forming a corporation to 
be known as Wisconsin Eclectic Med- 
ical College, at Milwaukee, without 
Capital Stock, the business and purpose 
of which shall be to conduct a medical 
college, etc., and verified as a true copy 
by the affidavit of Fred Rutland, M. D., 
and Ann Neve Rutland, M. D., who 
appear in said instrument as two of the 
signers of said articles; therefore the 
State of Wisconsin does hereby grant 
unto the said Wisconsin Eclectic Medi- 
cal College, at Milwaukee, the powers 
and privileges conferred by Chapter 86 
of the Revised Statutes of the State of 
Wisconsin, and all acts amendatory 
thereto, for the purposes above stated, 
and in accordance with their said articles 
of association. 

In witness whereof, I have hereunto 
set my hand and affixed my official seal, 
at the Capitol in the City of Madison, 



the thirty-first day of December, in the 
year of our Lord one thousand eight 
hundred and ninety-five. 
[seal] Henry Casson, 

Secretary of State. 

Also, inclosed with the letter, was a 
reduced copy of the diploma! as a u sam- 
ple. 11 It is gotten np in the usual gran- 
diloquent style, with Latin, flourishes,etc. 

What can the medical profession of 
Wisconsin think of this? What are they 
doing that they do not have a law in 
their State that will put a stop to all this. 
Why do not the respectable colleges of 
the country combine to stop this evil, 
for the degree of M. D. from Jefferson, 
Bellevue or Rush is diminished in value 
by the existence of all these spurious 
M.D.'s. Let the World Brotherhood 
make themselves felt by writing to the 
President or Secretary of the Wisconsin 
Medical Society, or even the Governor 
of the State. If you pour letters in upon 
them from all directions, they will realize 
that the finger of shame is being pointed 
at Wisconsin from all parts of the 
country ; and this, if anything, will in- 
duce them to render the continuance of 
this outrage upon the profession impossi- 
ble under the authority of their State, 
The President of the Wisconsin Medical 
Society is O. B. Reynolds, M. D., Lake 
Geneva, Wis. ; the Secretary is C. S. 
Sheldon, M. D., Madison, Wis. The 
next annual meeting takes place at 
Racine, Wis., May 4, 1897. 

Later: A sample of another circular 
letter sent out by this enterprising firm, 
addressed to another class, is sent us 
from Tennessee: 

Dear Doctor: 

We notice your name in a medical and 
surgical directory, but with a * appended. 
A foot-note to each page remarks, u No 
reply received in answer to inquiry re- 
garding graduation." 

As in such a case there is at least a 
presumption that the person so desig- 
nated, is not a graduate of a medical 

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THE MEDICAL WORLD. 



91 



school, and has no diploma, we venture 
to address you upon the subject If, 
however, it should be that you are a 
graduate, and have a regular diploma, 
then we can but tender our most sin- 
cere apologies for troubling you on the 
matter. But, on the other hand, if you 
are not a graduate, then the perusal of 
the enclosed prospectus cannot fail to 
be of the most primary importance and 
interest to you. We would also desire 
to draw attention to the fact, that to 
practising physicians our fees are much 
reduced from the regular rate. To this 
class our fees are $35, all inclusive. 

As proof of our legal standing and 
right to confer the degree of M. D., we 
can supply certified copies of our charter 
at 25 cents each, simply covering the 
cost of certifying officers 1 fee. 

Trusting soon to hear from you, and 
standing ready to answer any or all 
questions you may wish to submit, 

We are yours very sincerely, 
Wisconsin Eclectic Medical College, 

Fred Rutland, Ph.D., M. D. 

We find that Polk's Medical Directory 
has between 30,000 and 40,000 names 
with a star appended. Quite a rich field 
for this enterprising firm to " work." 
How do the established eclectic colleges 
like die idea of this " college" calling 
itself " eclectic ?" 

A circular was enclosed which gives 
full information, such as " no personal 
attendance required, 1 ' " examination in 
your own home," etc The methods of 
what are called "monopoly" colleges are 
railed against, but the writer of the cir- 
cular makes one good point : — that these 
colleges refuse to grant the degree of 
M. D. until the applicant has patronized 
the college a certain number of years, 
regardless of the knowledge he may pos- 
sess on entering. This is true, and we 
could never understand why it should be 
true. In student days the question 
seemed to be, how many courses have 
you taken ? rather than how much do 
you know ? It always seemed wrong to 
us. If a private institution is given the 



authority to grant a degree, it should be 
required to grant the degree to all comers 
who are found to be in every way worthy, 
and possessing the requisite amount of 
knowledge for the standard of such in- 
stitution, regardless of time of patron- 
age. 

But while this wrong should be righted, 
it does not justify the "mill" above referred 
to. If such c 'mills" grind out diplomas 
promiscuously very long, the degree of M. 
D. will be of no value unless followed 
by the name of the institution granting 
the same ; and this is not practicable, as 
there are now so many colleges of high 
standing. The result will be that few 
will care about the degree of M. D., for 
if these " mills" be continued it will 
lose its value ; but, instead, a license to 
practice from some board of examiners 
authorized by law will be more valuable 
than M. D. A law like that of Illinois, 
which gives the State board the right to 
require that a college must reach a cer- 
tain standard, else its diplomas will not 
be recognized, is a good one. With a 
safeguard like this the " mills " will do 
less harm, for their diplomas are not reo 
ognized in Illinois and States so guarded. 

We do not find Fred. Rutland, " M. D.," 
nor Ann Neve Rutland, U M. D.," nor 
Charles Podmore, "M.D. ? " in the third 
edition of Polk's Medical Directory. 
Query : Are their " M.D.'s " home-made ? 



This is the "grip " number — that is, 
the Editor has been suffering from 
" grip " while preparing this issue. On 
this account many interesting points in- 
tended for this issue cannot be presented 
until next issue. He has found spirits of 
camphor the most useful drug in this 
disease, taken preferably in milk, half 
a dram about every hour. By this means, 
and by use of quinia and st rychn ia as 
tonics, he has been enabled to u De about" 
a part of each day. Doctors require their 
patients to give up and go to bed ; but 
they don't like to do it themselves. How- 
ever, no evil consequences have resulted 
in this instance. 



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THE MEDICAL WORLD. 



Original Communications. 



Short articles on the treatment of diseases, and experience 
with new remedies, are solicited from tne profession for 
this department; also difficult canes for diagnosis and 
treatment. 

Articles accepted must be contributed to this journal only. 
The editors are not responsible for views expressed by 
contributors. 

Copy must be received on or before the twelfth of the 
month for publication in the next month. Unused 
manuscript cannot be returned. 

Certainly it is excellent discipline for an author to feci that ho 
must say all ho has to say in the fewest possible words, or 
his reader is sure to ship them; and in the plainest possible 



anything else.— Ruskxh . 
READ. REFLECT. COMPARE. RECORD. 

Emptying the Bowels.— Replies. 

Editor Mbdical World :— Two 
curious cases of "reflex" pain have 
been recently under treatment in the 
Hyde Park Sanatorium, which may be 
of interest One was a case of " rheu- 
matism," the diagnosis being based on 
the definition of rheumatism as "any- 
thing that hurts." The lady had had 
for years pains in her lumbar region, 
down the sciatic nerves, and in her 
knees. At times her great toes would 
swell, when her friends at once diagnosed 
gout But the pains were rarely con- 
stant ; they shifted in a few seconds from 
one locality to another. They were dis- 
tinctly worse at night She was also sub- 
ject to attacks of dysentery, which she 
kept in check by laudanum, of which 
she had got to using about two ounces 
weekly. With this, the bowels were pro- 
nounced regular. 

An examination revealed a small, but 
very sensitive ulcer in the posterior wall 
of the rectum, a rather tight sphincter, a 
prolapsed uterus and several small inter- 
nal hemorrhoids. The abdomen was 
rather uncertain in its percussion notes, 
and too tender to permit of thorough pal- 
pitation. The tongue was coated and 
disposed to exhibit a darkish stripe down 
the center. 

Now, I concluded that the key to the 
situation lay in the rectal disease ; but 
this proved not quite correct I gave her 
chloroform and replaced the uterus, 
dilated the anal sphincter, and needled 
the hemorrhoids. There was a discharge 
of fecal matter, mushy, light, well- 



digested and not unduly offensive. To 
prevent irritatio n of the rec tum, I or- 
dered s ma^j o t enemg^ repeated four 
ti mes a day . Here we began to get at 
the true cause of the trouble, for the de- 
jections contained black scybala, evi- 
dently of ancient date (paleozoic, the 
nurse declared). I began giving her 
apenta water, in doses of four ounces 
every four hours, and continued the 
enemas. It took us three weeks to re- 
move the accumulations from that 
woman's bowels. We had to be very 
cautious about the use of purgatives, as 
it would have taken very little to set up 
inflammation in the opium-weakened, 
feces-soaked tissues of the intestines. At 
times the occurrence ' of a recent stool 
made us think we had emptied the 
bowel, but the next enema would be 
black. During the first week we fre- 
quently expressed our wonder as to where 
the immense accumulation could have 
been stowed away ; but as time went on, 
and the end was not reached, we simply 
gave up that problem as inexplicable. 
Near the end of the third week the 
stools became offensive, and at once the 
evidences of fecal absorption and conse- 
quent auto-toxemia were manifested, 
such as frontal headache, nausea, and 
the old aches. These, however, were lost 
in a huge discharge of bile, which she 
vomited and purged for two days and 
nights. We thought that this would 
surely complete the clearing of the 
bowel, but the next enema returned 
black. Finally, at the end of twenty- 
four days, the alimentary canal was com- 
pletely cleansed, and rendered asceptic 
Dy a little sulpho-carbolate of lime. 

The result has been the total disap- 
pearance of all the ailments, the gout 
rheumatism, sciatica, dysentery, coated 
tongue, headache, opium habit and 
numberless minor discomforts which we 
group as haresthesias. 

Now, I thought I had surely had ex- 
perience enough to teach me how to 
empty a woman's bowels, but this case 
has taught me a lesson. Hereafter I 
shall agree with the genius who begins 
treatment in every case with a thumping 
big physic, and follow with the reme- 
dies indicated. I shall bid adieu to the 
gentle laxatives and revert to the lusty 
medicaments of our grandfathers — gam- 

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93 



boije, scammony, colocynth and palap ; 
reduced to a mass with croton oil, and 
add a dash of elaterinm. And we will 
hope that the patients will take the same 
enlightened view as their grandmothers, 
who judged of the skill of the doctor 
solely by the strength of his purgatives. 
Thus is the wisdom of the aged corrobo- 
rated, and modern science exhausts itself 
in finding the explanation of their 
success. 
9 The other case is very peculiar. A dis- 
tinguished citizen of a neighboring State 
received a severe injury to his head dur- 
ing childhood. That it did not injure 
the brain is evident, as he has won a high 
position at the hands of his fellow-citi- 
zens, with the prospect of a still higher 
in the future. But his right leg has 
not developed equally with the left, 
causing some lameness. The skull on 
the right side is depressed over the region 
corresponding to the leg, and there was 
a large scar in the scalp. I found this 
scar quite hyper-sensitive, especially to 
the faradic current There was a rectal 
ailment, and decidedly unpleasant sensa- 
tions ensued when one pole of the fara- 
dic was applied to the scar and the other 
in the rectum with a very mild current 
It will be noted that the injury was on 
the same side as the ill-developed limb. 

I concluded that the scar was the seat 
of the reflexes present and excised it. 
As yet, it is too soon to speak of the re- 
sult, but I believe it will be successful. 
The operation was done under local 
anesthesia, produced by the new agent, 
eucaine, a two per cent solution being 
injected into, not under, the skin along 
the lines of incision. 

On page 78, February World, Dr. 
Dodge asks about the treatment of facial 
neuralgia. I would amend the advice 
given by suggesting that he will not find 
his " warm, equable climate " in South- 
ern California. I have been compelled to 
order my consumptive girl out of Cali- 
fornia on account of the dampness and 
cold nights. The cold is of a peculiarly 
trying character, so that ladies accus- 
tomed to Chicago winters find it impos- 
sible to keep warm enough to sleep, even 
after piling on a small mountain of bed- 
ding. The girls are now at Phoenix, 
Arizona, from which I expect a better 
report. 



Dr. Dodge had better entrust himself 
to a competent oral surgeon, if Garretson 
left a successor. His experience con- 
vinced him that in every such case there 
was something interfering with the nerve 
at some part of its course. If so, what 
is the use of giving drugs which cannot 
release a nerve pinched in its passage 
through a foramen whose lumen is nar- 
rowed by inflammatory deposits. 

I would advise Dr. Andrus (page 79) to 
put his case of tachycard ia upon glonoin 
and hyo scy ami ne jMrTftenaroxysmsT and 
iodide of a rsenic ltTtEg mtervals. These 
nervous disorders often, if not always, 
indicate the presence of some structural 
derangement, and in the combination 
suggested we have the two most power- 
ful agents as yet known for combating 
cardiac lesions. 

Dr. Witney might try the hypodermic 
injection of chromic acid or formalin 
solution to cure the port wine mark 
(page 79). Inject a one-half per cent 
solution just under the skin, the needle 
being entered parallel with the surface 
for its full length. A very little of the 
solution is to be deposited as the needle 
is slowly withdrawn. 

To Dr. Stidworthy : In your next case 
of int ussusceptio n, inver t the c hild and 
give alof eeq enema of hot wafer. 

WlLUAM J^. WAUGH, M. D. 

103 State street, Chicago. 

Death off Twin in Uterus. 

Editor Mbdicai, World.— Not long 
since I was called to attend a clergyman's 
wife in confinement ; had attended her 
in four previous. The labor was normal 
as usual, and of short duration. Was 
obliged to remove after-birth as usual, 
and, as I grasped the secundines, I felt 
something the shape of a clam shell. 
After removal, I gave the nurse (aside) 
directions to put it aside till I could give 
it an examination. The examination re- 
vealed the skeleton of a fetus measuring 
8 inches in length, the parietal bones of 
skull being pressed nearly together, giv- 
ing the feel in utero of a clam shell as 
above stated. 

I could determine the sex, a male 
fetus, which, from some cause unknown, 
had died and remained till after the birth 
of its twin sister, which was a healthy 
child, and is to-day a fine, stout, rosy 

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THE MEDICAL WORLD. 



girl. The mother, a very intelligent 
lady, says she felt a considerable uneasi- 
ness and indisposition near the fifth 
month, which lasted only four or five 
days, and then till the expiration of term 
felt quite as well as usuaL To me it 
seemed a case of considerable interest 
H. Rowland, M. D. 
Newburgh, N. Y. 



Qangreoe off Bowels Due to iatusstucoptton. 

Operation for Relief on Ninth Day, 
Death on Tenth Day. 

Editor Medical World : — E. R., 
male, age ao years, of good physique, 
previous health good, except recurrent 
attacks of indigestion, of good habits, 
leading an active life upon the stock 
farm, was, without previous warning, 
seized with severe griping pains in the 
bowels while at school on December 8, 
1896. Soon after the onset of the pains 
he started to walk home, a distance of 
one-half mile. With great difficulty 
he succeeded in reaching his home, but 
no one being at the farm house, he was 
without help for about two hours longer. 
Upon the arrival of his mother, and 
after unsuccessful attempts being made 
to relieve the pain, he was placed in a 
conveyance, and they started to town to 
procure medical attention. Upon the 
way they were met by a physician, who 
administered some medicine and advised 
his immediate return home. Shortly 
after reaching home the physician called 
and administered salts to move the 
bowels, and morphine tablets for pain. 
The symptoms being worse, if anything, 
another physician was called, who ad- 
ministered cathartics, such as calomel 
and seidlitz powders, with no relief of 
pain and without producing an action 
from the bowels. 

On the fourth and fifth day two or 
three enemas of about one-half pint of 
water were administered, also seidlitz 
powders by enema, dissolved and in- 
jected separately. 

Upon the fifth day fecal vomiting set 
in, and at midnight I was called. Be- 
fore the arrival of the physician in at- 
tendance I proceeded to inject per rectum 
in knee-chest position large quantities of 
water, using a long rectal tube and Allen 
pump. The tube was inserted a distance 



of about two feet A small quantity of 
fecal matter came away with the water. 
Subsequently a large quantity of olive 
oil was injected in the same manner, but 
with no result At this time, in addition 
to fecal vomiting, the condition of the 
patient was as follows: temperature 
normal ; pulse 94 ; tympanites not well 
marked ; distention slight ; paroxysm of 
pain in right illiac region ; pain less than 
day before. The administration of food and 
medicine by way of stomach having been 
suspended, fiscal vomiting almost ceased. 
The pain and distention being very ma- 
terially lessened, the patient claimed to 
be very much better upon the sixth day. 

Failing to secure movement of the 
bowels inside of twenty-four hours, I felt 
warranted in a diagnosis of intussuscep- 
tion of the bowels located low down near 
the right side. On the seventh day his 
temperature became sub-normal ; patient 
evidently failing ; pulse becoming more 
frequent 

On the evening of the seventh day I 
telegraphed to Kansas City, Kan., for 
Dr. P. D. Hughes, who arrived at noon 
on the ninth day. 

We proceeded to operate as soon as the 
necessary preparations could be made, 
assisted by Dr. Catharine Berry Richard- 
son, of Kansas City. 

Under ether, an incision was made in 
mediam line from above umbilicus a dis- 
tance of about four inches towards the 
pubes. Distended intestinal coils pre- 
sented; no fluid or adhesion being ap- 
parent upon surface, a search was made 
along the sides and pelvic region of the 
cavity for possible hernia in the walls. 
The small intestines were then examined 
to stomach, then from stomach to about 
middle of ileum, at which point a gan- 
grenous mass of intestines and mesentery 
was found. The proximal portion was 
invagiated, the distal portion was free 
from invagination for a distance of 
about one foot In lifting the mass 
carefully toward the surface the entire 
inverted portion became disengaged, 
showing complete freedom from adhe- 
sion one to the other. 

As the gut slipped apart it ruptured in 
more than one place, the mesentery giv- 
ing away in spots also— the tissue being 
almost completely decomposed. The 
gangrenous portion was reduced in size 

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95 



very much, being about one inch in 
diameter when at rest 

Clamps were applied in several places, 
and many ligations were made at the 
base of the mesentery close to the column 
to eliminate the slough as much as pos- 
sible. The divided ends ol the gut were 
then attached by means of a Murphy 
button. Large glass drains were then 
inserted to stump of mesentery before 
closiug abdomen. All possible pre- 
cautions were taken to prevent soiling 
adjacent surfaces with the fluid from the 
necrotic area and from the lumen of the 
gut. The patient was returned to bed 
and the drainage tube aspirated hourly. 
Small quantities of bloody serum were 
removed during the night At intervals 
milk was injected per rectum. Liquid 
food was given by way of the stomach 
hourly. Food and stimulants were re- 
tained for the first time in nine days. 
Death occurred on the ioth day. 

Upon examination of the portion re- 
moved, the necrosed portion was found 
to be two feet nine inches in length. 
There were thirteen perforations in the 
wall of the bowel. 

J. F. Pickerel, M. D. 

Beverly, Kan. 

One Year Pregnant. 

Editor Medical World:— Mrs. S., 
wife of a prominent citizen residing in 
this city, called at my office about 
January 25, 1896, and requested me to 
examine her for the purpose of ascertain- 
ing if she was pregnant Her history 
was about as follows : She was 36 years 
old, had been married ten years, and 
although very desirous of having chil- 
dren, she had never been fortunate enough 
to become pregnant She had not 
menstruated for the past two months ; 
her general health had much improved, 
and her weight had increased several 
pounds. Her abdomen and breasts were 
enlarging, and she was troubled with a 
profuse lucorrheal discharge. While 
making a vaginal examination I attemp- 
ted to pass a uterine sound very carefully 
into the womb, and found that the in- 
ternal os was closed. I informed her 
that she was pregnant, much to her grati- 
fication, and she hastened home to 
impart the good news to her husband. 

February 20th she returned to my 



office very despondent over the reappear- 
ance of her menses on that morning. I 
told her not to worry over her disap- 
pointment and to return when her 
menses ceased for another examination. 
This she did on the third day following. 
The examination confirmed my previous 
diagnosis, and she went away again 
happy. She menstruated again on March 
20th, when it ceased, and never recurred 
during her pregnancy. About the mid- 
dle of April she first felt life, and the 
period advanced uneventfully until the 
expiration of her term — September. 

At that time I was taken ill of typhoid 
fever, and being unable to attend her, she 
employed another physician, and I dis- 
missed the case from my mind. One 
month later I was again on the street, 
but only for a few days, when I took a 
relapse, and it was two months before I 
recovered sufficiently to resume business. 

Imagine my surprise when one day 
shortly after opening office Mrs. S. 
waddled in and inquired if I would not 
now take charge of her case. She gave 
me a brief history as follows : Labor 
pains came on at the expiration of her 
term, she had called a doctor who gave 
her morphine to quiet her pains, but tell- 
ling her that it would make them 
stronger, and all would soon be over. 
This kind of treatment he continued un- 
til the patient grew angry and dis- 
charged him. She had suffered pains at 
intervals, sometimes coming regular 
every few minutes and lasting 24 hours, 
but never accomplishing anything. Her 
limbs and feet were swollen and loco- 
motion was quite difficult I sent her 
home, promising to call in an hour and 
make an examination. Vaginal exami- 
nation revealed a soft, easily dilatable 
cervix, her abdomen was enlarged to 
immense proportions for one of her 
stature, encroaching upon the lungs, 
producing dyspnea. Here was a primi- 
para 36 years old, twelve months preg- 
nant, with a womb so distended with the 
products of gestalion that its muscular 
fibers were so stretched and weakened 
that to produce a strong contraction 
was impossible. 

I decided to induce labor, and so in- 
formed my patient and her friends. I 
introduced a sponge tent into the cervi- 
cal canal, and tamponed the vagina wit 1 i 



96 



THE MEDICAL WORLD. 



absorbent cotton. This was allowed to 
remain for six hours, when it was re- 
moved, and, the os being nicely dilated, 
I introduced a silver probe and ruptured 
the membranes. Large quantities of 
liquor amnii gushed from her with each 
uterine contraction, and soon labor com- 
menced in earnest. Twenty-four hours 
of hard work brought the womb and its 
contents low down in the pelvis, where 
the lips of the cervix became wedged be- 
tween the head and bony structure of the 
pelvis, there swelling and becoming 
edematous, obstructing the passage of 
the head. In vain I attempted to dilate 
the cervix and force it back over the 
head with my finger during uterine con- 
tractions, until, finally exhausting both 
my patient and myself, I concluded to 
give her a rest I administered chloral 
hydrate grs. xv, morph. sulph. gr. #, 
and in a short time Mrs. S. was quietly 
sleeping, although the uterine contrac- 
tions continued just the same as when 
awake. She slept five hours, and awoke 
much refreshed. I examined her, and 
much to my surprise found that the cer- 
vix had dilated and retracted over the 
head, which was well advanced and 
firmly engaged in the bony outlet The 
expulsive pains now became strong and 
frequent, yet they lacked the vis a tergo 
necessary to terminate this second stage 
of labor. After several hours of exhaust- 
ive and painful effort, nothing being 
accomplished, the forceps were applied, 
and my patient was delivered of a bounc- 
ing boy, which gasped two or three times 
and died, although we tried hard for an 
hour to resuscitate it. It was an extra 
large, well-developed baby ; its nails were 
very long, and curved around the ends 
of fingers and toes. 

Although much exhausted from the 
long, tedious labor, Mrs. S. made a rapid 
and uneventful recovery. Her period of 
pregnancy began about December 15th 
to 20th, 1895, and terminated December 
17th, i8q6, thus stretching over an in- 
terval of twelve months. So far as I 
know, this is a rare, and was to me an 
interesting case. A question may arise 
in the minds of some of The World 
family whether or not the first two 
months of pregnancy were simply sup- 
pression of the menses. The history of 
the case is confirmed by physical exami- 



nations made January 25th and February 
23d or 24th, 1896. I cite them as answer 
sufficient P. A. Mblick, M. D. 

Williams, Arizona. 

The Specialist 

Editor Medical World:— The so- 
called specialist spends his spare time, of 
which he seems to have much, in the 
noble occupation of lifting the cloud of 
darkness from the minds of his benighted 
brother, the general practitioner. He 
invariably closes his long-drawn article 
by recommending the country practi- 
tioner to send his patient to a specialist 
This week I read an article on the ear 
containing this sentence : " In no case 
should anyone not a specialist use any 
form of a surgical instrument to extract 
a foreign body from the ear." I wonder 
if this specialist expects us to take that 
literally r Time and again have scores 
of country doctors given a little chloro- 
form, and with a surgical instrument, 
extracted foreign bodies from the ear, 
as easily and as well as any specialist 
Any doctor of ordinary skill should be 
able to remove polypi or foreign bodies 
from the ear, nose or throat with profit 
to himself and advantage to his reputa- 
tion; and,what is more,withan ophthal- 
moscope, a test case and a few instru- 
ments, he can treat ninety-nine per cent, 
of all eye diseases, and fit glasses so well 
that the traveling specialist in that line 
will pass the town in the night If gen- 
eral practitioners would assert themselves, 
and get the work that properly belongs 
to them, the specialist would be conspic- 
uous by his absence, and the wail of hard 
times among country doctors would not 
be heard. 

Every doctor should be able to success- 
fully reduce a hernia, or operate if neces- 
sary, operate for hair lip, "radically " 
cure piles, or remove a cataract He can 
always find some poor patient who will 
accept his services, and then the well-to- 
do will know that he can do such things 
when their turn comes. 

The most pitiable man in the world 
is the doctor who, when he meets a seri- 
ous case, is forced to go humiliatingly 
before, perhaps his best family, and 
explain that the services of a specialist 
are required. If this thing must be, let 
it occur so rarely that a former case may 



THE MEDICAL WORLD. 



97 



have faded away from the minds of the 
people. 

Daring the last few years appendicitis 
has become so much a " fad " that I have 
known a doctor to call in a specialist in 
a case of colic, and the patient was able 
to be out playing next day. No doubt 
the doctor and specialist were disap- 
pointed in different ways. 

At the present time the clinics of our 
State University are crowded, the wards 
of the hospital overflowing, and patients 
daily turned away, while hundreds of 
doctors all over the State are barely mak- 
ing a living; and instead of spending 
their time in curing their own cases, they 
are busy lauding the praises of " special- 
ism, " or extolling the advantages of this 
or that great institution. Let us rather 
teach the people to rely on their own 
family physician's ability, and to give 
his judgment in all matters relating to 
disease the preference every time. 

A General Practitioner. 

Michigan. 



Otitis Media Supuratlva Chronica. 

Editor Medical World:— With in- 
creasing knowledge of the nature and 
treatment of any disease in the field of 
medical science comes the increased 
demand upon the general practitioner for 
his attention in treating diseases in that 
particular field. There are certain sub- 
jects that properly require the skill of a 
specialist, but these are cases that infre- 
quently come before the general prac- 
titioner, and the successful management 
of which requires considerable time and 
preparation. On the contrary, with the 
affection under consideration, it is one 
that is commonly met with by the gen- 
eral practitioner. The neglect which 
has usually been accorded this affection 
by the average physician is my apology 
for this paper. • 

There is a popular belief among the 
laity, and until recently encouraged by 
the profession, that it is dangerous to 
stop a chronic discharge from the ear. 
With the advanced knowledge in treat- 
ing surgical affections, this idea, as far 
as the profession is concerned, has been 
abandoned. Not so, however, with the 
laity, so long encouraged in a feeling of 
false security from the alleged harmless- 



ness of an affection fraught with dangers 
to the life and health of the patient 
Quick to appreciate the evil effects of so 
simple an affection, many of our leading 
life insurance companies are refusing 
risks to persons suffering from a chronic 
discharge from the ears. 

Many a physician has prescribed for 
cases of otorrhea, or aural catarrh, with 
a limited knowledge of the true condi- 
tion, that he would not hesitate to con- 
demn as criminal in a brother practi- 
tioner who did not make a more careful 
diagnosis in other cases. In no other 
department of medicine has therapeutic 
advances been so slow to take advantage 
of accurate anatomical knowledge. In 
the largest proportion of cases, the sub- 
ject under consideration is the result of, 
or follows, the acute condition. The 
successful management of one involves 
a knowledge of the other. A correct 
knowledge of the anatomy and physiol- 
ogy of the middle ear will materially 
assist in attaining a correct idea of its 
pathological conditions. Lined by deli- 
cate mucous membrane, and surrounded 
by firm, unyielding, bony walls,communi- 
cating only with the pharynx through 
the Eustachian tube, and the internal 
ear by the fenestra ovalis and fenestra 
rotunda, it presents all the features of a 
closed cavity. In acute inflammatory 
conditions these openings are guarded 
by structures that resist with assiduous 
care any encroachment from exudative 
material. The tympanic membrane, 
guarding the outer wall of the tym- 
panum, is the only yielding structure 
surrounding this cavity, and here it is 
usually that egress is found for the prod- 
ucts of inflammation. The drum mem- 
brane is ruptured and relief is had from 
the severe pain that characterizes acute 
suppuration of the middle ear. 

Possessed of considerable recuperative 
powers, this membrane heals in advance 
of the suppurating process in the tym- 
panic cavity, and in a short time we have 
a repetition of the process. After a 
series of perforations, the drum mem- 
brane loses its vitality, granulations 
spring up in the middle ear, and we 
have the condition under consideration 
known as otitis media suppurativa 
chronica, or chronic suppurative inflam- 
mation of the middle ear. The process 

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THE MEDICAL WORLD. 



may continue until the bony walls of the 
cavity are affected and necrose. 

The treatment depends largely upon 
the conditions found, but the key-note 
of successful treatment is found in the 
modern antiseptic surgery. The diffi- 
culty in applying this method, because 
of the inaccessibility of the cavity, ex- 
plains the cause of the numerous failures 
of treatment in this affection. It does 
not require the knowledge of a specialist 
to treat these conditions successfully ; or, 
at least, every general practitioner should 
possess the ability to treat them. Afl£i- 
seps is isjhe ke y-note. Cle anse the tym- 
panies cavity and keep it 5R3 H17 and the 
larger number of cases will recover. 
Syringing the ear thoroughly through 
the extefnaLjpeatu^will be sufficient in 
most cases. A t^enty^ve per cent 
solution of peroxide a^Cydrogen is pre- 
ferred bymany for th is purpose on ac- 
count oTTEs mechanical effect in remov- 
ing pus. Inflation by Pezzer's method, 
or by the EustacbiaxLcaJheter, will assist 
in expelling the e xudate w hen thick. 
After this is done the tympanic cavity 
should be thoroughly dried with absorb- 
ent cotton and packed with boracic 
acid. This should be done daily until 
healing has taken place. Any naso- 
pharyngeal catarrh present should have 
appropriate treatment, as it will keep up 
the aural disease. 

In cleansing, drying and packing the 
cavity, great care is necessary, and should 
be done only with the aid of speculum 
$nd a good head mirror. When the ear 
. is dried thoroughly with the probe, a 
little of th e borac ic ac id is blown into 
the ear, and with the aid of mirror and 
probe is prggsed well mtgjhe middle ear. 
This is the only wayTopaclt the cavity. 
Blown into the ear, the powder falls 
short of the intended place. 

Constitutional treatment, when spe- 
cially indicated should be given. Care- 
ful, thorough local treatment along the 
lines indicated, will generally give good 
results. A. D. Cloyd, M. D. 

Shubert, Neb. 

" Bilious Colic." 

Editor Medical World : — I continue 
to take The World because it is -broad. 
It is not afraid to present facts from 
homeopathy, nor is it afraid to take up, 



boldly and progressively, financial and 
industrial questions when they affect the 
interests of the medical profession. 

While I use every good remedy, I must 
confess that I have had my best success 
when I have been able to stick closest to 
similia similibus curantur in prescribing 
in curable cases. Here is a sample case : 
About ten years ago a lady came to me 
and said: u Doctor, I have taken old 
school remedies all my life; I do not 
believe in any others. Yet I have come 
to a pass that they do me no good, and 
I come to you like as a drowning person 
grasps a straw. I don't believe you can 
help me, yet, in desperation, I am going 
to try." Then she told me that for years 
she had had what was called bilious 
colic about every six weeks, and that all 
she could do or have done, now that 
everything had been tried, was to take a 
hypodermic of morphine and wait in 
patience for the colic to leave. Her 
doctor, who had treated her and her 
family for years, had told her that he 
could do nothing more for her, and as 
for preventing the paroxysms, that was 
out of the question. She said that one 
of her spells was then coming on just as 
it had come on scores of times before, 
and she knew just what she was to go 
through unless possibly I could prevent 
it, which she very much doubted. I 
very carefully took her symptoms and 
made a prescription as nearly "homeo- 
pathic" to them as possible. The 
totality of her symptoms had in them 
several of the symptoms caused by two 
common remedies when taken in large 
doses by a healthy person, and I gave 
her both, with directions to take them 
in alternation, two disks at a time, every 
hour. Well, she did not have the 
" spell " that then threatened, and she 
has never had one since. She keeps her 
two remedies on hand, and when she 
feels her "bilious colic " coming on she 
takes them and the result is ever the 
same. The two remedies are bryonia 
2x and nu x vomic a 2x. This is is one 
case of a large iiUtnber of its kind, and 
with such an experience, why should 
not any sane person believe in the 
efficacy of drugs applied according to 
the law of homeopathy? The old 
school doctor makes a great mistake 
when he fights homeopathy instead of 

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THE "MMDICAL '^RED. 



99 



studying it; and the homeopathist 
makes a great mistake when he neglects 
to find out all that the old school teaches, 
and to apply all that he finds to be good. 
There is none too much of good in any 
or all schools to draw on in time of need. 

Yours for the uplifting of humanity, 
A. J. Woodruff, M. D. 

Babylon, N. Y. 

[When homeopathy arose, if the 
regular profession had been rational, it 
would have embraced and included the 
truths of homeopathy, instead of fight- 
ing them and excluding those who ad- 
vocated them. So with eclecticism. 
Then we would have had no divisions, 
but one great harmonious profession, 
with enough internal differences of 
opinion to make discussion always inter- 
esting and profitable. But, Doctor, you 
do not believe the above-mentioned case to 
have been gall stone colic, do you ? Your 
treatment could not have had any effect 
on the passing of gall stones, nor their 
formation. It must have been a nervous 
affection. The term " bilious colic " is 
frequently very loosely applied.— Ed.] 

Hemorrhage from Kidney. 

Editor Medical World : — Last No 
vember, a gentleman 46 years of age, 
good constitution and good habits, came 
to my office to consult me for hematuria. 
He brought a sample of urine, about 
half a pint, in which there was about an 
ounce of blood. The patient commenced 
passing this chocolate-colored urine the 
day after a long horseback ride on a 
rough horse. There has been no fever, 
and no pain, except once a violent pain 
of short duration, due to the passage of 
clots along the ureter. I am satisfied 
that the source of the hemorrhages is 
renal. At first I resorted to cupping, 
demulcents and saline drinks ; but with 
no benefit I then treated passive con- 
gestion ; calomel several times, followed 
by a purgative, and afterwards by astrin- 
gents. Under this treatment there was 
some improvement For several days 
there was no hemorrhage, but it soon re- 
turned. I have since then used various 
astringents, such as gallic acid in in- 
fusion of uva ursi, ergot, tincture of iron, 
etc.; but with negative results. 

The loss of blood is beginning to tell 
on the patient From being the picture 



of health, he has lost about 20 pounds, 
and is anemic and weak. Temperature 
normal ; pulse 70 ; tongue clean ; bowels 
regular; no pains. Will go all night 
without passing urine, and passes it in a 
bold stream with no uneasiness, usual 
quantity. 

Any suggestions as to treatment or 

diagnosis (if my diagnosis is not correct) 

in this case will be thankfully received, 

either by mail or through The World. 

Eugene Pendleton, M.D. 

Cuckoo, Va. 

Does Not Atropla Do More Harm Than Good 
When Given With Morphine? 

Editor Medical World:— I do not 
know what has been the experience of 
the World family in respect to the use 
of atropia to counteract the effect of 
morphia ; but my experience teaches me 
that it is a harmful combination for 
hypodermic use especially. In my prac- 
tice I have noticed that whenever I used 
morphia and atropia in conjunction, no 
matter what the dose or whose manufac- 
ture I use, I invariably have convul- 
sions if the dose is large, or severe cere- 
bral irritation if the dose is small; es- 
pecially is this the case if the motor 
nerves are affected, and the morphia and 
atropia aie given to quiet them ? I find 
that I can give the morphine alone with- 
out these complications occurring. I 
have come to the conclusion that many 
of the ills ascribed to morphia are due 
in part to the atropia, and I have not used 
the combination tablets for some time. 
Perhaps others have observed the same 
action of the two drugs combined, and in 
order that we may hear from them upon 
this subject is my excuse for taking up 
this space in your valuable journal. 

Doniphan, Neb. T. H. Line, M. D. 

From Another Doctor's Wife. 

Editor Medical World:— I think the 
Doctor's Wife is a " trump." She is a 
true model of the New Woman, for she 
seeks to make woman new ; new in 
physical and mental force, and the crown- 
ing glory of mankind. The old-time 
narrow sphere of woman is widening 
rapidly. Woman's brains, which have 
been 'dormant so many years in meek 
subjection to man's superiority(?) have 
suddenly awakened to mechanism that 



100 



••'.V T&k *MEfifek%' WORLD 



astonishes even the most active minds. 
What shall we owe to the Doctor's Wife 
when we become the dictator of how our 
children shall be born ? It is the mother's 
mind and impressions that influences 
the character of the offspring, and who 
then is better able to discern when the 
proper time has come for the bearing of 
children ? It is true that women do not 
fully realize the great responsibility 
when they are called to the marriage- 
union; nor do they know the value 
of rugged health to endure. What if she 
finds the man whom she has married an 
inebriate or devoted in his attentions to 
other women? Shall she endanger a 
new life with hereditary evils? For- 
merly woman suffered untold indignities. 
Now she finds a nobler purpose in her 
life than to be held down with rude hands 
an humble victim to a man's unreason- 
able demands. In the Woman's New 
World, built by women's ingenuity, is 
there now generous opportunity for real 
spiritual development This /in de Steele 
will crumble the "old maid" stigma, and 
woman will see the dawn of her noble 
mission. Why in so many depart- 
ments of life is sympathy lacking? 
Simply because the man has crowned all 
with exterior glory and given little 
thought to the interior — the soul. 
Woman brings the heait into action. 

That a man should utter: "Eve 
brought this misery into the world, and 
so must woman suffer," shows the old 
regime of religion. It is not the true 
conception in this enlightened age. 
Such a man should break away from the 
bonds of his doctrines and read the New 
Dispensation. The churches of the 
present day ring with this old idea. 
They are reverberated from the walls like 
echoes from the forests, and fill the ears 
of all. But "Behold, I make all things 
new." As new and beautiful truths are 
shining in the old words of the Bible, so 
shall woman's cause receivejustification. 
As woman bears the mental anxiety of 
the coming new life, should not physical 
pain be spared her ? Let the new light 
of the Doctor's Wife shine in your 
glorious profession ! My husband, bless 
him! voices the sentiments for alle- 
viating woman's sufferings. 

Another Doctor's Earnest Wife. 

The Riviera, Italy. 



Pulmonary Emphysema. 

Editor Medical World :— I was 
called upon to examine and prescribe for 
Mrs. P., in November, 1896. She was 
supposed to be suffering from chronic 
phthisis. This proved to be a very in- 
teresting case, as she had been under 
treatment from several local physicians, 
and was then taking treatment from a 
Cincinnati advertising firm for consump- 
tion. I found her suffering from a most 
distressing dyspnea. So pronounced was 
the symptom that she spoke only in 
whispers, and would have to rest often in 
the midst of sentences. The history was, 
that from early childhood she was easy 
to " get out of breath ; " running, climb- 
ing stairs, etc., were always very tire- 
some to her. About a year or more ago 
this became very much worse while vis- 
iting in an adjoining State, and the phy- 
sician who examined her then concluded 
that she had heart trouble, and the treat- 
ment, probably nitro-glycerine, gave her 
some relief. Upon careful examination 
I found the following condition : A very 
decided alteration in the shape of the 
chest, in that there was elevation and 
arching of the sternum, with consider- 
able bulging of the infra-clavicular and 
mammary regions, giving a perfect pic- 
ture of the " barrel-shaped chest of em- 
physema. There was an extensive 
bronchitis which, in my opinion, ac- 
counted for the constant elevation of 
temperature. There were crepitant and 
sub-crepitant rales over the entire chest, 
of a lower pitch, however, than usually 
heard. The expectoration was charac- 
teristic of bronchitis, and she told me she 
had had one hemorrhage. There was not 
the marked cyanosis one would expect in 
such a condition ; only a slight blueness 
of the lips ; but the physical condition 
was such as to warrant me in diagnosing 
it a case of emphysema with chronic 
bronchitis, with repeated acute attacks, 
as a complication or probably as an 
etiological factor in its development My 
prognosis was unfavorable, as the poor 
woman was already worn out by the re- 
. peated attacks of bronchitis and the great 
labor necessary to get breath. I gave her 
for the dyspnea, nitro-glycerine com- 
pound, and ordered for experiment the 
fl. ex. of asperdosperma, as it had been 
recently lauded |y ed en^5gfthorities 



THE MEDICAL WORLD. 



joi 



for asthmatic dyspnea. It was claimed 
for this remedy that it would carry 
enough oxygen to the blood to serve the 
demands of the economy, notwithstand- 
ing the failure of the lungs to properly 
aerate that fluid. I combined pot 
iodide in small doses for the existing 
bronchitis, and placed her upon a general 
tonic. The (Llj£g, Vmebracho J afforded 
some relief, but in a lew weeks this most 
excellent and interesting lady passed 
away. I was informed by her husband 
that no physician had ever examined her 
except in a very casual way before I was 
called in, so you can imagine my sur- 

}>rise when my attention was called to the 
act that two very eminent physicians had 
declared that I did not know what I was 
talking about when I said she had em- 
physema ; and that she certainly died 
of consumption. Would like to hear from 
you, Mr. editor, as to your experience in 
relieving this distressing complaint with 
the quebracho. Will say that upon in- 
quiry I found that the hemorrhage was 
nothing more than the slight hemoptysis 
spoken of as liable to occur by our 
authorities. W. H. Howell, M. D. 
Center Hill, Fla. 

[Have had no experience with que- 
bracho in emphysema. Hope our readers 
will discuss this case, and the subject of 
emphysema. — Ed.] 

Dementia. 

Editor Medical World :— With your 
consent, I will report a case for the 
consideration of The World family and 
yourself. 

Mrs. Iy. C. D., aged 62 years, came 
under my care about seven years ago. 
Previous health good, excepting irregu- 
lar menstruation and malise. At 56 years 
of age, patient ceased to menstruate. As 
the menses began to recede from the 
normal, she began to show signs of 
mental aberration. 

These hallucinations reached the 
climax on Christmas Day, 1893, at which 
time I was hurriedly called to see her. 
Found patient propped up in bed, and 
contending that nothing was ailing her. 
Upon examination I found pulse and 
temperature normal, tongue clean, appe- 
tite good, digestion normal, and bowels 
and kidneys regular. Respiration I 
found to be excellerated, and all ques- 



tions asked her were vaguely answered. 
I gave a placebo and began to search for 
the cause of this trouble. 

While there is no tendency to insanity 
in her family, yet tuberculosis is the 
family heritage, having brothers, sisters 
and two daughters to die of it Within 
the last two years patient's condition has 
grown from one of periodical dementia 
to one of continuous character. Her 
hallucinations are of a peculiar nature ; 
for while she has all faith and confidence 
in her husband, still she believes that he 
is responsible for all her troubles, claim- 
ing that if he but lay his hand upon her 
she will suffer intense pain. Upon this 
hypothesis she refuses to sleep with him, 
and will not even allow him to touch her 
by contact, even in passing by in house 
or out of doors. I wish to further add, 
that at her worst seizures her face will 
be covered with acne. She refuses to 
take treatment, claiming that there is 
nothing the matter with her, and medi- 
cine is not needed. What can be done? 
E. J. Yager, M. D. 

Graysville, Ind. 

Puerpural Eclampsia.— Fracture of Femur and 
Humerus of Child. 

Editor Medical World :— I was 
called Jan. 6, '97, at 5 a. m., to see Mrs. 
R., aged 35 ; pnmipara. Before reaching 
house was met by messenger, and told 
to hurry, as patient was very bad. On 
arrival I found her in convulsions ; was 
informed by husband that it was the 
third convulsion. On digital examina- 
tion I found no dilation of the os what- 
ever, and very weak contractions of 
uterus. Head of child in L. O. P. posi- 
tion. I immediately gave }£ £r. morph. 



sulph., hypodermically, and repeated it 
at end o£ half ho ur. I began dilating the 
os with mylingers, and stimulated con- 
traction with my disengaged hand, by 
gently kneading the abdomen. After 
working about three-quarters of an hour 
I had dilated the os sufficiently to admit 
one-half of my hand . I made an attempt 
to deliver with forceps, but failed, as 
patient was in such a severe convulsion. 
I did not wait to further dilate, but 
passed my hand up and grasped the left 
leg of the child. I could not discover 
any pulsation of the umbililcal cord, and 
presumed the child was d£2)^JL hastened 



102 



THE MEDICAL WORLD. 



to bring down the leg that I held in my 
hand, and snapped the femur in upper 
third. I then delivered ; had a retained 
placenta, which I at once removed. The 
child in a few minutes began to gasp, 
and soon revived. It was taken care of 
by an old lady that was called in to wash 
and dress the baby, as is the usual cus- 
tom. She called my attention to the 
peculiar way in which the child was 
holding the arm, which, upon examina- 
tion, I discovered was fractured (middle 
of left humerus.) 

The convulsions ceased as soon as 
child was born, but the mother remained 
unconscious for about twenty-four hours, 
when she began to show signs of return- 
ing consciousness, but for several days 
she was blind and had severe headache, 
after which she improved quite rapidly, 
so that by the end of the sixteenth day 
she was able to sit up about half an 
hour. 

The fractures were reduced and re- 
tained as follows: For humerus, an 
angular splint from shoulder to wrist, 
made out of pasteboard, two thicknesses. 
Femur was treated by vertical extension, 
viz.: Sound with fractured limb flexed 
at a right angle with pelvis and fixed 
by light wooden splints with short co- 
aptation splints of pasteboard over frac- 
ture, and hoisted up and fastened to a 
bar above the bed, which was made as 
follows : A piece of board three feet long 
and fourteen inches wide ; about ten 
inches from one end I nailed on each 
side, in a vertical position, a piece 
eighteen inches long and three-fourths 
of an inch thick. Across top I nailed 
what was to be the bar, a piece one- 
half inch thick. A pillow constituted 
the bed, and child was hoisted high 
enough to admit of placing a diaper 
under child and removing whenever 
soiled, without disturbing the child. At 
the end of three weeks all splints were 
removed and union of both bones found 
to be perfect The unique part was the 
bed, as it was so convenient ; if child 
worried they could pick up the child, 
board and all, and walk with it or 
gently sway it from side to side without 
disturbing the extension. 

I do not believe any treatment for 

puerperal convulsions will be found as 

uccessful as removing the cause, viz.: 



delivery of the child. In about 600 
labor cases I have lost two patients, one 
from suppurative metritis, the other 
from puerperal eclampsia — a case that I 
took out of sympathy, as the attending 
physician backed out and refused to 
attend. I rely on morphia hypodermi- 
cally in decided doses, repeated fre- 
quently if required, and delivery as 
quickly as possible. I have frequently 
seen cases where chloral, bromides, 
chloroform and bleeding had been used, 
but never with as good success as with 
morphia. After controlling the convul- 
sions with morphia then I believe you 
will get good results from chloral and 
the bromides. 

J. Sengstacken, M. D. 
. Stony Point, N. Y. 



Dressing for Burns. 



Editor Medical World:— I see lin- 
seed oil and lime water, equal parts, 
often objected to in the treatment of 
burns on account of it being "nasty." 
I have used it in many cases, and with 
perfect satisfaction both to myself and to 
the patient I have never found a 
cleaner dressing. Spread the "carrion 
oil" over thin layers of absorbent cotton. 
Apply this cotton, oiled side, to the 
burned surface, and over this apply* 
a soft roller bandage. The cotton takes 
up the excess of oil, and when it dries it 
makes a smooth, air-tight shield. Let it 
remain on from one to three days, as 
may be thought best When removed, 
it is found to be perfectly clean, some- 
what resembling chamois skin. It is 
the most cleanly as well as the most 
effective dressing I have ever used. 

G. M. Jameson, M. D. 

Buda, Texas. 



Neglect of Sexology. 

Editor Medical World:— The fol- 
lowing paragraph from Dr. Waugh's 
communication in the February World 
I consider particularly cold, heartless and 
cruel : 

"The woman who marries, knowing 
herself physically unfit for maternity, is 
guilty of a crime that deprives her of 
all claim to sympathy. 1 * 

Woman should not be punished for 
ignorance when gi ^ b ^@^ogl(jociety 



THE MEDICAL WORLD. 



103 



almost entirely preclude knowledge. 
How is a young woman to know whether 
she is fit for maternity or not when usage 
forbids her to even think of the science 
of sexology except as something dread- 
fully bad. Your schools and colleges 
will instruct her in the languages and 
Delsarte, but all taboo the subject of pro- 
creation, noth withstanding that the de- 
fect of knowledge on that one matter 
may mean to her a life-time of misery. 
You say she should be taught by her 
mother. But suppose her mother is as 
ignorant of sex as she ? My dear sir, 
give us mothers that are educated on sex 
lines, and the coming generations will be 
educated. But our system of moral 
ethics has purposely kept the mothers in 
ignorance of the use and misuse of the 
sex functions, and then you say that 
suffering womanhood, under certain 
conditions, has no claim for sympathy. 
If a family physician would even suggest 
any word of advice to the daughter 
about to marry, the family would be 
shocked. This is not so much the fault 
of the doctor as it is of the social code ; 
but the medical profession acquiesces in 
the outrage of misfit marriages, and lies 
back and accepts the fruits of post- 
9 marital miseries. Lenox. 

McKeesport, Pa. 

Some Thoughts Relative to Sending Patients 
Away from Home. 

Editor Medical World:— The physi- 
cian is confronted by a question of enor- 
mous importance when he is sought for 
advice as to whether the patient should 
seek a change of climate, and where to go. 

In order to advise properly, the physi- 
cian should be reasonably confident of 
the correctness of his views upon the 
following questions which may arise : 

1. Is the influence of therapeutic meas- 
ures, hygiene, sanitation and dietetics of 
no permanent avail ? 

2. Are there any poi gnant physical 
contra-indications to sending patient 
away? 

3. Is patient financially competent to 
procure the ordinary comforts at a dis- 
tant health resort ? 

4. Is patient willing and physically 
able to do light outdoor labor, or to ex- 
ercise judiciously in the open air? 

If it is decided that the patient should 



try climatic influence by a radical change 
of residence, the physician who is best 
competent to judge of the merits or de- 
merits of the particular locality best 
suited to each case is the one who gives 
some thought to the climatic and meteoro- 
logical conditions, to soil, railroad facili- 
ties and the social advantages of the 
place in question. 

Other points for him to consider are : 

1. The patient's physical condition 
under the climatic condition present in 
relation to what may be reasonably ex- 
pected from a journey (continued or in- 
termittent) to a locality the special atmo- 
spheric characteristics of which he is 
well aware. 

2. The choosing of that place where 
the most hours of daily sunshine are 
present, and where diurnal extremes of 
temperature are not characteristic. 

3. A locality sheltered from cold, 
damp or dust-laden winds. 

4. Kind of life intended to be pursued 
by patient. 

5. The mental and nervous character- 
istics, and the amount of hope displayed 
by the invalid. 

6. The season of year when change is 
to be made. 

7. The age, sex and social relations of 
the patient. 

H. Foster Hazlett, M. D. 
Pueblo, Colo. 

Blight's Disease.— Membranous Croup. 

Editor Medical World : — I would say 
to Dr. A. L. D., of Arkansas, that because 
one has Bright' s disease it does not neces- 
sarily follow that his doom has been pro- 
nounced. Taken in its early stages, 
Bright's disease may be cured, and even 
later it may be greatly benefited and life 
prolonged. 

Besides the good advice given you by 
the editor, as to keeping the skin acting 
freely, and using iron (Basham's mixture 
is good to alternate with the tincture), I 
would advise gLftngin ( nitro-glvc^r ine). 
Of this use a one per cent, solution, one 
drop four or five times daily. If this 
amount does nbt ' caussCaj^ffceptible 
flushin g of th e face gnd-fulness about the 
head, it may be increased until it can be 
felt, nofunpleasantT y7but noti ceably. I 
have never used this remedy without 
producing a nota^d^g^^^albu- 



104 



THE MEDICAL WORLD. 



men in *hfi ii^fi ; and when begun early 
I believe it a cure for such a condition. 
A prominent real estate agent of this 
city, who came here for his health a few 
years ago, was barely able to walk to my 
office, a distance of two blocks. He was 
anemic, feeble, digestion very poor, albu- 
men in urine, tubular casts noted micro- 
scopically. Put him on the glqnoin 
treatment wi&BaslnnT ,c mixture, largely 
milk d iet, with special directions asW 
the excretions, bowgl^, k idneys and skin. 



Kept this treatment 
the patient has made a complete recov- 
ery. He says he never enjoyed better 
health in his life, and is able to do an 
active real estate business. I have had 
occasion to use the same treatment in 
other cases several times since, and have 
never failed to note a decrease of albu- 
men during the use of the nitro-glycer- 
ine. 

As to membranous croup and diph- 
theria being the same, I am inclined to 
agree with Dr. Gibson. They appear to 
me to be totally different diseases. I have, 
during my twenty-five years of practice, 
treated quite a number of cases of mem- 
branous croup. The physician has no 
more powerful foe with which to contend. 
I believe it in the great majority of cases, 
however, curable. It requires energetic, 
not to say drastic, treatment If the case 
has so far progressed that breathing is 
difficult, I usually use first, the yellow 
subsulphate of mercury (turpeth mineral), 
according to Dr. Fordyce Barker's plan. 
Then follow with : 



Bichloride of mercury, 
Muriate of ammonia, - 
Alcohol, 
Glycerine, 
Aquaq.s., 



gr. i 
dr. iiss 
oz. i 
02. i 
ad. oz. iv 



Dose. — 10 to 15 drops to child every half 
hour. 

Alternate with one-half grain sulphide 
of calcium every half hour. Thus medi- 
cine is administered every fifteen min- 
utes, night and day. I usually pjecade 
this treatment with calomel to move 
bowels freely: *^~* *— -^ "* - ~ 

"One tfftlie worst cases I have seen for 
years, a 2-year-old child, whose breathing 
could be heard throughout the house and 
even in the yard when I entered, yielded 
after a time to this treatment The dif- 
ficult breathing, however, was noted for 



at least three days after giving these 
remedies, and only yielded by the per- 
sistent use of them. Of course, all the 
fresh air possible, day and night, was 
allowecQhe sufferer, without^ considering 
the c onyeni eh ce^Of th e ritTTSes. This, I 
think, is an important element, and worth 
quite as much as the vapor of slaked lime 
or steam. An equally severe case 
occurred in my practice while in Govern- 
ment service at the Rose Bud Agency, 
Dakota. In this case the membrane 
extended to the lips. The mother car* 
ried the child in her arms during almost 
the entire time, covering several days, 
out of doors in front of her dwelling, and 
it was freezing weather. The last dose 
or two of the turpeth mineral was not 
expelled by vomiting, but produced a 
most drastic effect upon the elimentary 
canal. The serious symptoms began to 
subside after this effect of the remedy, 
and the case went on to recovery. 

In both these cases, as well as many 
others to which I might refer, other chil- 
dren were in daily contact with the 
patients. Who ever heard of membra- 
nous croup being either contagious or 
infectious, or the membrane exciting a 
like disease in another exposed to its in- 
fluence ? The rules for isolation in cases 
of diphtheria show very well in what 
estimation that disease is held by the 
laity as well as the physicians. I should 
have said, that in all cases of membra- 
nous croup, nourishing food and stimu - 
lents should fre usSQSnLlhe first. The 
fearful etfort to_ob£ain breathy taxes the 
streng th of t he patient to th e ^ utmost. It 
is a fighTJor lfleTand t he pow ers of na- 
ture sh6m3jE.aiii£d to the utmost 

But I have already exceeded my limits, 
and will close with thanks for helpful 
suggestions from correspondents and 
from the editor of The World. 

Fordyce Grinnell, M. D. 

Pasadena, Cal. 

The Classes Who Prevent Conception. 

Editor Medical World.— The articles 
on prevention of conception which have 
appeared in the last few numbers of The 
World lead me to desire to add my " go 
slow " in the matter. Of six recent mis- 
carriages in my practice all were married ; 
and there is no question in my mind as 
to the cause in five of the six cases. They 

Digitized by VjOOQLC 



THE MEDICAL WORLD. 



105 



were evidently, in my judgment, self in- 
duced. The sixth case, I think, was acci- 
dental, and the only one in which any 
just excuse could be given. The woman 
is not more than half-witted, has several 
children, and her husband was arrested, 
about a year since, on complaint of his 
step-daughter for bastardy. She miscar- 
ried twice within about a year. But 
there is not one of the plans mentioned 
for prevention that they would bother 
with a minute. And so with the hordes 
of people like them. In fact, they care 
very little. There are but two things 
that will meet the requirements here : 
they are old age and castration. Of thfe 
other cases all were young or in the 
prime of life ; two were recently married 
and did notwantababy until they had been 
married a year or two at least Three of 
them had two children each already and 
did not want any more. None were 
wealthy, but all were healthy. I do not 
suppose these cases are unique by any 
means. They are in exact accordance 
with the observations of a large majority 
of physicians. The conclusions to be 
drawn are simply these : The poor, the 
sickly, and, above all, the degraded, are 
not the ones who would use the meas- 
ures suggested. It would be, above all, 
the wealthy ; then the well-to-do ; and 
especially that class, very numerous, 
who simply take a notion to get married, 
with no appreciation of what married 
life should be, and, of course, would 
never have children if they only knew 
how to keep from it, and still enjoy the 
pleasure. And then, last but not least, 
what a picnic the boys and girls would 
have if the girls only knew that by a very 
simple device they were just as safe from 
public disgrace as the boys. Let me re- 
peat, doctors, go slow. 

Why not take an open stand for cas- 
tration as a legal way of disposing of a 
class of cases that might be termed 
vicious, physically or mentally ? 

Georgetown, O. A. W. Mitchell. 

Prevention of Conception. 

Editor Medical World : — In Novem- 
ber World, u G " asks for information 
relative to the legitimate prevention of 
conception. 

That this query deserves serious con- 
sideration, and that it is a legitimate 



question for us to discuss, I heartily 
agree ; but that there is a legitimate way 
of preventing conception for the reasons 
enumerated is a u horse of a different 
color." Did "G" limit the indications 
for such interference to cases where such 
malformation in the anatomy of the pel- 
vis exists as to preclude a reasonable 
hope for normal delivery, it would be 
different. 

Between the lines of his article he 
plainly tells us that he believes there is 
a legitimate way to thwart one of na- 
ture's grandest laws, and one of the 
Almighty's commands. 

Nature is very exacting. When you 
endeavor, even by "common-sense meas- 
ures," to rend asunder established laws, 
you will pay dearly the forfeit which 
Nature demands. To what level is wed- 
lock tossed when the mental and physical 
workshop is thus dishonored ? 

Use what means you may, and the wife 
forfeits her conjugal rights ; and the re- 
sult, too often, is seen in the over-excited 
sexual disposition, supersensitive and con- 
gested surrounding parts. Following these 
conditions we have engorgements, ero- 
sions and displacements. A " natural 
and harmless" means of preventing con- 
ception does not and cannot exist. 

The argument that many wives are 
urged to submit at too frequent intervals 
to the sexual embrace by over-exacting 
husbands is not our responsibility, and is 
no excuse for our advising any means 
which tend to thwart uature, promul- 
gate vicious sexual relations, and thus 
abet an evil so fatal to healthy moral, 
mental and physiological life. 

The late Prof. Goodell once said : 
"Show me a house without children, 
and, ten to one, you show me an abode 
dreary in its loneliness, disturbed by 
jealousy or estrangement, distasteful 
from wayward caprice or from unlovable 
eccentricity." 

To my mind, our duty as physicians is 
plain on this question. H. 

Colo. 



How May Conception be Legitimately 
Prevented. 

Editor Medical World :— In the Jan- 
uary issue of The World appeared sev- 
eral articles under the above caption. 
That the preventi^ y q@^g^ under 



io6 



THE MEDICAL WORLD 



certain circumstances, is legitimate and 
proper there is no question in any well- 
balanced mind. What those circum- 
stances are is in the province of the phy- 
sician to decide. If the matter could 
only be left to and be controlled by in- 
telligent physicians, this country would 
soon produce a superior race of people. 
The legitimate controlling or preventing 
of conception should begin long before 
marriage.; in fact, before reaching a 
marriageable age. It should be in a 
proper education — a knowledge of self. 
There is a deplorable amount of igno- 
rance, even among the best educated and 
most refined, as to the sexual and pro- 
creative functions of the race. The stock- 
breeder makes the subject a study, finds 
means to legitimately prevent conception 
with his stock until such time and under 
such circumstances as is of the most 
advantage to the improvement of his 
stock. He may attend a stock breeders' 
association, discourse very learnedly on 
these important and vital topics, get half 
drunk with his friends, come home and 
abuse his wife, and while she is yet in 
tears impregnate her. In time she brings 
forth a child that is weak, perhaps half- 
witted and vicious. How can it be other- 
wise under such circumstances? More 
than nine-tenths of all the children born 
are conceived by accident — "didn't know 
it was loaded," as it were. 

The early education is at fault Boys 
should be taught that they are to become 
men, physically as well as mentally, and 
that they are expected to do their best to 
improve the race. Girls should be taught 
that to be a mother is the most glorious 
position she can attain. The society of 
bright, healthy children is far preferable 
and more elevating and refining than the 
opera, "zee altogether," a party of 
"high-flyers," etc 

If young people could only be edu- 
cated so that when they are married they 
would place themselves under the direc- 
tion of some sensible, honest physician, 
it would go far toward solving this ques- 
tion. The whole matter ought to be 
under the control of the women ; but as 
it is not, it is well to devise other means. 
It is amusing to note some of the means 
suggested by some of the physicians. 
One great difficulty in the matter is, that 
;f a physician teaches a method to some 



one who ought to know, she cannot re- 
frain from telling her neighbors what the 
doctor said, and it takes only about two 
weeks for a whole State to know. 

The suggestion of Dr. Monroe, an as- 
tringent suppository, is a very good one, 
but there are very few men who would 
want to submit to an inunction of an as- 
tringent ointment when there is no dis- 
ease. The condom is an abomination; 
the French pessary a nuisance ; onanism 
(withdrawal) the acme of nastiness ; the 
douche, or injection, into the vagina 
when the uterus is engorged and excited 
is a source of much mischief and disease ; 
the fine sponge, as suggested by Dr. 
Walker, is not always sate, besides it is 
extremely unfair to the woman, who is, 
perhaps, delicate and refined, as it would 
be left to her to purify the sponge ready 
for a new trial. She would hardly want 
to entrust the task to a servant, and the 
man would probably object to furnishing 
a new, expensive sponge for each occa- 
sion, especially for domestic use. 

The best method I have seen suggested 
where such things must, or should, be 
done, is to take a piece of fine sponge the 
size of the end of the thumb, compress it 
and insert it into the os uteri. By its 
expansibility it will retain its position 
until removed. Even the sucking and 
gasping motion of the uterus during the 
orgasm will fail to dislodge it 

D. D. Rose, M. D. 

Burlington, Iowa. 

fWe doubt if one woman in twenty, so 
instructed, could accomplish the above. 
Also, there is no provision for its re- 
moval. What has the doctor's experi- 
ence been ? — Ed.] 

Prevention of Conception. 

Editor Medical World: — I have 
been much pleased with the articles on 
44 Prevention ot Conception" in the Jan- 
uary World. I believe that if there is 
any harmless and effective preventative it 
should be made known to the medical 
profession, to be used by physicians in 
any and all cases where the woman from 
any cause cannot give birth to a living 
child. But the profession alone should 
know the means by which it is accom- 
plished. 

And I think that the public should 
be warned against those injurious meth- 

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ods with which they are all familiar, 
such as "premature withdrawal," or 
Onanism, which is only a specie of mas- 
turbation, and which not only under- 
mines the health of both, but their love 
for each other as well. The surest and 
most harmless method I know is for the 
male to use a "membrane condom" 
(said to be made from the bladder or 
some part of a fish). It should always 
be moistened before adjusting, which 
will prevent any possible chance of tear- 
ing. Being composed of animal material 
and very thin it admits of a free ex- 
change of "animal magnetism," and 
does not diminish the sensation in the 
least to either the male or female. The 
great fault is that when once given to a 
deserving couple they can and will give 
them to any and every one. 

A harmless method, and one which, 
if true, is the method, is the one given 
by Dr. F. Hollick in his work on repro- 
duction, entitled "Origin of Life." He 
says : " Conception takes place within 
sixteen days after a menstrual period, 
and usually within eight or nine days 
and at all other times impregnation is 
absolutely impossible, excepting possibly 
for a brief period before the actual cessa- 
tion." 

1. Is Dr. F. Hollick's theory correct ? 
2. How frequent on an average can con- 
nection be practised without injury to 
either party ? 3. How often should it 
be engaged in for health ? 4. How fre- 
quent do you suppose it is engaged in on 
an average by married couples ? These 
are important questions, and ones that 
are frequently asked ; but, I am afraid, 
not always satisfactorily answered. 
Will the editor or some oi the older M. 
D.'s undertake the task for a young doc- 
tor and the many readers of The World? 

West Virginia. X. 

[Study ovulation in your physiology 
and you will understand the basis for the 
theory mentioned by Dr. Hollick. It 
has been proven over and over that im- 
pregnation can occur at any time during 
the interim between menstrual periods ; 
but, as a matter of fact, impregnation is 
much more likely soon after cessation, 
and correspondingly less likely further 
on in the interim. 

As to frequency of copulation by mar- 
ried couples, there is wide diversity. 



Some remarkable instances are on record 
of copulation every night (of course, ex- 
cepting menstrual periods) for a succes- 
sion of years. These are, as they should 
be, very rare On the other hand, be- 
cause of repugnance, disability or disin- 
clination, some couples exercise this 
function very rarely or not at all. The 
happy or normal mean is difficult to 
place. Once a week is about as near as 
it can be placed, after the novelty of 
early married life has passed. What 
would be normal in good health, vigor- 
ous prime of life, healthful and active 
occupation, fortunate mating and happy 
conditions would be abnormal with these 
conditions reversed. During pregnancy, 
particularly when advanced, it is physio- 
logical for the male companion to not be 
inclined to exercise the sexual function. 
When this is not known, the husband 
may think he is losing his virility. — Ed.] 

Medical Journals Should Not be Lent to Lay 

Readers -Delicate Subjects Cannot 

be Discussed Publicly. 

Editor Medical World :— Your sug- 
gestion that a certain issue of your 
valuable journal be guarded from the 
lay public is timely and good. Why 
not apply it to all medical journals? In 
my own younger days I was occasionally 
tempted to show a medical journal to 
some lay friend ; in every instance I have 
regretted doing so, and for several years 
I have guarded my journals and my 
books from people who would miscon- 
strue either my motives or my journals. 
Few articles are comprehensible to the 
laity. They fail to grasp the spirit of 
charity that pervades our professional 
thought, and the spirit of "get some- 
thing for nothing" is as strong in most 
people that they remember the very 
things in our article that they should 
not, while they overlook the points we 
desire to impress. I remember reading 
a very nice description of a surgical 
operation to an interested party, with the 
best of motives, and for the benefit of the 
family of my listeners. She went away 
and told her neighbors that my office was 
full of "butcher books," and that I was 
44 one of those New York doctors that 
liked to cut people up alive." Good 
enough for me. I deserved it, but I 
make that mistake no more. Doctors do 



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THE MEDICAL WORLD. 



not associate with each other enough ; 
and the enthusiastic country physician 
gets lonesome for some one to talk to, 
but he makes a serious mistake when he 
talks with the laity about the contents 
of his books or journals. I know a doc- 
tor who carries his limited stock of jour- 
nals around with him, and leaves them 
at the homes of his patients. I haye 
known some of his patients to cut pre- 
scriptions out of these journals and take 
them to the drug store and get them 
filled. I know others who laugh at this 
doctor and call him " soft " for so doing. 
The questions that now engage The 
World, The Council and other journals, 
are being discussed for the welfare of all 
mankind. We want free discussion; 
but for one I cannot discuss them freely 
with the public, nor with any member of 
our profession who will turn the articles 
over to be misconstrued by those who 
have never studied the subject, and who 
have not followed both sides of the argu- 
ment. Oh ! that the profession could 
come together in the proper spirit and 
help the world at large to carry out so 
many needed reforms. But as it is now, 
we try to do for the public at the expense 
of the profession. A mdn tells me that 
creosote will cure every case of con- 
sumption ; he knows it ; he read it in 
one of Doctor B's medical papers, and he 
censures poor Doctor C because he loses 
a case of consumption. How Doctor C 
must admire the doctor who lent that 
journal. The time has not yet come that 
we can take the laity into our confidence. 
How can we trust the public until we 
can trust each other? Our profession 
has done much for suffering humanity 
that has never been appreciated. Most 
of the brilliant ideas of sanitary reform 
and board of health work has been 
donated by the profession. We are in 
line on all moral reforms. Let us keep 
on trying to better the condition of our 
fellow creatures, but let us not be too 
eager to announce new and untried ideas 
to those not sufficiently educated to judge 
their merits. Let us read our journals 
more carefully ourselves rather than give 
them to our lay friends that the profes- 
sion be damaged by a superficial reading 
by those who have no sympathy for the 
profession nor for suffering humanity, 
and who lack both education and judg- 



ment to properly interpret and apply the 
ideas of those who unselfishly write the 
profession for the benefit of all mankind. 

Mich. A. M. Erican. 

[In a private letter accompanying the 
above article, the doctor says to keep up 
the articles on economics ; and that he 
has just converted c * three hardshell Dem- 
ocrats and Republicans." Perhaps we 
can construe " hardshell " as we wish, 
and that these three were converted from 
partisanism to broad humanitarian think- 
ing. B ut would the Doctor confine these 
economic articles to the profession? 
Many of our readers pass them around 
among their patrons. The leaves could 
be cut out and passed around. But a 
better way is to have the articles pub- 
lished in your local paper. Many do this, 
and this is the best plan to pursue. But 
don't stop there. Follow them up by 
similar articles from your own pen. — 
Ed.] 

Arbutus for Albuminuria. 

Editor Medical World : — In the 
Quiz Department of January World 
Dr. A. L. D. , of Arkansas, wants treat- 
ment for albuminuria. I would like if 
he would try trailing arbutus, sometimes 
called u gravel plant,' * in his case, with 
hot or vapor baths. I have had such 
uniformly good results with it that I 
think it would do him much good. The 
infusion of the plant is better than the 
fluid extract In some cases, adding a 
little nitrate of potassium increases its 
action. If he wants to try it, I will send 
him the plant if he will report its effect 
to me later, as I am trying to get enough 
statistics for a paper. 

S. Shauwkckkr. 

Shanesville, Ohio. 

Dear Dr. Taylor :— Thanks for the 
galley slips you sent me several days 
ago. The reading has been completed, 
and I have given some thought to the 
clear and cogent expression of your 
views. There is little to dissent from, 
and much most warmly to approve. The 
imitation of the Swiss laws seems to me 
imperative, if our land is to be rescued 
from time-serving and corrupt politi- 
cians. 

Of course you are not Briareus nor 
Hercules, but could you not bring your 

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109 



strength to bear upon the disgraceful 
methods of advertising, directly or indi- 
rectly, by reputable members of the pro- 
fession, in newspapers ? Do you want to 

know who Dr. is? Behold his 

picture in a daily ! Do you desire infor- 
mation as to his skill and knowledge ? 
Read the newspaper account of an opera- 
tion he has done at Hospital. Do 

you want his opinions about " bikes " or 
babies, vaccination or antitoxin? A 
newspaper reporter has ascertained and 
put it in cold type. 

Then, again, another evil demands 

?rofessional and popular condemnation : 
*he unnecessary multiplication of hos- 
pitals, and especially appropriations 
made by state or city, to simply private 
institutions, conducted solely in the in- 
terest of the professional proprietor. 

The profession, I believe, need to be 
aroused to these great evils, evils that 
arc bearing their fruit in considerably 
coitributing to the 4< Passing of the 
Physician," as described in a recent edi- 
torial in a New York medical journal. 

I have been a member of the profession 
for nearly forty-five years, but never have 
I known so much of commercialism, of 
trade-ways, as are prominent to-day in 
medicine. 

[The above are selections from a private 
letter received from one of the "old 
juard" in medicine — one of our most 
eminent authors and teachers. His name 
:annot be given without first obtaining 
his consent, but the above is the thought. 
These pages are a medium of interchange 
of thought ; and sometimes the thought 
that is privately expressed is of greater 
interest than that which is culled and 
pruned for the public eye. — Ed.] 



Liver and Stomach on the Otitslde. 

Editor Medical World :— Pardon me 
for doing what I often have been tempted 
to do — write a short article to The 
World, as I get so many hints and helps 
from the World family. I will report 
a case to let Bro. L. Bowman know some 
of nature*s freaks in the West. 

Examining my note book, I find the 
following: On April 23, 1894, I was 
called to see Mrs. H.j mother of six chil- 
dren, and at this time in the seventh 
month of pregnancy. When I reached 



her the amniotic fluid had passed, and in 
less than ten minutes a female child, 
perfectly formed, was expelled ; weight, 
four pounds. After detaching it, I 
handed it to the nurse and gave my at- 
tention to the mother. I noticed that 
the pains were hard for expulsion of the 
placenta, and made an examination. I 
found that I had another child to deliver. 
When the membranes ruptured this time 
the fluid was so excessive that it ran off 
of the bed, and ten or twelve feet across 
the room (no carpet on the floor). With 
the next pain a female child, weighing 
three pounds, was expelled; feet, legs, 
hands and forearms deformed, head, 
neck and chest were perfect There was 
a fissure from the ensiform cartilage to 
the umbilicus; the liver and stomach 
protruded through fissure. The umbil- 
ical cord was about three inches long and 
passed through the fissure and dia- 
phragm. Child gasped two or three times 
and the heart continued to beat twenty- 
five minutes. The perfect child lived 
ten days. J. Fleetwood Reed. 

Iowa Park, Tex. 



Atropine in Anesthesia. 

Editor Medical World:— In ex- 
tracting a tooth, it will be found by ex- 
amining the pulse that the heart misses 
or skips a beat at the time of extracting. 
Why ? Because the shock given to the 
dental branch of the fifth nerve is carried 
to its central ending, and being so great 
and sudden, is conveyed to the vagus, 
whose origin is near that of the trigemi- 
mus, as some of the sensory fibres are 
found to arise down even into the 
medulla past the calamus scriptorius, 
thereby coming in close contact By this 
transmission it stimulates the inhibitory 
fibers of the vagus to such an extent that 
the heart fails to contract for the period 
of one cycle ; then comes a fluttering or 
rapid contraction of the cardiac muscles 
for a few beats, and there again comes 
the regular cardiac movements. 

We have also a paralysis of the vaso 
motor center, which lies in close prox- 
imity to the above-mentioned centers, 
and a subsequent return to their normal 
functions. This is the case when the 
extraction is done without the use of an 
anesthetic. But what is the result when 

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anesthetics are used ? It is a well known 
fact that a great proportion of the deaths 
reported from chloroform happen in the 
dental chair with the accompanying re* 
port of those present that the subject had 
only taken a "few whiffs and was only 
partly under. " So much the more dan- 
gerous. Chloroform, of itself, is a para- 
ly zer of the central endings of the sensory 
nerves as well as motors. The respira- 
tory centers with the vaso-motor and 
cardiac inhibitory are the last to be para- 
lyzed ; but complete anesthesia cannot 
be had without a depression of their 
respective functions. Neither can we 
have partial anesthesia without inhibiting 
their functions to some extent and mak- 
ing them less responsible for their failure 
to perform their functions after receiving 
a shock such as is given to them after a 
tooth has been drawn from its alveolus. 
We have a rapid weak heart with a 
decided lack of vaso-motor tension, and 
when the shock is transmitted from the 
trigeminus to the vaso-motor center in 
its present weakened condition we have 
paralysis of its function, dilation and 
complete relaxation of arteries and 
arterioles, and with the patient in the 
partial upright posture, the blood im- 
mediately seeks a lower level and leaves 
the brain, and accompanied with this we 
have an enormous stimulus given to the 
inhibitory fibres of the vagus, which 
causes the heart to stop at once and 
thereby returning no blood whatever to 
the brain ; and with the drain upon it 
by early inhibition of the vaso-motor 
center, with a weakened heart and the 
subsequent paralysis of all vaso. motor 
force, the brain substance is left very 
markedly anemic, to such an extent that 
all its functions cease at once without a 
moment's warning. The attendants are 
much surprised at the sudden death and 
attribute it to pre-existing morbid con- 
dition of the heart, which may be present 
in certain cases, but not necessary to the 
foregoing result 

Certain precautions would obviate such 
a result In the first place, a dental 
chair is no fit place to anesthetize a pa- 
tient He should lie flat upon the back 
with the head on a level or a little below 
that of the body, so that when the heart 
becomes enfeebled and arterial tension 
lowered, as it certainly must, the brain 



will not suffer disproportionately for the 
want of blood. 

The pulmonary circulation must be 
thought of and looked after also, and in 
the supine position we will have the* 
blood more fully oxidized and in a better 
condition to sustain the functions of the 
brain and spinal cord. And in case of 
temporary vaso-motor paralysis we do not 
have the immediate drain of blood from 
the cerebrum, but have in its place a 
normal supply of comparatively well 
aerated blood to enliven the functions of 
over-stimulated and temporarily para- 
lyzed functions, thereby giving the 
heart another impulse, contracting the 
arteries and arterioles, driving the blood 
on to aeration, and to perform its affer- 
ent functions, and thereby tiding the 
life of the patient over and hastening 
return of the other functions, both ceie- 
bral and spinal. 

But, with the above-mentioned pre- 
cautions, there is great danger in incom- 
plete anesthesia and it should never be 
practiced. If the cardiac and respiratory 
centers will not allow of complete anes- 
thesia they certainly will not be of much 
use when they are half paralyzed and 
then receive a shock such as is given 
them by the extraction of a molar. Ex- 
traction should never take place until 
the most complete anesthesia is pro- 
cured; and then it can be done with 
safety as far as the operation is con- 
cerned, for the sensory centres are com- 
pletely paralyzed and can transmit no 
impression to the other centres ; hence, 
we have no further disturbance there 
than that given by the chloroform itself, 
and the heart will not even miss its beat 
as it does when all the functions are 
acting. 

To be on the safe side is better far 
than to risk the life of the patient; and 
as belladonna and its alkaloid, atropine, 
have a decided stimulating effect on the 
accelerator fibres of the cardiac and the 
vaso-motor system in general, it is better 
to give hypodermically before an opera- 
tion of any kind a minimum dose of 
atropine; then, if complete anesthesia 
is not procured (as is not even when we 
think it is), we have the good effect of 
the atropia at the time of the shock to 
stimulate the heart to action, and the 
vaso-motor system in general. By giving 

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it before the chloroform we prevent the 
lowering of arterial tension and the 
rapid, fluttering heart to a certain 
extent, leaving it in a much better con- 
dition to withstand the shock given it 
by the operation. 

J. D. Buskirk, M. D. 
Grandville, Mich. 



An Outsider's Comment on the Pneumonia 
Discussion. 

Editor Medical World : — Although 
not a physician, yet I frequently have op- 
portunity to read The Medical World. 
In the February number I find three- 
communications in regard to the treat 
ment of pneumonia, by Drs. West, An- 
derson and Greenfield. My non-medical 
mind is greatly impressed by the diver- 
sity of their treatments of this disease. 
Dr. West would begin his treatment by 
bleeding; the first thing that Dr. An- 
derson does in such cases is to vomit his 
patient ; while Dr. Greenfield would do 
neither. I am moved to ask if this is 
the best showing that can be mkde by 
the medical fraternity at the close of 
the nineteenth century, in regard to the 
treatment of so common a disease ? Drs. 
West and Anderson seem to give good 
reasons for their mode of treatment. Dr. 
West claims that the blood of a person 
suffering from pneumonia is charged 
with toxic poison, and that therefore it is 
rational treatment to relieve the patient 
of this poisoned blood. Dr. Anderson 
claims that in such cases there is an over- 
abundance of bile in the stomach and 
duodenum, which, if not removed, would 
be absorbed into the system, and there- 
fore he claims that it is entirely rational 
to remove said bile by vomiting. If what 
they say is true, then to the legal mind 
it would seem to be entirely logical to 
both bleed and vomit in such cases. 
And it would further seem to be an irre- 
sistible conclusion that if the above two 
conditions actually exist, then a physi- 
cian who does not bleed and vomit his 
patients is guilty of malpractice. The 
practical question therefore seems to be 
whether or not in such cases the blood is 
so poisoned, and whether or not the 
stomach and duodenum are so overloaded 
with bile. It seems to me that the sub- 
scribers of The Medical World ought 
to be able to forever settle this question, 



and to conclusively confirm or discredit 
the above two modes of treatment. 
There is no better method of settling 
such questions than by correspondence 
in the columns of a medical journal, 
and I trust that the editor of The Medi- 
cal World will call for an expression in 
his columns of his subscribers on this 
question. The interests of suffering hu- 
manity would seem to demand a perma- 
nent settlement of these two modes of 
treatment, either for or against. Lex. 

[When the lawyers get after us we have 
to get down to "dots." It is a good 
thing for us to occasionally be forced to 
see ourselves as others see us, but it is 
sometimes rather severe. We will say to 
"Lex" that sometimes at the beginning 
of pneumonia, and other diseases, there 
is excess of bile in the stomach and du- 
odenum. When this is true, the first in- 
dication is to remove it ; and by emesis 
is a good and prompt way to do it, but 
not the only way. This condition would 
be likely to occur quite constantly in 
malarious districts. Perhaps Cornelia, 
Mo. (Dr. Anderson's residence), is in such 
a district ; if so, this treatment would be 
quite generally applicable there, whereas 
it might not be applicable in other sec- 
tions. Also, in the Indian Territory, 
where Dr. West lives, the people as a rule 
may be full-blooded and plethoric, and 
bleeding in pneumonia be quite the thing 
for them, while it would be distinctly 
contradicted in delicate people of other 
sections or of cities. If "Lex" were a 
physician, he would know the difference 
between treating the disease and treating 
the patient. As to the pneumo-bacillus, 
that is not a definitely settled question as 
yet ; and until it is settled, we must pur- 
sue our old and established lines. We 
must not'give up the old until we get a 
new that is demonstrated to be better. — 
Ed.] J 

The Drug-Habit.— Self-Prescribing. 

Editor Medical World :— Excessive 
drug-taking is a great evil. The habit 
is all too prevalent Nearly every family 
keeps on hand Dr. Pilgarlic's Universal 
Panacea, good for all ills, internal and ex- 
ternal — a sovereign remedy under all cir- 
cumstances. Old remedies become obso- 
lete, and new ones come in by scores to 
take their place. " Haarlem oil," u Elixir 

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THE MEDICAL WORLD. 



c 



ro, ' ' Hot drops, * * No. 6" are succeeded 
y modern synthetics and coal tar deriv- 
atives. 

Theresources of ad vertising have given 
us a free campaign of education in quasi 
medico-therapeutics. Printer's ink, the 
camera, the artist's pencil and the paint- 
er's brush are worked to their utmost to 
place and keep constantly before the 
people the wondrous virtues of new prep- 
arations. The daily paper, the literary 
magazine, the religious periodical, the 
fly leaves of cheap novels offend the sight 
with ever present display medical adver- 
tisements 

Millions of patent-medicine almanacs 
with grusesome cuts of the fetid sores of 
victims of loss of virility, or covered with 
scrofulous sores, mingled with phases of 
the planets, aspects of weather, eclipses, 
and "Take only Dr. Gullem's Specific" 
are annual visitors to every household, 
and penetrate even to the remotest ham- 
let in the land. 

Even the sanctuary is not free from 
this ruthless invasion. It is told that a 
poor chapel accepted a donation of hymn- 
books from an enterprising firm, and the 
people were startled at this unusual 
rendering of a favorite hymn : 
" Hark the herald angels sing, 
Beecham'8 pills are just the Sling ; 
Peace on earth and mercy mild, 
Two for man and one for child. " 

Even your druggist when he fills the 
prescription for your patients does a good 
stroke of advertising for his wares by 
tucking in a flyer stating that u Pestle's 
Pumpernickel" is the only sure cure for 
the very complaint you are presumably 
treating your patient for. 

Verily the doctor " is wounded in the 
house of his friends. " 

The doctor himself is not wholly 
blameless. He, too, often reveals the 
agencies he uses, even to advertised and 
proprietary nostrums, and frequently in- 
dulges in the luxury of a clinical lecture 
at the bedside, to display his wisdom and 
learning, with the patient for a text and 
the family as an audience. They would 
be dull indeed if they failed to profit by 
his gratuitous medical teaching. 

Through such agencies, the laity are 
enabled to talk glibly and hold discus- 
sion with the doctor respecting the phases 
of disease and the uses and relative vir- 



tues of the recent drugs introduced in 
medicine. Sometimes they even ques- 
tion the doctor's diagnosis and assume to 
instruct him as to what they must have 
or will not take, and presume as a right 
on knowing what drugs the doctor is 
using. 

Ignore it as we may, this is the pass to 
which we have come. 

Tablet- making and using opens up 
another avenue for self-prescribing. 

Shrewd tablet-makers stamp certain 
letters or devices upon their wares, 
avowedly to prevent substitution, but 
practically to enable the great public to 
prescribe for themselves and increase the 
demand for such goods. Short-sighted 
doctors put into the hands of their pa- 
tients such labeled tablets, possibly not 
realizing that when again similary ill 
the patient will go straightway to the 
druggist, perhaps with a sample pru- 
dently saved, get the medicine, mayhap 
relieve the ailment, pay the druggist his 
profit, and certainly ignore the medical 
man and his fees. Thus the Doctor leg- 
islates himself out of his legitimate busi- 
ness. 

The unmeasured abuse of cathartics 
comes under this head of self-medication. 
Constipation with its common attendant, 
hemorrhoids, is perpetuated and aggra- 
vated by the universal habit of taking 
physic. There is wide demand for a 
good "opening medicine." How gen- 
erous a provision has been made to meet 
the popular demand for cathartics may 
be appreciated when we take a census of 
the multitude of drugs and their com- 
binations placed on the market for this 
purpose. 

From a vest-pocket list now before me, 
issued by a reputable drug house, I find 
by actual count that they manufacture 
sixty-one different kinds of cathartic 
pills. In another I find sixty-five, an- 
other ninety-three, and still another one 
hundred and sixteen. Add to these the 
unofficial pills, the tablets, tinctures, 
fluid extracts, syrups and vaunted teas, 
and it will be evident that no more in 
his line are wanted at present. 

Self-prescribing is not always safe or 
pecuniarily profitable. Witness the 
opium fiends, chloral users, cocaine 
takers, alcoholics— all that vast army of 
abusers of stimulants and narcotics, 

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THE MEDICAL WORLD. 



ii3 



that take them, not only without medical 
sanction, but in direct opposition to 
argent medical counsel. 

Every medical man can call up from 
his experience cases in which self- 
prescribing led to untoward results. 

Having just returned from an autopsy 
on a young woman who died from taking 
an overdose of a cough mixture, sug- 
gested to her by a non-medical friend, I 
am ready to pass in review some of these 
cases that now recur to me. In this case 
the mixture taken consisted of equal 
parts of laudanum, spirits of camphor, 
essence of peppermint, and balsam of fir. 
In one night she took about two and one 
half ounces of this, making about five 
drams of each ingredient In the morn- 
ing she was found in profound coma, 
from which she never was awakened. 
Autopsy confirmed that death was due to 
the opium in the cough mixture. 

About a year ago I was called to see 
Mr. H., a man of means and high 
standing in the community. On rising 
in the morning he fainted. He was 
unable to stand, or sit upright on ac- 
count of actual u heart failure." No 
history of his illness was obtainable. To 
sustain and strengthen the heart was the 
obvious thing to do. In about two 
weeks he was able to walk about with 
care. He was taken to the Hot Springs 
of Virginia, where after a couple of 
months he was fairly himself again. 

Then I learned more of his history. 
He had read in the New York Matutinal 
Sphere, in the column devoted to the 
spread of medical knowledge, under the 
care of a reputed M. D. , that phenacetine 
was good for the grippe — doses not stated, 
and no cautions given. Believing him- 
self to have epidemic influenza, he had 
set about curing himself with phenace- 
tine, and only by a close shave did he 
escape being the central figure at a 
"wake." 

To save the doctor's fee of ten or 
fifteen dollars, he lost months of valuable 
time and expended several hundred dol- 
lars — and paid the doctor's fee besides. 

In the summer of '95 there came to my 
office a Mrs. C, attended by her 
husband. She had consulted several 
doctors in regard to a harrassing cough, 
but had failed to get relief. She 
wanted the cough cured. Examination 



revealed extensive tuberculosis. I ad- 
vised her as to her actual condition, and 
of the futility of stopping the cough. I 
saw no more of her for a year. I was 
then called in haste. Pound her in 
collapse, struggling for breath, covered 
with cold, clammy perspiration, cyanotic. 
Informed the family that she was dying. 
A council of physicians was called, but 
she soon expired. 

The history showed that she had been 
suffering from headache, and her hus- 
band had procured from a near-by drug- 
store some vaunted headache powders, 
which she had taken. She became 
stupid, incoherent, prostrated, alarming 
the family, and I was called in. 

The powders contained, among other 
ingredients, antipyrin. In her en- 
feebled condition her heart could not 
stand the depressing action of this 
dangerous coal-tar preparation. 

For 40 years Mr. C, her husband, had 
taken daily more or less of Bargold's 
Balsam, a proprietary compound, kept 
on hand as a household remedy. It 
gave him comfort and relief for his many 
fancied ills, and he could not do without 
it 

After the sudden death of his wife 
he felt even more the need of his com- 
forting balsam, and for a time he took an 
entire eight-ounce bottle of it daily. 

The mixture is put up as a remedy for 
diarrhea, dy sentry, colic, cramps, etc., 
and evidently contains considerable 
opium. The printed directions are : 
4 'One teaspoonful hourly for 3 doses, 
and if not then relieved, consult the 
doctor." 

September 1st I was called to this man. 
He had become a physical wreck. Ap- 
petite and digestion had failed, constipa- 
tion inveterate, eyes glassy and staring, 
skin sallow and dry, and nausea and 
vomiting such that neither food nor 
drink could be retained. He had lost all 
ambition, not even leaving his room for 
days, and had spells of crying, and 
wishing he was dead. His only comfort 
was a little more of the balsam. In 
short, without knowing it, this man had 
become a confirmed opium habitu6. 

By gradually withdrawing the drug 
and substituting something to satisfy his 
crying nerves, we did hope for a time to 
restore his lost manHood, but I am sorry 

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114 



THE MEDICAL WORLD. 



to say that he has relapsed, and is still 
wallowing in the mire. 

Mary B., 22 years of age, of good 
family, suffered much at her menstrual 
periods. In some way she found that 
phenacetine gave her relief. Eventually 
she felt that she needed it at times other 
than her monthly periods. She got into 
the habit of taking it in increasing and 
more frequent doses. She became pale, 
bloodless, debilitated, unable to walk 
hurriedly or climb a flight of stairs 
without being prostrated ; fainted on the 
least provocation. The case looked like 
one of chlorosis, and yet it bore the 
stamp of uncertainty. She denied taking 
or using drug or medicine of any kind. 
Later, her bosom companion revealed 
to me confidentially what Miss B. was 
habitually taking to satisfy a craving de- 
sire for it Stop it ? She has tried to, 
doubtless desires to do so, but the habit 
is as strongly confirmed as ever was that 
of opium taking. I suspect that she 
still occasionally falls from grace. 

The moral of all this is that it is wiser 
for the laity to pay more attention to 
sanitary living; to cultivate good habits 
of life ; take proper exercise ; breathe 
pure air ; dress becomingly ; eat whole- 
some, properly-prepared food ; use plenty 
of water internally and externally; 
avoid excesses of all kinds, and the 
need for the doctor's services will be 
greatly diminished. But when, in 
spite of wise precautions and right 
living, sickness and disease do come, 
call in the medicine man whose 
life business it is to detect and under- 
stand the varying phases of disease, and 
who is familiar with, and should be 
master of the agencies for alleviating 
pain, mitigating suffering, curing dis- 
ease and prolonging life. 

Brooklyn, N. Y. Benj. Edson, M.D. 

Chloroform in Labor. 

Editor Medical World : — 

I read the article by U A Doctor's 
Wife" with the greatest interest. Her 
article is good and well founded. Since 
she has children of her own, she can 
speak from experience. I can well 
remember the time when I would not 
give chloform in labor at all unless the 
husband would call in a brother physician 
to assist me. I allowed many a poor 



woman to suffer when I could have given 
her much relief. I was not at fault ; it 
was my teaching. All cases do not re- 
quire chloroform, but many do, and 
should have it If properly given it 
seldom prevents uterine contractions. 
It should not be given to complete an- 
aesthesia — only enough to make the pains 
less sensitive. By relieving sensation 
the patient is able to use a greater 
amount of expulsive force, thereby 
adding progress to her labor. I never 

fave chloroform to a woman during con- 
nement but what she thanked me for 
it afterward. All claim that labor is 
made more bearable by its use. We 
should not abuse its use, but give it only 
to such cases as require it I never allow 
an inexperienced person to administer 
the chloroform, but I j*ive it myself, and 
then only during a pain. My patients 
are always aware of everything that 
takes place around them while taking 
the chloroform. I have yet to see a sin- 
gle unfavorable symptom from chlo- 
roform given during labor pains. 
Since chloroform poisons by paralyzing 
the centres of respiration, and uterine 
contractions stimulate the respiratory 
centres, there can be little fear of pois- 
oning at such times. 

I find it necessary to make a special 
study of each case of obstetrics; this 
alone enables the attendant to give his 
patient a considerable amount of relief. 
I don't believe in doing something sim- 
ply for the sake of being busy ; but well- 
directed efforts never fail to win the 
good-will of our patients. It is the 
duty of every physician, when called to 
a case of confinement, to carry a well- 
supplied obstetric bag. Too many of 
our country doctors go wholly unpre- 
pared. Should an emergency arise they 
are unable to meet it on anything like 
scientific grounds. While many brilliant 
results may have been achieved with 
comparatively nothing to do them with, 
yet we feel much more at ease when well 
equipped. 

J. M. Simpson-Martin, M. D. 

Massey, Texas. 

Asthma Caused by Uric Acid. 

Editor Medical World: — I do not 
believe that this affection per se should 
be called a diseas^a^^^n dropsy. 



THE MEDICAL WORLD. 



US 



Both, I feel assured, are the resultings of 
other diseases. During the past year the 
opportunity has presented itself to satisfy 
me (acting on a hint seen in some foreign 
journal) that asthma is often the result 
of a uric acid diathesis. In rheumatism, 
asthma is very often an accompaniment. 
A patient of intelligence said: "When 
I have the asthma I have no rheumatism, 
and vice versa." A recent discussion in 
the Union County Medical Society, N.J., 
well ventilated this subject, and there is 
a growing belief that future observations 
will prove this conclusion. It is not 
asserted that all asthma is so caused ; but 
when asthma occurs in a rheumatic pa- 
tient, cure the rheumatism and you cure 
the asthma. This has been my later ex- 
perience. 
Rahway, N. J. E. B. Silvers. 

Antitoxin in Croup. 

Editor Medical World: — In the 
January World I see the question asked, 
what about antitoxin in croup, membran- 
ous, of course. 

Without going into any discussion of 
the old methods of treatment, suffice to 
say in true and genuine cases they have all 
died promptly, when counsel was called 
as well as when alone. Have used all the 
remedies I have seen mentioned, and used 
them vigorously, early and diligently. 

Now for a case in point : January 7, 
1895, I was consulted hy the father of 
Jessie R., 4 years old, on account of 
hoarseness ; in questioning him I found 
that the voice at times was entirely 
gone. I prescribed for her and told him 
I would see her that night, and found 
her playing around, and only at times 
could speak audibly. Told them my 
fears. Saw her next day and found some 
improvement, and did not see her January 

9, but early on the morning of January 

10, saw her and found the voice entirely 
gone, and severe coughing and Strang* 
ling spells came on. During one of these 
paroxysms of coughing and strangling, 
in my absence from office, a neighbor 
physician was called in and examined 
her, and told them she could not live 
over night On my return I visited her 
and was told what the neighbor phy- 
sician had told them. Then was my 
time, and I put in a plea for antitoxin. 
I told them I had never used it in mem- 



branous croup, but believing it to be 
identical with diphtheria, wished to try 
it. Knowing they had nothing to lose, 
they consented. Ten cc. Behring's red 
label was used, and all given at one in- 
jection, on chest, about 9 p. m., January 
10, 1895. That night she had several 
paroxysms of coughing, very severe, but 
toward morning rested easier and made 
a complete and uninterrupted recovery, 
and has enjoyed good health ever since. 

No. 2. — May 10, 1896. Called to see 
Helen O. N., 14 months old, with fever 
and sore throat. Low down on the tonsils 
patches of membrane could be seen, but 
they did not spread. That night the 
breathing became oppressed and voice 
was gone. May 11, found her in this 
condition ; ordered Behring's white label 
for children, gave one bottle ; same point 
selected for injection as before. Breathing 
soon began to improve, and she had bet- 
ter rest and could make a noise above 
a whisper, but toward evening began to 
tighten again. Gave her a second bottle 
tie same kind and same place, which 
completed the cure. The mother devel- 
oped diphtheria and I used a red label 
bottle of antitoxin serum on her with 
complete recovery. No other treatment, 
except a laxative to open bowels. None 
of the rest of the family were attacked. 

This is my experience with antitoxin 
in membranous croup. 

J. C. Hazlett, M. D. 
816 Wood st, Pittsburg, Pa. 

Antitoxin in Diphtheria. 

Editor Medical World : — Having 
read with much interest the articles in 
the January number of The World on 
diphtheria, I cannot refrain from adding 
my mite to the evidence in favor of anti- 
toxin, and particularly am I prompted 
to this course by Dr. J. W. Gibson's 
article. 

The concensus of opinion of medical 
writers of the present day is, that mem- 
branous croup and laryngeal diphtheria 
are identical conditions ; and I am told 
that our leading hospitals of the east 
have discarded the term of membranous 
croup, calling all cases which were 
formerly designated by that name laryn- 
geal diphtheria. This is a sufficient cue 
to the treatment. 

My experience ^it{i jntitoxin ^not 



n6 



THB MEDICAL WORLD. 



been very extensive, but covers a period of 
three years, and the results in every case 
have been most gratifying. For brevity's 
sake I will report but one case, my own. 
On November 19th last, I was called 
in consultation to see a little girl, set 
tw o and one-half y ears. She had been 
sick since November 14th with a slight 
cough, malaise and anorexia, but having 
grown much worse in the last twenty-four 
hours, her physician suspected laryngeal 
dipththeria, and requested me to see the 
case with him. Upon examination we 
found the ordinary symptoms of that 
disease in an advanced stage, pulse 130 
and quite feeble, temperature 102.5 m 
the rectum, hoarse rasping cough, voice 
lost, face and lips cyanotic, respirations 
rapid and very labored. The child was 
tossing about from one position to 
another in a vain effort to get more air. 
In the throat we found an innocent look- 
ing patch of false membrane on the 
right tonsil about the size of a coffee 
bean. The attending physician asked 
me if I thought it a proper case for anti- 
toxin ? to which I replied : " It un- 
questionably is, and no time should be 
lost in administering it" This was at 
10 a. m., and I made an appointment to 
meet him at 3 p. m. and use the serum, 
for I could not procure the necessary 
articles sooner, as I was several miles 
from home. At 3 p. m. we found the 
patient very much worse, and it then 
seemed that the little one would not live 
to exceed two hours. While we were 
preparing the injection one of the nurses 
came in and said, " It is no use ; she is 
dying." I thought that we had better 
give the serum on the theory that, "as 
long as there is life there is hope." So 
we gave 1,500 units of Mulford's serum, 
also we recommended small doses of 
whisky every hour. I left word to be 
notified at 9 p. m. as to the patient's 
condition. At that time I learned that 
she was breathing a little easier, and 
seemed somewhat stronger. As soon as 
I could reach her home we administered 
another dose of 1,500 units and also 
advising the nurse to give tr. fer. chlorid. 
gtt_iy ever y two hours, whi sky to be 
cont inued . Next morning the patient 
wasT>5tfer in every way except the 
breathing, which continued to be very 
much as on the day previous. She was 



allowed to inhale the fumes of slaking 
lime and the other treatment continued. 
On the aist she expelled some very large 
shreads of false membrane, and from 
that time her recovery was very rapid 
and uneventful. On the 23rd she was 
well except for a slight hoarseness and 
some loss of strength. 

This to me was a very interesting case, 
as I thought death would be the inevita- 
ble result, and so informed her parents. 
If I had entertained any doubts of the 
efficacy of antitoxin, this one case dis- 
pelled them. I felt sure I was throwing 
the serum away on this case, it looked 
so hopeless. 

You will observe that the doses used 
in this case were of the full adult size ; 
I did not wish to make the mistake of 
not having them large enough. 

There is one point I have not seen 
referred to in The World's articles on 
diphtheria, namely, the use of Loeffler's 
solution of toluene as a local application 
to the deposits in the throat. While the 
antitoxin is able to destroy the Loeffler 
bacillus, there are other pathogenic 
germs which may cause the death of 
your patient independently, if not prop- 
erly guarded against After numerous 
experiments, Loeffler gave the following 
to the medical world as the best : 

R Alcohol ... 60 parts 

Toluol . . . 36 " 
Liq. ferri sesquichlorati 4 " 

It has since been improved as follows : 



R Menthol . 
Creoline . 
Sol. ferri chlor. 
Toluol 
Alcohol qs. ad . 



10 parts 
2 " 

4 " 

36 » 

100 " 



This should be applie on a cotton 
swab to the spots of deposit every three 
hours until the temperature falls to nor- 
mal, and then three times a day until 
recovery takes placs. 

In my opinion antitoxin is our most 
powerful weapon in combating the 
scourge of diphtheria, and when used 
early and in sufficient doses, combined 
with antiseptic applications to the throat 
and supporting medicines internally, the 
mortality will be very small indeed. 

In the case reported above, we were 
not able to use the toluene solution on 
account of the patient's age. We made 



THE MEDICAL WORLD. 



117 



two successful trials, but could not. use it 
afterwards on account of the struggles of 
the child. My observation has been that 
in cases treated with the serum, instead 
of having a long convalescence of weeks, 
the period of sickness is reduced to a few 
days ; and it strikes me that this con- 
sideration alone ought to be sufficient 
reason for using it, granting that diph- 
theria is not usually a fatal disease, and 
that most all cases will recover under the 
use of the ordinary treatment, which, 
however, I do not grant to be a fact 

The only unpleasant symptoms I have 
ever seen arise from the use of antitoxin 
are the following : soreness in the tis- 
sues at the site of injection lasting a few 
days, and occasionally an eruption of 
urticaria, which subsides in 48 hours. 
The soreness can be obviated almost 
entirely if the operator will take plen ty 
of time find injffl thrjfriini slowly 

One word and I have done. It gives 
me much pleasure to receive The World, 
as it covers such a vast scope, and each 
issue seems more replete with good things 
than the one preceding. Dr. Waugh's 
articles are worth to me vastly more than 
the price of the journal ; next, the 
esteemed editor's valuable articles on 
economics affords me a large amount of 
pleasure and profit, and the medical 
fraternity cannot do better than study 
and digest every one of them. 

No. 1330 Grand ave., F. J. Iukn. 
Kansas City, Mo. 

[There is quite a general misunder- 
standing as to how antitoxin acts. It 
does not "destroy" the Loeffler bacillus. 
In fact, the bacilli can live in the anti- 
toxin serum. It is not the bacilli that 
kill the patient, but it is the poisonous 
excretion from the bacilli that kills the 
patient The antitoxin neutralizes this 
poison, and thus cures the patient. The 
word antitoxin means opposed to poison. 
If it killed the bacilli, it would be called 
diphtheritic bacillicide. . It seems that 
the bacilli themselves do very little harm; 
they run their course and become extinct; 
but the danger is in the poisonous ex- 
cretions thrown off while they are run- 
ning their course ; and it is this poison 
that the antitoxin antidotes. Let us 
keep these facts clearly in our minds 
while thinking or writing on this sub- 
ject—Ed.] 



Is Membranous Croup Diphtheria? 

Editor Medical World :— Glad to see 
antitoxin mentioned in membranous 
croup, or, as some contend, laryngeal 
diphtheria. But why is it, though, the 
most speedily fatal form ? It is the only 
form of diphtheria entirely wanting in 
the contagious element. I have seen 
twelve fatal cases of membranous croup 
in twenty years. They were not isolated 
— no anti-septics or disinfectants used. 
Still, I never saw the second case in the 
same family but once, and they were 
two years apart. There was a large 
family of children, some younger, some 
older, and no other cases. If antitoxin 
is a remedy in membranous croup we 
would be glad to know it 

There is seldom a case oi diphtheria 
seen here. Though we have occasional 
cases of membranous croup, which are 
generally fatal, though the contagious 
element seems to be entirely left out 
J. W. Kennedy, M. D. 

Lewisville, Texas. 

Various Topics. 

Editor Medical World :— The Janu- 
ary World is an improvement on its 
predecessors, if such is possible. The 
new, and so far as I know, original idea 
(page 3) of Submitting difficult cases to 
eminent physicians, is a feature which 
will be appreciated by all who are not too 
old to learn, or who do not think they 
know enough already. 

It is pleasing to note that The World 
has decided to cease its visits when the 
subscription expires. A physician who 
cannot send the cash would better wait 
about sending his order. If one is 
anxious for a paper to continue to come, 
he will remember to send the cash — at 
least when the paper stops. I remember 
some years ago I was so anxious for The 
World to continue to come that I kept 
sending money until I was five or six 
years ahead ; and one of the editors wrote 
me to withold my "generous hand." I 
am now a paid-up subscriber for eight 
years. I think I know a good thing when 
I see it, and though I may not live to 
read it, some one else will be benefited 
by it. Yes; stop the paper when the time 
expires. It is the only business plan ; 
besides, it is sometimes a difficult and 
delicate matter for a reader to stop a 

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n8 



THE MEDICAL WORLD. 



paper. It is generally the paper you do 
not want that "sticks to you closer than 
a brother." Some years ago, desiring to 
stop a paper, after meditating over the 
best plan, I wrote that my eyes were bad, 
which was true at that time. In due time 
I received a letter from the editor, say- 
ing my wife could read the paper to me; 
so it continued to come. 

I read with interest the articles on 
antitoxin. I am particularly interested 
in that from Dr. Lockhart (page 12). 
During a practice of nearly a quarter of 
a century, I suppose I have not seen more 
than twenty-five cases of diphtheria, 
though I treat many cases of sore throat 
every season. Just now, while the anti- 
toxin treatment is fashionable, there 
seems to be an unusual number of cases 
of diphtheria. You read more of this 
treatment now than you will a few years 
hence. 

Dr. Watt (page 31) is right when he 
says: "When we begin to study indi- 
viduality we cease curing diseases and 
commence to cure sick people." We 
should never forget for a moment that 
we must treat the patient and not the 
disease. When the brilliant R. G. Cow- 
ling, whose voice is now, alas! forever 
silent, once said to a body of English 
surgeons, that the forte of tfie American 
physician was to "treat disease," he 
should have said, to treat the patient. 

If there are no other symptoms than 
those given by A. L. D. (page 34) I do 
not think it certain that he has chronic 
Bright's disease. Every physician should 
read the articles by "A Doctor's Wife." 
4 'There is more truth than poetry" in 
what she says. C. Kendrick, M.D. 

Kendrick, Miss. 

Cinnamon in Surgery. 

Editor Medical World : — As you ask 
for details for using oil of cinnamon as 
a disinfectant in surgical work, though 
there may be better methods, my method 
in military and civil service is pretty 
much 3s stated in my article in January 
World. True, only a small amount of 
the oil dissolves in water, but only a 
small amount is needed ; for it acts like 
magic. In a recent wound of any kind, 
after stitching or whatever may be 
needed, I keep a compress wet with the 
aqua cinnamomi constantly applied until 



healing is complete, which usually takes 
place without suppuration. 

With me it takes the place of listerine, 
corrosive sublimate, and indeed of every- 
thing else. It is pleasant to use, cleanly, 
non-toxic, safe and cheap. As a douche 
after parturition it is ideal, not often 
requiring to be used more than two or 
three times. I add 3 or 4 drops of the 
oil of cinnamon to 2 quarts of warm 
water and direct it to be used as often as 
there is any scent to the lochia. 

In nasal catarrh it serves me well, and 
in fact wherever a germicide and dis- 
infectant is wanted. 

J. F. Baggott, M. D. 

Bamberg, S. C. 

Hoar-Glass Contraction. 

Editor Medical World:— About a 
month ago I was called to a case of 
obstetrics. When I got there I found 
an old lady there who does a good deal 
of " grannying " on her own account 
On making inquiries I found that the 

Eatient had been in labor about four 
ours. The old granny told me she 
gave her a teaspoonful of fluid extract of 
ergot as soon as she got there, which 
was about half an hour before I arrived. 
I asked her why she gave the ergot. 
She said, because she thought it was a 
good thing and would help the patient 
along; that she gave ergot to all the 
cases she attended. In half an hour the 
child was born; the patient was a primi- 
para. I waited for nearly half an hour 
on the after-birth, and it not coming, I 
manipulated over the womb, at the same 
time I introduced the fingers of the 
other hand and tried to draw the placenta 
down by way of the axis of the superior 
strait. I found I could not move it At 
intervals of ten minutes I tried hot and 
cold applications over the womb for the 
next hour and a half, at the same time 
trying to draw the placenta down ; but 
all to no purpose. Now, during this 
time, she had three gushes of hemorrhage 
with the pulse growing weaker all the 
time, I was becoming very much 
alarmed; so I concluded I would intro- 
duce my hand and take the placenta 
away, but, when I had reached the os, I 
found it so hard and contracted I could 
not begin to get in. I labored faithfully 
for fifteen minutes but could go no 

Digitized by VjOOQiC 



THE MEDICAL WORLD, 



119 



further; so I gave that method up. 
During all this time I noticed that she 
felt tired and worried, with an inclina- 
tion to nap. Common sense and judg- 
ment dictated that relaxation had to 
take place before the placenta could 
come; so I told her to be quiet and go 
to sleep if she could, judging that the 
quiet and repose would have a tendency 
to prevent any alarming hemorrhage, 
and at the same time help to produce 
relaxation of the os. Well, she went to 
sleep right away and slept for half an 
hour ; and when she awoke she said she 
felt something come. I made an exami- 
nation and found the placenta expelled 
completely and entirely on the outside 
of the vagina. She had no more trouble 
and recovered rapidly. Now, Mr. 
Editor, I want to know whether I did 
right in letting her go to sleep to obtain 
the relaxation needed. As I have no 
authority for it, I simply used my own 
judgment. The books don't say any- 
thing about failure in extracting the 
after-birth by hand, so I don't know 
whether my method was commendable 
or not. Of course I blamed the ergot 
given as the principal cause of the 
trouble. 

I will be glad to hear any criticism 
offered. J. P. McDonough, M. D. 

Ocker, Tex. 

[Your results are your justification. I 
well remember a remark by one of my 
associates years ago, a sterling country 
practitioner. He said : i i In hour- glass 
contraction, lay down and go to sleep 
by it" His almost constant condition 
was weariness from overwork. He 
meant by this remark that it is no use to 
work with an hour-glass contraction, 
but that it is best to await relaxation. 
One with less patience and less con- 
fidence in nature would anesthetize to 
relaxation and remove the placenta. The 
former method is the best when there is 
no imminent danger. — Ed.^ 

r 

Vacuum Treatment of Ataxia. 

Editor Medical World,:— Replying 
to " Ataxia's 'Snquiry as to the best treat- 
ment for locomoftu: ataxia, there is but one 
sure and positive rtaiedy. It is clearly 
settled that locomoK^ataxia may be 
cured in its first stage bymedication, but 
past that only by some means that will 



clean ou ^congestions, open jy>j£pllatrfed 
veins^nd ar teries , re-establish cirdula- 
tion ancTTnaifiEafii the DftJbd flow /roni 
day to day until the nerve and nqfiscle 



tissues shall 
their normal 
tivity. This 
pne uma tic or 
ment, using 
preference is 
and those 
progressively, 
under treatm 
to day. Mu 
ment must 
be treated for 
halkhgur, at 
until the dow 
ease is overco 
able. Some 
the bloodjich 
terial is desiral 
vomica, Preili 



muriate of <ju 
like preparation: 
sparinglyj^nd i 
and like tonics 
effect that numb 



ve been fully resto; 
rengthand a healt 
Ifficiency is found 
euum metho ds 
he best applian 
e Parker- Wilkin 
il fully, persiste: 
The action and 
t must be noted 
care, patience 
used. The pa 
rom fifteen min 
t sixTrnres e; 
ard tendency 
and recovery, 
[jcal treatme 
itfa tissue 
e, but i£ st: 
tonic, or 



ne 
are 



co. (PI 
used, il 
mittentlyj 
roduce 
the ner\ 



a tenderness of tne chordiand 



nerves that is not 

WlLLAI 

Topeka, Kan. 



sirabk 
,Cyr1 



I to 
ac- 
the 
treat- 
(my 
make) 
y and 
eaction 
rom day 
d judg- 
must 
:es to one 
h week, 
the dis- 
i notice- 
to keep 
lg ma- 
ia, nux 
phospho- 
ipp's), or 
should be 
Strychnia 
secondary 
producing 
spinal 



Francis. 



Oil of Cinnamon as a Disinfectant. 

Editor Medical World : — The ex- 
perience of Dr. Baggot, page 31, January 
World, leads me to speak of my experi- 
ence with oil of cinnamon. It is, as the 
Doctor says, one of the most perfect of 
, disinfectants, and a delightful deodorant. 
My use of it has generally been in the 
following combinations : 
R Acetanelid, . oz iv. 

Menthol, . . gr. xxxij. 

Boracic acid, . . gr. xvi. 

Oil cinnamon, . dr. j . 

Alcohol, qs. . qt j. 

M. Use as a general disinfectant, clear or in 
hot water, a dram to a pint. 

I use this in almost every way; to 
cleanse hands and instruments, to 
deodorize and disinfect sick peo- 
ple, sick rooms, etc., and as a local 
application in skin diseases. For in- 
stance, the worst case of tj nea ca pitis I 
ever saw was promptly ana elegantly 
cured by its local application, frill 
strength, three times daily, and wash- 



120 



THE MEDICAL WORLD 



ing in hot soajsuds every morning, Jib- 
ber' s itch, rtng^jjormsTetc, go in a way 
that will surprise you and your patient 

I always carry x / 2 oz. in my grip, 
and among other uses, I use it invariably 
after using thermometer, I wet a small 
pledget of cotton, and rub the thermome- 
ter thoroughly, then wipe off with dry 
pledget This is more convenient than 
to get a glass of water and clean napkin, 
and moreover it gives the next patient a 
clean thermometer, which cannot be in- 
sured by the usual method. 

In the proportion of ore dram to the 
pint, it makes a very satisfactory vaginal 
wash, or a delightful sponge bath. 

In this connection I would commend 
the use of the following for a more 
astringen t vatpn alwash. When its use is 
indicated it gptVCsthe very best of 
results. 



-\ 



aaoz iv. 



gr. xl. 
aa min. lxxx. 



R Powdered alum 

Powdered boracic acid, 

Powdered borax, 

Hydrastine sulph, 

Carbolic acid, ) 

Oil cinnamon, j 
Triturate. Use one teaspoonful in a pint of 
hot water for vaginal injection once daily. 

Of course in the above formulas, I 
recognize the benefit of the other ingred- 
ients, but the oil alone is a most powerful 
disinfectant and healing agent Aceta- 
nelid is another. 

W. B. House, M.D. 
Detour, Mich. 

Vaginal Suppository.— The Sense of Smell In 
Diagnosis. 

Editor Medical World:— In reply to 
Dr. Root, page 79, February World, 
will say that the following is about what 
I use: 

R. Cocoa butter - - - dr. 8 

Acid boracic gr. 36 

Acid tannic - - - gr. 25 

Oil olive - - - - dr. 1 

M. Make into 12 vaginal suppositories. 

In warm weather the olive oil should 
be omitted, as it would make the suppos- 
itories too soft. m 

To assist us in making up a diagnosis 
of any case, we ordinarily bring into use 
only three of the five special senses, 
namely, hearing, seeing and feeling. I 
wish to say something in behalf of the 
sense of smell as a help in making up a 
diagnosis in many cases. There are 



times, 'tis true, when the physician 
wishes he had no olfactory nerves, and 
yet occasions arise when their delicate 
appreciation of odor is a fortunate pos- 
session. All are familiar with the fetor 
of certain diseases and conditions, such 
as pulmonary gangrene, uterine cancer, 
measles and the odor emanating from the 
partruient woman. I have on several 
occasions made a correct diagnosis of 
pneumonia by the peculiar fetor of the 
expired air from the diseased lungs. It 
is said that the retention of urea in the 
system is detected by the urinous odor 
of the breath of the patient. There is 
a peculiar sour odor emanating from 
rheumatic patients. 

Will not some one who has greater 
opportunities to investigate than we 
countiy physicians give us a few point- 
ers along this line? 

H. P. Monroe, M. D. 

Harris, Kansas. 



For Cough. 

Editor Medical World : — Through 
the columns of The World a good gen- 
eral cough remedy has been asked for, 
one containing no opium. After an ex- 
perience of twenty years, can recom- 
mend the following as my favorite cough 
prescription : 
R. Tr. ipecac, ... dr. j 
Tr. lobelia inflata, . dr. j 

Chloroform C. P. . gtt v 

Tr. aconite, gtt x 

Syrupus simplex, q s. ad oz. viij 
M. S. % to 1 teaspoonful every 2 to 4 hoars 
to meet requirements. 

E. J. Yager, M.D. 
Grayville, Ind. 

One of our subscribers writes that he takes 
23 medical journals, but likes The World 
best of all. Follow the Doctor's example, and 
take "Jots" of journals. They are good and 
cheap. Don't let the trifling price stand in 
the way when you see what you want. Don't 
pay you have too many already. Is there any- 
thing you buy that is as large value for the 
f)rice as a yearly subscription to a magazine 
ike The Medical World, for example? 
Don't try to "skimp" or economize in this 
direction. It won't pay. 

Yes, we still send World and Medical 
Council both for $1.75 per year. Also World 
and Alkaloidal Clinic for $1.75; World and 
Hypnotic Magazine with a book on Hypnotism 
as a premium for $1.75; any three for $2.75; 
all four for $3.75. New subscribers to Clinic 
get a nine vial pocket case, filled, as a premium. 
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THE MEDICAL WORLD. 



121 



Quiz Department. 



Questions are solicited for this column. Communications 
not accompanied by the proper name and address of the 
writer (not necessarily for publication) will not be 
noticed. 

Tke great number of requests for private answers, for the 
information snd benefit of the writer, makes it neces- 
sary for us to charge s fee for the time required. This 
fee will be from one to five dollars, according to the 
amount of research and writing required. 

Corrections. 

In February World, page 62, second 
column, 13th line from top, change 
44 half an ounce of w ater " tojsilXAU&Qes 
of water! X1S6, page7J% n ^ ar middle of 
second column, change "onions" to 
wi nes, and u i odine " to sod ium?" Also, 
on same page, Urst colttflUT, second para- 
graph from bottom, first line, change 
u minimizing " to immunizing. 

We have carefully examined the manu- 
script since the above has been called 
to our attention and find that we have 
interpreted the manuscript as well as we 
could. Names of drugs and quantities 
should be written very distinctly. 

Dr. G. M. Norton, of Toronto, South 
Dakota, deprecates the discussion of pre- 
vention of conception, not only because 
of the immorality of such a procedure, 
but also because of the " almost empty 
school houses," and other evidences of 
the growing scarcity of children. 
While it is sad that any locality is lack- 
ing the joy of the presence of children, 
yet we are convinced that this is con- 
fined to a very few localities, while other 
localities have more than are supported 
as they should be. 

Induration in Corpus Cavernosum. 

Editor Medical World:— About one 
year ago, I began to experience consid- 
erable pain on erection. It is situated 
just back of the glans penis, on right 
side, and proved to be situated in right 
corpus cavernosum. It has gradually 
grown worse until at this time there is 
curvature toward right side. There are 
indurated lumps on both sides, which are 
very sensitive to the touch. The cause 
is unknown. I have received no injury 
at any time that I can call to mind, and 
have never had gonorrhea or syphilis ^t 
any time ; family history good, so far as 
I know, general health good. I have 
not taken treatment of any kind. I con- 
sulted a specialist early last spring, who 



advised the use of the sound. I used 
No. 24 French scale ; found no stricture. 
The indurated lumps were absent at that 
time? Now, brethren, I would like to 
hear from as many of you as I can, as I 
am in distress about my condition. 
Would especially like to hear from the 
Editor. I graduated last spring. 

Anxious. 
[This case was submitted to Dr. Jno. 
B. Deaver, the eminent surgeon, who 
said that while such cases were not com- 
mon, yet they are not rare. Inflamma- 
tion has been started at the points named, 
and exudation thrown out. It is likely 
that a blood vessel gave way in the cor- 
pus cavernosum during erection, and this 
exudate is a consequence. He advises 
general alterative treatment witjijodide 
of potassium ' as-*he base, tojpfomote 
absorbtion, and locally, free' application 
of an ointment consisting of one £art 
mercurial oi ntm ent, one b§£t .belladonna 
ointment, and t wo parts l^ hthvoL Also 
gentle mas sage of thepart, with sound 
insertedr tetter dilatetB^urethra (not 
its full course) to the full limit — Ed.] 

Editor Medical World : — Kindly 
tender me the information as to what 
other symptoms, outside of local, you 
have known in stricture of twelve or 
fifteen years' standing ; also your opinion 
as to the efficacy of treating by the 
sound and medication as against surgery. 
Do you know of any long-standing case 
of stricture that has been entirely and 
permanently absorbed by sounding and 
medication ? 

N. Y. Troy. 

[The above was submitted to Dr. Jno. 
B. Deaver, who has had a very large ex- 
perience in this class of cases. He says 
that the reflefcksymptoms excited by 
strictur^are confl5ecTl6 the region of the 
perineum ar|d jjg£tum ; h^ has never 
seen any more remote reflex symptoms, 
except as these sometimes cause nervous- 
ness and undermine the general health. 
The treatmentj>f stricture by sounds is 
preferable to a cutting operation, when 
it can be done successfully ; but a per- 
centage of cases will not yield to sounds, 
and they have to be cut. It is the 
opinion of authorities that a strictured 
urethra cannot be entirely restored to its 
previous condition anatomically by either 

igi ize y g 



122 



THE MEDICAL WORLD 



means, but it can be restored function- 
ally. We do not know what you mean 
by medical treatmeut of stricture. It is 
a mechanical condition, and recfuires 
mechanical treatment. — Ed.] 

Ulcer of Leg. 

Editor Medical World :— Will some 
of the writers for The World give us 
the very best treatment for ulcer of leg 
in patients that cannot give up their 
daily labor? I have in years past suc- 
ceeded in curing a few cases by making 
local application of iodoform, then apply- 
ing strips of linen cloth one and one-half 
inches wide, long enough to encircle 
two-thirds of the limb, wet with cold 
water and applied clap-board fashion ; 
over this a roller bandage from the toes 
to the knee. But have been treating 
this case on this plan, and, so far, have 
failed. I have never been able to use the 
rubber bandage recommended by all our 
works on surgery. The bandage causes 
a perspiration of the limb, and in a few 
hours begins to irritate the whole limb. 
J. B. Simpson, M. D. 

Mountain House, Ark. 

Editor Medical World : — I would 
be glad to get an expression of 
opinion from the editor of The World 
or some of its many readers as to the 
comparative value, therapeutically, of 
tinctures, fluid extracts, powders and 
tablets. As far as I have been able to judge, 
after some years* observation, the tinc- 
tures, such as the eclectics use, 
or the mother tincture of the homeo- 
paths, have given me the best results. 
They seem to be more uniform in strength 
and more certain in producing the physi- 
ological effect of the plant The tablets 
are often disappointing. 

Spartanburg, S. C. J. NoTT Moore. 

[Remedies in solution are more certain 
of absorption, and absorption is more 
easy and speedy. In fact, tablets, pow- 
ders and pills must come into solution 
before they can be absorbed. But reme- 
dies in solution taste badly, and the 
digestive juices are usually sufficient to 
insure the solution of powders, pills and 
tablets.— Ed.] 

Editor Medical World : — Have any 
of the World family any knowledge of 
the influence "signs "have on a surgi- 



cal operation, if at all ? Farmers and 
stockmen are very successful in their 
operations on stock, and they observe the 
44 signs." 

Eruptive diseases are milder in the 
South, at least in Kansas, than the same 
maladies in the North. 

A boy brought us a tapeworm he found 
in a rabbit — perhaps the tenia pisifor- 
mis. How do these rodents get these 
entozoa ? Do they eat flesh ? 

W. S. Newlon, M. D. 

Oswego, Kan. 

Cold Surface. 

Editor Medical World:— Would like 
some suggestions from the editor in re- 
gard to the following case : Lady, about 
42 years of age, mother of four children, 
general health pretty good, but feels 
chilly all the time. Hands and feet, and 
in fact the whole surface of body is al- 
ways cold. Pulse is normal, appetite 
good. This condition is of two or three 
years standing. Give me your idea of 
probable cause of trouble and treatment 
in your next issue. 

Millersburg, O. D. G. Olmstead. 

[What is the sublingual temperature ? 
Are supeificial veins normally filled? 
Are you sure that the heart action is 
normal? Does external application of 
heat relieve the sensation ? Do hot drinks 
and stimulants relieve? Is the patient 
subject to any drain, as leucorrhea or sup- 
puration ? The trouble is probably with 
the sympathetic nervous system or the 
circulation. Discover and remove the 
cause. Stop any drain, build up the 
system with tonics, good food, hygienics 
and plenty of exercise. Report later. 
—Ed.] 

Bloodless Treatment of Cancer. 

Editor Medical World :— I would 
like to ask the readers of The Medical 
World to give the World family their 
experience in the treatment of 
cancer by the bloodless method. There 
are thousands of timid patients of both 
sexes who will accept no other 
treatment. They either go to a cancer 
institute or place themselves under 
the treatment of some irresponsible, 
ignorant person who is supposed to be 
possessed of a paste or plaster that will 
cure cancer, and who charges from one 

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THE MEDICAL WORLD. 



123 



to two hundred dollars for the job. If a 
patient refuses to submit to an operation, 
it seems to me that the physician should 
never allow her to go away for treatment 
on account of being ignorant of other 
methods. So I ask the readers of The 
World to tell us all they know about 
internal treatment and external applica- 
tions in the treatment of this disease. 
Do the cancer institutes have a treatment 
of which the profession at large is 
ignorant? 

In writing, give all the details of the 
treatment, and your successes and 
failures. A Country Doctor. 

Minn. 

Dr. J. A. Henry, of Banning, Fayette 
Co., Pa., asks for best treatment for 
burns by gas in coal mines. Apply same 
general principles applicable to burns 
caused in other ways. Perhaps some 
reader can give us a good practical article 
on this subject. See an article on this 
subject in this issue. 

Dr. R. J. Bowen, of Berlin, Md., asks 
for remedy for tremor of hand while 
writing. He is in other ways in good 
health, but he is 70 years of age. No, 
doctor; there is no remedy. The years 
rest lightly upon you if this is all the in- 
firmity they have brought Take plenty 
of exercise in the open air, and plenty of 
sleep ; simple, nutritious food, and a 
happy, hopeful frame of mind. We hope 
this course will keep your name on our 
subscription books for many years to 
come. Thanks for your kind words for 
World, which you say you have read 
from its infancy. Don't mind a little 
tremor of the hand. If we live to be 70, 
we will be glad if we can say that a 
tremor of the hand while writing is our 
only infirmity. 

Dr. T. Hankins, of Ness City, Elan., 
reports an umbilical cord six feet long, 
and asks if any one can beat it. Do you 
ever measure length of cord ? 

Fracture of the Patella. 

Dr. C. W. Townsend, of Bower Hill, 
Pa., sends a description of an apparatus 
for fractured patella. Use a tin box well 
padded ; solder on five wire loops, one 
immediately beneath the knee, two 
below and two above. Numbering from 
below upward, loop number 1 is to retain 



the hand which binds the box to the 
tibia ; number 5 retains the femur band ; 
number 3, immediately beneath the knee, 
retains a band that extends over a rubber 
pad placed on the patella to keep it level ; 
loops number 2 and 4 retain rubber roller 
bandages, one extending from below to 
above the patella, drawing it down 
against the lower fragment, and the 
other extending from above the knee 
over the lower fragment, drawing it 
against the upper fragment He has 
never had a failure with this appliance, 
even when the cork of a horse-shoe broke 
the patella into several fragments. With 
this apparatus there is no use of wiring. 

Dr. E. H. Robinson, of Robinson 
Springs, Ala. , reports a case of heart on 
the outside, somewhat similar to that re- 
ported by Dr. Bowman in the January 
World. Dr. Robinson accounts for his 
case by the fact that the mother, early in 
the pregnancy, was present when the 
husband butchered a number of hogs, 
witnessing the act of opening the chest 
and taking out the heart and lungs. 

One of our subscribers in Upper 
Penasco, Lincoln county, New Mexico, 
writes that the climate of that region is 
excellent for tuberculosis. Several cases 
are mentioned that went there and 
recovered. 

Apropos of the discussion on the pre- 
vention of conception, I was very much 
surprised recently when a lady called 
upon me for some medicine to " make 
her breed " ; it is so often the other way. 

Wills Point, Texas. C. S. Collier. 

[Our beloved Prof. Ireland, of Louis- 
ville, used to tell us boys this : " There 
are only two kinds of women in the 
world. One kind will do anything under 
the sun to have children, the other kind 
will do anything under the sun not to 
have chil dren. " — Ed.] 

Dr. R. L. Stewart, of Des Moines, 
Iowa, asks for the composition of 
" Ayer's Hair Vigor." 

On page 103 March World, we find 
the following : tc Ayer's Hair Vigor " is 
a plain solution of acetate of lead, con- 
taining only about 0. 6 per cent, of the 
salt. 

Information is asked for concerning 
"alkavis." 

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THE MEDICAL WORLD. 



Current Medical Thought. 

A Plea for ClrcurocUlon. 

Dr. S. G. A. Brown, of Shippensburg, 
Pa., makes the above plea in January 
issue of Journal of Orificial Surgery. 

"Man in his primitive state was pro- 
vided by nature with this sheath (pre- 
puce) in order to protect the procreative 
organs from danger and harms, as he, 
like the animals by which he was sur- 
rounded, was attired in nature's garb, 
being exposed to the bites of insects, the 
prick of thorny briars, etc. But evolu- 
tion, environment and civilization have 
placed man in that position that he has 
no further use for this curious relic of a 
long- past barbaric age. 

44 All physicians are not agreed as to 
whether circumcision in childhood is the 
proper course to pursue, but surely if the 
matter were investigated thoroughly and 
with an unbiased mind, it would stand 
out as a self-evident fact that much good 
can be accomplished toward the preserva- 
tion of health in our children and the 
increase in their longevity. The Jews, 
who perform this operation on the eighth 
day after birth, are, from actual observa- 
tions, known to be exempt from many 
diseases which afflict other races. Their 
children are hardy, and grow up to man- 
hood and womanhood strangers to dis- 
ease, perfect in body, sound in mind, and 
with a morality above condemnation. It 
is rare that they figure in silly crimes, 
police or divorce courts. That an ap- 
pendage like the prepuce which under 
various conditions, as phimosis, short 
frenum or preputial adhesions, is the 
leading factor in the production of enure- 
sis, dysuria, impotence, calculi, cancer, 
syphilis, phthisis or various other reflex 
neuroses, can be considered as a natural 
physiological appendage, is absurd in the 
extreme. 

^ " In order to render the rising genera- 
tion ^ healthy, mentally, morally and 
physically, we must pay attention to this 
redundant tissue, and advise its early 
removal. Fully three-fourths of all 
male babies have abnormal prepuces. 
Prof. E. H. Pratt says : ( A perfectly 
formed foreskin in the relaxed state of 
the organ extends no further than the 
point of the glans penis ; it is free from 



all adhesions to the glans and corona, 
and exercises no degree of constriction 
on the glans itself, and when retracted 
shows no tendency whatever to pinch the 
penis. * 

44 The prepuce is an important factor in 
the production of phthisis. This can be 
proven by the immunity of the Jewish 
race from tubercular affections ; also the 
fact that there is a relation existing be- 
tween a syphilitic taint and a phthisical 
tendency. The sensitive and absorbing 
covering of the uncircumcised organ pre- 
sents a favorable medium for the trans- 
mission of the poison from one system to 
another. What an untold amount of 
suffering might be prevented, bjr turning 
our attention to this source of infection 
in childhood and early youth 1 

44 The elongated prepuce often plays 
an important part in enuresis. Children 
who pass their second year and are unable 
to control the vesical sphincter may be 
said to be suffering with enuresis. This 
is a very persistent condition, annoying 
to the mother, mortifying and humiliat- 
ing to the little sufferer. The irritation 
from preputial adhesions, or the extreme 
narrowness of the preputial orifice, is not 
infrequently the cause of this trouble. 
The irritating urine in passing over the 
sensitive mucous lining of the prepuce 
may create untold suffering and possibly 
death. It is only a few decades ago that 
innocent children were scolded and pun- 
ished when afflicted with nocturnal 
enuresis. Their irritability, carelessness, 
moroseness and stupidity were attributed 
to willful obstinacy, and they were pun- 
ished accordingly. In most instances 
these troubles can be traced to preputial 
irritation, the child having no control 
over them whatever. 

44 Many chronic and apparently ob- 
scure affections are induced or greatly 
aggravated by a phimosis. The writer 
would beg to submit a few cases that 
have been of unusual interest to him. 

44 Case i. Infant, aet 8 months. 
Mother said did nothing but cry from his 
birth ; otherwise, he had been perfectly 
healthy. Four weeks previous to my 
being called, he was attacked with a 
painless, non-exhausting diarrhea which 
the attending physician could not con- 
trol. Crying continued. Upon exam- 
ining the case I found nothing unusual, 

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THE MEDICAL WORLD. 



"5 



save a congenital phimosis. Notwith- 
standing, I prescribed carefully, I could 
not cure the diarrhea. Child was nursed 
at maternal breast Having received 
consent of parents, operated on prepuce. 
Result : rapid healing, diarrhea immedi- 
ately cured ; no more crying. 

" Case 2. — Baby, aet 10 months, had 
eczema for last six months. Baffled all 
internal and external medicinal treat- 
ment Was extremely nervous, with 
twitching of the right arm and right 
leg. Upon examination, found an 
elongated, leathery, redundant prepuce, 
completely adherent to the glans, with 
an opening so small as to scarcely admit 
the end of my groove-director. Operated 
promptly, tearing away the adhesions. 
Result: Nervousness with twitching 
immediately cured ; eczema well in ten 
days without further medication." 

The above are some quotations from 
the article. It is a strange thing that so 
many early peoples, and so many of the 
less advanced races up to the present 
day, practice circumcision. Is it a re- 
sponse to an instructive impulse ? It is 
certainly fortunate from a sanitary point 
of view. 

Cure for Crying in Children. 

In a certain New York nursery, as soon 
as a child begins to cry, the nurse catches 
it up, holds it gently, and places her 
hands over its nose and mouth, so that 
it cannot breathe (Med. Record). The 
crying ceases directly, and the child 
is allowed to breathe freely again. 
Should it a second time attempt to 
scream, the same simple and effectual 
method is applied. This is repeated 
until the baby imagines that the painful 
stoppage of the breath is caused by its 
own effort to scream, and so is careful to 
keep quiet. — Col. and Clin. Record. 

Examination of Unmarried Women. 

The Philadelphia Polyclinic remarks 
that in supposed pelvic disease in young 
unmarried women a pelvic examination 
is too often proposed and carried out 
It should be remembered in this connec- 
tion that the large majority of diseases 
peculiar to women are sequences of 
coition and its results, either preg- 
nancy or specific infection. Neo- 
plasms are, of course, excepted. Conse- 
quently it can usually be predicted that 



a pelvic examination will result nega- 
tively and is consequently unnecessary. 
Dr. Baldy finds this to be true in the 
majority of cases, and urges the advisa- 
bility of paying more attention to the 
¥itient's general health and antecedents, 
his is the more important, as a hys- 
teric or neurotic girl's attention being 
once pointedly directed to her pelvis as 
the seat of her trouble, she often becomes 
a chronic pelvic sufferer. As in the case 
with opium-eaters and chronic alcoholics, 
the medical profession is also responsible 
for making a large class of pelvic 
sufferers. — Mass. Med. Jour. 

Legal Decisions Affecting Physicians. 

Visiting Lists as Evidence of Services. 
— Courts have ruled that no " visiting- 
list" of which the entries are simply 
the names of patients accompanied by 
a succession of hieroglyphics unintel- 
gible to a jury, and requiring to be ex- 
plained and translated by the person 
making them, can be accepted as a book 
of original entries. "Allowing the 
utmost latitude to the plea of conve- 
nience and necessity, the law cannot 
tolerate as self-proving an entry of ser- 
vices which can be translated only by 
means of a glossary." Such books have 
been rejected in a suit for services in 
Pennsylvania, and the same rule pre- 
vails in other States except, perhaps, 
Mississippi. " A due regard for his own 
interests should lead the physician to 
keep a book of original entries, showing 
a charge for attendance, with the date, 
the name of the person against whom 
the charge is made, and the amount of 
compensation for the services or attend- 
ance."* 

Sale oj Practice. — An agreement for 
the sale of a practice for ten years was 
violated by the seller returning to the 
place and resuming practice after four 
years' absence. An offer by the seller to 
return the amount paid him was not 
considered final, the Supreme Court 
allowing further proceedings to deter- 
mine the loss likely to be sustained by 

* Attention is called to the fact that The 
Medical World Visiting I«ist was designed 
specially to fulfill the above-mentioned re- 
quirements of law. At the same time it is the 
lightest and least bulky list in use, as it con- 
sists of a handsome leather case and remov- 
able sections H^dfrzW^ C 



126 



THE MEDICAL WORLD. 



the buyer by reason of the change. The 
Court restrained the seller from practis- 
ing in the locality until the question of 
damages was settled. 

The Law of Libel and Slander as 
Affecting Physicians. — Libel consists in 
the utterance of any communication other- 
wise than by oral speech unjustifiably 
accusing private individuals, officials or 
governments of anything tending to 
make them ridiculous or injure them in 
reputation or public esteem. Slander is 
an oral statement unjustifiably accusing 
a person of a crime, a loathsome disease, 
incapacity, or dishonesty, or of any fault 
which tends to injure the person or his 
business. The Courts have decided that 
an accusation may be slanderous or not 
according to the vocation of the accused. 
To accuse a physician of general profes- 
sional ignorance or malpractice is action- 
able per se, but to state that in a special 
case he was at fault is not slanderous, 
unless special damage is proved. A re- 
tired physician, since he no longer gains 
his living by his profession, may be 
accused with impunity of what would 
"slander" a man in actual practice. 
Slanderous words uttered in one State 
may not be actionable in another State 
unless proved to be so also in the place 
uttered. A person uttering slander to a 
second party who repeats it to the detri- 
ment of an individual may escape respon- 
sibility if the damages result from the 
utterance of the second party and not from 
that of the originator. In case of libel, 
any accusation holding a person up to 
scorn or ridicule, whether professionally or 
as a private person, is actionable. A phy- 
sician who attempts to achieve notoriety 
by puffing himself cannot recover dam- 
ages from those who further his attempts. 
It is slander to falsely attribute a con- 
tagious disease to a person, unless a state- 
ment was'necessary and there was a mis- 
taken diagnosis. A physician condemn- 
ing any article used in medical practice 
is liable to the manufacturer, if the said 
physician's statement be incorrect. — Dr. 
Henry Leffmann, in Phila. Polyclinic. 

An Inspection of Parke, Davis & Co.'s Biologi- 
cal Laboratory. 

BY OSCAR L. DAISES, M D. , HEALTH OFFICER, GRAND 
RAPIDS, MICH. 

In November, 1896, I visited this lab- 
oratory for the purpose of inspecting its 



methods of manufacturing antitoxin. I 
found twenty-four horses, all in fine con- 
dition, seemingly strong and healthy. 
At the outset these animals are tested 
with tuberculin and mallein. 

Their quarters are scrupulously neat ; 
they are well groomed ; and, so far as I 
could ascertain, all the methods known 
to modern science are brought into requi- 
sition, from the selection of the animal 
to the final marketing of a germ-proof 
serum. 

At the head of this biological labora- 
tory are two thoroughly scientific gen- 
tlemen, Dr. Charles T. McClintock and 
Dr. E. M. Houghton, whose watchful 
supervision follows the serum through 
every stage of manufacture and is not 
content until its potency is demonstrated 
by the most searching tests. 

In the administration of antitoxin, I 
have used, and have seen others employ, 
that of Behring and Roux. The results 
yielded by foreign antitoxin have been 
in most instances successful. Yet in ad- 
ministering that prepared by Parke, Da- 
vis & Co. , I feel a greater degree of 
assurance, on the ground, first, that it 
can always be procured fresh when de- 
sired ; it has not spent weeks in crossing 
land and sea. Secondly, a decided ad- 
vantage resides in the hermeticallv 
sealed bulbs in which Parke, Davis & 
Co. put up their antitoxin, contamina- 
tion being wholly excluded. 



£laAS-Room Notes. 

[From College and Clinical Record ] 

In Carcinoma Uteris Prof. Montgomery 
advocates extirpation of the uterus 
through the vagina when the disease is 
confined to the uterine walls and presents 
no indication of involving the surround- 
ing tissues. 

In carcinoma uteri which has extended 
beyond the structure of the uterus, he 
advises abdominal hysterectomy, as it 
better enables the removal of the entire 
mass, the observation of the position, and 
evasion of the ureters. If there is much 
involvement of the broad ligament, or 
the disease extends down upon the vagi- 
nal walls, he advises ligation of the in- 
ternal iliac arteries immediately after the 
ligation of the ovarian arteries. This 
procedure enables him to remove the 



THE MEDflCAX WORLD. 



127 



diseased structures without the necessity 
of farther ligation. 

The value of Horseless Antiseptic 
Wax for controlling undue bleeding 
from the cut surface of a hone cannot be 
over-estimated. This wax is easily pre- 
pared, is antiseptic, and is always ready 
for use. It consists of bees-wax seven 
parts, almond oil one part, and salicylic 
acid one part Several years ago Prof. 
Keen introduced this preparation into 
the Jefferson Hospital, fie uses it ex- 
tensively to arrest bleeding from the 
bone during an operation. The bleeding 
that sometimes follows the sawing of 
a bone during an amputation, excision, 
or resection can be checked by pressing 
a small quantity of the wax against the 
bleeding surface. After the removal of 
a growth from the jaw, such as an exos- 
tosis or an epulis, the bleeding can be 
readily controlled by an application of 
this agent In bleeding from diploe or 
cancellous bone this wax is of great ser- 
vice. 

If the kidneys are not acutely inflamed, 
tiie following prescription is useful in 
Stomatitis : 

R. Potaasii ehlorat., . . dr. j 
Tinct. myrrhse, . gtt. zx 

Elixir. caUsayse, . 7 o*. iij M. 

Sig.— f dr. j in water every lour hours. 

— H*T€. 

In catarrhal gonorrhea injections 
through a blunt-pointed hard rubber 
syringe should be used : 

R. Zinci sulphatis, - gr. viij 
Plumbi acetatis, - gr. xv 
Aquae dest., - f oz. viij. M. 

— Da Costa. 

Acute Laryngitis may be treated inter- 
nally by a calomel purge, followed with 
the following : 
R. Tinct. aconiti, - m. xij vel xxiv 
Sodii bromid., - dr. ij 

Syr. lactucarii, - f oz. j 
Aquae, q. s ad f oz. iij. M. 

Sig. — f dr. ij every four hours. 

— Hare. 

In Cancer of the Uterus which has ex- 
tended to the surrounding tissues to such 
a degree as to contraindicate a radical 
operation, Prof. Montgomery advises 
curreting the surface and deep injections 
of absolute alcohol, subsequently dusting 
the parts with aristol and desiccated 
alum, three of the former to one of the 



latter, and packing the vagina with iodo- 
form gauze. This treatment should be 
repeated two or three times a week. The 
alcohol dries up the diseased tissue} and 
ultimately results in its being thrown off 
as a slough. Such treatment will delay 
the progress of the disease, but is not 
likely to prove curative. 

Dr. Horwitz uses the following mouth 
wash for Mucous Patches ; 

R. Acid, pyrotag., - «dr. j 

Aquae, - f oz. viij. M. 

Sig. — Wash the month every four hoars. 
.mm 1 , 1 1 . ,1 1 n inn i iu i i i i ii 1 

Our Monthly Talk. 

Dr. S. L. Scott, of Waukomis, Okla., writes : 
" After prescribing for a patient I make it a 
point to inform him why he is unable to pay 
his doctor bills. I also show him remedies 
for political as well as physical ills. " He says 
that 75 per cent, of the doctors of his county 
are political reformers- It should be 100 per 
cent., for doctors suffer so terribly from hard 
times. Even in good times their bills are 
the last paid, and in hard times they are fre- 
quently never paid. 

Dr. J. W. Coller, of WeUsville, N. Y. f writes 
a very interesting letter on the subjects dis- 
cussed in this department. If we had room 
we could publish many gems from it, as the 
following: ' ' These who are amassing wealth 
are not those who are earning it, and, of 
coarse, those who are earning it are not receiv- 
ing it. " As to recommending literature, he 
wishes to recommend the following: "Money: 
Its Nature, Function and Power;" by R.S. 
Thompson, and "The Law and the Facts; " 
by T. E. and £. E. Ballard— both published by 
the New Era Co., Springfield, O., price ten 
cents each. 

Sorry we can't publish the doctor's entire 
letter, but if we would undertake to publish 
all the really good things of this nature that 
come to us this would soon cease to be a medi- 
cal magazine. These things are of great 
importance to physicians, but The Worl© 
must remain primarily a medical magazine. 
We seek in this department to get thedoctots' 
thoughts started in the right direction ; and 
when this is done, don 't write articles for us, 
but write articles for your local papers. Talk 
to your neighbors, friends and patrons about 
these important questions that interest so 
vitally aU really useful citizens. Let your 
light shine in your community. 

The chief difference between a reptile and a 
warm-blooded animal is in circulation. 

Deficient circulation in a part will result in 
atrophy. The magnificent development of a 
black-smith's arm is by means of accelerated 
circulation in the part. 

The industrial and commercial life of a corn- 



Digitized by VjOOQLC 



128 



THE MEDICAL WORLD. 



munity or a nation depends upon its " arteries 
of commerce." In addition to navigable 
streams with their various crafts, we have, 
first, beasts of burden (in some countries man 
himself) following tortuous paths ; when the 
wheel comes into use a road must be made ; 
this greatly increases the amount of goods 
that a given amount of animal power can 
transport ; as the roads and the vehicles im- 
prove, quantity and rapidity of transportation 
increase ; canals increase the loads but decrease 
the speed, and they freeze in winter ; but the 
"iron horse " on his track of steel easily sur- 
passes all other modes of transportation. Rail- 
road transportation is the "circulation " of 
modern industrial and commercial life. 

This "circulation" is owned and operated 
by private parties. Does not this seem strange? 
For so important a function should be con- 
ducted in the interest of the nation as a whole 
and not in the interest of certain localities, 
and for a few individuals, as is naturally the 
case under private ownership. 

How railroads build up a community by 
favorable rates, and then destroy it by un- 
favorable rates, is an old and sad story ; but 
their favorite method is to build up certain 
firms or companies by specially favorable 
rates, thus enabling them to ruin all their 
competitors in the same line of business. This 
is the secret of the success of the Standard 
Oil Company and the cause of the ruin of 
hundreds of independent producers of oil. 
To be convinced of the evils and "anarchy " 
of our present railroad management, read 
"Wealth Against Commonwealth," by H. D. 
Lloyd; published by Harper's, N. Y.; |i. 
Also, "A General Freight and Passenger 
Post," by J. L. Cowles; published by Put- 
nam's, N. Y. ; 75c. The following are a few 
quotations from the latter book : 

In these special rates, distance was alto- 
gether lost sight of, one rate of twenty cents 
being made to Little Falls, 217 miles from New 
York, while that to Syracuse, 291 miles away, 
was but ten cents, and the rate to Black-Rock, 
a distance of 455 miles, was exactly the same 
as to Little Falls. The only rule for the deter- 
mination of the transportation taxes levied 
on the New York Central Railroad was the 
will of the President and that of the traffic 
manager. They changed the rates at some 
seasons of the year three or four times a day, 
said Mr. Vanderbilt." 

"At one time the rate on tin plate from 
Liverpool, via Philadelphia and the Pennsyl- 
vania Railroad to Chicago, was twenty-four 
cents a hundred, while the rate from Phila- 
delphia to Chicago, on the same article, over 
the same road, was twenty- eight cents a 
hundred." 

" The record in the Texas and Pacific case, 
lately tried in the Supreme Court of the United 
States, shows that the rate per hundred pounds 
charged for the transportation, on through 
bills of lading, of books, buttons, clothing 
and hosiery, from Liverpool and London, via 



New Orleans, over the Texas and Pacific and 
Southern Pacific railway systems to San Fran- 
cisco, is $1.07. On the same kind of domestic 
articles carried, it may be in the same train, 
the transportation tax over the same railroad 4 
is $2.88 from New Orleans to San Francisco. " 

"On foreign boots and shoes, cashmeres, 
confectionery, cutlery, gloves, hats and caps, 
laces and linens, the same blanket rate, $1.07 a 
hundred pounds, is levied for transportation 
from these English ports to San Francisco, 
while upon similar American goods shipped 
from New Orleans to the same destination, the 
railroad tax is $3.70 a hundred. A more ab- 
surd system of taxation than this can hardly 
be imagined, and yet the majority of the 
United States Supreme Court (Justices Harlan 
and Brown and Chief Justice Fuller dissenting, 
however), has decided that it is both just and 
lawful, and that American railway managers 
may with perfect impunity continue to tax 
Americans three or four times as much as they 
tax foreigners for a similar service. ' ' 

What is the use of a customs tariff when the 
railroads counteract it by discriminating 
against domestic goods ? 

" In the spring of 1895, certain farmers of 
my acquaintance endeavored to make contracts 
with the railroads to carry their crops to market 
for half what they would sell for, but their 
propositions were laughed at. Having the 
power the railroad managers preferred to con- 
fiscate the entire proceeds. And this, as the 
following instances will prove, they actually 
accomplished." 

Following, bills are given showing that the 
freights absorbed nearly all, and in some cases 
more than all, the value of the cargo after de- 
ducting commissions. A number of instances 
of railroad discriminations and robbery are 
given, and then the author says: "And 
people wonder why western farmers fail to pay 
interest on mortgages !" 

But worse, if possible, is the discrimination 
against the Government. The charge made to 
the Government for hauling mail bags is eight 
cents per pound for an average haul of 442 
miles ; but for similar service on similar trains 
the charge to others is only from one to three 
cents per pound. But what is little less than 
ridiculous, is a further charge of nearly two 
millions dollars per year for the use of mail 
cars! That amount would more than pur- 
chase all the mail cars in use and keep them 
in repair. But why charge quadruple rates, 
and then charge for the rolling stock besides? 
This is a double outrage. The Loud bill, B now 
before Congress, seeks to bar sample copies of 
journals and paper-covered books from second 
class privileges, in order to obviate the deficit 
in the postal department; better revise the 
railroad rates— require them to carry for Uncle 
Sam as cheaply as for any one else, and then 
there will be no deficit. 

The Government should own the postal cars 
and require the railroads to haul them as 
cheaply as for an^er^r^g^we coald 



THE MEDICAL WORLD. 



129 



reduce the rate on merchandise to eight cents 
per pound, the present rate on books, and soon, 
perhaps, we could reduce letter postage to one 
cent, and before long reduce package postage 
to four cents per pound, and thus the express 
business would be gradually absorbed. Also, 
the Government should take possession of the 
Pacific Railroads at once, and institute Govern- 
ment operation, which should gradually extend 
all over the country, and thus the «' circula- 
tion " would become normal in all parts, for 
the Government charges would be equal to all. 
No more discriminating in favor of large cities, 
no more robbing producers, no more robbing 
one business firm to build up another. This 
is as necessary to the nation as a normal cir- 
culation of the body. Shall we have it ? Shall 
we have freedom from the oppression we have 
so long borne? How shaH we get it? By 
striving for it. Do not be silent and idle. 
Write to your Congressman and Senators. If 
you are a Republican be doubly active, for 
your party has the power to give us this reform 
in the near future. Your last Postmaster-Gen- 
eral, Mr. Wanamaker, advocated the Govern- 
ment owning the mail cars, the telegraph lines, 
and also postal savings banks. If you are a 
Democrat, read Ex. -Postmaster-General Vilas' 
arguments in favor of Government ownership 
of postal cars in his reports. Mr. Cowles 
quotes from them on pages 65, 66 and 67 of 
his book. 

If, in a patient, you found the circulation so 
erratic, what would you first do ? You would 
equalize it ; make it just and uniform to the 
needs of each and every part. When quacks 
have charge of the Nation, we must go to the 
rescue! 

Better get both the above-mentioned books 
and circulate them among the influential peo- 
ple in your community. They will do the 
work. If this were done in every community, 
we would soon have a rational system of 
transportation, and more prosperous com- 
munities. C. F. T. 



9*T In deference to the wishes of many subscribers* lam Math 
nyr some of my articles on industrial and economic questions re- 
printed and will send them free to physicians on receipt of three 
cents Per set. It is understood that every one receiving these will 
pass them around among hu patrons, and make efforts to have 
them published in the local paper. This last is specially im- 
portant. C.F.T. 

Reform Books at Gold Standard Prices. 

The total failure of the plutocracy to keep 
its promises of increased prosperity to follow 
McKinley's election has left the people in a 
frame of mind that promises better results 
than ever before from the distribution of reform 
literature. The one great obstacle in the way 
is that few of the producing classes have a 
dollar to spare for the work. To meet this 
difficulty we have arranged with Charles H. 
Kerr & Company, of Chicago, to send any of 
our readers a large package of excellent reform 
books, all different, for only 30 cents in stamps. 
The package contains the following books : 



Warren 's Money Chart, a new and important 
work, 135 pages. 

The People vs. the Goldbugs, by A. D. 
Warner, 144 pages. 

The New Democracy and Bryan its Prophet, 
by C. R. Tuttle, 96 pages. 

How to Govern Chicago, by C.R. Tuttle, 118 
pages. 

A Story from Pullmantown, by Nico Bech- 
Meyer, no pages. 

The White Slave ; or, « * The Cross of Gold, • ' 
by Helen M. Sumner, 32 pages. 

The People or the Politician, a handbook of 
Direct Legislation, by R. L. Taylor, 60 pages. 

Shall We Change our Money Standard ? by 
Jesse F. Orton, 32 pages. 

Illustrated First Reader in Social Econom- 
ics, 16 pages. 

Sound Money from a Business Standpoint, 
by F. A. Cleveland, Ph. B., 32 pages. 

These ten books together contain 775 pages. 
Every one of them is well worth reading, and 
will help make votes if given or lent to those 
who have thus far voted with the plutocrats 
through ignorance. They are worth $1.60 at 
regular prices, and the supply will not last 
long. 

Charles H. Kerr & Co., Publishers, 

56 Fifth Ave., Chicago. 

Latest. 

The Camden druggist referred to on 
our first editorial page is already an 
M. D., a Jefferson Medical College gradu- 
ate, and one of our valued subscribers. 
At the same time that he sent us the 
circular letter received from Rutland, he 
wrote to the Governor of Wisconsin, 
inclosing the circular, and showing that 
the honor and laws of the State of 
Wisconsin are being made merchandise 
of. The following reply has just been 

received : 

Executive Chamber, 
Madison, Wis., February 23, 1897. 
Dr. G. W. Henry, 

Eighth and Walnut streets, Camden, N. J. 
My Dear Sir : — I am directed by the Gov- 
ernor to say in reply to your letter of recent 
date that proceedings have already been begun 
by the Attorney-General against the college of 
which you write. 

Respectfully yours, 
Wm. J. Anderson, Private Secretary. 

We clip the following from the Philadelphia 
Public Ledger tot February 27: 

BOGUS MlDDICAIi DIPLOMAS. 

Am Important Arrest by Postal Inspectors In 
Chicago. 

Chicago, Feb. 26. — " Doctor" Fred Rutland, 
who claims to be a graduate of two California 

Digitized by VjOOQlC 



!#> 



THE MEDICAL WORUD. 



colleges and the Medical University of Ohio, graduate would be competent to give. The 

was arrested to-day by postal inspector* on the diploma record shows that Willaid Chase 

charge of using the mails for fraudulent pttr- Ottntt, of Savannah, Ga., received five distinct 

poses. He will be given a hearing to-morrow degrees between June 26 and September 25 of 

befioce Commissioner Humphrey. Rutland last year. It is estimated that Rutland has 

has been operating the " Wisconsin Eclectic received $30,000 from his "college " since he 

Medical College, " which the inspectors allege came here from Milwaukee last May. 

is a bogus diploma distributing concern on a — 

big scale, They have in their possession a Sbu adv. this month of " Army and Navy 

book of names, addresses and classes of degrees Illustrated." The first issue is before us, and 

conferred, showing that 907 persons in every we never saw a handsomer publication of its 

State of the Union, Mexico, Canada, India kind — fine and heavy paper, illustrations* 

and France have received diplomas conferring grand. 

the degrees of Doctor of Medicine, Pharmacy, YoG cm ^ muc h g^ with Freileigh'a 

Philosophy and Science in rapid succession, Cough and Constituent Tablets duriag March, 

when a fee of $35 to $50 was received. Tr - ^^ ^ y<mr ^ag patients instead of 

It is alleged by the authorities that the only sending them to Fkmda. The chances are 

educational prerequisite for the granting of that the Tablets will do them much the most 

these diplomas was that the applicant should mpod. 

return answers to a list of medical and surgi- ,-. _ . -. ^ • M „_ . _ Atmt% „ ^^^ m ^ 

caU^sttMU, which the average public ,^1 Jg^^^Z^&g*^. 

PLBASK SKIfD ORIMUt Olf XSEI0 cathartic, or any kind. Take it between your 

BI**KK* fingers and pinch it right hard and s eejt re- 

duce to powder. If you haven't sufficient 

THB MEDICAL WORLD; 1520 Oheetnut " grip" lay it on the counter and press ft with 

Street, Philadelphia, Pa. your thumb. 

Gsmtumkn: — Enclosed find the sum of For people who have had a gay winter and 

Dollars come to you weary and worn, give Fellows' 

for which please send me HvooohoSDhits and rest. 

THE MBDIOAL WORLD for 1807 . . $1.00 V7\ F ~ JL, noertk anA ^„ A fnr M«m*\ 

Binder for the MedToal World 35 Sbe Keith a page and send for Manual 

Or Three Binders for LOO of Concentrated Tinctures. 

Awl for punching Worlds for Binder 5 Brace up the weak points with Flavell's 

cts. each, or Free with three binders. apparatus. See his page. 

Casartof Skin Dtaeaac* (reduced from To ^ Mood ^ |hdr yefal8 ^ them 

t^m^Jmm'm o si. Jm^'iALn * preparation of Wood— Bovirrine, It wete- 

^l2S?^sf«fv^^^ -, gant sitd palatable, and it will make blood 

T&M&oalW^^ ' ' * fest. Put a few drops in the baby's milk 

below. ... IOC ** ewery taking. A few weeks will moke it 

Vim ting List Section, per boson . . . 1.00 rosy. 

Ledger of Monthly Balances, as per ONKof our adv. pages is headed, "It is a 

notice below . .ao square fact." Did you ever notice it 

Total, particularly? 

Name, Please see adv. of Robinson's lime juice 

Address, and pepsin this month. This seems to be a 

very happy combination. See adv. and order 

Cross off what you do not want in above list it for trial, or write for further information. 

ffi^otSer**? 11 ?* -"^rediSer^ moncy sent by v ° st " Mfcssus. Wm. R. Warner & Co. wish to send 

° Send 8 cents extra for registration of each article (except you visiting records and prescription blanks. 

w ^ LD JLi fyou ^ htoin ?)?!f.. 8afe r d . e if vcry ii^ # ^ ^ They are just bringing out a pocket Medical 

TflBMwMCALWoaLD Visiting Ust consists of a band- t\:„/i^„„* ^c *^^JL Jl-*1* ~uZZT *~* **>n* 

some leather case and twelve removable sections. We now Dictionary Ot 10,000 WOrdS — aDOUt 300 pages, 

furnish onr new sections for List: they are improved over which they will Sellto phvsicianS at a nominal 

•«r former ones in several details. But we still have no ^ _, ^ m * xn\x\ u~ -JZaZ* „i~>„4. nr~~jL ** 

ledgers of Monthly Balances except those dated 188- price— 75c. Will be ready about March IO. 

instead of 189... To close out these Ledgers (which are QvoArmc-i* XT V TW% tt oft/\* 

perfectly good eaBcept for the trifling dlfiference in date), and SYRACUSE, JN. Y., JJec. II, 2500. 

to get you started with our system of bookkeeping, we wiU JOHN CARLE & SONS, New York City. 

give a tedger free to all who order the Visiting List complete, Ctuq . Tlnrina- tho miriril* r\f Mrvtnmitv»r T 

Jl.50. If bought separately the Ledger will cost 25 cents. , WHS. — liUTing tne middle OI WOVemDer, 1 

The regular price is 50 cents, but on account of the trifling had an attack OI pneumonia with VCTy great 

d ifference in date we are selling them at half price: difficulty in digesting my food ; On trial of the 

We are asked if we can still supply those various foods of which I had an abundance of 

elegant hypodermic syringes that we used to samples, I found none so palatable and easily 

futnish with " World " subscriptions. Yes. digested as IMPERIAL GRANUM. 

The syringe usually sells for $2. We can sup- Truly yours, ■ M. D. 

ply the syringe and li The Medical World" for The " Physician's Vest Pocket Formula 

1897 for $2. Send immediately, before this Book," published by McKesson & Robbins, 

passes from your mind. (Continued over next leaf.) 



Digitized by VjOOQIC 



THE MEDICAL WOULD. xi* 



FRIABILITT is no proof of SOLUBILITT. 

SPECIFY WM. U. WAKNEK & CO.'B 



SOLUBLE COATED PILLS 

THEY HAVE STOOD THE TEST OF FORTY YEARS 

B* net Mte»pt to TEST the MLWKJTY or INSOLUBILITY of • pill by hammeriag it on a pine 
boaxtL What 6^ it signify? SIMPLY TAKE A GLASS OF WATER 98° TO 100* AMI* SUSKHO THE 
PILL A9 M01CATEO BELOW : 

The TRUE TEST of the solubility of a pill. 




Tk» test io demonstrative and conclusive proof of the solubility of mass pill*, hearing the same 
of *NL R. WARMER A CO. because what MtSOLVES IN PLAIN WATER MOST DISSOLVE IN THE 
VISCERAL FLUIOS OF THE BODY. 



FRIABILITY is no proof of SOLUBILITY as is evidenced by the following experiment : 

Our chemist took Pil. Cathartic Comp of Wm. R. Warner & Co.'s make (and the same of 
Friable Pills) and placed them in water 98 to ioo°. 

These are the results :— 

PIL, CATHARTIC COMP. 

WM. R. WARNBR & CO. (Mass Pills) Friable Pills 

Sugar-coated— dissolved in 20 minutes. Dissolved in 65 minutes 

Gelatin-coated— dissolved in 25 minutes. 

Every five minutes the pills were rolled with the finger, each getting SAME AMOUNT of rolling, or 
about equivalent to peristaltic action. We have proven the solubility of our mass pills. We have 
proven that MASS PILLS ARE MORE SOLUBLE THAN FRIABLE PILLS. Try it yourself and you will 
reiterate our statement that 

FRIABILITY is no proof of SOLUBILITY. 

Our pill business has been established for the past forty years, and we have never had complaints 
as to the inactivity of our pills. By taking a dose of Cathartic Pills and noting results is all that is 
necessary to prove their efficacy. 

WM. R. WARNER & CO. 

Manufacturing Pharmacists. PHILADELPHIA. 

Digitized by VjOOQlC 



THE MEDICAL WORLD. 



will be found very useful to the practitioner. 
It contains a table of weights and measures, 
antidotes to poisons, various tables of reference, 
and a very complete series of tables, showing 
the composition of foods and alcoholic liquors. 
These tables should prove valuable to the 
physician in cases where special attention to 

(Continued over next leaf.) 



W J 



TTV>r SALE.- My office and adjoining lot ; splendid loca- 
r tion for a general or special practitioner. Price, $1,000. 
Address, with stamp, Da. Mackrss, C ony, Fa. 

TANTBD.-To buy a residence and practice ; near a 
. . railroad ; in Central or Southern Texas. Address. 
Da. Bdwajlds, Paris, Texas. 

WANTED.— A good location or partnership in Califor- 
nia. Will purchase good property, or trade Wash- 
ington property. Give full particulars. Lock Box, 248 
South Bend, Washington. 

Tjy>R SALS.— Proper ty and unopposed Tillage and country 
£* practice at discount Desire to change climate. 
Address, A P. Albauoh, Kilgore. Ohio. 

TYPEWRITEiTHEADQUARTERS, - 

and prifrw ^fr*"-!- Inuasnst stock for saMCttoa. 



TXTW, established Hospital and Physicians 4 Samp] 

VV House in New York; 112.000. Cause, ill health* 

proprietor. Address, " Hospea," care of M bdicax Womu 

_ 

walei 



R SALE.- Practice and prop e rty of the late A. C 
Osborne, M. D. Address, P. O. OsaoaJia, 1C D., Soattl 
ales, N. Y. 



r* OOD LOCATION.- Southern Oklahomo, Canadian Val 
VJ lev; town twelve hnndred inhabita n ts ; write foi 
particulars. 



Rare 



Da. T., Box 88, Lexington, O. T. 

R 8AXB OR RENT.— Village property : good practici 
gratis; $1,800 per year ; rich country; no op 
chance. Address, Docroa, Box 86, Pairdale, 



FOR SALE.- Large general practice in manufacturing 
city; county seat, surrounded by rich fanning com 
inanity. Terms easy. 8. O. KnuDam, M . D. Write tc 
Mrs. D. M. Kansleiter, for particulars, Bucyrus Ohio. 

WANTED.— A location in a town or Tillage. Central 
or Northern Indiana preferred. Willing to buy 
property. Address. Doctor. Box 34, Broad Ripple Ind. 

SENT FREE TO PHYSICIANS 



A Bampls of 
istsil will be mailed' free to sot phytJeisji 
as* already acquainted with their merua. 8st 
m soother ooiuun, Adores*, 

4 



NEW YORK SCHOOL OP CLINICAL MEDICINE. 

_ C>mtealliiatrnotiontoaTadnatasmn>emelnert 

The school olfcis the followlne. L- OumjU t limited clsassa, enabling each mambar to obtain parsooal toasrnotton. x— 1__ 

-olassas act as assistants to thacllntes, eramfno and treat patients and perform opsrs ttons under the dlraotlon of the proisasora 

PR OFES SORS i-BTJBQB BY; Ca rl Beck, M. D. IaBTNQOLOOY : T. W. B onche, M. D. PBDIATBIOS: 8. Hoary Dessaa, 
M.D. OTNSOOLOOT AND OB8TSTRICB: H.J.Oarrlfuas, A.MU M.D. OTNBOOLO&Y : Angostln H.Goek*, M.D. DKRMA 
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The Medical World 

The knowledge that a man can use is the only real knowledge ; the only knowledge that has 

life and growth in it and converts itself into practical power. The rest hangs 

like dust about the brain , or dries like raindrops off the stones, — Proude. 



The Medical World. 



C. P. TAYLOR, M.D., 

Editor and Publisher. 

subscription to any part of the United States and Canada, 
Ohk Dollar per year. To England and the British 
Colonies, Five Shillings pet year. Postage free. 
Single copies, Ten Cents. These rates must be paid 
invariably in advance. 

We cannot always supply back numbers. Should a num- 
ber fail to reach a subscriber, we will supply another, 
if notified before the end of the month. 

Vay no money to agents for this journal unless publisher's 
receipt is given. 

▲DDK*)** ALL COMMUNICATIONS TO 

"THE MEDICAL WORLD," 

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Vol. XV. 



April, 1897. 



No. 4. 



4IHIKKI >**'HEU14S 



Steps. 

Not long ago, easily in your memory 
and in mine, it was considered criminal 
to open the abdominal cavity, as it was 
thought to mean certain death. Now it 
is thought criminal negligence not to 
open the abdominal cavity in certain 
cases. 

A little while ago, quinine was the 
only reliable medicinal antipyretic 
known, and it disturbed the nervous 
system greatly, and was five dollars an 
ounce. Now an important class of rem- 
edies has come into use that reduces 



temperature better than quinine and re- 
lieves pain better than opium. 

Men still young in medicine have seen 
the rise of bacteriology, a development 
that threatens to revolutionize the prac- 
tice of medicine completely. 

A short time ago, appendicitis was not 
differentiated, but was confused with 
typhoid fever and other conditions. 

The few steps mentioned above indi- 
cate what strides medicine has taken in 
the memory of men still young. Many 
more such steps could easily be men- 
tioned. They indicate what we may 
reasonably expect in the coming years. 
Will we keep up with the procession, or 
lag behind ? Each individual must an- 
swer for himself. 



Municipal Aid in the Diagnosis of Typhoid. 

The Bureau of Health of this city 
now makes free bacteriological examina- 
tion of blood in suspected cases of 
typhoid fever. This free municipal 
laboratory work is a step in the right 
direction, for a number of reasons. The 
community is interested in having a 
dangerous disease in its midst diagnosed 
as accurately as possible. Accurate 
diagnosis is the first step toward proper 
treatment and limitations. We do not 
stop to ask, u Is this a step toward so- 
cialism ?" but we know that good sense 
and public safety demand it, and we do 
it The Bureau of Health is a branch 
of the Department of Public Safety, as 
it should be* Communities in their 
collective capacity are undertaking more 



13* 



THE MEDICAL WORLD. 



and more, and always with benefit to the 
community. Education is a public 
need; hence our free school system. 
Safety from robbery and violence is a 
public need ; hence our army, navy and 
police systems. Safety from contagion 
is also public need ; hence our boards of 
health, with their many salutary re- 
quirements, and now physicians are 
aided by the public safety department in 
diagnosing typhoid fever. " Mossbacks" 
may "croak" to their heart's content 
about "socialism" and "anarchy," but 
progressive communities will continue 
to widen the sphere of collective opera- 
tions as fast as demanded by public 
safety or public need. 

Indeed, public need now suggests sev- 
eral steps in this direction not yet ac- 
complished. The slums in our cities are 
a constant menace to public health. 
How to improve or abolish them has 
long been a pressing question. Several 
European cities have torn down the 
rookeries and built in their stead muni- 
cipal tenements and lodging houses. 
These are superior structures well 
adapted to the purpose, renting at rea- 
sonable rates, and required to be kept 
clean. This plan has succeeded well; 
but a municipal street car system that 
would furnish transportation at cost 
would do much more, as it would enable 
the poor to live out where the air is pure 
and room plenty, instead of being 
crowded and stifled in close quarters in 
the heart of the city. It is estimated 
that in our large cities two-cent fares 
would pay all the cost of local trans- 
portation and a profit besides, if owned 
by the city and conducted for the pnblic 
service instead of for private profit. This 
would clear out the disease-breeding 
slums. 

Medical Legislation. 

The legislative season is drawing to a 
close, and the results in the line of medi- 
cal legislation are imporfimt. It is too 



soon yet to make a summary, as some 
legislatures have not yet finished their 
work ; but some good results have been 
accomplished. For example, Indiana 
has passed a good and much-needed law. 
It is fair to all schools, as it admits regu- 
lars, homeopaths, eclectics and physio- 
medicals on its board. The bill was care- 
fully drawn and commanded the support 
of the respectable element of all schools. 
It is hard on quacks, and they opposed 
the bill with vigor, but in vain. A few 
of our readers think that every pre- 
tender should be " free " to practice 
medicine, and every incompetent should * 
be "free" to choose his own doctor. 
This is not freedom in the modern sense ; 
it is license on the one hand, and lack of 
protection on the other. It is the duty 
of the State to guarantee to its citizens 
that those authorized to pursue such a 
responsible calling as the practice oi 
medicine shall have reasonable qualifica- 
tions for that calling. 

The medical bill that the Idaho Medi- 
cal Society was pushing in the legisla- 
ture seemed likely to fail until Rutland's 
"diploma mill " was exposed. One of 
the members of the legislature sent $35 
to Rutland and got a diploma. This he 
exhibited in the legislature and Jhe bill 
passed in a hurry. Almost all of our 
States now have a medical law of some 
kind. 

Union. 

How many have noticed the design 
just below the date line on the editorial 
page? And how many know what it 
means ? It is the Union Label, and it 
means that all the work done on this 
magazine is done by union labor. We 
have all read of distressing industrial 
conditions, where labor is under-paid, 
overworked and ground under the cruel 
heel of capital. The union label on an 
article indicates that the article was made 
by members of labor unions receiving 

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TOE MEDICAL WORM). 



133 



anion wages, working a reasonable num- 
ber of hours per day, and under fair con- 
ditions. 

Doctors do not come in contact with 
the industrial world enough to become 
familiar with the trades union develop- 
ment of modern industrialism. Some 
capitalists and large employers have had 
much to say about what they call the 
4< tyranny of labor unions." Labor agi- 
tators have said much about the con- 
scienceless grinding of capital. Both 
are right and both are wrong. Only the 
broad-gauged man can see both sides. 
And what does the impartial ob- 
server first notice? That capital 
combines more and more every year. 
This is an age of large and powerful 
combinations ; and we can only surmise 
what the next generation will bring 
forth in this direction. Within certain 
limits, and with certain restrictions, this 
is all right ; for this is progress. But if 
combination of capital is right, combina- 
tion of labor must be right, also. Un- 
united labor cannot cope with united 
capital any more than an unorganized 
mob can cope with a regiment of drilled 
and disciplined soldiers. Labor must 
unite in its own defense— for its own pres- 
ervation. If it is right for capital to com- 
bine, it must be equally right for labor 
to combine ; and if it is wrong for labor 
to combine, it must be equally wrong for 
capital to combine. But some forms of 
combinations of capital are admittedly 
pernicious. For example, you cannot 
sweeten your cup of coffee without pay- 
ing tribute to the sugar trust ; you can- 
not buy your wife or child a pair of shoes 
without paying tribute to the leather 
trust ; you cannot live a single day with- 
out paying tribute to illegal trusts and 
monopolies by the dozen. So we could 
say much about the " tyranny of trusts.' ' 

Labor unions are not a final solution 
of our industrial problems, but they are a 
step made necessary by combinations on 
the other side. Perhaps both are neces- 



sary in the process of social evolution. 
Our sympathies are with the producing 
forces. But capital, in many of its uses, 
is a producing force. In this event, 
capital and labor should be in hearty 
sympathy, both sides being willing to 
arbitrate in case of difference ; but capi- 
tal usually objects to this (be it said to 
its shame). 

There are things that labor must guard 
against. The trusts and bondholders 
favor scarce and dear money, and they 
try to induce labor to think that the 
more a dollar will buy the better for 
labor. Not so ; for products are the re- 
sult of labor, and all the producing 
forces should stand together. Money 
that neither becomes dearer nor cheaper 
(as measured in our leading products} is 
the only just money. Intelligent labor 
has for years taken this position, and 
opposed the gold and bank combine ; it 
is important that all labor should be- 
come intelligent enough to do this. We 
doctors are laborers, and nine-tenths of 
our patrons belong to the producing 
* forces. The position that we should 
occupy is very plain. 

Please don't feel called upon to write 
on the prevention of conception. We 
have had enough, and many more arti- 
cles are now on hand that will not be 
printed. Write on something else. Look 
over your case book and see what dis- 
eases were most prevalent with you at 
this season last year, and write the les- 
sons and results of your treatment 

The most unsatisfactory part of our 
business is the clubbing department. It 
is very troublesome. The work comes 
just when we are the busiest, and yields 
no profit at all — nbt even pay for clerk 
hire. When the club comes directly to 
us it involves a lot of writing and time- 
consuming details, and no profit ; and 
when a clubbing order comes to us from 
some other publisher we get only seven- 
ty-five cents instead of one dollar. Near- 
ly all such are renewals, upon which we 
lose twenty-five cents each. We wish to 
discontinue all clubbing arrangements, 
better send your subscription directly to 
the publications desired. If you want to 
send in clubs, send to others not so busy 
as we, and include one dollar for World. 

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THE MEDICAL W0RLI5 



Original Communications. 

Short article* on the treatment of dlfteues. and experience 
with new remedies, are solicited from the profession for 
this department; also difficult cases for diagnosis and 
treatment 

Articles accepted must be contributed to this journal only. 
The editors are not responsible for views expressed by 
contributors. 

Copy must be received on or before the twelfth of the 
month for publication in the next month. Unused 
manuscript cannot be returned. 

Certainly it is excellent discipline for an author to feel that he 
must say all he has to say in the fewest possible wordi, or 
his reader is sure to skip them; and in the plainest possible 
words, or his reader will certainly misunderstand them* 
Generally, also, a downright fact may be told in a plain 
way; and we want downright facts at present more than 
anything «to.-RusKin. 

READ. REFLECT. COMPARE. RECORD. 

Many Thoughts. 

Editor Medical World: — I have 
read with much interest Dr. Melick's 
account of a twelve months' pregnancy 
(page 95, March World). In regard to 
the possibility of such an occurrence, it 
is well to take the position Huxley occu- 
pies in relation to miracles : that we are 
never* justified in saying a thing is im- 
possible, but that in every instance it is' 
simply a question of proof. And the 
more widely an alleged occurrence de- 
parts from the ordinary experience or 
knowledge of men, so much the more 
complete must be the proof. So that it 
is a pity Dr. Melick's case, which really 
looks like what he claims it was, should 
not have been made certain by the ap- 
plication of all the tests of pregnancy 
known, and confirmed by counsel. 

The closure of the internal os is not 
by itself an indication of pregnancy, nor 
is the open os a proof that pregnancy 
does not exist I have passed a sound 
up to the fundus without the slightest 
obstruction, when there was a fetus of 
several months' standing, hidden away 
somewhere in that womb ; and the un- 
usual depth to which my sound pene- 
trated was the first thing that warned me 
to keep out. Nor is the absence of men- 
struation a certain sign. 

Was there the violet discoloration of 
the vagina, the placental bruit, the fetal 
heart-beat, the softness of the uterine os, 
the rounding of the uterine body and 
enlargement of the organ ? Did ballote- 
ment reveal the presence of a ball float- 
ing in liquid ? 

The leucorrhea showed that there was 



an ailment in the genital system some- 
where, not dependent upon pregnancy, 
and this may have occasioned the symp- 
toms attributed to the latter cause. Then 
the fact that she menstruated twice after- 
wards militate against her having been 
pregnant. 

She " felt life" in April, five months, 
if we count her as pregnant two months 
when she first reported in January. This 
quickening is a very uncertain sign. 
The first evidences of movement on the 
part of the fetus are feeble and uncer- 
tain, and very frequently what is thought 
to be " life," is simply flatus. I would 
not like to pin my faith to so uncertain a 
sign, in a case which, if proved, would 
upset the common experience of man- 
kind. The French law allows a woman 
300 days in which she can bear a legiti- 
mate child after her husband's depart- 
ure ; and this is universally regarded as 
generous to the wdman. 

Of course Dr. Melick may have made 
these observations, but he does not tell 
us ; and as he did not expect at the time 
such a remarkable case, the chances are 
that he did not do more than doctors or- 
dinarily do on such occasions. 

I wish to add a hearty " Amen" 
to the remarks of "A General Prac- 
titioner," on page 96, about this 
matter of crowding the hospitals 
and dispensaries while the family 
doctor is starving. And I wish that out 
of the great World brotherhood there 
would arise the long- wished- for leader 
who would devise a plan on which we 
could all unite to effectually remedy the 
evil. But the successful doctor is too 
busy and the other has not the influence 
when he stands alone. Will we never 
learn the power of co-operative effort?* 
We are the world's altruists. We stand 
apart from the bulk of mankind in that 
we perform certain duties to our fellow- 
men, irrespective of their ability to pay 
us. The Bellamy system would be wel- 
comed with delight by the mass of our 
profession, as enabling us to do just what 
we are now doing, without the risk of 
starvation. Even this custom of sending 
cases to specialists is an evidence that to 
us the interest of the case outweighs that 
of our personal gain. But we are hus- 
bands and fathers ; we, as well as other 
men, want to see our families decentljr 

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THE MEDICAL WORLD. 



135 



clad, hc^used and educated, and their fu- 
ture provided for. Can we not devise a 
plan to restore the balance between us 
and the community? I have often 
thought that I would like to confine 
myself to a certain number of families, 
attending them for a specified salary, 
and devoting myself to the duty of keep- 
ing them in health as well as attending 
them in sickness. Would it work ? Can 
anyone suggest a better plan ? 

The hemorrhage in Dr. Pendleton's 
case (page 99) is from the kidney, and 
probably is due to calculus. I would 
suggest a trial of the oil of erigeron, 
five drops three times a day, and the free 
use of water, alkaline or acid, as the 
urine may indicate. If there should be 
no relief after a reasonable time has 
elapsed, the aid of the surgeon should 
be secured. 

Dr. Line asks if atropine is not more 
harmful than morphine (page 99). It is 
not wise to give two remedies when the 
effect of one is enough. Atropine coun- 
teracts a danger of morphine by dilating 
the vessels, and preventing the interfer- 
ence with elimination. Atropine also 
sustains the heart, checks the convulsive 
tendency, unless given in too large 
doses, and increases the hypnotic effect 
of morphine. But in the combination 
hypodermic tablets the dose of atropine 
is generally too large. About 1-150 
grain is as much as should be combined 
with % grain of morphine. 

Dr. Howell (page 100) has found an 
admirable remedy for dyspnea inaue- 
bra cho, though I prefer the alkaloid, 
aspictospermine. The case described is 
not clear. Emphysema may occur in 
the course of an ulcefStive phthisis, and 
neither primary emphysema nor bron- 
chitis would account for the fever. It 
is a pity that physicians do not avail 
themselves of the certain means of diag- 
nosing pulmonary affections aflorded by 
the microscope. The outfit, including an 
oil immersion lens, can be had for about 
$150, and the laboratories will examine 
a specimen of sputa for $5. Some diffi- 
culty exists about sending sputa in good 
condition. Richardson used to have 
urine forwarded in perfect condition by 
filling a vial with potassium acetate and 
pouring the urine over it With sputa, 
alcohol, formalin or boric acid solution 



would probably preserve from decompo 
sition and prevent the multiplication of 
the micro-organisms on the way. 

Dr. Yager had better send his patient 
with dementia to the asylum. She cer- 
tainly needs the discipline, sane or in- 
sane. If the latter, she should have the 
opportunity of recovery, which is not 
great even at the asylum, but much less 
at her home. When removed from her 
husband the irritation may subside ; and 
few insane patients are so crazy as not to 
realize the difference between a hospital 
and a good home, and that it requires 
self-control to enable them to get their 
release. 

I am sorry " Lenox " (page 102), con- 
siders my remark about sickly women 
marrying "cold, heartless and cruel." 
Perhaps we have different types in our 
minds. Certainly, if a man marries a 
sickly woman, knowing her to be such, 
and accepting the burden laid on him, 
there is nothing to be said. She is his 
choice, for better or worse, and he has 
no cause of complaint. But he must 
not spoil his chivalric choice by expect- 
ing her to bear the ordinary burdens of 
maternity, when he married her know- 
ing her unfitness. This is probably the 
case "Lenox" had in view. But my 
remarks applied to a totally different 
case, where the man thinks he is marry- 
ing a helpmate, and finds he has saddled 
himself with a burden. If the woman 
has let him marry her in ignorance that 
she is physically unfit to be a wife and 
mother, I say again, she deserves no 
sympathy. And the case I had in mind 
is one where the parents unloaded, upon 
an unsuspecting young fellow, a chronic 
invalid, an ill-natured, grumbling, selfish 
creature, who has kept his nose to the 
grindstone and made his home an earthly 
hell. Of course, there are no children. 
You should see my lady's scornful look 
at the suggestion. "Lenox" might 
sympathize with her, but after being 
called out of bed in a rain-storm (she 
never sends for me any other time) a few 
times, when there is nothing the matter 
but temper, his sympathy would run dry. 

My critic quotes my remarks about 
women marrying, knowing themselves 
unfit, and then goes on to ask why we 
should punish women who don't know 
they are unfit? When you undertake 

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THE MEDICAL WORLD. 



to criticise, it is well to read your oppo- 
nent's statements before questioning 
them. The ignorant are victims; the 
knowing ones are those I object to. I 
cannot go into this question any further 
without repeating what I have already 
said in recent World letters. 

Dr. Mitchell (page 104) hits the nail 
squarely upon the head. 

Dr. Simpson (page 122) asks about the 
treatment of old leg ulcers. When an 
ulcer does not heal it is because there is 
some irritant at work, or because the 
vitality is insufficient to set up the heal- 
ing process. If the first be the case 
here, use germicides like the mercurial 
ointments, or sanitas oil. Generally the 
difficulty is the debility, and then the 
patient should have iron and lime in 
generous doses ; the ulcer should be sup- 
ported by adhesive straps and dressed 
with raw white of egg or bovfnine, as 
local nutrients. At times an ulcer be- 
comes irritable, when a one per, cent, 
silver solution may be applied once, and 
the surface then covered with bismuth 
subnitrate, mixed to a creamy state with 
water. 

Dr. Moore (page 122) asks about prep- 
arations. I wonder if he has ever used 
the alkaloids — probably not, or he would 
not be asking for information. With 
accuracy in diagnosis, with an apprecia- 
tion of the essential pathological con- 
dition of the tissues affected, these little 
granules bear the same relation to the 
older galenical preparations that the rifle 
does to the shot-gun. Take sanguin- 
arine as a remedy to break up a cold. I 
cannot imagine any one going back to 
brown mixture and ammonia after test- 
ing this old remedy in its modern form. 

Dr. Olmstead presents a very interest- 
ing condition on page 122. Coldness of 
the extremities in women may be due to 
any of the depressing diseases, but in 
the absence of these the causes are tight 
lacing, lack of exercise and constipation. 
A grim old doctor of the ancient type 
used to recommend a live mouse on a 
string, dangled before the sufferer. But 
constipation is the important point, for 
among the ptomaines generated in that 
toxicological laboratory, the intestinal 
canal, is at least one that lowers the 
bodily temperature. There is a curious 
observation I have just made upon a case 



ot mammary cancer. The la$y has 
gained in weight and looks well, but her 
power of keeping up the body heat has 
notably diminished, so that she seems 
unable to warm herself when she goes to 
bed, as people usually do, but requires 
hot bottles, etc. There is as yet no indi- 
cation of impaired nutrition, except the 
gain in weight, and no evidence of blood 
deterioration. 

I am profoundly interested in the note 
upon cancer cures. In a non- operable 
case under observation, I noted that 
there seemed to be a pause in the symp- 
toms and the progress of the malady 
during menstruation. Take this with 
the frequency with which cancer develops 
about the change of life, and we have 
two more facts which may assist us in 
studying this affection. In considering 
the possibility of restraining the growth 
by internal medication, I am inclined to 
think that some effect can be seen from 
Phytolacca, cicutine and the iodide of 
arsenic, given together. Use the green 
drug fluid extract of phytolacca, and 
push the dose up as far as it can be tole* 
rated. Of the cicutine, I prefer the 
granules, and give enough to keep the 
pain under control. The iodide is the 
most active of all the arsenical prepara- 
tions, and the most effective. One 
granule, gr. 1-67, three times a day, is a 
dose that can rarely be exceeded with 
advantage. Of the new methods of 
treating cancer, none promises as well as 
the use of electricity, by the method of 
Inglis Parsons. The patient is anesthe- 
tized and the galvanic current is flashed 
in every direction through the growth. 
The method is based upon the well- 
known fact that the cancer cells are of a 
lower grade ot vitality than the healthy 
tissue, hence the tendency in the former 
to spontaneous death. By using a current 
strong enough to devitalize the cancer 
cells and yet not injure the healthy tis- 
sue, the neoplasm is destroyed, and the 
tumor shrinks to a hard, fibrous knot or 
scar. In the hands of a skilled operator, 
this method has had a fair measure of 
success, and as experience increases, it is 
fair to look for better results as time goes 
on. My one observation of the subsi- 
dence of a threatening growth in the 
scar left by removing a mammary cancer, 
has not yet been repeated. I employed 

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THE MEDICAL WORLD. 



137 



a mild faradic current, with the best 
rheotome procurable, and the growth 
subsided completely. But I have 
never had the chance to try it 
again ; the cancer cases preferring 
to go to institutions where they 
guarantee cures Ci without the use of the 
knife." While I have read very glow- 
ing accounts of the results of treating 
"cancers" in these places, no case of 
true malignant disease known to me as 
such has received benefit there. 

Dr. Bowen (page 123) may find in 
hyoscine a remedy for the tremor that 
annoys him. Take gr. 1-500 in hot 
water, gradually increased to gr. 1-100, or 
until the throat begins to dry, as when 
atropine is taken. Most forms of tremor 
are relieved by hyoscine. An ice bag 
applied intermittently to the spine, fol- 
lowed by brisk rubbing, may also prove 
beneficial. 

Why should Dr. Robinson attribute 
the extrocardia to the fact of the mother 
having witnessed the hog-killing ? Are 
there not thousands of women who, 
while in the early months of pregnancy, 
have seen and assisted at the butchery 
without having a deformed child ? Dar- 
win tried to get at the truth of this 
matter, but could not find a single 
authentic case in which the prospective 
mother predicted the child's injury 
before its birth. When the babe is born 
and is found to be marked, the women at 
once proceed to recall some occurrence 
to which they can attribute the deform- 
ity. 

Dr. Henry ought to write a description 
of the burns caused by gas in coal mines, 
and show how they differ from other 
burns, if it is true that they do. One car- 
dinal principle should be remembered in 
treating burns : Keep out the air and its 
accompanying microorganisms. The 
story of the man who fell in the vat of 
boiling soap, and was left covered with 
it, as a hopeless case, but recovered in 
consequence, should be told to every new 
class of medical students. 

Wiluam F. Waugh, M. D. 

103 State st. , Chicago. 

Creolin for Burns. 

Editor Medical World: — Number- 
less substances have been used with more 
or less satisfaction as applications in the 



treatment of burns. Many of them have 
been serviceable in particular cases, while 
notwell adapted to general use, or in burns 
of various degrees. Carron oil is always 
orthodox as a protection from the air. 
Beyond this it has no special value, and 
it is, of course, wholly wanting in germ- 
destroying properties. 

For recent burns of the first or second 
degree, bicarbonate of soda in saturated 
solution, or the powder sprinkled on the 
injured surface and covered with a wet 
cloth, gives speedy relief, and has the ad- 
vantage of being cheap and readily pro- 
cured in almost every household. Car- 
bolic acid, creosate, alcohol, picric acid 
and iodoform have their special advo- 
cates and their proper uses, but most of 
them have their drawbacks, and under 
some circumstances are objectionable. 

In burns of the third degree, aside 
from the sloughing of charred and steam- 
cooked tissues, the treatment called for 
is simply that which is proper for open 
wounds healing by granulation, or haply 
assisted by skin-grafting. 

Where there is a large open surface, 
the healing proceeds by extension of the 
bordering skin with its supply of blood- 
vessels and nerves, and usually pro- 
gresses satisfactorily for a time, but 
eventually, for want of sufficient vitality, 
£he process of repair comes to a stand- 
still ; may even take on retrograde ac- 
tion by the breaking down of the new 
and insufficiently nourished tissues. 
Stimulating by silver nitrate may revive 
the failing growth, but sooner or later 
we reach the point where only skin- 
grafting in some form will bridge over 
the open space. 

Something that will aid in continuing 
the work of repair to a completion would 
be a desideratum. Creolin comes nearer 
to meeting this indication than anything 
I have ever seen applied. It is of un- 
doubted value in the milder grades of 
burns, but its pre-eminent value is shown 
in its enabling us to bridge over larger 
areas and wider spaces by granular 
healing and extension of the marginal 
skin than under any other known 
method. 

It is almost incredible how rapidly 
healing takes place and good, sound new 
tissues and integument form. 

The mode of dressing burns is of the 

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THE MEDICAL WORLD. 



first importance. A satisfactory method 
is to apply surgeon's lint or soft cloths 
wrung out of a creolin solution at a tem- 
perature slightly above body heat. This 
is kept constantly wet with the solution, 
and the dressing is disturbed only at long 
intervals — say once a week, more or less, 
as is deemed best 

This simplicity of the treatment is one 
of the important features ; the absolute 
comfort of the patient is another; the 
antisepsis and rapid healing another. 
Nor are the cheapness and harmlessness 
of the application to be wholly over- 
looked. 

According to my observation, a strength 
of one-twentieth of one per cent is cer- 
tainly strong enough. I should prefer it 
even weaker, rather than stronger than 
this. Those who may think this an in- 
finitessimal strength should bear in mind 
that the evaporation that takes place is 
of the water, leaving behind a constantly 
increasing residuum of creolin. 

A case or two from my note- book may 
not be out of place. 

In August, '96, a baker accidentally 
stepped into a kettle of boiling fat used 
in frying crullers. The foot and leg 
were cooked to five inches above the 
ankle. As a matter of course they 
rushed at once to the druggist, who pre- 
pared them a mixture of linseed oil and ■ 
lime water. When they went for the 
third time to have the bottle refilled, 
they informed the druggist that the loot 
had turned black. He prudently refused 
to have anything more to do with the 
case. At this stage I first saw the pa- 
tient. The man had had no rest, no 
sleep since he was burned, and the foot 
was apparently gangrenous. I had it 
wrapped in cloths wrung out of warm 
creolin solution, and continued the ap- 
plication, not once removing the cover- 
ing for three weeks. In two or three 
weeks more the foot was usable, and to- 
day it is all right Of course the new 
skin is red, as would be expected, but it 
is not hypersensitive. 

About the same time I saw Mrs. R. , 
58 years old, whose foot was scalded with 
boiling water. It was first treated with 
domestic remedies, including carron oil, 
and later with poultices. I first saw it 
when it had been treated in this way for 
a week or ten days. The skin and tis- 



sues had sloughed from the dorsum of 
the foot, and the tendons were bare. I 
directed soaking the foot in creolin solu- 
tion for ten or twelve hours, and then 
made continuous applications of the 
solution by means of surgeon's lint In 
due time she made a good recovery. 

One more case, illustrating how not to 
do it, as well as how to do it, I give in 
some detail. 

Mamie C. , 8 years of age, was burned 
at a bonfire October 9, 1896. The pos- 
terior and outer aspect of the right arm 
and forearm, lateral aspect of the thorax, 
the buttock, thigh and leg, all on the 
right side, were blistered by the burning 
of her clothing. She was attended by 
Dr. X. On the second day he punctured 
the blisters, evacuated the serum, and 
also actually tore off the cuticle, expos- 
ing in all more than a square foot of raw 
surface. This was treated with nitrate 
of silver, presumably after the barbarous 
method recommended by Billroth, who 
himself admits that it causes a great deal 
of pain. After a few days of such treat- 
ment, the approach of the doctor was 
enough to frighten the child nearly into 
convulsions. Some of the neighbors gave 
notice that if this continued they would 
remove from the flat, on account of the 
heart-rending cries of the child while 
being treated. 

Following the nitrate of silver, some 
kind of salve was applied. This style of 
treatment was continued daily for six 
weeks. The doctor made forty-thr^e 
visits in that time, and received his fee 
at each visit. 

Matters were growing worse. No 
healing took place — rather the open 
sores were spreading — and the child had 
wasted almost to a skeleton. During all 
this time she had laid upon the left side, 
the right leg semi-flexed upon the thigh, 
and the knee joint had become anky- 
losed. 

The family being in moderate circum- 
stances, living upon the small wages of 
the husband, and having rent to pay, 
asked a little leniency in the matter of 
payments to the doctor, promising to pay 
in full in a short time. 

The doctor's visits ceased at once. 
After waiting two weeks for him, in the 
meantime treating the child with the ex- 
pensive ointment somewhat as the doctor 

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THE MEDICAL WORLD. 



139 



had done — the condition growing worse — 
I was asked to see the child. 

The haggard, skinny condition of the 
little girl was pitiable. The sores were 
all open, putrid, offensive beyond de- 
scription. That on the thigh and but- 
tock was the largest, being 13 inches 
lorg, and from 3^ to 6 inches wide. 

The mother seized the dirty rag that 
had stuck down into the raw sore, and 
pulled it off at one jerk, despite the 
screams of the child. Blood literally 
poured from all this bare surface, and 
ran in streams down upon the couch. 
Upon remonstrating, I was informed that 
that was the way the doctor did, he not 
having time to remove it slowly. 

Is it strange that there had been no 
progress in healing ? It was another case 
of the boy's pulling up the planted beans 
every day to see if they were growing. I 
softened the remaining cloths and cleaned 
with warm carbolic solution. 

Following a recent French suggestion, 
I saturated surgeon's lint with warm milk 
and covered the sores with these com- 
presses. This gave great comfort, and 
the sores at once took on abetter appear- 
ance. After a few days I became suspi- 
cious of the fermenting milk, and dis- 
continued it. 

From this time forward I used the creo- 
lin solution, applied constantly, and the 
process of healing was truly marvelous. 
The skin rapidly pushed out from all the 
borders, the blood vessels and nerve 
supply kept up their vitality, and even 
the buttock, where skin-grafting was 
believed to be necessary to cover the 
broad span six inches wide, continued to 
heal until fully covered with good, sound, 
healthy integument 

I repeat the caution to use only a weak 
solution of .creolin in water; keep the 
surface of the butfn constantly covered ; 
and avoid frequent dressing aud disturb- 
ance of the affected parts. 

Benj. Edson, M. D. 
83 St Mark's Avenue, Brooklyn, N. Y. 

Treatment of Burns. 

Editor Medical WpRLD :— Dr. J. A. 
Henry, of Banning, Pa., page 123, asks 
for " a good treatment of burns from 
coal gas." The burn is the same as 
from any other blaze, and similar to gun- 
powder burn. 

With a soft brush, rag or feather, 



smear all over the surface and a little 
over the edges with pure undiluted car- 
bolic acid. It turns the surface white 
and makes an impervious coating, under 
which a new skin forms in a few days. 
At the same time all pain ceases in- 
stantly. Have no fear of any untoward 
event of any kind. I have seen children 
go to sleep while the light cotton dress- 
ing and bandage were being applied. 
For a deep burn, as from a piece of red 
hot iron or a coal of fire, wet a piece of 
cotton with the acid and fill it into the 
cavity. The relief from pain is instan- 
taneous, only a few seconds being re- 
quired. 

When the skin is charred or dried, mix 
equal parts of boric acid and acetanilid 
in castor oil to a thin paste and spread 
over the surface ; cover with light cotton 
batting to protect. This acts slower in 
soothing pain than the carbolic acid, but 
is equally effective. 

On a surface of considerable extent, 
when the cuticle is scalded or burned so 
as to blister, I would prefer the carbolic 
acid to the above, as its action is im- 
mediate and safe every way. 

Dr. Allis' idea is that the acid forms a 
chemical composition with the serum 
and protects from air or further absorp- 
tion of acid. Ben H. Brodnax. 

Brodnax, La. 

Sub-normal Temperature In Pneumonia. 

Editor Mbdicai, World : — Although 
you asked for reports of cases of pneu- 
monia for the January World, I hope 
the following, which occurred in my 
practice during that month, will not be 
out of order : 

On January 13th I was called to see 
William F. , colored, aged about 30. I 
found him suffering with grip, tempera- 
ture 103. 4 , general aching, some little 
pain in right side, and a slight cough. 
He had been having chills and fever 
every other day for two weeks ; at this 
visit I found no trouble in lungs. I saw 
him again on the 14th, and found him 
better in every respect; temperature 
ioo°. 

On the 16th he was taken worse, and I 
was sent for in the afternoon. I found 
him with a temperature of 102. 2°, slight 
dullness over upper and middle lobe of 
right lung, $lso crepitant rales well 
marked over same area ; dull pain in 



140 



THE MEDICAL WORLD. 



side, but no rusty sputa. Of course 
my diagnosis was pneumonia, and I 
put him on appropriate treatment for 
same. 

Being detained on the morning of the 
17th, I did not see him until about 8 
p. m. I found him very weak and in a 
slight stupor; I also found the room full 
of company, two of whom were smoking 
old pipes, the scent proving this. I emp- 
tied the room of all but two people. My 
patient's temperature was 104. i°, which 
was easily reauced to 102 by cold spong- 
ing. His cough was much worse, with 
plenty of rusty sputa. I ordered whis- 
key, one-half tablespoonful every three 
hours, alternating with carbonate of am- 
monia grs. v, and nitrate of strychnine 
gr. 1-50. On the morning of the 18th I 
found him perfectly rational, dullness 
complete over the upper and middle lobe 
of right lung, pulse good and strong, 
temperature 99 , sputa rusty. On the 
morning of the 19th he expressed him- 
self as better ; temp. 97 °, skin warm 
and moist, lung still dull on percussion ; 
ausculation showed a few returning rales 
over apex. Not a single symptom of 
collapse, notwithstanding the sub- normal 
temperature. 

20th, in the afternoon, temp. 97 , 
pulse good, sputa slightly tinged with 
blood, dullness a little less marked. 

21st, temp. 97 , condition good, lung 
gradually clearing up ; rusty sputa ab- 
sent. 

22d, temp. 97 , feeling a little hun- 
gry, rales all over middle lobe, upper 
lobe perfectly clear. 

24th, lung all clear except a few rales 
in middle lobe ; temp. 97 . I dismissed 
the case with instructions to call at my 
office the first time he was in town. 

On finding his temperature 97 , I 
thought of course I was mistaken, or 
perhaps his mouth was unduly dry, so 
tried in axilla for fully five minutes ; re- 
sults the same. 

On the 20th, 2 1st, 22d and 24th, to be 
certain, I used two thermometers, both 
in axilla and under the tongue. There 
was no crisis, but a gradual and com- 
plete recovery, with no unfavorable 
symptom except the sub-normal tern* 
perature. As to my diagnosis there can 
be no mistake, for as far as ausculatory 
and percussion signs went, it was a typi- 



cal case ; in fact, in a practice often years 
I have never seen a plainer case. 

Now, as to my treatment, realizing that 
pneumonia is a self-limited disease, my 
treatment was entirely upon the support- 
ive plan, meeting complications as they 
arise. In above case, on my first visit, I 
gave for fever antikamnia with caffeine, 
but after pneumonia was detected no 
antipyretic except cold water was used. 
Up to the 22d, I used carbonate of am- 
monia and strychnine, then for the car- 
bonate I substituted muriate of ammonia. 
I do not use alcoholics as a matter of 
routine, but rely mainly on strychnine. 

According to instructions, the man 
called at my office on February 8th, and 
his temperature, taken with the same 
thermometer, was 98. 2. 

Now, Mr. Editor, I am fully aware that 
my case presents no points of interest 
except the subnormal temperature con- 
tinuing with no. other unfavorable symp- 
tom. I confess it has puzzled as well as 
interested me, as it is so foreign to the 
ordinary run of that disease. I hope to 
get some expression of opinion from 
some of the brother M. D.'s, as well as 
the Editor, as to its cause. I must beg 
your indulgence for encroaching, this 
my first time, upon so much of your 
valuable space. 

John H. Harden, M. D. 

Society Hill, S. C. 

[Don't know the cause. It is a unique 
case. The alcohol does not seem to have 
been given in sufficient quantity to cause 
sub- normal temperature. — Ed.] 



Pneumonia. A Reply to " Lex." 

Editor Medical World :— In the 
March World, page in, u Lex "is im- 
pressed with the diverse treatment of 
pneumonia advocated by two or three 
physicians, and thinks physicians should 
establish an ironclad rule one way or the 
other. 

" Lex " loses sight of a basic principle, 
the recognition of which would probably 
make plain to him many apparent dis- 
crepancies, viz : medicine is not an ex- 
act science; it is an art 

If medicine were an exact science it 
could be practiced with mathematical 
precision ; and we could lay dotrn fixed 
rules to be follow^ @6<$g[(in pneu- 



THE MEDICAL WORLD. 



141 



monia, but in every other ill to which 
human flesh is heir. Then, no need for 
long years of study — no need for four 
years in college — no need for hospital 
experience. "Lex" could buy a few 
medical books and at once practice medi- 
cine as well as the fathers in medicine. 

But how essential it is for long years 
o fstudy and preparation in order to be- 
come well grounded in the foundation 
principles; and then our success as a 
practitioner will depend upon the degree 
of judgment with which we apply and fit 
to our patients these fundamental princi- 
ples. How poorly equipped is he who 
must literally fit his text-book descrip- 
tion, prescriptions and all, to the case in 
hand. This, as the Editor so truly says, 
is treating the name of the disease, and 
not the diseased body. This gives the 
explanation of why, when Dr. A so 
highly recommends a certain line of 
treatment for, a certain disease, Dr. B 
tries it and signally fails. 

While to the lay mind there may be 
an apparent inconsistency in the differ- 
ent lines of treatment suggested in the 
discussion of pneumonia, there is none 
to the medical mind. In one case we 
must give expectorants in order to 
liquify inspissated mucus and inflam- 
matory products ; in another, astringents 
to check undue waste, tone up relaxed 
tissues and overcome hemorrhage; in 
another, we give cathartics to unload 
the primae viae ; in another, we must 
control diarrhea ; again, we may profit- 
ably produce emesis, while in another, 
probably more often required in the 
treatment of this disease in children, we 
must control vomiting and allay gastric 
irritability. All these different methods 
are strictly rational and scientific, and 
the intelligent physician resorts to them 
as indicated. 

I think I am safe in saying that when 
4 'Lex" takes pneumonia, he will want 
to be treated in accordance with what his 
own individual symptoms indicate to be 
right, and not necessarily along the lines 
followed when his neighbor was sick. 

I take it that "Lex" is a member of 
the legal profession. If he were called 
upon to defend a man charged with mur- 
der, he would pursue that line of defense 
offering the greatest prospect of success, 
and probably success would crown his 



efforts. Then in his next case of like 
charge he might have to take an entirely 
different line of defense and yet be equaly 
successful. In adapting himself to all 
the surroundings and circumstances of 
his different cases he would show he pos- 
sessed great legal acumen and skill. So 
the physician, in duly weighing all the 
circumstances, environments and symp- 
toms of his cases, and adapting his reme- 
dies thereto, indicates that he is a careful, 
painstaking and intelligent practitioner, 
and not a mere routinist 

L,. B. Allen, M. D. 
Humboldt, Neb. 



Dr. E. E. Gilmore, of Adrian, Mo., 
writes that pneumonia is indigenous in 
that vicinity, having occurred there 
every year since he has lived there, dat- 
ing back to 1857. It is more prevalent 
some years than others, but it is neither 
as prevalent nor so fatal now as 
formerly. This the doctor attributes to 
the comparative absence of malaria. 
The system weakened by malarial 
poisoning was much more prone to an 
attack of pneumonia, and a fatal result 
was much more likely. In treatment, he 
neither bleeds nor vomits ; he begins 
with 7 cathartics ; if pulse is full and 
rapid he gives aconite till it is down to 
90; he gives carb. ammon. in " tea- 
spoonful doses every four hours regularly 
till convalescence ; n ease pain with 
opium and control cough with Dover's 
powders and codein ; use a moderate 
amount of alcoholic stimulants and 
plenty of liquid nourishment ; in the 
third stage, support the heart with digi- 
talis, stroplathus and nux vomica. He 
says: "Under this treatment 95 per 
cent, will recover." 



Meditations on Antitoxin. 

Editor Medical World:— But why 
should I use antitoxin in the treatment 
of diphtheria? If I accept, without 
question, the statement that the anti- 
toxin treatment has reduced the mortal- 
ity from diphtheria, I should also accept 
the other no less important statement, 
that I, not being a bacteriologist, am not 
capable of diagnosing diphtheria. This 
would make the bacteriologist the real doc- 
tor.andmyself only *£gg^$«*^ 



142 



THE MEDICAL WORLD. 



head, as the case may be. The "American 
System of Practical Medicine," page 680, 
says: " In judging from the appearance 
and symptoms of a case, one must first 
acknowledge that there are certain 
mild exudative inflammations of the 
throat belonging both to diphtheria and 
pseudo-diphtheria which appear exactly 
alike, having similar symptoms and 
similar duration. It is even possible to 
examine two cases, knowing that one is 
surely diphtheria and the other surely is 
not, and yet be unable to determine which 
is true diphtheria and which is pseudo- 
diptheria." That seems to settle the 
matter. The statement is dogmatic and 
not to be contradicted. I may be blind, 
absolutely blind, as to the diagnosis of 
diphtheria, but when I fall into a logical 
ditch I cannot resist the inquiry whether 
they who insist on leading me are not a 
little myopic. 

Until the year 1890, or there about, 
the term " diphtheria " included all the 
throat anginas characterized by pseudo- 
membrane, with the possible exceptions 
of some cases of scarlet fever and mem- 
branous croup. But the bacteriologists 
were pregnant with a theory, and whether 
"the mountain labored and brought 
forth a mouse " is a question many very 
honest and able physicians hold still sub 
judice. They are not quite ready to 
believe that that which they had regarded 
as the morning star of scientific medicine 
was nothing but a meteor ot insignificant 
magnitude. They are not quite ready to 
believe that the brilliant morning star of 
medicine burst the clouds of ignorance 
in the zenith of scientific glory. 

Bacteriology labored and brought forth 
a theory; viz : The Klebs-LSffler bacillus 
is the cause of diphtheria. Soon it was 
demonstrated beyond the possibility of a 
doubt that the streptococcus and other 
bacteria produced a disease having all 
the clinical characteristics of diphtheria. 
What must be done ? Our nomenclature 
must be deformed to fit the theory. The 
edict went forth that only such anginas 
in which the existence of the LOffler 
bacillus was demonstrated should be 
recognized as diphtheria. This is equiva- 
lent to a court decision that was once 
actually rendered in this county. A man 
was acquitted of horse stealing because 
'* was proved in court that the animal he 



stole was a mare. The fact of the steal- 
ing w^s not questioned. 

Would it not be better to say Klebs- 
LQffler or Loffler diphtheria,or streptococ- 
cus diptheria, or Loffler-streptococcus 
diptheria, etc. ? 

But we are told that Roux and Yersin 
found that virulent diphtheria bacilli in- 
oculated on the healthy membrane in. 
the trachea of rabbits produce no lesions. 
Then it was discovered that the virulent 
bacilli might exist, develop and disap- 
pear from healthy human throats with- 
out producing any lesions. The virulent 
Loffler bacillus can be distinguished from 
other bacilli only by demonstrating its 
virulence ; this can be done only by the 
animal experiment, or guinea pig test, 
that requires four days. The Ldffler 
bacillus, streptococcus and other bacteria 
are often found in intimate association. 
Most persons are naturally immune to 
the virus of the Loffler bacillus. A 
person may be immune from diphtheria 
and non-immune to the virus of the 
streptococcus. Now y if the bacteriologist^ 
in a supposed case of diptheria^ finds 
these bacteria in association, how can he 
determine with any degree of certainty 
which caused the disease ? If in such a 
case there is no way to determine which 
caused the disease, and it is admitted 
that in the vast majority of cases these 
bacteria are found in intimate associa- 
tion, of what diagnostic value is the 
Loffler bacillus ? It seeme to me that 
the bacterial diagnosis of diphtheria is 
based on the assumption, altogether 
gratuitous, that the LSffler bug is an ex- 
pert in getting ahead of his relations 
with his disease- producing proclivities. 

Admitting that the bacterial diagnosis 
of diphtheria is all that is claimed for it, 
it is also admitted, on the other hand, 
that injections of antitoxin in cases that 
are not true of diphtheria are more likely 
to be attended with serious, and often 
fatal, results. It is very important, then, 
that the diagnosis should be made out, 
even if it does take four days before the 
antitoxin should be administered. If 
fatal or even serious results should fol- 
low the administration of antitoxin in a 
case afterward proved to be other than 
true diphtheria, the physician adminis- 
tering the dose could, and in justice 
should, be prose^ed^^litactice. 



THE MEDICAL WORLD. 



143 



A physician has no right to jeopardize 
the comfort, health or life of his patient 
by the administration of dangerous rem- 
edies until he is positive of the diag- 
nosis, and reasonably sure that less dan- 
gerous remedies will not produce the 
desired result If we use antitoxin in 
diphtheria with any hope of success, we 
must use the remedy first and diagnose 
the case afternoon — treat in naste 
and diagnose at leisure. Is that the 
keynote to the science of medicine? 
Table V, "A. S. P. M.," vol. I, page 
700, shows that of 4,232 cases injected 
on the first and second days, the mortal- 
ity was 6.3 per cent. Of 3,870 cases in- 
jected on the third and fourth days, the 
mortality was 17.2 per cent. Of 1,984 
cases treated after the fourth day, the 
mortality was 34.6 per cent. I believe 
that this is a much larger average mor- 
tality than occurs in ordinary country 
practice. 

Whether all the cases treated on the 
first and second days — before the diagno- 
sis could be made out — were afterward 
demonstrated, by the guinea pig test, to 
be true diphtheria, we are not told. We 
do know, however, if we rely on the 
assertions of the bacteriologists, that 
when the treatment was commenced 
these cases were not known to be diph- 
theria, and that the diagnosis was only 
surmised or guessed at ; and if not after- 
ward confirmed by the guinea pig test, 
are absolutely worthless as showing the 
value of antitoxin. If I ever use anti- 
toxin in the treatment of diphtheria, it 
will not be as the result of baseless 
assertion, balloon theories that need only 
the point of a pen to let the gas out, or 
statistics attenuated on the one hand and 
inflated on the other. Let us have light 

St John, Wash. J. W. Lockhart. 

Experiments with Snake Venom.— Charge of 
Abortion. 

Editor Medical World: — An excerpt 
from the New York Medical Journal^ 
published on page 450 of your volume 
XIV, says that Dr. Arthur Stradling, of 
Ceylon, had been done to death by a 
snake. The phraseology of the para- 
graph plainly points to the Indian Medi- 
cal Record as the source of information ; 
but happily this good doctor was not 
killed. The facts are, that emulating 



my old friend, Dr. Vincent Richards, 
once of Philadelphia, Pa., Dr. A. Strad- 
ling gave himself heart and soul to the 
antidotal aspects of ophiology, and had, 
as he thought, immunized himself. But 
in July last he was experimenting with 
one of the most deadly snakes of Ceylon, 
when the reptile bit him. He lay hover- 
ing between life and death for several 
hours, but ultimately recovered. Noting 
an announcement of his death in the 
Record, I telegraph to Ceylon for 
facts ; and though not furnished with 
full information, was glad to learn that 
the doctor was convalescent, which fact 
I communicated to the Indian Journal of 
Pharmacy {vide page 56) and the Record 
subsequently corrected itself; but perhaps 
the New York paper did not notice the 
correction. 

Apropos of antidotes to snake bite, a 
good deal has been said ; but I am not 
prepared to accept them as infallible, as 
in every instance of <c cure " there is no 
evidence of the bite having been a fair 
and square one with nothing interposing 
between the skin of the victim and the 
fangs of the snake. It is widely known 
that where a snake bites through cloth- 
ing there is every probability of the 
patient recovering without medicine, 
even though the fangs have sunk deep 
into his flesh. A good deal also depends 
on the condition of the reptile and the 
season and sequence of the bite, while 
the symptoms of the injection of the in- 
spissated poison differ considerably from 
those evinced by a fresh bite. These 
facts were elucidated in 1888 when Dr. 
W. J. Simpson, Municipal Health Officer 
of Calcutta ; Dr. Vincent Richards, Port 
Health Officer and Snake Specialist; Dr. 
Pedley, Health Officer of Rangoon ; Sur- 
geon-Major J. Stephenson, A.M.S., and I 
undertook a number of experiments with 
dogs who were subjected to (a) cobra bite 
unprotected, (6) injection of inspissated 
cobra poison, (c) injections of the various 
antidotes, (d) cobra bite through cloth, 
{e) antidote injected according to direc- 
tions after the injection of the inspissated 
cobra poison, (/) antidote injected after 
bite by cobra protected and not, {g) cobra 
bite after injection of antidote, (A) in- 
jection of inspissated poison after injec- 
tion of mixtures of antidote (k) injection 
of mixtures of antidotes and inspissated 

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cobra-poison, and these experiments were 
afterwards repeated by myself. Note 
results : a } b, c, //were reserved as control 
animals, all of d recovered, but a and b 
took longer to die than e y /, g and h ; 
while of c, those that had been injected 
with strychine and the u patent " anti- 
dote died, and inflammatory centres were 
set up in those injected with calcium 
chloride and permanganate of potash, 
which drugs, as also strychnine, gave the 
bekt results in those cases of class that 
were bitten through cloth, while they 
utterly failed in those of the same class 
where the fangs directly entered the 
flesh without the interposition of cloth. 
Antivenin was not tried, but it was a 
notable fact that in series k the other 
antidotes were useless, while strychnine, 
calcium chloride and permanganate of 
potash (merit in order of sequence) 
appeared to render the poison "inert" 
when mixed with it prior to injection, 
though the same drugs did not appear to 
exert a salutary influence in series e,g y h. 
Altogether 250 dogs were experimented 
on, and experimental errors were carefully 
guarded against by not letting the same 
reptile bite a second dog the same, and 
the inspissated poison was got by Dr. 
V. Richards and myself from uninjured 
cobras, somewhat after the manner in 
which crotalus and lachesis are obtained 
in America from the rattlesnake and 
trigonocephaly lachesis, dried in vacuo 
and preserved in hermetically sealed 
tubes to prevent oxidation and deteriora- 
tion. 

A very painful story comes from Hy- 
derabad, Deccan, in which Arthur Na- 
poleon Templeton, uncle to one of the 
children of the late Eugene Courjon, 
Prince of Chandernagore, French India, 
stands charged with having, on Dec. 6, 
1896, with intent to cause the miscar- 
riage of Marian Edith Whittaker, she 
being with child, done acts and abetted 
acts which caused the death of the said 
Mrs. Whittaker. The case is proceeding, 
but at the preliminary inquiry it leaked 
out that Surgeon-Captain P. Hebir, I. 
M. S., who was in attendance on the 
woman just before tetanus set in, sent for 
Surgeon-Colonel E. I,awrie, I. M. S., in 
consultation, and told him that Mrs. 
Whittaker u had been suffering from cold 
and sore throat for several days, and the 



day before she was suddenly taken ill 
with lockjaw and since had violent 
spasms, which were attributed to cold 
and want of care in bathing." Dr. Lawrie 
furthermore stated in court that when he 
suspected abortion he taxed Dr. Hebir 
with trying to mislead his diagnosis, 
when the latter apologized to him for 
having deceived him, confessed his cog- 
nizance of the case having been abor- 
tion, which he solemnly declared he did 
not in any way abet the commission of, 
and said he had deceived Dr. Lawrie in 
order to shield Mr. Templeton. Some 
evidence of the above nature having been 
recorded by the Residency Court on the 
22d ult., the case was remanded to let 
the police fully investigate the matter. 
Roger S. Chew, M. D., C. M., M. S. C. 
Editor Indian Jour, of Pharmacy. 
Jan. 13, 1897, n Wellesley st, Cal- 
cutta, India. 

Morphia and Atrophia. 

Editor Medical World : — Apropos 
of Dr. fine's letter, p. 99, March World, 
I will say, that in thirteen years* prac- 
tice I have made an almost routine prac- 
tice of giving a small amount of atropia 
with morphine, particularly when I use 
the syringe. I consider this plan the 
best. There is less nausea afterwards, 
and more perfect sleep. I have never 
seen a symptom of convulsions caused 
by it ; in fact, in convulsions the atropia, 
as far as the nervous symptoms are con- 
cerned, is a synergist to the morphine. 
Patients of other physicians who have 
told me that they cannot take morphine 
on account of the nausea afterwards, 
have taken morph. gr. ss., atropia, gr. 
1-150, and no nausea followed at all. 

Camden, S. C. J. W. Corbett. 

[The proportion mentioned above is 
about right ; but the atropia is frequently 
given in two or three times the above 
proportions, and that is likely to pro- 
duce nervous excitement. — Ed.] 

Morphine Poisoning. 

Editor Medical World : — I was 
called at 10 o'clock p. m. to see a case of 
morphine poisoning in a strong, vigor- 
ous man, a blacksmith by trade. I ar- 
rived at 10.15, found the patient sitting 
in a chair supported by two men. He 
was wild, wanting to fight, but was too 

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weak to stand or walk alone. The at- 
tendants said lie had taken morphine. 
Pnlse running from 90 to 100, full but 
not strong. Eyes (pupils) large, and he 
looked wfld. Could get very few answers 
from him. He would ask for morphine. 
Supposing he had been drinking and 
probably taken morphine to sober-off on, 
I sent a man to ask the druggist if he 
had gotten morphine there. Messenger 
leturned and reported he had gotten ten 
pills, % grain each. The attendant said 
he took the last one at 9.15 p. m.,just 
one hour before I saw him. I gave him 
a grs. permanganate of potassium just 
before sending messenger to druggist, 
and while he was gone I got 1-5 gr. apo- 
morphine ready to inject in arm, and 
when messenger said he had gotten ten 
pills, and we knew he took all, I thought 
it time to go to work in earnest, so in- 
jected apomorphine after starting mes- 
senger for stomach pump ; but had him 
vomiting heroically before messenger re- 
turned. Gave him warm water, a pint 
at a time, and kept him vomiting till 
everything was out of stomach ; kept 
him walking ; at 11.30 p. m. gave him 1 
gr. permanganate pot. hypodermically ; 
at 12 I went home leaving instructions to 
keep him moving till 3 or 4 in the morn- 
ing. Called next morning and found 
him resting well, but very weak. Was 
out at work in three or four days. Arm 
got very sore where I injected perman- 
ganate of potassium. Does it always 
make the arm sore when injected ? 

I would be glad for any comments 
from Editor or others as to treatment I 
am not in the habit of writing for publi- 
cation, but I enjoy reading the articles 
of others, and thought I ought to report 
this, and if the Editor thinks it worthy a 
place in The World, all right ; if not, 
drop it in the waste basket. 

T. W. Le Crone, M. D. 

Millersport, O. 

[Treatment very good. How do you 
account for dilated pupils ? Did the pills 
contain atropine ? It is your duty to re- 
port interesting and valuable experience 
to the medical press. The last few lines 
of the above are printed as a text for a 
few general remarks. It is our experi- 
ence that the best articles are modestly 
submitted. Whenever we receive an 
article and find at the beginning or in 



an accompanying letter the following: 
"Publish if you find worthy; if not, 
drop it in the waste basket," we nearly 
always find it to be a good article. On 
the other hand, if an article is pompously 
presented, it is rarely worth publishing. 
Modesty and ability usually go together. 
—Ed.] _ 

An Aid In the Treatment off Fevers. 

Editor Medical World -.—That the 
physiological way of keeping the body 
cool is not more closely imitated in the 
treatment of fevers, I have often thought 
strange ; and the more so as it can be 
followed so readily and is easily con- 
trolled, and, besides, can be used in con- 
junction with internal medication. 

Irving in a climate where at times in 
summer it is as torrid as 129 F. in the 
shade (this with an official thermometer), 
where everything is hot to the touchy 
and the air we breathe like that from an 
oven, a place where ice is unknown, we 
still have quite palatable water to drink, 
and cool, too (78 to 8o° F.), when we 
take into consideration its surroundings. 
How do we keep it so cool ? Exactly as 
the temperature of any healthy body re- 
mains normal under like circumstances. 

Our drinking water is cooled in large 
earthen ewers. These are slightly porous, 
so some of the water can pass through, 
and thus keep wet the cloths that sur- 
round them. It is the constant evapo- 
ration of this water from these cloths 
that causes the cooling, just as certainly 
as fire causes heat. Now, we have found 
if we want nice, cool water on hot days, 
we must not only fill these vessels and 
keep the cloths wet, but also place them 
where there is a free circulation of air. 

On sultry days, when the atmosphere 
is charged with moisture, we are espe- 
cially uncomfortable, for then the evap- 
oration from the skin does not take place 
readily, and we not only feel warmer, but 
the skin (in which the nerve ends sensi- 
tive to temperature are situated) is really 
warmer than on much hotter dry days. 
During such weather the water from the 
cloths around our ewers does not evapo- 
rate freely, and the drinking water is 
warm and unpalatable. I have repeated 
in the above description, for it has a 
direct bearing on what follows. 

We all have noticed the great relief to 

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a fever patient with a dry, hot skin, a 
frequent sponge bath is ; in fact, often 
this is all that is necessary to keep the 
temperature down. But sometimes it is 
not sufficient. Why? Because, as the 
water from the sponge bath evaporates, 
a zone surrounding the patient becomes 
charged with moisture, so evaporation 
cannot take place, or only so slowly as to 
do little good. The water then only 
cools while it is being heated to the 
body's temperature, and the patient is in 
the same condition as a person on & 
sultry day ; but this can be easily reme- 
died by keeping dry air next to his body. 
This may be accomplished by means of a 
fan or in any other convenient way. Not 
only the face, as is often done now, but 
the whole body, should be thus sponged 
and fanned when an active antipyretic is 
wanted ; by repeating the process the 
body can be kept at the temperature de- 
sired much more certainly and safely 
than with any antipyretic I know of. If 
advisable, the dry air forced next to the 
body may be first heated. 

Of course this procedure should not be 
continued until the temperature falls too 
much, for the body, with suitable appa- 
ratus, could be cooled far below the nor- 
mal by this means. The right use of the 
thermometer and the general condition 
of the patient must be our guides. 

The other day I had a good example 
of what follows when free evaporation 
cannot take place from the skin. A 
patient whose temperature the previous 
evening had been 102 , when visited in 
the morning was 105 ; the only cause I 
could attribute this rise to was the damp- 
ness of the room in which he lay, water 
having been spilt over the floor an hour 
before, and the air was so filled with 
moisture that the free evaporation from 
the skin could not take place. In a very 
short time after this was remedied the 
temperature fell to 101 without any 
other cause. 

Another circumstance I have noticed 
is, that in this climate where the air is 
so dry, the sponging of the body is far 
more effective in reducing fever tempera- 
tures than in the East where there al- 
ways is so much more moisture in the 
atmosphere. 

We all have noticed that breezes, even 
when hotter than the body, cool us when 



we are perspiring. In this place we have 
had very good examples of this when the 
air from the desert, 130 F. and upwards, 
came down upon us, as it often did last 
summer. At such times we drink very 
large quantities of water, and were we 
not aware of the invisible perspiration 
and evaporation, might wonder what be- 
came of it all. 

My deductions from the above are : 

Always use the simplest means that 
will accomplish the end desired. 

When the temperature is high, have 
the whole body of the patient sponged, 
and then fanned while the water is evap- 
orating. Do not allow a zone of damp 
air to remain around the patient For 
sponging, tepid water is more pleasant 
than cold, and equally effective. Alcohol 
in the water is often useful, for it evapo- 
rates more quickly than the water alone. 

But the point that must be observed, if 
this method is to be used with success, is 
to have the conditions so that free evap- 
oration will take place. 

Hubert W. Dudley, M. D. 

Parker, Yuma Co., Arizona. 

[I have been surprised to see water 
kept at quite a palatably cool tempera- 
ture in the above-described manner in 
the u blazing" heat of the Desert of 
Sahara.— Ed.] 

Central Paralysis. 

Editor Medical World : — A few 
months ago I was called on to treat a 
most interesting case which I desire to 
report to the World readers. While it 
is nothing new, we had the pleasure of 
partially verifying the diagnosis, which 
invariably makes a case interesting. 

October 29, 1896, E. R., female, aged 
58, called at my office for treatment 
Oral and physical examinations revealed 
the following : Slight headache, vertigo, 
nausea, insomnia, loss of appetite, an 
inability to do her household duties, on 
account of extreme weakness ; pulse 100 
per minute, irregular; tongue coated, 
white, broad and flabby ; temperature 
and respiration normal ; bowels consti- 
pated, but had been moving too freely a 
few days before. The urine was not 
analyzed. I prescribed : 



R. Spartein sulph. % gr. tablets, No. 2 
Sig. Take one tablet every three hours 
when awake. 

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R. Fl. ex. cascara sagrada, | oo 
Syr. simp. aa. J °*- ss ' 

M. Take one teaspoonful every night at 
bed-time. 

Patient was advised to drink two or 
three glasses of soda water daily and for- 
bidden doing any work. Did not see nor 
hear from her again until sent for No- 
vember 3. Arriving at her residence at 
9 a. m., found her about the same as 
when at office, except bowels were mov- 
ing daily and tongue coated brown. 
November 4, 9.30 a. m. — Pulse 80, strong 
and regular ; other symptoms about the 
same as on the third ; same treatment 
continued. 

November 5, 9.15 a. m. — Symptoms 
same as day before, plus vomiting. 
Attendant stated patient had a wheezing 
attack during the nighty lasting only 
a short time. I prescribed trs. nux 
vomica and ipecac, in small, frequently- 
repeated doses, and continued the spar- 
tein. 

November 6, 10 a. m. — Pulse 100, 
temperature 100, respiration normal; 
nausea; vomiting mucous, tinged with 
blood; pallor, choreiform twitching of 
muscles of the left arm; had another 
attack of dyspnea during the night; 
sleeps very little. I prescribed : 

R. Specific gelsemium, gtts. xxx. 
Specific nux. vom., gtts. x. 
Aquae, oz iv. 

M. Sig. Take one teaspoonful every hour 
when awake. 

Continued the spartein. 

November 7, 9.30 a. m. — Pulse 90, 
strong and regular; temperature and 
respiration normal ; walk is shuffling ; 
does not raise feet off the floor ; nausea ; 
vomiting about once every hour ; slept 
all night, except when vomiting ; has a 
slight asthmatic attack; twitching ex- 
tended over body. Thinking the nux 
vomica might have aggravated the 
twitching, it was discontinued and the 
gelsemium and spartein continued. 

November 8, 9.45 a. m. — Pulse 100; 
temperature and respiration normal; nau- 
sea and vomiting persist; twitching in- 
creased; eyes have a glassy, vacant look; 
partial loss of cutaneous sensibility; 
complains of being thirsty; water being 
rejected when drank, milk was recom- 
mended in its stead. Same treatment 
was continued; also prescribed chloro- 



form water, one teaspoonful to be taken 
after each vomiting attack. 

November 9, 10 a. m.— Pulse 80, ir- 
regular; respiration irregular, 16 to 24 
per minute; loss of cutaneous sensibility 
more marked; mental prostration; slight 
aphasia and difficult deglutition; drowsy; 
twitching all over body and limbs, more 
on left side than right; delirium; sudden 
starts; temporary Toss of consciousness; 
vacant stare; delusions; nausea. Same 
treatment continued, except two-drop 
doses of gelsemium were given, instead 
of one, as suggested by Dr. George 
Bley, Jr., who was called in consulta- 
tion. 

November 10, 9.45 a. m. — Pulse and 
respiration same as on the 9th ; partial 
paralysis of left side of face, left arm and 
leg; mouth drawn to right; slowness of 
speech; protrudes tongue with difficulty, 
a few moments after being requested to 
do so; last letter or syllable of words are 
left off; urine acid ; specific grav- 
ity 1. on; traces of sugar; no albumen. 
Same treatment continued. 

November n, 10 a. m. — Pulse 64 and 
weak; respiration 24; less twitching; 
paralysis more noticeable; temperature 
was not taken. Three o'clock p. m., 
pulse 60 and extremely weak; fingers on 
left hand, paralyzed side, are closed; 
right hand is cyanotic; pupils dilated; 
do not respond to light; semi-paralysis of 
body and right limbs. 

November 12, 10 a. m. — Pulse 60; 
temperature normal ; respiration 24 and 
stertorous; no twitching; hemiplegia on 
left side complete; tongue completely 
paralyzed ; coma is setting in. Death 
occurred at 12. 15 noon, on fifteenth day 
of illness. Autopsy at 5 p. m. revealed a 
reddish soft condition of the pons varolii, a 
small blood clot in right corporum striatum 
and a small soft spot about the center of 
the under surface of the right digastric 
lobe of the cerebellum. 

Present at autopsy, Drs. George Bley, 
Jr., A. R. Lyles and myself. This is my 
first attempt at writing up a case for a 
medical journal. If it suits the editor 
and the World readers I will report 
another case in the near future. 

C. C. Patchen, M. D. 

Beardstown, 111. 

[Very well reported. " Come again." 
—Ed.] 



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Placenta Previa. 

Editor MedicalWorld: — I avoid rush- 
ing into print with every case of real or 
imaginary importance; in fact, I have 
never written a line to a medical journal 
before ; but I desire to record briefly a 
recent case of midwifery which I believe 
will be of considerable interest to your 
readers, not only on account of its rather 
complex features, but also because of its 
unusual occurrence, happening once in 
over 800 labors, according to the most 
reliable authorities. 

On the morning of January 9th I was 
called to Emma G., colored, about five 
miles out of town. Upon my arrival the 
two midwives in attendance informed me 
that the patient, a multipara, had been 
painful and " flaming " for several days, 
and that during the night she had lost 
"quantities of blood," that "her waters 
had just broke," and that "she had no 
pains since." 

Her pulse was weak and thready, and 
she was indifferent to her surroundings, 
but wholly conscious. 

I made a vaginal examination and 
came first upon the placenta, of which I 
was positive by its rough, spongy, granu- 
lar texture. It was located just above 
margin of inner cervical ring on left side. 
My suspicion of placenta previa was 
then confirmed. The os was fairly well 
dilated. Pursuing my examination fur- 
ther I found a transverse presentation of 
child, dorso posterior, with head in right 
iliac fossa. I considered it folly to wait 
on nature, so I placed her crosswise, on 
back with nates drawn to edge of bed, 
•emptied her bladder with gum-elastic 
catheter, chloroformed her to complete 
anesthesia, and proceeded to turn. I in- 
troduced left hand into the vagina, and 
into the uterus, and with great difficulty 
succeeded in bringing down the feet. 
After the expulsion of the trunk by 
manual manipulation, the forceps were 
used very effectively to the after-coming 
head, which was very large. Placenta 
was easily detached and taken away. I 
then gave ergot as a precaution against 
hemorrhage, stimulants, etc., and author- 
ized warm carbolized injections. The 
case progressed favorably until the fourth 
day, when very severe headache and 
fever developed. The thermometer re- 
gistered 103 in axilla. These were con- 



trolled in forty-eight hours by quinine 
and acetanilid. There were no other 
untoward symptoms, and she is now up 
and doing well. 

X. H. Dreher, M.D. 
St Matthews, S. C. 

Placenta Previa.— Ether In Obstetrics. 

Editor Medical World: — February 
22, 1897, I was called hurriedly about 1 
a. m., to Mrs. P., whom I found flood- 
ing terribly. Upon examination, I found 
placenta previa. I tamponed the vagina, 
and sent for Dr. Young. Upon his ar- 
rival he made an examination, and we 
decided to tear a hole through the pla- 
centa, and then by pressure on the fun- 
dus, cause the child's head to plug the 
os, and if need be, use the forceps and 
deliver at once. 

Dr. Young proceeded to administer 
ether, and I easily tore ar hole through 
the placenta, and the water was soon 
evacuated. The child's head (a seven 
months' fetus), was pressed' down, and 
the hemorrhage was soon stopped, but 
contractions ceased, and in spite of 
pressure on the fundus, the hemorrhage 
began to be quite profuse again. 

Then we decided to administer ether 
and apply the forceps. The doctor be- 
gan to administer the ether, and I pre- 
pared to use my forceps, which I had 
previously sterilized; but I soon found 
that under the stimulus of the ether, the 
contractions were increasing in strength 
and frequency. The hemorrhage had 
ceased, as the head was already well 
down through the os. The child was 
soon born naturally, but apparently life- 
less. I tied and cut the cord, while Dr. 
Young performed artificial respiration. 
We also put the child in a warm bath, 
and dashed cold water on its chest, and 
in about five minutes we were rewarded 
with a faint cry. The doctor still con- 
tinued his efforts at artificial respiration 
for about twenty minutes, when the child 
began to breathe regularly, and has 
lived. 

I did not hurry the delivery of the 
placenta. In about thirty minutes pains 
came on, and the placenta was delivered 
easily, after Crede's method. We floated 
it out in water, and found the hole I had 
made. It was nearly in the centre. 

There was no further hemorrhage of 

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any account The pulse suddenly be- 
came very weak, and she complained 
that she could not see well. I asked for 
a. pint of warm water with a teaspoonful 
of salt in it This we injected in the 
rectum, which seemed to stimulate her 
very much, and she has made an excel- 
lent recovery. 

The child weighed 4 j£ pounds at seven 
months, and at this writing, two weeks, 
is growing and in everyway doing well. 

Now, Mr. Editor, what do you say 
about our plans and proceedings ? 

About ether in obstetrics, I always use 
it when it seems at all necessary. I never 
use chloroform ; I am afraid of it It 
has killed too many. I have never had 
any cause for alarm with sulphuric 
ether. I have frequently found the pains 
to become strong and expulsive under 
ether. J. C. Campbell, M. D. 

Albany, Vt • 

[Any plan that succeeds in placenta 
previa is a good plan. — Ed.] 

Slander and Malpractice. 

Editor Medical World: — Dr. Leff- 
man, in the March World, page 126, 
says : u To accuse a physician of gen- 
eral professional ignorance or malprac- 
tice is actionable per sc, but to state 
that in a special case he was at fault is 
not slanderous, unless special damage is 
proved." In the celebrated case of Dr. 
Cruikshank vs. Gordon, tried a few 
years since in New York City, the de- 
fendant's attorney insisted that the 
plaintiff must bring his books into court, 
and adduce other evidence in proof of 
damages. But the trial judge held that 
the plaintiff was not bound to prove 
the amount of damage he had sus- 
tained at the hands (or mouth) of Gor- 
don ; and at the same time stated that 
to require the plaintiff to produce such 
proof would be, for obvious reasons, to 
require him to do the impossible. The 
jury awarded Doctor Cruikshank $1,500 
damages, and the judgment. was affirmed 
by the highest court in New York. 

Another erroneous idea that crops out 
here and there in the writings of physi- 
cians is, that the patient or his relatives 
may relieve the physician of responsi- 
bility in the treatment of a case. Some 
years ago, in 1869, I think it was, Dr. 
Beckwith, of Cleveland, Ohio, was 



called to attend a man whose leg was so 
badly crushed as to require amputation. 
The doctor, on his arrival, recognized 
this fact, and at once declared his pur- 
pose to operate. But the patient refused 
to submit to amputation ; he told the 
doctor to go ahead with the treatment of 
the injured limb and save it if possible ; 
and at the same time assured the doctor 
that he (the patient) would be responsible 
for the outcome. After a few days, 
during which Dr. Beckwith was in almost 
constant attendance, the patient died. 
A damage suit followed, and Dr. Beck- 
with was mulcted in the sum of $4,500. 
In this case it appeared that the patient's 
death resulted from the doctors failure 
to amputate ; and the court held that he 
was legally bound to do his duty, even 
in the face of remonstrance, or to with- 
draw, at once, from the case. 

Too many physicians are sorely dis- 
tressed when a patient happens to pass 
from their care to that of another ; but, 
in my experience, covering a quarter of 
a century, it has as often proven a god- 
send to the doctor as otherwise. 

Portage, Wis. A. C. Kellogg. 

Alcoholism -Tetanus. 

Editor Medical World : — I wish you 
and the many readers of The Medical 
World would give me help in the fol- 
lowing case : F. F. C, a carpenter, aged 
50, a dipsomaniac, has drank more or 
less all his life — more when a young 
man — sometimes remains sober six or 
eight months; has been afflicted with 
rheumatism for a number of years. 
After he has been on a spree for a day or 
two he is attacked with cramps or pains. 
They may appear in any part of the 
body ; in a toe one minute, in the head, 
chest, or privates the next ; paroxysm 
comes on gradually ; after a moment or 
two it reaches the climax, in which the 
body becomes rigid, face livid, eyes seem 
starting from their sockets ; after a few 
moments he sinks back exhausted, and 
will lie for a few minutes and beg to be 
relieved or killed ; only to be disturbed 
by another paroxysm of pain. During 
the paroxysm he has to be held to pre- 
vent hurting himself. After four or six 
hours he gradually gets easier, and for a 
few days looks like he had had a hard 
spell of sickness. He says he knows he 

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suffers all the torments of the damned 
during this time, but denies that whis- 
key has anything to do with it Yet he 
never has one of these attacks except 
when drinking. I have given chloro- 
form, morphine by the mouth and hypo- 
dermically in % and % gr. doses, and 
many other things ; but opium is the 
only thing that seems to help him. I 
treated him awhile for alcoholism, but 
did not get his full co-operation, conse- 
quently did very little for him. 

I would like to know if any of the 
World readers have had any experience 
with antitoxin in tetanus. I recently 
lost a case of tetanus following gunshot 
wound of right thigh and scrotum. 
Right testicle was shot away. I did not 
use antitoxin. I have great confidence 
in diphtheria antitoxin, but have never 
seen any literature on tetanus antitoxin 
except the manufacturer's, which, I am 
sorry to say, must frequently be taken 
cum grano salts. 

W. W. Shafer, M. D. 

Ferguson, Mo. 

[Alcohol is evidently the cause of 
those "spells." Tell the patient that 
there is no cure for them except by stop- 

{)ing the use of alcohol absolutely and 
brever. The value of tetanus antitox- 
in is not yet well established. We 
know nothing detrimental to it, but suf- 
ficient affirmative evidence has not yet 
been accumulated to establish it — Ed.] 

Foreign Body in an Eye Two Years.— Its 
Removal. 

Editor Medical World:— On Jan- 
uary io, 1895, C. M., aet 35 years, arch- 
itectural iron worker, while running a 
punch press was struck with a piece of 
steel in the right eye, penetrating, as he 
supposed, the upper lid just beneath the 
upper edge of the orbit. There is no 
doubt but that he was struck in that re- 
gion, for the cicatrix clearly indicates 
that such was the case ; but as to the en- 
trance of the steel at that particular 
point, there is some room for doubt, as 
might be inferred from the subsequent 
history of the case. 

He had very little reaction the first 
five days, but subsequently had consid- 
erable pain, which was fairly well con- 
trolled by the use of hot applications. 
There was considerable inflammation, 



photophobia was well marked, and the 
tension was reduced to — 1. Vision was 
lowered from the first, and grew grad- 
ually worse till the 17th of March, when 
he discovered that he was totally blind in 
the affected eye. The inflammation sub- 
sided, the eye became quiet and remained 
so up till December 7, 1896, when first 
seen by the writer. Upon examination 
I discovered a foreign body penetrating 
the cornea near the inner corneo-scleral 
margin, which presented the appearance 
of a cilia, and was so diagnosed by an 
oculist, who examined it by reflected 
light. But appearances, sometimes de- 
ceiving, proved to be so in this case, for 
upon touching the foreign body with a 
spud, it became at once clearly manifest. 
The substance was of a decidedly metal- 
lic nature. 

When first seen the patient had a well 
marked conjunctivitis and a good deal of 
pain and lachrymation. There was also 
a traumatic cataract and posterior syne- 
chia^ but no haziness of tne cornea. 

An operation for removal of the for- 
eign substance was advised at once, but 
for some reason the patient put it off 
from time to time till February 4, 1897, 
when he appeared at my office for the 
purpose of having it removed. The fol- 
lowing day the operation was performed 
under cocaine anesthesia. I first made 
an incision about five millimeters deep 
with a Beer's knife alongside of the for- 
eign body ; then, with a pair of forceps, 
I was enabled, using considerable force, 
to extract the foreign substance, which 
proved to be a piece of steel, as had been 
previously diagnosed. It was about the 
size of the body of a pin, and was from 
five to six millimeters in length. 

The eye was then thoroughly washed 
out with a solution of boric acid and 
dressed with a triangular adhesive band- 
age. The patient had slight pain and 
some headache the first twenty-four 
hours, but since then has experienced no 
uneasiness at all. The inflammation 
subsided, the conjunctivitis rapidly im- 
proved, and the patient resumed his 
usual occupation on the third day after 
the operation. 

Now, the question is, might not this 
piece of steel have entered the globe at 
this point, and the fact never ascer- 
tained ? Might not the piece that struck 

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the upper lid have glanced off and did 
not enter the eye at all ? 

This case is of interest from the fact 
that the man never had even sympa- 
thetic irritation in the fellpw eye. It 
groes to prove how tolerant the eye is to 
all kinds of injuries, and reminds us of 
the fact that we cannot be too conserva- 
tive in our treatment of cases of this kind. 

A wound or foreign body in the ciliary 
region is, perhaps, the most unfavorable 
injury with which an eye may be affected 
except suppuration of the whole cornea 
or detachment of the retina. This was 
in the ciliary region — the danger line — 
and yet the fellow eye in this case es- 
caped uninjured. 

S. L. McCreight, M. D. 

103 £. Adams St., Chicago, 111. 



Safe Anesthesia. 



Editor Medical World :— 

Chloroform, one pound. 

Amyl nitrite, one measured dram. Mix. 

This combination has for many years 
been in use in this part of Indiana, but 
the fear of chloroform by the profession 
and the public has prevented its general 
adoption. Now that a simple and safe 
antidote is*found, I am more anxious that 
the method should be better known. In 
giving the mixture the usual precautions 
must be observed. A moderate opiate 
should be given about one hour before 
the anesthetic. The patient must be 
undressed, placed in the horizontal posi- 
tion, and the mixture given drop by 
drop until the desired effect is secured. 
If after that anything goes wrong with 
the heart or lungs, the remedy is to in- 
troduce a rectal dilator and apply force 
as needed. The effect is immediate and 
may be prolonged indefinitely. It seems 
to act like labor pains. As the antidote 
is mechanical it is safe in any case. 

If a more extended trial of this method 
should confirm what is claimed for it in 
this article, no other form of anesthesia 
would be needed. 

Goshen, Ind. M. M. Latta. 

[The above is a model of brief, clear 
and directed expression. A good disci- 
pline would be to read this article before 
beginning to write an article for The 
World. Accompanying the article, the 
Doctor says in a private letter : " This 



plan for using chloroform has been in 
use here for more than thirty years by 
good men, and so far as I know, without 
accident At first it was used only in 
cases of weak heart with purple lips and 
muddy complexion ; but later on for 
everything. The andidote is the out- 
growth of orificial surgery. I fully 
believe in it." If this plan is as valuable 
as it seems, it should not be confined to 
Northern Indiana. — Ed.] 



Cocaine for Tetanus. 

Editor Medical World:— In your 
summary on treatment by the various 
antitoxins, I notice that in case of 
tetanus the results are negative. I wish 
to give an experience by one of my 
neighboring physicians in regard to that 
disease. A Mexican boy, about 13 years 
old, had an undoubted case of tetanus, 
and as the doctor was at a loss to know 
what to do in the present light on that 
disease, concluded to give cocaine. He 
.wrote his prescription for the usual sized 
dose, but the druggist mistook his hiero- 
glyphics and gave ten times the amount 
prescribed. This was not known till 
after the medicine had been given, but 
the result was so pronounced for good, in 
fact, a complete recovery ensued, so the 
druggist was not censured. The same 
M. D. tried the same in another case 
with the same result I have not had an 
opportunity to try it personally, but felt 
that should there be any good in it the 
profession was entitled to its benefits. 
An investigation may prove it to be a 
benefit in such cases. I feel that we are 
warranted in giving it a trial. 
Sabinal, Tex. A. R. Bowman, M. D. 

[This is the true professional spirit. 
We owe so much to the profession that 
we should embrace every opportunity to 
pay our debt by spreading new ideas. — 
Ed.] 

Means of Preventing Conception. 

Editor Medical World : — According 
to my view, the main problem in the 
discussion on this subject ought not to 
be so much an inquiry into or a criticism 
of the various attitudes which may be 
taken with reference to the desirability 
of prevention of conception, but rathe- 
the recommendation to the medical pro 
fession of the best preventive measure 

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THE MEDICAL WORLD. 



when there exists an imperative necessity 
for such in practice. I take it for granted 
that every scientific practitioner of med- 
icine considers it his duty to advise pre- 
vention of conception whenever the state 
of a woman's health requires the avoid- 
ance of motherhood, or when there is 
great danger of transmitting diseases to 
offspring that would either doom the 
latter to a short life or one of perpetual 
physical misery, as, for instance, in the 
case of pulmonary phthisis and other 
grave hereditary diseases. 

Your previous contributors have each 
spoken in favor of some method of pre- 
vention, but the one I consider for many 
reasons the best of all has not been men- 
tioned. It is unquestionably the rubber 
pessary, known as the " womb veil, 11 in 
combination with an ointment of 80 grs. 
of muriate of quinine to an ounce of vas- 
eline as a chemical destroyer of the 
vitality of the spermatozoa, and the use 
of an irrigation before removing; the pes- 
sary. Any preventive will fail .if not 
applied properly. So the physician 
ought to give full instruction to the 
patient The mode of use of the womb 
veil is as follows : 

The inner as well as the outer sur- 
face of the pessary is smeared well with 
the ointment mentioned. For introduc- 
tion, the woman is to sit down, so to say, 
on her heels, with her legs spread apart, 
which will bring the womb down as low 
as possible. Then taking the womb veil 
into the right hand with the cavity look- 
ing upward and compressed from side to 
side, giving it thus the shape of an 
ellipse, she has to push it up the vagina 
as far as it will go. It will then spread 
out of its own accord and apply itself 
closely and firmly to the neck of the 
womb. To remove it, tell the patient 
to hook the index or middle finger at any 
point into the rim of the pessary ana 
pull it down slowly. Let an irrigation 
of warm water, best with a teaspoonful 
of carbolic acid to the quart of water, be 
used,injecting part of the liquid before and 
part of it after removing the womb veil. 

The advantages of this preventive over 
all others I know of, are many. If ap- 
plied as here directed it is almost abso- 
lutely reliable. It can be left in place 
till getting up in the morning, thus doing 
away with the injurious and inconven- 



ient irrigation while there is active con- 
gestion, as well as a great nervous excite- 
ment, of the whole sexual apparatus. It 
is furthermore non-injurious by not inter- 
fering in the least with the full and natural 
gratification, as the womb is a reproductive 
organ and little if at all concerned in 
the sexual pleasure. Again, and last, but 
not least, it satisfies also the esthetic 
instinct, and does not interrupt the poetic 
frame of mind naturally connected with 
the moment, as the womb veil allows of 
its application long before and of its 
removal long after actual coition. 

The best pessarys procurable are 
made in England ; there are several 
kinds, differing chiefly in the material of 
which the rim is made. The German 
pessary is more "baggy," but seems to 
give quite good satisfaction. The Ameri- 
can is the poorest made, for our laws on 
the subject of prevention encourage the 
manufacture and sale of inferior goods, 
competition being practically destroyed. 
In England, however, where such goods 
areopenly advertised and sold,compet ition 
tends to secure the survival of the fittest, 
and hence it is better to import them 
from that country. I would say that I 
do not think it advisable to hfwe a string 
attached to the pessary, as there is the 
liability of displacement during inter- 
course. 

For the interest of poorer patients 
who cannot well afford to spend several 
dollars for a good pessary, I would say : 
My attention has recently been called to 
a very cheap and I am confident an 
effective pessary. Take a common toy 
rubber ball about 2 inches in diameter ; 
part it at the middle and smooth the 
edges off nicely with sand paper. Care 
should be taken to part it at the joints, 
so as to leave no ridges across the inside. 
It should be partially rolled up and the 
pointed end introduced first, then pushed 
up and opened so as to cap over the 
womb. When this is carefully done a 
woman is impregnable, no matter what 
happens. 

Dr. Oscar Rotter. 

New York, N. Y. 

Editor Medical World : — It would 
seem more proper for those who are try- 
ing to devise some device for the preven- 
tion of conception, if they would turn their 

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attention to devise some method of stop- 
ping the ravages of those methods already 
in existence. It would appear that those 
writers who are advocating some method 
whereby the laws of physiology may be 
transgressed without its penalty, have 
mistaken their calling. If they will 
study the laws of physiology, they will 
soon learn that any and all foreign sub- 
stances become a source of irritation to 
those delicate tissues. Twenty-five years 
of close application in the field of gyne- 
ology has given me many startling facts, 
where the people have attempted to carry 
out some idea of harmless prevention. 

In my own practice there is not a day 
passes but that those who are able and 
well-to-do make application for a remedy 
to prevent or regulate their offspring, 
and wish to know what in my judgment 
is the best remedy. To all such I have 
one answer only. It is astonishing to 
listen to the large list of methods which 
have been devised and are being promul- 
gated among the people, some of which 
will make one think, what next can be 
possibly thought of for a preventative 
device ? In the number of methods that 
have been mentioned in The World, 
none of them are new, and all of them 
have their respective objections. Nearly 
two-thirds of the ills of men and women 
are from causes arising either directly or 
indirectly from attempting erroneous 
ideas of preventing conception. I have 
seen, and no doubt you, incurable ulcer- 
ation caused from destructive drugs used 
for the purpose. 

Then about one-half of the time the 
method fails ; the pretended protection 
either is not in proper place or the drugs 
have not sufficient strength. It would be 
far better to make a huge bonfire, and 
sacrifice all of the devices and also the 
drugs. Then if we would live up to 
nature's physiological rules, we would 
see very little of the ills of the present 
day. I. N. Barker, A. M. , M. D. 

Mansfield, O. 

[See January World for the Editor's 
views on the indications for, and the 
ethics of, this proceedure.] 

More from a " Doctor's Wife." 
Editor Medical World :— I wish to 
say something more in woman's defense, 
even at the risk of having that old-time 



adage thrown at me, that "a woman 
always wants the last word." Woman's 
motives for the prevention of conception 
have been so shamefully misrepresented 
by some writers that it is a wonder she 
has kept quiet so long. Our opponents 
are not giving us justice ; for we tried to 
make it plain that some children were 
desirable, and that a home is incomplete 
without them. They picture childless 
homes asthough we were advocating such. 

A number of writers try to make the 
impression that the only reason why a 
woman is desirous of preventing con- 
ception is because she does not want the 
trouble of children, and because she 
loves society better. I am willing to 
acknowledge that there are some such 
types, but I believe that they form only 
a small per cent, of the women who, 
under certain conditions, think it best to 
prevent conception. Is it so strange 
that a woman should not want to keep 
on and on encountering the perils inci- 
dent to maternity after she has all the 
children she wants, or that her husband 
canreasonably provide for ? Is it nothing 
that she should shrink from enduring 
the worst pain common to the lot of 
mortals after she thinks she has borne 
it long enough ? Christ, our great ex- 
ample, shrank from the sufferings of the 
cross, thus showing the human side of 
His nature, and prayed, if it were possi- 
ble that this cup might pass from Him. 
It could not have been because He feared 
the dissolution of soul and body, for 
after His cold reception here, His spirit 
must have longed to take its flight to the 
Father, and to the land of light, warmth 
and love, where He would be the chief 
attraction. His reward was the re- 
deemed of earth, yet the human side of 
His nature shrank from the suffering. 
Then, why count it a thing so strange 
that a woman should shrink from suf- 
fering so much when she can avoid it? 

I think physicians are doing right to 
come out squarely against criminal abor- 
tion. I believe when a woman becomes 
pregnant she should not only be willing 
to go to her full time, but should do it 
cheerfully, for the sake of her unborn 
child. But I think there can be a dis- 
tinct line drawn between willful abor- 
tion and prevention. 

Whoever knew a woman who thought 

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she was an angel ? The most of them 
by the time they pass through the cruci- 
ble of childbearing a few times, realize 
that they are mortal, even more so, if 
possible, than does even Dr. Waugh. 
Let me say, however, to her credit, that 
I believe a very great number are striv- 
ing to reach that seraphic state hereafter. 
But how can she hope to obtain it if she 
goes wholesale into divorcing, which Dr. 
Waugh advises. 

Yes, civilization has done much for 
woman, and is destined to do much 
more. Man has nothing whereof to 
boast that she has been so long in reach- 
ing this state. Woman has never been 
inferior toman save in physical strength, 
and that fact should have appealed to 
the heart of man ages and ages ago. 

Dr. Waugh, as he mentioned the dif- 
ferent grades in the progress of civiliza- 
tion, seems to assume that all our popu- 
lation has reached the last named, 
whereas the great bulk of our people 
have only reached the stage where the 
husband performs the out-door labor, and 
the wife the household duties, often in- 
cluding also the duties of seamstress, 
cook, washwoman and nurse. This will 
always be the case, too, as long as our 
President, other high officials, million- 
aires and capitalists are bound together 
by a golden band, locked and secured 
by a golden key, which key the masses 
have not The silver key of the com- 
mon people, though of handsome design 
and imposing appearance, has proven 
itself unable to unlock the band. There- 
fore, as all women are not the wives of 
those within the circle, we must con- 
sider the condition of those outside. 

I want to say a few words from the 
text : u Multiply and replenish the 
earth. " This is the defense behind 
which so many men are hiding and ex- 
cusing themselves for what would other- 
wise seem heartless and unreasonable. 
Had no other command been given 
whereby man might gain entrance into 
the celestial city, he would have marched 
in in almost one solid phalanx. True, 
some have failed, but most of them have 
done what they could, which would have 
been all that was required. Unfortu- 
nately for them, there are other things 
required. Does not the same book say 
also: "Be merciful ?" I know a man 



whose very delicate wife went through 
one confinement and abortion after an- 
other until she was confined to her bed 
a great deal of her time, and once after 
an abortion she became pregnant again 
before she was able to leave her bed. 
Was this man merciful ? The same book 
says: " Be temperate in all things." I 
know a man whose wife has passed 
through fifteen confinements. Almost 
all of her children were abnormally pre- 
sented, and but few of them lived to see 
the light of day. Was this man temper- 
ate ? The same book says : u Do as you 
would be done by." Would you, O 
man, if it were possible, bring such 
trouble and suffering on yourself fifteen 
times? Or ten times? Or even five 
times ? It has also been asked : " Is it 
nothing that the longing for offspring in 
man should be disregarded ?" Physicians 
of America, how many wives do you 
know who have refused to gratify this 
longing to a reasonable extent? If in 
the homes of this land, when the wife 
and mother reaches a point when she 
feels the burden of childbearing is rest- 
ing too heavily upon her, she should 
suggest as much to her husband. If, 
instead of telling her that that was what 
he got her for, and that she owed him 
that for shelter and support, if, instead of 
such an answer, he would say: "Yes, 
dear wife, I have not been an unmoved 
spectator of your trials and sufferings, 
and am quite willing to do as you say. 
You shall have my hearty co-operation. 
You shall not become the helpless victim 
of my passion, just because you loved 
me well enough to leave your own dear 
family to follow my fortunes. You have 
left all for me, and in me you shall find 
a sympathizing friend and not a despotic 
tyrant." I believe if more husbands 
would give such a considerate answer as 
this the star of hope would once more 
arise in many homes where it has almost 
set Without the hearty approval of the 
husband, such a course cannot be pleas- 
ant Loving, true wives are willing to 
endure almost anything to keep pjeace at 
home and the fire of love continually 
glowing. It is only the cause of such 
wives that I am pleading. I have in my 
mind a case which occurred quite re- 
cently in our neighborhood. The family 
are very poor and already had a family 

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consisting of ten children. The father, 
being very domineering in his faqiily, the 
children relied chiefly upon the mother 
for sympathy and affection. That 
mother sleeps in a new-made grave, her 
death the result of an abortion. A lady 
told me that she said to her one day that 
she had begged her husband to stop it ; 
that it looked like they had enough 
children considering their circumstances. 

It was enough to bring tears to the 
eyes of the stoutest heart to see the or- 
phans, as they gathered around the bier, 
and to hear their piteous cries for 
44 mother" as they gazed for the last 
time on her cold and lifeless form, as she 
lay there the helpless victim of her hus- 
band's lust 

I hope that all men will not take ex- 
ceptions to my remarks. There are 
many, many noble men in our land to 
whom they in no way apply, and who 
are willing to always give to woman her 
just dues, and are ever ready to rise in her 
defense. I am willing for this article to 
be criticised, if done in an argumentative 
manner. I am seeking the truth, and 
more light on the subject. But please 
do not make too loud a noise unless your 
toes are trod upon. 

I am also aware that this article will 
not meet with the approval of all of my 
own sex. In listening to some women's 
opinions on this subject, I have more 
than once been reminded of the old plan- 
tation darkey, when one of his comrades 
was being flogged. He said, hoping 
thereby to gain favor with the master : 
44 That's right, massa, lay it on; he is 
nothing but a nigger, no how." 

In conclusion, I would say to all who 
seem to be so uneasy on this subject, go 
to the orphan asylums of the country and 
try to be satisfied with the number of 
children that are born; go and see the 
little homeless waifs of the streets in 
their wretchedness and misery, and con- 
sole yourselves with the thought that 
there are no more of them. 

I do not feel concerned or responsible 
for the unborn, but oh, the vast concern 
we should all feel for those who are born. 

I feel justified in saying that should 
our country ever reach the point when 
reason, instead of blind passion, governs 
the number of our offspring, we shall 
have reached a state of civilization which 



will be a blessing to mankind — and need 
I say to womankind ? — and which, I be- 
lieve, will have the smiles of an approv- 
ing God resting upon it 

Tenn. A Doctor's Wife. 

[Earnest, vigorous expressions from 
good and sincere women help to make 
our standards. A rather lengthy argu- 
ment on the danger of over-population in 
this country, and referring to the starving 
multitudes in India at present, was omit- 
ted from the above article. It is esti- 
mated that with proper co-operation and 
economy in production, and absolutely 
just distribution, the State of New York 
would easily contain and sustain the 
present population of the United States. 
When we were sending shiploads of pro- 
visions to starving Ireland, some years 
ago, Ireland was shipping provisions to 
England. The English lords who owned 
the land claimed the produce, while we 
helped to feed the starving ones who 
tilled the soil. Even now, in India, the 
propor distribution of the food produced in 
India is quite as great a problem as get- 
ting more food into the country. We 
have had hungry people in this country 
in the last few years, yet the productive- 
ness of the country and the industry of 
the people were not at fault Just and 
equitable economic conditions would put 
our demoralized producing forces in mo- 
tion, and there would be plenty and hap- 
piness for all. — Ed % ] 

The Marriage Question. 

Editor Medical World : — By way of 
introduction to the distinguished clien- 
tele of The Medical World, I would 
say that I am a physician's daughter, a 
physician's sister, and I expect not only 
to one day be a physician's wife, but to 
become a physician myself at no distant 
date. At present I only read The Med- 
ical World from the view-point of an 
all-' round newspaper woman, or woman 
journalist, and student of medical litera- 
ture. Dr. Waugh's reply to 4< A Doctor's 
Wife" has put me to thinking, and I 
cannot but wonder if his idea of mar- 
riage is representative of his sex as a 
whole. If it is, I think all self-respect- 
ing women should hesitate before enter- 
ing that holy (?) estate. Down in every 
woman's nature is an inherent desire to 
be loved for her own personal worth, and 

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not simply for the selfish purpose of per- 
petuating the human race. She wants 
to know that she counts for something 
in the life of the man for whom she 
%i leaves all others." Most women in a 
normal condition want to know that 
sometime they will have children of 
their own, not merely to prove to the 
world their ability to reproduce, but be- 
cause motherhood is a natural instinct 
with them. But the average woman 
wants to be sure that the man of her 
choice will love her as a part of himself; 
and would as soon think of giving up 
his own life as to think of putting her 
away because of her inability to bear 
him children ; that he would be happier 
with her in a childless home, than with 
some other woman and a house full of 
children. She wants to know that her 
own intrinsic worth appeals stronger to 
him than does the thought of perpetuat- 
ing his name. Knowing all this, she is 
willing to go through anything for his 
sake. Without this knowledge she would 
naturally feel that she had gotten the 
worst half of the bargain. She is a hap- 
pier wife and a better mother for know- 
ing that it is not necessary for her to 
bear children to make her husband love 
and revere her. 

Naturally, a woman is more willing to 
endure pain, and to bear tiresome and 
heavy responsibilities for the sake of a 
man whom she knows loves her unself- 
ishly, than for the sort of biped Dr. 
Waugh would have us believe tne aver- 
age man to be. If, as a rule, instead of 
an exception, man had the proper con- 
ception of woman, wifehood would to- 
day be an honorable estate, and matern- 
ity no longer the principal constituent, 
but the mere adjunct of happy married 
life, as the Creator first intended. Man 
has not far passed the limits of barbar- 
ianism when he marries for the sole 
purpose of having a family. 

I agree with the Doctor that a woman 
who knows her inability to bear children 
would be several sorts of a fool to marry 
such a man. The question is if any 
woman can be sure of happiness with 
such a one, for there is always a possi- 
bility that even a healthy woman might 
in that particular prove a disappointment 
to her husband. 

If a woman should marry a man who 



is physically unfit to procreate healthy 
offsprings, would she rush to the divorce 
courts to remedy her mistake, that she 
might marry a man who could ? I rather 
think that would be a sorry and disgust- 
ing spectacle, and yet where's the differ- 
ence ! Let's have a " single standard." 

Just here did it ever occur to Dr. Waugh 
that nine-tenths of the society women 
who come to him for knowledge on the 
question of prevention of conception are 
the wives of men who through lives of 
prior licentiousness are unfitted to pro- 
create other than syphilitic offspring? 
that their husbands are just too cowardly 
to themselves seek the desired informa- 
tion, and the women care less what opin- 
ion the physician forms of their motive 
than they do to conceal the real facts of 
the case ? The devil doesn't always get 
his dues. Neither do women, for the 
average man is prone to judge all alike 
as being capable of no unselfish act. He 
measures them by his own standard. 

There is only one way to remedy the 
existing state of affairs as I see it Let 
the law require every man and woman 
jcontemplating marriage to obtain first a 
certificate of health from a reputable 
physician. If the woman fail, and the 
man wants to call the deal off, why she 
is most fortunate in having escaped being 
the wife of a brute and a barbarian ; and 
the man will be saved the expense of 
divorcing her later on, or, as is a more 
frequent thing rearing a family of diseased 
children. 

This course must appeal to the stirpi- 
culturists, for it would most effectually 
put an end to the procreating of consump- 
tives, inebriates, criminals and a syphi- 
litic race. 

Suppose a woman, realizing her unfit- 
ness to become a mother, has the cour- 
age to eschew matrimony, and strike out 
for herself (for she must support herself 
or subsist on charity), one Dr. Parkhurst, 
and men of his ilk, assert that " those 
women who are inclined to shirk wife- 
hood, motherhood and domestic limita- 
tions are morally or intellectually wrong, 
or ambitious for conspicuity," etc 
44 They are usurping man's place," and all 
that sort of thing. Thtfs we are arranged 
4, twixt the devil and the deep blue 
sea." 

44 A Doctor's Wife " puts the matter 

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plainly and impartially. She evidently 
occupies an unbiased position. I heartly 
endorse her in her plea for weak, mis- 
guided femininity, who, having become 
the wives of brutes, have not the courage 
to cut themselves adrift therefrom. I 
also agree with Dr. Waugh that a healthy 
man has a perfect right to expect to walk 
the floor nights with the colicky " pledge 
of his dear one's love ' ' — always provided 
that " dear one " be in a normal state of 
health, and be, furthermore, willing to 
make her part of the " pledge." She 
has an equal right to a voice in the 
matter, when you consider the fact that 
she has to do the breeding, bearing and 
training of same * * pledge. " 

It is unfortunate that all women can- 
not go into marriage fully cognizant of 
all the truest meaning of that relation, 
its exactions and responsibilities; with 
an entire knowledge of their own physi- 
cal conditions, and the moral character 
and habits of the men to whom they 
entrust their future welfare. Hardly one- 
tenth of them look at this side of the 
question ; they consider it indelicate, and 
detrimental to their purity and womanli- 
ness, and in the innocence of ignorance 
go into a relation for which they are 
unfit, possibly with a man who is yet 
reaping the harvest of some early folly, 
and swell the monstrous tide of diseased 
and vicious humanity. 

With an earnest plea for wider knowl- 
edge, and, if need be, legislative reform 
on these questions, I am 
A Doctor's Daughter, and an 

Embyro M. D. 

[The writer is not consistent in pro- 
posing a law requiring every man and 
woman contemplating marriage to first 
obtain a certificate of health, and then 
supposing that, if the woman fail, the 
man can "call the deal off." A law that 
could be thus u called off" would be no 
law at all. The idea of such a law is 
beautifully and powerfully set forth in a 
book that I have just finished: u Man or 
Dollar, Which ?" Published by Charles 
H. Kerr & Co., 56 Fifth Avenue, Chi- 
cago; price 25 cents. It is both a medi- 
cal and an economic work, intensely in- 
teresting and very progressive. I strongly 
recommend it to all medical, as well as 
non-medical, readers.* 

To "A Doctor's Daughter " I would 



say : As a rule, I think that men love 
their wives and children, and give their 
best endeavors and deepest thoughts to 
their families. Even some of the mean- 
est men I have ever known have been 
unselfishly devoted to their families. 
One of the greatest disturbers of domes- 
tic peace is poverty, much of which 
could be prevented by better and more 
just economic and industrial conditions. 
Men wish to give pleasant homes and 
comfort to their families. The inability 
to do so disheartens them, and sometimes 
makes beasts of them. Feasible changes 
in our economic and industrial systems 
would result in devoted husbands and 
happy homes, where now is despair and 
consequent misery. For example, a gov- 
ernment telegraph system would not 
only give us ten word messages to any 
part of the country for ten cents, but it 
would employ about four times the pres- 
ent number of telegraph operators, with 
wages increased from the present pay of 
from $20 to $50 per month to from $40 
to $80 per month. Thus, from thirty to 
fifty thousand families would be comfort- 
ably supported on what now goes to the 
Gould family as dividends on capital 
mostly fictitious, and the country would 
have a larger, better and cheaper tele- 
graph service. That is a good way to in- 
crease the number of devoted husbands, 
contented wives, cheerful homes and 
happy families. The average man's na- 
ture is better than some women think it 
is, but his conditions can be vastly im- 
proved. — Ed.] 

*We wrote to Messrs. Kerr & Co. concerning 
the importance of getting such progressive 
books as this in the hands of doctors, and 
suggesting that they allow us to announce 
some special arrangement by which this could 
be done. They replied as follows : 

•• Your favor of March 11th is received. We should be 
glad if you would announce that you have made a special 
arrangement with ns, by which your readers can receive 
1 Man or Dollar, Which?' * The Effects of the Gold Stand- 
ard.' 'The People or the Politician' (a pamphlet on 
direct legislation), and a copy of our reform magazine, 
• New Occasions,' all on receipt of 25 cents in stamps." 

Mention this announcement with order, and 
don't send to us, but to Chas. H Kerr & Co., 
56 Fifth avenue, Chicago, 111. This is an ex- 
ceedingly generous offer. We have expressed 
ourselves in previous issues as to Dr. Smith's 
" Effects of the Gold Standard." 



Send subscription immediately if you want the 
180/ volume complete. 



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THE MEDICAL WORLD. 



Appendicitis Complicating Pregnancy. 

Editor Medical World: — As com- 
paratively few cases of this kind have thus 
far been reported, perhaps the following 
may be of interest On November 24, 
1896, I was called to see Mrs. G., about 
40 years of age, mother of six children, 
and near her seventh confinement Her 
general health usually good. She was 
suffering from severe pain in the region 
of the appendix, which came on sud- 
denly. Temperature 102°, pulse 120, 
tenderness over McBurney's point, and 
very marked rigidity of right abdominal 
muscles ; bowels constipated. The next 
day there was a small, ill-defined swell- 
ing in right inguinal region, which grad- 
ually increased. On the 27th, after a 
quite severe labor of about six hours, she 
safely gave birth to a fully developed 
male child. The placenta was adherent 
and very friable, but with care and con- 
siderable difficulty was entirely removed. 
During labor, pain was severe at times 
in the region of the swelling. The next 
two or three days the swelling was as 
large over as a small saucer, entirely dis- 
tinct from the well- contracted uterus. 
At this time, after what the nurse 
described as two quite copious and ex- 
tremely offensive stools, the swelling 
very gradually subsided, also the tender- 
ness and fever. She was discharged well 
December 10th. The treatment from 
the. first and throughout was the admin- 
istration of the sulphates of sodium and 
magnesium, equal parts, in water, every 
three or four hours in sufficient doses to 
produce easy liquid stools, five or six in 
the 24 hours ; also between these doses 
intestinal antiseptics, in this case zyma- 
cide (Reed & Carnrick) in 20 or 30 drop 
doses, mild counter irritation, carbolized 
*vagnial douches twice daily, liquid diet, 
and as perfect rest as possible. Opiates 
were not used but once in this case. 
E. A. Sanborn, M. D. 

Somerville, Mass. 

[Sudden or rapid appearance of a tumor 
in right inguinal region, with as sudden 
appearance of severe pain and fever, in- 
dicates fecal impaction. Slow and grad- 
ual appearance of an enlargement in this 
region, with dull pain and no fever 
(sometimes the temperature is subnor- 
mal) indicates appendicitis. In either 
case, clear the bowels, preferably with 



castor oil. This being done thoroughly, 
if a fecal impaction, it will be removed 
with disappearance of all symptoms ; if 
appendicitis, the local symptoms will 
probably be improved, but the symptoms 
will persist, or they may become quies- 
cent for a time and reappear later. The 
above case was one of fecal impaction and 
not appendicitis. — Ed.] 

Some of Our Needs. 

A lamp or lantern which can be used 
by the " country doctor " while wrapped 
in his oil cape on a dark, rainy night, 
while travelling on horseback. One 
which can be attached to the stirrup, or 
stirrup leather, or to the horse in such a 
way that the light will not be obstructed 
and will be thrown in front of the rider. 

A saddle rug which can be put off and 
on with ease for use in horseback riding. 
One which will envelop the lower limbs 
and body with comfort, and readily 
adjusted after the rider is in the saddle. 

A truss which can readily control in- 
guinal or scrotal hernia, and can be worn 
with comfort by a laboring man. 

Do not answer above unless you have 
something first-class to offer. Let us 
hear through The World. 

Kentucky. Country Doctor. 

" That Curious Fever ; " This Time In the Far 
West. 

Editor Medical World : — Two hun- 
dred miles east of Portland, Oregon, and 
fifty miles south of the Columbia river, 
in the foothills of the Blue Mountains 
(the healthiest tract on earth), at an alti- 
tude of 2000 to 4000 feet, on the prairie 
and through the timber, in an and belt 
where malaria is unknown, we, too, have 
had a " curious fever." Dr. Corry, in 
your February number, page 56, hits us 
very well. 

Not having DaCosta at hand, I am un- 
informed as regards his symptoms of the 
Chickahominy fever ; yet there we could 
well expect abundant vegetable germs, 
while here they should be almost absent. 
I read the article with interest; the 
symptoms were well portrayed and in 
harmony with our observations here. In 
a hundred or more cases within a radius 
of twenty miles, perhaps a loss of 15 per 
cent, would cover the mortality, most of 
them being cases remote from physicians 
and subjected to home treatment until 

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the sepsis bad gone beyond control. 
There were wanting in all these cases the 
well-grounded elements of typhoid fever, 
yet the anatomical lesions are not known, 
as no autopsies were had. In only a 
single case was there a hemorrhage of 
the bowels, and it terminated in recov- 
ery. No symptoms of ulceration or per- 
foration have been noted. There was no 
prodromal stage nor general malaise pre- 
ceding the onset, but it was generally 
ushered in without warning by rigors 
more or less severe, followed by a tem- 
perature of 102 ° to 105 , bounding around 
for days between that and normal. 

The only pain complained of was at the 
nerve centers — brain and cord. Cases 
seen at once or very soon after the onset 
yielded to the thorough cleansing of the 
alimentary tract with calomel every two 
or three days, and the system saturated 
with antiseptics — sulfo-carbolate of cal- 
cum, sulfo-carbolate of zinc and salol 
being most commonly used. 

That the fever is contagious as well as 
auto-infectious is beyond question, as it 
attacks one after another in a family, 
and if the hygiene is bad rarely one es- 
capes. The u watchers" (we have no 
nurses out here) are often attacked. Ages 
from 5 to 30 seem most susceptible, yet 
cases from 50 to 60 have succumbed to 
it. 

Antipyretics, such as coal-tar deriva- 
tives, et al. y seem to have but little effect, 
and are believed by some to be injurious 
— heart sedatives in line of the u big 
four " the same. 

Whatever the microbe may be, it is a 
prolific creature (I suppose they are crea- 
tures). The patient often yields to his 
ravages in from 5 to 10 days when left 
unmolested. Calcium sulfo-carbolate, in 
daily quantities of from 30 to 40 grs., 
seemed to act as a prophylactic when 
preceded by a calomel purge. Alimen- 
tation consisted of sterilized milk, egg- 
nog, bo vi nine, etc., as long as sepsis was 
apparent in the system. 

Ordinarily, if attacked vigorously at 
the onset, and with clean surroundings, 
the duration was from 6 to to days. 
The fight — asepsis vs. microbes — was 
greatly aided by clean surroundings; 
bed and body linen changed daily, with 
antiseptic baths, also carbolized solutions 
often sprayed about the room, and carbo- 



lized water constantly on the stove. 
With these conditions observed, a most 
violent case convalesced in about 8 days. 

An apathetic condition of the alimen- 
tary tract is worth mentioning in these 
cases. Many of them nearly proof 
against all ordinary cathartics. 

Dr. E. R. Swinburne. 

Heppner, Ore. 

Extra-uterine Pregnancy in the Lower Animal*. 

Editor Medical World : — On page 
79, February World, I find the follow- 
ing query : " Have you ever known or 
heard of a case of extra-uterine pregnancy 
in the lower animals ? " I will answer in 
the affirmative; and state that this 
condition is of as frequent occurrence in 
the lower animals as in the human sub- 
jects ; especially so, among sheep and 
cattle. In our less regard for our dumb 
brutes, we overlook the condition and 
allow our dumb patients to die. Extra- 
uterine gestation is frequently met with 
in ewes especially. For information 
concerning a recent case, I will refer 
you to my cousin, Thomas E. Hayes, of 
Granville, Ohio, who last yeaning season, 
met a case of the above-named condition 
in one of his own flock. 

E. J. Yeager, M. D. 

Graysville, Ind. 

Ectopic Fetation in the Lower Animals. 

Editor Medical World: — In reply 
to your inquiry, page 79, February 
World, regarding the ectopic fetation 
in the lower animals, I write to say that 
a case of this kind occurred under my 
own observation in the spring of '93. I 
was summoned by the owner to a mare 
which had been in labor two days with- 
out any result The anus and vagina 
were protruding, but no sensation from 
the latter ; the animal was nearly dead 
from exhaustion. I made an examina- 
tion and found the womb empty. I in- 
formed Mr. B. (the owner) that the mare 
would die, as the colt had formed outside 
of the uterus ; but that I would incise 
the abdomen and remove the colt, which 
he might raise by hand, and give its 
mother her only chance for life. He 
readily consented, and on making the 
incision found a very large colt encased 
in a provisional uterus, and inside of 
that the water-sack, which was very thin 

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a ad already ruptured, as some of the 
liquor amnii escaped when the incision 
through the outside sack was made. 
After delivering, the incision was well 
closed with strong interrupted sutures, 
and wound dressed with iodoform oint- 
ment. The mare survived the operation 
about five days ; the colt lived two weeks 
and seemed to thrive on cow's milk, but 
the family being scarce of milk with- 
held a portion of that at the end of two 
weeks and substituted corn meal gruel, 
causing dysentery, which ended fatally. 
I believe, since my experience with this 
case, that had the operation been done 
earlier, the entire sack removed and 
stump ligated, the mare's life could have 
been saved. 

Your " Monthly Talk" is deeply inter- 
esting to me, and I trust you may continue 
to go on with the good work till every 
physician in all this favored land will be 
induced to use every means in his power 
to investigate and stamp out the loath- 
some maladies that are afflicting our body 
politic, 

Zion, Va. E. M. Sneed, M. D. 

Amputation of Uterus of Cow. 

Editor Medical World :— On Feb. i, 
1897, a neighbor's cow gave birth to a 
well- developed calf at full term, expel- 
ling the womb, which remained external 
for several hours, until it became swelled 
so large that it could not be replaced. 
To give the cow a chance for her life, he 
drew a ligature around the womb close 
up to the vagina, and cut off about as 
much of the womb in bulk as two large 
human placentas, without any hemor- 
rhage. The stump was pushed back into 
the vagina. The cow ate heartily, showed 
no symptoms of suffering, and recovered 
as fast as if her labor had been normal. 
J. W. Shemweix, M. D. 

Bumper's Mills, Tenn. 

Paralysis— Jaundice—Diarrhea in the Aged. 

Editor Medical World:— A little 
less than a year ago, or in the April 
number of your admirable journal, I pre- 
sented two cases for the consideration of 
your numerous readers. I was favored 
with a good many replies in regard to the 
case of jaundice, but only one writer, 
Prof. Waugh, said anything about the 
case of paralysis. He called it "pro- 



gressive paralysis," and recommended a 
certain line of treatment, which failed, 
as everything had before, and left him as 
helpless as ever. I then advised him to 
quit medicine and rely on zris medico^ 
trix naturae, which he finally did. He 
has almost entirely recovered, though 
still weak in one of his limbs, which is 
gradually improving in strength and 
mobility. He can walk around very 
well now, by using a cane to help sup- 
port the weak leg. Was Dr. Waugh *s 
diagnos is correct ? and do such cases gen- 
erally recover, regardless of medical 
treatment, as this case seemed to do? 
And are they uncommon ? This is my 
first case. 

The case of jaundice, for which I was 
favored with so many replies, most of 
which recommended certain mineral 
waters, gradually became worse, and 
finally succumbed to the disease. As I 
was not allowed to make a post-mortem 
examination of the body, I could not con- 
firm my diagnosis of obstructed gall 
duct, or ascertain the cause of the 
patient's death ; though I think he finally 
collapsed from heart failure, as he died 
rather unexpectedly, for he was walking 
around his room the day before his 
decease. Although medical aid proved 
futile, you can give my thanks to those 
of the medical fraternity that offered me 
their assistance. 

I will again be thankful if some of my 
medical brethren will suggest some rem- 
edy for a case I have at present on hand. 
The patient is an old gentleman, border- 
ing on four-score years and ten. He has 
been troubled with a peculiar diarrhea 
for over a year; sometimes intense in its 
discharges, and again nearly natural, and 
always without any pain. Most of the 
time he has a good deal of hemorrhage 
mixed up in the watery discharges. 
They seldom improve in any respect, 
without I keep him under the influence 
of opium and acetate of lead, with a 
little ipecac in the capsules containing 
the combination. By keeping his stom- 
ach well stored with these remedies, he 
gets along tolerably comfortably ; but as 
soon as he ceases to use them, in a few 
days the trouble returns as bad as ever. 
He has also been annoyed with a disease 
of the skin, resembling eczema, but he 
is not troubled with that very much at 

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present I have tried most everything 
for his diarrhea, but nothing seems to do 
any good but the prescription above, and 
that only alleviates the trouble and 
doesn't cure it ; so I have about made up 
my mind that the disease depends on a 
relaxation of the sphincter ani muscle 
from old age, or internal hemorrhoids, or 
both, though I have not been able to dis- 
cover them by digital examination or 
speculum. The old gentleman's appetite 
is good all the time, and he is never con- 
fined to his bed. When the weather 
suits he walks about over his farm, super- 
intending his affairs. As he is one of 
our most substantial citizens, I would be 
giateful if "ye" Editor, Prof. Waugh, 
or some of the medical brethren would 
help me. I tried hot water injections, 
plain and combined with various astring- 
ents, but with little effect I have also 
dieted the patient without effecting a 
cure; consequently I will await the 
decision of the fraternity before I try 
anything else, I have never used any- 
thing to compare with fld. ext cascara 
sagrada for constipation in infants. I 
used, it not long ago for a child whose 
bowels were not moved more, than twice 
a week, with the happiest results, 
Slanesville, W, Va, K, Taylor, M. D. 
[Diarrhea in the aged is always a seri- 
ous matter. Relaxed sphincter is not the 
cause in this case ; either a relaxed con- 
dition of the bowels in general, or 
increased peristalsis, is the probable 
cause. If the former, which is likely, 
tincture of iron, in from five to ten drop 
doses after meals, will be a promising 
remedy. Lead astringents should not be 
given internally for any considerable 
length of time. The reason is obvious. 
We have many unobjectionable astring- 
ents. Increased peristalis, if present, 
will necessitate a little opium to control 
it until the cause can be removed, or un- 
til it disappears. A bland, non-irritating 
diet is important ; corn bread, fruits, etc., 
should be avoided until the bowel trouble 
is cured. — Ed.] 

Pneumonia, 

Editor Medical World:— I was called 
recently, with another physician, to see 
a boy 14 years of age who had had pneu- 
monia for eight days. He was in a dying 
condition. On examination I found his 



temperature to be nearly 106, pulse 140, 
and wild with delirium. The tempera- 
ture and delirium I learned had been so 
extreme for four days and nights prior 
to my visit. In reviewing the treatment, 
I was informed that acetanilid had been 
given to reduce the high temperature, 
and frequently repeated doses of Pea- 
cock's bromides with chloral added at 
each dose ; also hypodermics of morphia 
% and atropia 1-150 to quit the delirium, 
all to little or no effect* Now, in the 
opinion of the Editor, would it not have 
been more rational and effective treat- 
ment to have instituted from the first 
hydro- therapy to reduce the temperature, 
instead of the acetanilid, and, at the same 
time, stimulate the nervous system, 
thereby preventing or modifying at least 
this violent delirium ? Again, under the 
treatment of hydro-therapy, when the case 
demanded the use of the chloral, bro- 
mides, etc, as auxiliary measures, would 
not their therapeutic value be somewhat 
enhanced? In conclusion, I will state 
that I have used the baths in just such 
cases, with the best possible results, but 
would like to have an expression from 
the World's editor. 

W. Va. Subscriber. 

[Cool sponging or baths and less med- 
icine, particularly of the depressing sort, 
were strongly indicated in the above 
case. — Ed.l 

Urethral Trouble. 

Editor Medical World:— I have a 
case on which perhaps you or some of the 
World's readers may be able to give me 
a little assistance. I first saw the case in 
Dec, 1894, while he was under the care 
of another physician for stricture. He 
could only pass his urine a drop at a time, 
and neither the other physician nor my- 
self could pass even a filiform bougie, 
though we tried for about one hour. No 
operation was performed and he grad- 
ually became better, so he could pass a 
small stream. 

In Sept., 1895, he came to me for treat- 
ment of an acute gonorrhea. On April 
22, 1896, I operated upon him for strict- 
ure, doing the perineal operation. 

The recovery from the operation was 
uneventful, the wound healing quickly 
and without suppuration. The urine 
now passes freely ; in fact, there is a cer- 

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THE MEDICAL WORLD. 



tain amount of incontinence, so that he 
has to wear a rubber urinal through the 
day. It never troubles him when he is 
lying down, and is much worse some 
days than others. 

There is also a slight discharge from 
the meatus which responds to the test for 
pus. At times he has hot flushes and 
feels feverish. 

He has had epididimitis twice on the 
right side since the operation, and the 
second time an orchitis also, which sub- 
sided upon treatment. 

I have considered it a case of purulent 
inflammation of the deep urethra, and 
have done pretty nearly everything I 
could think of that gave promise of bene- 
fiting him. I passed a cold steel sound 
twice a week, at the same time adminis- 
tering 10 m. of oil of sandalwood three 
times a day. After this I irrigated the 
urethra with a weak solution of perman- 
ganate of potash nearly every day for a 
month. There was some soreness in the 
vicinity of the prostate, which is less than 
before, but with that exception there is 
no particular result. 

What I want is some treatment that 
will cure the purulent inflammation of 
deep urethra, prostate, or seminal tubes, 
wherever it is located, medicinal or op- 
erative. What can be done for the 
incontinence, or can anything be done ? 
111. Query. 

[Dr. J. B. Deaver says in regard to this 
case : Bougie up to the normal standard 
of the urethra. The chief trouble is in 
the anterior portion of the urethra. Have 
the patient to inject the following solu- 
tion twice a day : % gr. permanganate of 
zinc to 4 oz. of distilled water.— Ed.l 



In October World, 1896, page 385, 
beginning near bottom of second col- 
umn, is an article on " Incontinence of 
Urine," extending over on the next page. 
Sanmetto is the principal remedy men- 
tioned in the article. At the end of the 
article is the following editorial note : 
44 It is only fair to state that Dr. J. W. 
Hamer, of Johnstown, Pa., reports to us 
that he has failed to get results from this 
remedy." Some readers have construed 
4 'this remedy" to be nitro-glycerine, 
which is incidentally mentioned in the 
last paragraph of the article. We wish 
to make it clear that Dr. Hamer has 



failed to get results from sanmetto. We 
did not think this note could be misun- 
derstood. We now make it so plain that 
misunderstanding is impossible. To re- 
peat : Dr. J. W. Hamer, of Johnstown, 
Pa. , has failed to get clinical results from 
the use of sanmetto. 



Editor Medical World: — My case 
of abdominal plethora is doing finely. 
Hasn't had a faint since I showed him 
your advice in the World. Many 
thanks. Could never persuade him to 
rein up his appetite before. 

Hollow, Mo. Dr. P. E. Walton. 

Experience with Anti-Tubercle Serum. 

Editor Medical World: — Last No- 
vember I had a convesation with the Rev. 
N., pastor of the Swedish Lutheran 
Church. He said that he was suffering 
with lung trouble and had been for nine 
years. He had received treatment in 
Chicago hospitals. Had tried the climate 
of California and the mountains. Had 
been under the care of eminent physi- 
cians in Sweden, and now thought it of 
no use to take treatment from any local 
physician. I remarked that his would 
be a difficult ckse to treat, but that the 
anti-tubercle serum was reported to be 
giving good results and might possibly 
be of benefit to him. 

A few weeks later Mr. N. said he 
wished to give the treatment a trial. 
His condition then was as follows: 
pulse, 92 ; respiration, 24 ; temperature, 
100 j4 ; emaciation not very marked ; 
somewhat jaundiced ; has to walk slowly; 
appetite poor and stomach irritable ; 
posterior pharyngeal wall injected and 
so irritable that a light application of 
boric acid would cause vomiting. Ex- 
pectoration yellow in the morning, and 
later white and frothy. 

I commenced injecting the serum in 
the back of the thorax, in 15 minim 
doses every other day. There was no 
reactionary fever, but patient would sleep 
four hours in the afternoon after the in- 
jection. The appetite also began to im- 
prove, and there was a change in the 
character of the sputum. After using 
nearly one bottle, patient complained of 
scantiness of urine, and a deposit in the 
vessel. Upon examination I found it 
highly albuminous. I then sent some 

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163 



of the sputum to a hospital in Chicago 
for microscopic examination. It was 
reported free from bacilli. For these 
reasons I thought it best to discontinue 
the serum and began using potass, iodide, 
amnion, chloride, etc. ; also a tonic cap- 
sule containing quinine, iron, arsenic 
and strychnia, but none of it seemed to 
agree and the appetite got worse. Patient 
consulted another physician who pre- 
scribed calisaya and strychnia, which 
R. never was filled. I then used the re- 
mainder oi the first bottle of serum with 
the result of improving the appetite and 
general well-being of the patient. T 
ordered another bottle and am using the 
same doses once a week. I think that is 
better for the kidneys. 

The Lutheran pastors have a good many 
extra meetings about Christmastime, and 
Mr. N. said that he felt more able for his 
work than for a long time previous. 

There is some evidence of a small 
cavity in the left lung. 

While these results are not very strik- 
ing, still I have not noticed any reports 
of the somnolence and increase of ap- 
petite elsewhere. I am still using the 
treatment, but am not very hopeful of a 
complete cure. 

Alpha, 111. W. B. Gray, M.D. 

Editor Medical World:— J. E. Slicer, 
M.D., is asking for a blank-book to re- 
cord valuable articles, where and when 
read, in what journal, etc. I keep a 
44 Medical Index," printed by Joel A. 
Miner, Ann Arbor, Mich. It is very 
practical and suitable tor twenty years' 
work ; only costs $1.50 or $2.00. Send 
for it and you will never rue the expense. 
Success to the World family. 
Auburn, Neb. A. Oppkrmann, M.D. 

Comments and Replies. 

Editor Medical World: — I am 
treating most cases of consumption now 
with guaiacol benzoate, bovmine and 
petroleum emulsion. Brothers, try 
this treatment, and add inhalations of 
protonuclein (special). 

Hemorrhoids can be cured by means 
of electrolysis. I am curing them pleas- 
antly, permanently and profitably. Also 
curing a case of procidentia recti of thirty 
years' standing the same way. 

"Country Doctor:" Vienna paste is 



an excellent application for removal of 
cancerous growths, if not situated over 
or too near important blood vessels. It 
is easily managed. 

Dr. J. B. Simpson, Mountain House, 
Ark. : If the ulcer has calloused edges, 
apply arg. nit. to soften. Wash ulcer oc- 
casionally with dilute hydrogen peroxide. 
Draw edges as close together as possible 
with adhesive strips, leaving room for 
applying medicine. Apply new strips 
every day. Dust ulcer each day with 
aristol or protonuclein (special). At night 
apply bovinine on absorbent cotton, or 
inject in edges of ulcer. This will cure. 
Doctor, you cannot keep some of these old 
ulcers cured, especially in persons that 
have diseased veins, and you most al- 
ways find this the case. 

J. T. Barnbtt, M. D. 

Hardinsburg, Ind. 

That Case of "Bilious Colic." 

Editor Medical World : — In your 
reference to my article in the March 
number, you ask me if I believe the 
case was one of gall-stone colic. I an- 
swer, no; it was one of congested liver, 
or, as some say, "an inactive or slug- 
gish liver," with consequent stomachic 
disorder. The symptoms were sharp 
pains and tenderness in right hypochon- 
driac and epigastric regions, prolonged 
vomiting of very bitter greenish matter, 
violent headache, heavily yellow-coated 
tongue. All symptoms greatly aggra- 
vated by the least motion — a case of 
what so many people call " bilious- 
ness," only much intensified and recur- 
ring at almost regular intervals. I used 
the term "bilious colic" because the 
patient used it as the term her doctors 
had given her for it The point to be 
noticed is, that a trouble which had re- 
curred at intervals for years returned no 
more after taking the remedies, or when 
indications of a return presented them- 
selves the remedies promptly headed off 
the attack. Perhaps, as my friend, an 
old-school doctor, suggested, it was only 
a case of coincidence. Perhaps all cases 
of cures and palliations are "coinci- 
dences." 

Have the readers of The World ever 
used permanganate of potash in the 
treatment of scarlet feVer ? I never saw 
it spoken of in r^tio d ^ to the treatment 



1 64 



THE MEDICAL WORLD. 



of that disease except as a gargle for the 
sore throat. I have used it with marked 
success. I make a solution a bright 
purple color and give a teaspoonful 
every hour or two, either alone or in al- 
ternation with some other remedies. If 
others have used it I should like to know 
their success. I will write up a case in 
which it seemed remarkably successful, 
if the Editor wishes it. 
Babylon, N. Y. A. J. Woodruff, M.D. 
[Would be pleased to have an article 
from you on scarlet fever. Perhaps it 
will start an interesting discussion. We 
have not had much on that subject for 
some time. — Ed.] 

Nutmeg Liver. 

Editor Medical World:— Will you 
please inform u Medic " that he can find 
all the information desired about 4t nut- 
meg liver" by consulting Dickson's 
"Elements of Medicine," 2d Ed., 1859, 
page 569 ; Bennett's " Practice of Medi- 
cine," 3d Ed., 1866, page 517, fig. 427 ; 
perilobular, fatty, or nutmeg liver, page 
518 ; for full description, commencing 
at third line from top, and fig. 428, pig- 
mented nutmeg liver. 

Robert W. Short, M. D., 
U. S. Examining Surgeon. 

Media nicsburg, Pa. 

Quick Relief for Lumbago* 

Dear World :— I have found out Aat 
The World is read. I answered t/day 
|r on " Quick Reljff for 
rfished in the Dramber 
Laticet copied thrarticle. 
say the mixtur# cannot 
publish whawurdrug- 
fche way, theiw is none 



the 127th lett^ 
Lumbago," pv 
World. The 



Quite a num 
be made. Pl< 
gist (and, by 
better) says. 

Woodstock, 
W. S. Cline, 

Dear Doctor 
ing that many 
complain that y 
Relief for Lumb 
torily prepared; 
tinizes. In reply 



W. 
D., 

I have you 

f your co 

formula 

o" canno 

at the 

would 



Cline. 



should be no trouMe with 

if the collodion is Made aci 

S. P. 1890, with et%r th 

1890 test. The collWi 

are mixed, and the 

added ; or the tr. iodine and aq. amm. 

fort, are mixed and the collodion added ; 



note stat- 

spondents 

r u Quick 

satisfac- 

ture gela- 

that there 

is mixture 

rding to U. 

answers the 

nd tr. iodine 

mon. fortoir 



it makes no difference which way. The 
mixture is then to some extent gelatin- 
ous, but after an hour or two, with occa^ 
sional shakings, the mixture becoi 
entirely fluid. After 
hours more the iodine 
orized, and the mixtt 



ber color. I am in 
the difficulty is mor| 
tience than impu 
there is no tricice 
preparation as soi 
you. Let them 




lk that 

impa- 

certainly 

making the 

suggested to 

again and wait 



two hours before writing. Yours truly, 
Woodstock, Va. B. Schmitt. 

Unnecessary Medication in Infancy. 

Editor Medical World : — When 
three days elapse, and a healthy growing 
infant that has never taken a drop of 
medicine has no action of the bowels, 
the old ladies become alarmed. Imme- 
diately the baby is doped with castor oil, 
and after that more or less illness fol- 
lows. Soothing syrups, paregoric, etc, 
then alternate day after day with oil or 
other cathartics, and ere long the doctor 
is called. 

It is very evident to him that the first 
dose of oil was given needlessly. The 
rapid growth of an infant in the first few 
weeks after birth often consumes nearly 
all the solids of the ingested milk. Under 
such circumstances, to hurry the partly 
digested milk out of the body with a 
dose of oil not only disturbs nature's 
harmony, but it inflicts temporary star- 
vation upon the child. Hungry absorb- 
ants wire their woes to the reflex centres 
that preside over peristalsis, and then 
confusion all along the alimentary canal 
begins. The baby has colic, whereupon 
the lady of large experience begins the 
use of various opiates. 

It is generally supposed by the laity 
that nature is unfit to attend to an in- 
fant's defecation. This prevailing error 
should be uprooted, for it undoubtedly 
figures largely in the infantile death 
rate, to say nothing of the far- reaching 
eftects of unnecessary medication in years 
after. Dr. C. E. Boynton. 

Los Banos, Cal. 

[A soap suppository, or a small in- 
jection of water, is better than a dose of 
oil, to secure an evacuation in an infant 
—Ed.] 



THE MEDICAL WORLD. 



165 



Quiz Department. 



Questions are solicited for this column. Communications 
not accompanied by the proper name and address of the 
writer (not necessarily for publication) will not be 
noticed. 

The great number of requests for private answers, for the 
information and benefit of the writer, makes it neces- 
sary for us to charge s fee for the time required. This 
fee will be from one to fire dollars, according to the 
amount of research and writing required. 

Queries received from " E. F. B. "— Commu- 
nications without the name of sender (not nec- 
essarily for publication) do not receive atten- 
tion . 

Who will suggest a remedy for eczema of the 
joints ? I have charge of a case which has 
failed to yield to my usual mode of treatment. 
The general health of the patient is good, yet 
the case seems very obstinate. B. 

Tenn. ' 

Editor Medical World : — Is there 
any foundation for the belief prevalent 
among the laity that the use of cotton- 
seed oil in any form as an article of diet 
will diminish sexual vitality ? 

Somerville, Mass. E. A. Sanborn. 

Hodgkin's Disease. 

Editor Medical World :— I have a 
long-standing case of Hodgkin's disease 
under treatment, with intense pruritus. 
Temperature runs about 101 . Have 
about exhausted the materia medica, but 
still without much success. Solution 
calcium chloride seems to ease itching 
somewhat, and triple bromides the ner- 
vousness, but still not much. Patient 
sleeps little ; very nervous ; good deal of 
laryngeal cough from pressure of en- 
larged glands, I think, as lungs seem 
normal. Shall be glad to hear at once 
from yourself or any of the " brethren " 
as to what they would suggest, after hav- 
ing had experience in cases of this dis- 
ease. Thos. D. Hulme, M. D. 

Commerce, Polk Co., Iowa. 

Hemorrhage from Urinary Tract. 

Editor Medical World : — Male, age 
30 years, fair complexion, medium size, 
weight about one hundred and twenty 
pounds. Three years ago he had a bad 
case of gonorrhea, which lasted five 
months. He used nitrate of silver 
injection. Since that time he has had 
hemorrhage of the bladder, which never 
has stopped ; keeps him very weak. I 
have tried all the remedies recommended 
in our text-books. Nothing seems to 



benefit him, only tincture of iron. If 
he has anything to do with his wife the 
hemorrhage is exaggerated. Any advice 
that will help me cure my patient will 
will be appreciated. 

Redfork, Ark. M. S. MOORE. 

[Dr. J. B. Deaver says of this case: 
To determine the source of hemorrhage, 
explore the urethra and bladder. There 
might be a stricture with a granulated 
surface behind it. Chemical and micro- 
scopic examination of urine should be 
made. Is there any pain ? If so, is it 
before, during or after urinating? Is 
there loss of flesh or strength ? Papil- 
loma of the bladder is suggested. — Ed.] 

Impotence. 

Editor Medical World: — I beg to 
submit a case of impotence under my 
care, with the hope that I may receive 
some light on the subject which will en- 
able me to treat it successfully. 

The patient practiced masturbation 
when young, beginning before puberty, 
and continuing until the act ceased to be 
of much pleasure. At about twenty he 
began having intercourse with women, 
but found that emissions occurred too 
soon and erections were weak. At about 
twenty-eight about all desire for inter- 
course had ceased. Now, at thirty-five, 
he has no desire for intercourse; penis 
shrivelled and cold. Through most of 
this period night emissions with good 
erection have been frequent. Lately they 
have been diminishing greatly, but it 
seems as soon as there is any energy 
stored up, a night emission occurs, with 
erection, but no sensation. Patient is 
single, and always has been, and is now 
the picture of health. He is an intelli- 
gent man of good habits. I have tried 
many drugs and the vacuum treatment, 
without the slightest good. He, of course, 
is very anxious for relief, and if any of 
your readers can give me a good sug- 
gestion I shall feel very grateful. 

G. Nelson Dolbeck, M. D. 

Port Chester, N. Y. 

[Dr. J. B. Deaver thinks that by the 
use of electricity and strychnia the pa- 
tient can be benefited ; perhaps restored. 
Use the Faradic battery, one pole in rec- 
tum and the other over the external 
genitalia. Local weakness is the cause 
of the too frequent emissions.— Ed.] 



166 



THB MEDICAX WORLD. 



Current Medical Thought, 

Recent Expressions of Modern Views of 
Pneumonia. 

There is hardly a prominent medical 
periodical, at the ontset of the year, that 
did not contain some interesting authori- 
tative allusion or paper, or some readable 
discussion on this very serious morbid 
condition. We are disposed to conclude 
from this that there is not yet perfect 
unanimity in the minds of practitioners 
either as to its pathology or treatment 
Here in Philadelphia, for instance, at a 
meeting of the Philadelphia County 
Medical Society, held just before the ex- 
piration of the year 1896, Dr. Thomas J. 
Mays read a valuable paper advocating, 
from collective investigation of a series, 
of cases, the local application of cold in 
acute pneumonia, and urging the view 
that the morbid process is in a great 
measure dependent on serious disturbance 
of the nervous system, in which the respir- 
atory nerves and centre participate very 
largely, and hence the increased frequency 
of breathing in this disease may be due 
partly to central and partly to reflex influ- 
ences. Moreover, he stated,* in close ana- 
tomic contact with the respiratory, the 
polypneic, and the heat-centres, is the con- 
vulsive centre, and in this close compan- 
ionship we have, perhaps, an explanation 
why almost all inflammatory diseases 
that implicate the base of the brain are 
attended with a frequent respiratory rate, 
high fever from the onset, with little 
fluctuation, together with convulsions 
occurring with greater or lesser fre- 
quency. The oblongata contains another 
centre, viz., the cardiac centre, which is 
invariably involved in pneumonia, and 
plays a very prominent r61e throughout 
the course of this disease. The thera- 
peutic indications are brought out very 
prominently : (1) abatement of the local 
process in the lungs ; (2) reduction of 
fever, and (3) allevation of cerebral and 
general nervous irritation. He believed 
that cold, applied externally, would 
meet these demands more satisfactorily 
than any other measure. Not only will 
it allay the morbid process in the lungs, 
but it possesses a direct ameliorating 
influence on those nerve-centres which 

* The Philadelphia Polyclinic, January 9, 1897. 



Elay a responsible part in the pathological 
istory of acute pneumonia. 
Different views are held by other 
authorities, who gave expression to them 
in the columns of several of our contem- 
poraries. Dr. Osier, for example, holds 
the modern view that the toxemia is the 
most dangerous element in pneumonia,! 
and that the interference with respira- 
tion and the circulation is of far less im- 
portance. He believes that it is to this 
that the excessive mortality from pneu- 
monia is due, and this belief contains 
for him little that is encouraging, for he 
confesses that we know of no means by 
which we may combat effectively the 
poison of the disease. 

Dr. Simon Baruch, of New York, holds 
the same views as Dr. Osier concerning 
the part played by toxemia in the 
mortality of the disease, but he has much 
greater confidence in the result of his 
thereapeutic measures, although admit- 
ting that the outlook in each case is very 
uncertain. He relies chiefly upon the 
effect of wet compresses, applied at a 
temperature of 6o° F., and renewed 
every hour or half hour, according to 
circumstances, although he also gives 
Learning's "sedative dose" of calomel 
(10 to 20 grains) at the beginning, and 
hypodermic injections of strychnine to 
spur up the flagging heart — two remedies 
which have been found efficacious in 
certain cases, even when not combined 
with hydrotherapy. These methods, in 
his view, offer, at the present time, the 
most favorable, yet not perfect, results 
in the management of patients suffering 
from pneumonia. % 

Dr. A. H. Smith, in another paper, 
refers to the familiar method of treat- 
ment of croupous pneumonia by inhala- 
tion, but doubt as to its practicability 
exists. "There is hope," says our ex- 
cellent contemporary just quoted, "that 
in pneumonia as well as in typhoid fever 
we may yet have an antitoxin upon 
which we can rely to save the patient in 
cases in which we fail (as we doubtless 
often, if not always, shall) to strangle 
the disease in its inception." — Editorial 
in Col. and Clin. Record. 



\Amer. /our. of the Medical Sciences, quoted 
in Med. Record. 



*fl§fl^y®Ob£ 



THE MEDICAL WORLD. 



167 



Facial Erysipelas Treated by Turpentine. 

KdwardO. — Case developed upon the 
ward and was immediately recognized 
by Dr. McAlexander. Patient had 
severe chill, and temperature rapidly 
ran up to 105.4, pulse 132. Patient had 
coated tongue, nausea and considerable 
muscular soreness. Gave extract pilo- 
carpi fluid, twenty drops, spirits frumenti 
one-half ounce, tincture ferri chloride 
twenty drops and four grains quinia 
every four hours. Applied ung. zinci 
oxidi and tincture iodide to the inflamed 
area, and kept head wrapped in hot bi- 
chloride towels all the time. The inflam- 
mation continued to spread until the 
whole face and scalp was involved. On 
the third day the patient became very 
delirious, and opium and chloral had to 
be used to keep him quiet On the 
eighth day the eruption began to subside 
and the patient improved rapidly, and 
was removed back to the hospital ward 
on the eleventh day. This patient was 
in the hospital for treatment for enlarged 
and suppurating cervical glands, which 
were very markedly improved by the 
attack of erysipelas. 

John J. was brought to the hospital on 
the fifth day of the disease ; temperature 
then was 104.2, pulse 122 ; eruption all 
over face and head, except chin. He 
was very delirious, and had to be watched 
until quieted by morphia, chloral and 
bromide. A mixture of ichthyol one- 
half ounce and lanoline one and one- 
half ounce was used as the local appli- 
cation, and the internal medication was 
same as Case 1. There was considerable 
suppuration and the hearing much im- 
paired. On the fifth day ofter admission 
the temperature began to decline, the 
delirium to abate, and on the eighth day 
the patient was discharged, not well, but 
out of danger and able to go home. 

Anna B. — When admitted the eruption 
covered all of one side of face and half 
the other; patient had coated tongue, 
foul breath, was nauseated, and had per- 
sistent vomiting; temperature 105.4, 
pulse 136. Gave cerium oxalate and 
ingluvin to quiet stomach, used stimu- 
lants, and applied common commercial 
turpentine freely to the inflamed area, 
and especially to its elevated border. 
Patient complained of some smarting 
where the turpentine touched the healthy 



skin ; otherwise was not painful. The 
eruption did not spread farther after the 
application. Patient never was delirious, 
and was discharged entirely well on the 
seventh day. I conceived the idea of 
using the turpentine on account of its 
germicidal, antiseptic and penetrating 
properties. 

In all the cases, of course, the bowels 
were thoroughly opened and kept regular. 
Nutritious and easily assimilated foods 
were supplied when the stomach would 
bear anything.— Dr. W. D. Schwartz, 
in Indiana Med. Jour. 

Cases Cured by Hypnotism. 

Dr. R. Osgood Mason, of New York 
City, has an exceedingly valuable article 
on "Educational Uses of Hypnotism," 
in February issue of Pediatrics, from 
which we quote the following cases : 

Case HI. — A little boy, seven years of 
age, was a most unhappy coward — afraid 
of the slightest pain, and a coward and 
cry-baby amongst his playmates. He 
had some slight disease of the scalp 
which it was necessary to treat, but he 
would cry and run away the moment I 
entered the room. After one or two un- 
happy and only partially successful 
attempts at treatment I decided to try 
suggestion. Placing him in a chair 
opposite me, I took his face and head 
firmly between my hands, and putting 
my face near his, I commanded him to 
look steadily in my eyes. It was very 
difficult to secure his attention, but, hav- 
ing succeeded, I soothed him with passes 
and light touches, until his eyelids 
dropped — he was perfectly quiet, subject- 
ive and sleepy, but not asleep. I then 
suggested that he would no longer be a 
crying, whimpering coward, but a strong, 
brave boy ; that he would take his treat- 
ment without fear, and that he would 
stand up sturdily for his rights among 
his playfellows. This was repeated over 
and over, gently but firmly — he all the 
while remaining passive and sleepy, and 
apparently taking no notice whatever of 
my suggestions. The next time I called 
he was shy but not troublesome, and 
with two or three repetitions of the sug- 
gestions he came promptly and bravely 
to his treatment 

I was also informed that the change in 
his manner among his playmates was 

Digitized by CjOOQIC 



1 68 



THB MBDICAI, WORLD. 

! i 



equally marked ; certainly all cringing 
and cowardly manner has disappeared, 
and he seems self-reliant and happy. 

Case IV. — A little girl, five years of 
age, was afflicted with night-terror. She 
went soundly to sleep when first put to 
bed, but after two or three hours she 
awoke screaming and trembling with 
terror, on account of the hideous black 
man whom she saw in her dream. The 
impression of the dream was vivid and 
persistent, and her screams kept the 
household aroused and alarmed for hours 
every night, and this state of things had 
already continued for months. One day 
when she was perfectly bright and happy 
I placed her in her high chair in front of 
me — put my hands gently upon her 
shoulders, and asked her to look steadily 
at a trinket easily in her view, and 
quieted her with passes and soothing 
touches until her drooping eyelids de- 
noted the subjective condition. I then 
commenced in a gentle, sing-song man- 
ner to suggest that she would go easily to 
sleep as usual at night, but that she 
would have no frightful dreams, that she 
would see the dreadful black man no 
more, but would sleep quietly on the 
whole night through. It was repeated 
over and over in the same gentle man- 
ner. 

That was a year ago— she has not seen 
the black man since, and her sleep and 
health have been perfect There was no 
repetition of the treatment 

Passing to still another class — that of 
sexual perversity — it would seem un- 
necessary to add anything to the work 
which has been done and reported by 
Krafft-Ebing, Von Schrenk and other 
well-known writers. 

Case V. — A tall, but pale and flabby 
boy, 1 6 years of age, was, at the request 
of his father, a prominent public man in 
a neighboring city, brought to me by his 
teacher, on account of the habit of self- 
abuse, and also the cigarette habit His 
memory was impaired ; he was backward 
in his studies ; he was dejected, dull and 
unmanly. He was under treatment by 
suggestion once a week, sometimes only 
once in two weeks, during two and a 
half months. The habit of sexual abuse 
was entirely cured in one month ; the 
cigarette habit was reduced to a cigarette 
once in a week, sometimes only one in 



two weeks. His memory and interest in 
his studies were both greatly improved ; 
he passed his examination with a per- 
centage which quite surprised his 
teachers and friends. His father after- 
wards called on me to express his thanks, 
and he informed me that the boy, in ad- 
dition to his improvement in his studies, 
had wonderfully improved in appear- 
ance, in brightness, self-respect and 
manliness. lie was sent to Europe to 
study and passed from under my obser- 
vation. 

Class-Room Notes. 

[Prom Colrege and Clinical Record.] 

In the internal treatment of Abscess^ 
the following tonic pill is of value : 
R. Strychninae sulph., - gr.j 
Feni redact, - gr. xv- 

Qaininae sulph., - gr. xx. M. 

Fiant pil. 20. 

Sig — One three times daily after meals. 

— Hare. 

An excellent dusting powder to be used 
in Excessive Sweating is as follows : 
R. Pulv. acidi salicylici, gr. x-xx 
Pulv. acidi borici, dr. ij 
Pulv. amyli, dr. vj. M. 

— Stelwagon. 

In Acute Eczema the following wash 
may be used, allowing the sediment to 
coat over the parts : 
R Calamine, 

Zind oxidi, aa . dr. ij vel dr. iij 

Glycerini, 

Alcoholis, aa fdr.j 

Wq. calcis, . . f oz ij 

Aquae, q. s. ad . f oz. ij M. 

— Stelwagon. 

In Fibroma Uteri of small size, where 
the removal would be associated with 
danger to the structure of the uterus, 
Pro? Montgomery advises the use of five 
grains thyroid extract three or four times 
daily, with a view to the absorption of 
the growth. 

To remove Comedo, or 4C blackheads,'' 
use pressure, frequent washings with hot 
water and tincture of green soap, and the 
following stimulating lotion : 
R Zinci sulph at is, 

Potassii sulphureti aa dr. j 

Aq rosae, .... foz iv M. 
If irritation is produced, discontinue the 
prescription for a time. 

— Stelwagon. 

Digitized by VjOOQIC 




THE MEDICAL WORLD. 



169 



"I have not 
years, by puttin 
and' fifth d< 
at once to 
during the 
gestation, n 
case I was co 



many 

r the fourth 

put an end 

of pregnancy, 

aining period ot 

what stage of the 

" — Prof. Parvin* 




Malaria, Influenza, Etc. 

Sander & Sons' " Eucalyptol," 'five 
to fifteen drops in hot milk or brandy 
and milk, three times a day. 

Grape Seed* and Appendicitis. 

We do not suppose that any amount 
of medical literature will ever disabuse 
the public of the idea that grapes are a 
dangerous fruit. So far as that is con- 
cerned there are some physicians who 
still hold to the idea that grape seeds 
are a frequent cause of appendicitis. In 
order to determine what toundation there 
was for this belief, Dr. Edmund An- 
drews, of Chicago, has made a study of 
the statistics of his city for every month 
during the last fourteen years. His re- 
port is published in full in a late number 
of The Journal It appears that there 
have been 3,709 cases of appendicitis in 
Chicago during this time. These cases 
are all arranged by months that it might 
be seen whether there were more cases 
of this disease during the grape-eating 
season or within a reasonable period 
after its close. The figures show con- 
clusively that there was no increased 
frequency during the four grape-eating 
months. In fact, precisely the opposite 
was true, for during this time there was 
a diminution in the number, due proba- 
bly, so the author says, to the fact that 
during these months there is less consti- 
pation and impaction of the colon than 
at other times of the year. While the 
majority of authors quoted in the article 
do not deny the possibility of appendici- 
tis being induced by foreign bodies, yet 
they think this cause is a rare one. 
They hold to the belief that catarrhal 
inflammation is the origin of most cases. 

Dr. Andrews gives good reasons why 
it is difficult for a seed or any other for- 
eign body to enter a healthy appendix. 
He concludes that there is no scientific 
proof whatever that grape seeds are any 
more disastrous than the hundreds of 
other small objects which we daily 
swallow with our food. This is most 



gratifying, and an effort should be made 
to let the public know this fact, for 
grapes are among the healthiest and 
>st agreeable of all fruits, and it is to 
regretted that any public delusion 
should prevent their use. — National 
Medical Hezriew. 



To Members of the Medical Profession, Indi- 
vidually, in the Interests of Medical Science. 

As there is evidence tending to prove 
the theory that all persons predisposed by 
heredity to consumption have a respira- 
tory capacity or action insufficient for 
good, vigorous health, probably apropor- 
tionately small chest with insufficiency 
of lung membrane — that the predisposi- 
tion is mainly or primarily due to this 
cause; in other words, that the insuffi- 
cient respiratory function is the special 
primary feature of the predisposition (a 
condition which may be, practically, ac- 
quired by habit, occupation, etc,), I de- 
sire the co-operation of the profession in 
an endeavor to help to establish, by 
means of collective investigations, the 
correctness or otherwise of this theory. 

In this behalf I hereby ask all physi- 
cians who have patients predisposed to, 
or in the early stage of consumption, to 
send to me (on a post card will suffice), 
the information below indicated. As 
soon as I can study and collate the re- 
plies I shall make the results known to 
the profession. 

Give (1) name or initials; (2) sex; (3) 
age ; (4) occupation ; (5) height ; (6), 
weight, average when in usual state of 
health ; (7) circumference of the chest on 
a level with sixth costo-sternal articula- 
tion when momentarily at rest after an 
ordinary expiration, and also (8) after 
habitual natural expansion or inspira- 
tion, which last (8) usually exceeds the 
first measurement, expiration (7), by an 
increase of only about one-fourth of an 
inch ; finally (9), the circumference after 
& forced expiration, and also (10) after a 
forced inspiration, these two measure- 
ments, 9 and 10, varying or showing a 
range of from 1 J^ to 4 inches. The pa- 
tient should, of course, be as calm as pos- 
sible, and had better, usually, practice 
the forced breathing for a few acts before 
these two last measurements, 9 and io v 
are taken. 

To be of value, all four measurements 

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should be taken as carefully, accurately 
and free from haste as possible. 

Any further information, in brief, as to 
degree of heredity (family history) in 
cases, prominent symptoms — loss in 
weight, cough, dullness on percussion, 
etc., or any remarks, will be a decided 
advantage. 

Measurements of two cases, or several, 
or the average, could be given on one 
card. 

With the hope that many will comply 
with the above request, and with much 
respect for and interest in the profession, 
I am, yours- truly, 

Edward Playter, M. D., 
Ottawa, Ontario, Canada. 



Contagious Impetigo. 



This is a self-limited contagious dis- 
ease of children, appearing in localized 
epidemics, and first described by Tilbury 
Fox in 1&64. Accompanied by a mod- 
erate fever and some gastric disturbance, 
there appear on the face and hands 
groups of flat vesicles filled with trans- 
parent or cloudy serum. These dry up 
into characteristic golden-yellow crusts, 
which fall off in two or three weeks, 
leaving circular, reddened, non-ulcerated 
areas behind. Successive crops of ves- 
icles may prolong the disease for two 
months or more. It is undoubtedly 
parasitic, but, though Kaposi claims to 
have found it, the etiological factor is 
still unknown. The treatment consists 
in removal of the crusts with olive oil 
compresses, cleansing the skin with hot 
water and soap, boric acid solution, etc., 
followed by the use of Lassar's paste : 
R Acid, salicylic, ... 3° grs. 

Petrolati, .... 1 oz. 

Zinci oxidi, 

Amyli a a. 1 2 oz. 

—William S. Gottheil, M. D., 
In " Pediatrics," October, 1896. 

Tentative Thyroid Therapeutics. 

Dr. Walter Lindley, of Los Angeles, 
Calif., has a good paper on this subject 
{South Calif. Practit, Nov., 1896). After 
reviewing the literature on it, he says it 
has been used in the form of desiccated 
thyroid ; some use tabloids ; many ad- 
minister the fresh sheep's thyroid finely 
hashed as a sandwich — having first re- 
moved the capsule ; some use three to 



twenty minims glycerine extract in. 
water. Undue acceleration of pulse — 
from ten to twenty additional beats a 
minute— indicates that the dose is quite 
large enough ; or a rise of temperature 
of one degree above normal also shows 
that the dose is too large. An overdose 
causes gastric irritation, nausea, heart 
weakness, dizziness, tremor, fever, rest- 
lessness, polyuria, and sometimes glyco- 
suria. It is contraindicated in acute in- 
sanity, tuberculosis, valvular heart 
disease, miasmatic states generally, etc 
The following are the conclusions of the 
paper: 

1. It has passed the experimental 
stage in the treatment of myxedema, and 
is a specific for that condition. 

a. There have been numerous un- 
doubted cures of obesity by its use. 

3. The results of its use for uterine 
fibroids are encouraging, and justify 
further trial. 

4. The reports where it has been used 
in the treatment of syphilis are favorable, 
but there is not enough data upon which 
to base an opinion. 

5. It has proven useful in the treat- 
ment of psoriasis and lupus. 

6. The reports as to its usefulness in 
goitre are conflicting, but it should be 
thoroughly tried before operation is de- 
termined upon. — Vcu Med. SemuMo. 

Our Monthly Talk. 

Money is a medium of exchange. 

Money is a portable system of accounts. 

Money is a convenient system of book- 
keeping. 

Money should not be a commodity, as gold 
or silver. 

Money is a legal creation. 

To print money on gold or silver is like 
keeping accounts on plates of gold or silver. 

Account books are made of paper. 

Money should be printed on paper. 

Notes, mortgages, bonds, etc,, are printed on 
paper, but their value is not in the paper they 
are printed on, but in what they represent. 

Money gets its value, not from what it is 
printed on, but from what it represents. 

Suppose a mountain of gold were suddenly 
discovered ; what would be the attitude of 
the banks and the " money power" toward 
gold ? Would they then consider the relation 
between products and gold an important mat- 
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171 



ter? When we had discoveries of silver in 
our country, the money power promptly de- 
monetized it. If a mountain of gold were 
discovered they would want to demonetize it, 
and monetize platinum or diamonds. They 
want scarce and dear money, so producers of 
real wealth, farmers, mechanics, etc., will be 
slaves to idle money kings. 

The gold standard keeps between three and 
four million men in idleness, and many more 
on partial employment, scant wages, and on 
the verge of want ; a Government fiat paper 
money, well managed, would maintain a 
steady value, neither appreciating nor depreci- 
ating (gold appreciates), and by facilitating ex- 
changes at well-maintained prices, good wages 
and plenty of work for everybody, all these 
idle hands would be called into action, and 
happiness and plenty would take the place of 
misery and want. 

The railroad kings !annul the protective 
features of the tariff at pleasure. For 
example, when the railroads charge more for 
freight on domestic goods from Philadelphia 
to Chicago than the entire freights on foreign 
goods from England to Chicago, via Philadel- 
phia, over the same road and perhaps in the 
same train from Philadelphia to Chicago, 
what chance has the Philadelphia-made goods 
in the Chicago market? The foreign goods 
can be sold cheaper than the domestic goods 
to the extent of the difference in freight in 
favor of the foreign goods, and to that extent 
the protection disappears. What we want is 
uniform freight rates for similar service ; and 
the rate should be, not the value of the service, 
but the cost of the service plus a reasoafcfe 
profit. '7*' 

Au, this gloomy winter the coal mineft 
in Pennsylvania have been suffering for food, 
and the farmers in Kansas, Nebraska and 
other parts of the West have been burning 
their corn in order to keep warm. But this 
winter has been no exception, for the same 
thing occurs every winter. And what are the 
railroads doing? Charging "all the traffic will 
bear" instead of the cost of the service with a 
reasonable profit, added. If we had Govern- 
ment railroads no profit need be added. A 
public utility like transportation should be 
conducted at cost by the Government for the 
service of the public and not for private profit. 
Then the corn would find its way to the starv- 
ing coal miners and the coal would find its 
way to the freezing farmers. Shall we con- 
tinue in the old way of starving one class and 
freezing another, or adopt a better plan that 
will bring food to the hungry and let them 
give in return fuel to the freezing. Would 
not that be more rational, and would not our 
country be better off and happier? But that 
wonld not please the speculators. 

Have you read of the Seeley banquet in 
New York a few months ago ? It was an ex- 
travagant, beastial and indecent orgie. The 



parties to the affair were a score or more of 
New York's "best" citizens and some hired 
women. These male animals voted in Novem- 
ber for "maintaining the national honor." 
What do they know about honor ? But those 
who know the least about honor talk the loud- 
est about it! In that city at that time there 
were 150,000 idle workingmen yearning for an 
opportunity to do an honest day's work to 
keep themselves and their families from starv- 
ing! When these things are true there is 
something wrong! "It is not all gold that 
glitters." 

Let us turn from the dark side and look at 
the other side— there is another side. I read 
in New Occasions of Mrs. O. H. P. Belmont. 
She is related to the Belmont- Rothschild- 
Morgan syndicate, that did so much to "up- 
hold our national honor. " If it had not been 
for them we would have sunk into such dis- 
grace that we could not look Spain, Turkey 
and other "honest money" nations in the 
face. Here is what this good lady, Mrs. Bel- 
mont, wore last season, and the cost : 



Ten gowns for ball and opera . 


. $3,000 


Ten bonnets 


. ' 95o 


One sealskin cape 


400 


Two fur muffs . 


150 


One ear muff 


129 


One opera cloak 


300 


One opera cloak 


250 


Six pairs walking shoes 


90 


Four pairs dancing shoes 


48 


Pour pairs kid slippers 


60 


Three dozen long gloves 


360 


Four dozen gloves for driving and 




walking 


144 


Ten tea gowns . 


2,200 


Six dressing gowns 


500 


Three riding habits 


400 


Fourteen corsets 


420 


Twelve pairs silk stockings . 


60 


Four dozen pairs lisle stockings 


. . 144 


Two pairs bedroom slippers . 


20 


Four suits silk underwear 


120 


Ten suits woolen underwear . 


200 


Lingerie . . . • 


1,500 


Four dozen handkerchiefs 


45 


Three dozen handkerchiefs 


36 


Two dozen handkerchiefs 


48 


Two dozen handkerchiefs 


36 


Toilet articles 


1,000 


Ten gowns for walking and driving 


1,000 


Three bath robes 


160 


Three fans 


75 


Three pairs riding boots 


75 


Two bicycle suits 


300 


Two traveling outfits . 


2CO 


Two winter wraps 


20O 


Two winter wraps 


I50 


Three skating outfits . 


275 


Trimmings, ribbons, etc. 


3OO 


Four umbrellas 


48 


One sable-trimmed wrap 


1,000 


Three dinner gowns 


1,200 


Two evening cloaks . ^ 


80O 



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One dozen veils 

Jewelry 

One fur wrap 

Two fur boas . 

Two morning gowns • 

Three sleighing outfits 

Three theater costumes 

One fancy dress ball costume . 

Six pairs overshoes 


150 
. 5*ooo 
800 
200 
200 
400 
300 
300 
6 



Total 



$25,749 



rHK wives of country doctors must get 
along the best way they can. They don't 
44 maintain the national honor;" while those 
who do so must have fine clothes to do it in. 
But, candidly, which do you think is the most 
useful woman, Mrs. Belmont or your wife? 
Did Mrs. Belmont or her husband earn the 
money to buy the above list of clothes ? You 
earn the money to get your wife's clothes, 
don't you? I know the lot of a country doc- 
tor. During these hard times, when people 
cannot pay, he earns the money several times 
over, and then doesn't get it. 

Some make ' ' maintaining the public honor ' ' 
pay handsomely. Would they do it if it didn't 
pay ? Did you ever think of that? And who 
pays them? The system that they maintain (do 
you help them maintain it) robs every pro- 
ducer. It makes money dear, and men and 
the products of men's labor cheap. The bills 
that you can't collect have gone to help pay 
for Mrs. Belmont's expensive wardrobe; but 
your wife can wear her old clothes. 

These people have a good time, plenty of 
money, plenty of clothes, fine houses, horses, 
carriages, etc. No hard times for them. But 
their taxes must be heavy, you think. Not 
much! Looking over the assessors' list in 
our large cities is very interesting. For exam- 
ple, according to the assessors' list, there is 
not a millionaire in Chicago. Elegant, expen- 
sive pianos are assessed at $150 or less, fine 
horses at $50, or even $25 ; other things in pro- 
portion. And when it comes to stocks, bonds, 
notes, mortgages, etc., the wealthy hide them 
and 4i lie out of it." A few years before Jay 
Gould's death, his assessment was raised from 
$250,000 to $500,000, against his vehement 
protest ; at his death his estate was valued at 
seventy millions! The Kansas Legislature 
has had before it an ingenious bill to catch 
tax liars I hope it will become a law in every 
State. It provides that all notes, mortgages 
and other securities shall be stamped each 
year by the assessor, the stamp showing that 
the same has been duly assessed. Any note or 
other security coming into court without the 
assessor's stamp shall be declared void. An- 
other good way is for each man to assess him- 
self, no questions being asked. But at his 
death anything belonging to his estate not as- 
sessed shall be turned over to the State as a 
probate fee; if anything is undervalued, the 
difference between this and the real value to be 



claimed by the State. If this were done, how 
the assessors' lists would swell! for no man 
would want to run the risk of his heirs losing 
a large part of the estate. We want some good, 
healthy honesty among our rich. If the church 
can 't put it there, let the law try it 

C. F. T. 

VaTCut "Our Monthly Talk" out every 
month and have it published in your local paper. 



Reviews. 

The medical profession is indebted to Mr. 
W. B. Saunders, the medical publisher, for a 
number of excellent books during the last few 
years. One of the best appears annually. 
It is: 

Th« American Ybar-Book op M*dicihe 
and Surgery, edited by Dr. Geo. M. Gould. 
The issue for 1897 is now before us. It is a 
handsome volume of 1,257 P*ge* (think of it !). 
It is " a yearly digest of progress and authori- 
tative opinion in all branches of medicine and 
surgery, drawn from journals, monographs 
and text-books, of the leading American and 
foreign investigators. " Dr. Gould has a large 
and distinguished corps of collaborators in 
this work. It is divided into convenient 
departments, and contains twenty full-page 
plates and a number of smaller illustrations. 
It is an exceedingly useful and valuable work. 
Price, cloth, $6.50. 

Anomalies and Curiosities op Mbdictjtb- 
This is the medical "old curiosity shop;" 
968 pages of wonders and curiosities from the 
earliest ages to the present time. The " side 
show " and dime museum " freaks " are classi- 
fied and illustrated. All kinds of anomalies, 
rare cases, malformations, etc., are here pre- 
sented. Don 't take this book up when you have 
much to do, for you will be liable to neglect 
something. It is intensely interesting. It is 
edited by Drs. Geo. M. Gould and W. L. Pyle, 
and published by W. B. Saunders, Philadel- 
phia. Price, doth, $6 net. 

Essentials op Physical Diagnosis op thk 
Thorax; by A M. Corwin, A.M., M.D., of 
Rush Medical College; published by W. B, 
Saunders, Philadelphia ; second edition. Price, 
$1.25, net. This is a little book of 199 pages. 
It is a very useful hand book upon the 
subject covered. 

Wit and Wisdom, 

I was the only passenger in the car. Mid- 
way on the block another came in. His hat 
was crushed and his clothing daubed with 
mud. For a long time he sat in gloomy medi- 
tation. Then he hitched up toward me and 
said : "I guess I'm the dodrottedest fool run- 
ning loose in this town." "So?" I said. 
4 'Yes, sir. I ain't got sense enough to be let 
go without a guardian. See that car up ahead 



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173 



ihere?" I did. It was half a dozen blocks 
1 way . * < Waal, sir, I ran like sixty for more'n 
1 block to ketch that car." " Couldn't catch 
t, eli ?" " Yes, I could. That's the trouble. 
[ did ketch it, an' I gin the conductor a dime 
)n the hind platform, an' he gin me a nickel 
:hange. Then somehow I up an' dropped the 
nickel overboard. I hollered to the conductor 
to stop the car, but he wouldn't do it, so I ups 
and jumps off backwards. Look a' my clo'es. 
When I got up that car was out o' reach, so I 
had to wait foi this one." "Did you find 
Four nickel!" "Oh, yes; found that right 
enough. Lost my car, split my clo's an' skint 
my back just for the gratify in' privilege of 
pickin' up that doddeen nickel an' givin' it to 
this conductor. I used to think Bill Thompson 
was the dingedest fool agoin', but I guess I'm 
clost onto him." "What did Bill do?" "Wy, 
don't you know? Bill's dog got his head 
stuck in a pitcher, an' Bill cut off the head to 
save the pitcher, and then broke the pitcher to 
get the head out. ' ' 

Now that spring is coming, "brace up" 
your little ones with Imperial Granum. Hot 
weather goes hard with them. Make them 
strong before the depressing heat comes. 

Cook County Hospital, 

Administration Building. 

Chicago, Dec. 31, 1896. 
Frank S. Betz, Kelley & Co., 

269 Dearborn St , Chicago, 111. 
Gentlemen — At my request the " Betz 
Baths" were ordered for the Wards of the 
Cook County Hospital, and they have given 
entire satisfaction. 

I have no hesitancy in recommending these 
baths to everyone. 

Yours truly, 

T. A. Davis, M. D , 
Pres. Medical Board C. C Hospital. 

Did you call at your druggist's as we sug- 
gested last month, and crush some Upjohn 's 
pills ? If not, do it to-day, and see how easily 
it is done. 

Now for cases of spring fever. Give them 
Fellow's hypophosphites. That will energize 
them. Don't neglect your convalescents. 

The little maid had been ill, and had strug- 
gled through the early stages of convales- 
cence. She had taken " nourishing " broths 
and "nourishing " jellies until her soul was 
weary within her. One morning she electri- 
fied the family by sitting bolt upright in bed 
and saying ; "I want you all to take notice. 
I am not going to take any more nourishment. 
I'm hungry, and I want my meals, and not 
another mouthful of nourishment will I eat." 
— Practical Medicine. 

Dr. T. M. Baird, of the Medical and Surgi- 
cal Staff of the Hot Springs, Ark., City Dis- 
pensary, writes . 

"For the past year I have used Campho- 
Phenique Powder as a surgical dressing, in 



private and dispensary practice, and consider 
it the best antiseptic and germicide on the 
market. It is put up in the most elegant and 
convenient manner imaginable, and is in every 
way satisfactory. 

Go to the marrow of the subject — that is, 
give Carnogen, made of red marrow. See be- 
neath contents. 

See top half of third cover page. 

When you use antitoxin, use a domestic 
product — Mulford 's. It hasn't taken a journey 
across the sea to get to you. 

Use Listerine. 

When you use ergot, use the best form of 
it — Sharp & Dohme's ergotole. It does not 
irritate if you want to give it hypodermically, 
nor does it nauseate if you give it by mouth. 

Have you sent an order for Dr. Waugh's 
book? Send to Alkaloidal Clinic, Station X, 
Chicago, 111. 

Dr Wilus H. Davis, Keokuk, Iowa, for 
instruments in the west. See his advertise- 
ment. Geo. C. Frye, Portland, Me., for instru- 
ments in the northeast See his advertise- 
ment. Isaac Phillips, Atlanta, Ga., for the 
south. See his advertisement. 

Do you know what Zomo-Anana is? If 
not, send postal to Zamo Pharmacal Company, 
St. Louis, Mo , and see what it will bring. 

Don't let those consumptives die without 
trying petroleum emulsion (Angier Chem. Co., 
Boston). Better begin, though, in the early 
stage while there is some chance for cure. 

Phytoline and Pineoline. See handsome 
adv. and send for samples. 

Stewart's " S. G. P. O." has been with us for 
many years, showing that doctors use pile 
ointment, and that this one is satisfactory. 
See adv. and send for a sample. • 

Teutonic is easy to remember as a malt tonic. 
It will not be disappointing. 

1 ' I received the sample of Unguentine you 
so kindly sent me some time ago, for which I 
wish to thank you It has remarkable healing 
powers without any irritation ; indeed, it can 
be used on even the tender skin of an infant 
without harm. I can most cheerfully recom- 
mend it as a splendid local dressing, and shall 
continue to use it." — Dr. S W. Bryan, Lay- 
ton, Pa. 

See list of ' ' standard remedies ' ' on page iii, 
this issue, and write for further information 
and samples. 

Apenta is a natural Hungarian bitter water, 
an unexcelled tonic aperient. Try it particu- 
larly for delicate patients ; and it does just as 
well for the strong. 

As a tonic during and following grip, we 
took Freleigh's Tonic, and found it wonderful. 
Those who think it an ordinary tonic do not 

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THE MEDICAL WORLD. 



take into consideration the free phosphorus in 
solution. That makes it different from any 
other tonic in existence, for Mr. Woodruff is 
the only pharmacist who can accomplish this 
pharmaceutical feat. The phosphorus takes 
hold of the latent energies and infuses new 
life. It is an ideal tonic, and different from 
any other. 

We lead the world in many things. One of 
those things is the artistic and ingenious 
manufacture of artificial limbs. Write to A. 
A. Marks, 701 Broadway, New York, N. Y. t for 
catalogue of "the world's greatest artificial 
limb manufactory. n 

When you order malt, order the best — 
" Braunschweiger Mumme." It is no dearer, 
and much better than other malts. 

Saved at the eleventh hour is better than 
never. See advertisement of Paris Medicine 
Co. and see how it was done. 

" 1 have found Resinol an excellent prepara- 
tion for skin affections. "— F. D. Clum, M. D., 
Cheviot, N. Y. 

"Resinol is a wonder-worker; it acts mar- 
velously. M — J. H. Drawbaugh, M. D., Robe- 
sonia, Pa. 

STRICTLY PROFESSIONAL. 

Section 9 — And it is further agreed between 
Dr. A. Gude & Co , party of the first part, and 
the M J Breitenbach Co , party of the second 
part, that if at any time the said M J. Breiten- 
bach Co. should, by device or by advertising, 
attempt to increase their business in Gude's 
Pepto Mangan other than through the recog- 
nized channels to the medical profession, then, 
in such event, this Contract is to become null 
and void, and all rights of the M. J. Breiten- 
bach Co existing under this instrument imme- 
diately become the property of said Dr. A. 
Gude & Co. without recourse to law. 

Have you sent for P. D. & Co. 's catalogue 
for constant consultation? If not, do so 
to-day. 

Get a glass of water and try the solubility of 
Warner & Co 's pills, as per illustration in their 
adv. Send to them for their prescription blanks, 
visiting memoranda, etc, free. 

Have you tried Micajah's uterine tonic 
wafers ? 

Support for weak places — Flavell. See his 
illustrated page and send your order. They 
have proven their worthiness of your orders. 

The best hemetic is made from blood, but it 
is not disagreeable take ; is perfectly aseptic, 
and easily assimilable — Bovinine. 

Phillips' for instruments. Write. 

An exhaustive report by the well known 
physiological chemist, Prof R H. Chittenden, 
of Yale, would seem to justify the claims set 
forth by the American Ferment Company re- 
garding their new vegetable digestive agent, 
"Caroid." This report shows the digestive 



activity of Caroid in various mediums and 1 
comparison with other well-known dig^estiv 
agents. It would seem that Caroid, which i 
a highly concentrated extract from the Paw 
paw plant, is not restricted as to class of food 
medium or combination with other drugs a 
far as its activity is concerned. This is a mat 
ter of decided interest to medical practitioners 
We are glad to see that the price of this nei 
Ferment does not make its general use pro 
hibitive. 

Dr. Richard I^enschner, of Mt. Clemens 
Mich., offers to send free to physicians a nea 
booklet of 54 pages, describing the minera 
waters of that place. 

Do you ever think to have your patients t< 
use bread made from entire wheat flour ? It ij 
not a "coarse food." intended* for people ii 
whom the animal elements predominate ; then 
are some persons of the most finely organized 
temperament that feel that they could not live 
without it. Many more, particularly brain 
workers, would not be without it if they would 
use it awhile. 

There are many ways of killing. Antiseptics 
kill microbes in various ways. Hydrozone 
destroys the food they feed on, hence they die, 
and then they are oxidized by the purifying 
hydrozone. Cleanliness is the first law of 
surgery now, and hydrozone seeks out particles 
of debris and pus from the remotest corners, 
out of reach of the sponge, and hence the kind 
and rapid healing under its influence. 

Justin Haynes, M. D., Western Springs, 111 , 
says : I have a patient in my Sanitarium who 
has scanty and painful menstruation ; she is 
now taking her third bottle of Aletris Cordial 
with marked beneficial results. I have pre- 
scribed it for a number of patients outside of 
my Sanitarium, and consider it a very valuable 
remedy for the conditions for which it is recom- 
mended. 

PNEUMONIA IN CHILDHOOD. 

The high temperature so frequently present 
in pneumonia in children is not only a danger 
signal, indicating an extension of the inflam- 
matory process, but is of itself attended with 
such serious consequences as to demand prompt 
intervention. The injurious effects of pro- 
longed pyrexia are especially manifested upon 
the circulation and nervous system, as evi- 
denced by the rapid and feeble pulse, the 
delirium, stupor, etc. While with some 
authorities the cold bath has met with favor, 
its inconvenience, the danger of shock, the 
prejudice of the laity have practically re- 
stricted its employment in hospitals, and the 
vast majorities still make use of one of the anti- 
pyretic drugs. No better test of the safety of 
any antipyretic can be afforded than its action 
in the pneumonia of children, and it is in this 
class of cases that phenacetine has proved de- 
cidedly superior to all other drugs of its kind. 
Although yielding in efficiency to none as a 



The Medical World 

The knowledge that a man can use is the only real knowledge; the only knowledge that has 

life and growth in it and contorts itself into practical power. The rest hangs 

like dust about the brain , or dries like raindrops off the stones.— Proude. 



The Medical World. 



C. P. TAYLOR, M.D., 

Editor and Publisher. 



•Mbecription to any part of the United State* and Canada, 
Onx Dollar per year. To England and the British 
Colonies, Pivb Shillings per year. Postage free. 
Single copies, Tbn Cents. These rates must be paid 
invariably in advance. 

We cannot always supply back numbers. Should a num- 
ber fail to reach a subscriber, we will supply another, 
if notified before the end of the month. 



Play no money to agents for this journal unle 
receipt is given. 

Ju>x>u*t all Communications to 



t publisher's 



'THE MEDICAL WORLD." 

i5» Chestnut Street, 

Philadelphia, Pa. 



Vol, XV. 



May, 1897. 



No. 6. 




A Mineral Spring Practice at Home. 

You have frequently sent patients to 
watering places to drink the water of a 
special mineral spring, and they have 
come back cured or greatly benefited. 
You have frequently wished to send poor 
patients to similar places, but they could 
not afford it. Out of season for watering 
places (in winter), or when your wealthy 
patient could not well go away, you have 
ordered the free use of the same water in 
bottles, with good effect. Did you ever 
examine closely and critically into the 
modus operandi of these cures ? 

When a patient reaches a mineral 
water health resort, he is examined by 
the resident physician and ordered to 



drink certain quantities of the water at 
certain times during the day ; this is in- 
creased from day to day until the maxi- 
mum quantity needed is reached. He is 
ordered to drink one or two glass-fulls 
upon rising, two or three glasses between 
breakfast and dinner, the same quantity 
in the afternoon, and a couple of glasses 
before going to bed. The patient is 
urged to take it whether he wants it or 
not He may say that he is not thirsty, 
but that makes no difference ; he must 
take it as a medicine. The quantity is 
increased until we have known thirty 
glasses per day to be taken. This ceases 
to seem extreme when we remember that 
we have heard young fellows boast that 
they have drank fifty glasses of beer in a 
day. 

A part of the benefit derived is because 
of the rest and change of scene ; a part, 
perhaps, is from the small quantity of 
the salts of lithia and other bases con- 
tained in these waters (we are not speak- 
ing of cathartic or calybeate waters), but 
the benefit from this source is very slight 
The secret of the cure is in the quantity of 
water taken. If the water be pure, free 
from organic matter, and taken in suffi- 
cient quantity, the results will be sub- 
stantially the same, regardless of the 
* 'traces" of lithia, and small quantities 
of sodium chloride and other salts. You 
can perform these cures at home with 
the ordinary drinking water, if of good 
quality, if you will require the patient to 
take it in the same quantity as at the 
springs. It is very easy to add lithia if 
desired ; but you must not lose sight of 
the fact that the quantity of water (not 
lithia) taken is the important thing. It 
acts by flooding the kidneys ; by washing 
out the bladder with a copious, bland 
and dilute urine; by unclogging the 
liver and clearing the brain. The pa- 
tient feels better from day to day ; he is 
better. Irritable bladder is relieved, the 



176 



THE MEDICAL WORLD. 



kidneys act freely — are " washed out " — 
and many effete substances are carried 
out with the flood; this clears the way 
for the liver to act freely and normally, 
for there is an intimate relation between 
the liver and kidneys. The kidneys 
are often blamed when the fault lies with 
the liver. The kidneys must excrete 
products that a deranged liver is responsi- 
ble for, and they often break down in the 
effort. Plenty of pure water makes their 
task easier, and helps to remove the 
trouble in the liver. Realize the fact 
that it does not require any special and 
expensive water, but any pure water will 
do this if taken in sufficient quantity. 
We cannot boast of our Schuylkill water 
here in Philadelphia, but if taken in 
sufficient quantity it promotes diuresis, 
relieves an irritable bladder, etc., sub- 
stantially as well as any other water. 

If you trill bear this in mind and put 
it into practice, it will be worth much to 
you. Many" of your " chronics' ' of 
various kinds can be greatly benefited 
by the free use of water at home. Filter 
or boil the water if necessary. In some 
cases you must resort to strategy, for 
some patients will not appreciate the im- 
portance of taking only water. You can 
leave a placebo consisting of small sugar 
globules or powders of sugar of milk or 
chloride of sodium with strict directions 
to take one every two hours dissolved in a 
glass brimming full of water. The dose 
before each meal (about half an hour be- 
fore the meal) might be taken as hot as 
can be borne. 

Patients who need saline waters to act 
on the bowels can take a teasponful of 
sulphate of magnesia or other saline 
as needed, dissolved in plenty of water, 
as well at home as at "springs." 
Calybeates and salines may be combined 
when desired, and with a little ingenuity 
you can do a good mineral spring practice 
at home, and give even your poorest 
patients the benefit of the same. 

Not Charity, but Justice. 

We are receiving some communica- 
tions from our patrons in the flooded dis- 
tricts of the Mississippi valley, stating 
that owing to this calamity they are un- 
able at present to send their subscrip- 
tions as usual, but hoping that they will 
^e able to in the fall, when they will 



gladly join our "family" again, and 
hoping that we will then be able to fur- 
nish to them the back numbers that they 
will miss in the meantime. These have 
been answered saying that no one under 
such a visitation and who expresses a 
wish to receive The World need be with- 
out it ; that we will continue sending The 
World right along without a thought 
of compensation while they are suffering 
from such a disaster. These communi- 
cations have caused us to think more 
deeply than ever before concerning our 
duty toward those who are visited by 
such a calamity. Floods, droughts, etc.,. 
can neither be foreseen nor prevented. 
The losses caused by such visitations 
should not be entirely borne by those 
who happen to live in the flooded or 
drought-stricken districts. We who are 
spared and safe owe something to those 
who have lost all through no fault of 
theirs. It seems to us that we owe what 
we can do in our special line to our 
unfortunate brethren in these districts* 
So we will say that all physicians in 
those districts who have become unable, 
because of the floods now or recently 
devastating parts of the Mississippi val- 
ley, to purchase needed medical litera- 
ture, can have The Medical World free 
of charge until they shall have an oppor- 
tunity to get on a paying basis again — 
say for the remainder of this year. 

The above statement may not reach 
the eyes of many of those who would be 
benefited by the same, so all are re- 
quested to please aid in having this infor- 
mation reaching those that it interests 
most. 

Some may think that those who have 
the misfortune to be burned out should 
be classed with the above. No; for 
those who have property and neglect to 
have it properly insured should not be 
helped on account of a condition caused 
by their neglect. Also many may think 
that those suffering from hard times, low 
prices, depressed conditions of business 
and trade, for which they are not person- 
ally responsible — in fact, having done all 
in their power for a better condition of 
things — should be given the same advan- 
tage as those suffering from a calamity 
of nature. No; for we all suffer from 
these causes and we are collectively re- 
sponsible for them ; so each must bear 



THE MEDICAL WORLD. 



177 



his share until we can succeed in chang- 
ing conditions for the better. 

The destruction of the timber of a 
country leads to alternate floods and 
drouths. Floods, because in a denuded 
country there is nothing to retain the 
moisture when rains come, and by the 
rapid flow of the water from the surface, 
the brooks and rivers are rapidly swollen, 
resulting in channel-cutting torrents and 
destructive floods. In such a country 
the sun rapidly dries the exposed sur- 
face, and drouth ensues. In a timbered 
country, the myriads of roots hold the 
moisture, allowing a gradual flow, which 
feeds gentle but constant streams ; and 
the verdure, by evaporation, gives back 
much of the moisture to the atmosphere. 
Assyria and Arabia were made aeserts 
by the unwise removal of timber; and 
Italy, Spain and France are suffering 
from the same cause. The French gov- 
ernment is now trying to repair the 
damage done by planting the mountain 
slopes with trees again. We should pre- 
serve the timber on our hill-sides and 
vast mountain slopes, and escape the 
fate of the countries just referred to. 
The vast timber reservations made by 
executive order near the close of Presi- 
dent Cleveland's administration was one 
of the most important public acts of re- 
cent years. A tariff on lumber saves 
Canadian timber and destroys ours. 

Hyper-sensitiveness and Meagre Ability. 

We frequently receive articles for pub- 
lication that are poorly written, poorly 
composed, poorly conceived, and contain- 
ing scientific errors, and yet containing 
the germ of a good idea. We are fre- 
quently tempted to return such manu- 
scripts with suggestions as to how to 
study, observe and experiment, and 
finally develop the idea in good and 
creditable shape. If the man at the other 
end is of the right kind of material, if he 
is devoted to science in the true sense, if 
he can bury himself in his thought and 
work, he appreciates such suggestions, 
and the final result is a very creditable 
and satisfactory production. We bring 
to mind one case in which the article was 
returned three or four times ; but by per- 
severance and work it was finally made a 
very good article. But we are sorry to 



say that most of the writers of imperfect 
and immature articles have abnormally 
thin and tender skins. They are hyper- 
sensitive and egotistical. In perhaps 
nine-tenths of these cases the man at the 
other end is offended at the thought that 
his work is not perfect. We have been 
compelled to observe the fact that such 
hypersensitiveness and meagre ability 
usually — perhaps invariably — go to- 
gether. It is well known that arrogance 
and ignorance are companions ; and we 
have occasion to observe every month 
that modesty and ability are companions. 
So uniform is this rule that whenever we 
receive an article with a private letter ac- 
companying requesting us to have no 
hesitancy in throwing the contribution 
into the waste basket it not found worthy 
of publication, we at once conclude that 
the contribution from such a modest man 
is certainly worth publishing, and almost 
invariably we find this to be true. Our 
best contributors are the most modest 

Our complaints of failure of The 
World to reach its destination, are 
usually repeated by the same subscribers. 
It seems difficult to get The World to 
some of our readers. In many of these 
instances it is impossible to account for 
this trouble excepting upon the theory 
that some one appropriates The World 
before it reaches its destination. This is 
a compliment to The World, but an 
inconvenience to our subscribers and our- 
selves. However, if our subscribers will 
not become discouraged, and always in- 
form us within the month if their World 
fails to reach them, we will always sup- 
ply another copy. We are as much in- 
terested in having World reach our sub- 
scribers as our subscribers can be in re- 
ceiving World. We do not wish any 
one who desires it, and pays for it, to miss 
it. We would rather lose a dozen num- 
bers than have a subscriber miss a single 
number. So persevere, and we will do 
the same. If the World were not so in- 
teresting we would not have this trouble. 
For years we have had patrons who have 
received other publications without diffi- 
culty, but The World was frequently 
missed. The trouble is not here at this 
end. Please do not get tired writing for 
missing numbers, and we will not get 
tired supplying them. 

Vr J S Digitized by VjOOQLC 



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THB MEDICAX WORLD. 



Original Communications. 

8bort articles on the treatment of diseases, and experience 
with new remedies, are solicited from the profession for 
this department; also difficult cases for diagnosis and 
treatment 

Articles accepted must be contributed to this journal only. 
The editors are not responsible for views expr esse d by 
contributors. 

Copy must be received on or before the twelfth of the 
month for publication In the next month. Unused 
manuscript cannot be returned. 

Certainly it is excellent discipline for an author to feel that he 
must say all he has to say in the fewest possible words, or 
his reader is sure to ship them; and in /*• plainest possible 
words, or his reader will certainly misunderstand them. 
Generally, also, a downright fact may be told in a plain 
way; and we want downright facts at present more than 
anything </xi.-Ruiu». 

READ. REFLECT. COMPARE. RECORD. 



Cocaine Addiction. 

Editor Medical World: — I have 
been searching recently for records of 
cocaine addiction, and have been disap- 
pointed to find so little in print upon the 
subject There must be a good many 
cases, and if each one who has met with 
these would put them on record it 
would be of great advantage to us all. 
While I have been treating drug 
habits for ten years, I have rarely met 
with cases of purely cocaine addiction. 
In nearly every instance those who had 
previously taken morphine simply added 
cocaine to their list of accomplishments 
or vices. It is generally stated that drug- 
topers increase their doses, because as 
they become accustomed to the drug, it 
requires a larger dose to produce the de- 
sired effect; relief, sleep or Ifeuphoria. 
But the vast majority of those I have 
questioned upon this point have admitted 
that this was not the case, but that they 
increased the dose in order to procure 
more of the effect, more euphoria espe- 
cially. There seems, however, to be a 
limit in regard to the extent to which 
morphine can be pushed, and beyond that 
point the habitue cannot go. Usually he 
stops at about fourteen grains per diem, 
and at this point he will remain for years. 
But as he still wants more euphoria, he 
seeks for other agents to produce it One 
man told me that, having made up his 
mind to come into my house for treat- 
ment for the morphine habit, he thought 
he might as well have all the comfort be 
could in the meantime, and so be started 
the use of cocaine. But usually the 



cocainist says he really does not know 
why he takes it, as there is no special 
benefit derived. And if well-advanced 
in the habit he lies about it, denying its 
use altogether, even when he is paying 
for a cure. 

The cocainist is peculiar in his manner 
of using the drug. He makes up a little 
vial of solution, and of this he injects a 
few drops, repeating the operation almost 
incessantly. He reminds one of the boy 
who sets off his fire-crackers one at a 
time to get a large number of little pops. 
The cocainist is careless to the last de- 
gree. He takes not the slightest pre- 
caution to keep his syringe in an aseptic 
condition, but mixes up his drug with 
anything that will flow through the short 
needle of his syringe, and injects solu- 
tion, dirt and air into himself anywhere, 
through his clothes, unless he hunts 
around for a vein into which he can in- 
ject it in order to secure prompter effects. 
He never loses an opportunity to provide 
himself with more syringes and needles; 
so that it is not uncommon to find him 
with dozens of syringes and hundreds 
of needles in his possession. He is cov- 
ered with sores, the result of his slovenly 
methods; but these he cultivates, as 
they serve as excuses for obtaining co- 
caine. He is peculiarly restless in his 
demeanor, never still for a moment He 
sits down, crosses one leg over the other, 
reverses them, clasps his hands over his 
knee, hangs one arm over the back of 
his chair, twists about until his legs are 
over the chair-arm, gets up, walks about, 
sits down again, and goes through num- 
berless other alterations of posture in 
the space of a minute. He gets out his 
syringe and takes an injection while 
conversing with you, apparently uncon- 
sciously, so mechanical or automatic has 
the action become. 

The effect upon the bodily health is 
difficult to determine, as these cases are, 
as I said before, usually old morphine 
habitues. But with the advent of co- 
caine the progress downwards is accel- 
erated. The emaciation goes on more 
rapidly; the complexion becomes pale 
or cachectic ; the physical activity is 
lessened, so far as useful work is con- 
cerned ; the appetite and digestive ca- 
pacity are decreased. One singular effect 



is to increase the 

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THB MEDICAL WORLD. 



179 



since the victim can take a dose that 
would ordinarily put him to sleep and 
then keep himself awake with cocaine. 
But as to the permanent effects upon the 
tissues or functions of the body caused 
by cocaine there is scarcely any informa- 
tion extant. So far as gross , macroscopic 
lesions are concerned, none have been as 
yet proved. But my own observations 
go to show that cocaine does not obtain 
the disastrous control over tissue meta- 
bolism that makes life so hard to the 
morphinist without his drug. When 
morphine is discontinued the cellular 
functions are performed so sluggishly 
that toxines accumulate and the body- 
temperature becomes subnormal, while 
an indescribable oppression and profound 
melancholy pervade every fibre of the 
victim's being. I have observed nothing 
of the kind with cocaine. On the con- 
trary, when this drug is withheld there 
is a general nervous hyperesthesia pres- 
ent. The slightest prick of the hypo- 
dermic needle, an injection of warm, 
normal salt solution, absolutely unirri- 
tant, is followed by the most exaggerated 
complaints of agonizing pain, of the tor- 
ments of the damned, which are kept up 
for days, when not the slightest external 
evidence of the injection is to be seen. 

And in recording this symptom of co- 
cainism, we pass to the consideration of 
the effect of this drug upon the mental 
and moral nature of the habitue. There 
is no question here as to the pernicious 
character of its influence ; and I unhesi- 
tatingly pronounce cocaine the most dis- 
astrous in its effects of any habit-drug I 
have as yet studied. It destioys the soul. 
In using this term, I follow Garretson, 
who described man as of a three-fold 
nature, consisting of the body, the ego 
and the soul. The body, the Rupa of 
the Buddhist, is the material, which is 
dropped at death ; the soul, the Buddhist 
Atmi, is the divine part, which at death 
returns into the Godhead if this is lost 
to its possessor ; and the Ego, the indi- 
vidual himself, who lays aside his body, 
and keeps or loses his soul. Now in the 
worst confirmed cases of cocaine addic- 
tion that have come under my observa- 
tion, the soul is gone; the moral con- 
sciousness is dead ; the sense of obliga- 
tion to do right has been extinguished. 
The cocainist is depraved ; he will take 



and break the most solemn obligations 
without compunction. To his dying day 
the morphinisms soul rises unconquered 
above the influence of the fiend which en- 
thralls him. Hestruggles against the over- 
mastering influence, and bitterly laments 
his degradation ; he is sensible of his 
obligations as a man, a husband and a 
father; and the suicide which so often 
ends his career is the last protest of an 
unconquered will, the final effort of the 
slave who, unable to free himself, seeks 
death rather than continue to live in 
bondage. Under the fierce craving for 
morphine he will lie, steal or murder to 
obtain his necessity; but he will suffer 
for his crime. 

Nothing of this sort is to be found in 
the cocainist He has no moral sense ; 
he has no sense of responsibility, no 
manly interests, no love for his family, 
no religious principle, no shame. He 
will lie for the pleasure of lying, and steal 
needlessly. I have exhausted every ap- 
peal that can be made to the better nature 
of man, and have not found a fibre of 
the heart that would ring true. There 
is nothing to build upon. He presents 
the semblanee of manhood, but the soul is 
dead. Trust his honor and he chuckles at 
your gullibility. Bring squarely before his 
face the proof of his deception and oath- 
breaking and he has no blush of shame,. 
no compunction. He simply laughs, and 
begins to devise a new scheme to obtain 
his drug, in which he displays much 
ingenuity. 

One of these men came down one 
morning holding his jaw, saying he had 
the toothache. The doctor offered to 
treat it, but the man said he would 
rather have it out. So a nurse took him 
to the dentist, where the following con- 
versation took place : 

" Can't you give me something to pre- 
vent pain?" 

c< Yes, I will give you gas." 

" But I can't take gas." 

"Then Pll inject cocaine into the 
gums." 

" All right, go ahead." 

"How is that ?» 

* * There is not enough to prevent pain." 

a< But the gum. is so full the solution is 
oozing out" 

" Then put some in the other side." 

u Now the other side is full." 

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THE MEDICAL WORLD. 



" Then inject a good slug in my arm." 

u Are you ready now?" 

" Yes ; go ahead." 

Ci Which tooth is it ?" 

"Oh, I don't care ad — n. Pull any 
one you wish." 

And so the moment he had his cocaine- 
hunger satisfied he dropped the decep- 
tion without the smallest thought for a 
future supply, confident of his ability to 
obtain it by some other method. This 
man had had nearly all his teeth ex- 
tracted in this way. 

When the later stages have been 
reached there are certain phenomena 
present The delusion of parasitic in- 
fection is manifested. The man believes 
he swarms with parasites. He examines 
little bits of epithelium with a magnifier 
and is sure they move. Still later come 
the delusions of persecution. He is 
hounded by enemies, harried by his 
relatives, and sometimes applies to the 
police for protection. Sometimes his 
stories have a certain plausibility and 
occasion great annoyance to those whom 
he selects as objects of his delusions. 
Or, he believes himself a criminal and 
accuses himself of atrocious crimes, 
wholesale butcheries. Suicide often ends 
his days, but not as with the morphinist, 
to break his chains, but to escape from 
his pursuers. Still more frequently death 
results from overdoses of some drug ; for 
if he has not access to cocaine enough 
he will take anything stupefying in his 
reach, and that in the most reckless man- 
ner. One of these men attached a rub- 
ber tube to the gas-jet and conveyed the 
gas to his bed, covered his face with the 
clothes and inhaled enough to stupefy him 
without the least regard to the danger. 

Are such men curable ? It depends on 
the degree to which the moral degenera- 
tion has progressed and on the means 
employed. If enough manhood is left to 
induce the patient to seek relief, there is 
a good prospect of cure, and the danger 
of relapse is much less than from mor- 
phine. But if he does not want to be 
cured, the only chance is in strict con- 
finement for a long period. Whether the 
moral sense can be restored when once 
lost is doubtful ; but from the absence of 
permanent physical changes from cocaine 
it seems fair to expect some degree of 
recovery even here, if enough time is 



given. But in the treatment no oppor- 
tunity must be allowed for obtaining 
cocaine. Morphinists can be given their 
drug with permission to take it if too 
hard pressed on the sole condition that 
they shall inform the physician if it is 
taken; and this trust is never, or but 
very rarely, misplaced. But the cocainist 
must be watched every minute, night and 
day, by incorruptible attendants, for at 
least two weeks, and longer in bad cases. 
Beyond this the treatment is singularly 
easy, painless and satisfactory. 

I will close with a word of warning to 
physicians as to the use of cocaine them- 
selves and for their patients. No man 
knows whether he is safe from the allure- 
ments of the drug until he has tried it, 
and when he has made the trial he can- 
not stop himself if he should prove liable 
to the habit Never give a patient 
cocaine in such a shape that he will 
know what he is taking or be able to 
supply himself without your aid. Dis- 
guise the drug and dispense it yourseLC 
Never use it for asthma, hay fever or any 
other affection for which it is only palli- 
ative and not curative. And discourage 
in every way the use of catarrh snuff and 
other nostrums that contain cocaine. 
William F. Waugh, M. D. 

103 State St, Chicago. 

Antitoxin in Diphtheria — Reply to Doctor 
Lockhart. 

Editor Medical World: — In the 
April World, page 141, Dr. Lockhart 
asks why should he use antitoxin in the 
treatment of diphtheria. He labors 
under an error regarding the province of 
the bacteriologist While he has been 
laboring clinically the bacteriologist has 
been experimenting in the laboratory. 
The bacteriologist does not diagnose 
diphtheria, but he aids the physician in 
making the diagnosis conclusive. To 
be as brief as possible, I will say that 
bacteriology has fully determined that 
the Klebs-Loffler bacillus is found in all 
cases of true diphtheria. All the other 
bacteria found associated with it have 
nothing to do with producing the dis- 
ease, as they are found also in other 
diseases. The streptococcus is found in 
all phlegmonous inflammations. 

The "Loffler bug" is an expert in 
getting ahead of his relations. This is 

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181 



not a gratuitous assumption. It the 
doctor will, with his next case of diph- 
theria, take a little portion of the mem- 
brane and place it in a test-tube, on the 
white of a hard-boiled egg:, he will find 
that the Loffler bacillus will grow rap- 
idly and can be determined in twenty- 
four hours under the microscope. The 
streptococcus will not grow on white of 
e Rg« The bacteriologist has thus en- 
abled us to diagnose early, without the 
guinea-pig or without being a blockhead. 

Do not fear of being prosecuted for 
malpractice in administering antitoxin 
in a case which, we will say, does not 
prove to be true diphtheria. Antitoxin, 
if pure and from healthy animals, cannot 
produce a fatal result. The reasons are, 
first, that it is a something generated by 
the human organism to antagonize or 
antidote the toxin poison of the Loffler 
bacillus. Secondly, any and all drugs 
are antagonistic with the human organ- 
ism, and, if given in sufficiently large 
doses, will produce a serious or fatal 
result. Antitoxin, being produced by 
the human organism, is not a drug, and 
therefore cannot act as a drug in produc- 
ing a serious or fatal result. Serious or 
fatal results in using antitoxin are due 
to lack of cleanliness, an impure article, 
or improper methods of administration. 
Antitoxin will immunize individuals ex- 
posed to diphtheria as vaccination will 
prevent small-pox. 

Doctor, do you always wait until you 
are sure of your diagnosis before admin- 
istering your remedies, dangerous or 
otherwise ? In your statistics you give 
a mortality of 6.3 per cent, where anti- 
toxin was administered the first or sec- 
ond day. Where it was administered 
later you give a higher mortality, this 
mortality growing larger as the number 
of days before applying the remedy in- 
crease. This is easily explained. The 
first or second day the toxin poison is 
small in amount and is neutralized by 
the antitoxin administered. As the 
days go on the bacilli increase rapidly 
and the system contains a large amount 
of toxin poison. Antitoxin is admin- 
istered, but it is too late in many cases. 
Too small an amount is used, or the sys- 
tem is so impregnated with the poison 
that the patient cannot rally. 

Your statistics teach, therefore, to 



make your diagnosis early, either clini- 
cally or bactenologically, or both, and 
apply your remedy at once. 

I know not what your mortality has 
been in diphtheria. I am sure, however, 
that if you will, in the future, adminis- 
ter antitoxin in all cases of diphtheria as 
soon as you make your diagnosis, your 
mortality will be much less than under 
the treatment you are now using. 

Use antitoxin boldly and fearlessly. 
A mild case requires less antitoxin than 
a severe one. Watch your patient, espe- 
cially the temperature. If the tempera- 
ture declines to normal, enough anti- 
toxin has been used. If it should decline 
to a point and remain stationary for ten 
or twelve hours, administer more anti- 
toxin. I am only a practicing physician, 
like yourself, but I believe that bacteri- 
ology, the brilliant morning star of medi- 
cine, has burst the clouds of ignorance 
and quackery in the zenith of scientific 
glory. A. J. Hunt, M. D. 

Hamilton Square, N. J. 

The Sulphur and Charcoal Treatment of 
Diphtheria. 

Editor Medical World :— In a com- 
munication which appeared in The Med- 
ical World for January 1805, 1 gave the 
results of my experience with the sulphur 
and charcoal treatment of diphtheria 
from June 22, 1894, . to December 
1, 1894. There were 25 cases, and all 
recovered. From December 1, 1894, 
to March 31, 1897, I have recorded 126 
additional cases, and have had the same 
number of recoveries. Not having seen 
any reports from others as to the treat- 
ment named, I infer that it has not 
appeared to your readers to be a good one 
and worthy of trial. I have refrained 
from any further communication upon 
the subject, not wishing to occupy 
valuable space with remarks upon an un- 
interesting topic. The efficacy of anti- 
toxin as a remedial agent does not seem 
to be determined. The sulphur and 
charcoal treatment having shown per- 
fectly good results in my practice, I have 
concluded to give my later experience 
with it, hoping that it may prove equally 
satisfactory to other practitioners. It is 
not an attractive treatment ; its appear- 
ance does not commend it to the patient ; 
it is apt to cause disparaging remarks in 

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THE MEDICAL WORLD. 



many instances ; it soils the hands and 
clothing with which it comes in contact; 
but these disadvantages are lost sight of 
when it begins its curative effect upon 
the Loeffler — or any other — bacillus 
which causes an exudation upon the ton- 
sils. Charcoal is an old product dating 
from the time that combustion first oc- 
curred. Sulphur is also very ancient, 
being coexistent with the creation. 
There are various biblical references to 
brimstone, which indicate that it was re- 
garded with consideration in early times. 
The antiquity of the remedies being un- 
doubted, the arguments so frequently 
used against antitoxin and other new 
products cannot be used against this 
combination. The combination of sul- 
phur and charcoal in the form of gun- 
powder, having been so destructive to 
the human family, its utility as a remedy 
for human ills should counterbalance in 
some degree its evil reputation. 

My 151 cases varied from the mildest 
to the severest forms. All had the 
characteristic exudation upon the ton- 
sils, painful deglutition, enlarged cervi- 
cal glands, and more or less fever. My 
practice is chiefly among persons re- 
siding in the country (Ladiesburg being 
a village) and I am compelled to carry 
my medicines with me when visiting 
patients. The sulphur and charcoal mix- 
as follows: I put gj4 
nto each of two glass 
ach holding nineteen 
i 95 grains of finely 
flowers of suljmur to 
hake well*/' L two 
180 grains cf pure 



ture is prepared 
ounces of water 
stoppered bottles, 
ounces. Then a< 
powdered ordinar 
each bottle, and 
ounce tin box hold] 
willow charcoal 
box is filled once 
ond time for each 1 
grains of charcoal, 
duced into the bottle! 



en level full/ This 
nearly full the sec- 
bottle, mailing 342 
hich is easiy intro- 
by meansfof a fun- 
nel. The bottles arlLwell shAen, and 
simple syrup added to ifili then* I have 
two mailing cases with\screw tops con- 
taining vials holding fourjoundes. These 
are nearly filled with the\ mixture, the 
corks are tied in with a &Ap of oiled 
cloth, and the cases placed in my buggy 
or cart, in compartments keeping them 
in an upright position. (These pre- 
cautions are taken because in February 
1895, a ten-ounce bottle of the mixture 
was broken in my overcoat pocket, and 



caused me to have a very uncomfortable 
experience). The treatment consists of 
the above mixture and a gargle. For 
the past year I have used for the latter 
an antiseptic compound prepared by 
Wm. Smith & Co., of York, Pa., con- 
taining thymol, benzoic acid, boracic 
acid, borate of sod}, gaultheria, etc. 
Two ounces of this 



to enough water to 
adult a teaspoonful 
for ten minutes, am 
a teaspoonful of tl 
coal mixture (the b 
shaken) is taken in 
ten minutes and s 1 
ten minutes follow; 
process is repeat 



mpoutrf are added 
ke a mnt For an 
held m the mouth 
hen erected. Then 
sulohur and char- 
tie having been well 
the mouth, held for 
llowed. A rest of 
and/then the whole 
unjil improvement 
few doses make 
In others the 



occurs. In most cAes 
a marked improvement 
treatment may be required for days. In 
October last one of the worst cases I 
had, a girl six yeat* old, received the 
medicine every half hour for four 
days and nights. The father and 
mother were devoted in their attentions, 
and one of them was always on duty. 
During the night the gargle was retained 
for only a few minutes and the char- 
coal mixture swallowed at once, thus 
giving the child opportunity to sleep 
part of the time. The room was in- 
adequately heated at first, and the 
patient had some rheumatic symptoms, 
which I attributed to the diaphoretic 
action of the sulphur. As soon as the 
room was kept at a regular temperature 
of 75 , these symptoms subsided and the 
child made an excellent recovery. Milk 
seems to be the best diet. A strip of 
muslin upon which a* small quantity of 
tar has been spread, r lay fife wonv^roapd 
the neck, or a strip 
and a half wide 
A thick bandagj 
creases the heat; 
and is a disadva: 
ternally is somet 1 
to swollen glands, 

The bottle containing the mixture 
should be kept in a cool place, and it is 
well to have the cork tied in, if it is not 
used frequently. In my cases no other 
treatment has been used than that de- 
scribed. In November, 1894, a neighbor- 
ing physician had to go to Washington 
City, and asked me to attend a child two 

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lstifcad. 



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involved, 
iodine ex- 
ssary, applied 



THE MEDICAL WORLD. 



183 



years old, having diphtheria, which had 
been under treatment for four days. The 
exudation had extended to the nares and 
larynx. Large doses. of potass, chlor., 
tr. fer. chlorid., ana/quinine had been 
used from the beginning. I immediately 
put it upon the sulphur and charcoal 
treatment, but could not perceive any 
benefit. The child died in 36 hours after 
I saw it. I have not included it in my 
list of cases. A few patients had diffi- 
culty in retaining the medicine. At my 
second visit they reported that every 
dose of the charcoal mixture had been 
rejected. I advised them to swallow it 



and keep the 
five minutes. /( 
taste of the 
retain it easil 
medicine had 
key, as the c 
In very youti/ 
a stick may 
to the tonsi! 
charcoal 
If the exu< 
nares, they 
the antiseptic 




or 

the 

could 

lilies the 

lock and 

fond of it. 

[uslin swab on 

Tpply the gargle 

or two, and the 

^swallowed at once. 

extended to the 

juently sprayed with 

Solution. 



Ladiesburg, Md. John J. Liggkt, M. D. 

Antitoxin in ilembranous Croup.— Report of 
Two Cases. 

Editor Medical World:— I was called 
on February 24th to see A. W., aged 21 
months, for croup, so the father stated. 
On seeing the child I at once told the 
parents the child had membranous croup, 
and urged them to let me use antitoxin, 
as that was the last resort. The child 
was cyanotic, pulse 160, resp. 40 per 
minute. 8 c.c. of Mulford's antitoxin 
(patent) were given in the right groin at 
2 p. m. ; 8 c.c. were given in the left groin 
at 10 p. m. The next morning the child 
was somewhat better, but still cyanotic. 
During the second day 24 c. c. were given, 
with decided improvement. On the third 
day 8c.c were given. The child made 
a complete recovery. 

G.F., aged 18 months, was taken with 
croup on the 30th of March. The par- 
ents did not want antitoxin used, but as 
the child got worse they consented. 8 c.c. 
of Mulford's antitoxin (potent) were 
given in abdomen. The next morning 
the child was somewhat better. 16 c.c. 
were given on the 31st, and 8 c.c. on the 



1st of April. The child made a perfect 
recovery. 

Alfred Corn well, M. D. 
Bridgeton, N. J. 

Antitoxin in Diphtheria. 

Editor Medical World: — For the 
last year I have been quite interested in 
the reports on antitoxin in The World, 
and I must confess I have at times been 
among the skeptical in regard to its use. 
For the last few years there have been 
no cases of malignant diphtheria in this 
place, so that there was no opportunity 
to test the value of the new treatment. 
This year, however, there were a number 
of cases in a large family of children, 
and a short account might be interesting 
to the readers of The World. 

Previous to my entering the family, a 
boy about three years of age was attacked 
with diphtheria, and, apparently, the 
attending physician did not understand 
the nature of the disease ; at least he 
did not so report it, and the child died 
on the sixth day. My first patient (in* 
this same family) was a boy about five 
years of age, who had been sick three 
or four days before I assumed charge of 
the case, and was gradually growing 
worse. It was a well marked case of 
malignant diphtheria, tonsils enormously 
swollen and completely covered with 
the characteristic membrane, offensive 
odor, high fever, great prostration and 
inability to retain anything taken into 
the stomach. Internal medication was, 
therefore, almost entirely dispensed with, 
and I commenced the antitoxin treat- 
ment. I gave three injections of 5 c.c 
at intervals of twelve hours, without 
apparently improving the condition of 
the patient, excepting that the vomiting 
ceased, and the countenance assumed a 
brighter expression. On the second day 
I gave an injection of 10 c.c, and after 
twelve hours 5 c.c more, shortly after 
which I began to see an improvement in 
the case ; membrane loosening, appetite 
returning, and every indication of speedy 
recovery. In a few days more the 
patient had passed the danger point and 
was convalescent. 

In the meantime two other children 
had been taken, both of a verv severe 
type, developing so rapidly that in twelve 
hours from the onset of the disease they 

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1 84 



THE MEDICAL WORLD. 



were seemingly beyond help. In one 
of them the glands of the neck were 
enormously Swollen, the tonsils, also, to 
such an extent that swallowing was al- 
most impossible, and the odor emanat- 
ing from the poisonous membrane could 
be detected half way across the room. 
Twelve hours after the disease had fully 
set in she lay in almost a complete 
stupor, with her mouth open, breathing 
heavily, and apparently in a dying con- 
dition. However, the antioxin was ad- 
ministered energetically, ancl at the third 
injection, about thirty-six hours after 
the attack set in, she finally began to 
improve. She remarked to me: "I 
don't remember a thing about yesterday; 
I must have been pretty sick." The 
other case was, also, a serious one, from 
the fact that the membrane invaded the 
nose, which is always regarded as a dan- 
gerous symptom. She began to im- 
prove, however, about the same time as , 
the others, under the antitoxin treatment. 
Besides these two girls, there were two 
other older ones, who had been exposed 
to the disease. It was thought best to 
immunize these, if possible, and prevent 
their having the disease. Accordingly 
they were mnoculated with the anti- 
toxin and closely watched. Only one 
injection was necessary, and they escaped 
without any symptoms of the disease 
appearing. The mother, also, had a 
slight deposit of membrane on the throat, 
but by the timely administration of the 
remedy the case was quickly cut short. 

After all the cases were apparently 
beyond danger, the nurse, Miss Austin, 
of Auburn, was attacked ; but on being 
subjected to the same treatment, she had 
only a mild form of the disease. It 
would seem as though the use of anti- 
toxin in these cases was conclusive of 
its virtue, and I am thoroughly convinced 
that by its timely use the horrors of the 
dread disease, diphtheria, are immeasur- 
ably lessened, and its hitherto fatal 
ravages may, in a great measure, be 
averted. ' F. W. Benedict, M.D. 

Weedsport, N. Y. 

Leg Ulcers. 

Editor Medical World : — Our 
esteemed brother from Mountain House, 
Arkansas, asks for treatment for ulcer of 
leg in patients that cannot give up their 



daily labor. Of course the treatment 
depends to a large extent upon the 
variety. We have the inflamed or phleg- 
monous ulcer ; fhe sloughing ; the weak 
or, edematous ; the neuralgic or iritable ; 
indolent or callous ; and the ulcer of 
specific origin. The last two are the 
most common forms of ulcer on the leg, 
and it is presumed he has reference to 
these. The indolent or callous ulcer 
occurs usually in those of middle life, and 
is situated in the lower half of the leg, 
and more often on the fibular than on 
the tibial surface. The ulcer is surround- 
ed by an elevated ring of very dense and 
indurated tissue, which seems to be a 
provision of nature to prevent the spread 
of the disease, acting indeed as a kind 
of natural splint to keep the ulcerated 
surface at rest As long as this hard 
ring remains, healing will not occur; 
hence to depress the edges is the first 
step in the treatment of an indolent ulcer. 
Some make radiating incisions, extend- 
about one-quarter of an inch into sound 
tissue. Others have obtained good 
results by strapping the ulcer by means 
of adhesive strips laid on in an imbri- 
cated manner, and then applying a mus- 
lin bandage. 

I have received excellent results from 
the following treatment : First spray the 
ulcer with peroxide of hydrogen ; while 
not germicidal, it has the effect of de- 
stroying the albuminoid material upon 
which the bacteria exist. Then wash it 
with a bichloride solution i-iooo. I have 
dusted with acetanilid, but since several 
cases of poisoning from the dni£ have 
been reported, I use aristol. If it be a 
syphilitic ulcer, we dust it with calomel 
and give proto-iodide of mercury, % gr. 
three times per day ; then apply your 
antiseptic gauze, i-iooo bichloride ; then 
apply wax paper; finally bandage tightly. 
Often when the ulcer is irresistible to 
ordinary treatment, transplantation of 
cuticle is often beneficial. 

I have used with good advantage the 
following powder : 

Bismuth subnitrate, 

Sterate of zinc, 

Oxide of zinc, aa dr. iij. 

Sig. Dust on ulcer and apply bichloride 
gauze dipped in bichloride solution, i-iooo, 
then apply bandage. 

I remember one case of ulcer of the 



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THE MEDICAI, WORLD. 



185 



leg that nearly exhausted my patience. 
A young man had excoriated his shin 
-while playing foot-ball. The physician 
employed by the team applied cosmoline ; 
thought it would.be antiseptic if he 
added carbolic acid. Instead of mix- 
ing the carbolic acid with the cos- 
moline before application, he poured the 
carbolic acid on the cosmoline while on 
the leg, with the result of a horrible 
ulcer extending around the entire cir- 
cumference of the leg. After some 
weeks of futile efforts of the physician 
to repair the damage done by the acid, 
he was discharged. I washed it daily 
with permanganate of potash and dusted 
it with a powder composed of boracic 
acid, seven parts, and iodoform one 
part Then applied iodoform gauze, 
and wrapped with a bandage. While it 
was a slow and tedious process it finally 
yielded to the treatment, to the gratifica- 
tion of the patient. 

S. A, Buchman, M. D. 
432 Snyder avenue, Phila., Pa. 

Treatment of Ulcer of the Leg. 

Editor Medical World:— On page 
122, Dr. J. B. Simpson asks for treatment 
of ulcer of the leg. I would like for him 
to^ try the following : Wash the ulcer 
with sterilized salt solution, sprinkle a 
small amount of pyoktanin over the 
ulcer, put a bit of sterilized gutta percha 
tissue over the surface, then ordinary 
antiseptic gauze, and bandage from toes 
to knee. Have the patient to apply this 
dressing and bandage in the morning be- 
fore he assumes the erect position. 
•Apply the bandage lightly, as by the 
swelling on rising the proper pressure 
will be attained. The bandage should 
not be removed at night until the patient 
has gone to bed. 

I have cured one case of thirteen years' 
standing with the above treatment. I 
have gotten very good result from the 
above treatment leaving oft the pyoktan- 
in. I never did get very much result from 
idoform in ulcers of leg. Please try, and 
report results. E. L. Tunstall. 

Mammoth Spring, Ark. 

Treatment for Ulcer of the Leg. 

Editor Medical World : — Replying 
to Dr. I. B. Simpson's inquiry as to the 
very best treatment for ulcers of the leg, 



I would advise him to try the following 
before giving up the treatment as a bad 
job, as far as a cure is Concerned. Of 
course! rest is really required, although 
my patients get arouni and do their 
work jilst the same. I Advise them, in 
case of being unable to lay up altogether, 
to rest as much as possible, keeping the 
leg up on a chair resting on a pillow, and 
at night; to lay a pillow under the knee 
and two kinder leg anf foot. 

Internal treatment /in the majority of 
cases is required. If anemic, iron in 
some form, preferatyy pil. Blaud or syr. 
s must be fresh. If 
oned saline mixture, 
breakfast If rheu- 
nerally in the chronic 
ic acid (Wampole's). 
uble, Basham's mix- 



befor^ 
.81 



*y ** 



ferri. iod.' The 
costive, the old-fais 
to be taken 
matic, and >t is ^ 
stage, syr. liydri 
If any kidu 
ture. 

Local treatl 
morning wittf 
boric acid, an 
be much disc! 
following : 

R Boric acid, 
Iodoform, 
Bis. subnitrat 
Zinc oxide, 
M. ft. powdei 



Wash the leg every 

saturated solution of 

ash it clean. If there 

rge, powder it with the 



parts 3 
•• 1 
" 2 
11 1 



has lessened, when 
the Yfollowing unguent, 
fount} to be almost a 

dr.j 
Mm. x 
grs. xxx 
grs. xxx 
ad oz. j. 

iled silk (green 

the ulcer half 

orated so as 



until the disAarg< 
he might us J "* 
which I hav 
specific : 

R Ichthyol, 
Acid carboli< 
Acid boric, | 
Bismuth subnt, 
Zinc oxide, j 
M.ft. ung. ? 

This is to b$ spread on 
protective} cut to over! 
an inch all abound and 
to allow discljarge to corned through, then 
cover this with borated absorbent cotton, 
the silk to be dipped in boric acid solu- 
tion before applying, then Bandage from 
the toes to the knee, making even pres- 
sure, and put over this a snug fitting 
stocking, which is not to be kept up by 
a circular garter which causes compres- 
sion of the vessels. 

If the granulations be excessive, apply 
powdered alum or paint with a saturated 
solution of cupric sulphate, or argent, nit 
60 grains to the ounce ; or pure ichthyol 
will, I have found, soon accomplish the 



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186 



THE MEDICAL WORLD 



purpose. Of course, when using the 
powder, the ulcer is to be protected with 
the oiled silk, etc., as described for the 
unguent. 

The World solves many a mystery 
for the puzzled practitioner. I am 
anxiously looking tor the answers to the 
44 bloodless treatment of cancers," if 
there be one. It is too bad to see our 
patients leave us and go to some charla- 
tan who puts on a plaster, gives some 
medicine and in a few days our patient 
returns with the cancer in a bottle, and 
apparently well, when our only treat- 
ment would be the knife. I have always 
been a firm believer in the knife until I 
saw one case where an epithelioma had 
been removed from a lip and returned. 
The patient had it " drawn out" and 
it is over a year now and no recurrence. 
It recurred after the knife in eight or ten 
weeks. Medicus. 

Moore, Ont, Can. 

Diagnosis of Pregnancy. 

Editor Medical World :— Not long 
since I was called to see a woman in 
rather poor health who informed me that 
she was in the sixth month of preg- 
nancy ; that she had felt motion about 
two months before, and that two weeks 
before my visit a little girl, with whom 
she slept one night, had kicked her 
severely in the abdomen, since which 
time she had felt no motion and feared 
the fetus was dead. Menstruation had 
been suspended ; the abdomen enlarged, 
the breasts enlarged and tender, the gen- 
eral health about the same as in former 
pregnancies. I placed my hand upon 
the abdomen, but to my surprise could 
feel no enlarged uterus. After a little 
manipulation I succeeded in feeling the 
promontory of the sacrum. Introducing 
a finger into the vagina I found a uterus 
of normal size, in normal position, with 
a tumor, probably fibroid, on its posterior 
surface and about one inch from the os. 
I informed the patient that she was not 
six months nor even three months along, 
and if pregnancy existed in her case it 
was of too recent origin for me to diag- 
nose. I put her on aletris cordial and 
syr. hypophosphites co. and she is now 
about well. 

This woman, the mother of four chil- 
dren, actually believed herself to be 



pregnant Suppose pregnancy had oc- 
curred at the end of the fourth month of 
supposed pregnancy and continued for 
nine months. I imagine it would have 
been a difficult matter to convince that 
woman and her friends that she bad not 
been pregnant for thirteen months. 
Now, without wishing to reflect on Dr. 
Melick, I think there is good reason for 
assuming that he was mistaken in his 
diagnosis, and that he probably induced 
labor at about the eighth month of preg- 
nancy. The doctor says " her abdomen 
was enlarged to immense proportions," 
but he also says that " large quantities 
of liquor amnii gushed from her with 
each uterine contraction." The large 
quantity of liquor amnii therefore ac- 
counts for the extra enlargement. Then, 
u twenty-four hours of hard work brought 
the womb and its contents low down in 
the pelvis," just where it should, and 
probably would have been, at the end ot 
the ninth month. The physical diagno- 
sis was, in my opinion, not sufficient to 
warrant the diagnosis of pregnancy at 
the time of the first examinations. 

Dr. J. W. Lockhart. 
St. John, Wash. 



Epsom Salts Cures Two Cases of Dropsy, 
One f tym Organic Heart Disease, and 
le from Bright's Disease. 

Editor Medical World:— G. T. C. 
Master Masota. sixty-seven years old r 
very bad valvu\r hearfcl Iseas^ developed 
dropsy, which ttte nsual treatment for 
heart trouble wounUiot toudn . Was j ust 
about to give him uras lost/ or rather was 
about to begin to tap\he^domen, when 
I chanced to see the 
firm down South (no 
sent for a trial box of 
ten or twelve large bo! 
end of a man's little fi 
directions as to howj 
full directions as to 



,\ 



rtisement of a 

ter where), and 

icine. A box of 

sct, as big as the 

;er, dame with full 

o givkthem ; also 

king Efcom salts. 



I made up my minfi that therxmmense 
pills were only a bind to get thfeatient 
to send for more nledicine at $50 ror the 
treatment, and qfcmmenced giving the 
salts just as directed, viz : 

First day, 7 a. m., one hea ping table- 
spoonful in a glass of water; 8 a. m., 
one teaspoonfiil in water ; 9 aHB^one 
teaspoon ful in water, and so on f ]c>ne 
teaspoonful in water, every hour, uSBl 

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THE MEDICAL WORLD. 



187 



he had had twelve or fourteen operations 
from them. He required about seven 
doses in all to get the fourteen opera- 
tions a day. The last operations were 
all water. 

Second day, rest. 

Third day, take the salt* same as first 
day, and so. on. Every other day take 
salts like tfce first day/ till the dropsy 
goes. He tdpk salts seven days in all, 
tdays treatment, when his 
e. Luring the day that 
en, At very lijjht, almost 
d oft uses griping of the 
ostration is not as severe 
nfc 
renal dropsy as bad as 
tment ; same result. 
a year ago. The man 
takes salts a day or 
le, when he finds the 
nd keeps fairly well. 



or fourteen 
dropsy was 
the salts are 
nothing, as 
bowels. The 
as one would t 

Case 11.—]. 
Case I. Same 

This was ov< 
with heart 
two, once in a w 
dropsy returning, 
Can't work : nev 



diseal 



can ; is thankful to 



be living. 

The man with Blight's disease is work- 
ing as a lootnfixer In a cotton mill. Of 
course he is weakland nervous ; can't 
sleep well ; has badtspells of prostration, 
etc, as any one will whose kidneys are 
in so bad conditio^ ; but (and please 
make a note of it) by^he use of the salts 
and an iron tonic, he is earning a living 
for his family. 

I returned the liquorice pills to the 
firm, as they requested in case they were 
not used. 

Perhaps I did wrong in stealing the 
information as to how to use physic ; if 
I did, remember, dear reader, the par- 
taker i$as bad as the thief. 

W. H. Judson, M. D. 

Danielson, Conn. 

Solution of Oil of Cinnamon as a Dressing. 

Editor Medical World :— J. R., col- 
ored, was thrown or fell from a passing 
train upon which he and some other col- 
ored boys were stealing a ride. In fall- 
ing he struck upon the sharp corner of 
an upturned steel rail, which penetrated 
the cavity of the abdomen just over the 
greater curvature of the stomach, allow- 
ing the entire viscus to be extruded. The 
wound was received about 9 o'clock at 
night, and was seen by me 12 hours after. 
The extruded' viscus was so much swollen 
that the orifice of exit had to be enlarged 



to permit reduction, which, under chlor- 
oform, was successfully performed. After 
properly suturing the wound, a large 
compress was applied kept constantly 
saturated with the following : 



Ol. Cinnamomi 
Aq. font . 



gtto viij 
Oiv 



Healing was accomplished and the boy 
was out in ten days. 

E. G., school-boy, scalped himself run- 
ning through a fence. Twelve sutures, 
aqua cinnamon compress. Out in three 
days in the rain rabbit hunting. 

And so on. It never fails when prop- 
erly used as a dressing on recent wounds. 
J. F. Baggot, M.D. 

Bamberg, S. C. 

The "Insomnia Habit "and its Treatment by 
Natural ilethods. 

Editor Medical World: — It is not 
my intention in this short paper to cover 
insomnia thoroughly, but I shall en- 
deavor to point out a line of treatment 
which, if applied accurately and pa- 
tiently, will certainly overcome even the 
most obstinate case of the " insomnia 
habit" 

The "insomnia habit," as I shall call it, 
is, as a rule, one of the most unsatisfactory 
and annoying complaints the physician 
is called upon to treat. 

Every practitioner has encountered 
cases of it by the score. Usually, after 
having resorted to all the hypnotics in 
the pharmacopeia without obtaining any 
permanent relief, the doctor in despair 
hustles the patient out of his sight to 
some rest cure or distant climate. But 
such cases can be cured, and I have yet 
to encounter one that will not yield to 
proper treatment. 

Before a case can be diagnosed as one 
of u insomnia habit" it is necessary to 
be certain that no pain or cerebral lesion 
exists, that every function' is in perfect 
order, and that every apparent cause is 
removed. 

Let us imagine, then, that we have 
such a patient for treatment. Experience 
has taught us that such cases rarely 
yield to customary methods, so let us 
ascertain what psycho-physiological 
treatment will accomplish. 

It has been said that we are creatures 
of habit ; but the only means by which 

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THB MEDICAL WORLD. 



a habit is formed is by constant repeti- 
tion of an action, thought, or sensation. 
If day after day we retire or arise at 
certain hours, we soon begin to feel 
drowsy at the proper time every evening, 
and will wake within a few minutes of 
the regular hour every morning, no 
alarm clock being necessary. 

Habits of diet are formed in this way, 
and so, also, is the "insomnia habit." 
Careful inquiry of sufferers from the lat- 
ter trouble will in almost every instance 
reveal the fact that at some previous 
period the patient was compelled to stay 
awake every night, until he firmly be- 
lieved he could not sleep again, even 
after the exciting cause had been re- 
moved. The exciting cause in the first 
place may have been due to pain, en- 
vironment, digestive disturbances, grief, 
worry or any other mental or physical 
disorder, which, for a certain period, 
kept the mind active. 

It is a well-known fact that the more 
active the mind the greater is the quan- 
tity of blood supplied to the brain. The 
converse is also true, for, to the same 
degree in which the blood leaves the 
brain is the activity of the mind de- 
creased, so that during the interval pre- 
ceding death from hemorrhage the pa- 
tient passes through a variety of mental 
conditions, starting with slight dizziness 
or drowsiness and ending in coma. 

During natural sleep the conscious 
mind becomes inactive, and there is a 
corresponding diminution in the quantity 
of blood supplied to the brain. By tak- 
ing into consideration the foregoing 
facts, the proper treatment is very clearly 
indicated. Resort to any means which 
will draw the blood from the head, and, 
to assist this, make the mind as inactive 
as possible. To secure the intelligent 
cooperation of the patient, explain care- 
fully to him the objects you are trying 
to accomplish. 

There are many ways by which the 
blood supply may be lessened. One of 
the simplest is a light .supper before re- 
tiring. All animals become drowsyafter 
eating, owing to the activity of the 
stomach, which necessitates an increase 
of the blood supply to that organ at the 
ex pense of other parts. Throughuthe force 
of gravit>\jane of the first places drawn 
upon fo/blood is the head. N Exercise is 



also an important agent, for the increased 
activity of the muscles necessitates freer 
circulation through them to remove the 
waste products formed there. ^Hot water 
applied to the lower extremities is valu- 
able, but not nearly as effective as cold. 
In using this method I instruct my 
patient to prepare for bed, then, having 
rolled his night gown up under his arms, 
to sit in a bath of very cold water for not 
more than an instant, and then to spring 
into bed without drying. In a few mo- 
ments the limbs begin to glow and sleeps 
ensues. This method should be em- 
ployed judiciously in weak patients or 
women, for with the latter it frequently 
starts menstruation before it is normally 
due. 

I frequently instruct a patient to put 
out his light, and then with closed eyes 
to stand beside his bed for from three to 
twenty minutes ; at the same.time sway- 
ing his body and head around or swing- 
ing his arms back and forth by his sides, 
until he feels that it would be a relief to 
lie down. The patient should sleep with 
his head high. 

In a number of cases I have had suc- 
cess by inducing the patient to break his 
regular habits, getting him to eat and 
sleep at very irregular hours, and to keep 
this up for a week or two. 

To control the mental activity I invari- 
ably resort to hypnosis, making very 
positive suggestions that the patient 
must sleep at a certain hour, and that at 
that hour his mind will quiet down. ' Be- 
sides this I teach him how to control his 
attention and how to overcome his worry, 
grief, or any other mental condition 
which may have produced the brain 
activity at night. I get the patient to 
relax himself a number of times during 
the day, and, while in this condition, to 
think seriously of the exact hour he in- 
tends to retire that evening, as well as 
the precise length of time he wishes to 
sleep. In this way the expectant atten- 
tion is kept active. It is the same mental 
process which we all unconsciously em- 
ploy to arouse ourselves, when necessary, 
at any desired hour. 

It is very rarely that a victim of the 
u insomnia habit " goes into a deep stage 
of hypnosis, and it is still rarer to pro- 
duce immediate sleep. However, a deep 
state is not an essential, for some of the 

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THE MEDICAL WORLD. 



189 



best results I have obtained were secured 
in patients in whom not even drowsiness 
was induced, to say nothing of fixation 
of the eyelids. The only condition, then, 
which is necessary for the suggestive 
treatment, is general relaxation. 

The average length of time necessary 
to effect a cure is from one to three weeks, ' 
and the patient, besides receiving the 
suggestive treatment daily, should be 
taught the use of auto-suggestion. 

1 trust these few ideas may be of some 
assistance to those who read them. I 
should not advise confining the treat- 
ment to any one method, but would sug- 
gest instead, using the various ways men- 
tioned in combination, with judgment in 
their selection. 

While I have outlined these methods 
for use in the treatment of the " insom- 
nia" habit alone, nevertheless most of 
them will be found to assist the treatment 
of every other form of insomnia. 

Herbert A. Parkyn, M. D., 
Medical Supt Chicago School of Psy- 
chology. 



Bums, and How I Treat Them. 

Editor Medical World: — Unless a 
practitioner has had considerable experi- 
ence, or lately looked the subject up, 
there is nothing more apt to make him 
lose his mental equilibrium, or, in com- 
mon parlance, u get him rattled," than 
to.be called to tteat a severe 'burn. This 
part of general piactice has fallen to my 
lot repeatedly theVast yirar, and I wish 
to impress a few points f learned by ex 



penence, and not fr^p>6ooks. 

~* - - ..^ with morphia 

the burn is not 



First, control the 
hypodermically, buty 
large this is hardlj 
following treatmer 
soon relieves thf 
water to clean 
it at all at first, 
of skin and flesh that you 1 
hold of. 

Don't forget there is a pei 
sion or shock that is soon 
ticipate it by giving stry 
grain, whiskey ^ ounce. If 1 
sufficient, and the patient is 
threatened with rigors, £ive a 11-250 gr. 
granule of glonoin dissolved in hot 
water every fifteen minutes ufitil the 
skin gets red. The best dressing to use 



fcessary, for the 

:>perly applied, 

Do not use 

do not clean 

' loose shreds 

easily get 

of depres- 
sing. An- 
nit 1-60 
this is not 
\pale and 



at first is linseed oil, lime andjywrtejy 
Notice, I did not say carron oil ; neither^ 
did I say lime water.^ Water only take 
up four- tenths of 1 per cent, of lit 
This is not lime enough. I prepare 
lime and water by putting a lum#of 
unslacked lime the size of my fist iiKo a 
half gallon j^t, fill it two-thirds Mil of 
warm water, lei it slack, get a soft£otton 
cloth, perfectlyNclean, the properaize to 
cover the burnXstir up the Mme and 
water until it loom like thin clam, dip 
the cloth in it, thek in the oil Jad lay it 
on the burn. Covet with an«her cloth, 
then with absorbentVotton, Jfver which 
put a roller bandage.A Don Wbe afraid to 
put the lime on, and \oxxf patient will 
bless you for it, I do not k 
this is according to $r 
curantur or not, but the) 
pain. Leave this on f| 
twenty-four hours, theij 
all places that do not 
them clean with hydrvfn 



aow whether 
lia simillibus 
lime stops the 
eighteen to 
^ke it off, and 
clean, make 
eroxide and 



water, equal parts, pJl onAwith a soit 
cloth or sponge. Amtx it fc perfeptly 
clean, put on a freaf drfssing like the 
first and leave it om two days* Take it 
off, and if the pain Is still present, dress 
same way again ; ig no pain, usb the fol- 
lowing : 

R- Campho-phei*qtie, 

Acid boracicj . aa dr. ij 

Acetanilid pflv., dr. ea 

Vaseline, . f . • oz. xij 

Misce ft. ung, 



Spread on 
ciently, and a 
cotton and 
second day. 
to prevent c 
lameness by 

The first 



lean cloth, warm suffi- 
y. Cover wit!| absorbent 
ndage. Change every 
near joints, use splints 
atrization from causing 
ntraction. 
ay or two I give a 1-6 gr. 



granule of ofelcium sulphide every two 
hours, then-fevery four hours ; give plenty 
of fresh hot milk, Horlick's malted milk, 
chicken and beef soups, etc. If the 
patient is young, do not fail to look after 
the kidneys as well as the bowels. 

D. C. Roney, M.D. 
Pierceville, Ind. 



Treatment of Burns. 

Editor Medical World :— Seeing an 
inquiry by Dr. J. A. Henry, page 123, 
March number, how to treat burns 4< by 



190 



THE MEDICAL WORLD. 



gas in coal mines," and your reference to 
my article, prompts me to report a few 
cases of burns. I have read so many 
good practical articles in The World 
that I would be glad if I were able to 
add something to its pages. 

August 15, 1895, I was called to see a 
burned child. W., colored, aged two 
years, in playing had run, as only scared 
negroes can run, into a hot fire around a 
wash-pot Its hands and arms were run 
into the boiling water in the pot to 
above the elbows. Its abdomen and breast 
were run against the pot It was a 
serious burn, the hands and arms and 
the feet being a solid blister, while the 
abdomen and the breast were also badly 
burned. 

The accident happened about 3 p. m. 
and I saw the patient at 11.30 p. m. 
The patient was in a nest of filth and 
rags, the family all nearly asleep, and 
the laziest set I ever saw. Had it not 
been for a lantern that I carried with me, 
I could not have seen how to dress the 
wounds. Treatment : After considerable 
trouble in getting the negroes to act, the 
burns were tolefably well cleansed in 
boiled warm water, made more antisep- 
tic with carbolic acid. A mixture of 
equal parts of linseed oil and lime water 
was spread over thin layers of absorbent 
cotton, and the layers applied to the 
burned surface, and over this a soft roller 
bandage was applied. The finge rs were 
were separated by small piecesof absorb- 
ent cotton, an^Tkept straight on a padded 
-splin t reac hing from the finger-tips to 
the elbowsT The toes were separated in 
*the same manner. 

Stimulants, anodynes, and laxatives 
were given to meet the general condition 
•of the patient. 

August 19th the patient was brought 
to my office, over a rough road, a distance 
of seven or eight miles. 

The dressing being removed, the 
wounds were found to be in a clean, 
healthy condition. The blisters were 
punctured at the lower edge, and the 
water gently pressed out. The parts 
were gently cleaned with boiled, carbol- 
ized water, then dusted well with cam- 
pho-phenique powder. Over this thin 
layers of absorbent cotton were applied 
and held in position by a soft roller band- 
age. The fingers and the toes were kept 



apart and straight in the same manner as 
in the first dressing. 

The general condition was met by 
anodynes, laxatives, and stimulants. 

August 23d the patient was seen and 
the wounds were dressed the third and 
the last time. After the dressing had 
been removed, the dead skin came oft 
from the elbows to the finger-tips, almost 
in solid pieces, like a snake shell. The 
new skin was tender, but not raw. The 
parts were well cleaned, powdered and 
bandaged in the same manner as they 
were on the 19th. 

The patient was well in a few days 
from the last dressing, almost without a 
mark. 

Case //.—October 5th, 1895, I was 
called to see little S., aged about one 
year. She had been severely scalded by a 
dish-pan of hot water being turned over on 
her. The head,face, neck, left shoulder, 
and left arm, to an inch or more below 
the elbow, and the left side of the breast 
and the abdomen had been badly scalded. 
Two or three of the largest blisters had 
been broken open, which left raw, ugly 
sores. The burned surface had been par- 
tially covered with scraped Irish potatoes. 

The parts were cleansed with boiled, 
carbolized water, then the absorbent cot- 
ton, well covered on one side with "car- 
ron oil," was applied to the burned sur- 
face and held tnere by a soft roller band- 
age, as in Case I. 

The general condition of the patient 
was met by stimulants, laxatives, ano- 
dynes, etc , as in Case I. 

On the 6th I saw patient again. It 
seemed to be doing well, and I continued 
the treatment. 

On the 7th I removed the first dressing 
and let the water out of the blisters, there 
being two large ones and several small 
ones on the forehead, a few small ones 
scattered over the head, some small ones 
on the eye-lids, several large ones on the 
abdomen and on the breast, some smaller 
ones on the neck and on the shoulder, 
and the arm to the elbow being almost a 
solid blister. The parts were cleaned 
and dressed as in the second dress- 
ing, Case I, except sennine powder was 
used. 

The general condition of the patient 
was met with appropriate medicines. 

On the 1 2th the wounds were dressed 



THE MEDICAL WORLD. 



191 



the third and last time, just like the 
second dressing. 

In a short time from the third dressing 
my little patient was well without a mark 
or a scar, except where the blisters were 
broken before I saw the patient. 

My observation is, never break a blister 
in burns till the second dressing. By 
following this rule I think you will leave 
no scars, unless the burn is very deep. 

This patient got well so quick, and 
-with so little suffering that the parents 
were simply surprised and delighted. 

Buda, Tex. G. M. Jameson, M. D. 

[Is it not better practice to not open 
the blisters at all, but allow the water 
to be absorbed?— Ed.] 

To Prevent Nausea Following Administration 
of ilorphin. 

EditorXEDiCAL WoiaD :— I suppose 
all physician have observed the nausea- 
ting effect ot\jorphjfion particular indi- 
viduals. 

To prevent thMame, I am in the habit 
of following th^achmnist ration of mor- 
phin to such nptientsia from twenty to 
thirty minuw with a tlSee to five grain 
dose of hyrate of chloraiS^hich effect- 
ually prevents the nausea. 

' W. H. Cowan, M.D. 

Shilob, Texas. 



The ilorphia and Atropia Combination. 

Editor Medical World :— Your nu- 
merous readers are discussing the mor- 
phia and atropia combination. For 
many years I have invariably used mor- 
phia and atropia to relieve pain, given 
nypodermically. I make the proportions 
to suit my cases as I think best. 

Many years ago I attended a middle- 
aged man suffering severely from sci- 
atica. On the second day I gave a 
hypodermic: morph. sulph. gr. #, 
atropia sulph. gr. 1-140. Pain not much 
benefited. Next day patient objected 
to another injection on account of fear 
of pain from needle insertion. I fought 
four weeks with this patient without any 
result. He then consented to another 
hypodermic I gave him moiph. sulph. 

fr. Y^ atropia sulph. gr. 1-80. Next 
ay he felt much better, but still some 
pain. Patient consented to another in- 
mjection. Gave morph. sulph. gr. j£, 
atropia sulph. gr. i-ioo, at 10 a. m.; ar- 



rived home at 1 p. m., and messenger 
came to tell me to see my patient at 
once ; that he was delirious and red in 
his face; An hour later I was at his 
house and found patient as reported. 
He smiled, felt dry in his mouth and 
throat, pain all gone, his body as red as 
if he had scarlet rash. I informed the 
family that all resulted from the injec- 
tion and he would be all right by next 
day. He was slightly delirious next 
day; no return of pain, and a speedy 
recovery followed. No return since. 

Several years ago I was asked to 
attend a lady who was confined to bed 
from December 24th to the following 
April without being able to move, aud 
suffering the most excruciating pain. I 
was asked what was the trouble. I said 
lumbago. The husband said the med- 
ical attendant said she was suffering 
from kidney trouble. I was asked to 
take charge of the case, and I at once 
injected morph. sulph. gr. % y atropia 
sulph. gr. Vv, deep into her back. 
Also prescribed sweet spirits of nitre 
and sulphate of quinine every three 
hours. In the evening I was asked to 
come to the patient at once. Told the 
messenger to go home and report, " All 
will be right; no need for anxiety. " 
Upon second thought I ordered my team, 
to see the patient She was smiling, 
more or less delirious, and the atropia 
rash was over her body. On the follow- 
ing day the rash had disappeared and I 
felt as if I should repeat the injection. 
The husband said, " You are the doctor: 
but if it must be, put it off for several 
days." I did not inject, and the lady 
made a good and speedy recovery. 

Some time ago I attended a lady, aged 
64 years, suffering from sciatica. I gave 
her hypodermic injections of morphia 
and atropia in connection with internal 
treatment I at no time gave the former 
large dose, generally morph. gr. }4 } atro- 
pia gr. T £tf. Relieved pain for a day 
or two, then it would return. At the 
end of six weeks the case was cured, but 
at no time was the medicine pushed to 
its physiological effect. I always make 
my combinations without weighing. Use 
no put-up proportion tablets. 

Frank R. Brunner, M.D. ; 

Eshbach. Pa. 

[There is an o$ pi g^ now neglected, 



192 



THE MEDICAL WORLD. 



cure for sciatica, as follows : Inject a full 
dose of atropia, say ^ of a grain, or 
more, deeply at the seat of pain. To be 
successful it musfTJe a full dose, suffi- 
cient to produce the characteristic effects 
of the drug distinctly ; small doses re- 
peated will not answer. This treatment 
is perhaps equally applicable to lumbago. 
It is this treatment (hat. the Doctor has 
unwittingly used in some of his cases. 
If he uses atropia by " guess," he often 
uses much larger quantities than he sup- 
poses. We consider it dangerous to do 
this, and would strongly advise him to 
use tablets or granules, in which the 
quantities of the drug are accurately 
measured. Atropia is a powerful drug, 
and in the usual combination with mor- 
phia for injection is generally used in 
too large quantity, frequently causing 
nervons excitement instead of the desired 
rest. For % grain of morphia, T | Vf or 
perhaps, v £? grain of atropia is suffi- 
cient — Ed.] 

Sub-normal Temperature in Pneumonia fol- 
lowing Grip -Guaiacol Locally as an 
Antipyretic. 

Editor Medical World :— In the 
April World, Dr. J. H. Horden reports 
a case of pneumonia following grip, with 
sub-normal temperature. I have seen 
two cases like his, both following grip. 
In each case, as soon as the pneumonia 
symptoms became prominent as shown 
by the physical signs, blood-mixed sputa, 
etc., the temperature fell gradually 
(within 36 hours) from 103 to 96 , and 
remained there until recovery was well 
established. There was a corresponding 
drop in the pulse, in one case going to 
40 per minute. This condition lasted in 
each case for over a week, and bore no 
resemblance to the ordinary case of sud- 
den collapse, except that the skin felt 
too cold to the touch. Both recovered. 

I have recently seen a case where the 
temperature is above normal. In a little 
girl recovering from typho-malarial 
fpver, the temperature got to 99^° and 
stopped. After a week or more of gen- 
eral improvement, the temperature still 
remaining above the normal, the child 
was allowed to sit up and begin solid 
food. Improvement continued, and 
now, two months after, with the child 
apparently well and going where she 
pleases, her temperature is still 99^. 



Several thermometers give the same 
result. 

I wish to attest to the benefit I have 
gotten from guaiacol used locally as an 
antipyretic. From five to fifteen drops 
rubbed in over the iliac region will gen- 
erally reduce a temperature of 104° or 
iO£° to normal in two hours. Wash the 
skin well with soap and warm water, 
dry thoroughly, then rub in the guaiacol, 
a drop or two at a time, taking about 
twenty minutes to rub it in well. Cover 
with oiled silk or oiled paper. Rarely 
have I seen any depression or profuse 
sweating, the skin merely becoming cool 
and pleasant In several cases of mala- 
rial fever of the continued type, it seemed 
to abort the disease, as the temperature 
never rose again to its former height, 
and after a second application the fever 
stopped entirely. This, too, after ph en- 
ace tine had been used tor several days, 
the temperature rising after each reduc- 
tion with phenacetine. I seldom use the 
guaiacol over once in 24 hours. Begin 
with five drops, and if no effect, 
tiy ten ; I have never had to use over 
fifteen. Usually, after getting the effect 
once, the dose may be decreased next 
time. It is especially fine in typho- 
malarial trouble. In many cases I prefer 
it to the coal-tar preparations. In cases 
where it has been used only locally, the 
odor of Iguaiacol has been plainly noted 
in the stools. If it produces irritation 
of the skin, apply to the other side. 
Gavin Rawls, M. D. 

Carrsville, Pa. 

Twins with Locked Heads. 

Editor Medical World : — In 1853, 
the second year of my practice, having 
had but little of this kind of work (due 
to age and that lack of public confidence 
in young practitioners), I was called to 
see a German lady who was, as it proved, 

S'ving birth to twins. The first was a 
otling, the second a head presentation. 
When the first was delivered to the neck, 
it was found that the head of the second 
was preceded by the head of the first It 
was impossible, from the size and firm- 
ness of the bony structure of each head, 
to slide one or compress either to pass 
the other. Finding that the cord had 
ceased to pulsate, the head of the one so 
far delivered was amputated, pushed up 



THE MEDICAL WORLD. 



193 



and past the other, forceps applied to the 
second and delivered. At that time I 
had not received any instruction, oral or 
written, on this kind of case. I acted 
on my own mechanical judgment. Think- 
ing I might have done better, when next 
time in the city of New York, I called 
on Professor Gilman, who had lectured 
to our class of '52 on obstetrics at the 
College of Physicians and Surgeons. I 
told him what had been done, and asked 
him what he would have done under like 
circumstances. He said that these cases 
were rare, and that he, with all his ap- 
pliances at hand, would have bored into 
the base of the skull, emptied it of its 
contents, compressed the skull, and thus 
have made it possible to slide the first 
past the second. This seemed to me 
the most scientific procedure, as I recog- 
nized that in the rotation of the skull, 
aside from its being in the way, it might 
possibly, from some infinitesimal projec- 
tion of bone, have lacerated the soft 
parts of the mother. Some fifteen years 
ago, wishing to brush up my knowledge, 
I attended a full course of lectures at 
this same institution. I listened to Pro- 
fessor M on obstetrics. He taught 

the class to do as I had done of my own 
volition. I followed him after the lecture 
into his private room, related my case as 
I had treated it, and told him the plan 
which our former professor had sug- 
gested, and emphasized my belief as to 
its being the better plan. He confessed 
he had never had such a case. Will 
some of your obstetrical readers state 
which, in their opinion, is the better 
method ? 

Rahway, N. J. Elihu B. Silvers. 



Knee Joint Trouble. 

Editor Medical World: — Will you 
or some of your many subscribers give 
me diagnosis and suggest the proper 
treatment for the following case ? Mr. 
F., aged 49, carpenter, when about 15 
years of age became overheated while at 
work in a wheat field ; right knee be- 
came stiff; could not move it in the 
least; continued so for three months. 
Recovery complete. In 1885, while hunt- 
ing, stepped on a round stick, right foot 
rolled under him and he fell upon right 
leg. Knee popped. Had considerable 
-difficulty in straightening leg, but finally 



succeeded. Knee popped again. Re- 
covery in about ten days. In January, 
1896, was working at his trade carrying 
lumber up a flight of stairs. First no- 
ticed that he could not raise with right 
leg. Had to quit work. No other symp- 
tom than weakness. About June 1st 
commenced to experience pain in knee, 
which at times has been severe. Occa- 
sionally since, for one or two days at a 
time, has enjoyed immunity from pain. 
Swelling began about the same time and 
has continued. 
Measurements : 

Left knee — Immediately above patella, 17 in. 
Over patella, 15^ in. 
Immediately below patella, 15 in. 
Right knee — Immediately above patella, 

i6# in. 

Over patella, 17 in. 

Immediately below patella, 15 in. 

Above injured knee muscles are slightly 
atrophied. Now and then pain along 
course of sciatic nerve. Slight varicos- 
ity of veins below knee. At times cre- 
pitus in knee joint. 

Treatment tried : — Elastic bandage, 
worn in day time ; cold and hot water 
compresses at night ; massage ; poultice 
of hot wet wheat bran ; compress of oil 
of wintergreen and liniments by the 
dozen. W. T. Waters, M.D. 

Louisiana, Mo. 

Is This a Form of Influenza? 

Editor Medical World :— For the 
past three years, but more especially for 
the past two months, I have had to deal 
with a peculiar condition which I will 
in brief describe, and ask the editor of 
The World and its readers to discuss it 
through the columns of that valuable 
and much-read magazine. One patient 
may be taken with a light chill as the 
first symptom ; in others there will be a 
week or two of malaise, then a light chill 
or perhaps no chill ; the temperature will 
rise to ioo° or 101 , then some headache 
and muscular pains, then marked tym- 
panites over the ascending and transverse 
colon and over the stomach ; marked 
gurgling and sometimes tenderness in 
the ilio- cecal region. In two or three 
days the temperature fell to 97 , and in 
old or debilitated subjects to as low as 
96 . The heart's action is very weak 
and sometimes slow^he(§^^^a rule 



194 



THB MEDICAL WORLD, 



are constipated, the appetite is fairly 
good ; there is marked nervous prostra- 
tion. The above condition, under favor- 
able circumstances, will last three or four 
weeks, then slowly improve. The cases 
are prone to relapses and I have had the 
condition last for eight months. My 
diagnosis is a form of "grip." My treat- 
ment is absolute rest in bed, intestinal 
antiseptics, quinine and strychnia. Let 
me hear from the readers of The World. 

Burden, Kan. W. H. Mauser. 

[A form of influenza seems the most 
rational view of the above. Have our 
readers in Owher sections observed it? 
The treatment mentioned is good. Cod 
liver oil might advantageously be added 
in some cases. — Ed.] 

Hemorrhage from the Kidneys. 

Editor Medical World : — I wish to 
return thanks through the columns of 
The World to the brothers who kindly 
advised me as to treatment of my case of 
hemorrhage from kidneys, mentioned in 
March number, page 99. Besides the 
advice given in April World, I received 
letters by every mail from Canada to 
Texas and from New York to California. 
Now, as to the result Shortly after 
writing to The World, and before I had 
had time to leceive advice, I began a new 
treatment. I gave the patient half a 
teaspoonful of saw palmetto compound 
every three hours through the day. In 
two days there was improvement, in one 
week there was no hemorrage, nor has 
there been any since. The patient has 
gained fifteen pounds in flesh, is up and 
around attending to business, about as 
well as before this trouble. While,as it has 
turned out, I had no occasion to use the 
treatments suggested, yet this interchange 
of ideas, I trust, will be of some help to 
us all. Eugene Pendleton, M. D. 

Cuckoo, Va. 

Pruritis Ani. 

Editor Medical World :— Will some 
of the brothers suggest a cure for .an ag- 
gravated case of pruritis Ani ? I have 
used injections for pin worms and found 
none. Locally, pineoline, resinol, sali- 
cyilic acid, ichthyol and Dr. Waugh's new 
combination in the February World, 
viz.: Camphophenique, losophan and 
cosmoline. Am now trying balsam 



peru, oil amygdala and flexible collo- 
dion (without much hope of success), 
together with tine, red clover and laxa- 
tives internally. Any suggestions will 
be thankfully received. 

H. O Rockwell, M. D. 
East Troy, Wis. 

A Pendulous Scrotum an Indication of Illness 
in the Male Infant. 

Editor Medical World: — lam just 
rounding out my fourth year in practice, 
and I have had the benefit of The World 
visits most of the time. I wish to offer 
a mite in return. There are few physi- 
cians but what at some time in their 
practice have been called to see infants 
that were playing or resting quietly, in 
apparent nealth, and, after a hurried 
superficial examination, would, ^in an air 
of wisdom, state that there is nothing 
the matter. But in certain cases the 
physician may be called the next day, or 
hear that another physician is called, and 
the child is, indeed, sick — may be in con- 
vulsions from digestive disturbances or 
cyanosed by capillary bronchitis. The 
latter was the experience in a case where 
a physician, older than myself, was called, 
and such experience does not increase 
the confidence of the parents in doctors. 
The point I wish to call attention to will, 
in the case of the male infant, guard the 
physician against this mistake. It is the 
pendulous and relaxed condition of the 
scrotum. It will be found in a more or 
less marked degree, according to the dis- 
turbance of the system, whether from 
digestive or other troubles. When pre- 
sent it is sufficient indication for a 
thorough investigation of the case. 
Again, in the child of eight months or 
more, if the condition is absent, that is, 
if the scrotum be drawn up in a rounded 
compact ball, it is safe to conclude that 
there is no disturbance of the system, and 
any peevishness is due to the child being 
humored in everything. This relaxed 
condition of the scrotum will be found 
of use in determining the conditioaof 
the system in the adult also ; though it 
may be caused by excessive exercise as 
well as by disease. I would be glad to 
see a report of the observations of others 
on this point. B. W. Stearns, M. D. 

Long Eddy, N. Y. 

[Does not the writer express himself 

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THE MEDICAL WORLD. 



195 



rather positively ? The observations of 
many are necessary to establish a matter 
of this kind, and they may or may not 
establish the writers claims. — Ed.] 

Ten Years of Dosimetric Practice* 

[a continued story. ] 
Editor Medical World: — Being in 
my 64th year, and having retired from 
general practice, after 40 years of almost 
continuous arduous duty in harness as a 
studious, conscientious; true eclectic 
physician (although graduated regular 
allopathic), I am impressed with the 
feeling that I have still a duty to per- 
form by which I may possibly benefit 
my professional brethren, and, through 
them, suffering humanity. 

It is, to write and have published a 
series of articles giving a r6sum6 of my 
ten years' experience in the practice of 
Dr. ^ Ad. Burggraeve's method, called 
Dosimetry, which I will say, just here, 
means " measured doses/' as I still find 
many who do not know it's meaning, 
and it is not found in ordinary diction- 
aries. I have selected that old reliable 
and excellent journal, The Medical 
World, as the best medium for their 
publication, because they will be seen 
and read by more live, up-to-date phy- 
sicians than in any other current medi- 
cal journal published in America. While 
I am totally ignorant of the extent of 
their subscription list, I base this asser- 
tion upon the extraordinary attention 
given my first simple little squib of an 
article on "Dosimetry," published in 
July World, 1890. Before that issue 
reached me I had received dozens of 
letters from physicians living in close 
proximity to the office of publication, 
that great medical center, Philadelphia, 
from which all useful medical knowl- 
edge is supposed to emanate, and letters 
continued to arrive daily, till by the end 
of the year I had received over a thou- 
sand, from physicians in every State in 
the Union, Canada, Nova Scotia, New- 
Poundland, Cuba, Mexico, Central and 
South America and Australia, all seek- 
ing more light, and asking the meaning 
of the word, and where they could ob- 
tain literature upon the subject, and the 
granules which I used. Judging from 
these letters, I concluded that each 
monthly issue of that popular magazine, 



The Medical World, could certainly 
be found in every mail embraced in the 
Postal Union, for I received letters from 
London and Paris, referring to that little 
article, and it was reproduced in Burg- 
graeve's Paris journal as Veil as in the 
London Dosimetric Therapeutic Journal. 

There was nothing of any great in- 
trinsic value in the article itself, but it 
was the novelty of the subject that at- 
tracted attention, though the Dosimetric 
J?ezriew } New York, was in its fourth 
year, and there were about three thou- 
sand physicians in the United States 
practising the method then. 

The intense interest manifested by the 
writers of these letters evidenced the 
inability of the old method to give satis- 
faction, and many expressed themselves 
as being disgusted with the uncertainties 
of galenic preparations and ready to 
abandon medicine. These were the old 
men in the list, most of whom adopted 
this scientific method gladly ; but many 
of the younger men, while not expressing 
it in words, showed that they thought I 
had discovered a method which was a 
u panacea." If they tried it under this 
impression, I fear they met disappoint- 
ment and returned to their first love. 
While there is no such thing as a "cure- 
all," yet Dosimetry, when practiced with 
a full understanding of the etiology of 
disease and a correct knowledge of the 
therapeutic, physiologic and toxicologic 
effects of medicaments, comes nearer be- 
ing such, and wards off the advances of 
the "grim monster" better and longer 
than any mode ever tried by the profes- 
sion. It is, indeed, the crowning dis- 
covery in the wonderful evolution of 
medicine during the last half of the 
nineteenth century, and constitutes a 
mode* so catholic in its teaching that 
true physicians of all schools can, with- 
out hesitancy, adopt it. It is not a sys- 
tem, but simply therapeutic science in 
full battle array. It gives the physician 
4 'arms of precision," and a power over 
disease he never possessed before. It 
enables him to do what was unknown in 
medicine previously ; that is, to abort 
and jugulate disease in the dynamic and 
formative stages. 

Physicians, of all men, ought to be the 
most liberal and freest from bigotry and 
prejudice in regard to the views of others, 

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196 



THB MEDICAI, WORLD. 



and be ever ready to investigate and try 
any rational plan that promises to aid 
them in alleviating the sufferings and 
healing the sick. That Dosimetry is a 
rational and scientific method of medica- 
tion cannot be gainsaid by any candid 
and unbiased investigator, and it passes 
my comprehension why, being so simple 
and so easily tried, any true, honest 
physician will neglect it, especially at 
this day, when so many thousands of in- 
telligent physicians testify to its superi- 
ority over all old methods. It must be 
because man is naturally a creature of 
prejudice, for an honest self-examination 
reveals the fact that all men are, consci- 
ously or unconsciously, governed by some 
prejudice. I thought I had reached the 
age when I would be free from all preju- 
dice, but I feel like kicking myself on 
recalling the lost opportunities of the 
past year ; lost because I so obstinately 
rejected the advice of my friends to in- 
vestigate and try nuclein, all because of 
prejudice on account of the company it 
kept. Stern, bitter necessity finally 
forced me to yield and try it in my own 
case and several of my household, all 
convalesing from seveie attacks of la 
grippe in December last, and it surpassed 
all my expectation in rapidly restoring 
health, strength and appetite, in connec- 
tion with the dosimetric vital incitants. 
Since then I have used 2,600 tablets and 
2}i ounces of nuclein solution (Aulde), 
and it has given splendid results and 
proven satisfactory in every case in which 
I have given it. It fulfills more indica- 
tions than any one known therapeutic 
agent, and bids fair to lay claim to being 
the second greatest medical discovery of 
the age ; but this is a digression, and was 
mentioned only to show how one may re- 
gret being swayed by prejudice. I know 
dozens of physicians who speak con- 
temptuously of Dosimetry ; some charg- 
ing that it is in a line with patent medi- 
cine; others that it is homeopathy under 
a new name, and still others that it is 
dangerous, because it uses only concen- 
trated poisons. If they only knew how 
ridiculous they appear to the initiated 
they would certainly study up a subject 
about which they are so densely ignorant 
before they attempted to discuss it again. 
I will close this introductory paper by 
saying that subsequent ones will consist 



principally of condensed clinical notes of 
cases treated dosimetrically as they came 
up in daily practice, for my notes are not 
so as to conveniently devote one paper to 
a single disease. W. L. Coleman, M. D. 
Navasota, Texas. 

Persistent Hiccups. 

Editor Medical World: — I have a 
patient, now about 70 years of ag^, male, 
now troubled with chronic rheumatism. 
About fou\ years ago he had a very 
severe attacllof hiccups, lasting nearly 
two weeks, wttch nearly exhausted him, 
and finally yiemed to very large doses of 
morphine hypcJlermically. Jvater on he 
had another attack, equally severe, 
which finally wal conquerm by a large 
cantharides blist* over tjfe diaphragm. 
A third attack u Aye a^my " to a strong 
decoction of sweetlag. /bout two weeks 
ago he was taken with Ja fourth attack, 
following upon th^pa^ned pneumonia. 



He hiccupped cons! 
awake or asleep, 
tioned above, whic 
relief, failed, as we 
spasmodics. He w; 
weak, having hicc 
ten days. On Sat 
3, ice cream was s 
and administered, 
spoonful he s 
there has not b^en i 
up to this time. *The p 
this last attack,* was 1 1 
the arrest of the^disease. 
attacks the hiccupping 
ually, and fiujtlly sto] 
relief this ^st time 
taneous. I w^uld like 
others who may have 
ence with the Jast-mentioni 
this disease. Would sha 
internally or applied extern 
the same effect? Is ice rec< 
remedy in this affection? ,* ^w^**^ 
give the ice cream the credit^ of curing 
this case, for at the time he site it he was 
hiccupping just as hard atad as fre- 
quently as he had for ten days, and it 
stopped at once. 

Charles P. McCabe. 

Greenville, N. Y. 

[This is a nervous affection, and is 
cured by influences that will make an 
impression on the nervous system. A 

Digitized by VjOOQIC 



y day and night, 
lie remedies men- 
had before given 
a host of anti- 
etting extremely 
incessantly for 
afternoon, April 
ed as a remedy 
taking the first 
iccupping and 
slightest return 
culiar feature of 
t suddenness of 
In the former 
ubsided grad- 
d ; but the 
was instan- 
hear from 
ad experi- 
remedy in 
d ice taken 
ly have had 
nized as a 
I certainly 




THE MEDICAL WORLD. 



197 



sudden fright or surprise will usually 
stop them. In the above case the cold 
of the ice cream made just the kind of 
impression needed, hence the cure. It 
might fail in other cases just as the other 
remedies failed in this. The ice cream 
was a happy thought in this case. Al- 
ways empty the siomach and bowels 
thoroughly in persistent , cases, as the 
contractions may be a reflex action 
caused by an irritation in the digestive 
tract— Ed.] 

Petit Mai. 

Editor Medical World : — Mamie K., 
six years old, was a healthy child until 
three years of age, when she was taken 
suddenly with fever, followed in a few 
hours by a " spasm " which her parents 
inform me lasted five hours. The spasm 
or clonic contractions were in the right 
side. She was confined to her bed about 
thirty days, paralysis of right leg and 
arm having followed the spasm. There 
was also incomplete paralysis of facial 
muscles of the right cheek and complete 
loss of speech. For the past three years 
she has been having what her parents 
call spells, and which I call petit mal for 
want of a better name. She has regained 
the use of her leg and arm, also her 
speech. Occasionally the partial paral- 
ysis of the iace shows more plainly, 
especially when she has one of the spells. 

These spells her parents described to 
me as follows : While engaged in play 
she will suddenly complain of her stom- 
ach, run to her mother and say she is 
afraid of dogs; will draw up her legs, 
draw in her arms and crouch beside her 
mother for a few seconds, and for a short 
period has a blank expression as if there 
was a partial loss of consciousness. This 
passes away and she resumes her play. 
Once or twice during the last three years 
she has had a severe clonic convulsion. 

I began to treat her about a year ago 
upon the following plan: cod liver oil 
emulsion with hypophosphites of lime 
and soda, also bromide of ammonium in 
10 grain doses three times a day. Her 
general health is now good, and the 
spells are lighter and farther apart, but 
she does not get entirely well. I have 
used combined bromides, and suspended 
their use when circumstances would 
seem to warrant, but, besides the general 



improvement and the spells being lighter 
and farther apart, there is no direct im- 
provement. I also tried the hydrocyan- 
ate of iron, but could not see that it had 
any advantage over the bromides. Let 
me hear from the good brothers. 
Center Hill, Fla. W. H. Howell. 

Obstruction of Bowels, or Congestion of the 
Stomach, Which ? 

Editor Medical World : — I wish to 
report the following case because of the 
interest the profession always takes in 
something out of the ordinary, and 
because I would like for you, or some of 
your readers to name it foj; us. 

Patient, male, white, age 70, had been 
subject to attacks at irregular intervals 
of from six months to a year of bilious- 
ness; i.e. y dizziness, pain in the region 
of the stomach, followed and relieved by 
the vomiting of bile and imperfectly 
digested food. These attacks would not 
be severe enough to require the attention 
of a doctor, and would not last over 24 
hours. On the 9th of February, 1897, 
he sent for me and I found him easy, 
although he had been suflering a great 
deal, which was relieved by vomiting an 
hour before my arrival. This spell had 
been more painful in the region of his 
stomach and lasted longer than previous 
spells. I prescribed y 2 gr. of calomel 
every half hour till three doses were 
given, and then every three hours till 
bowels moved freely, and as an aid in 
re-establishing the function of digestion 
I gave a desertspoonful of Robinson's 
lime juice and pepsin at meal time, and 
between meals if there was any distress 
in his stomach ; and J recommended an 
abstinence from food for the next two 
meals. The calomel worked well and 
he was up the next day and continued 
to feel very well, though his bowels were 
a "little slow" he said. On Thursday, 
the 18th of February, he sent for me 
after suflering and vomiting considerably 
during the latter part of the night. His 
pulse was 47, temp. 98 , bowels had 
moved the day before ; no tenderness 
over abdomen except over stomach, and 
only slight there ; no tympanites. He 
continued to vomit and to suffer before 
vomiting, and that night vomited a cham- 
ber two-thirds full of bile and mucus. 
An enema brought away considerable 

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198 



THE MEDICAL WORLD 



fecal matter on Saturday. At this time 
his pulse was 72, and his heart action 
labored. On Saturday night he began 
to vomit stercoraceous matter, and when 
I saw him on Sunday his pulse was 90, 
temperature normal, his mind clear, his 
tongue moist and coated very little, and 
suffering with no pain except at stomach. 
1 had been giving bismuth sub-nit, lime 
juice and pepsin, peptenzyme, Upjohn's 
aloin, belladonna and strychina pills by 
the stomach, and morphia and atropia 
hypodermically ; but 1 don't believe any 
of the medicine given internally was 
absorbed. I had also been giving large 
enemas. 

I now felt sure he would die, and as 
my prospects for seeing him again in 
the next few hours were not good (on 
account of high water), I recommended 
morphia by the rectum to give relief. I 
saw him no more. He died at 3 p. m. 
Monday, five days from the beginning of 
the last attack. 

Now, although during the last attack 
I was never able to get a free passage 
through the alimentary canal, I believe 
that was because of non-absorption from 
the stomach and a reversion of peristalsis, 
and not from any obstruction. There 
was no tumor, no tenderness, no tym- 
panites till Sunday, and no fever at any 
time ; his pulse was on the first day 47, 
second 60, third 72, fourth 90. His 
urine was scant and high colored from 
the beginning, and was very acid, but 
contained no albumin nor tube casts on 
Friday — the only day it was tested. 

Now, if others can suggest a name for 
this disease other than congestion of the 
stomach, I would he glad to have their 
ideas. 

G. G. Thomton, M. D. 

Gravel Switch, Ky. 

Triplets. 

Editor Medical World:— Boy and 
two girls ; boy head presentation, both 
girls feet presentation. Mother and 
children doing well ; tenth day since 
birth. R. H. Drewry, M. D. 

Brooks Sta., Ga. 

A few imperfect copies of April World 
were sent out before we knew it. If you 
got one we will send you a perfect one. 

Those who want back numbers for 1897 
send subscription immediately. 



The Fifty-Cent Co-operative Hospital Associ- 
ation. 

Editor Medical World : — The med- 
ical profession in St Louis at the present 
time are greatly agitated over the appear- 
ance in our midst of the Co-operative 
Hospital Association. The medical so- 
ciety has investigated the matter thor- 
oughly by committee, discussed the 
same from all points of view in open 
meeting, and condemned the association 
in no uncertain tone. 

Great inroads have been made in the 
income of all general practitioners, and 
it is estimated that an amount equal to 
$300 for each authorized physician in 
the city is annually distributed by- the 
officers of these associations. This rep- 
resents the loss to the profession at large, 
and the consequent deprivation of the 
luxuries of life, to say the least, to sev- 
eral hundreds of medical men. T dare 
say that many other cities of these United 
States have suffered in like proportion. 

The question is, therefore, one of more 
than average importance, and journals 
all over the country should not remain 
silent For this reason I feel it my duty 
to add my feeble contribution, and try 
to do my part to aid in the settlement of 
the apparent calamity which has fallen, 
like a blighting frost, upon our pro- 
fession. 

Dr. Emory La upbear, of the American 
Journal of Surgery and Gynecology of 
this city, has sent out circulars to all 
well-known physicians soliciting their 
opinions on the subject, many of which 
he has published. Information on this 
subject as regards extent, methods em- 
ployed, the ones benefited, the ones in- 
jured by these associations, the economic 
reasons leading to their organization and 
their probable trend is remarkably scarce. 
There exists some uncertainty as to how 
they should be looked upon by the phy- 
sician not interested in said associations, 
and considerable ignorance in regard to 
the general therapeutics of the situation. 
Hospitals caring for the sick of these 
associations have been appealed to, and 
almost without exception tney reply that 
they do no contract work, but simply 
receive the patients sent by the associa- 
tion, at the regular prices charged to 
other patients. The physicians who 
attend the patients of these associations 



THE MEDICAL WORLD. 



199 



deny any contract to treat patients for 
fifty cents per month, which, by the way, 
is the usual price, claiming that when 
they do work for these associations they 
receive their regular fees for the work 
done. They declare that they have done 
nothing unethical. 

Circulars have been distributed broad- 
cast lauding in most extravagant terms 
the benefits of the association, and the 
wonderful ability and loving care of the 
physicians attached to the association. 
These circulars bear the names of many 
of our hitherto most respected members 
of our profession. Specialists, teachers 
in colleges, editors, hospital superin- 
tendents, presidents of medical societies 
are all represented. 

These men, when brought to account, 
strenuously deny that they gave authority 
for these publications, and declare that 
the use of their names was without their 
knowledge, consent or approval. How- 
ever fishy these denials may seem, we 
are, of course, unable to prove such au- 
thorization, but no party has, to our 
knowledge, been sued for forgery. It is 
fair to suppose that the practitioners in 
question have gathered the benefits de- 
rived from such gratuitous advertising, 
and calmly winked the other eye, thank- 
ing Providence for the flood lately setting 
in in their direction. We were informed 
the other day, by a reputable practitioner 
of our acquaintance, of the following 
circumstance : The practitioner in ques- 
tion had engaged with a prospective pa- 
tient, in consideration of forty dollars, to 
perform a certain operation for the relief 
of a rectal fistula. The patient was to 
enter a hospital ward secured by the sur- 
geon on the next day. The surgeon had 
his assistant ready and the room prepared, 
but the patient showed not up, nor did 
the surgeon see his patient for the pe- 
riod of three weeks thereafter, when he 
chanced to meet him on the street. 

The surgeon inquired the reason why 
he had been thus treated. The patient 
laughed at the surgeon and informed 
him that someone had " put him on to a 
good deal softer snap." That he had 
paid fifty cents dues, in advance, to a co- 
operative hospital association, and had 
been by them sent to a well-known hos- 
pital where a certain well-known sur- 
geon, of equal or greater ability than the 



one addressed, had operated on him, aid 
cured him, andall free ofany extra charge. 
Room, board in hospital, nurse and sur- 
geon, all for the small sum of fifty cents! 
He had since concluded to cease paying 
dues, and allow himself to be dropped 
from the roll of members. The surgeon 
took a piece of sand paper and went home 
and polished his bald head, for that was 
all he could do. This is a fair specimen 
of the methods of these associations. 

We have been led to believe that upon 
our profession the so-called trust could 
have no influence ; that the medical 
profession was united by ties of an 
entirely different kind. That our code 
of ethics would protect us from serious 
dissensions within, and that the necessity 
for our services would protect us from 
without That we might continue to 
offer to the young academician a decent 
living and the opportunity for develop- 
ing a noble manhood. But the condi- 
tion of things offered by such associa- 
tions savors mightily of the trust. 

Other occupatious have been rendered 
slavish and servile by the introduction 
of machinery and altered social condi- 
tions ; now the medical profession must 
be made to draw the band wagon and 
compete with one another for subsistence. 
While this is unfortunate, it is to be ex- 
pected. The same depression and crowd- 
ing forced upon other occupations must 
finally react upon ours. Boys who find 
better wages in medicine than on the 
farm or in the factory will flock into 
medicine, and thus the profession 
becomes over-crowded. This cannot be 
avoided. Every scheme designed to 
reduce competition is unjust and bound 
to fail, and all legislation looking to that 
end is class legislation and will receive 
no favor at the hands of modern political 
economy. The evening and leveling 
process which civilization brings is bound 
to go on in some direction. The force of 
a river was never destroyed by damming 
it 

Is it any wonder that the selfish of our 
profession attempt to corner practice by 
organizing these monthly payment asso- 
ciations? They have existed for many 
years in the old country, and now find 
welcome footing here among the poorer 
classes of people. The opportunity thus 
offered to obtain board and lodging when 



200 



THE MEDICAL WORLD. 



sick, or when they find it convenient to 
complain of sickness, in a decent com- 
fortable hospital, with medical advice 
thrown in, must be very agreeable for 
poverty-stricken inhabitants of large 
cities to contemplate. This possibility 
to unite for the common good is a right 
which cannot be denied, and should in 
no way be abridged. It seems to us that 
all that is wanting to make these asso- 
ciations desirable from the point of view 
of our profession is that their by-laws 
should allow the member to choose his 
own medical attendant from the ranks of 
the authorized profession. Also, that the 
association should adopt a reasonable fee 
bill, according to which all physicians 
called to a home or hospital, or with 
whom a member of the association might 
consult at the office, should be paid. 

No physician would object to having 
his patient of moderate circumstances 
cared for in a hospital when such might 
be necessary, nor would he object to 
having his fees collected by a responsible 
association. What we do object to is 
that certain members of the profession 
should enjoy a monopoly of this practice, 
which, although it might not pay large 
or exhorbitant fees, still forms at present 
the only resource to which the young 
and rising practitioner has to look for 
his subsistence. If these associations 
pay regular fees for their physicians, why 
should they care what particular physi- 
cian received these fees, so long as the 
welfare of the patient is properly at- 
tended to ? If this plan which I suggest 
were carried out, it would result in great 
good both to the profession and to the 
patient ; but, if allowed to go on in the 
present groove, it means the financial 
ruin of the profession, and the neglect 
and careless treatment of a large number 
of patients. 

We expect to hear strong objections to 
the plan from those physicians who are 
already connected with* these associa- 
tions, but we firmly believe this is the 
only basis on which the medical societies, 
organized under the American Code of 
Etnics, can tolerate the Co-operative 
Hospital Associations or the practitioners 
connected with them. 

R. C. Blackmer, M. D., 
Prof, of hegal Medicine, Barnes Medical College. 

6746 Waldemaf ave. , St. Louis, Mo. 



Impaction of Bowel. 

Editor Medical World:— On Sept 3d 
last I was summoned to see Mr. P. W. 
A., aged 56. I found him suffering from 
a deranged or slightly inflamed stomach, 
and the physical examination apparently- 
revealed congestion of the liver, but this 
was obscured by a pendulous abdomen. 
His stomach had rejected solid food, but 
liquids were. retained. 

The bowels, according to his state- 
ment, were regular, but four or five days 
before he had a slight diarrhea. The 
tongue was coated with red borders. I 
gave him some ipecac to settle his stom- 
ach. I also gave him two calomel and 
podophyllin tablets to open the bowels. 

Second visit, September 4th. At this 
time he seemed better. No more vomit- 
ing, and the bowels had moved twice. 
The medicine, however, had not passed 
through the bowels, for the stools were 
hard and dry. His condition being so 
much improved, I did not deem it neces- 
sary to make another visit, and so in- 
formed the family. But on the morning 
of the 5th I was hurriedly summoned, the 
messenger stating that he was very sick. 
In a very short time they sent forme again. 

When I entered the room and took 
one look at his face it made an impres- 
sion upon me that will not soon be 
effaced. A perfect picture of distress 
and agony. His breathing was about 60 
per minute; his abdomen distended to 
the utmost, and the entire body bathed 
with a cold perspiration. He declared 
that it was useless to attempt relief, as 
he could live but a short time. 

I immediately injected all the warm 
water that the bowel could take, and re- 
peated it. This brought a considerable 
quantity of hard, black, scybalous 
masses, and gave temporary relief. At 
this time he began to vomit incessantly, 
which was at first bilious but soon 
changed to the black vomit similar to 
that in yellow fever. In the afternoon a 
consultation was held and it was decided 
to resort to Dr. Waugh's " thumping big 
physic. " 

Accordingly we gave him two table- 
spoonfuls of cascara. 

At this time he was vomiting only at 
intervals of one or two hours, but its 
character was unchanged. 

He retained the cascara for some time, 



THE MEDICAL WORLD. 



20I 



but finally vomited it. The same dose 
was repeated with the same result. This 
was the mistake, and I hope to never do 
so again. He was suffering from fecal 
impaction, and my experience in this 
case has shown me the fallacy of such a 
course. 

The fortnight following this I was 
with the patient more than half the 
time, and used hot water enemas as often 
as the condition of the patient would 
permit. I would use about four gallons 
of water at a time — that is, before I al- 
lowed him to rest The bowel at first 
would hold only about one quart ; this 
would be passed and each time hiring 
away some fecal matter. I constantly 
looked for a fatal termination, as the 
gravest of symptoms were present for 
more than two weeks. But I now real- 
ized that the man's life depended en- 
tirely on thelremoval of the obstruction, 
and to this/endjrf€iV my measures di- 
rected. Tne o^ntentaof tj^Fbowel were 
gradually neoved bywwraiilic means, 
as it weipJfor it was impossible to dilate 
the cgldnlufficient to/f[ow the water to 
ie Astruction. /Toward the last I 

ed larfe quantitip oflelycenne with 
the greatest benefijr I aEo used castor 
oil by lnunctionf applying it over the 
abdomen* witho/t producing any effect 
The cec mtt <hto ascending Ycolon were 
packed with the accumulated feces, and 
the entire gut became severely inflamed. 

When I succeeded in clearing the 
bowel, the patient, now a mere skeleton, 
began to improve. At the height of the 
attack a severe stomatitis developed. 

I allowed him to use cracked ice, lem- 
onade and all the purely liquid food he 
would take. The latter, however, he 
took very little of. 

The only medicine used after the 
bowel was clear was strychnia sulph., 
gr. i-ioo, two tablets three times a day. 
I report this case particularly for the 
younger readers of The World, and 
hope it will cause them to hesitate before 
using purgatives in similar cases. After 
the lumen of tlje intestine has become 
occluded and the bowels distended with 
gas, no purgative, however strong, will 
go through, and to apply them means 
injury to your patient 

D. Orbstus McCracy, M.D. 

Semmes, Ala. 



Treatment of Cancer with Marsden's Paste. 

Editor Medical WoRLDi-^In reply to 
" A Country Doctor's' ' qt^tyj P a & e I22 , 
as to bl\odless method of ijeating cancer, 
I would>6ay that in situ; 
knife cairaot be used, o: 
jects|to itsVise, I have 
paste to an&tarer the pi 

It is quite^Munful qfld 
is apt to produce co: 
but I have nevV k 



tional symptom; 
suiting from the a! 
The greatest obj« 
pain and time, 
should remain 
or longer, ow: 
the afiected 
growth or 
lost its vital 
complish 
of morphi 
the pain #f 
paste is rj 
vaselin 



>ns where the 
he patient ob- 
und Marsden's 
se very well. 
about the face 
derable swelling ; 
of any constitu- 



■esult. The scar re- 

nic is inconspicuous. 

ions to its use are the 

rlbuired. The paste 

foMwenty-four hours, 

to Vie appearance of 

t whenexamined. The 

is blacA or shows it has 

, when thV arsenic has ac- 

its mission. \ Hypodermics 

may be indicated to relieve 

the application After the 

oved, a dressing Vcarbolized 

n lint is sufficient iThe slough 



is genefally soon thrown of, and the 
resultyg ulcer heals kindly and rapidly 
whenfthe arsenic has been effectually 
used/ Marsden's paste is equal parts 
arsenious acid and pulverized accacia 
wet with water. 

E. P. Edwards, M. D. 

Paris, Texas. 

[Gould's Dictionary says : "Marsden's 
mucilage or paste. A caustic paste con- 
sisting of one part of white arsenic to 
two of gum arabic. " — Ed.1 



Hysteria and Neurasthenia. 

Editor Medical World : — The gene- 
ral practitioner in the country is most in- 
terested in the most common and the most 
difficult diseases to manage; because, 
unlike his city brother, he is often, from 
circumstances over which he has no con- 
trol, forced to rely on his own resources, 
where his more fortunately located city 
brother would either call in a consultant 
or send the patient to a specialist. Spe- 
cialists npw are legion ; the oculist, the 
aurist, gynecologist, chloroformist, lap- 
arotomist, dermatologist, neurologist, 
surgeon, genito-urinary surgeon, ad infi- 
nitum. It would seem that the general 
practitioner in the city has little to do 
except sort out the cases for the specalist 
In the country % g ^oQ^ has to be 



202 



THE MEDICAL WORLD. 



all sorts of a specialist, and use all kinds of 
un trained nurses, and be subjected to the 
criticisms of all the cranky old women 
who have a burning desire to pose as a 
u good baby doctor," or a good u nuss. M 

In no one specially that I now call to 
mind is there such a great field for the 
general practitioner to do good and give 
relief and happiness as that of neurol- 
ogist ; particularly so far as the proper 
management and treatment of the two 
great diseases mentioned above embrace 
that term. While I recognize the fact 
that either of these diseases may occur 
in either sex, I don't think it far wrong 
to say that neurasthenia is in the male 
the analogue of hysteria in the female. 
Probably no race, station, or age among 
civilized people, after we leave childhood, 
is exempt from either of these diseases ; 
but there can be no question that they 
are more frequently found iir what is 
called the " upper" and "middle " than 
in the u lower " classes. The explanation 
of this is easy when we remember that in 
this age of hurry, push and worry, every 
fellow for himself, with the nervous sys- 
tem running under high pressure, the 
father and mother become "nervous," 
and by the laws of heredity impart a 
tendency that way to their offspring, and 
generation after generation by heredity 
and cultivation, so to speak, it takes no 
pessimistic eye to see us a nation of 
nervous bankrupts (paupers), as well as 
financial paupers if the gold standard is 
to prevail. 

These diseases are of great importance 
to the general practitioner, not only be- 
cause of their frequency, but because of 
their symptoms simulating and the 
deseases complicating so many of the 
graver diseases, thereby tending to mis- 
lead him in diognosis, prognosis and 
treatment. They are important also 
because of the fact that they legimately 
belong to him, and because, if skillful in 
their management, he can often treat and 
cure them more rapidly and cheaper than 
the city specialist. I have seen two cases 
of hysterical convulsions coming on 
immediately after delivery, in which 
they simulated puerperal eclampsia so 
closely that I was compelled to make 
heavy drafts on my gray matter to decide 
positively which they were not. I have 
seen cases of hysterical vomiting accom- 



panied by pain in the region of the stomach 
which was so persistent as to make it 
difficult to decide positively that there 
was no gastritis. 

One case I will relate here, as it will 
show how I cured one case that gave me 
a great deal of trouble. Mrs. P., white, 
age 34, mother of one child, dead, of a 
nervous temperament, began having 
hysterical attacks with her stomach, 
vomiting and suffering great pain, which 
I at first thought to be neuralagia of the 
stomach, and began by giving a hypo- 
dermic of morphia and other remedies 
which in time brought relief in a few 
days. These attacks would recur at 
irregular intervals of from three to six 
months, and would usually occur on a 
very bad night, after she had done more 
work than she ought She would begin 
by feeling like she were going to have a 
"spell," and then she would say some- 
thing about it being such a bad night to 
go for the doctor if she did have a 
u spell," and then she would immediately 
go into a "spell." I always gave her a 
hypodermic of morphia, as the vomiting 
was persistent and her suffering great, 
and her family was always greatly 
alarmed about her, although after the 
first few attacks I had assured them there 
was no danger in the spells ; that it was 
not neuralgia, but a functional disturb- 
ance of the nervous system. I treated 
her with tonics, antispasmodics, by 
suggestion, and in every rational way I 
could think of, until I almost despaired 
of curing her. She would take remedies 
to ward off an attack, but vomit them up, 
and finally the hypodermic would be 
required to give the much-desired relief. 
Finally I decided to stop that, and so 
told her on one of my visits, and began 
giving her different remedies by the 
mouth, not being very particular how 
bad they were, telling her that even if 
she did vomit, probably some of it would 
be absorbed ; as soon as she would vomit 
I would give more, in this way hoping to 
bring her system under the influence of 
medicine and thus convince her that she 
could get relief without the hypodermic, 
but my hopes were in vain. After 
staying from 8 p. m. till i a. m., and 
despairing of relieving her by this 
method, I remarked to her that I would 
have to give the hypodermic, which I 

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THE MEDICAL WORLD. 



203 



did of plain warm water^ remarking to 
her that she would be easy in half an 
hour. I now left the room and returned 
in twenty minutes, and asked her if she 
were easy, to which she replied that I 
had not given her much morphine. I told 
her she that did not need much. When 
the thirty minutes were up she fell 
asleep, and I shortly took my departure. 
However, before I left, I assured her 
husband that I had given her nothing 
hypodermically but warm water, and 
cautioned them to not tell her that 
night, but to be sure and tell' her the 
next morningt That has been over a 
year, and she has been in good health 
since. 

As in all other diseases, the first thing 
is to be positive in making the diagnosis 
and as positive in the prognosis, always 
remembering, however, that the term 
44 hysterics" has a more odius meaning 
to most people than itch or syphilis. A 
functional disturbance of the nervous 
system sounds better to them and gives 
the doctor a better show to hold his case 
and benefit the patient 

The treatment should begin by show- 
ing the patient you thoroughly under- 
stand the case, and that you fully sym- 
pathize with her ; that so far as death is 
concerned, there is no danger unless 
something else should come up; that 
however badly she feels, you can assure 
her there are thousands who feel as badly 
or worse. Don't tell these patients not 
to notice the smothering sensations, or 
the globus hystericus, or the palpitating 
heart, or the " queer feeling " bf which 
many of them complain, because they 
could no more do so than they could do 
the same in regard to an aching tooth or 
a piercing headache. However, it is im- 
portant to divert their minds from their 
condition by advising them to have some 
light employment which will give the 
muscles and mind some exercise. Re- 
member always that the nervous system 
is somewhat like a bank account, requir- 
ing us to put in as much force as we 
draw out, and that mental worry is one 
of the main factors in the waste of nerve 
force. The patient should be taught 
that the vital functions, such as respira- 
tion, circulation and digestion, will do 
better when left unnoticed, and that as 
far as possible they should refrain from 



trying to keep watch over these 
functions. 

Sleep being " nature's sweet restorer," 
we should always see to it that our 
patient gets all the sleep which tired 
nature in these cases requires. In ordi 7 
nary cases of neurasthenia I get good 
suits from that very useful and my£h 
abused drug, acetanilid, by giving Jrom 
eight to ffen grains in hot water Jrbout 
half an how: before retiring. 

One esseVtial in the manag^bent of 
these cases i\for the patient to lave the 
ence in the docto/ and for 



utmost confi< 

the doctor tolhave the same 
in his own a\ility to man 
properly ; thenV>y a proper 
remedies the cuk is readily 
The bowels shVuld be ke, 
the principle th^t activi 



nfidence 

e the case 

lection of 

ffected. 

moving on 

is life knd 

s can often be 

et triturate of 

'trychnia before 

a dose of phos- 

morning. The 

combined with 

elixYkola toinp. of 

parts, \nd given in 

s t will\often yield 



ta 



stagnation is dise; 
done best by givin 
aloin, belladonna art 
each meal, or by givf 
phate of sodium ev< 
syr. hypopos. coi 
either celerina or t 
P. D. & Co., equa] 
dessertspoonful di 

brilliant results ; Also the syA hypophos. 
comp. with maltAe and cascaki sagrada, 
equal parts, anfl given the sWe way ; 
also giving a lose of potassium brom 
about twenty^grains three to h\ times 
*ts the indications, 
will be benefited by asa- 
>y camphor monobrom., in 
(three grain doses, some by a 
of brom. soda and brom. 
grs. eachiand twenty 
am&onia three or 
Peacock's bro- 
be benefited by 
these remedies 
>omtfetfvill be cured 
permanently, others /cured temporarily, 
to relapse in time because of the neurotic 
tendency in some cases. * 

G. G. ThoMton, M. D. 
Gravel Switch, Ky. / 



daily often m 

Some c 
fetida, som 
from two t 
combinatio; 
potassa fifteen 
drops of afrom. 
four time? daily, s< 
mides, and all cases 
a combination of som< 
with a tonic course. 



The " North American Vulture " Must do. 

Editor Medical World : — We are in- 
terested in the discussion of the yarious 
economic questions which are presented 
from time to time for the consideration 
of the WORLDfamil b y ^dj^ly, too, 



204 



THE MEDICAL WORLD. 



for we believe that every question that 
either directly or indirectly affects the 
physician* s exchequer should be discussed 
in a medical magazine. Let me present 
one which Jr would like to hear discussed 
throughout our entire nation. It is this : 
The turkey buzzard is a carrier of con- 
1 tagion. Should it not be exterminated ? 
I* have had several tests made, both in 
Iowa and in this State, which have 
thoroughly convinced me that the buz- 
zard brings the hog cholera to our coun- 
try, and scatters the disease from herd to 
herd, until a loss of millions of swine is 
the result. Has a patron ever called 
at your office and communicated to you 
the unpleasant news that he could not 
pay his bill as the result of the swine 
plague, or hog cholera, and thus made 
you feel so very uncomfortable? How 
many seasons are you deprived of the 
greater part of your earnings, by reason 
of this same scourge ? We are informed 
that many States have a statutory law, 
making it a misdemeanor, finable in the 
sum of $5.00, to kill a buzzard. Would 
it not be better for each State to give a 
bounty of $2.00 on every buzzard killed ? 

Graysville, Ind. E.J. Yager, M.D. 

[This illustrates our interdependence. 
We do not raise swine, yet we are inter- 
ested in the prosperity of those who do, 
for when they suffer loss we suffer loss. 
" Every one for himself" is not a good 
motto ; it does not pay. Mutual help is 
the best self help. 

If buzzards carry hog cholera, they 
can carry other diseases. — Ed. 1 

Was it Appendicitis ? 

Editor Medical World:— I note 
your criticism of my article, page 158, 
April World. I mentioned the princi- 
pal facts, not all the minutiae. Your 
method of differentiating between ap- 
pendicitis and fecal impaction is, I sup- 
pose, familiar to all physicians. I pre- 
fer salines to castor-oil, if there is fever. 
I am somewhat familiar with cases of 
impaction of the large bowel in different 
locations. In my experience, cases of 
impaction without inflammation of some 
tissue airenot ^fctfipctecl with fever, while 
cases of appendicitis usually are. When 
the impaction is removed the swelling is 

tone, and does not take eight or ten 
ays to disappear gradually together 



with the fever. This is, I think, in ac- 
cord with most of the authorities. I 
am aware that there are those now who 
claim that all cases of apparent appen- 
dicitis are not such if they recover with- 
out an operation, but are cases of impac- 
tion. Of course, it is about as difficult 
to disprove this absolutely as it is the 
doctrine of fatalism. I suppose thefe 
may be different degrees of severity in 
appendicitis. In the case which I re- 
ported, the pain came on suddenly with 
fever the day before I saw her, and in- 
creased. The swelling appeared gradu- 
ally and reached the maximum about 
six days from the start, and could be felt 
per vaginam. The bowels seemed to 
have been thoroughly cleared within 24 
hours of my first visit, but the signs and 
symptoms increased for several days. 
The decubitus was constantly dorsal. 
The nurse has since told me that the 
two stoofc mentioned were liquid, gray 
in color, and looked like pus. I did not 
see them. I have seen the patient within 
a few days. There is no tumor nor 
swelling now, but a feeling of rather 
greater resistance at the site of the former 
swelling (the centre of which was at the 
upper and inner part of the right in- 
guinal region) than elsewhere. She 
tells me that overexertion, such as heavy 
lifting, sweeping, etc, causes some pain 
and tenderness there, which subsides 
with rest and cold applications. Her 
uterus and ovaries are normal. Her 
bowels are now, and have been since 
her attack, perfectly regular. Constipa- 
tion existed, but was not extreme nor 
habitual, before. Call her attack ca- 
tarrhal appendicitis (Wood), typhlitis, 
paratyphlitis, or perityphlitis, or all to- 
gether, but not, in my humble opinion, 
simply fecal impaction. 

E. A. Sanborn, M.D. 
Somerville, Mass. 



/ 



Eczema: 

Editor Medical World :— Please ask 
u B," of Tenn., if he has tried boric acid 
and acetanilid, equal parts, finely pow- 
dered in mortar? Clean off scabs, etc., 
with a poultice followed by warm water 
(or good soap and water), and dust the 
parts thickly with above powder, apply 
cotton and a bandage. Redress ^every 
twenty-four hours. I have seen eczema 

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V 



THE MEDICAL WORLD. 



205 



of almost every part of the tody, and 
some very bad cases, yield in a few days 
to this treatment. ^^**** 

Years ago I used \^0KToi blue stone 
to 1 oz. water an^^Iram of laudanum 
in same wa^/frifrngood success. Arsen- 
iate of strychnia and iron, 1-67 gr. every 
four hours, will aid. 

Brodnax, La. Ben. H. Brodnax, 

Index-Book. 

Dr. Ernest E. Guinn, Alto, Texas, 
writes : u Now, let me advise all of the 
readers of this journal and others to ob- 
tain binders and bind their Worlds, as 
they are worth tar more than text-books. 
When you read an article that you think 
will hereafter be of any help to you, 
mark it, and at some leisure moment 
note it in your index-book, giving the 
journal, Vol. — , No. — , etc., like this : 
Medical World, Vol. 14, No. 12, page 
— . I use a small paper back book for 
my index-book, and I can refer. to any 
subject that I may wish to in ten 
minutes." 

Dr. J. G. Jennett, of Collisburgh, 
Tex., writes as follows : " Concerning 
tabulating interesting articles in jour- 
nals, I would say that my method is to 
order a binder with my World subscrip- 
tion each year. I bind January World 
and add each issue thereafter as it 
arrives ; then I have all my numbers to- 
gether in their regular order and pro- 
tected from being torn, soiled or scat- 
tered and lost. At the first of the year I 
paste good ruled paper on the inside of 
the covers of the binder, and there create 
my special index to articles which I think 
I will wish to refer to hereafter." 

Notes from Practice. 

Rheum atism-Dipthheria— La Grippe -Scar- 
latina—Diabetes Mei<litus— Whooping 
Cough — Dysentery — Typhoid Fever 
Pneumonia. 

Editor Medical World : — For acute 
rheumatism I have found tongaline in 
dram doses every two hours, accompanied 
by an occasional dose of antikamnia, the 
best medication for internal use. Locally 
I use the following : 
R Salicylic acid, . . dr. j 
Sulphuric ether, . . oz. j 
Alcohol, oz. ij 

Olive oil (or cotton seed) dr. j 
Mix. -Apply locally, three times a day. 



grs. 
grs. 



for a 






day of the) 

chnia sulphate, 

ofagrain,every 

ally I spray with 

Full strength at 

to slough I 

four or five, 

ery two or 



In diphtheria, first I use antitoxi 
besides antitoxin I make use of 
following : 

R Ammonia bromide, 
Ammonia iodide, 
Acid carbolic, - . 
Water, . 
Sig. Teaspoonfol, every thi 
Ud 12 years old 

About the second 
disease I begin wit 
in doses from 1-120 to 
three or four hours 
peroxide of hydroi 
first ; as membra^F be 
dilute with waJK, one 
and continue^spraying 
three hours. 

In la gtype I have found l\e follow- 
ing treatfrent to give good res 
R. §JKi salicyl., df^v 

potass., ... dr. 
aconiti, . . . gtt. 
Aquae, . . . q 8^ oz. V9 

M. Sig.— Teaspoonful, well di^tejj/every 
three hours. 
R. Antil 

Mak£^fHfo four powders ^roe even four 
hours until relieved of the intense aching 

I have found the following 
good.results in scarlatina : 

R. JPotassii. bromidi., •j^^ x - *J 

tassii. iodidi., . Jr dr. j 
Ti^aconiti, . V^« £ tt - 3o 
Tr. W^ladonnae,^r gtt. 30 

Acidi a^jbolicL((F . gtt. 24 

Aquas, ^^V^ q. s. oz. iv 

M. Sig. — Temtenful (diluted) every three 
hours for chiy^welv^years of age. 



Carbjmc acid 

\>felifle, 
M. Apply locally three tl! 
Diabetes mellitus : 
L. B^mide potass., 

Fowrat's solution. 

Water, 



gtts. 40 
oz. ij 
\ a day. 



oz j 
dr.j 
oz. viij 



M. Sig. — Teaspipful (diluted) every three 
hours. 

R. Codeia/^Sig.— C 
creased to^wo grains. Col 
ous f" 



grain a day, in- 
ae to a nitrogen- 



Whooping cough : 



Pdt^ssi bromidi, 

Amm&JHi^bromidi, 

Sodii bromfc 

Acidi carboliciT* 

Aquae, . r . .""N^q. 

Sig. — Teaspoonful ever 



dr. 11 
^J*r5ss 
" dr. jas 
gtts. 30 
_,s. oz. iv 
M. Sig. — Teaspoonful eve^^Jiree hours, 
for a child twelve years of age. 

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206 



THE MBDICAL WORLD. 




The following is a treatment par ex- 
cellence n|r dysentery : 

R. Sulph.fiqagnesia, . oz. iij 

Make three a^ses ; give^fne every hour, 
until the bowels movjr copiously three 
or four times froriwJrae magnesia ; be 
sure and give two doles of the magnesia 
any way. Thi^rfill sVp the blood and 
tenesmus. A^r the frefe watery actions, 
begin the^iflowing : 

R. Jbefoum Sulphuricum Arom., dr. ij 
Tr. opium, . . . dr. yj 

M. Sig. — Thirty drops every three hours 
for pains and diarrhea. 

Follow this treatment, and, if ad- 
ministered early in the disease, you will 
never have to make the second visit . 



R. 



loid fever : 

act. iodine, 
Dlic acid, 



q. *J 



£Teaspoonful in a 
three hours. 



fne glass of 



grs. xv 

ae every three 
r the same hours as 



M. Si 
ice water 

R. Quint^ 
Kt. Caps 
hours during 
the above 

For hyperpyrex J^old water, cold wet 
sheet or the bdXm Repeat as often as 
needed. Diet w MilHkand soups and 
nothing else fdr ten dayswer the patient 
has been deaf of fever. Tfcen you may 
add solids wutiously, but livery, very 
careful h<m you administer sofed food to 
your patient until he is thoroughly con- 
valescyL Move the bowels eve^ other 
day bXlarge injections. If tympanies be 
pre^it give turpentine, ten drops\very 
four hours in sweetened water. 

In conclusion, I will say to " Lex : " In 
pneumonia you have congestion and en- 
gorgement of the lungs and a disturbance 
in the blood current. We have a stasis in 
the pulmonary circulation and a more or 
less damming of the blood current ; we 
also have a hemmorrhage or an oozing 
of blood into the air cells. In H. C. 
Woods' materia medica we read that 
ipecac equalizes the circulation, thereby 
relieving the congestion and stasis in 
the lungs, and it promotes the flow of 



sweat It is a hemostatic and is recom- 
mended by high authority for hemor- 
rhage from the lungs. Therefore it les- 
sens the o ozing of blood into the a ir cells 
and di minishes the rusty expec toration. 
It is one of the best expectorants, and 
last, but not least, it unloads the stomach 
of bile, which I find in all these grippe 
pneumonias. The patients are sick at 
the stomach and cannot retain their 
medicine. This condition of affairs is 
relieved after the free vomiting. But if 
getting the bile out of the stomach was 
all I expected from ipecac I would not 
use it at all. I would just use my stom- 
ach tube and siphon it out, but in con- 
nection with unloading the stomach I 
fet the other very valuable effects of the 
rug. V As I said in my article, to ac- 
complish good results it must be used in 
the early stage of the disease. I would 
not use it after hepitization is thoroughly 
established, but it is ^ood preliminary 
treatment in all cases seen early. 

J. T. Anderson, M. D. 
Cornelia, Mo. 



Some individuals have a natural apti- 
tude for medicine, but are forced by cir- 
cumstances out of the sphere for which 
nature intended them. Forexample, we 
have had for some years a railroad conduc- 
tor on our subscription list, and he writes 
that he has been taking medical jour- 
nals for over twenty years, as he finds 
them the most interesting reading that 
he can find. He carries on his train a 
well- stocked case of medicines, and this 
is always ready for any emergency. He 
writes: " I have never had an ill result 
in the handling of medicine, and have 
never charged or received a cent for any- 
thing I have ever done for a sick passen- 
ger. I would rather take a passenger 
out of a case of cramp colic than go to a 
circus." 

It is a pity that this man could not 
have studied medicine, and some "mis- 
fit* * doctor have been a railroad con- 
ductor in his place. An ideal condition 
of society would give opportunity for the 
cultivation of talents in their natural 
direction, and would not force anyone 
into an occupation for which nature has 
not fitted him, and which is not con- 
genial to him. 



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THE MEDICAL WORLD. 



207 



Quiz Department. 



Questions are solicited for this column. Communication* 
not accompanud by the proper name and address of the 
writer (not necessarily for publication) will not be 
noticed. 

The great number of requests for private answers, for the 
information and benefit of the writer, makes it neces- 
sary for us to charge a fee for the time required This 
fee will be from one to five dollars, according to the 
amount of research and writing required. 



Chronic Diarrhea. 

Editor Medical World: — M. W., 
age 21, farmer. Has chronic diarrhea. 
Says his father has been troubled with it 
all his life. I was called to treat a sister 
of his with same complaint of seven years' 
standing. She told me when she vom- 
ited freely she did not have diarrhea, but 
when the vomiting ceased the diarrhea 
returned. Think there is scrofula in the 
family. Would like best line of treat- 
ment. J. D. Kernodle, M.D. 

Clarkson, O. 

[The article in January World, page 
17, " Can Diarrhea be Inherited?" has 
not brought forth as nruch correspond- 
ence as we hoped. We have talked with 
a number of prominent medical men 
upon this subject, but this question had 
not before occurred to any one of them. 
We wish to ask again if any have noticed 
a tendency toward diarrhea among the 
children of old soldiers who have been 
for years victims of the chronic form of 
that trouble. Concerning the above 
cases, and the treatment of chronic diar- 
ahea in general, we will quote Dr. R. G. 
Curtin, of this city, a gentleman of long 
and large experience and observation, 
with whom we recently conversed. He 
has not noticed any tendency of this kind 
among the children of old soldiers suf- 
fering from the complaint, but he has 
noticed this tendency to be present in 
certain families. As to treatment, he 
considers the main thing to correct de- 
rangements of the digestion ; for that is 
almost always present and is perhaps the 
chief cause of the continuance of the 
trouble. The leading indication is to 
correct the diet That does not neces- 
sarily mean to avoid fruits and vegeta- 
bles. To illustrate, he mentioned the 
following instance: An old victim of this 
complaint, who had long been severely 
cautious concerning his diet, bough t some 
nice peaches one day, having decided 
that he would rather have the peaches 



and an exaceibation of his trouble than 
to do without the peaches. He took them 
home and ate of them freely, skins and 
all. To his surprise his diarrhea was 
cured instead of increased. The Doctor 
thinks that the system needed an acid to 
complete digestion, which the peaches 
supplied. He was also able to bring to 
mind other similar cases whose diarrhea 
always decreased in the fall of the year, 
when peaches and other acid fruits were 

Plentiful ; one was particularly benefited 
y cider, which, as we all know, causes 
diarrhea in most persons. As to medi- 
cine, any medicinal aid to digestion indi- 
cated should be used. Powdered char- 
coal, if fermentation or excessive forma- 
tion of gas be present ; bismuth in some 
cases, and bicarbonate of soda in exces- 
sive acidity. An important aid which 
is itself sometimes sufficient to produce a 
cure is the maintenance of constant and 
uniform warmth over the abdomen. A 
woolen girdle, or an apron of from one 
to several extra thicknesses of flannel 
attached to one of the under garments 
and constantly worn, is a great aid. This 
reminds us of the old liver pad, which 
did much good in many cases by main- 
taining warmth. Some of these cases are 
anemic. Such should have iron. The 
old-fashioned tincture of iron, given well 
diluted after meals, is not only a very 
useful hematic, but an efficient astring- 
ent, which will be of use in these cases ; 
however, the use of astringents per se 
has usually been abused during the early 
years of these cases, and in vain ; hence 
it is necessary to aim at removing th$ 
cause, which is usually deranged diges- 
tion, or anemia. A careful adoption of 
the above suggestions, and persistency 
in their use, should lead to satisfactory 
management of these cases. — Ed.] 

Short Freoum. 

Editor Medical World: — I am puz- 
zled with what may be a simple matter, 
but to the patient, who thinks of taking 
unto himself a " rib," it is a most serious 
matter. 

E. F., age 30, single, not accustomed to 
coitus. Prepuce not long, no phimosis, 
though the glans penis is always covered ; 
no adhesions and no deposit of smegma. 
Prepuce can be retracted with ease over 
the glans, but if the retraction be con- 

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THE MEDICAL WORLD. 



tinued it causes the glans to be almost 
doubled upon the penis, and the penis is 
constricted to a painful degree; especially 
is this true during an erection. The 
whole trouble seems to come from an 
exceedingly short and firm frenum. 
Would the trouble be removed should 
the frenum be severed? or is circumcision 
indicated ? The advice from older heads, 
and from wisdom begotton of years of 
practice will be appreciated by 

New York. A Youngster. 

[Circumcision is not indicated. It 
seems that simply dividing the frenum 
would remedy the difficulty. We sub- 
mitted the matter to Dr. J no. B. Deaver, 
who has had large operative experience, 
and he confirms this view. He has repeat- 
edly relieved similiar cases by this sim- 
ple procedure. — Ed.] 

Numbness and Prickling Sensations. 

Editor Medical World:— Mrs. B., 
age 38, married, no children ; menstrua- 
tion regular, bowels regular. Has had 
muscular rheumatism at times; very 
corpulent ; seen\ to be in fair health ex- 



numbn 



cept complains o: 
ling sensation jn 
night; worse""tow; 
her every night 
urine and find qua: 
1025, no albumen or 
uric acid. What is 
trouble? I have 
and never been abl 
Any light on this su 
appreciated. D 

Fairdale, 111. 

[We had a long 
Daland concernin; 
the following is a ^su 
ination for uric 
ing, but after din 
be emptied befcfe dinner] 
taken two or thrfe hours a: 
seems probabl^fthat this is 
America; 



and prick- 
hands at 
ing; affects 
xamined the 
ormal, sp. gr.„ 
, t no excess of 
cause of tbfai 
veral such cases 
relieve them, 
t will be greatly 
E. Meyers. 

ith Dr. Judson 



of this condit 



case, of which 
Make exam- 
in the morn- 
ladder should 
nd the urine 
r dinner. It 
case of what 
gout." The 
n is that it 
instead of 



Dr. Daland c 
characteristic 

affects the devyes or visce: 
the articuMttions, as in Eilglish gout 
The viscefal forms usually are gastric, 
intestinal or hepatic, or al combined, 
causing mental depression, i: citable tem- 
per, headache, coated tongue loss of ap- 
petite, general malaise, etc. *\ /'hat is gen- 
erally called u biliousness " i frequently 



this form of g 
toms are varied 
case illustrates 
The Doctor's tre; 
is as follows: Ph 
ically pure, one^ 
bier of hot hater 
before breakfast 
complete b efore bl 
the lapse ot one 
crease the sodiu 
get two movemen 
Imported vichy 
freely. If that c 



expensive, 



then 



should be taken i 
four or five times 
stomach. The vi 
the Doctor uses is 



t The nervous symj 
nd protean; the aboi 
e of its many for 
ment of American jffiit 
phate of sodium, cKm- 
wo drams in«um- 
n rising and oim hour 
Absorption shrold be 
akfast is taky; hence 
our. Increpe or de- 
phosphate A order to 
of the bowls per day. 
ter shojpd be taken 
not b^iad, or is toa 
vich# lithia tablet 
tutpMerful of water 
r <my y on an empty 
y/thia tablet that 
sed as follows : 
28 



Carbonate of soda, 1 # • • g« 

Carbonate of potaisAM. gr. $ 

Sulphate of magnesV gr . ij 

Calcium chloride (ftfled), . . gr. j| 

Sodium chloride, . 1 . . gr. ^. 



Sodium arseniate, 
Sulphate of iron, 
Citrate of lithia, 

These tablets a: 
tor by Frank Bi 
1629 Walnut street 
supplies them at 
physicians, 75 cents 
event of these tablet 
the Doctor directs 
to thirty grains of bi 
five grains of lithia 
water. The patient 
abundance of water, 
and sugars, and regul 
it will be sufficient 



1 



. gr. 
. gr. 
. grs. 5 

pared for the Doc- 
organ, apothecary, 
Philadelphia, who 

fer hundred — to 
undred. In the 
ot being obtained, 
substitute twenty 
bonate of soda and 
each tumbler of 
should take an 
Omit red meats 
e the diet so that 
o maintain the 
r the accumula- 



strength, but not to fa 1 
tion of flesh. 

It should be said that 'a hysteric ele- 
ment is a possibility in this case. — Ed.] 

Neurasthenia. 

Editor Medical World : — Kindly 
submit best course for the following: 
Patient a young married woman, married 
about seven months. Subject to inter- 
mittent attacks of melancholy feelings * r 
is gloomy, with fearful forebodings; 
cries and wishes herself dead ; cannot be 
alone ; in company is quite contented. 
She is not pregnant ; changes come about 
the middle of the month, with much 
pain. She is of a very nervous disposi- 
tion, excited on receiving company and 

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209 



preparing meals. Cannot eat at home, 
out eats when away. Has had gastric 
catarrh with fermentation ; has piles and 
leucorrhea. Has had no intercourse, as 
she wanted no children. She is a twin 
sister, and delicate ; her sister is the op- 
posite. Was nursed at bottle. Had 
wasting disease when small. Has had 
these spells of depression and nervous- 
ness from girlhood up, gradually getting 
worse. Has beei a dressmaker, but could 
not stand it ; t<k> nervous and suffered 
with headaches ind painful eyesight I 
suggested a com panion for company, but 
she is not satisf ed ; neither will she re- 
main away for want of husband. Has 
taken tonics aiid nervines. Gave her 
celerina, virbun urn comp. , hot water for 
stomach before meals, and local syring- 
ing. Outside cf these recurring spells 
she is all right Would she be happier 
if she should become a mothdr? She is 
fond of children^ yet from a jjtfined sense 
my thus fa/ What can 



would not have 
we do for her? 
Harrisburg, Pj 
[Very probabl 
present in this 
do is to send he 
with Dr. E. E 
case, who, after 
be sent to an 
There is evidentl 
tion present. Tl 
the rest treatmen 
bed, massage, 
Usually rest-cure 
lated from their 
thiz ing f riends ; 
cateffm this cas< 
This woman m 
mission to perf< 
it In order t< 
normally. It 
woman shoul 
dent idea. S 



of refraction is 

e first thing to 

list. We talked 

mery about this 

g that she should 

says as follows: 

eurasthenic condi- 

t thing for this is 

insisting of rest in 

_2, feeding, etc. 

tients should be iso- 

latives and sympa- 

particularly indi- 

he needs discipline. 

ze that she has a 

she must perform 

she must live 

t that a married 

ding to her evi- 

must fulfil the intentions 



of nature as afcarried wokan. The urine 
should be examined, as it may throw ad- 
ditional light upon the case. — Ed.] 

Editor Medical World : — I desire to 
present to the readers of The Medical 
World the following case for diagnosis 
and treatment: Male, aged 66 years; 
always healthy until four years ago. 
This man is a farmer and has worked 
hard all his life. The onset of his mal- 



ady was gradual, commencing with con- 
stipation, which was at first slight, but 
gradually increasing in obstinacy until a 
period of seven or eight days would 
elapse without a movement, unless some 
artificial procedure was inaugurated. 
Soon after the constipation 3, feeling of 
numbness from the waist downward, af- 
fecting the whole body below the waist 
line, was experienced. This symptom 
has continued unabated up to the present 
time. The numbness is felt with greatest 
intensity in the abdomen and hips. A 
feeling of weight in the abdominal cav- 
ity is a prominent complaint of the pa- 
tient. Digestion normal. No ankle 
clonus ; knee jerk greatly exaggerated ; 
Argyll-Robertson symptom not present. 
There is some jerking and spasm of 
lower extremities at times. Vertigo is a 
prominent symptom. No headache is 
experienced. Patient unable to stand 
with feet approximated and eyes closed. 
The floor does not seem irregular to pa- 
tient when walking. There is inability 
to guide the feet to any object or to step 
unless the foot is guided by the eyes. 
For this reason the patient is unable 
to ascend a flight of stairs in the 
dark. In this case there is no pain, no 
thirst, no heart lesion (pulse 78 per min- 
ute), no palpitation, no fur on tongue and 
no history of specific disease. Tongue 
clean, thin and tremulous when pro- 
truded. Patient is nervous and easily 
excited He sleeps fairly well. Appetite 
somewhat diminished, although weight 
is undiminished. The main symptom 
complained of is the numb, stiff and 
strange sensation felt in lower part of 
body and lower extremities. I would 
like to hear from the World family on 
the above case through your valuable 
journal. Also would be pleased to have 
the editor advise as to diagnosis and 
treatment S. M. Seafuse, M.D. 

Gillett, Pa. 

[The above was submitted to an emi- 
nent authority, who declined to make a 
diagnosis upon so difficult a case without 
personal examination. The only sugges- 
tion ventured was that iodide of potas- 
sium in progressively increasing doses 
might be given to advantage, pending a 
more thorough examination of the pa- 
tient, leading to positive diagnosis and 
suitable treatment — Ed.] 



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THE MEDICAL WORLD. 



Editor Medical World :— Will you 
or some of the many contributors to The 
World give me a treatment for a woman 
who is subject to post partum hemor- 
rhage? Is there any medicine or treat- 
ment that can be resorted to, say a month 
or so before confinement, that will be of 
benefit ? \ 

J. A. Hershky, M.D. 
Massey Station, Ont., Can. 



Palmar Eczema. 

Editor Medical World: I Have a 
patient for whom I would like verjr much 
to have the advice of The Wor£d read- 
ers. She nas an eruption on both hands 
that be^an\as a small blister or pimple, 
which DJursA and then began enlarging. 
It cornnfenctd near outer palmar surface 
and ha^ continued in spite of my treat- 
ment until r >w it is near three inches in 
diameter, co ering most of pahn and ex- 
tendin 
It pre 





it is 
tin. 



rough > appearance 
under pr des roy the skin 
is sore at edj es and tend 
diagnosed ri I worm and 
for this, but tiled ; then 
and still fail* 1. It is s 
lea\ ng a red, 
surf :e, with a 

edge,Bhere 

ring I i si 

thanjc ally 

J, 
Sicily fslar 1, La. 

[This ca^e was s 
Shoemaker/ le e 
skin diseased, who 
judge that 1 r. U 
from palmar: czei: 
to be a rebellious $ 
generally 
fissures. 



niter side) to back of band, 
very red and cracked or 
Seen 



to burrow 
it goes. It 
all over. I 
ied treatment 
tried for tetter 
11 gradually en- 
racked or scaly- 
'aw or sore streak 
ndermining and 
Any assistance 
ed. 
Usher, M. D. 



imi 



itted to Dr. J. V. 

ent specialist on 

s as follows: "I 

r's patient suffers 

which is very apt 

ection, and which 

formation of painful 

i| j>inrf off the hand^Jn water 



must be siru in lojisl J Avoided ; trie scabs 
may be rdmd 'eH/by fflie application of a 
bland oil, as olive oil, or cod-liver oil; 
subsequently mould employ a mild dust- 
ing power, j nth as-calamine, oxide of 
zinc, etf., or km ointment containing one 
or twoMrams *ach of carbonate of lead 
or carbonate if zinc to the ounce of cold 
cream. As tme inSammation subsides a 
mildly-stimulating ointment may be 
substituted."] 



Please ask the brethren what is the 
best treatment for pin worms. 

W. D. F. Ward, M. D. 
Fortuna, Cal. 



What is the formula for "Orange 
Blossom " ? N. Aikens, M.D. 

Hamilton, Ont, Canada. 

We copy the following from World 
for May, 1891 : 

Orange Blossom. 

Our analysis shows it to be about as 
follows : An oblong body, about an inch 
long by on&half inch wide and one-half 
inch thick, weighing fully twp grammes 
(31 grains). 1 A single fold of heavy tin- 
foil surroui ds and endows a* light, 
grayish-yell< w, unguentow mass, of a 
rancid, fattj odor, and dftringent, me- 
tallic taste. The reacpon very acid. 
The constitt ents are : 

Zincsulp ate, 

Alum, . 

Cocoa-but pr, 

White waA . 

Oil sweet aYnon 

Ext henbanV, 




dr. 1. 
KT. 15- 
dr.3. 
dr. #. 
dr. i#. 
gr. 1. 
— New Idea* 



Dry Cups for Luml 

Editor Med 
your last issu 
for the relief 
and your read 
seat of pain (Iu| 
will not find it 
mixture of coll 
hours. Therelie 1 
ent Try it, and' 

Jacksonville, Fla 



: — I notice in 

cle of Dr. Cline 

If the Doctor 

use dry cups over 

e beer glasses) they 

to prepare the 

, etc., and wait two 

prompt and perman- 

port. 

E. F. Sabal. 



Yes, Brother, Return to the Fold. 

Dr. D. W. Montgomery, of Concord, Tex., 
writes: ''After a long absence, I am com- 
pelled to knock for admission again into the 
old family— by your consent. I inclose sub- 
scription, for I want to talk again with the 
World family. I find no journal that gives 
as much practical work as The World. m 

Dr. Wm Childs, of Church Point, I*., 
writes : "I am proud to say, in renewing my 
subscription, that I like The Medical World 
better and better as the years roll by, and that 
the article entitled " 1897/' in January num- 
ber, is simply grand. Reading it made me a 
better man, and I hope it will prove a means 
of making a better doctor of me." 



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THB MBDICAL WORLD. 



211 



Current Medical Thought. 

The Semi-centennial Meeting of the American 
Medical Association. 

The semi-centennial meeting of the 
American Medical Association, which 
will be held in Philadelphia on the i, 2, 
3 and 4 of June, 1897, bids fair to sur- 
pass in the character of the entertain- 
ment, the scientific papers and the num- 
ber in attendance any meeting which 
has heretofore been held. The commit- 
tee in charge have been able to obtain 
large and roomy places of meeting for 
the general meetings and the Section 
meetings, all within a single block and 
within very short walking distance, or 
immediately adjacent to the largest and 
most comfortable of the Philadelphia 
hotels. 

For the week preceding and following 
the meeting the Committee of Arrange- 
ments have also arranged for clinical 
courses, which will be open, without 
charge, to all physicians who may visit 
the city at the time. These courses cover 
every branch in medicine and its special- 
ties, and will afford visitors the oppor- 
tunity of seeing the active clinical work 
of all the great teachers of Philadelphia, 
which is now, as it has been for so many 
years in the past, in every respect the 
medical centre of the United States. 



Jledkal Laws in Different States. 

As we receive many inquiries concern- 
ing the medical laws in different States, 
we republish below the table formulated 
at the 1895 meeting of the National 
Conference of State Medical Examining 
Boards. It must be borne in mind, how- 
ever, that changes are likely to be made 
in one or more States every winter. For 
example, the recent Legislature in In- 
diana has passed a very good medical 
law, taking that State out of the class 
in which it appears below ; the same is 
true of Idaho ; and possibly the table 
below is now inaccurate in a number 
of other instances that we cannot bring 
to mind. For the latest information 
concerning the medical law of any State 
address the Secretary of State of such 
State. 

A. Stales and Te> ritories whose Medi- 
cal Laws Practically Permit any one to 
Open an Office to Practice Medicine : 

Alaska, Arizona, District of Columbia, 



Idaho, Indiana, Kansas, Michigan, Ne- 
vada, New Hampshire, Texas, Wiscon- 
sin and Wyoming. 

B. States and Territories which Merely 
Exercise a Super irision of the Diploma 
held by the Pet son Desiring to Practice 
Medicine : 

California, Kentucky, -Missouri and 
Nebraska. 

C. States and Teritories which requve 
an Examination fo" a Lvense, but Accept 
the Diplomas of Certain Colleges as Evi- 
dence of that Examination : 

Arkansas, Colorado, Connecticut, 
Illinois, Indian Territory, Chocktaw Nap 
tion, Iowa, Massachusetts, New Mexico, 
Oklahoma, Rhode Island, South Dakota. 
Tennessee and Vermont. 

D. States and Territories that require 
Passing an Examination before a State 
Board of Examiners before Issuing a 
License to Practice Medicine : 

I. A Single Board of Examiners. 
Alabama, Indian Territory, Cherokee 
Nation, Maine, Minnesota, Mississippi, 
Montana, New Jersey, North Carolina, 
North Dakota, Oregon, South Carolina, 
Utah, Virginia, Washington, West Vir- 
ginia. 

II. Two Boards of Examiners one 0/ 

them Homeopathic : 
Delaware, Florida, Louisiana and 
Maryland. 

III. Three Boards of Examiners. One 
of them Homeopathic, and another 
Electic : 

Georgia, New York and Pennsylvania. 

E. States from which no reply has 
been Received to Letters of Inquiry : 

Indian Territory — Creek Natior. 

Is Privacy Disappearing? 

I have recently taken notice of an un- 
usual increase in the exhibition of cer- 
tain useful, if not ornamental, wares in 
our drug-store windows. I allude to the 
profusion of fancy boxes, prominently 
displayed and obligingly laid open, pre- 
senting a variety of rubber bags and 
cunning little pipes of assorted sizes to fit 
the (supposed) private orifices of poor 
humanity. These exhibits are, in many 
instances, enriched by trusses to uphold 
ruptures and abdominal belts for pendu- 
lous bellies, to say nothing of the many 
pretty appliances to support the testicles. 
Surely persons who are in need of such 

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THE MEDICAL WORLD. 



articles might "inquire within" for 
them, and it is hardly necessary to excite 
the curiosity of school-girls and youthful 
idlers of both sexes as to the meaning of 
these funny little pipes and bags. The 
customary display of the bivalve specu- 
lum, pessaries and huge obstetrical for- 
ceps, in the modest pawnbroker's store, 
sinks into insignificance when compared 
with the galaxy of " fore-and-aft' ' con- 
trivances that greet the inquisitive gaze 
of young people who will learn their 
uses soon enough. — Louis Lewis, M. /?., 
in Medical Bulletin. 

["When we were boys," that blissful 
time that will never come again, we 
knew little and cared less about the mys- 
teries of feminine underwear. Now, if 
we venture into a dry goods store, or 
even pass the windows on the street, all 
these " mysteries" are boldly flaunted in 
our faces. — Ed.] 

The Treatment of Appendicitis According to 
the Authorities. 

Prof. Jno. Wyeth advises an operation 
in every case of appendicitis. He says : 
"The materia medica possesses no agent 
that can prevent infection of the peri- 
toneum from a diseased appendix, or 
that can cure the disease when once 
established." He says further : " In my 
entire experience with this lesion, I have 
yet to see a death which could not 
properly be ascribed to delay in timely 
and skillful surgical interference." 
McBurney says: "That if a mild case 
does not begin to improve in 36 
hours, operate." Deaver, of Philadel- 
phia, says: "Early operation is a con- 
servative and not a radical procedure," 
and advises the surgical treatment of all 
cases. Murphy operates on every case 
as soon as the diagnosis is made, even 
when the temperature is not above 99 
P., and the pulse not above 80. White 
advises an operation in mild attacks of 
appendicitis, if the symptoms are more 
severe at the end of 48 hours, or earlier, 
if there is much pain and tympany. 
Dr. Norman Bridge • believes that the 
disease is always a surgical one, and 
operates at the end of 36 hours if there 
is no improvement Dr. Robt. T. Morris 
says: " Operate as soon as an accurate 
diagnosis of infective appendicitis can be 
made. " Gerster advises laparotomy and 



removal of the appendix whenever 
severe symptoms persist and increase 
for more than 48 hours. Dr. Samuel 
Lord, of New York, operates on all cases 
at the earliest possible moment, and so 
does Prof. W. F. Westmoreland, of At- 
lanta. 

Dr. Louis TiflFany says : " The pulse 
progressively increasing in frequency, 
the temperature rising or remaining high, 
acute pain on pressure in the right iliac 
fossa, near McBurney's point, constipa- 
tion present, with or without a swelling 
in the right iliac region, rigid right 
rectus, are the indications which call for 
an operation. 

Dr. W. T. Bull, of New York, is in 
favor of an early operation, his dictum 
being: "The more rapid the develop- 
ment of symptoms, the earlier should 
the surgeon interfere." 

Sir Fred Treeves, of London, maintains 
that the use of a knife is not called for be- 
fore the fifth day, except in the presence of 
very emphatic symptoms. Keith, of Edin- 
burgh, is very conservative in his views. 
He says: "The pendulum has swung 
too far toward the surgical treatment of 
appendicitis, and the time is coming, as 
it has already come in regard to removal 
of the ovaries, when a definite stand 
must be made against the indiscriminate 
removal ot the appendix." W. W. Keen, 
of Philadelphia, is also of the opinion 
that some of the American surgeons in 
particular are too radical in their ideas 
concerning this affection. He says : 
"Medical treatment has still its place, 
and medical men must continue to have 
special interest in this disease." Dr. 
Hunter McGuire, of Richmond, claims 
that if he can prevail upon physicians 
not to be too hasty in removing the ap- 
pendix, he will have accomplished a good 
work. 

Swain maintains that in view of the 
fact that 90 per cent, of all cases recover 
spontaneously, operative interference in 
most cases is unjustifiable. He says : 
"An operation is indicated if pus has 
formed ; and if there is uncertainty as to 
pus formation, the operation should be 
delayed. " During a discussion upon this 
subject at the Congress for Internal 
Medicine, at Leipsic, the prevailing * 
opinion was a very conservative one in 
regard to surgical interference. Millard, 

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213 



at a recent meeting of the Societe Medical 
des Hospitaux, advised the medical treat- 
ment of this disease almost to the ex- 
clusion of surgical measures, and all of 
the physicians present agreed with him 
in this opinion. In view of such great 
differences of opinion among the authori- 
ties, an ordinary practitioner scarcely 
knows how to proceed in the treatment 
of this disease, but has this assurance, 
that whatever course he might pursue, 
whether of a radical or conservative 
nature, he will have the sanction of some 
of the highest authorities in the land. — 
.S. W. Med. Rec. 



Class Room Notes. 

[From College and Clinical Record.] 

There are few absolute rules in the 
practice of medicine. — Parvin. 

Hysteria is a bona fide affection, with 
as distinct and characteristic symptoms 
as any other nervous H iseasfr — p*mm 

In Cattarhal In^tHmalton of the 
treat ment is curette- 
men^*n5wed by 
ietffne. — Parvin. 

Pro£ Coplin doubts whether there ever 
occurs a case of croupous pneumonia 
which recovers witho ut Pleur itic Ad- 
hesionshexng formed. 

In Fra c ture of the Nasaf Bone^ lit mil 
expggPRnSS Sjn cre ffi5*tftBe patient is 
not seen eaihif3frTBwiN M£yented by th e 
rapjj^^tnnltration wmct ociurs.— 
Brtntan. 

Acetanilid is contraindicated in Pul- 
monary Tuberculosis because it increases 
the sw eating and the^g yanosis, besides 
its general depressing influence on the 
system. — Haxs. v 

In the Croupous Pneumoniaof^iieoholics 
the /w^ttt^^ cy^iptjj|| IB | i^Jiiii7 1 myjj, 
fever, and A^u Wlf iMii a re apt to be ab- 
1 ij]_ 11 IH11MI11 1 mli 111 I|MhhiIh uii 
may not early recognize the affection. — 
Wilson. 

In ordinary Skin Wart, when favor- 
ably located for such treatment, as on the 
scalp, the repeated application of ordi- 
nary castor oil is an efficient and agree- 
able remedy. — Hearn. 

In Internal Strabismus tenotomy on 
the rectus internus corrects about 50 per 
cent of the anomaly. If the strabismus 



does not exceed 25 degrees the remain- 
der may be relieved by advancement^ 
the rectus externus. — De Schweinitz. 

In all obscure fractures about the 
Shoulder a shoulder-c^j^SHould be ap- 
plie<lfor protecti frtfluid support. It is 
best ma^m Utf B T^ paste board or shellac, 
rendered spfHSfr^feSagLfor a short ti me 
in hot^r&er previous to Lclllg UlUliltd to 
the shoulder.— Brinton. 

In the majority of cases oiLUerine Fu 
broids, operative treatment can be avoided 
if the proper s ymp tomatic treatment is 
practised. — ParvtJF 

In Gradual Dilatation of the Urethra* 
fii iI^iiIwmTul) 11 soft rubbe^rtfflgie to 
smootno3n8^feiaKMUHtfSrane. This 
will lessen the dajpS^n^OTyoprtw^the 
metal dilatiitf^rougie is introduc 
Hearn^ 

It is especially important that the phy- 
sician be capable of promptly recognizing 
and understanding the significance of 
Skodaic Resonance, as it is invariably the 
key to conditions existing elsewhere in 
the lung structure. — Wilson. 

In a case of Leucoplakia Buccalis, 
shown in his clinic, Dr. Kyle prescribed 
a mouth wash of potassium chlorate, and 
had the white patches touched daily with 
pure tincture of iodine. For internal 
use he t prescribed ^ of a grain of the 
double sulphide of arsenic as a systemic 
measure. 

In cases of inflammatory Eruption on 
the Jjaces of Children betweenth^tfgA of 
one aiidiour years, the affpjfcWIuis almost 
inv ariabl^Bg ema-JPB^most important 
etiological njfcifj^llii 1 cases is im- 
prqg^fopdfSnd Miiirrm^njii ni digestive 
disturbances. It i$ ndrmor^*nimon in 
the lowe? than in the higher classes of 
society. — Stelwagon. 

To NM^yent Ecchymosis of the Eyelid, 
or " blafcl^- eye, " after injuries about that 
with4:he following, 
e the surface is 




organ, _ 

not applyi 

broken : ,* 

R. Muc. g^etae, 
Tiact. capscii, 
Glycerim, 



q. s. 



f oz. ss 
fdr.j 
f oz. \. 



—J. Chalmers Da Costa. 
The use of the Uterine Sound to re- 
duce retrodisjjlacement of the uterus, 
although recommended by some text- 
books, is never to be resorted to. The 

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214 



THE MEDICAL WORLD. 



dangers, from liability to perforate the 
organ, of carrying infection into its 
cavity, or of injuring its mucous mem- 
brane lining so that germs that are 
already present may invade the tissues, 
are too great to warrant the risk. The 
sounds should never be used for this 
purpose. — Montgomery. . 

In the treatment of Tubercular Joints 
the m i | rr n i nhn i ilj alw ay saja at, rather 
than awiay from, a!l*wfeL Not that 



ankylosis 
clinical ext 



that 



is a matter of 



in these cases 
jointsjtave been kepbit^perfect fixation 
for years, and perfect movefttootxetained. 
— H. A. Wilson. 

Dr. Kyle recommended for the treat- 
ment of Enlarged Tonsils^ of the soft, 
boggy variety, the careful cleansing of 
the crypts with hydrogen peroxide and 
cinnamon water, equal parts, and, after 
drying with a pledget of cotton, the local 
application of dilute hydrochloric acid in 
each crypt If, how$var. the tonsil be 
fibrous he recommended the removal of 
a portion of the tonsil. 

In Inoperable Carctngpta Pro£ Heern 
has found that no remedy does so much 
to holcf\the disease in check and secure 
rest and] comfort to the patien^ssrjacetum 
o p i i . He begins w ith io jU^ij gtt 
an3 increases as tlmT$3raies insufficient 
Chloral may alsoj^added. This prep- 
aration V^JjgtMrborne t>y the stomach 
and does not constipate so much. In 
these cases disregard the tfpium habit 

Every Pregnant Woman should drink 
at least a q^tLotwater, or its equpr&ent, 
daily ,^moshould ea t freehK Ttt fruits. 
These wiff^iQnd to keeftne excreting 
organs actigg^^d^^nich is so impor- 
tant during thl^jrmktfa woman's life. 
The dangero^clampsia»iiidirect pro- 
portion toMeactivity of theseAm^tions, 
and n«(ffa^HEas been supposed, to the 
amount of albumin in the urine. — E. P. 
Davis. 

An able surgeon never fears Hemor- 
rAagjrifQm an open wound. It is in 
them a franfc^nemy. Concealed hemor- 
rhage is the thief^gtcom^rrn the night 
In large dissectio^pMj^te the larger, 
central vessels jj^fne woth^so far as 
possible, an£<<ii'any bleeding poh^gjnay 
be checjbeaby a single ligation. - 

In Peripheral Neuritis^ due to cold, 



with suspected rheumatic tendencies, 
and accompanied by Qjg&E sorej^Ss, glist- 
ening q ^A ti ngling ^f ths<gkin- great 

I Ill ii III f HMjf ill IM 1 iiIiIiiiiii il from 

the administraj^n^f^il^ylate of soda 
increased to^^WSufjJosesyxrt. d. When 
the acute<4w)*ptoins subside, supplant it 
by bichlonrfe of mercury, in A of a grain 
dose. — Uercunu — - 

In a case of neglected Irido-cyclilts^ 
occimixtg in a little girl, in whjph there 
was severe inflammation j^T anterior 
synechia nhd formed, J^f. De Sch- 
weinitz keptNhe puojlrdilated bv in- 
stilling atropia tWjyiaily, and ordered 
hot compresses^l^^Heve the pain and 
stimulate jn^mnliiiii^fj inflammatory 
products, wfom el for it s aiSgative effects, 
and arsenic and Iron as a conic to the 
general system. 

Our Monthly Talk. 

Many of our subscribers make comments 
concerning The Medical World when re- 
newing their annual subscription. We wish 
to encourage this, and will take this occasion 
to request our readers at any and all times to 
express themselves freely to the Editor. We 
have our clerks instructed to save out letters 
containing comments of interest, for the eyes 
of the Editor. Among the thousands of letters 
recently received a large number were 
saved out, and I have only recently gotten to 
them. Many of the comments were concerning 
this column, and the requests for its con- 
tinuance are very urgent. Physicians are 
beginning to realize that they must look to 
their interests as citizens — that they must be 
citizens in the complete sense of that term as 
well as physicians. They realize that their 
interests are identical with the interests of the 
masses of the people whom they serve. When 
the masses prosper, they prosper ; when the 
masses suffer, they suffer. The question with 
them is, what measures will favor the per- 
manent prosperity of the masses'of the people? 
These measures physicians must favor ; not 
only because it is to their pecuniary interest, 
but also because it is right 

It is plain to everyone that the interests of 
the trusts'and the interests of the masses are 
not identical. Trusts and monopolies of all 
sorts live off the people. Railroads, telegraph 
companies, express companies, etc., charge 
14 all the traffic will bear, M instead of perform- 
ing their highest function, that of performing 
the greatest possible service to the people with 
only a reasonably profit above the cost of the 
service. It is plain that physicians belong to 
the peoples' side; that they should favor those 
means that will crush monopolies and trusts, 



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THE MEDICAL WORLD. 



215 



and place the great public utilities (transporta- 
tion and telegraph service, banking, etc), 
under such regulations that the object will not 
be to demand " all the traffic will bear," but 
the greatest possible service to the people. 

It is only fair to state that of the letters above 
referred to, two or three took exception to the 
work that the Editor is doing in this column. 
I wish to state here that by reason of the 
power that an editor naturally has over his 
own columns, I do not wish to be unfair or 
partial in the least degree. Hence, I wish to 
say that if anyone has any real argument to 
present against the doctrines that have been 
promulgated in this column I will cheerfully 
give him an opportunity to present them. For 
example, I have advocated a Government tele- 
graph as against a monopoly private corpora- 
tion telegraph. If anyone has any arguments 
in favor of continuing our present monopoly 
corporation system, and against a Government 
telegraph which would be a part of the postal 
service, let us jiave them. The same concern- 
ing postal savings banks. I have tried to make 
it clear that if every post office in this country 
had a savings bank department, it would place 
a savings bank of absolute security in the 
reach of every citizen in this great Republic. 
The encouragement of thrift and the increase 
of patriotism caused by this measure would 
be very great indeed. At present, people of 
small means have no absolutely safe place to 
put their savings. Savings banks are main- 
tained only in large cities, and their frequent 
failure has been a sad warning to many who 
have trusted them. Rich people have hun- 
dreds of millions of dollars in United 
States bonds and they are absolutely safe. 
Poor people should have an opportunity 
to place their savings with the Government, 
so that they would be equally secure. A 
measure like this would bring many millions 
of small depositors to the government, and 
this would make them more patriotic citizens, 
more thrifty men and women, and better pa- 
trons for doctors. The help to the Govern- 
ment is a secondary matter, but this would 
also be very great. For example, a law like 
this would have rendered the issue of bonds 
in recent years unnecessary. As we have be- 
fore said, Postal or Government Savings Banks 
have been established in most of the leading 
countries of the world and have been success- 
ful and satisfactory without exception. If any oi 
our readers know any argument against them, 
please send it along. As we have' before 
said,' every civilized country in the world has 
a Government telegraph as a part of its postal 
service, except Honduras, Bolivia, Cyprus, 
Cuba, Hawaii and the United States. Thus, 
we are keeping company with tenth- rate 
nations. Do we belong there? Shall we 
remain there? Most of the progressive na- 
tions of the world have a Government savings 
bank system, but our nation is not in this pro- 
gressive list. Shall we put it there ? 

During the last campaign we advocated, as 



being in the interest of the masses of the 
people, and hence of physicians, the unlimited 
coinage of silver and gold in the legal and 
historic ratio of 16 to 1. I have nothing \o 
retract that I have said or written upon this 
subject ; but at the same time, I have always 
claimed that the silver issue is only a small 
part of our financial problem. With many 
the financial problem is a matter of standard 
of value, and they sincerely believe gold to be 
the best possible standard, and that a double 
standard would be awkward, illogical and well 
nigh impossible. Let us consider for a mo- 
ment the question of a standard of value. 
The English law says that a pound sterling 
shall consist of 123.274 grains of gold ft 
fine, and it makes this pound its monetary 
unit, its standard of value, and gives it the 
power of absorbing all other kinds of prop- 
erty, and requires taxes and all kinds of obli- 
gations to be paid in these pounds sterling. 
Other leading countries show the same favor 
to this product, and our country at present 
coins all the gold presented into dollars of 
25 8-10 grains, ^ fine, and this dollar is the 
only dollar that is a legal tender for all pur- 
poses under our present laws It is not strange 
that the inceeasing and 1 exclusive favor given 
to this one product (gold) during recent years 
has increased the demand for it, and hence 
ineraased the value of it Conversely, the 
demonetization of silver has decreased the de- 
mand for silver and hence decreased its relative 
value. But while the legislative and ad- 
ministrative favors to gold have increased its 
value, the relative value of all other products 
as measured in gold has decreased. The ques- 
tion is, is it fair, is it just, is it prudent, to 
give all the legislative favors to one product 
and hence debase all other products ? If gold 
were not thus favored, it would fall in value 
as much or more than silver lias fallen. If 
silver had not been sacrificed, it would have 
maintained its value along with gold. When 
we have the privilege of paying in either of 
two substances, we naturally choose that sub- 
stance that is easiest to get. That universal 
choice so increases the demand for that par- 
ticular substance that its value is increased, 
and the decreased demand for the other sub- 
stance decreases its value ; hence the value of 
the two substances approximate and are main- 
tained substantially the same. This was true 
of silver and gold until the demonetization acts 
in the early '70 's. The tremendous and ruin- 
ous fall of prices under the exclusive gold 
standard shows that this standard is unstable 
and unreliable. The ideal standard is one 
under which prices will remain stable. The 
fall of prices of products in general indicates a 
rise of price of the standard of value — at pres- 
sentgold. This is a fatal objection to any 
standard. Under a double standard, silver and 
gold, if one should rise in comparison to the 
value of products in general, the burden of 
exchange will be transferred to the one that 
does not rise. The increased use of this one 



2l6 



THE MEDICAL WORLD. 



will tend to raise its value, and the decreased 
use of the other one will tend to decrease its 
relative value until they approximate again. 
Hence, an equilibrium is automatically main- 
tained. 

If two standards are better than one, then 
many standards would be better than two ; for 
both silver and gold might rise in value as 
measured in other products. Thus the same 
objection might obtain to the silver and gold 
standard that at present obtains to the gold 
standard. All values are relative. There is 
no justice in measuring values of all products 
either in gold or in gold and silver combined. 
As all values are relative, every product ought 
to play its part in establishing a standard. 
For example, a gold miner should not have the 
privilege of fixing the value of all other prod- 
ucts by his product ; nor should a gold and 
silver miner combined have this privilege. 
The farmer and coal miner have as much right 
to establish the value of the product of the 
gold and silver miner as the gold and silver 
miner has to establish the value of the prod- 
ucts of the farmer and coal miner. This is 
so axiomatic and so just that no one, except 
those blinded by prejudice or personal interest, 
can take exception to it. The ideal, just 
standard would be to calculate the standard of 
the dollar according to the quantity and rela- 
tive values of each and every product. This, 
however, would be an impossible problem, as 
many kinds of products are unimportant. 
But justice would be satisfied by taking, say 
fifty or one hundred of the leading products of 
the country and establish a value in harmony 
with the general average among all these. 
This is what is called the multiple standard. 
It is directly opposite to the single standard, 
whether that single standard be of gold or any 
other single substance. A double standard, 
that is, a standard consisting of both gold and 
silver, is a step, but only a step, toward the 
just multiple standard. With the multiple 
standard the dollar could not consist of each 
of the fifty or one hundred leading products ; 
for it would be impossible to coin a coal dollar 
or a wheat dollar. The dollar must be a paper 
dollar (as most dollars in actual use are), 
and the value of this dollar should be deter- 
mined from time to time, say monthly, quar- 
terly, annually, or whenever occasion might 
arise, by a Government commission on the 
basis of the multiple standard above men- 
tioned. In this way all industrious producers 
of our leading and necessary products would 
be protected against any abnormal fall in 
prices, for any such fall would immediately be 
met by a new average ; and purchasers would 
be protected against any abnormal rise in 
prices, for any such rise would immediately be 
met by a new average. 

It is easy to see that undgr a regime like this 
any doctor who has an industrious clientele 
would also have a prosperous clientele. Then 
we would not receive letters from doctors say- 
ing that their people are industrious and pro- 



duce bountifully, but the prices are so low 
that they can scarcely get money enough even 
to pay their taxes. Stimulated by a just mone- 
tary system as above indicated, there would be 
no reason for the present widespread idleness, 
want and misery. A normal dollar will bring 
normal rewards tolindustry . The gold standard 
dollar is an abnormal dollar ; hence our abnor- 
mal conditions. A dollar based on both gold 
and silver would be nearer normal than the 
gold standard dollar, but it would still be ab- 
normal. The multiple standard dollar would 
be a normal dollar, and it would give us nor- 
mal conditions. 

The normal dollar, based on the multiple 
standard, is engaging some of the most ad- 
vanced students of economics. What is said 
above is merely suggestive. The details are 
yet to be worked out. There can be no doubt 
that the real solution of the money question 
lies in this direction. C. F. T. 

W6F Cut "Our Monthly Talk" out every month 
and have it published in your local paper. 

Dr. John H. Jambs, Anderson, Ind., writes : 
" When I was a boy, physicians could collect 
90 per cent, of their bills. That was when we 
had 16 to 1, and a per capita circulation of 
over $5000 to every person living in the 
United States. Now, under a gold standard, a 
physician does well that collects 40 per cent, 
of his accounts, and things are growing 
worse." 

Dr. Charles A. Littler, of Jackson, 
Mich., writes : "If doctors would study Dr. 
C. F. Taylor's articles on political economy, 
they would know enough pn time to cast an 
intelligent ballot in favor of their own inter- 
ests. M 

Dr. J. D. Edmundson, of Orland, Cal., 
writes that the wave of prosperity has not yet 
come his way, and he fears that it will not 
until we make a better solution of our difficul- 
.ties than a higher tariff. He takes advantage 
of our offer of "A Physician as a Business 
Man " for 50c., hoping this will help him out 
until prosperity really arrives. 

The editor of a prominent daily paper 
of large circulation writes us as follows : 

"In behalf of Government ownership of 
railroads are countless facts and arguments of 
the most overwhelming description. It would 
stop inequality in rates ; stop discriminations 
against localities and against individuals, cor- 
porations and firms, and greatly restrict the 
powers of trusts in consequence; all profits 
would go to the Government, or the Govern- 
ment might transport in behalf of the public at 
cost, and railway extortions would cease; 
thus trade would be greatly stimulated, and 
passenger traffic would be greatly increased 
and suburban properties be built up, and the 
pressure now upon narrow and contracted 
cities be reduced and the whole people be made 
better oft through the easier means of inter- 
communication. " ized by Vj( 



THE MEDICAL WORLD. 



217 



Summer diseases will soon be on us. 
Consult your records for last year and 
give us an article immediately, so that 
your experience last year will help the 
brethren this year. Do it to-day if you 
can possibly spare the time. 

HOW TO SUBSCRIBE. 

Guess we would better print the fol- 
lowing again from January World. If 
there is any special reason why you can't 
pay when you order, say so, and say 
what you can do. If you want The 
World, we want you to have it, and will 
make any reasonable arrangement to 
meet special conditions. But those who 
have an irresponsible habit of ordering 
and putting off pay day, which fre- 
quently never comes— those so afflicted 
cannot come with us unless they break 
their pernicious habit. 

" A word as to how to subscribe for a medi- 
cal journal. Some write on a postal card: 
' ' Please enter my name on your subscription 
list for 1897." Others write a letter saying : 
'• Please continue my subscription to The 
Medical World, 1 ' but fail to enclose the sub- 
scription price. It is said that some publishers 
are glad to get any excuse to put a new name 
on their list, and that they continue the paper 
from year to year without authority, and, fin- 
ally, put the accumulated account into the 
hands of a collection agency, and begin a 
process of " hounding " the doctor. Well, we 
don't do that. We say, if you want Thb 
Medical World, pay for it when you order 
it. That is the only business way. And when 
your subscription expires, renew it by sending 
the price again if you want it continued. We 
can't live on used postal cards, and we don't 
want accounts of $1 00 each scattered all over 
the country, and you don't want such accounts 
against you. 

•'Our mission is to benefit the medical pro- 
fession. It sadly needs benefit in a business 
way. If we can inculcate the habit of paying 
cash, we will be doing much for the profes- 
sion. On the other hand, make prompt collec- 
tions from your patrons. They will respect 
you all the more for it. We now have our 
readers so trained that we get very few postal 
card subscriptions; but we don't want any.' 1 

Don't forget the Hypodermic Syringes. A 
$2 syringe and World for '97, for $2. 

An enterprising subscriber in a Southern 
State, alter having taken advantage of our offer 
of World for 1897, and a thermometer for 
$1.50, writes: "I sold the thermometer for 
$1.25, leaving cost of World only 25 cents." 

J. C. Burlington, M. D , Attica, Ind., writes : 
41 1 have begun to realize what an immense in- 



tellectual feast I have missed by dropping out 
from World two years ago, but I will try and 
make amends by having it constantly on my 
desk in future." 

Dr. John H. Pool, South Mills, N. C, 
writes: "With The World and the ideas 
fresh from its pages, a very ordinary man 
ought to make a good physician. In many 
trying times it has lifted me over a hole and 
added to my reputation and brought new 
patients." 

Wit and Wisdom. 

Why is the baby like wheat? It is first 
cradled, then thrashed, then becomes the 
flower (flour) of the family. 

Use dosimetric granules made by the Phila- 
delphia Granule Company. Send for their 
price list and give them a trial order. If you 
are not acquainted with their granules, send 
postal for their price list, to-day. 10 S. 18th 
St., Philadelphia. 

See the offer of prizes this month beneath 
contents. 

Schiefpelin's page is always interesting. 
See the changes this month. 

Remember that entire wheat bread is a good 
thing for invalids, convalescents and poorly- 
nourished people. 

Braunschweiger Mumme— don't be afraid 
of the name. It is what your convalescents 
need to build up on. A liquid food, a liquid 
bread. Helps weak mothers. Try it. 

We put Messrs. Flavell's page in a handy 
place for you this month, page iii, just over 
from title page. Take a look at it. These 
gentlemen are devoted to their business, and 
take the most careful pains with each order. 
Bear this in mind and you will have occasion 
to give them an order about every month. 
Do not some of your patients now need an 
elastic truss, an abdominal supporter, a uterine 
supporter, or an elastic stocking? Don't let 
them "swag" any longer, but brace up the 
weak points. 

See Betz's bath apparatus adv. and send for 
circulars. You will not regret it. He is enter- 
prising in the right way. He gives the best 
and latest devices, and at "hard times" 
prices. 

Micajah's uterine wafers have recently been 
put to a new use. Turn to their page and 
note it. 

Have you sent for catalogue W ? If not, 
send a card to the Deimel Linen-Mesh System 
Co., 409 Pearl street, New York, N. Y., for 
one. The proper wear next the skin is an 
important matter. Consider it carefully. It 
is as important in summer as in winter. 

Bdw. L. H. Barry, Jr., M.D., Jersey ville, 
111., says : I have used Aletris Cordial with 
excellent results in the following: Miss R., 19 
years of age, brunette, well-developed, but 



218 



THB MEDICAL WORU). 



troubled with dysmenorrhea, called at my 
office, and after explaining her affliction said, 
" Doctor if there is anything you can prescribe 
to relieve my suffering do so, for life is a 
burden to me npw." I thought of the Aletris 
Cordial at once, and gave her a six- ounce bot- 
tle, directing her to take a teaspoonful three 
times a day, commencing four or five days 
before the regular period. Several weeks after- 
ward she returned with the empty bottle, 
remarking, "I've come back for more of that 
medicine, for it's the only thing I ever had to 
give me relief. ' ' I can cheerfully recommend 
Aletris Cordial to the profession. 

Don't you think that Mr. Chas. Marchand 
did a good thing for the profession when he 
introduced his peroxide of hydrogen? Are 
you acquainted with his glycozone and hydro- 
zone? Both these are improvements on the 
first preparation. 

Prosperity, Pa., April 10, 1893. 

As far as I have used the samples you kindly 
sent, they have proved all you claim for them, 
and even mare. I am well pleased with them. 
I use Freligh's Tonic every day— would not 
do without it. E. H. Cary, M. D. 

Class of 1864. 

It is a noteworthy fact that the opposition 
to the serum therapy of diphtheria is now 
admitting cure from the serum, but argue that 
the cure is due to the carbolic acid, which they 
say antitoxin always contains. Mulford 'a Con- 
centrated Antitoxin contains no carbolic acid, 
and never did. Mulford *s Antitoxin is pre- 
served with trikresol, in the proportion of one- 
half of 1 per cent. Aside from being a valuable 
antiseptic agent, trikresol is not known to 
have therapeutic value, especially in the small 
quantities, 3-20 to 12-20 of a minum, in which 
it is administered in the use of Mulford 's 
diphtheria antitoxin. 

See offer of prizes beneath Contents, this 
month. 

Always have Messrs. Parke, Davis & Co.'s 
catalogue handy, as you can refer to it for any- 
thing you need. It will be of great service to 
you in many ways. Had for the asking ; a 
postal card will bring it to you. 

Crush those pills ! But most pills can't be 
crushed. They are like bullets. How do you 
think they are in the stomach? You can 
crush Upjohn 's pills between thumb and 
finger, and reduce them to powder. Try it. 
Go to the nearest drug store to day and ask 
for an Upjohn , pill and crush it just for fun. 
Then, every time you prescribe pills you will 
think about it. 

Pale face, ashen lips, weak, miserable, 
bloodless patient. Why? Because you haven't 
thought to put her on Bovinine. Think of it 
to day and do it; and in a few days you will 
notice the color returning, the eyes brighten- 
ing and the step more elastic ; bringing joy to 
the hearts of the family. The rationale is 
simple. If blood is needed in the system, put it 



there by giving bovinine. See illustration in 
adv. in this issue. 

Read Wm. R. Warner & Co.'s adv. and 
write to them for their prescription blanks, 
visiting records, etc., free to the medical 
profession. 

When you are puzzled, give Fellows' hypo- 
phosphites. You can scarcely miss the mark 
with it. It is just the thing just now for 
a spring tonic. 

Cascarbts come to us this month. See 
the page devoted to them. Cute cathartic 
candy cascarets. Just the thing for children 
and grown people, too. A box to you free- 
When you see them and try them you will 
forget all about oil—ugh ! Turn to their page 
now and ask for a sample box free. 

Daniel's Passiflora Incarnata. — This 
well-known remedy has been on the market 
for a number of years and has earned a degree 
of popularity seldom attained by other like 
preparations, due solely to the fact that it pos- 
sesses real merit, and has ever been main- 
tained up to the highest standard of excel- 
lence. Many eminent physicians have highly 
endorsed this preparation and both constantly 
use and prescribe it in all sections of the coun- 
try. It is especially commendable in cases of 
spasms, tetanus and all nervous diseases, and 
has been prescribed with great success in cases 
of delirium tremens and in typhoid and other 
fevers. Write for particulars to the well- 
known and thoroughly reliable firm of Jno. 
B. Daniels, 34 Wall Street, Atlanta, Ga. 

Do you give the fat babies the advantage 
of Fehr's Compound Talcum Powder ? Being 
fat is not their fault, but if you allow them 
to suffer discomfort it is your fault. Pat grown 
people need this powder, too. It is not ex- 
pensive—not sold at a fancy price. 

Your opinion of the bicycle is likely to de- 
pend on the kind of saddle used. See adv. of 
the "Christy." 

The greatest element of the cost of mineral 
waters at home is the transportation. You 
have plenty of water at home, but it isn't the 
right kind. But if you have the right stuff to 
put in it, you can make it the right kind. 
The Ripley Company, 159 West Twenty-third 
street, N. Y., has struck the idea. No use 
hauling their water all over the country ; so 
they evaporate the water and make tablets of 
the remaining salt. See their adv. 

See illustrations of the Allison operating 
table and cabinet. Can you imagine anything 
more perfect ? Write for catalogue. 

You perhaps have patients who must wear 
an elastic stocking constantly. To get a new 
one occasionally is expensive. Try the " Mas- 
ter" (Pomeroy Co.), which stays in its place 
better, and lasts much longer than the ordi- 
nary. 

The Globe Manufacturing Company, Battle 

{Continued over next letf.) 



The Medical World 

The knowledge that a man can use is the only real knowledge; the only knowledge that has 

life and growth in it and converts itself into practical power. The rest hangs 

like dust about the brain, or dries like raindrops off the slones.—JhLOUDn. 



The Medical World. 



F. TAYLOR, M.D., 

Editor and Publisher. 



•ubscription to any part of the United States and Canada, 
Ohb Dollar per year. To England and the British 
Colonies, Five Shillings per year. Postage free. 
Single copies, Ten Cents. These rates most be paid 
invariably in advance. 

We cannot always supply back numbers. Should a num- 
ber fail to reach a subscriber, we will supply another, 
if notified before the end of the month. 

Pay no money to agents for this journal unless publisher's 
receipt is given. 

Addum all Communications to 

"THE MEDICAL WORLD," 

1530 Chestnut Street, 

Philadelphia, Pa. 



Vol. XV. 



June, 1897. 



No. 6. 




Organization. 

While you are reading these lines, the 
American Medical Association will be 
holding its jubilee meeting in this " City 
of Brotherly Love," where it was born, 
fifty years ago. The policy of this asso- 
ciation is to meet in a different city each 
year. During its existence of half a 
century it has met in all portions of the 
Union, from the Atlantic to the Pacific 
and from the Canadian border to the 
Gulf, and now, on its fiftieth anniver- 
sary, it is fitting that it should return to 
Philadelphia, the city of its birth. 

The average membership of the Asso- 



ciation is about five thousand, while 
there are over hundred thousand phy- 
sicians in the country. And these five 
thousand largely mold the thought and 
wield the influence of the profession. 
Such is the power of organization and 
concert of action. 

Are you a member of your local medi- 
cal society, and of your State society, 
thus becoming eligible to membership 
in the National organization ? If not, 
can you afford to stand alone? 

We are speaking to homeopaths and 
eclectics, as well as to regulars, for the 
same argument applies to all. We can 
address all the schools, for physicians 
of all schools read The World. If 
we had our way there would be only 
ONE school, and that would include all 
men of honesty and education in all 
schools. It is a great pity that narrow 
views obtained in earlier years, which 
led to a separation of our forces. The 
profession of medicine should be large 
enough for all truth from all sojirces. If 
any physician wishes to practice accord- 
ing to any set rule, it should be his 
privilege; although we should in all 
friendliness and fraternity endeavor to 
show him that by limiting himself to 
any set rule he is narrowing his sphere of 
usefulness. But this is no reason why we 
should cut him off" from our association 
— the opposite, rather, for if we think 
he is wrong, he needs our association all 
the more. By cutting him off* we only 
widen the breech, and rob ourselves of 
the help he might be to us, as well as rob- 
bing him of our own assistance. We 
have many times published our regret 

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that the narrow and unfraternal course 
was pursued in early years, establishing 
separate existence of " schools of medi- 
cine." There should be only one school 
of medicine, and that should embrace 
all earnest investigators. We have not 
given up hope that this may some time 
be accomplished. 

But to return to our subject Can you 
afford to stand alone ? In your com- 
munity you are stronger with the co- 
operation and sympathy of your fellow- 
workers. This strength increases i f this 
co-operation is extended to State and 
National scope. You are stronger in 
the opinions of men as a part of a great 
whole than as a " single fagot." 

Only a fractional part of the laboring 
men of this country belong to labor or- 
ganizations ; yet this fraction maintains 
wages to a much higher level than would 
be possible without organization. The 
difference between civilization and bar- 
barism is organization. We have pro- 
gressed from tribes to nations ; and the 
nations are being bound together more 
and more intimately by treaties, the in- 
ternational postal union, etc. 

And are you standing alone as one 
single doctor, without a membership in 
any medical society ? If so, your influ- 
ence does not and will not count for 
much. If there is no medical society in 
your community which you can join, 
form one ; if this is not practicable, join 
the nearest one to you, even if in the 
next State. Being a member, you will 
have an opportunity to help mold its 
thought, and determine its action. 



Rutland Aided iledlcal Legislation. 

In his circulars Fred. Rutland advises 
his " graduates " to confine their practice 
to certain states, naming them. This 
has proved a stimulus to the sentiment 
favoring medical legislation, in those 
states,and in several instances it has borne 
important fruit. Wisconsin, the state that 



gave Rutland his charter, felt the shame 
of it and passed a medical law promptly 
after the exposure. We sent a large 
number of March Worlds, containing 
the exposure, to physicians in Wisconsin. 
That state can now lift up her head 
without a blush of shame. Indiana also 
passed a good medical law, as did Idaho 
and New Hampshire. In Idaho, Rut- 
land's unwitting assistance helped to 
hurry the bill through. One of the 
legislators purchased a Rutland diploma 
and exhibited it in the legislature. This 
caused a number of hesitating law 
makers to decide, and the bill was 
passed without difficulty. Still a few 
otherwise progressive states Jag behind, 
but if another Rutland diploma mill gets 
into full blast about the time of the 
next meeting of the legislature in those 
states, they can probably be stimulated 
to action. There is scarcely anything 
in which there is absolutely no good. 
Even Rutland has done some good in 
stimulating the advancement of medical 
legislation. 

It is fortunate that most, if not all, 
the legislation is disposed to treat the 
various "schools" fairly. Either mixed 
boards, or separate boards of examiners 
are provided, so that the fitness of each 
applicant can be tested by representa- 
tives of the particular school which he 
proposes to practice. It is unfortunate 
that there is any division. The science 
of medicine is broad enough to embrace 
all "schools," and include all in one 
school ; that school need have no name 
except medicine ; its members need have 
no name except physicians. No dis- 
tinctive title for school or individual. 
When this is accomplished we will be a 
united brotherhood. 



The National Confederation of State 
Medical Examining and Licensing 
Boards will meet in Philadelphia on 
Monday, May 31st The program is an 

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attractive one, showing that they are 
doing good and useful work. For ex- 
ample, there will be a report of the com- 
mittee on minimum standard of require- 
ments, and discussion and action there- 
on. The obiect of the confederation is 
to consider questions pertaining to State 
control in medicine, and to compare 
methods in vogue in the several States ; 
the collection and dissemination of in- 
formation relating to medical education, 
and to consider propositions that have 
for their purpose advancement of the 
standards in the United States. This is 
a step which, we hope, will lead to a 
uniform standard throughout the United 
States. Then perhaps we can get some 
National medical legislation, perhaps 
leading to a certificate or license that 
will entitle the holder to practice any- 
where in the Union regardless of State 
lines. 

Doctors, our discussions on diphthe- 
ria and other subjects are extending into 
hot weather, and our discussions on hot 
weather diseases have not yet begun. If 
some of our enterprising and " long 
headed " subscribers will always write 
from last year's experience, just before 
the season for certain diseases to begin 
again, they will be certain to find a place 
in the columns of The World, and have 
the satisfaction of starting the discus- 
sion. We have suggested this course in 
the last two issues, but you are " back- 
ward about coming forward." Any one 
can write about summer diseases in Sep- 
tember, but it is only the careful, record- 
keeping, systematic man that can write 
about them in April. Please let July 
World be filled with seasonable matter 
from all parts of the Union. Articles 
for July number should reach us by June 
15th, and as much earlier as possible. 

One of our readers expresses the hope 
that some one will contribute a good 
article on arterial sclerosis. He has been 
examining medical magazines for the last 
five years for literature on this subject, but 
has found very little. 



Original Communications. 



Short article* on the treatment of diseases, mad experience 
with new remedies, are solicited from the profession for 
this department; also difficult cases for diagnosis an* 
treatment. 

Articles accepted must be contributed to this journal onljn. 
The editors are not responsible lor views expressed by 
contributors. 

Copy must be received on or before the twelfth of the? 
month for publication in the next month. Unused 
manuscript cannot be returned. 

Certainly it is excellent discipline Jar an author to feel that h* 
must say all he has to say in the fewest possible words, or 
hts reader is sure to ship them; and tn the plainest possible- 
words, or his reader will certainly misunderstand themu. 
Generally, also, a downright fyct may be told tn a pJatm 
way; and we want downright facts at present more tham 
anything «te.— Ruskxn . 

READ. REFLECT. COMPARE. RECORD 

Treatment of Hysteria. 

Editor Medical World: — From time 
to time I notice in the various medical 
journals lengthy articles on the treat- 
ment of hysteria. The text books re- 
commend tonics, antispasmodics, dieti- 
tic and hygienic managemeut, etc. , etc* 

It has fallen to my lot to see a great 
many of these peculiar cases, and 
I must confess that I have yet to 
see a case in which I did not sus- 
pect that there was "something lack- 
ing in the upper story." These 
patients are of an unstable, nervous 
make-up, love sympathy and notoriety, 
and will resort to all sorts of methods 
and practices to secure them. I used to 
treat these cases in the old stereotyped 
manner, and secured, I suppose, an aver- 
age result, t. e. y " they went to the next 
neighbor." 

When you look at one of these poor, 
pitiable, sympathy-begging, curiosity- 
seeking individuals, *with aphonia, en- 
larged knee, paralysis of limb, globus, or 
in a general clonic convulsion, you are 
reminded of that trite and truthful ex- 
pression of the late W. A. Hammond : 
" It looks like they will not ; they say 
they cannot ; but the truth is they can- 
not will!" After some painful expe- 
rience, it must be confessed that a diag- 
nosis should be reached with the utmost 
care and painstaking analysis of symp- 
toms, for the phenomena presented in 
one of these cases may so completely 
simulate those usually found in other 
and graver diseases as to mislead us en- 
tirely. The worst cases to correctly 

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diagnose are those where some serious 
disease is present, and hysterical symp- 
toms coexist, as, for example, uremia, 
meningitis, cerebral hemorrhage, etc. 
It does seem that there is that certain in- 
born or acquired mental make-up which 
so thoroughly and completely stamps it- 
self upon the every act and thought of 
these poor creatures that in the very 
agonies of death a close observer can dis- 
cern it. Why ? From cells, cells must 
come ; and the cells that come are like 
the cells from whence they came, modi- 
fied only by environment. So that we 
can see how education, social conditions, 
eta , may tend to add to or subtract from 
an inborn proclivity to hysteria. 

But I am digressing from the first ob- 
ject of this communication, and that was 
the therapeutics for certain hysterical 
manifestations, especially hysterical con- 
vulsions, coma, paralysis, etc. But be- 
fore speaking of the therapy for these 
conditions, I wish to 'mention a ready 
method of making a differential diagnosis 
between cerebral apoplexy and hysteria. 
When called to a case in which doubt 
exists, if you will pour some aqua am- 
monia oh a handkerchief and hold it to 
the patient's nose (cautiously to be sure), 
if it is one of hysteria there will be mani- 
fested an instantaneous desire to " come 
out." They cannot and will not stand 
such pungent odors. I owe this sugges- 
tion to Dr. Charles Long, of Pierceton, 
Ind. Now as to the treatment of the 
above-named conditions, viz., convul- 
sions, coma, paralysis, etc. , I m^ short 
work of them as follows : Aftaf making 
sure that there is no error vm the diag- 
nosis, I make 3d, to 30 po , wpers of sul- 
phate of quininet pulv. assgetjda, qiuri- 
ate of amm onia amd cay eSge pepper, and 
then, placing one in aJspoon, dry, say 
aloud so that themncowcious (?) patient 
can hear: "I w^laive one every five 
minutes until she emerges IrSin her un- 
conscious state, and they must be given 
dry, as otherwise they will have no 
effect." Pry the patient's mouth open, 
drop in the horrid mixture, close the 
mouth firmly with your hand. In about 
one minute you will be able to detect 
signs of a feeble desire to get back to the 
state of consciousness. When five min- 
utes have elapsed you give another pow- 
der, and while so doing you again repeat 



your original statement and add : u It 
certainly will not take more than one 
more, if indeed it does that many." Now 
you observe more pronounced symptoms 
of wanting to come ashore, such as a 
half-conscious look,staringor an apparent- 
ly half-bewildered look at the friends or 
physician. Now right here is where it 
requires tact. These patients are will- 
ing to emerge, but they want a good ex- 
cuse for so doing, and you must help 
them to make . the friends believe that 
your horrible compound did the work. 
It may require the third powder, but I 
have never seen a case so stubborn that 
it required the fourth one. These pow- 
ders will be all that is required. Patient 
arouses, talks with her friends, wants to 
know where she has been and how long 
they have been there, etc., etc., all of 
which the gaping, credulous friends 
and visitors take in at 100 per cent. 

When I leave a case I say to the 
nurse : " If there are any symptoms of 
relapse, administer a powder, dry, every 
five minutes until they disappear." A 
word to the wise is sufficient You 
cannot get them to take the powders a 
second time. Make large powders ; a 
whole teaspoonful, as no similia simili- 
bus curatur doses will reach one of 
these cases. 

A few years ago I saw an old lady in 
the morning suffering from a pronounced 
case of the malady under consideration ; 
late in the afternoon I saw a young mar- 
ried lady who " had e'ni bad ;" at 9 p.m. 
I saw a middle aged lady who showed a 
periodical desire to stand on her heels 
and the back of her head, froth at the 
mouth, hold her breath until she was 
purple in the face, etc., etc. This lady 
had been treated by about all the phy- 
sicians in that section of the country, 
but "the spells " would return, especi- 
ally when she became angered for any 
reason. The powders did the work and 
none of them have ever had a return of 
the trouble. The husband oi the last- 
named patient told me that he had about 
twenty-five of those powders and that he 
would not take $500 for them. In the 
case of young girls, unless the parents 
have more sense than the patient, you 
are indeed in a bad predicament for the 
reason that they are sure that the 
daughter is "awfully sick," and willlnot 

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believe your diagnosis or countenance 
your treatment. In such cases tell them 
that after they have tried as many doctors 
and patent medicines as they wish, and 
do not find relief, to let you know and 
you will cure the case. To tell one of 
these patients that she has hysterics and 
that she is trying to deceive, is to lay 
the foundation for failure in the treat- 
ment ; for deep down in the mind of all 
these unfortunates is a burning desire to 
convince the world, doctors included, 
that they are suffering from a severe,