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The  MedicalWorld 


Tk4  knamUdge  that  a  man  can  use  is  the  only  real  knowledge;  tne  only  know- 
ledge thai  has  life  and  g  owth  in  it  and  converts  it*el/  into  practical  fower.      The 

rest  hangs  tike  dust  about  the  brain,  or  dries  like  raindrops  off  the  stones.^  Froudb. 


The  Medical  World. 

PUBU8HBD  M0MTHI.T,  by  C.  P.  Taylor,  M.  D. 


C.  F.  Taylor,  M.  D., 
J.  J.  Tayi^r,  M.  D., 


>  Editors. 


•■bKripdon  to  any  part  of  the  United  States  and  Canada, 
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Pay  no  money  to  agents  for  this  journal  unle 
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I  publisher's 


Address  all  Communications  to 

''THE   MEDICAL  WORLD." 
tsao  Chestnut  Street, 

PHILADELPHIA.  PA. 


VoL  XIL 


January,  1894. 


Na  1. 


Our  New  Title  Design. 

We  hope  you  like  it.  The  face  of  a  maga- 
zine is  like  the  face  of  an  old  and  familiar 
friend,  and  it  should  not  be  changed  except  for 
distinct  improvement.  When,  a  few  years  ago, 
we  changed  from  a  plain  type  heading  to  an 
ornamental  design,  many  of  our  readers  sighed 
for  the  old  plain  heading.  Our  present  change 
is  in  the  direction  of  plainness  and  distinctness, 
yet  not  devoid  of  ornament  We  hope  it  will 
be  received  kindly  by  our  readers.  We  send 
this  issue  to  a  number  of  subscribers  who  have 
not  yet  renewed  for  1894,  that  they  may  not 
forget  an  old  friend  in  a  new  guise.  In  more 
than  one  department  we  have  added  to  our  ex- 
penses, even  in  the  face  of  ''hard  times."  It 
may  seMn  strange  to  make  improvement  during 


a  period  of  financial  depression,  but  when  you 
consider  that  our  readers  cling  to  The  World 
even  closer  during  hard  times,  you  can  see  that 
we  can  afford  improvement  as  well  now  as  any 
other  time.  We  strive  to  be  the  proverbial 
''friend  in  need,"  and  these  are  needy  time& 
It  is  gratifying  to  know  that  we  fulfill  our 
chosen  mission  so  acceptably. 


Value  of  Effloient  Sanitary  Service. 
We  wonder  if  the  general  public  realizes  its 
great  debt  to  the  hard-working,  poorly-paid, 
self-sacrificing  medical  profession  for  that  mo0t 
important  and  nearly  always  unrecognized  phase 
of  its  activity,  the  prevention  of  diseases  and  epi- 
demics. All  such  work  is  directly  against  the 
financial  interests  of  the  profession,  as  reducing 
the  amount  of  practice  to  be  done,  and  is  also  a 
very  unappreciated  devotion  to  our  higher  duty 
to  our  race.  This  is  the  only  example  in  our 
industrial  system  of  a  class  of  workers  helping 
to  destroy  the  market  for  their  own  services  in 
the  interests  of  those  who  would  otherwise  have 
to  employ  them,  and  shows  the  medical  profes- 
sion to  be  the  only  truly  socialistic  profession  in 
our  industrial  field.  The  whole  country  has 
witnessed  with  interest  the  battle  going  on  ibr 
the  past  eighteen  months  in  New  York  harbor 
and  other  exposed  ports  between  the  dreadful 
scourge  of  cholera  and  our  advance  sanitary 
picket  line,  in  which  our  scientific  defenders  have 
thus  far  maintained  a  victorious  front.  But  we 
doubt  whether  the  social  and  commercial  world 
realizes  what  the  profession  has  saved  them  in 
health,  lives  and  the  vast  commercial  and  in- 
dustrial interests  threatened  by  a  great  epi- 
demic. Truly,  he  who  prevents  or  limits  the 
spread  of  disease  is  greater  than  he  who  wins  a 
hundred  battles.  In  view  of  this  and  other  ex- 
amples of  the  value  of  preventive    measures 


174231 


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THE  MEDICAL  WORLD. 


against  disease  we  hope  soon  to  see  the  estab- 
lishment of  a  cx)mplete  national  system  of  sani- 
tary service,  extending  down  to  the  most  remote 
hamlet  and  township  in  the  country,  scientific- 
ally qualified,  thoroughly  equipped  and  well 
paid,  with  due  authority  to  take  any  necessary 
measures  to  prevent  the  development  or  exten- 
sion of  disease,  so  far  as  is  known  to  sanitary 
science.  We  believe  that  every  true  physician, 
those  in  the  highest  sense  worthy  to  practice  the 
healing  art,  entertains  these  wishes  for  the 
benefit  of  humanity  even  if  against  the  advance- 
ment of  his  own  temporary  interests. 


A  National  Medical  College. 
We  note  with  pleasure  that  an  Army  Medi- 
cal School  has  been  established  in  Washington 
in  connection  with  the  medical  department  of 
the  United  States  Army,  for  the  higher  scientific 
education  of  those  who  have  in  recent  years 
been  admitted  into  this  department.  We  pre- 
dict that  it  will  prove  as  great  an  educational 
success  in  its  sphere  as  are  the  Military 
Academy  at  West  Point  and  the  Naval  Academy 
at  Annapolis.  We  should  be  very  much  pleased 
to  see  established  a  well  organized  system  of 
medical  schools  in  the  different  sections  of  the 
country,  entirely  under  the  auspices  of  the 
National  government,  for  the  thorough  pro- 
fessional education  of  those  who  wish  to  avail 
themselves  of  its  advantages,  and  for 
the  examination,  according  to  its  high 
standard,  of  all  those  educated  in  other 
institutions,  domestic  or  foreign,  who  wish 
to  begin  practice  in  any  portion  of  the 
Hnited  States,  and  whose  diploma  or  certificate 
of  successful  examination  shall  be  accepted  as 
sufficient  authority  for  practice  in  every  State. 
Education  in  medical  science  should  be  con- 
ducted entirely  with  a  view  to  the  protection  of 
the  public  and  the  advancement  of  true  science 
rather  than  to  the  enrichment  or  glorification  of 
self-constituted  professors. 


In  the  hygiene  of  old  age  it  is  recommended 
with  high  authority  that  the  diet  should  consist 
more  of  the  heat  produ*  iug  foods  rather  than 
those  which  contribute  to  tissue  building.  Also 
the  food  should  be  taken  more  frequently  but 
less  in  amount  than  when  in  the  prime  of  life. 


A  Caution  In  Local  Applioationa. 

It  should  be  well  known  to  all  practicing 
physicians  that  no  local  applications  of 
mercury  in  any  form — calomel,  ointments, 
powders  or  washes  containing  any  of  the 
salts  of  mercury — ^should  be  made  to 
any  diseaaed  surface  of  skin  or  mucous  mem- 
brane of  a  patient  who  Is  taking  iodine  in  any 
form  or  any  of  its  salts  internally.  The  iodine 
appears  in  the  natural  secretions  found  on  the 
membranes — tears,  saliva,  mucus — and  in  the 
pathologiial  secretions  of  sores,  ulcers  and  in- 
flamed surfaces.  Coming  thus  into  contact  with 
the  mercury,  the  very  irritant  and  even  caustic 
iodide  of  mercury  is  formed.  Many  a  doctor 
has  been  puzzled  as  to  why  the  eye  or  the  ulcer 
became  suddenly  so  much  worse  when  he  only 
applied  the  usually  mild  calomel.  Patients 
should  be  questioned  before  any  local  mercurial 
application,  or  even  its  administration  by  the 
stomach,  as  to  what  they  may  have  been  taking 
unknown  to  the  physician. 


Radical  Treatment  of  Naso-Pharyngeal   Catarrh. 

Dr.  S.  Lewis  Zeigler,  1504  Walnut  St, 
Philadelphia,  in  a  private  conversation  with  the 
editor,  gives  the  following  local  treatment,  with 
which  he  has  had  marked  success 

The  instruments  required  are  slender  nasal 
applicators  and  a  throat  applicator,  with  the 
necessary  mirrors  and  specula  for  examination 

Pure  compound  tincture  of  benzoin  is  firs*^ 
painted  upon  the  entire  membrane,  anterior  and 
posterior  nares  and  pharynx. 

This  is  followed  with  an  application  of  cam- 
phor-menthol (camphor  and  menthol  of  each 
five  grains,  in  one  ounce  of  liquid  vaseline  or 
other  liquid  petroleum).  These  applications  are 
made  every  other  day. 

As  a  preliminary  application,  to  prepare  the 
membrane  for  these  remedies  if  the  membrane 
is  in  a  state  of  acute  inflammation,  with  full  tis- 
sues and  free  discharge,  the  entire  surface  is 
thoroughly  painted  or  swabbed  with  first  a  so 
lution  of  cocaine,  (twenty  grains  to  the  ounce) 
.  to  constringe  the  tissues  and  soothe  the  irritated 
nerves,  foUowei  by  a  solution  of  antipyrine 
(thirty  grains  to  the  ounce);  whicq  has  a  simi- 
lar effect  to  cocaine,  lusting  several    hours :  in 


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THE  MEDICAI.  WORI<D. 


about  three  minutes  the  surface  is  ready  for 
the  principal  reaimeut  with  benzoin  and  cam- 
phor-iuenthol  as  given  above.  In  acute  cases 
treat  daily. 

These  are  all  applied  by  the  usual  means  of  a 
mop  of  absorbent  cotton,  twisted  on  the  applicator. 
After  this  treatment  has  been  followed  two  or 
three  times  a  week  for  several  months,  until 
all  soft  pathological  enlargements  have  been 
entirely  reduced,  there  may  remain  some  carti- 
laginous or  bony  growths  which  will  have  to 
be  removed  by  the  chisel,  under  cocaine  local 
aneflthesia. 


International  Prevention  of  Diteatet. 

There  is  a  large  class  of  diseases  recognized 
38  being  more  or  less  communicable  or  due  to 
uncleanliness  or  other  preventable  causes.  It  is 
one  of  the  very  first  duties  of  a  government  to 
protect  its  citizens  as  far  as  possible  against  ex- 
posure to  all  forms  of  contagious  or  other  pre- 
ventable diseases.  We  legislate  carefully 
enough  for  the  protection  of  our  cattle,  horses 
and  hogs,  and  are  ready  to  go  to  war  for  the 
financial  value  of  a  few  thousand  seals  on  re- 
mote islands  in  the  sea.  Is  not  the  health  of  our 
people  of  infinitely  more  importance  than  such 
interests  as  those?  What  can  be  more  to  the 
credit  of  a  nation  than  to  be  able  to  show  a 
healthy  population  and  a  low  death  rate  ?  Thia 
with  due  attention  to  enlightened  intelligence,  a 
high  standard  of  morals  and  an  equitable  dif- 
fusion of  wealth  among  the  people  make  a  na- 
tion strongest  in  every  respect — one  that  its  sub- 
jects will  love  and  will  protect  with  their  lives  if 
necessary. 

The  proposed  establishment  of  a  cabinet  de- 
partment of  public  health  would  be  a  practical 
step  in  the  direction  of  caring  for  the  health  of 
the  people,  supplementing  the  work  of  our  State 
Boards  and  bringing  the  systematic  direction  of 
the  work  over  the  entire  country  under  one 
efficient  department.  This  is  national  protec- 
tion. 

The  next  logical  step  must  be  international 
protection  We  must  have  our  sentinels  located 
in  all  countries  with  which  we  maintain  com- 
mercial relations.  These  should  study  con- 
stantly the  sanitary  conditions  of  the  countries 


in  which  they  are  stationed  and  should  have  fulY 
authority  to  guard  against  the  importation  of 
diseases  by  means  of  immigration  or  commerce.. 
A  clean  bill  of  health  from  them  should  be  re- 
quired of  all  intended  immigrants  or  of  all  car- 
goes bound  for  this  country  before  they  are  ad- 
missible into  our  ports.  We  would  suggest  that 
we  already  have  representatives  in  all  civilized 
countries,  whose  positions,  so  far  as  active  duties 
are  concerned,  are  principally  ornamental.  To 
the  nominal  duties  they  now  have  might 
appropriately  be  added  this  real  one.  A 
measure  like  this,  taken  up  by  civilized  nations 
generally,  would  result  in  much  greater  atten- 
tion being  paid  to  restricting  epidemics  to  the 
actual  points  where  they  originate  and  suppress- 
ing them  in  their  incipiency.  If  the  authoritiea 
of  a  country  were  convinced  that  they  must  es-  . 
tablish  hygienic  conditions  among  their  own 
people  in  order  to  maintain  their  commercial  re- 
lations with  the  worid  they  would  at  once  see 
the  practical  side  of  the  matter.  Then  we  might 
hope  that  in  time  those  diseases  that  are  pre- 
ventable by  general  public  action  would  finally 
die  out  altogether,  and  we  would  have  to  con- 
tend with  only  those  that  are  due  to  individual' 
imprudences  and  exposures. 

For  Miook  and  Collapse. 

Atropine  is  the  quickest  and  most  valuable 
remedy  known  in  surgical  shock  and  in  those- 
conditions  in  disease  which  resemble  it,  as  the 
stage  of  collapse  in  cholera  and  cholera  in- 
fantum. It  may  be  given  hydodermically,  or 
by  mouth  in  the  n>rm  of  a  granule  dissolved  in. 
hot  water  every  ten  minutes  until  the  desired 
reaction  occurs. 


Mucus  Our  Natural  Protector. 
Recent  bacteriological  experiments  have- 
demonstrated  that  the  normal  secretion,  mucus,, 
is  an  effective  bactericidal  agent  To  be  effec- 
tive, however,  it  must  be  normal  in  quality 
and,  further,  its  germicidal  property  may  be- 
exhausted  by  an  overwhelming  supply  of  rapidly 
growing  germs. 


Hydrastine  is  said  to  possess  powerful  anti*- 
spasmodic  properties  and  has  recently  been* 
recommended  for  the  treatment  of  epilepsy. 


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THE  MEDICAL  WORLD. 


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

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

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  h* 
must  say  all  he  has  to  say  in  the  fewest  possible  words,  ot 
his  reader  is  sure  to  skip  them;  and  in  the  plainest  possibU 
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  Resent  mare  than 
^jfthing  «/jtf.— RusKnf . 


READ.     REFLECT.     COMPARE.     RECORD. 


Notes  and  Commentt. 

Editor  Medical  World:— On  page  419, 
December  World,  M.  R  C.  describes  a  case 
where  the  umbilical  cord  was  three  times  around 
the  child's  neck,  causing  asphyxiation.  Many 
years  ago  I  had  such  a  case,  and  there  was  also 
a  knot  in  the  cord.  The  child  lost  its  life  dur- 
ing birth.  The  shortening  ot  the  cord  seemed 
to  check  the  progress  of  the  cnild  through  the 
pelvis.  Several  times  since  I  have  not^  the 
presence  of  an  obstacle,  and  found  it  was  due 
to  this  cause.  Once  I  managed  to  get  the  for 
ceps  on  and  delivered  in  a  hurry,  and  always  I 
have  had  trouble  to  save  the  child. 

That  gonorrhea  lessens  the  chinces  of  preg- 
nancy cannot  be  doubted.  The  gynecologists 
all  call  attention  to  the  frequency  of  pyosalpinx 
and  ovarian  disease,  necessitating  castration  in 
gonorrheal  women.  But  women  do  become 
pregnant  in  spite  of  gonococci,  and  that  fre- 
quently, so  that  the  sterility  is  not  absolute  in 
such  cases. 

Dr.  Sonn  (page  427)  asks  why  hepatic  dis- 
ease is  attended  with  epistaxis.  Obstruction  to 
the  circulation  in  the  liver  causes  difficulty  in 
unloading  the  veins,  and  hence  engorgement  of 
the  capillaries.  Nowhere  do  these  bear  disten- 
tion so  ill  as  in  the  nose,  and  hen^e  the  tendency 
to  hemorrhage. 

Wild  hairs  are  extra  sets  of  eyelashes,  by  an 
eccentricity  of  nature  forming  inside  the  lid,and 
causing  no  end  of  annoyance. 

The  malic  acid  of  cider  readily  unites  with 
'/inc  to  form  a  malate,  whose  properties  resemble 
the  acetate  of  this  metal  The  treatment 
should  be  by  demulcents,  anodynes  and  stimu- 
lants, with  emetics  if  the  patient  has  not  already 
vomited. 

Has  not  Dr  MitcheH's  case  (page  427)  a 
urinary  calculus?    Salol,  five  grains  every  four 


hours,  relieves  acute  cystitis  speedily,  with  hot 
cloths  and  anodynes  as  adjuvants. 

For  Dr.  McDonough's  case  I  would  use  an- 
tiseptic baths,  wash  the  afflicted  skin  with  pure 
soap  and  then  rinse  off  with  cold  water ;  dry 
and  apply  ointment  of  red  iodide  of  mercury, 
five  grains  to  the  ounce  of  lanoline.  Then 
apply  benzoated  zinc  ointment  with  a  little  oil 
of  rose.  Keep  the  general  health  in  good 
order.  If  the  case  does  not  get  well  there  is  a 
local  cause  at  work  that  musi  be  destroyed  by 
germicide?,  or  else  the  general  health  is  so  far 
below  par  that  healing  processes  cannot  be  in- 
stituted. This  means  iron,  quinine  and  cod 
liver  oiL  Why  not  try  keeping  the  skin  wet 
with  Bovinine,  The  effects  of  this  on  chronic 
ulcers  are  said  to  be  remarkable. 

Dr.  Coates  might  get  a  clear  solution  (page 
428)  of  benzoin  by  adding  ammonia,  making 
benzoate  of  ammonia;  but  the  gum  will  precipi- 
tate in  water. 

In  the  Current  Medical  Thought^  under  the 
head  ot  Requirements  for  Medical  Practitioners, 
there  is  a  mistake  in  r^ard  to  Pennsylvania. 
The  registry  law  requires  colleges  to  examine 
an  applicant  before  endorsing  his  diploma. 

In  the  December  number  I  asked  for  reports 
regarding  hemorrhage  from  quinine.  (Why 
don't  you  reform  the  spelling  of  that  word  ?  It 
is  worse  than  the  diphthongs.)  Dr.  C.  C 
Stockard,  Atlanta,  Ga.,  writes  to  me  as  follows  : 

"Noticing  your  request  in  The  Medical 
World  for  reports  of  cases  of  hemorrhage  from 
the  use  of  quinine,  I  will  give  the  following:  I 
was  called  a  few  years  ago  to  see  a  child  whose 
urine  had  been  bloody  for  several  weeks.  As 
it  was  in  a  malarious  locality,  I  put  it  on  iron 
and  quinine.  About  a  week  later  the  mother 
informed  me  that  it  had  gotten  worse  steadily. 
She  said  that  before  I  saw  the  child  she  had 
given  it  a  tonic  and  that,  as  several  years  before 
her  urine  became  bloody  after  taking  quinine, 
she  thought  the  tonic  she  had  been  giving  might 
have  quinine  in  it,  and  after  stopping  it  the 
urine  had  gotten  clearer  till  she  took  the  medi- 
cine I  prescribed,  when  it  immediately  became 
more  bloody.  I  told  her  my  medicine  con- 
tained quinine  and  to  dipcontinue  it.  In  a 
few  dajs  the  urine  was  clear  and  IVe  never 
heard  of  any  return  of  the  trouble.  I  think 
the  quinine  certainly  caused  the  hemorrhage." 

I  think  so,  too.  My  reason  for  asking  was 
that  I  had  a  case  of  purpura  hemorrhagica  frora 
quinine.  I  am  inclined  to  credit  this  drug  with 
causing  hematuria  sometimes.  I  have  also  re- 
ceived the  following  letter  from  Dr.  Ben.  H. 
Brodnax,  Brodnax,  La.: 

"In  1863,  while  in  Mississippi,  I  was  troubled 
for  the  first  time  with  chills.     Dr.   Hart  made 


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me  a  solution  of  quinine  (by  mistake)  of  one 
hundred  (100)  grains  to  two  oz.  dilute  acid  and 
water;  directions  "  to  be  taken  in  four  doses," 
I  took  three  doses,  one  hour  apart,  but  lost  con- 
consciousness  before  the  fourth  dose  was  taken. 
Was  insensible  for  twelve  hours,  but  on  return- 
ing conscioumess  found  my  drawers  saturated 
with  blood.  On  getting  up  to  urinate  I  passed 
about  two  ounces  of  fluid  blood  that  clotted  in 
the  chamber.  This  passed  ofl.  I  had  taken  no 
quinine  previously  nor  afterward;  had  no  return 
of  the  hemorrhage.  In  1879  I  took  twenty 
grains  of  quinine  in  four  doses.  Result,  I 
passed  blood  from  bladder  three  times  in  twelve 
hours— about  one  half  pint  in  all.  Took  no 
more  quinine ;  bad  no  more  bleeding.  In  1886 
had  charge  of  several  cases  of  chills.  In  four 
of  them  (three  in  one  family)  a  three-grain  dose 
of  quinine  was  followed  in  about  three  or  four 
hours  with  pure  blood  from  the  bladder.  Other 
antiperiodics,  arsenic,  strychnine,  pipirine,  etc, 
produced  no  hemorrhage. 

In  1878  I  had  a  case  of  congestive  chill,  boy 
6  years  old.  The  mother  had  given  him  three 
doses  (three  grains  each)  of  quinioe  before  the 
chill  came  on.  When  I  arrived  I  gave  a  small 
dose  of  chloroform  by  mouth.  In  a  few  moments 
(five  or  six)  he  got  up,  passed  from  the  bowels 
a  coflee  cup  full  of  clotted  and  fluid  blood. 
Half  an  hour  afterward  he  was  perspiring 
freely  and  recovered  under  other  antiperiodics. 

These  are  all  the  cases  I  know,  or  can  now 
remember,  of  hemorrhage  which  can  be  directly 
laid  to  quinine,  except,  I  may  add,  several 
(about  eighteen  cases)  of  soKsalled  swamp  fever. 

This  disease  as  I  view  it,  is  not  a  distinct 
disease,  but  really  a  ht^morrhage  brought  on  by 
the  injudicious  use  of  quinine.  Idiosyncrasy 
prevails  in  these  cases.  Some  can  stand 
quinine,  some  cannot,  and  these  are  the  ones  in 
which  quinine  is  the  systemic  poison,  showiog 
itself  in  its  action  on  the  kidneys.  True  Congo 
or  Egypdan  swamp  fever  I  don't  think  has  ex- 
isted in  this  secdon.  I  don't  think  the  peculiar 
filuria  has  ever  been  found.  The  malarial 
hematuria,  so-called,  is,  in  my  opinion,  an 
idiopathy — a  blood  poison  by  quinine.  Allow 
me  to  express  my  admiration  of  the  articles 
written  by  you  that  have  come  under  my  notice 
in  The  World." 

A  curious  case  has  come  into  my  hands  lately. 
A  lady,  aged  44,  whose  mother  died  of  cancer, 
b^an  to  run  rapidly  into  a  condition  of  great 
debility.  In  six  months  she  had  lost  sixty 
poimds,  became  quite  pallid  and  so  weak  that 
&he  had  to  be  helped  into  her  carriage.  She 
was  pronounced  a  victim  of  cancer  of  the  stom- 
ach. Nevertheless,  there  was  no  vomiting,  no 
tomor,  nor  was  there  any  symptom  of  cancer  in 


any  internal  organ;  nothing  but  this  singular 
and  apparendy  causeless  depression.  Such  a 
state  of  things  certainly  pointed  to  cancer  prob- 
ably imbedded  deeply  in  the  liver,  and  I  waited 
in  the  expectation  that  it  would  declare  itself 
when  the  disease  reached  the  surface.  One  day 
the  lady  remained  that  she  had  eaten  some  raw 
oysters  and  had  thrown  them  up  two  hours  later. 
Knowing  that  raw  oysters  should  be  digested 
in  an  hour,  I  asked  what  was  their  condition 
when  vomited.  She  informed  me  that  they 
were  just  as  she  had  eaten  them,  not  digested 
and  not  even  acidulated.  There  was  evidently  a 
total  failure  of  the  secretion  of  gastric  juice.  I 
gave  her  acid  and  pepsin  and  a  few  days  later 
some  "  malted  beef."  She  at  once  began  to  im- 
[Nrove,  and  that  so  markedly  that  we  are*  now 
satisfied  there  is  no  cancer. 

William  F.  Waugh,  RLD. 


Permanent  Cure  of  Rheumatism  by  Otmio  Acid. 

Editor  Medical  World. — ^I  will  give  what 
in  my  hands  has  given  the  best  results  in  com- 
plicated cases  oi  sciatica  with  rheumatism.  My 
cases  have  been  from  all  classes,  ages  and  con- 
ditions and  from  all  parts  of  the  country.  I 
am  indebted  to  my  medical  brethren  for  the 
most  of  my  cases  at  this  watering  place. 

I  had  been  treating  cases  with  varying  de- 
grees of  success  and  &ilure  up  to  three  years 
ago,  when  I  thought  I  would  try  the  effect  of 
osmic  acid  in  connection  with  the  waters  here. 
I  used  osmic  acid  on  two  cases  at  that  time, 
when  I  received  a  report  of  another  experi- 
menier  who  bad  very  bad  results  from  the 
same.  My  two  cases  had  five  and  seven  hypo- 
dermic injections  respectively  at  that  time,  and 
were  apparently  cured.  I  then  discontinued 
the  acid  and  commenced  galvanism  and  had  fair 
success  for  a  time.  In  some  cases  morphia,  atro- 
pia  and  chlorof(Min  were  used,  and  in  some  only 
the  salt  bath.  I  then  had  other  cases  that  did 
not  improve  as  I  thou^t  they  should. 

In  cases  one  and  two  osmic  acid  was  used. 
In  September,  1890,  in  case  one,  six  injections 
were  put  in,  when  the  gentleman  was  called 
home,  sa3ring  that  if  he -had  further  pain  he 
would  return.  Six  months  afterwards  he  wrote 
me  a  Ime  saying  that  he  had  not  had  any 
further  pain.  This  gentleman  had  been  under 
the  treatment  of  three  or  four  of  the  best  physi- 
cians of  this  State  for  nine  months,  before  this 
time. 

Case  two,  May,  1891,  was  acute;  an  actor 
by  occupation;  was  very  much  drawn  to  one 
side  and  with  such  extreme  pain  that  he  could 
not  move.  After  the  first  injection  of  osmic 
acid  th^re  was  a  marked  improvement,   and 


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after  the  eeventh  there  was  uo  pain  at  all.  I 
continued  the  baths  and  electricity  for  a  week 
longer  and  then  he  resumed  his  work  again. 
At  this  point  I  received  the  bad  reports  of 
others  before  spoken  of,  and  discontinued  for 
-about  two  years.  In  that  time  there  were  some 
that  went  through  my  hands  cured  from  the 
bath  and  two  that  were  not  All  were  chronic 
•casps.  Then  I  ascertained  that  the  cases  which 
I  had  injected  were  still  well  and  that  no  un- 
ipleasant  symptoms  had  supervened.  I  com- 
menced the  use  of  osmic  acid  again. 

Case  three:  I  had  used  two  injections  when 
the  fellow  was  so  far  relieved  that  he  got  on 
his  crutches  and  went  to  one  of  the  bath  houses. 
One  of  his  fellow  bathers  informed  him  that  it 
was  morphine  and  that  it  would  only  last  while 
it  was  being  used,  and  I  did  not  see  him  again. 

Case  four,  was  here  in  May  of  1892,  and  re- 
mained two  weeks.  Bathing  and  morphine  was 
used  several  times  at  that  time.  He  returned 
home  for  one  week,  then  came  back  and  I  used 
five  hypodermic  injections  of  osmio  acid.  There 
was  no  pain  or  soreness  left,  and  he  returned 
home  with  still  a  lai^e  amount  of  atrophy  of 
muscles. 

Case  five  was  in  August  of  this  year.  A 
gentleman,  age  65;  it  was  of  that  form  that  the 
pain  was  the  greatest  when  remaining  quiet; 
while  moving  the  pain  was  not  so  acute.  There 
was  a  great  deal  of  atrophy;  the  pain  was  so 
bad  that  he  could  neither  eat  nor  sleep  without 
opiates.  After  taking  baths  for  one  week  I 
commenced  the  use  of  osmic  acid  and  five  injec- 
tions were  used,  and  at  the  same  time  a  down- 
ward current  of  galvanism.  At  that  time  I  went 
to  Washington  for  one  week  and  left  him  in  the 
hands  of  my  assistant  He  took  the  advantage 
of  my  departure  to  go  to  the  World's  Fair  at 
Chicago,  and  returned  at  the  same  time  that  I 
<lid,  and  reported  no  more  pain.  He  took  the 
baths  for  one  week  more  and  returned  home 
without  the  return  of  any  pain. 

Case  six  is  a  man  of  70,  now  under  treatment 
In  this  case  morphine  has  been  used  by  the 
patient  himself,  which  I  think  no  physician 
should  recommend.  He  used  from  five  to  six 
quarter  grain  doses  each  twenty-four  hours 
hypodermically,  and  at  the  time  I  first  saw  him 
he  had  used  six  in  twelve  hours  and  was  scream- 
ing with  pain.  I  then  used  at  eight  in  the 
evening,  one- half  grain  of  morphine  and  the 
osmic  acid.  He  went  to  sleep  in  a  half-hour 
and  had  no  more  morphine  up  to  the  next  time 
I  saw  him,  eight  the  following  evening — 
when  the  second  hypodermic  of  .)smic  acid  with- 
out morphine  was  used.  The  followingr  day  at 
four  o'clock  his  daugnter  used  one  quarter 
grain  of  morphine  and  the  third  injection  of 


osmic  acid  was  used  that  night,  and  the  next 
day  five  grains  of  antifebrine  was  given,  and  the 
fourth  hypodermic  in  the  evening.  The  pain  is 
gone,  but  there  is  soreness  and  there  is  contrac- 
tion of  some  muscles  and  atrophy  of  others. 
The  case  has  now  reached  a  point  where ,  gal- 
vanism can  be  used  to  an  advantage.  Under 
osmic  acid  the  muscles  relax  so  that  the  patient 
can  use  his  limb  as  before.  Of  course,  the 
number  of  my  cases  is  small,  and  from  others 
bad  results  are  reported.  I  was  afraid  to  use 
it  excepting  in  otherwise  hopeless  cases.  The 
mild  cases  I  have  said  nothing  about  They 
get  well  from  the  baths  or  with  a  very  small 
amount  of  medication.  But  in  these  few  cases 
I  have  hoped  to  establish  the  fact  that  osmic 
acid  is  of  benefit  in  extreme  cases  It  is  safe  to 
use  in  the  hands  of  a  conservative  physician,  at 
least  I  have  found  no  ill  effects  in  any  shape 
or  form.  In  case  six  there  is  no  other  treat- 
ment but  baths  and  osmic  acid.  In  the  other 
cases  there  was  galvanism  used  with  it.  In 
case  two,  tonics,  in  case  five,  galvanism  and  in 
the  others,  baths.  A.  W.  Shotwell,  M.D. 
Mount  Clemens  Springs,  Macomb  Co.,  Mich. 


Suipho-lchthyolate  of  Ammonium  in  tlie  Treat- 
ment of  Rfreumatio  Arthritis. 

Editor  Medical  World:— Mr.  C,  aged  83, 
had  been  treated  for  thirty  days  for  rheumatic 
arthritis  of  left  knee  when  I  was  called.  He 
had  lain  on  his  back  until  he  had  developed 
large  bed  sores.  I  found  that  he  had  been 
treated  by  hot  cloths  locally  to  the  joint  I 
tried  besides  internal  medication,  most  of  the 
local  anodynes  and  massage,  without  avail,  and 
found  the  joint  getting  more  swollen  and  pain- 
ful, to  such  an  extent  that  he  could  not  have  it 
touched.  I,  as  a  last  resort,  thought  of 
ichthyol  and,  having  a  small  amount  of  the 
medicine  at  hand,  I  made  a  thorough  applicar 
tion  with  a  feather,  painting  the  painful  joint 
and  vicinity  thoroughly.  I  saw  him  twenty- 
four  hours  later  and  found  all  the  fever  (local) 
and  pain,  redness  and  other  symptoms  gone.  I 
have  applied  the  medicine  twice  since  and  find 
patient  rapidly  improving.  I  am  led  to  be- 
lieve, from  this  one  case,  that  it  may  prove  to 
be  the  proper  remedy  for  infiamed  and  painful 
joints  I  would  like  for  some  of  The  Wokld 
readers  to  give  it  a  trial  in  similar  cases  and  re- 
port success.  W.  A  Dorman,  M.  D. 

Lebanon,  Ind. 


What  if  an  inyestment  returning  25  per  cent,  profit 
were  offered  you?  To  wve  25  per  cent,  is  juct  as  K;ood. 
World /our  years  for  $3.00,  an  averiige  of  76  cents  per 
year  and  trouble  and  expense  of  remitting  every  year 
18  also  saved. 


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The  Swab  in  the  Treatment  of  Diphtheria. 

Editor  Medical  World  : — I  wish  to  men- 
tion  one  simple  little  mechanical  implement  that 
has  proven  so  able  an  ally,  so  trustworthy  a 
iriend  in  my  experience  with  diphtheria,  that  I 
desire  to  offer  a  word  in  its  behalf.  This  little 
mechanical  contrivance  is  none  other  than  the 
swab,  whose  enemies  are  bristling  up  about  it, 
impelling  me  to  its  defence. 

To  successfully  combat  an  attack  of  malig- 
nant diphtheria  the  case  must  be  seen  early, 
«ince,  after  the  system  has  become  saturated 
with  the  poisonous  virus  the  likelihood  of  sue- 
-ceaa  is  necessarily  vastly  lessened. 

The  extended  and  graphic  arguments  urged 
gainst  the  employ  ment  of  the  swab  by  physi- 
•cians  whose  success  is  described  in  such  argu- 
ments, are  undeniable,  if  the  physician  permits 
an  ill  advised  use  of  the  instrument 

I  am  sure  it  is  possible  to  render  a  diph- 
theritic throat  antiseptic,  since  I  have  seen  the 
throat  of  a  patient  who  was  already  in  a  dying 
<x>ndition  from  the  systemic  effects  of  this  dis- 
ease made  clean,  his  breath  rendered  pure  and 
«weet,  and  his  condition  in  every  way  benefitted 
in  twelve  hours  after  the  first  application  of  the 
antiseptic  by  means  of  the  swab. 

In  this  family  three  deaths  had  already  oc- 
curred in  less  than  a  fortnight,  the  cases  being 
under  the  care  of  another  physician.  At  my 
first  visit,  this  young  man,  about  sixteen  years  of 
age,  was  in  an  almost  putrid  state,  emitting  so 
foul  a  stench  that  attendance  upon  him,  even 
from  those  who  loved  him,  was  scarcely  endura- 
ble. I  entertained  no  hope  and  offered  no  en- 
<X)uragement  as  to  his  recovery,  warning  the 
parents  that  death  must  almost  inevitably  re- 
sult, though  promising  them  to  give  him  ease 
and  clean  his  throat  In  twelve  hours  he  was 
80  much  improved  as  to  express  gratitude  for 
the  relief  afforded,  especially  from  the  loath- 
some stench  of  which  not  a  trace  now  remained. 
He  made  surprising  progress  for  several  days, 
.  but  his  system  had  become  so  poisoned  from  the 
disease  before  I  saw  him,  that  upon  being  raised 
to  a  sittiDg  posture  to  receive  a  drink  he  ex- 
pired. 

Only  two  children  of  this  family  were  now 
left  and  both  had  their  turn  at  the  disease,  but 
a  strict  adherence  to  the  treatment  prescribed 
brought  ihem  through  in  short  order  and  with- 
out a  breath  of  offensive  odor. 

In  another  family  the  first  stricken  was  a 
thirteenyear-old  boy.  Though  I  had  the  case 
«arly,  the  symptoms  were  all  well  developed. 
After  warning  the  parents  as  to  the  nature  of 
the  disease  and  its  danger,  I  urged  upon  them 
Che  necessity  of  stricriy  following  the  line  of 
treatment  in  order  to  pull  him  through. 


The  treatment  consists  in  swabbing  the  throat 
every  two  hours  with  a  mixture  of  creolin,  ferri 
subsulph.  and  glycerine,  followed  frequently  in 
the  intervals  with  a  spray  of  hydrogen  per  ox. 
(Marchand)  small  granules  of  hydrargchlor. 
mitis,  gr.  one- sixth,  every  hour  until  bowels 
move  freely,  and  a  granule,  one-sixth  gr., 
calcium  sulphide  every  hour.  If  temperature 
runs  high  I  give  the  defervescent  granule  with 
strych.  ars.  until  lowered,  whisky  when  indi- 
cated, with  strict  attention  to  diet  After  using 
the  swab,  I  instruct  the  nurse  to  cleanse  it  with 
a  saturated  solution  of  kali  chlorate.  For 
twenty-four  hours  this  boy  did  well,  but  his  ob- 
jection to  the  swab,  and  the  interference  of  an 
ignorant  physician  who  assured  the  parents  that 
their  boy  had  "only  putrid  sore  throat,"  and 
would  recover  without  such  diligent  attention, 
prevailed  upon  them  to  relax  their  efforts.  lu 
less  than  twelve  hours  that  boy  was  dead. 

That  was  a  sorrowful  lesson  and  it  served  to 
convince  those  misguided  people  that  I  had  not 
been  in  error.  As  another  child,  a  girl  of  fif- 
teen, was  developing  the  disease,  they  consented 
to  follow  the  treatment,  swabbing  and  all,  in 
spite  of  opposition.  A  competent  nurse  was 
placed  in  charge  of  this  case  and  after  a  hard 
fight  the  girl  was  restored  to  health.  In  the 
three  remaining  children  ranging  from  two  and 
one-half  to  eighteen  years,  the  same  treatment 
was  attended  by  the  same  satisfying  results. 

Cases  innumerable  might  be  cited  in  illustra- 
tion, but  these  examples  show  both  sides  of  the 
matter. 

In  my  judgment  the  swab  has  no  rival  as  a 
means  of  applying  the  local  treatment  to  a 
diphtheritic  throat 

The  operation  should  not  be  one  of  violence. 
It  is  the  business  of  the  physician  to  first  obtain 
the  confidence  of  the  patient  and  let  it  know 
that  he  does  not  desire  to  hurt  it  After  a  few 
applications,  even  the  youngest  patient  will  learn, 
if  you  are  gentle  and  kind,  though  determined, 
to  submit  quietly  and  get  the  business  over  as 
quickly  as  possible. 

There  need  be  no  strangling,  but  if  the  swab 
happens  to  gag  the  patient  a  little  that  is  no 
great  hardship,  since  the  expulsive  effort  only 
serves  to  cough  up  the  membrane  already  de- 
tached and  leaves  the  throat  so  much  freer 
and  the  patient  so  much  more  comfortable. 

The  creolin,  possessing  powerful  antiseptic 
properties,  destroys  the  disease  germs  and  stays 
their  further  growth,  while  it  deodorizes  and 
thoroughly  disinfects  the  throat  The  liquor 
ferri  subsulph.  exerts  its  powerful  astringent 
properties  and  keeps  the  terminal  blood  vessels 
closed,  cutting  off  the  poisonous  virus  from  the 
general  circulation.     It  withers  the  accumulated 


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membrane,  causiDg  it  to  peel  from  the  mucous 
surfaces  of  the  throat  and  also  prevents  necrosis 
of  the  underlying  tissues,  aflfording  them  a  re- 
sistence  to  the  lodgment  of  the  pathogenic  germs. 
If  any  of  the  iron  gets  into  the  stomach  it  only 
serves  to  build  up  the  system. 

Of  the  creolin  it  may  be  further  said,  it  is  not 
only  superior  to  all  other  antiseptics  because  of 
its  combined  properties,  but  it  is  safer,  because 
it  is  non-irritant  and  non-poisonous.  I  have 
continued  its  use  several  days  after  the  throat 
had  become  entirely  clean,  and  small  children 
have  swallowed  it  ad  libittim  without  any  bad 
efifects. 

The  pus- destroying  and  general  beneficial  ef- 
fects of  spraying  the  anterior  and  posterior 
nares  with  the  Hj  O2  needs  no  comment  here. 

There  need  be  no  such  horrible  scenes  attend- 
ing the  employment  of  the  swab  as  are  some- 
times described.  When  the  physician  does  not 
make  the  application  personally  the  attendant 
should  be  thoroughly  instructed  in  his  sacred 
duty  and  only  one  who  can  be  relied  upon  to 
use  it  in  all  gentleness  should  be  trusted. 

The  absorption  of  the  ptomaines  being 
checked  in  the  start,  there  is  no  exhaustion  from 
systemic  poisoning  and  the  patient  has  a  good 
fighting  chance,  and  such  enervation  as  must  re- 
sult from  combating  the  local  condition  must 
be  carefully  watch^  for  and  met  by  the  phy- 
sician as  its  urgency  shall  demand. 

Arguments  in  favor  of  the  swab  in  connection 
with  these  remedies  might  be  prolonged  indefi- 
nitely. However,  the  proof  is  at  the  command 
of  any  physician  who  now  decries  the  swab,  since 
a  test  trial  will  surely  bring  the  gratifying  re- 
sults that  my  own  success  warranted  me  in 
promising  others.     W.  B.  Parkinson,  M.D. 

Logan  City,  Utah. 


Caloium  Sulphide  in  Syttemio  Infection. 

(fourth  paper.) 

Editor  Medical  World  : — It  is  presumed 
that  anything  helpful  in  the  treatment  of  diph- 
theria will  be  gladly  received  by  the  profession 
at  large,  as  it  is  by  the  author  of  this  paper, 
and  it  is  with  a  desire  to  be  helpful  that  we 
*  come  before  you  with  a  few  suggestions  regard- 
ing the  use  of  the  drug  under  consideration. 

There  is  no  question  but  that  diphtheria  is, 
sooner  or  later,  a  systemic  infection,  neither  is 
there  any  question  but  that  calcium  sulphide  is 
one  of  our  best,  if  not  the  best,  of  systemic  disin- 
fectants, hence  its  application  to  the  relief  of 
this  condition  is  based  upon  rational  grounds. 

As  will  be  seen  by  my  previous  paper  (Dec 
World),  I  always  use  the  calcium  sulphide  in 
every  form  of  tonsillitis  attended  by  the  least 


constitutional  disturbances  and  get  good  results 
therefrom.  The  line  of  demarcation  is  often  so 
slight  that  it  gives  a  feeling  of  security  to  know 
that,  whether  the  case  we  see  in  the  night 
proves  to  be  simple  tonsillitis,  as  we  think,  or 
diphtheria,  we  occupy  the  vantage  ground. 

Many  cases  of  diphtheria  are,  primarily,  local, 
and  it  is  here  that  the  calcium  sulphide  gets  in 
good  work  in  preventing  or  modifying  systemic 
infection.  This  leads  to  another  valuable  point 
and  that  is  the  use  of  this  drug  as  a  prophylac- 
tic for  exposed  persons.  It  is  my  practice  in 
all  such  cases  to  give  the  members  of  an  ex- 
posed family  about  one-third  the  amount  we  use 
with  the  sick  one.  This,  in  many  instances, 
effectually  prevents  the  development  of  the  dis- 
ease or  so  modifies  its  intensity  that  the  attack 
is  very  light 

As  will  be  inferred  from  the  usefulness  of 
this  drug  as  a  prophylactic,  to  be  the  most  help- 
ful it  must  be  begun  early.  With  the  very- 
first  symptoms  it  should  be  begun  in  large  doses, 
three  or  four  granules,  one-sixth  gr.  each, 
every  fifteen  minutes  until  the  characteristic 
odor  is  smelled  in  the  breath,  the  urine  and  the 
feces,  after  which  it  should  be  continued  at  less 
frequent  intervals  but  sufficient  to  keep  up  the 
impression. 

The  above  recommendation  is  for  a  child  of 
ten  or  twelve  years.  For  an  adult  a  somewhat 
larger  dose  may  be  needed,  while  for  younger 
children  lees  will  be  required. 

As  a  rule,  children  do  not  object  to  its  pecul- 
iar taste,  and  even  babies  will  take  it  nicely, 
triturated  with  sugar  of  milk.  Don't  depend 
upon  the  calcium  sulphide  of  the  shops  but  use 
your  granules  and  attend  to  the  trituration  your- 
self. If  this  treatment  ia  begun  early  you  will 
be  surprised  to  see  how  little  depressed  your 
patient  will  be.  The  drug  so  effectually  de- 
stroys the  ptomaines  that  little  epanemia  is  pro- 
duced. 

Fever  usually  is  present  at  first  and  calls  for 
aocmitine,  in  connection  with  which  digitalin  and 
strychnine  are  helpful.  I  know  of  no  better 
combination  with  which  to  handle  the  general 
condition.  Local  treatment  should  not  be  omit- 
ted, as  the  first  astringent  applications  are  of 
service.  I  have  used,  to  much  advantage, 
lemon  juice  and  tannic  acid  ;  later,  as  decompo- 
sition of  the  patches  b^ins  to  take  place,  an  ac- 
tive germicide  is  required,  and  here  we  may  de- 
pend upon  the  solution  of  peroxide  of  hydn^n. 
In  our  anxiety  for  the  wellfare  of  the  phamyx 
the  nose  must  not  be  forgotten.  Not  long  ago 
I  was  called  to  a  case  dismissed  two  days  before 
by  another  practitioner  as  cured  and  found  the 
nasal  passages  filled  with  exudate,  with  systemic 
infection  just  beginning. 


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The  above  detailed  treatment  saved  the  case. 
The  noee  was  so  filled  with  exudate  that  it  was 
with  difficulty  I  could  force  a  catheter  into  the 
nose,  but  I  at  last  succeeded  in  doing  so  and  in- 
jected a  few  drops  of  peroxide,  then  others  and 
others  till  a  hole  was  oxidized  through,  kept 
open  and  the  child  was  saved.  Two  boys,  aged 
ten  months,  came  down  the  second  day  of  my 
attendance,  but  granule?  of  the  above  mentioned 
drugs  mixed  Mrith  black  berry  jam  carried  them 
safely^  through.  The  extent  to  which  calcium 
sulphide  saturates  the  tissues  was  recently  well 
illustrated  in  a  case  under  the  care  of  a  friend 
to  whom  I  had  the  pleasure  of  recommending 
its  use,  thereby  apparently  saving  a  life.  As 
the  child  began  to  recover  the  cervical  glands, 
enormously  swollen,  broke  down,  forming  an  ab- 
cess,  which,  when  incised,  was  reeking  with  the 
characteristic  odor  of  the  drug.  Used  in  the 
same  way  calcium  sulphide  becomes  the  domi- 
nant treatment  in  scarlet  fever  and  measles  as 
well,  and  will  materially  modify  the  course  of 
both.  In  fact,  I  know  of  no  condition  charac- 
terized by  absorption  of  the  various  elements  of 
decomposition  but  that  is  materially  benefited 
by  the  use  of  this  drug.  Should  you  try  any  of 
the  foregoing  suggestions  and  not  be  successful, 
refresh  your  memory  of  the  points  made  in  my 
first  paper  relative  to  the  pharmacy  of  this  drug. 
W.  C.  Abbott,  M.D. 

Eavenswood,  P.  0.,  Chicago,  111. 


Dr.  J.  A.  Muenich,  of  Jefferson,  Wis.,  in  a  note 
to  the  editor,  confirms  the  value  of  chloride  of 
calcium  in  the  treatment  of  pneumonia,  as 
experienced  in  his  practice. 


A  reader  sends  us  a  copy  of  the  new  Con- 
necticut Medical  Law,  which  shows  that  State 
to  require  an  examination  on  the  part  of  appli- 
cants. 


Epithelial  Cancer  and  Its  Treatment. 

Editor  Medical  World: — In  August,  1892, 
Mr.  R  came  to  my  office  for  treatment  Upon 
examinHtion  I  found  an  epithelioma  of  the  noee 
about  the  size  of  a  hazel  nut  He  was  con- 
siderably despondent  when  told  its  nature  and 
course.  I  b^an  treatment  with  the  chloride  of 
sdnc  paste,  as  laid  down  by  Prof.  Roberts  Barth- 
olow  in  his  Materia  Mediea.  Keeping  the  appli- 
cation to  the  diseased  parts  and  a  little  bejond 
for  twenty-four  hours,  considerable  inflamma- 
tion followed  A  poultice  of  flaxseed  meal  was 
then  applied  and  kept  constantly  to  the  parts 
for  some  twenty- six  hours,  when  the  cancer 
mass  rolled  out,  leaving  a  cavity  that  granulated 
in  with  very  little  scar  tissue  remaining, 


In  October,  1893,  this  same  patient  again 
consulted  me  at  my  office  for  further  treatment, 
but  this  time  the  lower  lip  was  the  location 
selected  for  the  attack  of  the  cancer  cells.  There 
was  a  superficial  and  quite  extensive  epithelioma 
of  about  the  size  of  a  large  hickory  nut  It  had 
an  ugly  appearance.  1  advised  him  to  go  to 
Detroit  for  treatment  to  my  illustrious  preceptor 
Prof.  Hal  C.  Wyman ;  but  he,  being  over  70 
years  of  age,  stated  that  death  was  preferable  to 
a  cutting  operation.  I  then  treated  him  by  the 
same  method  used  the  year  previous  with  bril- 
liant results.  The  cancer  mass  rolled  out  after 
six  days'  treatment,  and  the  process  of  tissue 
repair  has  gone  on  to  a  successful  terminaaion. 

Rogers  Gty,  Mich.        K  Erskine.  M.  D. 


Pelvic  Inflammation. 


Editor  Medical  World  : — The  old  line  of 
treatment  with  opium,  hot  poultices  and  hot 
water  irrigation  alone  has  not  given  me  entire 
satisfaction  in  acute  pelvic  peritonitis.  In 
several  cases  the  inflammatory  action  has  re- 
sulted in  an  abscess,  and  in  one,  general  periton- 
itis and  fatal  issue  by  a  rupture  of  purulent 
infiltration.  Since  using  ichthyol  not  a  single 
case  has  developed  beyond  the  stage  of  lymph 
and  serum.  To  illustrate :  Mrs.  A.,  after 
using  upon  herself,  subsequent  to  parturition,  a 
syringe  which  her  husband  had  formerly  used 
on  the  sly  for  gonorrhea,  was  taken  violently  ill 
with  pains,  fever,  rapid  pulBC  and  extreme 
tenderness  about  the  uterus.  Vaginal  examin- 
ation revealed  a  fixed  cervix  with  an  indurated 
roof  of  the  pelvis,  and  a  profuse  muco-purulent 
discharge.  There  was  some  general  peritonitis. 
After  rapidly  growing  worse  until  the  utero- 
rectal  tumor  had  nearly  obliterated  the  vagina, 
improvement  began  and  continued  slowly  until 
recovery  was  complete  and  perfect  health 
restored  without  an  abscess. 

The  treatment  principally  consisted  of  large 
doses  of  morphine  (i  to  1  grain)  to  control  pain 
and  produce  quiet,  and  No.  3  capsules  of  ichthyol 
every  three  hours,  both  per  rectum.  Very  hot 
water  applications  to  the  abdomen  with  occa- 
sionally a  little  turpentine.  Copious  irrigations 
of  very  hot  water  night  and  morning.  Eleva 
tion  of  the  foot  of  the  bed  about  ten  inches  ; 
legs  fixed  over  a  pillow.  Gave  no  acdve 
physic,  but  avoided  impaction  of  the  bowels  or 
rectum.  Used  a  catheter  often  when  required. 
Gave  a  light  but  nutritious  diet ;  a  blister  and 
iodine  later  to  clear  up  the  exudation.  Abso- 
lute rest  with  dorsal  decubitus  until  all  indura- 
tion had  disappeared.  As  the  ichthyol  is  apt 
to  dissolve  a  capsule,  it  should  be  left  in  a  vial 
and  the  capsules  empty  to  be  filled  as  used. 


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While  ichthyol  in  the  acute  form  has  acted  like 
a  charm  it  has  not  done  well  with  chronic  cases. 
Early  in  the  case  I  use  morphine  freely,  but 
later  it  is  a  dangerous  screen  and  may  conceal 
the  need  of  a  surgeon. 

Dr.  F.  G.  Greenfield. 
Edinboro,  Pa. 


Varioua  Topioa. 

Editor  Medical  World:— On  page  397, 
November  World,  is  a  quotation  from  Dr. 
Goodell  in  which  he  says  he  has  never  known 
a  woman  to  become  pregnant  after  having 
gonorrhea.  If  there  is  anything  in  medicine 
that  I  do  know  it  is  that  women  can  and  do 
have  children  after  having  gonorrhea. 
Three  years  ago  I  treated  both  husband 
and  wife  for  gonorrhea.  The  woman's 
case  was  the  most  rebellious  I  think  that 
ever  came  under  my  notice.  This  year  I 
attended  her  in  labor.  She  was  delivered  of  a 
large,  healthy  boy.  I  never  saw  a  mother  and 
child  do  better  than  they  did.  Many  similar 
cases  could  be  cited  if  necessary.  Strumpets 
frequently  use  means  to  prevent  pregnancy  or 
cause  abortion  or  miscarriage.  The  fact  that 
they  seldom  have  children  should  not  be 
charged  to  gonorrhea  alone.  We  should  not 
forget  that  such  characters  often  have  syphilis 
and  this  may  account  to  some  extent  for  the 
small  number  of  children  born  to  them. 

Diet  during  the  last  weeks  of  pregnancy 
(page  395)  may  prevent  the  growth  of  the 
fetus.  I  have  thought  that  it  did  in  some 
cases  I  have  observed.  But  the  rule  (if  it  may 
be  called  one)  is  not  without  exceptions.  Long 
ago  Dr.  Rigin  Thompson  stated  that  epsom 
salts  taken  freely  during  the  last  two  months  of 

5regnancy  would  check  the  growth  of  the  fetus, 
'o  this  rule  there  are  also  exceptions. 

The  proposition  for  a  permanent  journal  in 
the  Latin  language  (page  370)  is  not  likely  to 
prove  a  grand  success.  Very  few  who  read 
Latin  at  all  read  it  well  enough  to  'waste 
time"  over  it.  The  busy  practitioner  will  have 
little  to  do  with  it  For  the  general  practitioner 
one  language  is  enough.  The  future  medical 
historian  will  find  enough  and  more  than 
enough  in  his  "own  tongue  wherein  he  was 
bom"  from  which  to  gather  abstracts  and  data. 

Physicians  who  have  worried  for  many 
months  over  old  cases  of  psoriasis  will  hail  with 
joy  the  discovery  of  the  "thyroid  gland"  cure 
for  this  troublesome  disease  (see  page  370). 
Possibly  some  doctors  will  (like  myself)  lack 
faith  in  this  treatment 

On  page  369  the  editors  suggest  that  public 
funerals  in  cases  of  death  from  contagious  dis- 
eases should  be  abolished.     This  is  right.     In- 


deed, I  have  always  thought  public  funerals,  in 
towns  and  cities  especially,  and  more  especially 
during  an  epidemic  or  endemic,  should  be- 
abolished.  The  tolling  bell,  or  even  conversa- 
tion about  a  funeral,  will  Sdldom  fail  to  mak& 
worse  the  patient  who  is  dangerously  ill.  But 
the  time  will  never  come  when  the  world  will 
be  free  from  contagious  diseases.  like  the  poor, 
they  are  always  with  us.  They  originated  d& 
novo  once,  why  not  again  ?  But  it  is  in  ihe 
power  of  men  and  governments  or  nations  to  do 
a  vast  amount  of  good  in  checking  and  pie- 
venting  the  ravages  of  not  only  contajjious  but 
all  other  diseases.  It  is  the  duty  of  the  physi- 
cian to  do  all  in  his  power  in  ihat  direciioa. 
Too  often  the  advice  and  suggestions  of  physi- 
cians are  unheeded,  and  legislatures  are  pro- 
verbily  slow  in  enacting  laws  calculated  to  pie- 
vent  disease. 

Carroll  Kendrick,  M.D. 
Kendrick,  Miss. 

Conception  After   Gonorrhea.     Natural    CleanI/ 
Conduct  of  Labor.     Cord   Three  Times 
Around  the  Neolc. 

Editor  Medical  World  : — As  to  conception 
in  a  female  who  previously  had  gonorrhea,  I 
have  an  interesting  case  to  report.  A  married 
woman  in  her  fourth  (4th)  mouth  of  pregnancy 
contracted  gonorrhea  from  her  husband. .  She 
was  subsequently  delivered  at  full  term  of  a 
healthy  child,  she  having  of  course,  recovered 
from  her  attack  long  before. 

The  child  showed  at  no  time  any  untoward 
symptoms,  and  after  two  years  the  woman  is 
again  pregnant 

The  lack  of  concepdon  in  prostitutes  appears 
to  be  owing  more  to  an  inflamed  coodition  of 
the  endometrium,  which  may  be  owing  to  any 
one  or  more  of  manj  causes  rather  than  to  the 
fact  that  gonitrrhea  may  have  been  present  in 
any  particular  case 

I  fully  agree  with  Dr.  Parker  in  his  article 
on  peritonitis  following  birth  at  any  period  of 
gestation. 

In  the  first  place  be  certain  of  the  cleanliuess 
and  disinfection  of  every  thing  which  m^y  come 
into  contact  with  the  parturient  canal.  Also  be 
sure  that  delivery  is  complete,  not  only  of  the 
fetus  and  membranes,  but  also  of  clot,  and  firm 
contraction  secured. 

Then  cleanse  the  external  parts  thoroughly 
with  disinfecting  solutions  and  direct  the  process 
to  be  repeated  at  least  twice  a  day,  with  a  dis- 
infected cloth  covering  the  external  genitals  in 
the  intervals,  and  leave  the  parturient  canal, 
etc.  strictly  alone,  and  ill  recoveries  from  a  truly 
natural  event  will  be  very  much  scarcer  thaa 
at  present. 


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Birth,  March.  1887  ;  primipara,  labdr  tedi- 
ous, cord  found  to  be  three  times  around  the 
neck.  I  was  obliged  to  tie  and  cut  the  cord  to 
effect  delivery  after  the  birth  of  the  head.  Im- 
mediate manual  delivery ;  still  birth ;  good  re- 
covery of  mother.  R.  S.  Frost,  M.D. 

Kinmount,  Out,  Canada. 

Editor  Medical  World  : — As  the  subject  of 
gonorrhea  and  its  effects  upon  the  uterus  is  up 
for  discussion,  I  will  report  a  case.  A  woman 
had  gonorrhea  during  pregnancy  and  confine- 
ment twelve  years  ago.  The  child  a  boy,  had 
so  terrible  a  case  of  gonorrheal  ophthalmia  that 
he  lost  the  sight  of  one  eye,  yet  that  woman  has 
borne  two  healthy  children  since,  although  she 
has  never  married.  I  could  report  many  inter- 
esting cases  gathered  in  an  active  practice  of 
fifteen  years.  Frank  W.  Lewis,  M.D. 

Litwalton,  Virginia. 

A  Large  and  a  Small  Pair  of  Twins 
Editor  Medical    World. — In  November 
World  Dr.  L.  Rupert,  of  Rupert,  W,  Va., 
reports  a  large  pair  of  twins.     I  can  get  close  to 
him. 

On  October  26,  1893,  I  was  called  to  see 
Mrs.  8.  A.,  aged  30,  at  4  o'clock  a.m.  Found 
her  in  labor,  and  in  two  hours  delivered  her  of 
twins,  both  boys,  each  a  head  presentation  ;  one 
followed  the  other  in  half  an  hour,  smallest  first 
One  large  placenta  with  two  cords.  They 
weighed  7  J  and  8i  pounds.  There  was  a  good 
deal  of  hemorrhage,  but  the  womb  contriusted 
well  I  saw  her  the  next  day  and  she  was 
doing  nicely.  I  have  attended  her  in  several 
miscarriages.  She  would  become  pr^nant  and 
go  two  or  three  months,  and  once  as  long  as 
Bye  months-  I  then  began  treating  her  to  avoid 
this  and  succeeded  well;  had  no  more  trouble. 
She  has  four  children.  I  did  not  see  the  case 
after  the  day  following  her  confinement,  but 
understood  from  her  husband  that  she  was  doing 
well.  I  prescribed  for  constipation,  and  sent 
her  a  vaginal  wash  a  few  days  after  her  confine- 
ment. Her  husband  said  also  that  she  had  some 
pleuritic  pains,  but  perhaps  did  not  give  this  the 
weight  he  should  have  done,  as  she  had  had 
pleuritis  a  year  or  two  ago,  and  did  not  request 
me  to  see  her.  I  have  seen  somewhere  that  the 
symptoms  of  pleuritis  sometimes  follow  labor 
when  the  true  cause  is  in  the  uterus,  and  sep- 
ticemia may  develop  when  some  of  the  symp- 
toms rather  point  to  the  pleura  or  diaphragm. 
She  grew  worse  the  last  days  of  November  and 
died  on  December  2 — while  her  husband  was 
away  from  home — a  victim  to  blood  poisoning, 
which  might  have  been  prevented  had  I  seen 
her  or  known  her  condition  in  time,  it  being 
about  five  weeks  after  she  was  confined. 


On  November  10,  about  two  weeks  aft»r  I 
delivered  Mrs.  S.  A.,  I  was  called  to  Mrs.  W. 
S.,  age  about  32,  in  labor,  but  as  I  was  not  at 
home  Dr.  8.  was  called,  who  reached  there  in 
the  early  mornm:;,  one  baby  being  bom  before 
he  got  there.  After  eight  hours  ^e  other  was 
born.  I  was  called  when  they  were  two  weeks 
old  to  see  them,  as  one  of  them  was  thought  to 
be  dying,  as  they  had  given  it  a  large  dose 
of  tincture  of  opium  and  camphor  to  quiet  it 
They  were  very  much  jaundiced,  but  that  is  dis- 
appearing; are  doing  well  now  They  are 
females,  and  weighed  4^  and  di  pounds  when 
bom.  F.  W.  B 

[We  can  only  express  our  regretful  criticism 
of  the  manner  in  which  the  first  case  was 
allowed  to  die  without  proper  attention.  The 
husband  was  certainly  to  blame  if  being  at  all 
able  to  pay  for  medical  services,  he  requested 
the  physician  to  cease  calling  before  the  mother 
was  well.  However,  there  are  many  so  un- 
fortunate that  they  must  limit  their  expenses  for 
medical  attention  to  only  that  which  seems  to  be 
urgently  necessary,  needing  all  their  income  for 
supplying  the  other  necessities  of  life.  In  such 
a  case  if  the  physician  undertakes  an  obstetrical 
case  it  is  incumbent  upon  him  to  keep  the  patient 
under  his  own  observation  until  she  has  properly 
recovered  from  the  puerperal  ondition. — Ed.] 


Kneeling  Posture  in  Labor. 

Editor  Medical  World  : — Dr.  J.  A. 
White  wants  some  one's  experience  with  labor 
in  a  kneeling  position.  I  have  for  many  years, 
when  labor  was  slow  and  I  didn't  think  it 
necessary  to  use  the  forceps,  requested  my 
patient  to  get  on  her  knees  in  the  bed  and, 
when  the  head  of  the  child  got  about  one-quar- 
ter through  the  labia,  I  would  have  them  laid 
back  in  their  usual  position.  While  in  the  kneel- 
ing position  the  child  gravitates  toward  the  outer 
world,  and  I  sit  at  the  back  of  patient  with 
my  hand  against  the  labia  merely  to  stop  a  sud- 
den exit  of  the  child.  I  have  something  for 
the  woman  to  lean  on  or  some  one  to  support 
her  while  in  this  position. 

I  never  keep  my  patient  in  this  position  any 
longer  than  to  get  the  head  partly  through  the 
labia.  However,  I  believe  it  would  be  a  good 
way  to  deliver,  for,  instead  of  the  child  dragging 
over  the  perineum  it  would  be  over  the  pubis. 
J.  H.  Stanley,  M.D. 

Beardstown,  Tenn. 


Editor  Medical  Wobld.— "The  Physician  as  a 
Business  Man  *'  reached  me  several  days  since,  and  I 
am  very  much  pleaded  with  it.  Such  a  book  should 
be  read  by  every  member  of  the  profession,  and  I  am 
sore  there  would  be  more  harmony  and  snocess 
attending  them  through  life.    S.  J.  Sum mxbs,  M.D. 

Haigler,S.  0. 


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THE  MEDICAL  WORLD. 


Answer  to  Drs.  Harry  Brown,  P.  B.  Hardy  and 
J.  W.  Shemwell.    Quiz  in  Relation  to  Cystitis. 

Editor  Medical  World  : — I  will  try  to 
answer  a  few  of  the  quizzes  and  then  I  wish  The 
World  to  solve  a  question  for  me. 

Dr.  Harry  Brown's  case,  page  358,  October, 
Dr.  P.  B.  Hardy's,  page  394  and  Dr.  J.  W. 
Shemweirs,  page  394,  November,  are  all  from 
one  and  the  same  cause,  inflammation  along  the 
spine.  Internal  remedies  are  useless  as  curative 
treatment.  Of  course,  keep  the  digestive  or- 
gans in  good  condition,  build  up  the  general 
health  as  far  as  possible.  To  relieve  the  pain 
in  a  severe  attack  allow  the  patient  to  inhale 
chloric  or  sulphuric  ether  just  sufficient  to  re- 
lieve the  pain  but  not  to  full  anesthesia. 

For  the  curative  treatment  begin  at  the  base 
of  the  skull  and  make  firm  pressure  along  the 
spinous  processes  and  then  over  the  transverse 
processes  on  either  side  of  the  spinal  column 
down  to  the  coccyx  and  locate  the  tender  spots 
which  indicate  the  points  of  inflammation  along 
the  spinal  cord  and  roots  of  the  spinal  nerves. 

Now  blister  and  blister,  yes,  use  the  good  old 
Spanish  flies,  over  i'every  tender  point,  one  after 
another,  and  repeat  them  until  you  have  taken 
the  soreness  all  out  of  the  spine,  or  as  nearly  so 
as  possible,  and  your  patients  will  be  well  in 
proportion  as  the  same  is  removed. 

Don't  let  them  lift  or  do  any  kind  of  work, 
walking  or  riding,  that  will  jar  or  in  any  way 
strain  the  spine. 

Dr.  Hanly's  patient  has  some  very  tender 
spots  over  the  transverse  processes  of  the  tenth, 
eleventh  and  twelfth  dorsal  and  probably  first 
and  second  lumber  vertebrae.  This  gives  reflex 
pain  over  the  region  of  the  ovaries  and  possibly 
though  the  sympathetic  nerves— real  ovarian 
neuralgia,  but  the  blisters  over  the  above 
named  regions  will  benefit  and  cure  if  persisted 
in. 

Dr.  Shemwell's  patient  has  very  tender 
points  along  the  spine  between  the  scapulse. 
This,  in  turn,  has  given  the  peripheral  irritation 
over  the  region  of  the  stomach,  and  by  its  dis- 
turbance of  the  spinal  roots  of  the  sympathetic 
nerves,  affects  his  digestion,  and  produces  the 
apparent  d3r8pepsia  which  is  often  called  nervous 
dyspepsia  without  any  definite  knowledge  of  why 
it  is  so  called.  In  his  case,  now,  the  inflamma- 
tion has  extended  up  nearer  the  base  of  the 
skull.  Blister  and  follow  it  up  over  any  sore 
spot 

I  use  massage,  using  the  following  ointment : 

B.  Vaseline dr.  vi 

Parafflne dr.  U 

Melt  together  and  when  nearly  cool  add 

MenthoL dr.  1  dlsaolTed  in 

Oil  of  turpentine dr.  1 

OllsaMamts drs.  sa.  to  perfbrne 

Mix  all  thoroughly. 


This  works  admirably  as  a  topical  application. 
Let's  hear  through  The  World  how  they  pro- 
gress. 

The  help  I  want  is  for  a  case  of  cystitis  of 
fifteen  or  sixteen  years  standing  in  a  woman, 
married,  aged  forty-seven,  menstruates  every 
two  to  four  months  now,  who  has  been  confined 
to  her  bed  for  that  length  of  time. 

The  symptoms  are  as  follows:  Severe  pain  and 
discomfort  about  the  bladder  and  urethra  all 
the  time.  She  is  obliged  to  pass  water  every  fif- 
teen to  fifty  minutes,  day  and  night.  Urine 
contains  mucus  and  blood,  sticks  to  the  bottom 
of  the  chamber  and  has  an  offensive  odor. 
Upon  examination  there  is  much  tenderness 
over  the  region  of  the  bladder.  By  vaginal  ex- 
amination the  urethra  was  very  sore,  and  the 
neck  of  the  bladder  is  exquisitely  tender. 

Eighteen  months  ago,  when  I  first  began 
treating  this  caae,  I  dilated  the  urethra  thor- 
oughly and  expected  to  cure  the  case  as  I  had 
in  several  others  apparently  like  this  one,  but 
the  dilatation  only  afforded  temporary  relief. 
I  then  educated  her  to  use  a  glass  catheter  which 
gives  the  most  relief.  I  washed  out  the  bladder, 
using  sulpho-carbolate  of  zinc  and  golden  seal 
and  various  other  things  at  different  times.  In- 
ternally, carbonate  of  lithia  has  done  the  best 
of  ail  the  remedies  used  except  hyoscyamine  to 
relieve  spasms  of  the  bladder  and  urethera.  I 
should  like  to  hear  what  The  World  readers 
will  advise.  J.  C.  Campbell,  M.D. 

Albany,  Vermont 


Hystero-Epilepsy. 

Editor  Medical  World: —  I  read  with 
interest  Dr.  Waugh's  comments  upon  the  case 
reported  to  your  journal  by  myself  on  page  394. 

Itmay  be  of  interest  to  Dr.  Waugh  to  learn  that 
we  do  live  **in  the  backwoods"  and  that  the  case 
of  hystero-epilepsy  was  relieved  of  both  hyper- 
esthesia and  convulsive  siezures  by  forty  grains, 
of  quinine  given  in  four  doses  during  twelve 
hours  and  repeated  on  the  seventh  day. 

Britton,  Mich.  P.  B.  Hardy.  M.D. 


Pemphigus. 

REPLY   TO   J.    D.    MCDONOUGH,    M.D. 

Editor  Medical  World: — The  case  re- 
ported in  December  Medical  World,  page 
428,  I  diagnose  as  pemphigus,  caused  by  a 
vitiated  state  of  the  system.  I  had  a  case  in 
July — a  young  man  with  both  arms  completely 
covered  with  scales  and  scabs  from  the  elbow 
to  the  wrist ;  fiery  red  under  scabs  of  yellow  ; 
when  a  child  he  was  covered  from  head  to  foot, 
with  a  mass  of  sores,  but  the  disease  seemed  to 
be  cured  when  he  was  six  years  old.  When  he 
came  to  me  he  had  a  good  head  of  hair,  said  he 


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slept  well,  ate  well  and  had  no  trouble  with  his 

digestion.     I    found  his  pulse  very  slow  and 

weak,  about  forty-five  and  his  tongue  pale.  His 

age  was  thirty  and   he  was  not  married.     He 

had  various  sores  on   his  limbs,   whenever  he 

bruised   or  scratched    them.      His  arms  had 

been  in  this  condition  for  over  six  months,  and 

he  had  been  treated  by  the  local  physician  of 

the  place  where  he  resided,  but  he  said  that  he 

was  growing  worse  instead  of  better.  I  told  him 

that  the  cure  would  be  very  slow,  that  he  would 

not  see  much  improvement  under  three  months. 

My  mode  of  treatment  was  as  follows :     In  the 

first  place  wash  the  sores  in  strong  salt  water 

with  a  soft  sponge  every   night  and  morning ; 

then  apply  a  cerate  which  I    gave  him      The 

cerate   was  one   per  cent,   of  yellow   oxide  of 

mercury  in  purified  lard.     For  an  alterative  I 

gave  him : 

RocheUe  salts 5  ounces 

Pure  cream  of  tartar 2  ounces 

Flower  of  sulphur I  ounce. 

This  was  mixed  in  a  pint  of  syrup  and  a  tea- 
spoonful  taken  night  and  morning,  enough  to 
produce  two  operations  a  day. 

To  build  up  the  whole  system  I  gave  McAr- 
thur  s  hypophosphites  a  dessertspoonful  after 
each  meal. 

The  first  month  there  was  but  little  improve- 
ment in  the  sores,  except  that  the  fiery  red  of 
the  skin  seemed  less.  The  second  month  the 
scales  and  scabs  began  to  come  ofi  and  new  skin 
began  to  form.  The  third  month  the  arms  be- 
gan to  look  natural  and,  as  the  new  skin  formed, 
no  scais  were  left  and  the  disease  appeared  to 
be  cured.  I  had  him  continue  this  treatment 
two  months  longer  so  as  to  keep  his  blood  in  a 
good  condition,  and  to  all  outward  appearance 
he  is  cured.  Dr.  L.  M.  Holmes. 

46  Union  Park,  Boston,  Mass. 


Treatment  of  Dysentery. 

Editor  Medical  World  : — ^In  your  Novem- 
ber issue  I  notice  "yarrow  for  dysentery."  As 
I  have  had  numerous  occasions,  especially  this 
autumn,  to  observe  the  disease  in  both  adults 
and  the  young,  and  have  used  yarrow  as  a  tea 
in  some,  allow  me  to  detail  my  procedure,  de- 
scribing at  die  same  time  the  character  of  the 
disease  as  displayed  in  this  locality,  directly 
bordering  on  the  sea  and  supplied  with  a  tem- 
perate climate,  good  drainage  and  air  currents. 

In  nearly  all  cases  I  found,  when  called 
early,  constipation,  anorexia,  fever  and  head- 
ache, followed  in  the  young  by  nervous  phe- 
nomena, quite  often  convulsions,  and  in  the  old 
nausea  and  emesis.  It  was  my  practice  when 
constipation  existed  to  prescribe  minute  doses  of 
calomel  and  sola,  and  as  the  case  would  go  on 


with  profuse  diarrhea,  after  which,  as  a  rule, 
the  pyretic  symptoms  would  ameliorate,  I  would 
resort  to  a  compound  powder  of  lactopeptin, 
bismuth  and  salol,  in  doing  which,  I  bear  in 
mind  the  possible  complication  of  enteric  fever. 
Dieting,  of  course,  was  rigidly  observed,  but  as 
regards  injections  of  starchy  water,  etc.,  the 
tenesmus  and  anal  irritation  proved  so  great 
that  I  simply  ordered  one  or  two  enemas  of 
warm  water  to  clear  the  bowels  of  old  fecal 
matter  and  let  this  part  rest  at  that  In  adults 
I  almost  universally  prescribed  after  the  calo- 
mel aperient  the  fallowing : 

B   MAffnesise  sulph oz.  li 

AcTdisulpharom dr.  11  to  dr.  It 

Tr.  Cinnamoml os.  as 

Tr.  opU dr.  11  ss 

Aquse  camphors ad oz.   vUl 

M.  S.— One  half  ounce  every  two  hours. 

This,  with  restricted  diet  and  absolute  rest  in 

bed,  ameliorated  all  symptoms  at  once,  but  if 

the  case  had  gone  on  too  far,  and  the  dejections 

consisted    of  much   blood  and   pus  frequently 

voided  with  much  pain  and  general  disturbance, 

I  ordered 

R    Pulverisopii .* gr.  ss 

Argentl  mtratis gr.  % 

Plumbi  acetaci^ gr.  I 

Mix  and  make  six  such  doses.    8.    One  houily  tlU  re- 
Itered. 

No  chronic  dysentery  has  been  observed  by 
me  after  the  abo7P,  which,  although  somewhat 
polypharmacal,  did  the  work  satisfactorily. 

In  children,  after  bowels  moved  and  showed 
the  characteristic  stool,  I  ordered 

R    PulverisopU gr.  1-10 

Pulyerlslpeoacuanhee gr.  ^ 

Saccharl  lactis *^ gr.  u 

M.  a— Hourly,  If  needed,  as  shown  by  pain. 

Fever  and  eclampsia  were  combatted  by 
acetanilid  and  cold  cloths. 

In  cases  both  of  adults  and  children  I  uni- 
versally prescribed  for  the  thirst,  which,  of 
course,  was  always  present  in  greater  or  lesser 
degree,  tea  made  out  of  one  ounce  of  yarrow  to 
one  pint  of  boiling  water  and  allowed  to  cool 
somewhat 

This  taken  freely  and  mixed  with  a  little 
sugar  seemed  agreeable  and  has  no  doubt  acted 
well.  I  believe  that  a  mild  case  of  dysentery 
would  do  well  with  dieting,  rest  and  some  such 
tea  to  assuage  thirst  and  balance  the  waste  of 
fluids  per  rectum. 

Emil  Weschcke,  Ph.G.  M.D. 

Pt  Arena,  Cal. 


Editor  Medical  World. — Let  all  physicians  first 
read  "  The  Physician  as  a  Business  Man^'  and  follow 
out  all  instructions.  Then  let  them  adopt  jour  sys- 
tem of  bookkeepini?  (Vbiting  List  and  Ledger.)  It 
will  make  them  feel  as  if  th^  had  a  place  in  the 
bnsinesB  world.  At  the  same  time  it  will  make  their 
work  lighter  and  they  will  feel  contented  with  them- 
selves and  all  the  world.       J,  H.  Johnston,  M.D. 

Bed  Lodge,  Montana. 


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THE  MEDICAX  WORLD. 


Animal  ileotrioity. 

Editor  Medical  World  : — In  the  issue  of 
the  World  for  November,  1893,  page  391,  a 
communication  appears  from  Dr.  J.  Meeker,  of 
Newark,  N.  J.,  under  the  heading  of  "The 
Proper  Use  of  Natural  Forces  in  Medicinal  Treat- 
ment,*' in  wh.ch  the  following  appears : 

*'If  we  place  a  man  upon  an  insulated  stand 
and  let  a  wire  pass  from  the  soles  of  his  feet  to 
the  earth,  and  if  in  this  situation  he  exercise 
brifckly,  electric  currents  will  pass  from  his  feet 
to  the  ground  while  this  is  going  on." 

Ideas  of  this  kind  for  a  long  time  found 
credence,  chiefly  as  the  results  of  the  elaborate 
experiments  of  Du  Bois  Reymond  and  others, 
who  believed  that  they  had  demonstrated  the 
presence  of  electric  currents  in  nerves  and  mus- 
cles. But  the.<e  experiments  have  been  thor- 
oughly discredited  by  Prof.  Trowbridge,  of 
Harvard  College,  who  repeated  them  under 
such  precautions  as  to  establish  conclusively 
that  the  currents  of  electricity  indicated  by  the 
galvanometer  originated  not  in  the  nerves  and 
muscles  but  in  chemical  action  set  up  in  por- 
tions of  the  apparatus  employed.  Some  ac- 
comes  of  Prof.  Trowbridge's  experiments  and 
their  results,  may  be  read  in  Beard  &  Rock- 
welFs  Medical  and  Surgical  Electricity.  Per- 
haps Dr.  Meeker  has  something  later  to  show 
on  this  subject ;  if  so,  he  will  confer  a  favor  by 
producing  ii;  for  so  far  as  appears  at  present 
there  is  no  scientific  evidence  whatever  that 
currents  of  electricity  play  any  part  in  the  ac- 
tion of  nerve  and  muscle  or  in  the  phenomena 
of  animal  life. 

It  seems  unnecessary  to  recapitulate  the  evi- 
dence that  nerve  force  and  electricity  are  wholly 
unlike,  and  that  neither  of  these  forces  can  be 
transformed  into  the  other.  Indeed  if  The 
Medical  World  chooses  to  afford  me  the 
necessary  space,  I  am  prepared  to  furnish 
scientific  evidence  that  so  far  from  being  the 
ally  or  the  alter  ego  of  nerve  force,  electricity 
is  a  paralyzing  agent  and  in  so  far  as  involun- 
tary muscles  are  concerned  that  electricity  pro- 
duces similar  effects  to  motor  nerve  action. 
I  infer  from  other  portions  of  Dr.  M's  commu- 
nication that  he  has  been  reading  the  ''Re- 
searches of  Baron  Von  Reichenbach  on  Mag- 
netism" etc.,  and  has  been  impressed  by  the  ex- 
periences therein  recorded.  It  would  be  out 
of  place  to  enter  on  any  discussion  of  that  sub- 
ject here,  but  surely  the  alleged  **odylic  eman- 
ations" have  been  sufficiently  discredited  not  to 
be  accepted  seriously  at  the  present  time.  If 
Dr.  M.  does  not  think  so,  I  would  respectfully 
recommend  him  and  any  of  your  readers  sim- 
ilarly impressed,  to  consult  Dr.  W.  B.  Carpen- 
ter's ''Mental  Physiology,"   Appleton's,  1884, 


pp.  159-161,  where  these  experiences  are  esti 
mated  at  their  true  value. 

Thomas  W.  Poole,  M.D. 
Lindsay,  Out,  Canada. 


The  Humbug  and  Tinkering  in  Gynecology. 

Editor  Medical  World  :  —  I  frequently^ 
meet  general  practitioners  from  50  to  60  years 
of  age  who  unhesitatiogly  say  that  the  practice 
of  diseases  of  women  is  a  humbug.  It  must  oot 
be  ihought  that  such  men  are  especially  lacking* 
in  intellect,  for  personally  I  can  successfuUj 
contradict  it  When  these  men  began  to  prac- 
tice, gynecology  was  in  its  pure  infancy;  iheir 
ideas  were  gained  by  the  results  of  practice 
and  observation  on  diseased  women  of  40  year» 
ago  My  argument  that  gynecology  has  im- 
proved much  of  late  would  only  induce  the  sug- 
gestive remark  that  ''gynecology  must  have 
changed."  At  first,  though,  we  think  that  the 
old  doctor's  view  that  gynecology  is  a  bumbug 
is  entirely  too  sweeping.  But  one  who  has 
opportunity  to  study  the  methods  of  the  general 
priictitioner  may  yet  side  with  the  old  doctor. 
Gynecology  may  be  a  humbug  in  two  ways: 
1.  The  gynecologist  may  do  more  than  he  ought. 
This  is  what  I  shall  style  tinkering,  which 
brings  innumerable  ills  in  its  wake.  2.  The 
gynecologist  may  treat  and  treat  and  do  noth- 
ing. Of  the  two  methods  which  induce  the  old 
doctor  to  call  all  gynecology  a  humbug  no  doubt 
the  case  in  which  there  is  too  much  tinkering  is 
by  far  the  worst  From  what  does  this  aggres- 
sive tinkering  arise?  It  may  arise  from  the 
physician's  desire  to  do  something  so  as  to  gain 
a  reputation  for  fame  or  skill.  It  may  arise 
from  the  doctor's  idea  to  really  cure  the  disease, 
but  it  generally  arises  from  ignorance  of  present 
and  subsequent  pathology.  Tinkering  aiises 
from  lack  of  physiological  and  anatomical  know- 
ledge. In  no,  single  instance  does  tinkering 
and  lack  of  pathological  knowledge  creep  out  so 
fiercely  as  in  the  use  of  the  uterine  dilator. 

It  is  not  uncommon  for  a  woman  to  come  to 
me  and  say  that  several  months  previous  Dr. 
A.  dilated  her  uterus,  and  I  now  find  pyosalpinx 
on  one  or  both  sides.  The  old  doctor,  no  doubt, 
had  observed  that  when  Dr.  A.  had  tinkered 
with  Mrs.  B.  with  a  dilator  that  she  became 
sicker  with  the  months.  Three  months  ago 
Mrs.  X  had  her  uterus  dilated;  from  that 
time  on  she  got  worse  and  at  the  end  of  three 
months  I  removed  a  double  pyosalpinx  and  itn 
ovarian  abscess.  Such  tinkering  is  frequently 
done  at  the  clinics,  and  the  woman  allowed  to 
walk  home.  Let  us  see  what  is  the  disaster  of 
indiscriminately  dilating  the  uterus.  For  ex- 
ample, the  cervix  is  never  prepared  for  an  abor- 
tion, but  the  uterus  is  always  ready  to  expel  it 


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15. 


conteuts  Now  wheu  the  fetus  is  suddenly 
forced  through  it,  it  dilates  it  and  paralyzes 
it  so  that  its  mouth  Btauds  wide  open  for  two  or 
three  days.  During  the  time  the  os  is  wide  open 
infection  enters  freely.  Now,  the  os  recovers 
from  its  paral)8i8  and  closes  its  mouth  vigor- 
ously. Any  infection  which  passed  into  it  is 
now  securely  imprisoned  in  the  uterine  cavity. 
There  is  no  drainage,  the  germs  multiply  and 
the  uterus  and  tubes  are  made  into  sewers  while 
the  pelvic  peritoneum  acts  as  a  cess  pool.  This 
is  the  reason  that  abortion  is  worse  than  labor, 

because  its  infection  is  not  drained.     A 

similar  process  occurs  when  a  uterus,  already 
suffering  from  endometritis  and  salpingitis  is 
widely  dilated.  The  infection  there  existing 
rapidly  invades  new  territory  from  ruptured 
tissue,  from  trauma,  and  also  additional  infection 
comes  occasionally  on  the  dilator. 

Practitioners  do  not  sufficiently  realize  the 
immediate  and  remote  dangers  of  dilating  the 
uterus.  Again,  when  some  ddate  they  do  it  so 
rapidly  that  the  uterus  is  wounded  more  than  it 
is  at  labor.  New  fresh  channels  are  opened 
for  microbic  invasion. 

The  physiological  function  of  the  uterus  and 
OS  differ  so  much  that  it  should  be  studied  by 
those  who  will  act  The  uterus  gestates  and 
expels  while  the  os  is  a  guard  to  the  uterus,  aliie 
repelling  invaders  and  retaining  deserters. 
The  tiokering  with  uterine  dilators  has  made 
many  a  pyoealpinx.  Again,  physicians  tinker 
with  the  sound.  I  know  of  two  cases  where  the 
doctor  actually  killed  the  woman,  by  the  aggres- 
sive and  foolish  use  of  the  instrument  given  to 
us  by  Simpson  and  Kiwish.  One  doctor  killed 
a  very  prominent  woman  from  his  lack  of  know- 
ledge The  woman  complained  of  frequent 
urination  and  the  doctor  on  digital  examination 
found  the  fundus  against  the  bladder.  Now  he 
thought  that  it  was  the  pressure  of  the  uterine 
fundus  on  the  bladder  that  caused  the  frequent 
micturition,  so  he  said  he  would  replace  the 
displaced  uterus  by  the  aid  of  the  sound;  so  he 
introduced  the  sound  and  pried  the  uterus  back. 
The  woman  died  three  days  after,  and  the 
autopsy  showed  that  he  had  penetrated  the 
uterus  with  the  sound  and  the  little  fetus  had 
passed  out  of  the  same  hole  into  the  abdominal 
cavity.  That  was  a  practical  murder  from 
tinkering  with  the  sound.  The  sound  in  general 
has  done  more  harm  than  good.  The  specialist 
uses  it  but  little  at  present  Its  chief  use  now 
is  with  the  general  practitioner.  I  know  of  an- 
other who  used  the  sound  to  replace  a  retroflexed 
uterus;  she  died  in  less  than  two  days,  and  the 
post  mortem  showed  that  he  had  ruptured  a 
pyosalpinx,  another  practical  murder  from 
lack  of  knowledge  and  sound  tinkering. 


Again,  another  foolish  piece  of  tinkering  in 
g)  necology  is  the  determined  view  that  a  dis- 
placed uterus  must  be  replaced.  Only  two  week» 
ago  a  colleague  insisted  on  replacing  auterus, 
and  the  woman  died  the  next  day.  He  had,  no- 
doubt,  ruptured  a  pus  sac.  Really  a  big  hum- 
bug has  existed  in  regard  to  ''  replacing  th& 
womb  "  It  is  extensive  amongst  general  prac- 
titioners, but  I  have  seen  even  a  New  York 
gynecologist  go  through  the  most  insipid  manuvre* 
with  a  class  of  sixty  doctors,  of  replacing  the 
uterus  in  a  young  woman.  In  the  first  plac& 
such  vague  ideas  are  held  as  to  the  normal  posi- 
tion of  tihe  uterus,  and  in  the  second  place  th& 
vague  and  erroneous  views  as  to  what  a  dis- 
placed uterus  is.  The  normal  position  of  the 
uterus  is  a  position  of  wide  range,  but  a  dis- 
placed uterus  is  one  permanently  out  of  its  nor- 
mal place.  A  displaced  uterus  is  one  having 
abnormal  stability.  A  fixed  uterus  is  not  in 
normal  position.  Now,  it  is  dangerous  to  force 
a  fixed  uterus  in  normal  position,  and  if  a  uteru» 
is  so  mobile  that  one  considers  it  out  of  place  it 
is  utterly  useless  to  push  it  hither  and  thither 
and  call  such  action  replacing  the  womb.  So 
that  merely  pushing  a  supposed  uterus  into  sup- 
posed normal  position  is  mere  tinkering.  There 
is  no  utility  in  it at  least  for  the  woman. 

Agam,  how  about  removing  the  many  ovaries 
which  are  nearly  normal.  Has  not  tinkering 
been  running  at  high  carnival  in  removing  so- 
called  *•  cystic  "  ovaries  ?  Are  not  all  ovaries 
cystic  ?  Are  there  not  scores  of  tubes  and  ovar- 
ies unnecessarily  sacrificed  annually  in  thi» 
country.  I  know  myself  of  many  lives  being 
lost  by  amateur  operations  in  order  to  learn 
laparotomy.  Is  that  not  tinkering  ?  Is  that  not 
"humbug"  in  gynecology?  So  that  the  old 
doctor's  cutting  remark  is  not  all  untrue.  Suf- 
fice it  to  say  unnecessary  so-called  aggressive 
operations  are  really  a  humbug  and  should  be 
called  tinkering.  Now,  in  regard  to  the  second 
class,  where  the  so  called  uterine  applications 
are  done  with  tri- weekly  mathematical  certainty 
These  doctors  tell  the  woman  the  has  '  uh  ers 
in  the  womb"  whatever  that  means.  Surt  ly  1  have 
seen  many,  many  clear  cases  of  tinkering  of  this 
sort  Some  physicians  carry  this  do  nothing 
treatment  to  daogerous  points  while  some  real  and 
vital  pathology  is  overlooked.  Such  treatment 
reminds  one  of  the  philosopher  who  put  a  board 
on  Mt.  Vesuvius  and  sat  on  it  thinking  to  keep 
down  all  trouble.  Such  philosophers  forget  that 
much  trouble  lies  in  the  interior. 

In  conclusion  it  may  be  said  that  to  become 
a  skilful  gynecologist  is  probably  more  difiScult 
than  any  other  medical  department  One  must 
not  only  treat  the  disease  but  the  patient  as 
weU.    Mind  and  matter  seem  to  be  at  variance 


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THE  MEDICAL  WORLD. 


in  some  women.  The  movable,  elastic  and  alter- 
able organs  are  difficult  to  comprehend.  The 
anatomy  and  physiology  are  both  very  difficult 
in  the  pelvisu 

To  discriminate  real  from  imaginary  pain  is 
not  always  easy.  To  know  always  when  to  act 
or  not  to  act  in  gynecological  cases  requires  much 
good  judgment  The  pathology  of  the  female 
organs  requires  long  and  careful  study,  practice 
and  observation  to  master.  Besides  few  have 
sufficient  mental  balance  to  make  reliable  spe- 
cialists. So  many  make  sweeping  generaliza- 
tions. Unlimited  generalization  is  very  danger- 
ous in  gynecology.  No  doubt  the  knaving  and 
avarice  for  gold  of  some  so-called  gynecologists 
makes  *'  humbugging  "  more  apparent  It  does 
at  times  seem  that  some  will  work  their  judg- 
ment simply  to  get  a  pay  case  of  laparotomy. 
The  spread  of  real  pathological  knowledge  with 
good  instruction  in  practical  gynecology  will 
soon  lift  it  above  the  reproach  of  "humbug" 
trade.  F.  Byron  Robinson. 

34  Washington  St.,  Chicago,  111. 


Bleeding  in  Pneumonia. 


Editor  Medical  World  : — I  have  been  an 
active  practitioner  of  medicine  (until  recently) 
since  1848,  and  have  been  a  subscriber  of  The 
World  ever  since  it  was  published. 

I  wish  to  endorse  what  G.  W.  Kemper,  of 
Port  Republic,  Va.,  on  page  41,  of  the  Feb- 
ruary 1893,  number,  says  in  r^ard  to  "Bleeding 
in  Pneumonia." 

I,  too,  may  be  regarded  as  an  "Old  Fogy." 
But  his  experience  is  mine  in  full.  His  classifi- 
cation of  pneumonia,  as  to  condition,  into  acute 
or  sthenic  and  typhoid  or  asthenic,  is  correct 
When  I  commenced  the  practice  of  medicine  in 
Missouri  most  all  cases  were  of  the  aciUe  form 
and  if  a  physician  had  failed  to  bleed  he  would 
have  been  charged  with  mal-practice  When  the 
patient  had  been  bled  to  syncope,  or  approach- 
ing it,  the  pain  is  always  relieved.  If  not,  a 
good  blister  finishes  the  cure.  Of  course, 
there  will  be  a  necessity  for  additional  treatment, 
calomel,  quinine,  etc.,  and  as  Watson,  Gross, 
McDonell,  and  Drape  used  to  teach  in  the  sec- 
ond or  third  stage,  egg  nog.  But  now  a- days, 
especially  in  southern  climates,  most  of  the  cases 
are  of  a  typhoid  character,  and  do  not  require 
bloodletting,  but  a  blister  always  does  good. 

Whitesboro,  Texas.      W.  H.  Trolinger, 


For  Alopecia. 

Editor  Medical  World  : — On  page  420  of 
the  December  number  of  your  journal  Dr. 
Homer  C.  Bennett  asks  for  a  prescription  that 
will  stimulate  the  growth  of  hair  on  bald  scalps. 
If  the  doctor  will  use  either  of  the  prescriptions 
which  I  shall  give  below  I  trust  that  the  re- 
sults will  be  good,  the  first  of  which  is  perhaps 
the  best : 

R.  Sulphur  lac. 
PlambL  acetatls. 

Tr.  cantharldis aa dr.  1 

Spte.  amon.  arom oz.i 

Glyceiini  (pur)  :.. oi.  1 

AqUS.  10886 (W.  fl 

AquflB  pur  q.  ».  ad O  j 

M.  8.— Apply  to  scalp  thoroughly  thrice  weekly. 

Another  good  one  is : 

R.  Bay  rum. 

Olyoerlue aa oz.  J! 

Tr.  cantharides dr. J 

Oil  bergam dr.  n 

Tr.  capsicum « dr.  J 

Sulph.  quinine gr.  x 

Aquse  pur q.  8.aa oz.yJ 

M.  S.— Apply  every  morning;  disca'd  all  grease. 

A  happy  New  Year  to  the  good  old  World 
and  all  its  readers.     R.  A.  Prichard,  M.D. 
Gamer,  Ky. 


Editor  Medical  World.— The  Medical  World 
18  really  an  inyaluable  journal,  serving  as  it  does  in  a 
lirofessional  way  the  purposes  of  an  experience  meeting 
of  your  subscribers  in  a  high  degree. 

Kinmount,  Ont.,  Can.  B.  S.  Frost,  M.D. 


Dosimetry. 

Editor  Medical  World: — I  am  asked  so 
many  questions  about  dosimetry  and  the  new 
manual  that  I  take  the  opportunity  to  reply  to 
them  through  the  columns  of  The  World,  well 
assured  that  I  shall  reach  the  vast  body  of 
practical  men  through  it  Dosimetry  was  as- 
suredly intended  by  Burggraeve  to  form  a  new 
system  of  medical  treatment.  This  I  believe  to  be 
a  mistake.  No  complete  system  of  medical 
treatment  can  be  formed,  leaving  out  all  such 
remedies  as  are  unsuitable  for  administration  in 
granules.  Selecting  a  granule  for  form  when 
there  ia  a  better  remedy  in  another  shape,  shows 
that  the  doctor's  devotion  to  the  system  is  greater 
than  his  desire  to  benefit  his  patient  So,  also,* 
I  disagree  with  Burggraeve  in  his  endeavor  to 
reduce  all  doses  to  a  uniform  size.  Why  give 
the  same  dose  of  two  drugs  when  one  has  twenty 
times  the  therapeutic  value  of  the  other?  Only 
by  reducing  all  to  the  dead  level  of  homeo- 
pathic infinitesimalism  can  this  be  done.  Burg- 
graeve is  led  by  this  mistake  into  the  same  er- 
ror as  Hahnemann,  in  attributing  to  certain 
remedies  valuable  properties  in  doses  too  little 
to  exert  any  appreciable  effect  What  folly  to 
give  a  milligramme  of  kousseine,  juglandine, 
piperine  or  tannate  of  cannabin,  and  expect  any 
result  I  Or  what  effect  is  a  centigramme  of 
croton  chloral  expected  to  manifest  when  the  or- 
dinary dose  is  twenty  to  thirty  grains  ?  It  can- 
not be  said  that  the  difference  lies  in  the  purity 
of  the  drug,  for  you  cannot  kill  a  tape  worm 
with  -^  grain  of  the  purest  kousseine,  and  the 


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worst  specimen  of  croton  chloral  in  the  market 
has  not  ninety-nine  per  cent  of  impurity.  The 
one  thing  of  eminent  importance  in  Burggraeve's 
sjrstem  is  the  doctrine  of  "jugulating"  acute 
fevers.  I  have  for  many  years  been  in  the 
habit  of  jugulating  acute  pharyngeal  catarrh 
by  the  local  use  of  a  powerful  astringent  acid 
antiseptic  remedy.  Acute  orchitis  is  readily 
jugulated  by  the  application  of  a  twenty-five  per 
cent  nitrate  of  silver  solution.  Spilzka,  I  think, 
recommended  full  doses  of  strychnine  in  acute 
myelitis,  and  I  gave  this  drug  successfully 
several  years  ago  in  a  curious  case  presenting 
all  the  symptoms  of  locomotor  ataxy,  but,  com- 
ing on  acutely.  But  Burggraeve  deserves  the 
credit  of  popularizing  the  jugulation  of  acute 
inflammations  and  fevers  by  this  method.  The 
use  of  strychnine  in  pneumonia  has  recently 
been  advocated  by  Mays,  and  Petrescu  has 
urged  the  treatment  of  this  disease  by  huge  doses 
of  digitalis.  Both  act  as  jugulators,  driving 
the  blood  out  of  ihe  affected  tissues  by  power- 
fully contracting  the  vessels. 

I  have  quoted  very  little  from  Burggraeve  in 
my  manual,  because  his  own  is  supplied  at  a 
very  small  price,  and  can  be  easily  procured  by 
those  who  desire  it 

Now  for  the  other  advocates  of  specific  medi- 
cation, the  eclectics.  I  expected  a  good  deal 
from  them,  but  must  confess  to  my  disappoint- 
ment Many  of  their  specific  indications  are  taken 
bodily  from  homeopathy,  and  are  worthless  to 
those  who  do  not  care  to  pin  their  faith  on  such 
intangible  potencies.  But  a  small  number  of 
the  drugs  distinctively  identified  with  the  eclec- 
tic school  have  been  really  studied  in  a  scien- 
tific way.  Scudder's  book  is  full  of  appeals  to 
his  brethren  to  fumidh  reliable  information  as 
to  the  vegetable  remedies  in  common  use  by 
them.  Instead  of  this,  we  are  apt  to  get  some 
such  an  mcongruous  jumble  as  the  following : 

Properties — Anti-spasmodic,  alterative,  tonic, 
emmenagogue,  parturifacient,  diaphoretic,  di- 
uretic, and  vermifuge. 

Principal  influence — Upon  the  utero-genital 
system,  giving  tone  and  energy. 

Employment — Amenorrhea,  dysmenorrhea, 
menorrhagia,  leucorrhea,  vaginitis,  urethritis, 
chronic  bronchitis,  vaginal  prolapsus,  to  pro- 
mote delivery,  after-pains,  rheumatism,  dropsy, 
whoop  ing-cough,  hiccough,  hysteria,  hysteritis, 
apthous  sore  mouth,  to  expel  worms,  etc. 

How  can  the  little  squaw- root  be  all  those 
and  do  ail  those  things  at  one  and  the  same 
time  ?  Can  it  be  a  tonic — a  toner  or  contractor 
of  tissue,  and  also  an  antispasmodic  and  dia- 
phoretic? 

Or,  take  our  much  valued  cimicifuga.  We 
are  told  that  it  has  all  the  following  properties  : 


Alterative,  anti-spasmodic,  stimulant,  dia- 
phoretic, diuretic,  expectorant,  resolvent,  ner- 
vine, emmenagogue,  parturient,  tonic,  narcotic, 
and  metastatic.  Possesses  great  power  over  exan- 
thematous  fevers,  transfers  to  the  skin  eruptive 
diseases,  which  have  receded  from  the  skin  to  the 
mucous  membrane,  gives  tone  and  energy  to 
the  nervous  system  and  contributes  to  the  gener- 
ation of  nerve  force. 

Employment — Amenorrhea,  leucorrhea,  dys- 
menorrhea, hysteria,  chorea,  chlorosis,  to  facili- 
tate delivery,  rheumatism,  coughs,  colds,  asthma^ 
whooping-cough,  phthisis,  small-pox,  croup,  con-  • 
vulsions,  epilepsy,  neuralgia,  scrofula,  indiges- 
tion, typhoid  fever,  scarlatina,  diphtheria,  pro- 
lapsus uteri,  gonorrhea,  gleet,  spermatorrhea^ 
intermittent  fever,  cutaneous  diseases,  bronchitis, 
larjmgitis. 

We  presume  it  would  be  safe  to  say  in  case 
of  doubt,  give  macrotin,  for  it  does  about  all  a 
doctor  could  wish  except  collect  his  bills. 

How  can  any  one  get  an  idea  of  the  •  real 
properties  of  a  drug  irom  such  a  mess?  In 
many  cases  our  eclectic  brethren  have  not  clearly 
distinguished  between  the  effects  of  their  reme- 
dies and  those  of  the*  hot  water  in  which  the 
drugs  were  administered.  I  have,  therefore,  in 
quoting  from  such  sources  placed  the  indications 
in  parentheses,  that  the  reader  may  kifow  that 
I  do  not  consider  the  authority  trustworthy. 
And  this  is  not  at  all  because  the  writers  are 
eclectics,  for  I  wish  to  give  these  gentlemen  full 
credit  for  their  work,  and  care  not  at  all  from 
whom  I  get  an  idea  provided  it  is  a  good  one. 
Indeed,  I  have  recommended  the  eclectic 
preparations;  the  **ins,"  instead  of  the  officinal 
extracts,  because  I  believe  the  former  can  be 
procured  more  readily  and  of  better  quality.  I 
imagine  a  doctor  who  prescribed  extract  of 
chelidonium  would  have  a  good  deal  of  diffi- 
culty in  procuring  a  really  active  preparation  ; 
whereas  the  chelidonin  could  be  obtained  easily. 
Even  so,  many  of  the  native  plants  show  but 
little  of  their  true  value,  unless  given  in  prep- 
arations from  the  .  green  drug.  Hamamelis, 
rhus  and  prunus  virginiana  are  examples  in 
point  The  dried  plants  are  inert,  the  fresh 
possess  remedial  virtues  of  undoubted  value ; 
but  to  isolate  the  active  principles  and  confine 
them  in  a  granule  that  will  retain  their  activity 
indefinitely  is  beyond  the  art  of  the  pharmacist. 
Should  we  therefore  refuse  to  avail  ourselves  of 
these  and  other  valuable  drugs  because  we  can- 
not put  them  in  granules,  or  because  the  active 
principles  have  not  been  extracted?  Surely, 
here  is  the  weak  spot  of  all  exclusive  systems,  in 
that  they  put  the  system  ahead  of  the  only  right 
and  proper  consideration  of  the  physician — his 
patient's  welfare.    William  F.  Waugh,  M.  D. 


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THE  MEDICAL  WORLD. 


The  Post-Partum  Douohe. 

Editor  Medical  World  ; — It  is  an  old  and 
trite  saying  that  '^meddlesome  midwifery  is 
bad/'  and  this  idea  is  often  carried  to  such  an 
•extent  that  it  becomes  a  mania  or  rule  with 
some  to  never  interfere  in  an  obstetrical  case  at 
all,  and  to  "leave  everything  to  nature."  It 
may  not  be  out  of  place  right  here  to  inquire 
what  we  are  called  for  at  all  in  such  cases,  for 
if  everything  is  to  be  "left  to  nature,"  we  are 
not  needed  and  it  would  be  cheaper  for  the 
patients  not  to  call  us,  as  nature  can  do  the 
work  without  us.  However  it  is  a  consoling 
fact  that  the  sect  of  ultra  never  meddling  peo- 
ple are  greatly  in  the  minority  and  are  rapidly 
■dying  off.  But  with  so  much  conflicting  advice 
as  to  what  to  do,  and  what  not  to  do,  the 
younger  obstetrician  is  often  in  a  quandary, 
and  in  evading  Scylla  he  often  falls  into  Char- 
ybdis,  and  in  the  language  of  the  puzzled 
legislator  of  the  last  Congress,  he  will  not  even 
know  "where  we  are  at." 

Experience  is  a  good  teacher  but  she  charges 
sometimes  exorbitant  prices,  and  we  should  not 
trust  entirely  to  our  own  knowledge  and  ex- 
perience for  our  methods  of  work,  but  must 
draw  largely  from  the  great  storehouse  of  the 
lives  and  work  of  others. 

"One  swallow  does  not  make  a  spring," 
neither  does  one  success  or  failure  establish  or 
abolish  the  value  of  a  principle,  and  it  requires 
a  careful  mind  to  find  a  suitable  and  safe  mean 
between  the  extremes. 

In  the  ordinary  course  of  obstetrical  practice, 
the  physician  for  reasons  of  convenience  to 
himself  and  economy  to  the  patient,  is  not 
called  to  attend  in  confinement  until  there  is 
either  real  or  fancied  need  for  his  services. 
Therefore,  the  ante-partum  care  and  treatment 
is  not  so  much  under  his  control  as  is  the  post- 
partum attention. 

In  hospital  practice  the  usage  is  more  oft;en 
different,  but  even  there  there  are  emergency 
cases  that  receive  no  care  prior  to  delivery. 

The  care  of  the  patient,*  before  and  during 
labor  will  not  be  treated  of  in  this  article,  but 
our  consideration  will  be  in  regard  to  that  imme- 
diately following  delivery  of  the  child  and  pla- 
centa. 

In  case  of  post  partum  hemorrhage,  I  trust 
that  none  of  us  will  not  advocate  the  rapid  and 
thorough  evacuation  of  the  contents  of  the 
uterine  cavity,  by  some  means  or  other.  I 
believe  the  favorite  method  of  delivering  the 
placenta  and  clots  is  by  the  method  first  advo- 
cated by  Cred^,  viz.:  the  conjoined  manipulation 
of  the  fundus  externally  and  by  manual  trac- 
tion   upon   the  placenta  internally,   although 


most  often  the  external  kneading  of  the  fundus 
is  alone  sufficient. 

It  is  too  often  the  case  that  the  puerperal 
woman  is  left  to  the  mercies  of  an  ignorant  or 
unskilled  nurse,  and  even  where  they  are  at- 
tended by  one  who  is  experienced,  it  is  often 
some  old  woman  with  many  crochety  notions, 
not  unmixed  with  superstition  and  an  animosity 
to  young  men  and  new  ideas,  and  your  instruc- 
tions will  either  be  ignored  entirely  or  not  half 
executed. 

Therefore  it  is  usually  best  for  all  concerned 
to  either  wait  and  see  that  your  instructions  are 
obeyed,  or  to  "do  it  yourself  and  then  you  know 
that  it  is  well  done."  How  often  have  you 
known,  by  the  sense  of  smell,  that  there  is  a 
puerperal  woman  in  the  house,  as  soon  as  you 
enter  the  outer  door  ? 

How  often  have  you  been  called  to  cases 
where  neither  the  clothes  nor  bedding  had  been 
changed,  nor  the  patient  bathed  for  several 
days  ?  None  of  the  lower  animals  will  allow 
themselves  to  lie  in  such  a  fix,  but  will  imme- 
diately remove  to  a  clean  spot  and  proceed  to 
"cfearnfp,"  yet  civilized  and  enlightened  beings, 
and  I  regret  to  say  some  seemingly  intelligent 
physicians,  will  compel  a  woman  to  lie  in  a  lot 
of  rotten  filth  for  several  days  after  delivery. 

Of  course  none  of  us  are  perfect,  and  all  of 
our  ways  are  open  to  criticism  and  improve- 
ment, and  he  who  lives  in  this  day  and  age  and 
knows  it  all  and  cannot  still  learn  something, 
has  become  a  nuisance  to  the  world  and  a  bur- 
den to  the  body  politic,  and  would  better  die. 

As  we  all  know,  a  certain  amount  of  tissues 
must  be  thrown  off  in  the  form  of  the  lochia, 
which  are  commonly  and  properly  called 
"cfeaTwinflrd,"  and  it  is  our  duty  as  careful  and 
progressive  physicians  to  aid  nature  in  this 
effort  The  method  that  will  do  this  the  most 
safely  quickly  and  pleasantly  is  undoubtedly 
the  best ;  water,  the  blood  of  the  earth,  is  the 
universal  solvent  and  cleansing  agent  Heat  is 
nature's  antiseptic  and  germicide.  Then  what 
is  more  rational  than  the  free  use  of  hot  water 
as  a  detergent  and  cleansing  agent  for  the  par- 
turient canal  after  labor?  By  its  use  small 
clots  and  shreds  of  placenta  and  membranes, 
mucus,  blood,  urine,  feces,  and  all  foreign 
matter  may  be  removed,  and  the  part^  rendered 
clean  and  pure.  It  will  cause  a  sense  of  well- 
being  and  restfulness  that  is  very  grateful  to 
the  patient  and  hastens  the  convalescence. 

The  water  should  be  hot,  and  by  that  term  is 
meant  Jiotf  not  warm  or  tepid  water 

It  is  a  well  established  fact  that  the  mucous 
and  serous  membranes  are  not  as  well  supplied 
with  sentient  nerves  as  is  the  skin,  and  that 


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^hese  surfaces  will  tolerate  a  degree  of  heat, 
without  discomfort,  that  would  be  unbearable 
to  the  skin. 

In  order  to  prevent  the  hot  water  flowing 
-over  the  skin  of  the  vulva  and  being  painful,  it 
is  best  to  use  some  appliance  that  will  fill  or 
block  up  the  external  opening  of  the  vagina, 
and  yet  allow  a  free  circulation  of  the  hot 
water  in  the  vagina. 

Such  appliances  can  be  secured  of  all  instru- 
ment makers,  and  while  the  cost  is  not  a  little, 
yet  the  ease  of  operation  and  the  comfort  and 
safety  guaranteed  by  their  use  will  bring  praise 
from  the  patient  and  an  increased  patronage, 
which  will  in  the  end  justify  the  extra  expense. 

While  using  this  method  it  might  be  an  ad- 
vantage to  incorporate  in  the  solution  some  one 
•of  the  many  well-known  antiseptics,  germicides 
and  healing  chemicals.  Of  these  carbolic  acid  is 
about  as  good  as  any  if  not  the  best  Corrosive 
«nblimate  may  be  used  but  there  is  more  danger 
of  poisoning  by  absorption  when  in  contact  with 
torn  or  raw  surfaces. 

By  the  use  of  what  is  known  as  the  "Ideal" 
or  **Knap"  douche,  given  with  a  fountain 
syringe,  the  vagina  can  be  ballooned,  all  the 
folds  washed  clean,  clots  removed  and  emptied 
into  a  vessel  beside  the  bed,  without  spilling  a 
drop  of  water  or  wetting  the  patient  or  the  bed. 

With  an  Alpha  fountain  the  reservoir  can 
be  filled  and  emptied  easily  by  syphonage,  and 
^ves  a  steady,  constant  flow,  the  force  of  which 
is  easily  regulated  at  will . 

The  objection  may  be  raised  that  water  may 
be  forced  into  the  fallopian  tubes,  and  it  is  pro- 
bable that  by  using  great  pressure  it  could  be 
•done,  but  a  little  judgment  will  avoid  any  such 
trouble. 

It  has  been  said  that  it  is  too  much  trouble 
to  do  so  much  work,  that  it  is  the  duty  of  the 
nurse  to  attend  to  that  work,  or  that  the  physi- 
<;ian  can  get  his  fee  just  as  well  without  as  with 
that  extra  attention ;  yet  if  we  have  our  patient's 
best  interests  to  serve,  and  we  wish  to  do  our 
whole  duty,  we  should  use  every  means  to  attain 
those  ends. 

Usually  one  douche  is  suflicient,  but  it  is 
best  to  leave  orders  to  report  any  signs  of  offen- 
sive odor  of  the  lochia,  and  it  can  be  at  once  re- 
moved by  one  or  two  hot  carholized  water 
douches,  and  maybe  prevent  systemic  infection, 
and  possible  death. 

It  has  been  my  experience  that  but  few  of 
ray  multipara  have  been  previously  treated  to  a 
post-partum  douche,  and  they  never  object  but 
always  are  plea^  with  it  and  are  grateful  for 
the  comfort  it  affords;  while  the  primiparse 
always  like  it  and  they  and  their  friends  who 
see  it  used  always  commend  it. 


It  may  be  a  mere  coincidence,  and  it  may 
not  be,  but  it  is  a  fact,  that  after  using  it  in 
over  fifty  puerperal  cases  there  has  never  been 
a  single  case  in  which  there  were  any  bad 
symptoms,  while  I  have  had  a  number  of  cases 
fall  into  my  hands  where  it  had  not  been  used 
by  the  accoucheur,  and  all  sorts  of  complica- 
tions were  found,  but  on  the  beginning  of  the 
use  of  the  douche  they  were  either  partly  or 
entirely  relieved. 

It  has  been  objected  that  many  thousands 
make  good  recoveries  without  any  douching. 
True,  yet  how  many  thousands  of  us  are  never 
exposed  to  small-pox,  and  therefore  cannot  take 
it,  yet  how  many  of  us  are  there  who,  because 
of  there  being  no  danger  of  small-pox,  will  be 
satisfied  to  go  un  vaccinated  ?  The  hot  douche 
is  the  parturient  woman's  vaccination  against 
puerperal  septicemia  and  kindred  troubles. 

It  has  become  part  of  my  necessary  treatment 
and  I  almost  invariably  use  it,  and  have  no 
doubt  whatever  that  it  has  been  the  means  of 
saving  life,  as  some  of  my  cases  have  been  de- 
livered under  the  most  favorable  circumstances 
for  puerperal  infection,  yet  by  a  free  ufie  of  hot 
antiseptic  douches  a  rapid  recovery  followed. 

If  you  wish  to  have  the  gratitude  of  the 
women,  the  admiration  of  the  nurse  and  friends, 
and  the  satisfaction  of  knowing  that  you  have 
done  your  duty  and  fully  earned  your  money^ 
whether  you  get  it  or  not,  'and  fortified  your 
patients  against  disease,  then  use  the  hot  postpar- 
tum  douche.        Homer  C.  Bennett,  M.D. 

Lima,  Ohio. 

Med.  Dept  Univ.  Wooster,  1888. 
Med.  College  of  Ohio,  1889. 


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Qaestions  are  soUdted  for  this  Column.  CommtmicatiotM 
not  accompanied  by  the  proper  name  and  address  of  the 
writer  (not  necessarily  for  pubUcation),  wiU  not  be 
noticed. 

The  great  number  of  requesU  tbr  private  answers,  for  the 
information  and  benefit  of  the  writer,  makes  it  necess- 
ary for  us  to  charsre  a  fee  for  the  time  requited.  Thk 
fee  wiU  be  fixMn  one  to  five  dollars,  according  to  the 
amount  of  research  and  writing  required. 


Editor  Medical  World. — Having  observed 
the  Samaritan  spirit  not  only  of  the  editors  hut 
of  the  numerous  correspondents  of  The  World 
in  giving  aid  to  those  in  need,  I  am  encouraged 
to  ask  assistance  in  the  following  case: — Mrs. 
B.,  aged  50,  mother  of  four  children,  youngest 
15  years  of  age,  had  change  of  life  ten  years 
ago  without  any  trouble,  and,  excepting  occa- 
sional attacks  of  indigestion,  as  evidenced  by 
nausea  and  vomiting  and  usually  followed  by 
lienteric  diarrhea  la»^ting  a  day  or  two,    her 


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THE  MEDICAI.  WORLD. 


health  has  been  fairly  good,  until  about  the  first 
of  last  December,  when  she  began  to  be  troubled 
with  borborygmus,  which  continued  to  a  greater 
or  le«s  extent  for  several  weeks,  always  being 
worse  at  night  During  its  continuance  a  morn- 
ing diarrhea  began  and  still  continues,  with  the 
exception  of  occasional  intervals  of  a  week  or 
ten  days,  as  influenced  by  treatment  The 
diarrhea  has  never  been  excessive,  seldom  ex- 
ceeding one  action  a  day,  which  usually  occurs 
very  soon  after  breakfast  and  is  about  the  con- 
sistency of  soup.  On  the  outset  of  this  trouble 
she  weighed  145  pounds.  Notwithstanding  a 
fairly  good  appetite,  she  has  lost  during  the 
year  about  thirty  pounds.  There  has  never 
been  complaint  of  pain,  soreness,  tenderness  or 
distress  of  any  kind,  but  rather  a  feeling  of 
weakness  and  emptiness  of  the  bowels  at  times, 
with  a  feeling  of  inability  of  the  rectum  to  act 
with  the  upper  bowels.  Thus  has  the  case 
progressed  for  a  twelvemonth. 

In  regard  to  the  treatment  I  will  just  say  that 
it  would  be  easier  to  tell  of  some  things  still 
untried  than  of  the  numerous  remedies  tested. 
Suffice  it  to  say  that,  whereas,  some  have  seemed 
to  be  beneficial  for  a  week  or  two,  all  treatment 
has  thus  far  failed  to  effect  a  cure.  What 
makes  the  case  doubly  interesting  to  me  is  that 
the  patient  is  my  wife,  and  hence  you  will  right- 
fully infer  then  that  my  chief  concern  is  to 
attract  the  attention  of  some  one  who  will  sug- 
gest the  remedy.  Dr.  Bronson. 

Editor  Medical  World  : — I  write  to  ask 
the  opinion  of  my  fellow  practitioners  in  regard 
to  my  case.  I  have  been  ill  for  the  past  four 
months,  during  which  I  have  lost  over  thirty 
pounds.  My  weight  when  in  health  was  over 
200.  Am  38  years  of  age,  and  have  always 
been  robust  I  will  describe  my  symptoms  as 
fully  as  possible: 

Tongue  slightly  coated  on  base  with  white 
coating  ;  no  fever  at  any  time  ;  uneasy  feeling 
through  stomach  and  bowels ;  development  of 
gas  in  bowels ;  liquid  stools,  three,  four  and 
five  times  per  day,  preceded  by  griping,  cutting 
pain  in  bowels.  All  of  the  discharges  of  the 
bowels  are  horribly  offensive.  I  feel  weak  and 
without  ambition ;  hands  and  feet  pallid  and 
cold.  A  good  deal  of  the  time  I  am  quite 
dizzy.  Would  like  diagnosis  and  treatment 
Have  tried  many  things  without  benefit 

Columbus,  O.  H.  L.  K.,  M.D. 

Editor  Medical  World  : — Will  some  one 
inform  me  whether  or  not  it  has  ever  been  ascer- 
tained how  high  a  temperature  it  requires  to  de- 
stroy the  diphtheria  bacillus  ? 

Monrovia,  Cal.  C.  Bardill,  M.D. 


Editor  Medical  World  : — Here  is  a  case  of 
some  interest  that  I  would  submit  to  the  World 
family  for  solution:  A  deceased  person  was 
presented  at  the  grave  for  burial,  whom  the 
mother  was  afraid  was  about  to  be  interred 
alive.  She  requested  the  body  to  be  looked  at 
by  another  physician  and  myself.  We  found 
the  body  quite  cold,  no  rigor  mortis,  no  odor, 
the  lips  reddish  purple,  around  the  eyes  the 
same  color,  eyes  had  the  look  or  expression  of 
a  living  person.  She  had  fainted  alway  several 
times  before  dying  and  had  the  appearance  oi 
being  dead  for  a  short  while. 

Whilst  1  haven't  the  slightest  doubt  that  she 
was  really  dead,  since  this  other  physician  was 
present  and  witnessed  her  death,  there  is  an  in- 
terest in  the  case.  I  would  like  for  some  one 
with  experience  to  inform  me  as  to  the  correct- 
ness of  my  belief,  that  the  treatment  for  con- 
sumption (Amick's),  which  I  suppose  consists 
mostly  of  creasote,  had  everything  to  do  in  the 
post-mortem  appearances  in  the  case  just  stated. 

Lever,  S.  C.  J.  D.  F.  Lever,  M.D. 

[In  all  cases  like  the  above  we  should  advise 
keeping  the  body  above  ground  until  all  inter- 
ested are  convinced  beyond  doubt  that  death 
has  taken  place.  There  is  no  harm  whatever  in 
keeping  the  body  until  unmistakable  signs  of 
decomposition  b^n  to  show.  Some  large 
cemeteries  have  one  or  more  vaults  v^'here  bodies 
may  be  kept  until  it  is  desirable  to  inter  them. 
In  these  they  may  be  kept  under  observation,  if 
thought  desirable. — Ed.] 


Editor  Medical  World  : — I  have  an  obsti- 
nate case  of  eruption  of  the  face  which  has  not 
yielded,  so  far,  to  any  treatment  I  have  given. 
The  patient  is  a  clergyman  of  middle  age,  a 
married  man,  and  in  every  way  in  good  health. 
There  is  no  heredity  of  scrofula  or  any  specific 
taint  in  the  system,  so  far  as  is  known.  The 
eruption  never  entirely  disappears,  but  is  worse 
at  times.  The  principal  parts  affected  are  the 
nose  and  cheeks  and  some  on  the  forehead ; 
never  any  in  the  scalp  or  beard  or  on  the  neck. 
It  makes  its  appearance  in  little  boils,  with  con- 
siderable redness  of  the  skin.  It  is  not  a  case 
of  lupus,  rosacea  or  eczema.  It  is  more  like 
rupea,  for  the  pimples  degenerate  into  scabs^ 
then  return  again  like  little  boils,  then  break 
with  a  small  amount  of  pus.  Only  a  few  go  in 
this  way,  many  appear  under  the  skin  and  go 
away  without  coming  to  a  head.  I  used  a  lo- 
tion made  of  corrosive  sublimate,  xx  grs.,  and 
sulphate  of  zinc,dr.  iii,  rose  water,  oz.  vi,well  ap- 
plied night  and  morning,  and  I  direct  the 
pimples  to  be  squeezed.  I  also  used  a  salve  of 
tannic  acid,dr.  i,  boric  acid,gr8.  x,  morphine,gr. 


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i,  chloroform,  grs.  xx.  These  treatments  were 
used  for  three  weeks  at  a  time,  alternatiDg. 
Meanwhile,  I  gave  Fowler's  solution,  grs.  iii, 
threi'  times  a  day,  with  cascara  and  sulphate  of 
magnesia  at  proper  intervals,  with  light  diet 
Us^  Parke  Davis  &  Co*8  liquid  antiseptic  soap 
for  cleansing;  and  kept  the  bowels  free.  Under 
this  treatment  the  case  seemed  to  be  almost  well 
at  times,  but  would  return  to  the  discomfort  of 
the  patient  and  to  my  disappointment  I  would 
request  some  treatment  that  would  cure  this 
case.  Medicus. 


Editor  Medical  World. — Is  there  any 
deviation  generally  required  in  the  treatment  of 
pneumonia  in  the  negro,  as  that  disease  seems  so 
fatal  to  the  race  in  this  section  ?  Dr.  D. 

Nebraska. 


Editor  Medical  World. — Will  you  please 
re<{uest  in  your  next  issue  the  best  and  easiest 
^ay  to  make  a  plaster  paris  cast  or  model  ? 
For  instance,  I  wish  to  make  a  model  of  a  foot 
or  hand  and  arm;  what  is  the  best  mode  of 
procedure?  D,  Barringer,  M.D. 

Rocky  Ridge,  O.  ^ 


Editor  Medical  World. — I  should  be 
pleased  to  see  an  article  on  the  treatment  of 
'^spasmodic  croup."  S.  Smith,  M.D. 

Filley,  Neb. 


Editor  Medical  World. — Will  you  or  some 
of  your  readers  please  suggest  some  means  for 
the  removal  of  an  unsightly,  brownish  discolora- 
tion of  the  cuticle  of  the  cheek,  which  resembles 
in  every  respect  or  appearance  a  "  birthmark  V* 

The  cause  is  due  to  the  application  for  too 
long  a  time  of  an  alum  and  glycerine  mixture 
to  an  inflanted  spot  about  three  months  ago, 
which  produced  a  blister  of  the  epidermis  and 
subsequent  desquamation  of  the  destroyed 
epitheliuHL 

Any  information  enabling  me  to  remove  this 
most  objectionable  appearance  will  be  highly 
esteemed  as  a  valuable  favor  conferred  to  one 
who  anxiously  awaits  a  response.      B.  L.  N. 

Editor  Medical  World. — What  will  re- 
move superflous  hair  from  the  body  without 
injury  to  the  skin?  Will  some  reader  please  be 
so  kind  as  to  inform  me  in  your  next  number. 
No  electricity.  X.  X.  X. 


Editor  Medical  World. — I  would  like  to 
ask  the  opinion  of  the  readers  on  the  following 
case :     The   umbilicus  on  an   infant  is    five- 


eighths  inch  long,  oue^half  inch  or  less  at  base 
and  five  eighths  inch  or  more  in  diameter  at  the 
distal  end.  It  is  firm  in  texture  and  normal  in 
color. 

The  nurse  saw  it  on  the  second  day.  It  was 
feared  to  be  a  hernia,  hence  I  was  called  to  see 
it  Condition  of  child  appears  to  be  good.  One 
child  4  years  old  had  hairlip. 

Will  some  of  the  readers  of  The  World 
kindly  give  their  experience  in  the  treatment  of 
alopecia  areata.  Dr.  Mantey. 

Minerva,  O. 

[The  Doctor  will  find  valuable  assistance  in 
the  treatment  of  umbilical  hernia  by  consulting 
the  volume  of  this  jourtial  for  1893. — Ed.] 

Editor  Medical  World. — Will  you  kindly 
ask  the  readers  of  The  World  to  give  me  ad- 
vice in  the  following  case  : 

Miss  B.,  36  years  of  age,  white,  extremely 
corpulent,  has  alwajs  been  healthy  and  worked 
very  hard.  About  three  or  four  months  ago  I 
was  called  to  see  her.  Found  her  suffering 
from  suppression  of  urine;  complained  of  severe 
"pain  in  belly."  I  passed  a  catheter  without 
any  opposition  or  distress  to  the  patient,. and 
drew  ofi  nearly  a  half  gallon  of  healthy  urine 
to  the  intense  relief  of  the  woman,  who  declared 
herself  "  all  right"  She  continued  "  all  right" 
for  fourteen  days,  when  I  was  called  agaiu  and 
found  her  in  the  same  condioion,  and  again  drew 
off  a  wash-basin  two-thirds  full  of  clear  urine, 
and  I  have  been  going  through  this  performance 
ever  since  with  wonderful  regularity  about  every 
fourteen  days.  She  has  no  trouble  between 
these  times,  passes  her  water  freely,  has  no  pain, 
eats  and  sleeps  well.  She  has  for  a  number  of 
years  been  getting  up  once  in  the  night  to  void 
water,  generally  about  12,  or  1  o'clock,  and  it  is 
always  at  this  time  that  her  trouble  comes  on. 
She  passes  the  water  freely  just  before  going  to 
bed,  but  about  the  time  she  usually  gets  up  to 
urinate  in  the  night  she  awakes  with  "a  pain  in 
the  belly"  and  complete  suppression  of  urine. 

She  suffers  very  much  from  that  until  she 
reaches  my  office,  about  8  o'clock  a  m,  when  the 
catheter  affords  complete  relief  until  "next 
time,"  as  the  poor  girl  says,  when  she  leaves. 
**Goodbye,  doctor,  until  next  time."  And  that 
**next  time"  comes  with  vexing  regularity  in 
spite  of  all  I  can  do. 

She  is  wearing  a  nicely  fitting  abdominal  belt 
(Flavell's)  all  the  time  except  at  night  Ex- 
cessive fat  makes  examination  difficult  and  un- 
certain. 

Now,  brothers,  a  word  of  advice  through  the 
columns  of  The  World  will  be  thankfully 
received.  Medico. 


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Current    Medical  Thought.       o.mphor.M«»thoi  m  c.th.rrh.i  01^.^.. 

,  Dr.  Beth  S.  Bishop,  of  Chicago,   in  a  paper 

thus  entitled,  reported  a  large  number  of  eases 
of  nasa  pharyngeal  catarrh,  hay  fever,  and  dis- 
eases of  the  ear  as  having  been  treated  with 
camphor- menthol  with  much  better  results  thatt 
menthol  alone  produced.  The  presence  of  cam- 
phor seemed  to  intensify  the  action  of  menthol. 

A  number  of  hay  fever  sufferers,  among  them 
the  president  of  the  United  States  Hay  Fever 
Association,  had  obtained  greater  relief  from 
this  inhalant  than  any  other  they  had  ever 
tried.  The  effect  of  camphor-menthol  in  reduce 
ing  turgescence  and  consequent  tumefaction  of 
the  turbinated  bodies  had  rendered  a  contem- 
plated operation  for  stenosis  unnecessary  in 
several  cases  cited. 

Injections  of  a  ten  per  cent  solution  in  lanolin 
into  constricted  Eustachian  tubes  had  caused 
them  to  become  patulous.  The  improved  ventila- 
tion of  the  middle  ear  thus  effected,  together 
with  inflation  with  a  five  or  ten  per  cent  spray  of 
the  same  liquid  in  hypertrophic  tympanic  catarrh, 
increased  the  hearing,  and  produced  a  sense  o(  . 
clearness  in  the  head. 

Cases  of  laryngitis,  with  the  voices  reduced  to 
a  whisper,  had  been  treated  with  inhalations 
varying  from  five  per  cent  to  twenty-five  per 
cent,  in  strength,  with  the  result  of  restoring  the 
voices  completely  in  from  twenty-four  to  iorty- 
eight  hours. 

No  ill  results  had  followed  the  use  of  this 
remedy  in  the  nose,  throat,  larynx  or  middle 
ear.  The  ordinary  strength  of  inhalation  re- 
commended by  the  reader  was  three  per  cent  or 
five  per  cent  for  very  susceptible  or  sensitive 
individuals,  like  hay  fever  patients,  and  ten  per 
cent  for  less  nervous  patients  with  hypertrophic 
catarrh,  etc.  In  order  to  reduce  great  swelling 
of  the  turbinates  and  relieve  stenosis,  the  solu- 
tion shall  confflst  of  twenty  or  tw%nty-five  per 
cent  of  the  camphor- menthol.  The  full  strength 
of  the  camphor-menthol  applied  to  eczematous 
eruptions  relieved  the  itching  and  dissipated  the 
redness  and  swelling.  Similar  results  followed 
its  application  to  hepatic  eruptions 

Finally,  camphor-menthol  contracted  the  cap- 
ilary  blood  vessels  of  the  mucous  membrane, 
reduced  swelling,  relieved  pain  and  fullness  in 
the  head,  or  stenosis,  arrested  sneezing,  checked 
excessive  discharges,  and  corrected  perverted 
secretiont. — N,  Y.  Med,  Timea. 


Does  Gonorrhea  in  the  Female  Invariably  Prevent 
Conception. 

Dr.  John  T.  Wilson,  of  Sherman,  Texas, 
read  a  paper  on  this  subject  before  the  Southern 
Surg,  and  Gynec  Association. 

He  said  it  has  long  been  known  that  gonorr- 
hea in  the  female  was  sometimes  attended  with 
complicatioDS  that  proved  troublesome  and  of 
serious  import  Authors  had  for  many  years 
been  describing  endometritis,  metritis,  inflam- 
mations of  the  tubes,  ovaries  and  peritoneum 
produced  by  an  ascending  specific  vaginitis,  these 
structures  being  invaded  by  the  poison,  it  slowly 
creeping  up  through  the  cervix,  involving  first 
the  mucous  membranes  in  its  track  and  extend- 
ing by  continuity  of  struaure  to  the  deeper 
tissues.  The  more  serious  results,  however,  were 
not  appreciated  nor  so  well  understood  until 
within  recent  years,  laparotomy  became  so  com- 
mon an  operation,  and  the  pathology  of  the 
more  important  sequelae  were  studied  from  the 
specimens  themselves.  According  to  the  exper- 
ience of  our  best  authorities  it  is  so  difficult  to 
positively  differentiate  between  gonorrheal  and 
severe  simple  vaginitis  without  a  clear  and 
authentic  history,  it  being  attended  with  the 
same  symptoms  and  the  properties  of  also  infect- 
ng  the  male,  that  it  is  not  altogether  an  easy 
task  to  say  when  ovarian,  tubal  and  uterine 
troubles,  even  with  the  presence  of  the  Neisser 
gonococcus,  have  a  specific  origin,  especially  as 
simple  vaginitis  will  sometimes  produce  them 
all.  Dr.  Wilson  had  observed  quite  a  number 
of  women  who  were  the  victims  of  gonorrheal 
infection,  many  of  them  innocently  so,  having 
contracted  it  from  their  husbands,  and  believed 
it  to  be  an  ordinary  leucorrhea ;  many  of  those 
whose  history  he  was  enabled  to  follow  after- 
ward bore  children  for  many  years,  were  appar- 
ently healthy,  and  gave  no  evidence  of  the  usual 
complications. 

Dr.  Wilson  then  reported  cases  illustrative  M 
some  of  these  conditions  and  results.  That  gon- 
orrhea does  frequently  prevent  conception  is 
probably  well  established  ;  but  he  does  not  think 
it  is  by  any  means  the  universal  rule,  clinical 
illustrations  are  too  many  to  the  contrary.  If 
Noeggerath's  statements  are  literally  true  sterile 
women  and  fruitless  marriages  would  be  far 
more  common  and  the  increase  in  the  race  would 
be  greatly  lessened,  for  there  are  a  surprisingly 
large  percentage  of  men,  judging  from  his  ex- 
perience, who,  if  they  confessed  the  truth,  have 
sufiered  at  sometime  in  their  lives  with  gonorrhea. 


Ths  MsnicAii  WoBLB  is  a  medical  society  in  Wpe. 
with  monthly  meetings  in  yoar  office.  No  medical 
society  in  ihe  world  ever  had  as  many  members  as  the 
readers  of  Thb  Mbdicai.  Wobld  ;  and  no  members 
were  erer  so  mutually  helpfnl.  Cost  of  membership 
Ib  We&iJ>  soeietj,  only  $1.00  pet  yeai. 


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Abortive  Treatment  of  Gonorrhea   with  Oii   of 
Cinnamon. 

J.  Chalmera  DaCoeta  (Medical  News)  urge% 
first,  the  thorough  cleiasing  of  the  urethral 
canal  by  injecting,  or  spraying  within  it,  the 
fifteen  volume  solution  of  hydrogen  dioxid  with 
a  caution  about  permitting  it  to  produce  much 
pain  by  over  distention.  The  aatiseptic  solu- 
tion is  then  used,  either  with  the  atomizer  or  by 
injection.  It  consists  of  the  oil  of  cinnamon 
dissolved  in  one  of  the  liquid  petroleum  prepara- 
tions. The  first  day  the  solution  is  made  of  one 
drop  to  the  ounce ;  the  second  day,  two  drops 
to  the  ounce ;  and  after  that,  three  drops  to  the 
ounce. — Phila,  Polyclinic 

The  Forms  of  Diabetes. 
Dr.  Greorge  Harley  gives  the  following  classi- 
fication of  diabetes : 

1.  Hepatic  diabetes— including  the  gouty 
variety. 

2.  Cerebral  diabetes— including  all  cases  of 
saccharine  urine  arising  from  nerve  derange- 
ments. 

3.  Pancreatic  diabetes — the  most  deadly  farm 
of  the  disease. 

4.  Hereditary  diabetes — ^a  form  by  no  means 
uncommon,  and  one,  too,  where  both  brothers 
and  sisters  may  labor  under  the  disease  without 
either  their  maternal  or  paternal  parent  having 
been  afifected  by  diabetes,  though  more  distant 
members  of  the  family  may  have  suffered 
from  it. 

5.  Food  diabetes— including  all  forms  of 
saccharine  urine  arising  from  the  ingestion  of 
unwholesome  substance. 

In  the  matter  of  treatment,  besides  diet  and 
opium  or  codeine.  Dr.  Harley  recommends  cro- 
ton  chloral,  strychnine,  phosphoric  acid  for 
thirst,  and  an  absolute  prohibition  of  alcohol. — 
Med,  Record, 


Ten  Reasons  Why  the  Abdominal  Bandage  Should 
Not  Be  Used  Af.er  Labor. 

1st — It  is  unnatural. 

2d. — It  is  liable  to  become  soiled  and  hence 
a  harbor  for  microbes. 

3rd. — It  increases  irritation  of  the  tired  and 
overworked  abdominal  organs. 

4th. — It  interferes  with  the  necessity  of  fre- 
quent antiseptic  ablutions. 

5th. — It  is  difficult  to  keep  in  place,  unless 
made  to  order. 

6th. — It  binds  do<vn  the  weak  uterus  and 
promotes  the  return  of  a  displacement  or  a  sub- 
mvolution. 

7th. — It  predisposes  to  puerperal  infection, 
disturbing  the  peripheral  and  cerebrospinal 
centers. 


8th. — It  increases  rather  than  diminishes  the 
danger  of  post-partum  hemorrhage. 

9th. — It  prevents  digestion,  assimilation,  and 
intestinal  peristalsis  and  tends  to  bladder 
trouble. 

10th. — It  is  unsafe  to  apply  it  by  any  one 
except  the  accoucheur  or  an  experienced  nurse. 
— W.  B.  Conway,  M.D.,  Athens,  Ga.,  in  South 
Med.  Record. 


Practical   Observations   on   the     Formulas   and 

Action  of  Certain  Diuretlos  and  Purgatives  in 

the  Treatment  of  Some  Forms  of  Dropsy, 

Resulting  From  Various  Causes,  as 

Cardiac  and  Renal  Diseases. 

By  Joseph  Jonbb,  M.D.,  LL.D., 
of  New  Orleans,  La. 

Prolessor  of  Cheminry  and  Toxicoloey,  aod  of  Clinicftl 
Medicine,  Tulane  Uuiver  iiy,  etc. 

We  shall,  in  this  brief  article,  endeavor  to 
avoid  theoretical  discussions,  tedious  classifica- 
tion, and  needless  detail,  and  shall  content  our- 
selves with  expretj«itig  some  of  the  results  ob- 
tained from  our  experience  in  the  Charity  Hos- 
pital, of  New  Orleans,  during  the  past  twenty- 
six  years,  and  in  private  practice. 

The  successful  treatment  of  dropsy  must  be 
based  upon  a  knowledge  of  its  various  causes 
and  effects,  and  upon  the  action  of  the  various 
remedies  employed. 

Derangements  of  the  due  relationship  of  secre- 
tion to  absorption  in  the  tissues  and  cavities  of 
the  body  may  depend  upon — 

1st  Derangements  in  the  nutrition  of  the 
tissues,  leading  either  to  the  increase  of  secre- 
tion or  diminution  of  absorption. 

2d.  Derangemt  nts  or  alterations  of  the  blood, 
leading  to  derangements  of  the  nutrition  of  the 
tissues,  with  an  iucrease  of  secretion  or  diminu- 
tion of  absorption. 

3d.  Derangements  of  the  circulatory  apparatus 
attended  with  venous  obstruction  and  congestion, 
increased  serous  effusion  from  the  distended 
blood  vessels,  and  diminished  absorption. 

4th.  Derangements  of  the  functions  of  those 
organs  which  regulate  the  amount  of  the  blood, 
as  well  as  the  constitution,  by  regulating  the 
amount  of  the  watery  element,  by  the  elimina- 
tion of  excrementitious  materials. 

A.  Dropsy  arising  from  the  prolonged  action 
of  the  malarial  poison,  characterized  by  destruc- 
tion and  diminution  of  the  colored  blood  corpus- 
cles, splenic  enlargements,  and  hepatic  de- 
rangements. 

Chronic  hepatitis,  parenchymatous  hepatitis, 
portal  obstruction,  anemia,  and  general 
anasarca,  are  frequent  results  of  the  prolonged 
action  of  the  malarial  poison  in  the  Valley  of 
the  Mississippi. 


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The  remedies  best  adapted  to  relieve  the  dis- 
tressing and  dangerous  conditions  induced  by 
the  prolonged  action  of  the  malarial  poison 
may  thus  be  enumerated  : 

(a)  Sulphate  of  quinia,  bromide  of  quinia, 
valerianate  and  hydrochlorate  of  quinia. 

(b)  Arsenic  (anenious  acid,  Fowler's  solu- 
tion.) 

(c)  Iron  (the  various  preparations  of  iron — 
sesquichloride,  citrate  of  iron  and  quinia, 
tri basic  phosphate  of  iron,  etc) 

(d)  Mercurials  in  occasional  doses,  to  relieve 
hepatic  congestions  and  derangements,  as  blue 
mass,  calomel,  carbonate  of  soda  and  calomel. 

(e)  Saline  purgatives,  as  bitartrateof  potassa, 
Roehelie  salts,  sulphate  of  soda,  sulphate  of 
magnesia. 

(f)  Diuretics,  as  juniper  berry  tea,  nitric 
ether,  jaborandi,  pilocarpin,  digitalis)  etc. 

The  results  are  doubtful  in  those  cases  in 
which  the  liver  has  been  structurally  altered  by 
the  prolonged  action  of  the  malarial  poison. 

B.  Dropsy  resulting  from  valvular  disease 
of  the  heart,  mitral  and  tricuspid  obstructions. 

Valvular  disease  of  the  heart  is  attended 
\vith  more  or  less  hepatic  obstruction,  and  bene- 
fit is  often  experienced  by  the  judicious  use  of 
mercurials.  Purgatives  and  diuretics  are 
essential. 

The  agents  used  in  the  treatment  of  cardiac 
dropsy  may  be  considered  in  connection  with 
the  following  class : 

C.  Dropsy  resulting  from  various  structural 
alterations  of  the  kidneys,  included  generally 
•under  the  head  of  Bright's  disease,  acute  and 
xjhronic  nephritis,  parenchymatous  and  intersti- 
tial nephritis,  gouty  and  cirrhotic  kidney,  etc. 
In  this  class  of  dropsy  (G),  as  with  that  indicated 
by  ( B),  all  portions  of  the  cellular  tissue,  as  well 
as  the  abdominal  and  pleural  cavities,  may  be 
enormously  distended  with  serous  effusions,  and 
the  skill  of  the  physician  is  often  taxed  to  the 
uttermost  to  relieve  the  great  embarrassment  of 
the  circulation  and  respiration. 

The  lesion  of  the  kidneys  attended  with 
albuminuria  may  result  from  the  cardiac  lesion, 
and  the  latter  may  also  result  primarily  from 
the  former.  In  many  cases,  great  and  immedi- 
ate benefit  may  be  derived  from  various  purga- 
tives and  diuretics. 

The  following  formula  may  be  used  in  many 
cases  of  dropsy  arising  from  cardiac  and  renal 
lesions : 

R.    Bitartrateof  potassa lb.  J 

Divide  into  sixteen  packages.  Add  one  pint 
of  boiling  water  to  one  package  (one  ounce)  of 
bitartrate  of  potassa,  and  to  one  ounce  of 
juniper  berries.  Place  the  jimiper  berries  (one 
ounce),  and  the  bitartrate  of  potassa  (cream  of 


tartar),  in  a  small  porcelain  pitcher  or  vessel. 
Cover  the  mouth  of  the  vessel  with  a  piece  of 
mosquito  netting  or  strainer,  so  as  to  preventthe 
juniper  berries  from  pouring  out. 

Sig. — Stir  the  bitartrate  of  potash  in  juniper 
berry  tea  well,  and  drink  a  wineglassful  every 
three  or  four  hours,  so  as  to  consume  the  entire 
pint  in  twenty-four  hours. 

This  mixture  will  induce  both  purgation  and 
diuresis,  and  will,  in  maiiy  cases,  rapidly  in- 
duce the  reduction  of  the  most  extensive  and 
obstinate  dropsies.  The  tincture  and  extract  or 
infusion  of  digitalis  will  greatly  promote  the 
diuretic  action  of  the  juniper  berry  tea  and 
cream  of  tartar. 

I  am  in  the  habit  of  using  from  6  to  10  drops 
of  the  tincture  of  digitalis  every  three,  four,  six 
or  eight  hours,  with  marked  benefit,  in  many 
cases  of  cardiac  and  renal  dropsies. 

In  my  opinion,  digitalis  is  used  in  too  large 
doses,  and  in  a  reckless  manner,  and  often  with 
fatal  results,  by  many  practitioners,  who  em- 
ploy it  usually  in  large  doses. 

In  some  cases,  the  practitioner  may  resort  to 
various  diuretics  in  addition  to  digitalis,  as 
jaborandi,  pilocarpin,  uva  ursi,  buchu,  acetate 
of  potash,  nitrate  of  potash,  sweet  spirits  of  nitre 
(nitric  ether),  and  other  agents. 
.  I  have  found  a  benefit  fiom  several  combina- 
tions, as  the  following : 
Diuretic  Wine  for  cedemOj  general  anasarca  and 

dropsy,  in  cardiac  and  renal  diseases, 

R.    Fluid  exract of lalap „....f drams lli 

Fluid  extract  of  squiUs f  drams  lii 

Fluid  extract  of  Jaborandi J[<»\ 

Fluid  extract  of  digitalis jn  xxx 

Nitrate  of  potash  cpulv.) dramsiy 

Angelica  wine OIj 

M.  f.  s,  a.— Big— One  tablbspoonnil  every  three  hours. 

I  have  obtained  most  satisfactory  results  from 
this  diuretic  and  purgative  wine  in  the  speedy 
and  wonderful  relief  of  the  most  extended 
dropsical  efiusiona  resulting  from  valvular 
disease  of  the  heart 

I  have  also  employed  a  diuretic  mixture  in 

dropsy  resulting  from  cardiac  disease,  similar  to 

that  of  Fothergill,  as  follows  r 

R.    Spirits  of  chloroform f  drams  ir 

Acetate  of  potessa ..drams  It 

Tincture  of  dlRitalls f  drams  ^ 

Infusion  of  bncnu  to  make  in  aU t  os  x 

M.  Sig.— Tablespoonfkil  to  two  tablespoonfUls  eyery  two  to 
four  hours. 

We  have  thus  presented  a  few  practical  ob- 
servations and  suggestions,  with  the  hope  that 
they  may  prove  of  practical  value. 

In  the  treatment  of  the  dropsical  effects  of 
hepatic,  portal,  cardiac  and  renal  lesions  and 
obstructions  with  purgatives  and  diuretics,  the 
physician  should  endeavor  to  sustain  the 
strength  of  his  patients.  No  fixed  rule  can  be 
laid  down  as  to  the  amounts  of  the  various 
diuretics  and  purgaMves  to  be  used  in  any  given 

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case ;  each  case  should  be  carefully  examined 
and  studied,  and  the  effects  of  each  remedy 
used  carefully  watched.  The  results  of  treat- 
ment will  depend  largely  upan  the  nature  and 
extent  of  the  organic  lesions. 

In  cases  of  ascites,  dependent  upon  cirrhosis 
of  the  liver,  much  may  be  accomplished  by  pur- 
gatives and  diuretics  to  prolong  life  and  over 
come  the  constant  tendency  to  the  accumulation 
of  serous  fluid  in  the  abdomenal  cavity  ;  and 
when  these  measures  fail,  we  must  remove  the 
fluid  by  the  trochar. 

In  many  cases  of  cirrhosis  and  ascites,  caused 
by  excessive  spirit  (alcoholic)  drinking,  we  have 
frequent  y  removed,  by  successive  tappings, 
hundreds  of  pounds.  Sooner  or  later,  these 
cases  of  ascites  perish  from  the  exhaustion 
caused  by  the  repeated  tappings.  In  one 
case  of  cirrhosis  of  the  liver,  occurring  in  an 
Irish  laborer,  who  hacl  consumed  enormous 
quantities  of  rum,  gin  and  whisky,  it  was  neces- 
sary to  evacuate  the  serous  fluid  from  the  ab- 
dominal cavity  almost  every  seven  or  twelve 
days— from  one  to  two  gallons  of  serous  fluid  were 
evacuated  at  each  operation.  The  patient  died 
at  the  end  of  the  sixth  operation.  Throughout 
his  illness  his  intellect  was  clear. 

In  ascites  resulting  from  the  cirrhotic  condi- 
tion of  the  liver,  death  speedily  ensues,  if  the 
distended  abdomen  of  the  patient  is  not  relieved 
by  the  trochar. 

Under  all  circumstances,  and  even  in  neces- 
sarily fatal  cases,  the  physician  m&y  accomplish 
valuable  service  by  relieving  sutfering  and  pro- 
longing human  life. —  Va,  Med.  Monthly. 

False  Accusations  Against  Physicians. 
Dr.  J.  G.  McCoy,  of  Springfield,  Ohio  ,  has 
recently  disagreeably  experienced  a  legal  peril 
which  environs  the  conscientious  physician's  life. 
He  attended  a  man  for  venereal  disease  and, 
not  very  wisely,  trusted  him.  Payment  of  the 
bill  was  refused,  whereupon  suit  was  brought 
Dr.  McCoy  was  thereupon  indicted  for  criminal 
abortion  on  the  evidence  of  his  debtor  and  a 
courtesan.  The  courtesan  broke  down  on  cross- 
examination,  and  admitted  she  asked  Dr.  Mc- 
Coy to  perform  an  abortion,  who  refused,  and 
advised  her  to  marry.  The  trial  jury  honorably 
acquitted  Dr.  McCoy.  False  accusations  of 
abortion,  some  of  them  even  antemort^m,  are 
often  made  out  of  revenge  against  physicians 
who  refuse  to  perform  abortions,  by  the  women 
who  have  them  done  unskillfully  elsewhere. 
This  mental  peculiarity  of  women  who  have 
abortions  done  should  alwajrs  be  token  into  ac- 
count in  judging  of  the  validity  of  any  abortion 
accusation  against  a  reputable  physician. — Med. 
Standard. 


Sodium  Bisulphite  in  Tonsillitis  and  Coryza. 

Excellent  results  are  reported  from  the  use  of 
iodium  bisulphite  in  aborting  tonsillitis  and 
coryza.  Tablespoonful  doses  of  a  saturated 
solution  may  be  given  every  hour  or  two  for 
twenty  four  hours,  or  even  longer  if  necessary. 
The  disease  is  usually  controlled  in  twenty-four 
hours  under  tbis  treatment — Notes  on  New 
Remedies. 

Sir  Morrell  Mackenzie  finds  that  by  exciting 
a  rival  reflex,  the  laryngeal  spasm  is  at  once 
overcome.  By  exciting  a  imroxysm  of  sneer- 
ing, immediate  relief  is  procured.  This  is  best 
done  by  the  inhalation  of  a  pinch  of  snuff  into- 
the  nares,  or  pepper  may  be  used  in  thesame^ 
way.  It  is  sometimes  possible  to  produce  sneez- 
ing by  tickling  the  nasal  mucous  membrane. — 
Med.  and  Surg,  Rep. 


Physicians  In  Japan. 

An  ex-attache  writes:  "Perhaps  the  most 
charming  manner  of  compensating  physicians . 
for  their  care  and  attention  is  that  wMch  is  cu»* 
tomary  among  the  natives  of  Japan.  Physicians, 
do  not  charge  for  their  services,  but  on  the  con- 
trary decline  to  name  an  amount,  and  protest 
against  any  idea  of  remuneration.  Patients  on 
their  side  are  too  proud  to  accept  such  services- 
free,  and  send  to  the  physician,  not  as  a  fee,  but 
more  as  a  friendly  gift  or  token  of  gratitude,  a. 
sum  of  money,  proportionate  to  the  means  of  the- 
giver,  with  some  piece  of  silk,  bronze,  or  lacquer- 
work,  the  idea  being  that  medical  attendance  is 
by  far  too  important  and  elevated  a  character 
to  be  desecrated  by  barter  for  filthy  lucre."" 
What  a  pity  that  our  western  civilization,  with 
all  its  commonplace  vulgarity  and  lack  of 
delicacy,  will  not  admit  of  adoption  of  such  a 
charming  method  of  intercourse  between  the 
medical  man  and  his  patients. — The  Medical i 
Age. 


Treatment  of  Arterial  Hemorrhage  From  the  Pafrvr 
of  the  Hand. 

Most  of  our  readers  have  probably  discovered 
that  hemorrhage  from  the  palm  of  the  hand  is 
troublesome,  more  particularly  from  a  punc- 
tured wouncl.  When  the  vessel  can  be  found 
and  ligatured,  or  twisted,  the  result  is  generally 
satisfactory.  The  most  painstaking  surgeon, 
however,  will  often  have  to  give  over  searching 
for  the  two  ends  of  the  wounded  vessel.  Before 
proceeding  to  apply  a  ligature  to  the  brachial 
artery  (a  practice  which,  in  neglected  cases, 
may  be  called  for  at  once).  Dr.  Chalmet,  of 
Landemeau,  France,  in  Revue  Oenerale  de 
Clinique  ei  de  ThtrapeiUique,  advises  a  combi- 


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THE  MEDICAL  WORLD. 


nation  of  known  procedures,  which  heretofore 
have  not  been  employed  simultaneously.  His 
method  is  as  follows : 

1.  Flexion  (not  extreme)  of  the  forearm  on 
the  arm 

2.  Moderate  pressure  over  the  wound  (previ- 
oualy  bathed  with  an  antiseptic  lotion),  by  a 
<x)mpress  of  salicylated  absorbent  cotton,  which  is 
retained  by  a  bandage. 

3.  Moderate  compression  of  the  radial  and 
ulnar  arteries  by  two  little  compresses  kept  in 
position  by  a  bandage  ;  a  third  compress  should 
be  placed  at  the  b^nd  of  the  arm  and  fresh 
turns  of  bandage  applied  pretty  tightly. 

4  Fixation  of  the  arm  in  a  square  sling 
€titched  together,  so  that  the  arm  shall  be 
be  pressed  to  the  side  of  the  body,  the  elbow 
elevated,  the  forearm  flexed,  and  the  hand  laid 
supine  on  the  sternum  (which  should  be  partly 
uncovered  so  as  to  permit  observation). 

5.  G)mplete  rest,  avoiding  all  effort,  daily 
examination  of  the  dressing,  which  should  he 
removed  about  the  eight  day. 

Dr.  Chalmet  does  not  claim  originality.  As 
he  says,  "direct  compression  is  known  to  every 
one;  placing  compresses  over  the  radial  and 
ulnar  artries  is  Nelaion's  invention ;  flexion  of 
the  forearm  on  the  arm  has  been  pointed  out  by 
fiichat;  Gosselin  recommended  elevation  of  the 
arm  with  pressure  at  the  wound,  and  also  at  the 
bend  of  the  arm;  humero-costal  pressure  (bring- 
ing into  play  the  weight  of  the  body)  has  been 
employed  by  Schiverlbein." 

The  combination,  in  spite  of  Dr.  Chalmet's 
modest  disclaimer,  may  be  considered  a  happy 
one,  and  may  be  recommended  on  the  express 
conditions,  however,  however,  that  the  wound  is 
kept  in  a  thoroughly  aseptic  condition,  and  the 
wound  and  the  wounded  one  kept  under  con- 
tinual observation. — Dominion  Med.  Monthly. 


Collodion  for  the  Treatment  of  Inoontlnenoa  of 
Urine  in  Childhood  and  Youth. 

The  mechanical  treatment  to  which  attention 
is  called  is  the  treatment  by  collodion.  It  is 
most  easy  of  application,  occupies  scarcely  a 
minute,  and  can  be  carried  out  at  school,  col- 
lege, or  elsewhere,  in  perfect  privacy.  All  that 
is  necessary  is  while  the  prepuce,  sHghtly  curved 
up,  is  held  with  the  left  hand,  to  smear  over  the 
little  cup  thus  formed  by  the  extremity  of  the 
prepuce  with  collodion  by  means  of  a  small 
camel's-hair  pencil  or  blunt  end  of  a  penholder. 
Almost  as  fast  as  applied  the  collodion  solidifies. 
In  contracting  it  draws  closely  together  the 
edges  of  the  prepuce,  and  thus  the  exit  for  the 
escaping  urine  is  closed. 

A  boy  of  eleven  years  of  age  has  after  one 


lesson,  been  able  to  use  the  collodion,  and  haa 
used  it  every  night  carefully  and  diligently,  so 
anxious  has  he  been  to  cure  himself  of  what  he 
considered  a  disgrace.  A  fortnight's  use  is 
sometimes  sufiicient  for  the  cure.  A  relapse  is 
easily  dealt  with.  A  solution  of  guttapercha  in 
chloroform  would  seem  at  first  sight  to  be 
equally  applicable,  but  it  is  not  The  solution 
of  guttapercha,  is  much  longer  in  hardening, 
and  it  possesses  no  contractile  powers.  When 
the  child  desires  to  pass  water,  the  little  wedge 
or  cap  of  collodion  is  easily  removed  with  the 
finger  nail. 

When  I  first  used  this  collodion  application, 
my  expectation  was  that  the  bladder  would  act 
so  forcibly  against  it  as  to  cause  sudden  pain, 
and  oblige  the  patient  to  jump  at  once  out  of 
bed  and  quickly  remove  the  collodion,  and  that 
he  should  then  repeat  the  application  before  re- 
turning to  sleep.  I  was  greatly  disappointed. 
There  was  no  pain  ;  no  awakening ;  but  on 
rising  in  the  morning  the  prepuce  was  found 
slightly  distended  with  urine,  and  the  collodion 
was  removed  without  difficulty. — J.  R  Powers, 
M.D.,  in  Mass.  Med,  Jour. 


A  New  Treatment  for  Acute  Rheumatism. 

Prof.  Bourget  (Lausanne)  has  obtained  re- 
markable results  from  the  simple  application, 
without  friction,  of  an  ointment  of  salicylic  add 
to  the  inflamed  joints  in  rheumatic  fever.  The 
joints  are  then  enveloped  in  flannel. 

The  difficulty  with  which  Prof.  Bourget  was 
confuted  in  his  experiments  on  this  subjeot 
was  to  find  a  vehicle  that  would  rapidly  carrj 
the  acid  into  the  general  circulation.  The  fourtk 
fumula  experimented  with,  and  the  one  foas4 
to  be  successful  was  the  following : 

R.    SaUcyllc  add „....) 

Turpentine Waaoca 

Lanoline j 

Lard o«  It 

Within  half  an  hour  after  the  application  the 
urine  yields  a  strong  reaction  of  salicylic  acid. 
The  result  of  twenty  quantitative  examinations 
showed  that  the  total  amount  of  add  eliminated 
in  the  twenty-four  hours  varied  from  twenty  te 
eighty  four  centigrammes  (3  to  14  grains). 

For  the  last  two  years  every  case  of  acute 
rheumatism  admitted  into  Prof.  Bourget's  wards 
is  treated  by  the  application  of  this  ointment  to 
the  exclusion  of  all  other  treatment.  No 
salicylate  administered  internally.  The  results 
are  as  follows , 

Pain  disappears  a  few  hours  afl^r  the  appli- 
cation of  the  ointment  Swelling  usuallj 
diminishes  as  early  as  the  second  day,  Tem- 
perature comes  down  between  the  third  and  fifkh 


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daj.  Lastly,  this  method  of  treatment  is  never 
attended  by  any  of  the  accidents  which  are  oc 
casionally  observed  to  follow  the  internal  ad- 
ministration of  salicylates  and  allied  bodies 

This  method  presents  the  further  advantage 
that  it  is  much  less  expensive  than  others  in 
general  uae.— Medical  Week. 


Treatment  of  Scabies. 


Dr.  Ohmann-Dumesnil.  Professor  of  Derma- 
tology and  Syphilography  at  the  Collie  of 
Physicians  and  Surgeons  of  St  Louis,  recom- 
mends a  very  simple  method  of  treatment  for 
flcabies. 

The  patient  takes  a  bath  in  the  morning. 
After  wiping  himself  dry  he  ruba  himself  with 
the  following  solution : 

Dtoffiledirater jaaozvj 

P.  a  A.~Exteroal  use. 

The  solution  is  allowed  to  evaporate  on  the 
skin.  When  dry  the  patient  puts  on  clean  linen 
and  new  clothes. 

In  the  evening  before  going  to  bed  the  fol- 
lowing lotion  is  applied : 

R.    Dilmea  hydrochloric  acid ^oji  iv 

DisUled  water ozvj 

Mix.—Extenial  use. 

Should  this  lotion  appear  tOD  strong  it  can  be 
diluted  according  to  the  necessities  of  tbe  ca^. 

Scabies  have  been  cured  in  four  days  by  this 
method  — North  Amer.  Practitioner, 


An  idea  of  the  social  status  of  the  medical 
profession  in  London,  Eugland,  may  be  gleaned 
from  the  fact  that  the  Duke  of  Westminster,  a 
lai^e  proprietor  of  houses  in  a  fashionable  quar- 
ter, refuses  to  lease  any  of  these  to  physicians, 
surgeons  or  dentists,  lest  pro^ipective  fashiona- 
ble tenants  be  frightened  away. — Tke  Medical 
Standard. 

Thus,  in  all  countries,  the  lines  are  being 
rapidly  drawn  between  the  really  "dangerous 
classes" — the  few  idle  and  of ccn  vicious  wealthy 
para.'ites  upon  society—- on  the  one  hand,  and  on 
the  other,  the  many  useful,  earnest,  productive 
members  of  society,  who  alone,  by  industrious 
toil  and  intellectual  activity,  produce  the  wealth 
of  the  world  and  who,  alone,  contribute  to  its 
progress.  The  physician  belongs  to  the  latter 
class,  and  he  may  well  be  proud  of  it  The 
sooner  we  recognize  our  identity  as  members  of 
that  grand  ''industrial  army"  whose  honorable 
labor  of  hand  and  brain  is  the  only  support  of 
the  present  and  the  only  hope  of  posterity,  the 
sooner  we  can  intelligently  co  operate  with  our 
fellows  in  changing  those  conditions  which 
create  the  artificial  division  into  ' 'classes,"  with 


unfair  privileges  and  supercilious  distinctions. 
The  time  must  come  soon,  when  the  noble,  the 
true  of  earth  cin  no  longer  be  dominated  by  those 
who  have  no  other  merit  than  that  they  have 
succeeded  in  speculation  or  been  born  into  great 
poesesssons.  The  example  of  Rush,  Warren 
and  many  other  illustrious  physicians  in  past 
struggles  for  human  freedom  justify  the  belief 
that,  in  any  future  struggle,  and  also  in  the 
gradual  process  of  social  evolution  constantly 
going  on,  the  members  of  the  medical  profession 
will  be  found  ever  active  and  on  the  right 
side — that  of  humanity  in  its  widest  sense. 


A  Case  of  Pneumonia  Cured  by  the  Subcutaneous 
Injection  of  the  Essence  of  Turpentine. 

The  mteresting   case  of  a  young  man,   29 
years  of  a^ie,   suffering    from  a  most  serious 
attack  of  pneumonia,  as  a  consequence  of  hard 
drinking  is  reported  by  Gingeot  {La  Medecine 
Hypodermique,  August,  1892),  as  cured  by  the 
hypodermic  injection  of  the  essence  of  turpentine. 
Among  the  symptoms  exhibited  by  the  patient 
there  were  delirium,  a  temperature  of  104°F, 
diarrhea,  albuminous  urine,  sputa  charged  with 
pneumococc*i,  streptococci,  and  other  cocci,  the 
whole  lung  being  invaded.     On  each  extremity 
one  gramme  of  the  drug  was  injected.     Two 
hours  afterwards  the  bodily  temperature  fell  to 
102^F.,  and  continued  to  descend  on  the  follow- 
ing   days.     Amelioration    became    permanent, 
and  a  complete  cure  was  effected.     The  local 
reaction,  however,  was  a  violent  one,  as  abscesses 
were  formed.     Gelineau,   commenting  on   the 
case,  says  that  if  the  results  of  this  medication, 
as  reported,  are  confirmed  by  future  observa- 
tions, it  becomes  necessary  to  endeavor,  for  the 
sake  of  our  patients,  to  render  the  injections  lees 
painful  and  offensive.     The  abscesses,  continues 
the    writer   produced    by  the    injections    and 
accompanied  by  an  amelioration,  cannot  be  con- 
sidered as  fixed  or  derived  abscesses,  as  they  are 
called  by  Frochier  and  Dieulafoy,  respectively, 
and  which  have  been   referred  to  by  Frochier 
as  a  novel  argument  in  favor  of  the  method  pro 
posed   by  this  author,    which   consists  in   arti- 
ficially producing   phlegmons   to  enhance  the 
happy   termination   of  the  infectious  diseases, 
such  as  puerperal  septi^mia,  pneumonia,  ery- 
sipelas, and  others. — Therapeutic  Oazette. 


Symptoms  of  Mental  Dissolution. 

At  the  meeting  of  the  Royal  Society  of  Lon- 
don, March  20,  Dr.  Savage  presented  a  paper 
upon  this  subject  with  the  following  preliminary 
remarks :  ''I  have  taken  as  the  basis  of  my  paper 
chiefly   my   experience  of  seventeen  years  at 


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Bethlem,  leaving  out  tabUs  of  all  patients  over 
«ixty,  these  tables  being  useful  only  as  general 
indicators  of  the  way  in  which  the  senile  disso- 
lution shows  itself  Natural  decay  follows  cer- 
tain lines,  but  these  differ  in  individuals 
Premature  decay  occurs  in  certain  diseases,  such 
as  general  paralysis  of  the  insane.  It  also  fol- 
lows certain  toxic  conditions,  such  as  those  due 
to  alcohol.  No  single  symptom  is  pathognom- 
onic of  mental  dissolution,  though  loss  of  memory 
is  the  most  common.  In  all  stages  of  dissolution 
there  is  loss  of  mental  power  which  may  be 
shown  in  different  ways  and  different  degrees; 
thei-e  may  be  loss  of  power  or  loss  of  self  control. 
Dissolution  is  early  shown  by  a  reduced  power 
of  acquisition,  next  by  a  reduction  of  the  power 
of  retention  of  recent  impressions,  next  by  defect 
of  coordination,  later  by  loss  of  CDntrol  and  of 
judgment  Dissolution  is  on  the  whole  the 
reverse  of  evolution,  but  does  not  follow  quite 
in  the  same  lines,  (Dr.  Savage  then  dealt  first 
with  dissolution  as  seen  in  general  paralysis  of 
the  insane,  next  with  disorders  of  control  of  a 
general  kind,  such  as  h}  steria,  epilepsy,  mania, 
melancholia  and  dementia,  taking  in  fact  the 
groups  of  symptoms  before  the  individual 
symptoms,  specially  noting  the  danger  of  impulse 
in  the  maniacal,  suicidal  and  melancholic  states.) 
Of  the  special  or  individual  symptoms  of  disso- 
lution, loss  of  recent  memory,  varying  much  in 
kind  and  degree,  is  the  most  important;  loss  of 
emotional  control  is  next  in  frequency,  and  is 
even  more  important  as  leading  to  sexual  faults. 
There  is  a  tendency  to  collect  objects  of  all  kinds 
which  may  depend  on  several  different  errors  of 
reason .  There  is  frequently  also  a  disregard  of 
cleanliness  which  is  difficult  to  understand. 
Judgment  may  remain  for  a  long  time  after 
memory  is  weakened  and  the  control  defective." 
— 3f€d.  Progress. 


pus,  but  before  undertaking  such  measures  we 
thought  it  best  to  examine  the  urine.  Next  day 
the  urine  was  examined.  Its  sp.  gr.  was  1035, 
and  it  was  loaded  with  sugar.  Thb  result  pre- 
vented us  undertaking  the  larger  operation,  and 
we  made  only  small  punctures  here  and  thereto 
let  out  the  pus,  and  filled  these  openings  with 
pure  carbolic  acid,  dry  antiseptic  dressing  being 
applied  and  changed  twice  a  day.  The  general 
mass  of  the  tumor  was  painted  with  liniment  of 
iodine  once  a  day.  Internally  we  gave  him 
quinine  and  iron.  The  day  after  the  incisions 
the  patient  b^an  to  make  steady  progress 
towards  recovery,  and  the  spread  of  the  swelling 
and  inflammation  were  arrested.  Recovery  was 
so  rapid  th.at  it  seemed  almost  an  impossibility 
in  the  case  of  a  diabetic  patient  After  a  week 
we  examined  his  urine  again  and  were  very 
much  surprised  to  notice  that  its  sp.  gr.  was 
si  008,  without  a  trace  of  sugar. 

As  far  as  we  could  ascertain  there  were  no 
symptoms  of  glycosuria  previous  to  the  onset  of 
the  carbuncle. 

This  case  is  remarkable  from  the  spontaneous 
disappearance  of  sugar  from  the  urine,  without 
any  apparent  treatment,  and  the  rapid  recovery 
of  the  patient  from  such  an  extensive  carbuncle. 
— Indian  Med.  Record. 


Huge   Carbuncle   with    Temporary    Glycosuria, 

Rapid  Recovery  Under  Carbolic  Crystals 

Treatment. 

BY  PUK80N  SINGH,  H.   A. 
In  Charge  Sholapur  Dispensary. 

Mr.  B.,  a  contractor,  aged  55,  admitted  on 
the  8th  January,  1893,  with  an  extensive  car- 
buncle situated  on  the  neck,  involving  the  whole 
occiput  and  reaching  down  to  the  third  dorsal 
vertebra.  The  whole  neck  was  involved  in  the 
swelling,  save  the  larynx.  The  carbuncle 
seemed  extending  rapidly  everyday,  and  it  had 
several  small  sinuses  on  its  surface.  There  was 
severe  pain  and  restlessness.  In  consultation 
with  Mr.  V.  R.  Kirloskar,  L.M.,  &  S.,  medical 
practitioner  at  Sholapur,  it  was  first  decided  to 
make  extensive  incisions  and  to  squeeze  out  the 


Pheneucalyptoi. 


J.  Roussel  (La  M^dedne  Hypodermique, 
August,  1892),  calls  attention  to  the  above  sub- 
stance as  the  best  combination  for  the  adminis- 
tration of  phenic  acid.  He  employs  pheneu- 
calyptoi with  good  results  in  the  treatment  of 
phthisis,  even  in  the  third  stage  of  the  disease. 
He  first  uses  in  these  patients  eucalyptol  by 
itself,  and  after  one  or  two  months  he  injects  the 
new  combination  for  a  period  of  two  weeks. 
When  adenitis,  arthritis  or  periositis  is  present, 
the  injections  are  applied  interstitially.  Phenic 
acid  or  pheneucalyptoi  is  injected  superficially 
and  often  in  solutions  of  the  strength  of  twenty 
per  cent  in  cases  of  anthrax,  pustules,  epitheli- 
omas and  tubercular  lupus.  These  injections  do 
not  produce  the  violent  effects  caused  by  Koch's 
tuberculin.  The  writer  recomm^^nds  the  follow- 
ing solutions:  1.  Eucalyptol,  10  ^>arts;  phenic 
acid,  10;  vegetable  oil,  100.  2.  Eucalyptol,  15 
parts;  phenic  acid,  15.  vegetable  oil,  100.  3. 
Eucalyptol,  20  parts;  phenic  acid,  20  parts; 
vegetable  oil,  100  The  injections  made  with 
solutions  containing  ten  and  twenty  per  cent,  of 
phenic  acid  are  painless,  and  produce  no  local 
effects.  The  dose  of  such  solutions  may  be  put 
down  as  cne  cubic  centimetre.' — IherapetUie 
Gazette. 


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'  The  Palmo-Plantar  Sign  in  Typhoid  Fever. 

Dr.  Filipovitch,  of  OdeesSy  Russia,  accord- 
ing to  the  St  Louis  Medical  and  Surgical 
Journal  has  demonstrated  that  one  of  the 
earliest  phenomena  observable  in  typhoid 
fever  is  '*a  peculiar  callous  look  and  an 
orange-yellow  or  saffron-yellow  hue  of  all 
the  prominent  parts  of  the  palms  of  the  hands 
and  the  soles  of  the  feet — parts  which,  as  is  well 
known,  are  more  or  less  rosy  in  health  and  be- 
come bluish  in  cases  of  cyanosis.  The  phenom- 
enon is  explained  in  the  enfeebled  action  of  the 
heart,  a  diminished  amount  of  blood  in  the 
capillaries,  and  the  dryness  of  the  skin.  The 
sign  difuippears  as  soon  as  convalescence  begins. 
The  sign  is  however  an  expression  of  certain 
states  of  hepatic  exhaustion  rather  than  simply 
typhoid  fever." 

It  is  our  opinion  that  this  may  be  observed  in 
many  other  low  febrile  states. 


Danger  in  Breathing  Bronze  Dutt 

The  bronze  dust  used  by  printers  is  composed 
principally  of  copper  and  zinc.  When  brought 
mto  contact  with  the  mucus  of  the  nose  by  the 
process  of  respiration  they  are  converted  into 
the  corrosive  and  irritant  chlorides  of  the  metals, 
causing  serious  inflammation  of  the  membranes. 


Cramps  of  the  Legs  in  Pregnant  Women. 

Administer  at  bed  time  five  milligrammes  of 
sulphate  of  copper.  This  can  be  administered 
every  night  without  inconvenience. — La  Oazette 
Medioale — Amer.  Oynec,  Jour. 


ECZEMA. 

Lanara  claims  good  results  in  thirty  cases  of 
eczema  (twenty  chronic  and  six  acute),  from 
painting  the  affected  surface  twice  daily  with  a 
mixture  composed  of 

B   AlcboHo  extiact  of  flllx  mat. drams  vii« 

AloohoL ounces  m 

Szfcnct  of  myrrh 

Pure  extract  of  opinm .aa dramij 

H.  Siff.— flbake  ylgorously  before  oi ing.  Once  a  dav:  before 
aiyplytag  the  aboTe  mixture,  the  lurfkce  is  washed  with  green 
toap  and  the  crusts  removed. 

— La  Revue  Medicate — Med,  Bulletin. 


Sulphate  of  Sodium  (Glauber  salts)  is  the 
best  chemical  antidote  to  be  given  in  case  of 
carbolic  add  poisoning.  Sulpho-carbolate  of 
sodium  is  formed. 


Bichromate  of  Potassium  as  an  Expectorant. 

"  It  was  during  the  winter  of  1875  that  I  was 
in  attendance  upon  a  child  two  years  of  age, 
who  was  ill  with  bronchitis.  Though  seventeen 
years  have  elapsed  I  well  remember  the  child 
as  it  lay  then,  breathing  at  the  rate  of  90  respir 
ations  per  minute,  pulse  too  rapid  and  feeble 
for  me  to  count  it,  countenance  cyanosed,  veins 
of  forehead  and  neck  prominent  and  turgid, 
and  a  cool  moisture  covering  the  little  sufferer's 
body.  The  child  was  8uff>cating  and  seemed 
to  me  to  be  dying.  I  called  for  consultation, 
and  my  friend  Dr.  Alexander  Hutchins,  re- 
sponded. He  produced  from  his  pocket  a  pow- 
der, telling  me  that  it  contained  1  grain  of  the 
bichromate  of  potassium,  triturated  with  9' 
grains  of  sugar  of  milk,  directing  me  to  place  ik 
n  a  tumbler  with  20  teaspoonfuls  of  water,  and 
give  of  the  solution  a  teaspoonful  to  the  child 
every  ten  minutes  till  the  symptoms  were  mod< 
ified.  That  was  in  the  evening,  and  in  less 
than  two  hours  the  symptoms  of  suffocation  were- 
so  much  relieved  that  I  was  able  t  j  leave  the 
child  for  the  night  with  directions  that  the^ 
medication  should  be  kept  up  at  one  hour  inter- 
vals. The  change  in  the  condition  of  the  child 
when  I  visited  it  the  next  morning  was  surpris- 
ing. The  respirations  had  dropped  to  less  tha» 
40 ;  the  child  had  been  able  to  sleep  and  take 
some  nourishment;  the  cough,  which  before 
was  dry  and  barking,  had  become  looser,  and 
the  lung,  which  the  night  before  hardly 
admitted  any  air,  was  now  filled  with  loose 
moist  bronchial  rales.  The  aspect  of  the  case 
was  changed  from  that  of  a  child  evidently 
dying  from  what  we  than  called  capillary 
bronchitis  to  a  plain  case  of  bronchitis,  which 
went  on  to  success^l  recovery.'* 


A  habit  which  will  contribute  very  much  to 
long  life  and  immunity  from  disease  is  that  of 
thoroughly  toasting  the  feet  before  a  hot  fire 
for  a  half-hour  or  so  each  night  before  gomg  to 
bed.  If  to  this  be  added  that  of  nightly  rub- 
bing the  skin  with  a  harsh  towel,  the  protection 
will  be  still  more  complete. 


Editor  Medical  World:— Having  been  a  constant 
reader  of  The  World  for  two  years,  1  find  it  a  source 
of  much  valuable  information  which  is  not  obtainable 
elsewhere.  1  would  as  soon  think  of  being  without 
my  complete  medical  lihrarv  altogether  as  Mnr  with- 
out the  *Thysiclan's  Friend,"  Thb  Mkdical  World. 
I  keep  every  nnmher  on  file  for  fumre  reference,  and 
find  them  indispensable,  any  physician  who  does  not 
read  The  World  surely  cannot  appreciate  the  assis- 
tance of  a  high  grade  publication. 

Boston,  Mass.  Wm.  A.  Hale,  M.D. 


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THE  MEDICAL  WORLD. 


Formulas. 


Pneumonia. 
Dr.  Arnot  Spence  prescribes  : 

R.    Tr.  aoonid '. , •  ^  xxtv 

Tr.  oplt  camphoratre fdrauia  ij 

Liq.  ammonil  acetatls. 

Syr.  zingiberia aa  foz*8 

Aquae Q-  •»•  *" f  <>*  ^J 

M.    Big.— Half-ounce  every  two  hours. 

— InterticUional  Medical  Magazine, 


Bronohitis  of  the  Aged. 
Dr.  Maragliano  praises : 

R,    Benaoic  acid gr.  v 

Tannic  acid gr.  iiss 

M.— Fur  oue  Ubiet.    Take  4  or  6  Ubleta  during  the  day. 

—El  Siglo  Medico.     The  Med.  Bulletin. 

Asthma. 

Liegeois  advises  the  use  of : 

R.    Iodide  of  potassiuiD drams  as 

(Jhlorlde  of  potassium drains  J 

Water .fosir 

M.   Big.— Teaspoonful  every  hour  during  an  atlack,  or  a 
de9«ertspooniul  every  two  hours. 

The  iodide  and  chloride  of  potassium  are  not 

incompatible,  and  can  be  given  simultaneously. 

—El  Siglo  Medico.     lb. 


M. 


Biliary  Calouii. 

Benzoate  of  sodium; 
Salicylate  of  sodium, 

Powdered  rhubarb aa  drams  iiss 

Powdered  uux  vomica gr.  iij 

Make  Into  20  powders.    One  powder  at  each  meal. 

— La  Riforma  Medico.     lb. 


M. 
night. 


Pigmentation  of  Pregnanoy. 

zinc.  ozid.pur gr.  Iv 

Hydrarg.  ox.  flay..- ,-gr  xvj 

OL  ricin., 

01.  theobrom aaoz  illss 

Otto  rosse gtL  x 

Big.— Use  twice  daily,  and  allow  some  to  remain  on  at 

— British  Journal  of  Dermatology. 


Chlorotio  Dyspepsia* 

R.    Protoxalate  of  iron gr.  viij 

Calcined  magnesia gr.  xv 

Carbonate oicaloium gr  vilj 

M.    8U.— Make  into  10  cachets.    One  to  be  laken  before 
each  meaU 

— Le  Progres  Med. 


Cancer  of  the  Stomach. 

R.    White  oondurango-Toot drams  iiss 

Boiled  and  distillt^  water Oss 

Macerate  for  twelve  hours  and  add  : 

Chlor  te  of  sodium „ oz  s^ 

Syrup  of  quinine foziss. 

M.     Slg.— Tablespoonf ul  from  one  to  four  times  a  day. 

--Ibid. 


An  Agreeable  Salicylic  Mixture. 

R.    Potassll  acetatis ounces  ii 

Acidi  salloyll *•     ss 

Syrupl  llmonis ••     li 

Aqn»  nenthae  piperita "  vlii 

Big  —Oue  tablespoonftil  every  three  hours. 


To  Prevent  Cracked  Nipples. 

Dr.  Virginia  M.  Davis,  of  New  York,  is  ao- 
cu&tomed  to  apply  lanolin  with  the  onset  of  labor 
four  times  daily  till  lactation  is  established. 
The  nipples  are  then  after  each  nursing,  anoint- 
ed with  the  following : 

R.    Tr.  Benzoin  oomp gtt  xv 

01.  olivtt f  drams  I| 

L •nolin drams  vj 

M.  ft.  ungt. 

— Prescription. 


A  Chalybeate  Lemonade. 

R    Tind.  ferri  perchloride drams  Iv 

Aoidi  phoBphorici  dLuti "    iv 

TinctUmonis  'Mi 

Byrupus  simpUcts ad «« "  vi 

Big.— Two  teaspooufuls  of  the  syrup  in  a  smaU  tumblerful 
of  w&ter  alter  meals. 

— Epitome. 


Voice  Lozenge. 

A  physician  recommends  as  the  best  voioe- 
lozenge  to  counteract  the  ordinary  hoarseness  of 
singers  and  orators  one  composed  according  to 
the  following  formula : 

R.    Cubeba 1-2  gr. 

Benzoic  aoid l-Sgr. 

Hydrochl*.  of  cocaine 1.70  gr. 

Pulv.  tragacanth ....1  4gr. 

Extr.  of  Uquorice 6  gr*. 

Bngar 18grs. 

Encalyptol 1-4  mtnim 

Oil  of  anise 1.20  minims 

Black  currant  paste  enough  to  make 20  grs. 

A  small  Piece  of  the  lozenge  is  to  be  allowed  to  dissolve  in 
the  mouth  Just  before  using  the  voice  for  singing  or  reciting. 


Tuberculosis. 

Prof.  Potain  {Revue  Medico- PharmaeeuHgue 
de  Constantinople,  No.  7,  1893.)  presctibeo,  in 
tuberculosis  the  following  formula  : 

R.    Chloride  of  sodium gms.  10,  (drs.  IJcs) 

Bromide  of  sodium gms  5,  (drs.  )H) 

Iodide  of  sodium ftm^.  10,  (drs.  ijss) 

Dis'iUed  waier gmn.  lOn  (drs.  i\]st) 

A  tea^poonftil  every  morning  in  a  cup  of  milk. 

— Lancet  Clinic. 


Ulcer  of  the  Stomach. 

Dr.  Stepp  (La  Semains  Medicale,  No.  61, 
1893)  recommends  the  following  formula  in  gas- 
tric ulcer. 

B.    Chloroform gm.  1  (grs.  xv) 

Subnitrate  of  bismuth gms.  8  (grs.  xlv) 

Water gma  15>(oz8ivss) 

A  soup)  oonfUl  every  hour  or  twoj   Shake  well  before 
using. 

— Lancet  Clinic 


A  Deodorizer  of  Iodoform. 

In  the  Norsk  Magatdn  for  LcRgevidemkahen^ 
No.  3,  1893,  the  following  formula  is  given  as 
a  deodorizer  of  iodoform  : 

R.    Iodoform gms.  197,  (ozs.  vj) 

Carbolic  add gm  1.  (gtti.  xv) 

Peppermint  oU gma  2.  (gtis,  xxx) 

—Ih. 


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31 


For  Removing  Wartt. 

R.  Acid  lalicylt gT%  xxx 

Ungt  axmm  roNB .aramsn 

M.  Slg.— Applv  twice  daily  for  two  days,  after  whldi  the 
i^rowths  oeiug  softened,  they  should  be  remoTed  by  a  dermal 
ctiTHtte.  and  bv  using  tbese  means  you  can  safely  say  that  the 
vrurt  will  not  return. 

— Dr,  J,  Abbott  Cantrell, 


Treatment  of  Pleurisy. 

The  following  is  recommended  : 

R.  Qualaool  jmre „.^ „ dram  1 

Tincture  of  Iodine ^ "  vlj 

Paint  the  whole  of  this  liquid  each  evening  on  the  afftcted 
side.  Tbe  temperature  quickly  fals,  an  abundant  perspirar 
don  takes  place,  and  the  effasion  soon  becomes  absorbed. 

— Afed,  Press  and  Oiraular. 


Reynolds'  Gout  Speoiflc. 

A  formula  said  to  produce  a  similar  prepara- 
tion adopted  from  Dor^ault  was  printed  in  the 
Druggists'  Circular  for  March  1883,  page  40. 
Dorvault's  formula  is  as  follows : 

WINE  OF   OOIXMICUM   (REYNOLDS). 

».    Sherry ftOO  grams 

Colohioum  root 250     •* 

Bum 80     " 

Poppy  flowen,  sufficient  to  color. 

Hager  speaks  of  it  as  wine  of  colchicum,  and 
others  have  claimed  that  it  is  identical  with  wine 
•of  colchicum,  B.  P.,  which  is  made  by  macera- 
tion using  four  ounces  of  the  root  io  a  pint  of  the 
i&nished  wine. 


Typhoid  Fever. 

R.    Sncalyptol  (Sander  A  Sons*) dr.  iil. 

Oum  arable oz.  m 

Agus  q.  s.  ad.  flat  emulsio »oz.  iv. 

Syrup  or  glyoerini  ad.  libitum 
SI<r.     Outt  teaapoonAil  every  two  to  four  hours  according  to 
urgency. 

Also  apply  eucalyptol  (Sander  &  Sons') 
thirty  to  forty  drops  on  hot  flannel  over  the 
abdomen.  This  treatment  has  proved  far  su- 
perior to  the  old  method  of  applying  turpentine, 
as  the  benefit  derived  from  the  anodyne  and  an- 
tiseptic qualities  of  eucalyptol  by  far  surpasses 
the  advantage  of  the  counter-irritant  action  of 
the  turpentine. 


Big  Q 

A  correspondent  has  furnished  the  following 
formula,  which  he  says  yields  a  preparation  al- 
most identical  with  <*Big  G."  in  appearance  and 
effect: 

Berberlne  hyd'ooh^orate 1  gram. 

Zinc  acetate 1  gmm. 

Glcerin 15  c  c 

Water,  to  make 210  c.  c. 

— Druggists*  Circular, 


IMayer's  Ointment. 

A.  T.,  Colorado,  Icindly  suggests  that  by 
Meyer^s  ointment  mquired  about  by  R  H.  W., 
Mayer's  ointment  is  probably  meant,  and  refers 


to  a  formula  for  the  latter  given  in  King's 

American  Dispensatory,  which  is  as  follows  : 

Olive  oil 2Klbs. 

White  tur.  entine X  lb. 

Beeswax 4  ozs. 

Unsalted  butter 4  ozs. 

Red  lead 1  lb. 

Honey 12  ozs. 

Powdered  camphor J4  lb. 

Melt  the  oil,  turpentine,  war  and  butter  to- 
gether and  strain  ;  then  heat  the  mixture  nearly 
to  the  boiling  point,  and  gradually  add  the  red 
lead,  stirring  the  mixture  constantly  until  it  be- 
comes black  or  brown,  then  remove  from  the 
fire  and  when  it  becomes  somewhat  cool,  add 
the  honey  and  camphor  previously  mixed  to- 
gether. 

This  gives  a  product  nearly  identical  with 
the  motherV  ointment  and  mothers'  plaster  lately 
mentioned  in  these  pages. — Ib. 

Curls  Without  Papers. 

R.  **otaa8a  Carb « 2  fl  drs. 

Aqua  Ammonia....... 2  fl  dr. 

8pt.Vin.  Rect, 12fl  dis. 

Aqua.  Rosae^q.  s *. I8fl  oas. 

Big.    Moisten  hair,  adjust  loosely.    It  curls  upon  drying. 

FOR  KKEPIMO  UAIB  IN  CURL. 

R.    Borax 2oxs. 

Gum  Acacia , lor. 

Hot  water « „12floz«. 

When  cool  add  twelve  fluid  drachms  of  spirit  camphor.  Wet 
the  hair  with  above  and  roll  on  papers  as  usuaL  Let  dry,  and 
unroU  and  form  inio  ringlets. 

Meyer  Bros\  Druggist, 

Reviews. 

Do  not  fail  to  see  notice  of  redaction  in  price  of  the 
venerable  Philadelphia  Medical  and  Surgical  Bepcrier^ 
jnst  below  contents  on  page  xix.  World  and  Report 
ter  together  for  1894  only  $3.25 ;  formerij  $6.  8end 
order  to  either  office. 

As  a  rule,  reprints  mentioned  in  these  colamns  are 
offered  to  be  sent  iree,  unless  a  price  is  suted,  upon 
application  to  the  author,  mentioning  The  Medical 
World. 

Ststem  of  Diseases  of  the  Ear,  Nose  and  Throat. 
By  Charles  H.  Burnett,  M  D.,   Vol.  II.    Com- 
plete  in    two  volumes.    Price,  cloth,   $6  00  per 
vol.    J.  B.  Lippinoott  Co.,  Philadelphia,  Pa. 
This  is,  as  we  stated  in  our  notice  of  the  first  volume 
in  oar  last  June  issue,  a  complete  system  hy  authors 
eminent  in  the  different  specalties.    Anv  one  wishing 
to  practice  intelligently  the  treatment  of  diseases  of 
these  regions  must  have  a  comprehensive  work  of  this 
kind. 

A  Theory  op  Development  and  Hpredity.    By 
Prof.  Henry  B.  Orr,  Ph.  D.,  of  Tulane  University, 
14 ew  Orleans,  La.    Cloth,  255  pages,  $1.50.  Mac- 
miilan  &  Co.,  New  York. 
The  learned  author  has  given  us  a  work  of  extended 
research  and  profound  reaiH>ning  which  the  physicians 
interested  in  the  science  of  life  will  find  of  exceeding 
interest  and  value.    The  activity  of  investigation  into 
this  subject,  of  ijuch  great  importance  to  us  as  students  of 
the  physical  history  of  the  race,  has  been  steadily  in- 
creasing of  late      It  •«  wiiK  plAOfiiirA  that  we  commend 
this  scholarly  work  to  our  readers. 
Interna TTOTff AT    rii.TvrnR,     SaHpo  8.  vol.  S.     Price 
$2.75.     J.  15.  Liippincott  Co.,  Pbiia. 
This  is  a  series  of  the  best  clinical  lectures  by  emi- 


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THB  MEDICAL  WORLD. 


nent  ftpecialists  in  the  various  departments  of  mediclDe 
and  sargery.  To  the  physician  who  is  too  busy  to 
take  a  trip  to  the  great  medical  centers  annually,  these 
lectures  will  serve  the  purpose  of  keeping  him  in  line 
with  the  progress  of  the  profession. 

The  full  number  of  words  and  terms  in  the  various 
dictionaries  is  as  follows :  Stormonth,  60,000;  Worcentei', 
106,000;  Webster  (International),  125,000,  Cenlvry {sit 
volumes,  complete),  226,000;  Standard^  published  by 
Funk  &  WagnalFs,  New  York,  280,000. 

Alcoholtsm  and  its  Treatment.  By  J.  K  Usher, 
M.D.  Cloth,  151  pages,  $1.25.  G.  P.  Putnam's 
Sons,  New  York. 

This  is  a  thoroughly  scientific  consideration  of  this 
disease  and  its  modern  treatment.  Any  practicing 
physician  of  ordinary  ability,  by  following  out  its  plain 
and  easy  teachings,  can  treat  his  cases  at  home  and 
thus  save  the  enormous  expense  to  his  patients  attend- 
ed upon  a  "course"  on  a  so-called  '•institute.'  The 
following  is  an  outline  of  it^  contents  . 

Pathological  changes  in  alcoholism,  (two  chapters); 
Inherited,  Acquired  and  Infantile  forms  of  alcoholism; 
Insanity  and  Alcoholism;  Alcoholic  trance  and  crime; 
L^al  relations :  Treatment  (three  chapters);  Adver- 
tise nostrums  (formulas  given). 

The  French  Doctobs'  Book.    Published  by  Wm. 

VanBergen,  89  Court  St.,   Boston,  Mass.    Price 

$2.00. 

This  is  a  book  of  1200  favorite  prescriptions  selected 

from  the  practice  of  eminent  French  and  other  foreign 

physicians 

The  Treatment  op  Cutaneous  Malignant  Epi- 
THELIOMATA.    Bj  A.  R.  Robinson,  M.D.,  L.  R. 
C.  P.  -t  S.  (Edin).    Qoth,  68  pages,  $1.00.    In- 
ternational Journal  of  Surgery  Co.,  14  Piatt  St., 
New  York.  N.  Y. 
In  this  little  book  a  pretty  full  consideration  of  the 
pathology  of  cancer  is  given,  followed  bv  what  the  au- 
thor recommends  as  a  generallv  desirable  treatment  by 
the  various  caustic  agents.    1? hese  are  treated  of  in 
detail,  appropriate  formulas  being  given. 

Exercise  por  Pulmonary  Invalids.    By  Charles 
A.  Dennison,  A.M.,  M.D.     Price  35  cents.  Chain 
h  Hardy,  1609  Arapahoe  St,  Denver,  Col. 
This  is  an  excellent  little  work  showing  in  detail 

the  extreme  value  of  pulmonary  exercise. 

How  TO  Judge  a  Horse.  By  Optain  F.  W.  Bach, 
12mo  cloth,  fully  illustrated,  $1.00.  New  York, 
W.  R.  Jenkins. 

Everybody  loves  a  horse  Everybody  ought  to  study 
its  conformation.  Every  purchaser  knows  by  experi- 
ence how  difScult  it  is  to  arrive  at  correct  conclusions 
as  to  its  soundness  and  qualities. 

Unlike  manv  valuable  books  on  the  exterior  of  the 
horse,  this  little  treatise  has  the  advantage  of  srreat 
concisf  ness  in  pointing  out,  in  few  pagep,  the  most  im- 
portant guiding  points  for  the  judgin^r,  and  some  points 
on  methods  of  training  young  or  obstinate  horses  are 
added,  as  it  may  become  necessary  for  the  owner  to 
break-in  his  young  stock  himself  or  correct  those 
having  formed  bad  or  dangerous  habits,  especially  if 
living  in  the  country  with  nobody  near  capable  of 
handling  young  or  obstinate  horses. 

A  few  remarks,  concerning  how  to  handle  the  reins 
properly  in  driving,  may  be  of  interest  to  some  of  the 
readers.  Also  bits  and  bittibg,  saddles  and  saddling, 
and  stable  drainage  are  considered 

All  horse  owners  or  persons  intending  to  purchase  a 
horse  should  read  this  work. 


RE(iISTER  OF  THE  NeW  YoRK  CoUNTY  MeDICAL  AS- 
SOCIATION, p.  B.  Porter,  Sec,  8  W.  85th  St., 
New  York,  N.  Y.  % 

The  CONNBcncuT  State  Medical  Directory.  Pub- 
lished by  the  Danbury  Medical  Printing  Co., 
Danbury,  Conn. 

The  Era  Key  to  the  U.  S.  P.,  1898.  A  vest  pocket 
manual,  price  25  cents.  D.  O.  Haynes  &  Co.,  De- 
troit, Mich. 

The  Physician's  Visiting  List.    Price  $1.00.    P. 
Blakiston,  Son  &  Co.,  1012  Walnut  St.,  Phila. 
This  is  an  old  favorite,  whose  excellent  qualiiie**  are 
kept  up  to  the  standard. 

We  take  unusual  pleasure  in  announcinsr  the  ap- 
proaching appearance  of  a  new  illustrated  Dictionary 
of  Medicine  and  Collateral  Sciences,  by  P.  Blakiston, 
Son  &  Co ,  Phila.  )Ve  have  examined  the  advance 
sheets  and  are  able  to  pronounce  it  most  excellent. 

Sciatic  Neuritis,  its  Pathology  and  Treatment. 

By     Robert      Simpson,      LR.CP.,      L.R.C.S. 

Price  one  shilling.     John  Wright  &  Co.,  Stone 

Bridge,  Bristol,  England. 
This  is  a  handsome  little  work  of  convenient  pocket 
size,  giving  what  we  believe  to  be  the  only  rational  and 
successful  treatment  for  the  obstinate  disease,  sciatica 
— that  of  electrical  and  mechanical  stimulation  of  the 
nutrition  of  the  parts. 

"What  IS  Phrenology  ?"  and  "Amateur  Phen- 
ologists.*'  Price  10  cents  each.  Fowler  & 
Wells  Co.,  27  East  21st  St..  New  York. 

Mechanical  Aids  in  the  Treatment  of  Chronic 
Forms  op  Disease.    By  George  H.  Taylor,  M.D. 
Paper,  109  pages,  published  by  Gerge  \V.  Rogers, 
New  York,  N.  Y.     Price  60  cents. 
This  book  is  one  of  those  that  give  far  more  than 
•  the  trifling  cost  price  back  to  the  doctor  in  the  shape 
of  practical  ideas  in  using  natural  forces  in  the  treat- 
ment of  disease. 

Outlines  op  Obstetrics.    By  Charles  Jewett,  A.  M., 
M.D.    Cloth,  264  pages,  $2.00.    W.  B.  Saunders, 
925  Walnut  St.,  Phila.,  Pa. 
This  boek  is  a  syllabus  of  lectures  delivered  at  the 
Long  Island  College  Hospital.    It  is  useful  as  an  out- 
line of  the  subject,  well  classified. 

£2s8BNtial8  op  Minor  Surgery,  Bandaging  and 

VenereXl  Diseases.    By  Edward  Martin,  M.D. 

Cloth  $1.00.    W.  B.  Saunders,  Phila. 

This  is  a  students'  quiz  manual.    The  illustrations 

are  many  of  them  from  The  American  Text  book  of 

Surgery. 

How  the  Other  Half  Lives.    By  Jacob  A.  Riis. 

304  pages,  $1.00.     Charles  Scribner's  Sons,  New 

York. 
This  is  a  book  which  touches  the  heart  of  every  lover 
of  hum  uiity.  It  deals  with  the  life  and  lot  of  the  pov- 
erty-stricken in  our  densely  populated  communities. 
It  shows  th6  base  corruption  and  the  miHerable  failure 
(in  all  that  constitutes  true,  honest  public  service)  of 
Republican  and  Democratic  politics.  It  demonstrates 
the  necessity  of  controlling  and  finally  entirely  wiping 
out  the  abominable  rum  power.  It  suggests  the  neces- 
sity of  modifying  our  immigration  laws  and  guarding 
our  franchise  so  that  none  but  the  better  elements  of 
European  population  could  gain  citizenship  and  politi- 
cal power  among  us.  A  careful  perusal  of  its  pages 
should  suggest  to  the  reader  the  proper  scope  of  aU 
true,  consistent  missionary  work — that  we  should  first 


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33 


cast  the  "logs"  ofsqiiarK!  mU'ry,  vi'»e  and  crime  from 
.the  eyea  of  oar  o^n  body  politic  before  presuming  to 
send  emissaries  to  other  countries  to  try  to  plack  the 
infiiiite.«iimal  mote  of  possible  theological  error  from 
the  eyes  of  their  contented  inhabitants.  The  illustra- 
tions are  from  photographs  taken  from  real  scenes  and 
actual  life  by  tne  author. 

Aii>STO  FamflyGovervmekt,  or  FbomthbCJradle 

TO  THE  ^^HOOL,   ACCORDING    TO   FrOEBEL.     By 

Bertha  Meyer.    Translated  from  the  German  by 
M.  L.  Holbrook,  M.D.    Paper,  pages  201     Pub- 
lished  by  the  translator,  46   East  21st  St.,  New 
York. 
This  book  is  a  sensible  adaptation  of  the  principles 
and  idea<  of  the  kindertcarten  to  the  home-life.  Every 
iather  and  mother  in  the  land  should  read  it  and  con- 
salt  it  daily.     No  idea  of  its  true  worth  cau  be  given 
in  a  brief  notice.     The  price  is  a  mere  bagatele  com- 
pared to  its  value. 

Eating  rm  Strength  or  Food  in  Relation  to 
Health  and  Work.     By  M.  L.  Holbrook,  M.D. 
Cloth,  246  pa((e4,  piice$l'00.    Published  by  the 
author,  New  York. 
We  have  examined  this  book  with  great  care  and 
consider  it  a  valuable  presentation  of  this  important 
subject,  useful  to  physicians,  nurses,  managers  of  in- 
stitutions, teachers,  parents,  cooks  and  every  individual 
who  wishes  to  wisely  regulate  his  own  nutritions. 

The   Child,   Physically   and   Mentally.     By 

Bertha  Meyer,  translated  from  the  German  by 

Frederick  Salomon.  Paper,  pages  165,  price  50  cts. 

Published  by  M.  L.  Holbrook  Co.,  46  East  21st 

St,  New  York. 

This  little  book  is  the  advice  of  a  mother,  according 

to  the  teachings  and  experience  of  hygienic  science, 

and  is  useful  as  a  guide  for  mothers  and  educators. 

How  to  Strengthen  the  Memory;  or  the  Art  op 
Never  Forgetting.  By  M.  L.  Holbrook,  M.D. 
Cloth,  161  pages,  price  $1.00.  Published  by  the 
author,  46  East  21st  St.,  New  York. 
So  great  is  the  desire  to  have  our  knowledge  easily 
at  our  command  that  there  is  as  eager  a  search  for 
means  to  acquire  a  prodigious  memory  as  there  is  for 
the  mythical  philosopher  a  stone.  Almost  every  new 
avenue  for  sach  a  search  proves  to  be  a  disappoint- 
ment. This  is  mainly  because  we  expect  too  much. 
There  is  no  such  thing  as  a  magical  method  by  which 
we  may  rapidly  acquire  and  surely  retain  knowledge 
to  a  marvelous  extent.  This  little  book  gives  sensible, 
intelligent  directions  for  training,  cultivating  and 
strengthening  the  memory  by  systematic  and^  suitable 
exercise.  By  a  careful  study  and  practice  of  its  teach- 
ings every  day  for  a  few  months  we  feel  sure  that  the 
memory  may  be  very  much  improved.  This  is  quite 
worth  the  effort  required  and  ought  to  satisfy  any 
seeker.  The  book  exposes  the  absurdities  of  most  of  the 
machine  methods  of  mnemonics.  We  hope  that  some 
time  in  the  future  the  ideal  work  on  this  subject  will 
be  written  and  adopted  in  our  school  system. 

The  Religion  op  Science  Library.  In  order  to 
place  our  publications  within  reach  of  persons  of 
limited  means  and  to  obtain  thereby  a  wider  cir- 
c«ilation  for  the  same,  it  is  proposed  to  issue,  com- 
mencing in  June,  the  following  list  of  works  in 
paper  covers  under  the  general  heading,  **The 
Religion  of  Science  Library."  The  books  will  be 
issued  bi-monthly  as  second  class  matter,  and  will 
be  printed  from  large  type  on  good  paper,  and 
well  bound.    The  stuwcriptioa  price  will  be  f  1.50 


a  year,  postpaid  in  the  United  States,  Canada  and 
Mexico ;  75  cents  for  six  months,  and  25  cents  fur 
single  numbers. 
The  "library**  will  contain  among  others:  "The 
Religion  of  Science,"  by  Paul  Carus,  Ph.  D.  **Three 
Introductory  Lectunes  on  the  Science  of  Thought,"  by 
Prof.  F.  Max  Muller.  **Three  Lectures  on  the  Scienci 
of  Language,"  by  Prof.  F.  Max  Muller.  "The  Psy- 
chology of  Attention,"  by  Th.  Ribot  "The  Lo-rt 
Manuscript,"  a  novel,  double  number,  by  Gustav 
Freytag.  "The  Psychic  Life  of  Micro-Organisms,  by 
Alfred  Binet.  "Fundamental  Problems,  by  Paul 
Cares,  Ph.  D.  "On  Double  Consciousness,"  by  Alfred 
Binet.  "The  Diseases  of  Personality,"  by  Th.  Ribot 
"The  Ethical  Problem,"  by  Paul  Carus  Ph.  D.  "Epi- 
tomes of  Three  Sciences,'*  Prof.  H.  Oldenberg,  Prof. 
Joseph  Jastrow,  Prof.  C  H.  Cornill.  "Homilies  of 
Science,**  by  Paul  Carus,  Ph.  D.  The  Open  Court 
Publishing  Co.,  824  Dearborn  St.,  Chicago. 

[We  have  read  the  first  and  second  number  of  this 
series  and  find  them  to  be  very  valuaole  books  for 
thoughtful  students  of  science  in  its  higher  aspects. — 
Ed.] 

"The  Religions  op  the  World.'* 

This  is  a  neat  pamphlet  giving  a  number  of 
the  choicest  essays  r^  at  the  recent  Parlia- 
ment of  Religions  at  Chicago,  with  a  valuable 
introduction  by  D  wight  Baldwin.  It  is  '^he 
world*B  g^reatest  religions  clearly  defined  by  their 
greatest  living  exponents.**  Published  bv  the  Latin 
Historical  Society,  Owincs  Building,  Chicago,  price, 
25  cents.  It  is  worth  many  times  its  price  to  one  not 
possessing  a  fuller  report  of  that  important  gathering, 
or  to  one  not  having  time  to  read  a  tuller  report. 

Hie  Medical  Quarterly  is  the  title  of  a  journal  to  ap- 
pear soon,  with  Dr.  Joseph  M.  Matthews  as  editor  and 
Dr.  Henry  E.  Tuley  as  business  manager,  box  434 
Louisville,  Ky.  The  journal  will  be  devoted  to  gastro- 
intestinal and  rectal  surgery  and  diseases. 

The  Paeifie  Medical  Record,  Portland,  Oregon,  has 
changed  its  name  to  the  Medical  Sentinel  It  m  edited 
and  published  by  the  same  parties,  and  is  well  con- 
ducted. 

The  Tri-State  Medical  Journal,  Keokuk,  Iowa. 
Monihly,  $1.00  per  year. 
This  is  a  new  medical  journal  that  has  the  courage 
to  face  a  cold  world  in  these  troublesome  times.  It  is 
a  well-prepared  journal  and  we  wish  it  success.  Two 
articles  especially  deserving  of  notice  in  the  first  niim 
ber  are  ''Appropriations  of  Condemned  Criminals  to 
to  the  Experimental  Physiologist"  and  "The  Country 
Doctor.** 

Littell's  Living  Age  for  1894. — Lovers  of  choice 
literature  will  feel  themselves  repaid  for  a  subscription 
to  this  rare  and  valuable  old  periodical.  Closing  its 
fiftieth  year,  and  entering  upcn  its  200th  volume,  it 
was  never  better  than  now,  and  it  enters  the  new  year 
with  renewed  vigor  and  vim. 

Elaborate  reviews  of  recent  publications;  the  latest 
results  of  scientific  research  ;  biographical  nketches  of 
eminent  characters ;  travel  exploration,  literary  criti- 
cism and  every  phase  of  culture*  and  progress  in  the 
European  world  ;  with  fiction  and  choice  poetry  ,  all 
these  make  up  The  Living  Age 

This  magazine  at  $8  00  a  year  is  cheap.  Sample 
copies  with  descriptive  and  club  circulars  may  be  ob- 
tained by  sending  15  cents  to  Littell  <&  Co.,  Boston, 
Mass. 

We  are  pleased  to  note  that  the  Christian  Staridard, 
921  Arch  St,.  Phila,  has  announced  its  intention  not 


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34 


THE  MBDICAX  WORLD. 


to  accept  of  any  patent  medicine  advertisement 
or  any  medical  advertisement  whatever,  hereafter. 
Acting  upon  this  rule  they  have  already  returned 
a  number  of  profitable  contracts  offered  them  for 
various  medical  preparations. 

The  Funny-Bone.    Price   50    cents.    The  Funny- 
Bone  Publishing  Co  ,  1421  Market  St.,  St.  Louis, 
Mo. 
Thb  is  a  collection  of  a  lot  of  the  funniest  jokes  and 
illustrations  (original  and  selected)  that  we  have  ever 
seen.     It  is  fully  worth  its  price  to  place  on  your  of- 
fice table  to  draw  patients  to  your  office. 

For  any  of  the  following;  reprints  and  pamphlets 
send  to  the  respective  addresses  given. 

A  Study  of  the  III  Effects  of  Tobacco  on  the 

Nose  and  Throat.    By  William  T.  Gathell,  M. 

D.,  Baltimore,  Md. 

This  is  a  pamphlet  which  every  physician  should 

read,  as  the  entirely  unnecessary  use  of  tobacco  should 

be  thoroughly  understood  by  the  profession. 

^  A  NOVEL  proposition,  revolutionizing  the  distribu- 
tion of  wealth.  Freight  transported  nt  a  uniform  rate 
for  all  distances.  Send  to  David  Lubin,  Sacramento, 
Cal. 

Results  op  Aseptic  Celiotomy.  By  W.  H.  Wathen, 
M.D.,  Louisville,  Ky. 

Transactions  Med.  Practitioners'  Protectivb 
Alliance.  W.  V.  WU«on,  M.D.,  Pres.,  West 
Haven,  Conn. 

A  Convenient  I'rism  Scale.  By  S.  Lewis  Zieffler, 
M.p.,  1504  Walnut  St,  Phila. 
Thb  is  a  vast  improvement  over  any  scale  now  in 
use.  Our  long  acquaintance  with  the  talented  author 
of  this  paper  has  ffiven  us  the  highest  confidence  in 
his  ability  and  judgment.  The  physician  who  is  at  all 
interested  in  the  treatment  of  the  eye  should  request 
this  valuable  reprint. 

Manual  of  U  S.  Hay  Fever  Association  for 
1893.    S.  S.  Bishop,  M.D.,  719  Adams  St.  Chicago. 

The  Concentrated  Rays  of  the  Sun  as  a  Thbr- 
apeutic  Agent.  O.  V.  Thayer,  M.D.,  212} 
Post  St.,  San  Francisco,  Cal. 

Discovery  of  Surgical  Anesthesia.  By  L.  B. 
Granby,  M.D  ,  Atlanta  Ga. 

Hepatic  Abscess.  By  W.  B.  Stewart,  A.M.,  M.D., 
Bryn  Mawr,  Pa. 

The  Operative  Treatment  of  Stricture  of  the 
Male  Urethra. 

Thyroidectomy. 

These  are  two  valuable  papers  by  a  rising  Rurgeon, 
Dr.  John  B.  Deaver,  of  the  Univ.,  of  Penna.,  Phila. 

A  New  Method  of  Fixation  of  the  Fragments 
in  Compound  and  Ununited  Fractures.  By 
Nicholas  Senu,  M.D.,  Ph.  D.,  LL.  D.,  Chicago. 

Two  Cases  of  Laminectomy.  By  H.  O.  Pantzer, 
M.D.,  Indiaoapolib,  Ind. 

The  following  are  valuable  reprints  by  Dr.  Mary  A. 
Dixon  Jones,  Brooklyn,  N.  Y.  ^'Microscopical 
Studies  in  Pelvic  Peritonitis,"  "Sierility  in  Woman, 
Causes  and  Treatment,"  "Carcinoma  of  the  Floor  of 
the  Pelvis." 

As  A  Christmas  present  we  have  received  a  hand- 
some pocket  visiting  list  and  case  from  the  Anlikam- 
nia  Co.,  St.  Louis,  Mo. 


The  Wage- Workers  of  America:  The  Relation^ 
Between  Capital  and  Labor.  By  John 
Stolze,  M.D.,  Reading,  Pa.  221  large  pages;^ 
cloth,  $1.60.  Address  the  author. 
The  physician  comes  into  intimate  association  with 
the  capitalist  and  laborer.  Hence  he  is  peculiarly 
fitted  to  study  into  those  profound  problems  that  are 
now  puzzling  the  people,  not  only  of  this  country,  but 
of  the  entire  civilized  world.  Dr.  Stolze  has  taken  up 
these  important  questions  with  the  abilivy  bom  of  wide 
reading  and  an  analytical  mind.  However,  we  cannot 
help  thinking  that  he  has  undertaken  this  task  with  a 
mind  largely  biased  in  favor  of  capital,  as  he  seems  to 
incline  in  that  direction  in  all  points  of  doubt.  Ten 
years  ago  his  thoughts  might  have  been  regarded  a» 
somewhat  advanced ;  now  they  seem  to  us  to  be  obso- 
lescent, so  rapidly  does  human  evolution  proceed. 
The  signs  of  the  times  seem  to  point  to  the  fact  that 
before  another  ten  years  have  elap>*ed  we  may  see  the 
blossoming  out  of  the  full  cooperative  commonwealth. 

-J.J.T 
Those  who  miss  the  December  number  of  the  Coa- 
mopolitan  (the  Worlds  Fh'it  number)  for  only   12 J 
cents,  miss  a  rare  treat.    Published  in  New  York. 

The  Columbia  Desk  Calendar,  by  the  Pope  Mfg. 
Co.,  of  Columbia  Bicycle  fame,  is  out  for  1894.  It  is  a 
pad  calendar,  having  a  leaf  for  each  day,  space  on 
each  page  for  memoranda,  and  contains  manj  testi- 
monials and  suggestions  concerning  the  use  of  bicycles.. 
Among  them  we  notice  a  number  fiom  physicians 
We  often  wonder  why  physicians  are  so  slow  in  taking 
advantage  of  the  pleasant  and  time  saving  qualities  of 
the  cycle  in  their  everyday  work.  Physicians  writine 
to  Pope  Mfg.  Co.,  Boston,  Mass.,  and  enclosing  10 
cents  for  packing  and  postage,  will  receive  the  ciueu- 
dar  free. 

Wit  and  Wisdom, 

Those  Strumous  Children. 

Why  give  them  iodide  of  potassium,  or  iodide  of  way 
other  alkaline  base?  True,  they  need  the  alterative 
efiect  of  iodine,  but  the  alkalies  further  weaken  their 
tissues.  Syrup  Hydriodic  Acid  (Hostelley's)  is  just 
the  thing.  It  is  pUaacmt  to  take.  It  is  effective.  It  ia 
ck8  cheapt  or  cheaper  than  the  iodide  of  potassium  for  the 
therapeutic  effect  produced,  and  it  carries  no  ii^urioua 
effect  with  it.  The  fact  is,  wherever  iodine  is  indi- 
cated, the  alkalies  are  contra-indicated.  This  is  true 
in  struma  syphilis,  incipient  phthisis,  and  wherever 
an  alterative  is  indicated,with.perbaps  the  single  excep- 
tion of  rheumatism,  and  even  here,  in  the  chronic  or 
sub-acute  form,  hydriodic  acid  acts  with  peculiar 
energy.  The  fact  is,  that  iodine  in  the  form  of  hydri- 
odic acid  is  ready  for  a*«similation  immediately,  and  it 
goes  directly  to  work  at  its  therapeutic  mission,  while 
when  given  in  any  other  form,  its  assimilation  is  a 
matter  of  uncertainty.  This  is  one  reason  why  hydri- 
odic acid  is  so  much  more  efficient  than  any  other 
form  of  iodine.  Iodine  is  the  king  of  alterativtas. 
Hydriodic  acid  is  its  pleasantest  and  most  active  form. 
Why  not  use  it  thus  instead  of  in  the  form  of  alkaline 
salts?  Formerly  the  objection  to  it  was  its  liability  lo 
decompose.  Hostelleys  preparation  is  absolutely 
stable.  Send  for  literature  giving  formulas  for  its  com- 
bination with  other  alteratives,  and  with  tonics. 
Advise  your  druggist  to  always  keep  it  in  stock  far 
you.  If  he  hasn't  it  at  the  pretent  time,  see  very 
liberal  offer  at  bottom  of  last  cover  page  this  issue. 

See  new  adv.  of  the  M<ilntosh  Battery  and  Optical 
and  Battery  Co.  this  month  on  page  opposite  content  & 
Hereafter    it  will   be  in  their  old  position  on  third 


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THE  MEDICAL  WORLD. 


35 


cover    page.    Commnnicate  with  them  for  whatever 
vou  want  in  their  line. 

Have  you  yet  sent  for  that  sample  of  Sozoderma, 
the  celebrated  antiseptic  thymoline  soap,  as  invitc'd  in 
onr  la^t  number  ?  If  not,  please  send  request  to  Hall 
&  Ruckel,  216  Greenwich  St,  New  York,  N.  Y. 

The  Pill  of  Coca  made  by  W.  H.  Schiefielin  A  Co.. 
New  York,  is  a  valuable  agent. 

Try  the  saline  tonic,  Salitonia,  prepared  by  the 
Pheniqne  Chemical  Co.,  St.  Lfouis,  Mo. 

One  of  the  finest  laxatives  in  the  world  is  the  Cas- 
cara  Aromatic  of  Frederick  Steams  &  Co.,  Detroit, 
Mich.    Sampl^free. 

When  prescribing  HoflTs  Malt  Extract  specify 
«*  Tarrant." 

The  Emr^ire  Mfg.  Co ,  Lockport,  N.  Y.,  make 
reliable  goods  in  woven  elastic  ware. 

Avarice  is  always  poor,  but  poor  by  its  own  facdt» 
— Johnson. 

Guest  (angrily) — "Say  boy,  I've  been  waiting  here 
an  hour."  Waiter— "  That*s  all  right,  boss.  IVe 
been  waiting  here  five  years. — Detroit  Free  Press. 

Fo^your  weaning  mothers  use  the  Mizp^h  Breast 
Pump,  and  for  your  bottle  fed  babies  the  Mitpah  Nip- 
ple, made  by  Walter  F.  Ware,  70  North  Third  St., 
Philadelphia. 

For  good  surgical  instruments  and  the  lowest  rates, 
tend  to  I.  Phillips,  69}  Whitehall  St.,  Atlanta,  Ga, 

TjafE  Compound  Syrup  of  the  Hypophosphites,  of 
Fellows,  is  a  reliable  and  standard  preparation. 

A   MODIFIED  CANNON  BALL  TREATMENT  OF  OBESITY. 

Dr.  Felkin,  of  Edinburg,  in  recommending  hiR  gym- 
nastic method  was  not  aware  of  the  production  of  a 
much  better  and  more  rapid  agent,  Pytoline  (Walker) 
in  the  reduction  of  superfluous  fat.  Had  he  known  of 
its  existence  he  would  have  prescribed  a  remedy  and 
a  treatment  which  obesity  patients  would  consider  a 
pleasure  to  take,  rather  than  one  which  in  a  short 
time  becomes  very  distasteful  to  them. 

the  therapeutic  merit  of  combined  REMEDIES. 

A  full  dose  of  quinine  and  antikamnia  will  promptly 
relieve  any  case  of  la  i^rippe.  In  the  gastric  catarrh 
of  drunkards  this  combination  is  valuable.  Quinia  is 
a  poison  to  the  minute  organism — sarcina  ;  and  anti- 
kamnia exerts  a  soothing  quieting  eflfect  on  the  nerve 
filaments.  A  full  dose  of  antikamnia  and  quinia  will 
often  arrest  a  commencing  pneumonia  of  pleuritis. 
This  combination  is  also  useful  in  the  typho  malarial 
fever  of  the  South — particularly  for  the  hyperpyrexia 
— both  quinia  and  antikamnia,  as  previously  said, 
being  decided  fever  reducers.  The  combination  of 
antikamnia  with  quinia  is  valuable  in  the  racking 
headache,  with  high  fever,  attendant  upon  malarial 
disorder^}.  It  is  likewise  valuable  in  cases  of  period- 
ical attacks  of  headache  of  nondefined  origin ;  of  the 
so-called  bilious  attacks ';  of  dengue ;  in  neuralgia  of 
the  trigemini;  in  that  of  'ovarian  catarrh';  and,  in 
fhorU  in  nearly  everv  case  where  quinine  would  or- 
dinarily be  prescribed. —  Vir.  Med.  Monthly 

David  Slowpay— "I  shall  bring  you  those  dark 
trousers  to  be  reseated,  Mr.  Snip." 

Snip  (tailor)—"  All  right,  and  if  you'll  bring  the 


bill  I  sent  you  six  months  ago,  I  shall  be  pleased  to 
receipt  that  also. 

"  It  ain't  no  wonder  that  city  folks  don't  live  lorg," 
said  old  Mrs.  Jason.  **  Law  me !  If  I  had  as  many 
neighbors  to  look  after  as  folks  that  lives  in  cities 
must  have,  I'd  be  dead  in  less'n  a  year. 

For  a  ready  laxative  use  Syrup  of  Figs. 

Present  your  wife,  son,  daughter,  husband, 
brother,  sister  or  friend  a  copy  of  Webster's  Un- 
abridged Dictionary. 

The  St.  Louis  Medical  Eh-a,  in  an  editorial  on 
svphilis,  recommends  in  the  treatment  of  the  disease 
the  Elixir  of  Six  Iodides,  made  by  the  Walker-Green 
Pharmaceutical  Co.,  Kansas  City,  Mo. 

The  wisdom  of  a  large  number  of  French  and  other 
eminent  European  physicians  is  found  in  the  French 
Doctors'  Book,  1200  Favorite  Prescriptions,  published 
by  W.  Von  Berger,  89  Court  St.,  Boston. 

As  a  tonic  alterative  use  Henry's  Tri-iodides.  Kenz 
A  Henry  Pharmacal  Co.,  Louisville,  Ky. 

For  Dr.  Hinkle's  Cascara  Cathartic  Pill  a^drees 
Wm.  R.  Warner  &  Co.,  1228  Market  St.,  Phila. 

Editor  Medical  World: — Please  send  Wobli> 
for  one  year  and  oblige.  I  have  been  sick  for  one  year 
with  pulmonary  trouole,  though  I  am  getting  very 
much  better  through  the  a&sistanoe  of  God  and  Fre- 
lights  Constituent  Tablets.  Please  ask  some  of  the 
fraternity  a  remedy  for  insomnia  to  take  the  place  of 
opium.    Dr.  S.  A.  Sumby, 

316  F.  St.,  S.  W.,  Washington,  D.  C. 

Rudisch's  Beef  Tontc  is  a  valuable  article  of  diet. 
Sample  free.  The  Rudisch  Co.,  317  Greenwich  St., 
New  York,  N.  Y. 

Have  you  tried  Sanmetto  in  the  treatment  of  blad- 
der troubles  ? 

Dr  O.  W.  Holmes,  who  once  made  some  remarks 
in  reference  to  a  charge  that  in  his  writings  he  drew 
all  his  villians  from  the  clerical  and  legal  profession, 
said:  *'  I  am  afraid  I  shall  have  to  square  accounts  by 
writing  one  more  story  with  a  physician  figuring  in  it. 
I  have  long  been  looking  in  vain  for  such  a  one  to 
serve  as  a  model.  I  thought  I  had  found  a  very  ex- 
cellent villian  at  one  time,  but  it  turned  out  he  was  no 
physician  at  all,  only  a — 1  mean  not  what  we  consider 
a  practitioner  of  medicine.  I  will  venture  to  propose 
a  sentiment  which,  as  I  am  not  a  working  physician, 
need  not  include  the  proposer  in  its  eulogy:  The 
medical  profession — so  full  of  good  people  that  Its 
own  story  tellers  have  to  go  outside  of  it  to  find  their 
villians. 

Mr.  Lanks  (the  new  boarder) — Please  help  me  to 
another  portion  of  the  wild  duck.  Mrs.  Flint." 

Mrs.  Flint  (the  landlady) — "I'm  sorry  Mr.  Lanks, 
b'lt  there  is  a  limit  to  this  little  game.'' — Brooklyn 
Ltfe. 

"  Monet  talks,"  but  the  least  little  scare  will  shut 
it  up  tight. — Binghamton  Bepubliean. 


A  little  wholesowe  advice  to  the  laity. 

1.  Leave  your  bedroom  window  open  at  the  top, 
except  in  damp  weather  ;  the  night  air  is  purer  than 
that  of  the  day,  despite  the  alarming  fairy  tales  of  our 


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gr  indraothers ;  but,  when  70a  arise  in  the  morning, 
close  the  window,  andptUl  dxmn  the  blind  until  you  are 
completely  dressed. 

2.  Get  your  wife  to  tack  a  band  of  flannel  about  a 
foot  wide  on  the  inside  of  your  undershirt  over  the 
region  of  the  kidneys.  This  will  save  many  a  cold, 
backache  and  derangement  of  important  org^ans.  If 
you  haven't  a  wife,  get  one. 

3.  If  you  irt^  drink  intoxicating  liquors,  do  so  only 
at  the  time  of  eatinr.  This,  at  least,  will  mitigate  the 
direct  effects  of  alcohol  on  the  lining  of  the  stomach ; 
for  the  presence  of  food  causes  the  gastric  juices  to 
flow,  and  this  protects  the  delicate  membrane.  To 
avoid  a  bad  taste  in  your  nouth  in  the  morning  show 
vour  good  taste  in  what  you  put  in  it  at  night.  If  the 
Dad  taste  pers^'sts,  and  is  not  due  to  indi^crte  eating  or 
drinking,  have  your  heart  examined. 

4.  If  you  tnll  smoke,  give  a  better  price  for  your 
cigars  and  reduce  the  number.  And  do  not  smoke 
your  cigars  "  to  the  bitter  end,"  but  throw  the  stumps 
into  the  street.  The  Italian  gamins  will  gather  them 
in  to  sell  to  the  cheap  cigarette  makers ;  so  you  may 
some  day  meet  your  old  flame  again  upder  a  different 
guises 

5.  In  partaking  of  joints  eat  only  the  flesh  and  fat, 
cutting  out  the  veins  and  other  vessels.  They  are 
useless  to  the  economy,  and  only  give  the  stomach 
work  that  will  not  be  paid  for. 

6.  When,  by  friction  of  the  surface  of  the  limbs  or 
body,  little  rolls  of  solid  are  produced,  they  are  the 
jhtaam  of  wrecked  tissues,  which  encumbers  the  func- 
tions of  the  skin.  Get  a  Turkish  bath  and  throw  off 
your  debris.  You  will  then  breath  through  your 
whole  body. 

— Louis  Lewis,  M.D.,  in  Times  and  Register, 


B.  Keith  A  Co.,  75  Williams  St.,  New  York,  make 
a  useful  line  of  concentrations.  They  are  always  re- 
liable. 

For  hollow  suppositories  and  glycerine  suppositor- 
ies address  Hall  &  Ruckel,  216  Greenwich  81.,  New 
York.    Sample  free. 

It  is  said  that  the  tendons  found  in  the  tail  of  a  dog 
make  better  sutures  than  either  catgut  or  kangaroo 
tendon  wheYi  properly  prepared  in  sublimate. 

Havk  you  tried  Mirajah's  Uterine  Wafers?  Sam- 
ples for  trial  free.    Micajah  h  Co.,  Warren,  Pa. 

Fob  reliable  electrical  apparatus  send  to  Jerome 
Kidder  Mfg.  Co.,  820  Croadway,  New  York,  N.  Y. 

Fine  dosimetric  granules  can  be  had  of  the  Detroit 
Metric  Granule  Co,  Detroit,  Mich. 

The  Vinolia  Soaps  are  indeed  fine  preparations — 
veritable  luxuries.  Sample.  Blondeau  et  Cie,  78 
Watts  St.,  New  York,  N.  Y. 

For  fine  elastic  trusses  address  G.  W.  Flavell  A  Bro., 
1006  Spring  Garden  St.,  Phila 

Sample  free  of  Syrupus  Roborans  and  Peter's  Pep- 
tic Essence  if  you  will  pay  express  charges.  Arthur 
Peter  &  Co.,  Louisville,  Ky. 

A  man's  idea  of  economy  is  to  preach  it  three  times 
a  day  to  his  vrife. 

GuBBT — **  Landlord,  you  may  bring  me  a  sirloin 
steak.  Let  it  be  fresh  and  juicy,  broiled  half  through, 
but  not  too  rare,  very  tender,  and  be  sure  that  you  use 


real  fresh  butter."  Landlord— "Why,  if  I  had  »uch  a 
fine  thing  as  that,  sir,  I'd  eat  it  myself."— fYt>a«irf« 
Blaettn. 

"  I  CAN  only  be  as'i'ster  to  you,*  a?  the  typewriter 
said  to  her  employer. — Plain  Dealer, 

A  BEAUT(FUL  and  useful  Christmas  pre^ut  would 
be  one  of  the  elegant  hol'ow  physician^  cane^  made 
by  W.J.  Cona  »r,  M  D  ,  Labette  City.  Kan. 

For  first-class  pilU  and  firranules  address  the  Up- 
john Pill  and  Granule  Co.,  Kalamazoo,  Mich. 

Parke,  Davis  &  Co,  Detroit,  Mich,  are  Vnowa. 
and  respected  as  reliable  manufac.uring  pharmacists 
and  chemist**. 

Newfoundland  dogs  are  to  be  employed  to  rescue 
the  persons  who  fall  or  thr  >w  them^elv^  into  the 
Seine.  The  dogs  are  to  be  housed  upon  barget*  an* 
chored  in  the  river.  The  skill  with  which  these  dogs 
recognize  the  falling  of  persons  into  the  water,  and 
the  unerring  certainty  with  which  they  reach  the 
t)ody  by  the  most  direct  route  and  seize  it  at  the  proper 
place  and  swiftly  bring  it  to  the  barge  or  shore  are 
matters  of  marvel  to  all  observers. — Amerioan  Lancet. 

8EMNINE  IN  ECZEMA  AND  VENERAL  FLCERS. 


Eureka  Springs,  Ark.,  Nov.  9th, 

Dios  Chemical  (^o.,  St.  Ix)ui'»,  Mo., 

Gentlemen: — The  sample  of  Senoine  you  seat  me 
came  safely  to  hand,  and  I  happened  to  have  some 
cases  that  visited  my  office  daily  for  treatment.  In 
two  cases  of  eczema  covering  the  inner  side  of  thigh 
I  applied  the  Sennine  iust  a-*  I  received  it  from  you  ; 
that  is,  full  strength,  dry,  and,  I  am  happy  to  say,  it 
acted  like  a  charm  in  both  cases.  Agtin  I  applied 
Sennine  to  venereal  ulcer  and  must  say  that  it  did  all 
anyone  could  ask.  I  look  upon  Sennine  as  the  anti- 
septic of  all  others  and  shall  continue  to  use  it  in  my 
pract'ce.  W.  R.  Habdbbty,  M.D. 

Prof.  Harvey  L.  Byrd,  of  Baltimore,  writes: 
"  You  are  at  liberty  to  say  that  after  two  years'  use  of 
Dr.  Mc Arthur's  Chemically  Pure  Syrup  <»f  the  Hypo- 
phosphites  in  my  practice,  I  am  prepared  to  reiterate 
with  emphasis  what  I  said  in  a  medical  journal  at 
that  time,  viz.:  *  I  do  not  hesitate  to  commend  it  to 
the  profession  as  worthy  of  confidence." 

I  HAVE  used  Peacock's  Bromides  with  success.  In 
epileptic  fits,  especially  one  case  of  ten  y^arn*  standing, 
in  which  I  exhausted  all  remedies  at  my  command,  it 
has  proven  a  valuable  remedy,  alwavs  positive  and  con- 
stant. I  cheerfully  recommend  ii  to  the  medical  pro- 
fession. Horace  C  George,  A.M.,  M.D. 

Altoona,  Pa. 

CELERINA. 

We  have  long  been  acquainted  with  the  reputation 
of  this  fine  pharmaceutical  pref)aration.  Celerina  is  ji 
nerve  tonic,  stimulant  and  antispnsmodic.  It  is  pre- 
pared ftrom  celery,  c<^ca  kol»,  viburnum  and  arom- 
aticB,  and  is  specially  indicated  in  Iohs  of  nerve  power, 
nervous  headache,  neurnlgia,  brain  fag,  neurasthenia, 
alcoholic  excess,  inebriety,  drunkenness,  opium  habit, 
paralysis,  dysmenorrhea,  hysteria,  sexual  incapacity, 
spermatorrhea,  impotency,  and,  in  fact,  in  all  languid 
and  debilitated  conditions  of  the  syntem  arising  from 
excessive  expenditure  or  abuse  of  the  sexual  functions, 
or  over-indulgence  in  alcohol  and  confirmed  drunken- 
ness. So  far  as  our  experience  goes  in  the  use  of 
Celerina,  we  have  found  it  an  excellent  and  efficient 
nerve  tonic,  acting  especially  upon  the  organs  of  gen- 
eration, giving  tone  to  the  nervous  system  and  contin- 


{ConHnued  en  i»ext  Uqf.) 


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Tk€  knowledge  thai  a  man  can  use  is  the  only  real  knowledge;  tne  only  know- 

ledge  thai  has  life  and  g'owth  in  it  and  converts  itself  into  practical  power.      The 

rtsi  hangs  like  dust  about  the  brain,  or  dries  like  raindrops  off  the  stones.^^ROVDM, 


The  Medical  World. 

PUBLiSHKD  Monthly,  by  C.  F.  Tatix>r,  M.  D. 


C  P.  Tayix)ii,  M.  D., 
J.  J.  Tavw)*,  M.  D., 


>Bditors. 


ilAtcriptloii  to  any  part  of  the  United  States  and  Canada, 
Oms  Dollar  per  year.  To  England  and  the  British 
Ooionies,  Ftvb  Shilungs  per  year.  Postaere  free, 
aingle  copies,  Tbn  Cents.  These  rates  must  be  paid 
^mpoHdblx  in  adtfance. 

We  cannot  always  snpply  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  a^nts  for  thin  Journal  unless  publisher's 
receipt  is  gi^en. 


all  Communications  to 
*'THE   MEDICAL  WORLD," 
1520  Chestnut  Street, 

PHILADKLPHIA.  PA. 

VoL  XIL         February,  1894.         Na  2. 

Making  the  Care  of  the  Public  (Peoples')  Health 
a  Public  Function* 

In  an  article  in  The  Counselor,  Lincoln, 
Neb.,  Dr.  A.  Coleman,  of  Denver,  Col.,  argues 
very  convincingly  in  favor  of  a  general  nation- 
alidng  of  the  entire  range  of  medical  service — 
preventive  medicine,  medical  and  surgical  treat- 
ment and  providing  medical  and  surgical  sup- 
plies. When  that  takes  place  (as  the  function 
of  public  education  is  novr  conducted)  we  should 
have  a  healthy  people,  a  steadily  improving 
race,  well  educated  and  liberally  paid  doctors, 
the  system  of  medicine  exalted  into  a  true 
science  and  its  practice  developed  into  a  fine  art 
The  doctor  is  not  a  pioneer  in  thi«  advocacy, 
as  Blaurice  J.  Burstein,  A.  M.,  M.D.,  180 
Henry  Street,  New  York  City,  published 
some    years    ago    in    The    DodoT^s    Weekly, 


quite  an  elaborate  article  on  the  subject, 
and  both  received  their  hint  from  reading 
Edward  Bellamy's  ''Looking  Backward,"  to 
which  they  both  accord  due  credit. 


A  Law  Clinlo.  ;  .,^ 
In  a  lecture  upon  the  ethics  of  the  medical 
profeasion,  Dr.  S.  Weir  Mitchell  recentiysaid: 
"Who  ever  heard  of  a  law  hospital  ?"  This 
taunt  put  il6me  lawyers  to  work  upon  the  sub- 
ject, and  now  the  law  students  of  the  University 
of  Pennsylvania  have  established  a  regular  law 
dispensary,  with  semi-monthly  clinics,  where 
poor  clients  can  have  their  cases  taken  charge 
of  and  carried  through  the  necessary  courts.  Of 
course,  the  client  or  his  friends  must  pay  the 
court  costs. 


Castor  Oil  as  a  Lubricant 

John  M.  Kitchen,  M.D.,  of  Indianapolis, 
gives  an  interesting  letter  in  the  N.  Y.  Med, 
Jour.,  in  which  he  gives  as  the  points  of  su- 
periority of  refined  castor  oil  as  a  lubricant  for 
catheters,  bougies  and  for  general  surgical  pur- 
poses, the  fact  that  it  is  noA-irritating,  very 
tenacious  and  in  itself  sufiicienUy  antiseptic  not 
to  require  any  additional  sterilizing  agent  Its 
use  also  seems  to  preserve  rubber  and  silk  cath- 
eters. 


The  Great  Medical  Error  of  the  Day. 

Prof.  William  Goodell,  in  the  University 
Medical  Magazine,  (Philadelphia),  under  the 
above  title,  deplores  the  tendency  of  the  pro- 
fession to  attribute  all  the  illnesses  and  weak- 
nesses of  women  to  local  disease  of  tne  genera- 
tive organs,  ignoring  the  prevailing  existence  of 
functional  derangement  of  the  nervous  system, 
causing  all  the  pathological  symptoms  and  often 
really  causing  whatever  sexual  derangements 


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there  may  be  noticed.  The  woman  is  mutila- 
ted bj  the  Temoval  of  some  one  or  more  of  her 
organs  and  becomes  no  better,  but  often  worse, 
while  the  original  diagnosis  is  never  questioned, 
and  the  nerves  and  general  system  are,  entirely 
neglected  in  the  treatment  The  article  is  full 
of  strong  points  and  sensible  directions,  and 
should  be  read  by  all  general  practioners. 


Sanitation  it  True  Economy. 

The  London  Sanitary  Record  draws  a  parallel 
between  the  stingy  city  authorities  who,  in 
Browning's  poem,  "The  Pied  Piper  of  Ham- 
elin,"  refused  to  pay  the  stipulated  price  for  de- 
stroying the  rats  and  lost  all  thdr  children  in 
consequence,  and  many  of  our  own  modem 
cities  and  States  who  are  too  mean  to  pay  for 
scientific  sanitary  work,  but  allow  epidemics  to 
have  almost  unrestricted  sway.  They  wti^pay 
finally — ^ifnotin  dollars,  then  in  lives.  But 
the  Record  might  have  gone  farther  and  shown 
that,  if  the  short-sighted  officials  (or  voters)  pre- 
fer to  take  the  chances  and  pay  in  children, 
they  must,  finally  in  addition,  pay  in  dollars  even 
many  tunes  more  (as  the  expenses  of  the  epi- 
demic)  than  the  original  sanitation  would  have 
cost 

A  Common  Precaution  Not  Sufflciontly  Observed. 
We  fear  that  the  importance  is  not  sufiiciently 
regarded  by  many  practitioners,  of  piotectbg 
the  eyes  from  contact  with  active  purulent  dis- 
charges occurring  in  other  part».  When  one 
eye  is  affected  with  purulent  inflammation  the 
sound  eye  should  be  carefully  guarded  from 
contagion.  Every  patient  suffering  from 
gonorrhea  should  be  profoundly  impressed  with 
the  great  care  which  he  should  observe  to  pre- 
vent conveying  the  disease  either  directly  or  in- 
termediately to  either  his  own  or  others'  eyes, 
and  his  awful  responsibility  if  any  one  should 
loose  one  or  both  eyes  through  his  carelessness 
in  this  respect  The  most  scrupulous  cleanli- 
ness of  hands  and  immediate  destruction  by 
burning,  of  all  soiled  articles  should  be  enjoined, 
as  well  as  private  use  of  towels,  handkerchiefs 
and  other  personal  articles.  Infected  clothing 
should  not  be  given  to  ignorant  persons  to  wash 
and  thus  convey  the  disease,  and,  on  the  other 


hand,  persons  doing  strange  laundry  work  should 
not  rub  their  eyes  with  fingers  damp  ^m  the 
suds. 

Antiseptic  Ointments  for  Eruptive  Fevers. 
The  treatment-  of  certain  eruptive  diseases  by 
inunction  of  the  skin  with  an  ointment  contain- 
ing eucalyptol  would  seem  to  be  beneficial,  both 
on  purely  theoretical  grounds  and  by  analogy, 
as  it  is  very  beneficial  in  scarlet  fever  and 
small-pox.  However,  it  is  to  be  tried  in  other 
disuses  very  cautiously,  as  a  report  of  five 
cases  in  Prcutitioner^  of  London,  indicates  that 
it  does  very  badly  in  measles.  However,  we 
should  like  to  see  it  more  fairly  tried,  even  in 
this  disease,  as  in  the  cases  mentioned  it  seems 
to  have  been  tried  with  a  proprietary  medicine 
daid  to  contain  eucalyptol,  rather  than  with  the 
pure  drug  itself. 

Artenite  of  Copper  for  Typhoid  Fovor. 
A.  H.  Thomas,  M.  D.,  of  Hurley,  Wis.,  re- 
ports  a  series  of  ninety  cases  of  typhoid  fever 
{Avner,  Therapist)  treated  with  arsenite  of  cop- 
per, with  but  one  death,  and  that  one  from 
hemorrhage.  The  daily  dosage  was  yj^  grain ; 
this  amount  was  dissolved  in  about  two  ounces 
of  water,  and  taken  in  hourly  teaspoonful  doses 
until  it  was  all  taken.  This  was  repeated  in 
the  same  manner  each  day.  Occasional  use  was 
made  of  coattar  antipyretics  and  quinine,  ac- 
cording to  symptoms.  The  doctor  also  reports 
that  the  after  condition  of  those  who  recovered 
under  this  treatment  was  better  than  under  the 
usual  treatment;  this  was  especially  true  of  the 
condition  of  the  intestinal  tract 


Proper  Out-Houset  for  School  Children. 
Hon.  Nathan  C.  Schaeffer,  Supt  of  Public 
Instruction  in  Pennsylvania,  is  making  a  com- 
mendable agitation  for  well-built  and  decently 
kept  school  out-houses.  This  subject  should  be 
agitated  all  over  the  civilized  world  until  the 
desired  object  is  universally  attained.  No  one 
knows  better  than  the  physician  the  great 
amount  of  disease  and  suffering  entailed  upon 
the  human  race  in  consequence  of  the  sins 
prompted  by  impure  impressions  made  upon  the 
mind  in  childhood.  Every  influence  surround- 
ing the  child  should  be  of  an  improving  and  en- 
nobling   character.      Hygienic    and    properly 


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89 


kept  school  out-houses  will  pay  the  best  kind  of 
interest  on  their  cost 

But  there  should  also  be  properly  kept  public 
water-cloeets  for  every  square  or  two,  without 
regard  to  school-houses,  in  all  large  cities 
in  the  interest  of  health,  decency  and  sobriety. 

Malaria  Cured  by   Hydroohlorate  of  Phenooell. 

In  the  Therap,  MonaL  Cueco  details  eighty- 
four  cases  treated,  of  which  fifty-two  were  cured 
and  all  the  rest  but  four  improved.  The 
dosage  is  from  fifteen  to  twenty-two  grains 
daily.  A  promising  substitute  for  quinine,  pro- 
ducing no  unpleasant  results. 

Pilooarpina  for  Diphtheria. 
For  diphtheria  give  pilocarpine  until  the 
characteristic  salivation  and  sweating  are  thor^ 
oughl^  established.  This  usually  requires 
hourly  doses  of  ^m  1-40  grain  to  1-10  grain 
according  to  the  age  of  the  patient  After  that 
give  at  longer  intervals  to  keep  up  the  effect 

Treatment  of  Typhoid  Fever. 

In  an  article  in  the  N.  Y.  Med.  Jour,,  Dr.  T. 
J.  Shuell,  of  Pamell,  I&,  states  his  belief  that 
the  toxic  products  of  the  inflammation  find  their 
principal  lodgement  in  the  colon  whence  they 
are  absorbed  and  enter  the  circulation. 

"The  indications  for  treatment  will  range 
themselves  under  three  headings  in  the  order  of 
their  importance. 

1.  To  remove,  at  as  early  a  date  as  possible, 
all  ptomaines  and  decomposing  substances  from 
the  colon. 

2.  To  destroy  or  neutralize  the  effect  of  all 
micro  organisms  above  the  csecum  by  proper  in- 
ternal germicides,  if  any  be  found  that  will  not 
impair  the  animal  economy. 

3.  To  enforce  proper  dietary  and  to  treat 
rationally  symptoms  and  indications  as  they  may 
arise. 

The  first  indication  may  be  met  only  by 
thorough  irrigation  of  the  colon.  But  thorough 
irrigation  of  the  colon  can  not  be  effected  unless 
we  pass  a  tube  above  the  sigmoid  flexure.  The 
ordinary  colon  tube  may  be  used,  but  I  prefer 
a  softprubber  tube  of  a  caliber  of  from  25  to  32, 
American  scale,  and  about  three  feet  in  length. 

By  attaching  this  to  a  fountain  syringe  and 
permittmg,    while  it  is  being  introduced,  the 


stream  to  flow,  it  may  readily  be  made  to  pass 
the  sigmoid  flexure  of  the  colon  and  reach  to, 
or  near,  the  csecum.  The  water  used  should  be 
warm  and  aseptic,  which  can  be  effected  by 
boiling.  Only  in  exceptional  cases  should  it  be 
made  antiseptic  fjr  fear  of  producing  systemic 
poisoning.  At  least  naif  a  gallon  of  water 
should  be  injected  in  adults.  The  injection  will 
distend  the  gut,  remove  the  accretions  from  the 
sacculi,  and  result  in  such  an  evacuati(m  of  foul- 
smelling  fsBces  intermixed  with  scybalse  as  will 
surprise  both  patient  and  physician.  These  in- 
jections to  effect  the  most  good  should  be  em- 
ployed early  in  the  disease,  before  the  high  fever 
and  severe  nervous  symptoms  8h6w  themselves. 
They  may  be  repeated,  if  neceesary,  at  intervals 
of  three  days  for  the  first  week  or  ten  days.  The 
only  precaution  is  that  they  should  be  used 
warily  .when  the  stage  of  necrosis  of  theglandu^ 
lar  tissue  is  reached,  as  the  aolitary  glandit  of 
the  large  intestine  are  affected  in  a  large  pro- 
portion of  cases." 

The  doctor  recommends  milk  as  the  best  ai:ti- 
cle  of  diet,  and  gives  plenty  of  pure  cold  water 
to  drink  one  to  two  quarts  daily. 

Antipyretics  in  Typhoid  Fever. 

In  Am.  Med.  Surg.  Bulletin,  Dr.  C.  W.  Oarran, 
of  Va.,  has  an  artide  developing  the  following 
conclusions : 

1st — The  so-called  antipyretic  remedies  are 
more  or  less  injurious  to  the  patient  when  given 
in  large  doses,  or  when  their  use  is  continued 
for  a  considerable  period. 

2d — They  should  be  prescribed  only  when 
cold  water  cannot  be  used  in  some  manner,  and 
then  only  long  enough  to  secure  the  end  indi- 
cated. 

3d — Cold  water  is  a  safe  and  efficient  meaa- 
ure  with  which  to  combat  high  temperature  in 
most  cases  of  typhoid  fever  ;  and  the  manner  of 
its  use  should  be  impressed  upon  the  laity  moie 
fully  by  the  physician. 

The  antipyretics  referred  to  by  the  Doctor 
are  the  coal-tar  derivatires  only.  He  does  not 
appear  to  have  tried  the  alkaloidal  fever  reduc- 
ers, which  are  so  useful  because  they  break  up 
the  inflammation  which  causes  the  fever  in  so 
many  cases.  We  favor  his  conclusion  recom- 
mending cold  water  as  an  antipyretic 


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THB  MEDICAI.  WORLD. 


Original  Qommunioations. 

Short  articles  on  the  treatment  of  dlaeaaea,  and  experience 
with  iiew  remedies,  are  solicited  from  the  profession  foi 
this  department ;  also  difficult  cases  for  diagnosis  an<f 
treatment. 

Articles  accepted  must  be  contributed  to  this  journal  onh 
The  editors  are  not  responsible  for  views  expressed  hj 
contributon. 

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

Ctriatnfy  it  is  txcettent  discipline  for  an  author  to  feel  that  k* 
must  say  all  he  has  to  sav  in  the  fewest  possible  words^  op 
his  reader  is  sure  to  skip  them;  and  in  the  plainest  possibU 
words^  or  his  reader  tnll  certainly  misunderstand  them. 
Generally,  also,  a  downright  fact  may  be  told  in  a  plain 
way:  and  we  want  downright  facts  at  present  more  than 
"yoking  else,^Ru9xni. 


READ.     REFLECT.     COMPARE.     RECORD. 


T4ie  Chicago  Qrip.— A  New  Remedy  in  Morphin- 
ism.—Replies. 

Editor  Medical  World: — ^After  three 
weeks'  experience  with  the  variety  of  grip  pre- 
valent m  Chicago,  I  am  prepared  to  achait  that 
PhiUidelphia  is  not  in  it  At  least,  from  per- 
sonal experience  I  can  testifj  that  when  the  Chi- 
cago grip  gets  hold  of  an  Eastern  'tenderfodt," 
it  assuredly  has  some  fun  with  him.  It  took  me 
suddenly  with  excruciating  pain  in  the  head  and 
back,  aching  legs,  profound  debility,  inability 
to  eat,  and  a  temperature  of  104  degrees. 
Pulse  feeble  and  fW>m  100  to  112.  In  a  week 
the  symptoms  lessened  and  I  started  off  quite 
brightly,  walking  as  rapidly  as  usual,  for  about 
an  hour.  Then  the  pace  slackened,  gradually 
to  the  hobble  of  an  aged  man,  with  every  motion 
developing  a  new  ache,  and  I  was  forced  to 
take  the  arm  of  a  friend.  During  the  third 
week  there  has  been  a  steady  aching  in  the  left 
temple  and  nose,  relieved  at  intervals  by  small 
hemorrhages,  t  never  quite  comprehended  the 
neurasthenic  state  before.  I  get  up  in  the 
morning  and  tumble.into  a  cold  bath,  dress,  and 
go  out  for  a  brisk  walk,  setting  my  teeth  to- 
gether with  the  determination  &at  I  toanH  be 
ill,  but  will  throw  the  wretched  thing  off.  In 
spite  of  myself  in  a  minute  or  so  I  am  simply 
incapable  of  dragging  myself  along. 

Pardon  me  for  talking  about  myself  so  much; 
but  I  have  always  thought  that  no  records  of 
cases  are  so  valuable  as  when  the  patient  is  him- 
self a  physician  And  I  want  to  acknowledge 
ttiat  I  have  not  done  full  justice  to  neurasthe- 
nics, having  had  a  lurking  suspicion  that  they 
could  work  if  they  had  the  will.  I  am  their 
fnend  and  champion  from  this  time  on. 

In  treating  of  morphine  habitues,  I  have 
spoken  of  the  value  of  pain  as  a  therapeutic  re- 
source, in  developing  that  self-control  that  alone 
makes  a  cure  permanent.     But  not  all 


can  bear  much  pain,  and  in  the  dark  hours  of 
their  trial  one  must  be  merdfuL  I  have  just 
had  a  case  in  the  course  of  which  we  have  made 
what  appears  likely  to  prove  a  discovery  of 
some  importance.  Every  one  who  has  treated 
these  cases  knows  that  there  is  little  difficulty  in 
reducing  the  daily  dose  to  a  gnun  or  even  to  a 
quarter-grain  ;  but  it  is  in  getting  rid  of  the  last 
bit  that  the  suffering  comes  in.  Nothing  has 
hitherto  been  found  to  take  the  place  of  mor- 
phine. Ammonium  bromide,  cannabis,  codeine, 
and  all  the  rest  have  been  tried  and  proved  of 
very  little  value.  The  case  I  speak  of  was  a 
young  man,  26  years  old,  neurotic  from  birth,  a 
periodic  dipsomaniac  and  a  morphine  habitue  of 
years  standing,  who  had  been  *'cnred"  by 
Keeley  and  several  others,  and  returned  like 
the  canine  mentioned  in  Holy  Writ  He  was 
quite  debilitated,  had  absolutely  no  moral 
force  to  which  one  could  appeal,  and  no  self- 
control  whatever.  Nor  had  he  the  powerful 
incentive  to  fortitude  possessed  by  a  husband 
and  fother.  There  was  no  real  desire  on  his 
part  to  be  cured.  Altogether  this  was  a  very 
unpromising  case,  and  it  was  not  at  all  likely 
that  he  would  deceive  himself  as  to  the  effects 
of  a  substitute.  Nevertheless,  one  drug  gave 
him  such  complete  relief  that  he  could  hiuxlly  be 
persuaded  that  there  was  no  morphine  in  it  One 
swallow  does  not  make  a  summer,  and  I  may 
not  succeed  so  well  with  the  next  case,  but  as 
this  remedy  was  selected  as  directly  antagoniz- 
ing the  pathological  condition  present,  I  have 
hopes  of  it  It  is  a  tonic,  not  a  *' habit-pro- 
ducer, "  and  could  be  taken  for  any  length  of 
time  with  impunity. 

Has  not  Dr.  Campbell's  case,  (page  12),  a 
vesical  calculus?  The  discharge  of  mucus  and 
blood  shows  something  more  than  a  simple 
cystic  catarrh;  for  after  so  many  years  the 
mucus  and  blood  usually  disappear  from  the 
urine.  Dilate  the  urethra,  examine  the  blad- 
der with  the  finger ;  and  if  there  be  nothing 
but  catarrh,  wa^  out  thrice  daily  with  hot 
water  and  hammamelis,  or  one  grain  of  silver 
nitrate  to  eight  ounces.  Salol,  hydrangea  and 
hyoecyamus  relieve  the  acute  manifestadons. 

I  wish  I  could  put  Dr.  Hardey's  case  of 
hystero-epilepsy  cured  by  quinine,  (page  12), 
on  record  beside  the  hundreds  of  cases  sub- 
jected to  castration  and  not  cured  thereby.  I 
am  not  opposed  to  any  advance  in  surgery,  but 
why  do  the  ovariotonists  not  give  us  a  record  of 
their  successes  and  failures?  Up  to  the  present, 
they  have  only  classified  their  results  as  recov- 
eries or  deaths. 

Dr.  Bronson,  (page  19),  should  examine  his 
wife's  rectum  for  ulcer  or  cancer.  A  morning 
diarrhea  in  a  woman  of  her  age  is  suspicious.  If 


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nothing  is  revealed  by  examination,  give  her 
very  small  doses  of  arsenic,  gr.  1-120,  before 
each  meal,  and  an  enema  of  a  grain  of  silver 
nibrate  in  eight  ounces  of  hot  water  once  a  day. 
Still  smaller  dos^  of  corrosive  sublimate,  gr. 
1-180,  once  acted  well  in  a  similar  case  for  ma 

I  would  suggest  the  same  treatment  for  H. 
L.  K.,  (page  20),  adding  that  there  is  less  like- 
lihood of  rectal  disease.  The  old-fashioned 
mixture  of  rhubarb,,  hydrastis  and  potassium 
carbonate  would  probably  be  useful  to  him,  as 
it  usually  is  when  there  are  fetid,  unhealthy 
stools.  With  this  a  diet  exclusively  of  hot  milk, 
until  his  stools  are  normal ;  then  returning  very 
gradually  to  his  usual  diet  I  think  he  has 
ulceratioq  of  the  bowels,  although  the  absence 
of  fever  is  against  this.  Has  he  noticed  whether 
there  are  mucous,  semi-membraneous  casts  of 
the  bowels  in  the  stools?  Mucous  colitis  pre- 
sents such  symptoiQS  as  he  describes. 

Dr.  Lever's  case  (page  20),  reminds  me  that 
I  have  often  seen  such  an  appearance  in  persons 
dead  from  consumption.  The  certain  evidence 
of  death  is  decomposition  ;  but  the  fact  that  the 
heart  has  ceased  to  beat,  and  the  pulsations  can- 
not be  heard  by  the  trained  ear  of  the  physician 
is  ftdly  as  positive.  Some  years  ago  I  traced  up 
every  story  of  burial  alive  appearing  in  the 
papers,  and  found  that  all  came  from  the  same 
source — the  reporter  who  was  in  straits  for  some- 
thing to  fill  up  space. 

Medicus,  (page  20),  could  not  improve  on  his 
local  treatment,  but  why  not  give  sulphide  of 
calcium  internally,  one  grain  daily  ?  Don't  be 
discouraged,  for  furunculosis  is  often  obstinate. 
Sedentary  habits  in  a  man  whose  body  was  de- 
signed for  manual  labor,  coffee,  beer,  sewer 
gas  or  other  foul  air  in  the  house,  often  keep  up 
this  affection.  One  of  my  cases  resisted  all  my 
efforts  till  the  plumber  cured  her  by  ripping 
out  the  ''jerry  "  drain  pipes  and  putting  in  good 
work. 

In  the  negro,  I  have  found  it  necessary  to 
use  hot  applications  for  pneumonia,  to  treat 
the  case  vigorously  at  first,  feed  well,  and 
lookout  for  collapse  at  the  crisis.  They 
rarely  have  the  nerve  or  the  resisting  power  of 
the  whites. 

As  to  making  a  plaster  cast.  Dr.  Barringer, 
(page  20),  should  shave  the  skin  if  it  has  any 
hairs,  soap  or  grease  it  well,  and  then  apply  the 
plaster.  Lay  two  threads  or  wires  along  the 
aides,  and  as  the  plaster  begins  to  set,  withdraw 
these  and  the  cast  may  with  care  be  removed 
entire.  When  quite  firmly  set^  the  inside  is  to 
be  greased,  the  two  sides  placed  together  and 
plarter  run  in  to  form  the  cast 

Spasmodic  croup  is  peculiar  to  infants  under 
one  year  old.     The  treatment  is  uncertain ;  but 


counter  irritants  along  the  pneumogastic  in  the 
neck,  (mustard  is  best)  should  give  prompt 
relief. 

For  the  removal  of  a  brown  discoloration 
on  the  face,  B.  L.  N.,  (page  21),  may  paint 
with  corrosive  sublimate  solution,  one  grain  to 
the  ounce  or  stronger,  till  the  epidermis  is  re- 
moved ;  then  rub  with  compound  iodine  oint- 
ment, diluted,  and  then  apply  lanoline  till  the 
skin  is  restored. 

X.  X  X.  asks  what  will  remove  superfluous 
hair  from  the  skin,  besides  electricity.  Nothing. 

Dr.  Mantey,  (page  21)  will  find  alopecea 
areata  likely  to  be  of  syphilitic  origin.  Mercury 
and  potassium  iodide  internally,  and  canthar- 
ides,  30  drops  of  the  tincture  to  an  ounce  of 
benzoated  lard  locally,  would  be  pretty  good 
treatment 

I  feel  like  asking  "  Medico  "  (page  21),  what 
he  wants  to  cure  his  patient  for.  He  should 
notice  whether  the  womb  is  tipped  back.  If 
not,  let  her  take  a  full  dose  of  quinine  the 
night  before  the  accustomed  attack ;  or  a  full 
dose  of  atropine  (gr.  1-100)  ;  or  else  teach  her 
to  catheterize  herself. 

I  hope  the  two  valuable  letters  of  Drs. 
Stocker  and  Brodnax,  in  the  January  World, 
will  not  be  all  we  are  to  have  on  ^e  subject 
of  quinine  causing  hemorrhage.  The  Medical 
World  family,  with  its  thirty  odd  thousand 
members,  in  every  State  and  Territory,  could 
settle  this  important  question  if  each  one  who 
has  noted  such  cases  would  report  them.  But 
the  great  fault  I  have  to  find  with  you  is  that 
you  leave  a  few  of  us  to  do  the  talking  and 
keep  to  yourselves  experience  that  would  be  of 
the  greatest  value  to  your  fellow  <}octors. 

You  will  see  by  the  new  address  that  I  have 
gone  West  to  grow  up  with  Chicago. 

WILLLA.M  F.  WaUGH,  M.D. 

834  Opera  House  Block,  Chicago.  111. 


Thoughts  on  the  Principle  of  Cure  of  Maiaria. 

Editor  Medical  World  : — In  the  Medical 
Waif,  March,  1888,  Dr.  H.  B.  Delaney,  of 
Windsor,  Arkansas,  reported  his  treatment  of 
chronic  chills,  as  follows : 

R     PodophyUinl gr.  xll 

Saoch.  LftcUsM ...» rt.  xl 

Ft.  chart. No.  vl 

S.  One  powder  every  two  hours. 

This  was  found  to  be  too  violent  in  its  action 
so  he  reduced  the  prodophyllin  one-half.  The 
reduced  dose  causes  free  purging  and,  in  some 
cases,  vomiting.  At  the  time  of  writing  Dr. 
D.  had  used  the  remedy  about  three  years, 
without  failure,  and  no  relapse  reported  to  him. 
Since  that  time  I  have  used    podophyllin  in 


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THE  MEDICAL  WORLD. 


every  case  of  malaria  that  has  presented  itself 
for  treatment,  and  always  with  brilliant  suc- 
cess. 

I  will  mention  one  case  only.  Over  three 
years  ago,  when  I  practiced  in  the  country,  a 
etout,  able  bodied  man  called  to  be  treated  lor 
ague.  He  had  had  the  disease  three  months  the 
year  before,  and,  although  vigorously  treated 
by  two  physicians,  he  did  not  get  well  until  cold 
weather  set  in.  He  expressed  a  desire  to  be 
cured  at  once  if  possible,  as  he  was  a  laboring 
man  with  a  family  to  provide  for.  Having 
made  an  examination  I  accepted  his  own  diag- 
nosis, and  expressed  the  opinion  that  I  could 
cure  him  promptly  if  he  did  not  object  to  being 
made  right  sick  for  a  short  time.  I  prescribed 
podophyllin  in  full  doses,  and  explained  to  him 
the  action  the  medicine  was  expected  1o  hava 
He  told  me  afterwards  that  the  powders  made 
him  awfully  sick,  so  he  took  four  only,  but 
when  he  recovered  from  the  effects  of  the  medi- 
cme  he  was  well.  He  has  not  had  a  return  of 
the  disease  since.  Three  years  ago  I  treated  a 
medical  missionary  sick  of  typhoid  fever.  He 
had  been  in  the  mission  field,  Sjria,  Asia,  for 
twenty-five  years.  Malarial  fever  prevails  in 
that  coimtry.  He  told  me  that  elaterium  in 
large  doses  was  his  sheet  anchor  in  obstinate 
cases.     The  dose  mentioned  was  very  large. 

Several  of  the  World's  writers  have  had 
good  results  from  the  use  of  nitrate  of  potassium 
in  such  cases,  and  one  used  apocynum  cannab, 
flu.  ex.  successfully. 

Some  three  years  ago  two  doctors,  partners,  in 
«  Southern  State  (I  cannot  now  find  the  article 
to  name  them),  advanced  the  opinion  that  chills 
are  caused  by  an  excess  of  water  in  the  blood. 
They  claim  that  the  sweat  following  the  chill 
eliminates  the  excess  of  water,  and  in  this  way 
the  patient  is  relieved  until  the  water  reaccumu- 
iates.  Reasoning  thus  they  prescribed  acetate 
of  potassium  with  results  that  confirmed  them 
in  their  belief  as  to  the  cause.  The  articles  of 
*' Rhubarb"  and  Dr.  W.  B.  Crawford,  Decem-^ 
ber  World,  page  422,  are  the  occasion  of  these 
thoughts  being  offered  for  publication. 

It  will  be  obtterved  that  all  the  remedies 
herein  mentioned  deplete  the  blood  of  water  by 
acting  on  the  bowels  and  kidneye,  in  this  way 
effecting  a  cure ;  thus  confirming  the  correctness 
of  the  theory  of  the  doctors  referred  to  above, 
unless,  perchance,  the  poison  be  such  that  it  is 
simply  washed  out  by  the  watery  discharges 

In  conclusion  I  express  the  opinion  that  the 
cause  of  chronic  chills  can  be  removed  by  any 
remedy  that  acts  strongly  en  the  excretory  and 
secretory  organs,  particularly  the  skin,  bowels  or 
kidneys. 

Those  of  your  readers  who  practice  in  malar- 


ial districts  can  test  this  mode  of  treatment  and 
report  results. 

If  any  of  the  World's  family  can  reduce  en- 
larged tonsils  to  their  proper  size  by  injections, 
please  report  how. 

Of  six  medical  journals  which  I  take,  I  like 
the  World  the  best. 

J.  S.  DoDDS,  M.  D. 

6224  Station  st,  Pittsburg,  Pa. 


Milk  Sickness. 

Editor  Medical  World  : — The  affection  is 
not  due  to  milk  alone,  but  beef  and  butter  from 
affected  animals  entail  it  as  well  as  water  from 
certain  springs  and  seeps  from  the  earth. 

My  first  experience  with  the  ailment  was  ob- 
tained through  treatment  of  a  family  who  lived 
on  a  farm  about  three  miles  south  of  the  village 
of  Harrodsburgh,  Indiana,  in  1857.  The  said 
farm  had  be^  abandoned  in  disgust  by  its 
owner,  and  its  cabin  became  the  stopping  place 
of  any  who  chose  to  risk  it 

The  evil  was  finally  located  in  a  spring  near 
the  cabin  and  fenced  by  the  neighbors,  when  all 
again  went  well. 

A  little  further  down  the  ravine  was  another 
spring  wholly  free  from  the  pest ;  'but  children 
ignorant  and  indolent,  were  trusted  to  bring 
water,  which  they  procured  from  the  nearest 
source  until  the  mischief  was  done. 

There  can  be  no  question  as  to  the  correct- 
ness of  diagnosis,  for  leading  physicians  of  Bed- 
ford had  treated  other  cases  on  this  same 
farm,  and  among  others,  this  same  family,  who 
this  time  recognized  their  ailment  before  send- 
ing for  medical  aid.  This  family  could  not 
have  contracted  the  affection  from  milk,  butter 
or  beef  for  by  confession  they  had  neither,  and 
the  children  finally  confessed  to  having  carried 
water  from  the  "Milk-sick  Spring." 

Where  the  water  from  the  two  springs  unite 
and  mingle,  stock  may  drink  with  impunity,  and 
in  winter  and  spring  time  when  the  earth  is  full 
of  water,  that  from  the  "Milk-sick  Spring"  may 
be  used  without  detriment  This  all  points  to 
a  poison  in  water  which,  when  largely  diluted, 
is  not  received  in  sufficient  quantity  to  do  per- 
ceptible harm ;  but  in  summer  and  in  autumn, 
more  or  less  early  according  to  accession  of 
drought,  the  poison  is  more  concentrated  and 
the  so-called  milk  sickness  results 

In  1858,  while  living  at  Effingham,  111.,  my- 
self and  wife  had  milk  sickness,  and  the  per- 
sonal experience  thus  gained,  together  with  its 
frequent  occurrence  there,  led  me  to  seek  infor- 
mation from  every  available  source  and  I  here 
offer  a  statement  of  factJB  pertaining  to  the  mat- 
ter. 

After  heavy  autumn  rains  come,  people  in 


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milk  sick  regions  may  permit  their  cattle  to  run 
at  large  without  evil  consequences.  And  yet, 
if  protracted  drought  sets  in  again,  and  especi- 
ally so  if  warm  days  prevail,  in  which  case  cat- 
tle drink  more  water,  and  it  being  more  concen- 
trated, experience  has  taught  that  cattle  must 
be  put  up,  or  milk  sickness  be  expected. 

In  those  parts  of  Effingham,  Clay  and  Jasper 
counties  covered  by  my  observation,  many  low 
boggy  places,  (there  are  no  springs)  were  fenced 
up  and  milk  sickness  at  once  ceased  except  in 
the  case  of  breachy  stock  which  broke  into  the 
enclosures  now  and  then  or  strayed  to  other 
sources  of  the  evil. 

Then  again,  if  cattle  are  kept  up  in  the 
morning  until  the  dew  has  dried  off  and  then 
returning  to  the  pen  before  nightfall,  they  may 
run  at  large  during  the  day  time  throughout 
the  year  with  perfect  impunity,  provided  there 
be  no  opportunity  to  drink  fiom  the  poisonous 
seeps. 

Or,  cattle  may  be  put  into  the  milk  sick 
patches  after  the  dew  has  dried  off  and  eat 
every  vestige  of  vegetation  and  no. harm  comes 
of  it  if  there  be  no  surface  water  to  drink. 

And  then,  if  removed  before  nightfall  and 
sheaf  oats  be  spread  over  the  ground  and  al- 
lowed to  receive  the  dew  deposited  from  con 
densation  of  warm  vapor  arising  from  the  moist 
earth  beneath  and  this  be  fed  ti>  a  calf  in  the 
stall,  milk  sickness  follows  as  certainly  as  any 
other  effect  follows  a  sufficient  cause. 

This  points  clearly  to  a  poison  in  the  earth, 
soluble  in  water,  and  which  is  finally  removed 
by  drainage  and  cultivation. 

The  two  prominent  characteristics  of  milk 
sickness  are  persistent  vomiting  and  obstinate 
constipation. 

The  red,  pointed  tongue,  the  intense  gastric 
initability,  the  persistent  nausea,  the  nasty  me- 
tallic taste  in  the  mouth  and  the  greenish  acid 
▼omit  with  tenacious  mucous,  often  streaked  with 
blood,  is  an  exact  counterpart,  to  arsenical  poi- 
soning, but  strangely,  more  persistent  and  less 
dangerous. 

The  obstinate  constipation  recalls  a  chief 
symptom  of  lead  poisoning,  but  the  character- 
istic blue  line,  wrist  drop  and  all  other  objec- 
tive signs  and  symptoms  are  lacking. 

In  treatment,  the  stomach,  above  all  things, 
requires  rest,  and  nothing  secures  this  so  quickly 
and  efficiently  as  a  thorough  evacuation  of  the 
bowels  ;  but  the  stomach  itself  being  sick  must 
not  be  called  upon  to  labor  in  their  behalf. 
The  rectal  tube  now  in  use  will  probably  super- 
tede  the  ungraceful  plan  I  had  of  turning  ''the 
other  end  up,"  while  using  the  syringe,  but 
must  be  used  persistently  to  tie  end  that  nature 
shall  have  a  continuous  outlet  through  which  to 


rid  itself  of  the  poison.  I  have  never  known  a 
case  to  get  better  until  this  condition  was 
brought  about,  nor  fail  in  doing  so  after  it  had 
been  accomplished. 

A  mixture  of  neutralizing  cordial  and  brandy 
equal  parts  given  freely,  was  my  most  popular 
medicament.  The  cordial  neutralized  the  acid 
fluids  in  the  stomach  and  gave  a  short  but  grate- 
ful feeling  of  relief,  while  the  brandy  abated 
the  neivous  prostration  and  feeling  of  ''gone- 
ness" so  persistently  present  Minute  doses  oi 
morphine  with  bismuth  was  also  popular  with 
most  patients,  but  I  would  now  ^ggest  cocaine 
instead. 

Diet,  of  course,  should  be  light  and  bland^ 
but  there  being  the  most  utter  disgust  for  food^ 
little  restraint  will  be  required.  The  fact  thai 
milk  sickness  is  chiefly  confined  to  malar- 
ial districts  and  prevails  at  a  season  when  that 
disorder  is  most  prevalent,  would  seem,  during 
the  stage  of  convalescence,  to  call  for  quinine^ 
and  the  nervous  prostrations  (trembles)  to  de- 
mand nux  vomica,  and  in  actual  pi  act  ice  I 
have  found  these  articles  exceptionally  useful. 

It  is  a  common  belief  that  persons  who  have 
milk  sickness  never  fully  recover,  but  this  is 
erroneous.  Still,  many  persons  of  feeble  consti- 
tution take  on  dyspeptic  symptoms  which  last 
through  life,  and  the — "trembles" — continue  as 
a  consequence  of  defective  nutrition. 

U.  N.  Mellette,  M.D. 

DeLand,  Florida. 


Diphtheria. 
Editor  Medical  World: — In  the  March 
number  of  The  World  for  1893,  the  subjeci 
of  diphtheria  was  pretty  thoroughly  ventilated, 
and  one  ought  to  be  benefitted  by  reading  that 
number.  But  then,  one  must  confess,  after 
having  read  it  through,  that  he  is  somewhat  be- 
wildered what  plan  of  treatment  to  adopt,  if  he 
has  none  of  his  own.  It  is  somewhat  strange 
when  we  read  of  the  experiences  of  those  lights 
whose  articles  appeared  in  that  number,  where 
they  state  so  many  cases  and  no  deaths  under 
their  plans  of  treatment,  and  when  some  one 
else  tries  that  treatment  to  find  his  success  quite 
diflerent  On  page  83  of  that  number  J.  M, 
Waters  reports  sixteen  cases,  without  a  death* 
On  page  424,  December  number,  W.  S.  Ram- 
sey reports  six  cases  with  recovery.  On  page 
431,  of  the  same  month.  Dr.  Stroell  reports 
twenty- two  favorable  cases.  On  page  99  of 
March  number,  500  cases  are  reported  with  a 
moTtalitj  of  less  than  ^  per  cent  All  of  these 
cases  are  reported  as  having  been  treated  in 
diflerent  ways.  Can  it  be  possible  that  all  these 
were  cases  of  genuine  diphtheria?  We  read 
almost  daily,  in  the  p»<blie  prints,  reports  of  the 


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fearful  mortality  of  this  diseaae  in  different 
sections  of  the  country,  as  many  as  four  or  five 
in  the  same  family  dying  from  iL  I  make  the 
assertion,  that  when  one  gets  a  genuine  or 
malignant  case,  he  has  something  on  his  hands 
he  would  like  to  get  rid  of,  and  the  probability 
is,  in  some  cases,  whatever  the  plan  of  treatment, 
he  will  stand  a  good  chance  of  getting  rid  of 
them  in  a  way  he  does  not  like;  and  in  a  severe 
epidemic  he  may  think  himself  well  off  if  he  gets 
through  with  a  mortality  of  25  per  cent  Un- 
doubtodly  the  mortality  of  any  epidemic  will 
depend  largely  upon  its  virulency,  the  age,  cir- 
cumstances and  previous  condition  of  the  patient's 
health,  complications,  constitution  and  environ- 
ment of  the  patient,  as  well  as  the  kind  of  treat- 
ment adopted  and  the  ability  to  have  it  carried 
out  For  a  regular  physician  to  assert  that  he 
never  lost  a  case  of  diphtheria,  or  that  he  would 
give  $25  for  a  case  that  he  could  not  cure, 
shows  that  he  does  not  know  what  he  says,  that 
he  never  saw  a  genuine  case,  that  he  was  unable 
to  make  a  correct  diagnosis,  that  he  cannot  be 
believed  or  that  he  is  dominated  by  selfishness. 
Such  a  one  ought  to  write  a  book  for  the  rest  of 
us  in  order  that  we  might  learn  how  to  treat 
such  cases.  It  is  strange  what  views  some 
physicians  take  in  the  treatment  of  disea^. 
When  one  reads:  "Let  the  patient  have  to  eat 
any  thing  he  may  desire;"  and  another,  "when 
I  see  in  one  line  the  advocacy  of  milk  as  a  diet" 
in  typhoid  fever,  I  expect  to  read  in  the  next  line 
that  *4n  many  cases  hemorrhage  occurs/'  the 
inexperienced  knows  not  what  to  believe.  The 
inexperienced  is  almost  like  the  mariner  with- 
out a  compass  or  the  ship  without  a  rudder, 
when  he  reads  such  opinions  from  medical  men. 
To  all  such  I  would  say,  read  up  closely,  ex- 
amine thoroughly,  sift  out  carefully  and  then 
adopt  the  most  rational  plan  of  treatment  Qive 
the  patient,  and  especially  a  bad  diphtheritic  one, 
unremitting  attention,  neglect  no  duty  and  do 
not  expect  every  case  to  recover. 

Notwithstanding  that  the  etiology  of  diph- 
theria seems  to  be  pretty  well  settled, 
there  are  very  interesting  questions,  still, 
that  might  be  propounded  to  the  fra- 
ternity, but  esfiecially  to  the  scientific  in- 
veetigatora.  The  first  one  I  wish  to  suggest  is: 
Can  a  so-called  peeudo  diphtheritic  case  commu- 
nicate or  generate  in  another  person  true  diph- 
theria or  the  KlebsLoeffler  bacillus?  2d. 
In  how  short  a  time  is  it  possible  for  a  case  to  re- 
cover from  true  diptheria,  when  the  symptoms 
were  pronounced  at  the  start?  By  recovery  in 
this  question  is  meant,  that  to  a  physician  un- 
acquainted with  the  case,  he  would  be  unable  to 
know  that  the  individual  had  had  any  sickness. 
8d.  Gould  it  be  possible  (without  a  sa  called 


microscopic  examination)  for  a  physician  to 
diagnose  a  case  as  diptheria  when  the  sjrmptoms 
were  as  above  and  when  the  patient  recovered 
at  the  farthest  in  six  days?  And  is  it  possible  or 
probable  that  such  a  case  could  or  would  start 
an  epidemic  in  which  a  number  lost  their  lives? 
4th.  What  would  be  the  effect  of  inoculating  a 
person  on  the  arm,  for  instance,  with  the  Klebs- 
Loeffler bacillus  ?  Would  it  manifest  itself  on 
the  tonsils  first  or  be  local  primarily,  then  consti- 
tutionally, and  afterward  tonsilar?  5th.  Has 
any  one  known  or  seen  cases  where  the  Klebe- 
Loiefiier,  or  true  diphtheria  has  occurred  the 
second  time  ?  It  is  a  very  important  thing  that 
the  diagnosis  of  this  disease  be  correct ;  but,  un- 
fortunately, this  is  sometimes  impracticable.  It 
is  not  so  alone  for  the  patient's  sake  as  for  the 
community  in  which  the  patient  lives.  Patients 
are  treated  according  to  the  symptoms  they  pre- 
sent, and  if  a  patient  has  the  Klebs-Leoffler 
diphtheria  and  recover,  apparently,  in  a  few 
days,  he  is  liable  to  inoculate  a  whole  neighbor- 
hood if  restraints  are  not  imposed,  or  he  should 
come  into  certain  contact  with  the  unsuspecting. 
It  is  a  pity  that  not  more  of  us  are  not  more  ex- 
pert with  the  microscope  and  the  methods  of  cul- 
ture. If  the  present  theory  of  the  disease  is 
correct  it  must  be  the  only  way  in  which  errors 
of  diagnosis  can  be  avoided.  Would  it  not, 
therefore,  be  well  to  have  paid  experts,  in  every 
county  seat,  whose  business  it  should  be  to  give 
a  diagnosis  from  an  examination  of  the  speci- 
mens submitted  to  him  by  the  physicians  of  his 
county?  In  the  matter  of  treatment,  I  refrain 
from  giving  a  detailed  plan  or  my  experience.  I 
try  to  suit  the  treatment,  as  far  as  I  can,  to  the 
individual  case.  Regarding  the  disease  as 
primarily  local,  afterward,  systemic,  it  occurs 
to  me  that  too  much  importance  cannot  be  given 
to  local  treatment  Any  of  the  germicides 
which  have  been  given  in  the  March  number 
are  good.  Some  are  perhaps  better  than  others. 
The  peroxide  of  hydrogen  is,  perhaps,  as  good  as 
any.  Before  its  introduction  I  formerly  used 
chlorine  water  and  Monsell's  Solution  with  a 
swab,  and  I  may  say  that  my  success  was  equal 
to  if  not  better  than  that  with  any  other  appli- 
cation. The  hand  atomizer,  of  more  recent  intro- 
duction, is  a  great  addition  in  the  treatment 
This  can  be  entrusted  better  to  the  attendants  to 
have  the  local  treatment  carried  out  than  when 
done  by  the  swab  by  the  same  parties.  There 
is  nothing,  however,  that  equals  the  Bwab  when 
properly  used>-but  its  improper  use  is  the 
trouble  with  that  instrument 

I  should  not  omit  to  say  that  lemon  juice  will 
often' abort  an  incipient  diphtheritic  patch,  and 
is  invaluable  in  cases  of  epistaxis.  For  consti- 
tutional treatment  this  must  be  varied  according 


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to  the  stage  of  the  disease  and  condition  of  the 
patient.  At  the  beginning,  a  mild  laxative  pre- 
fkeed  by  mild  chloride;  and  for  the  fever, 
aconite,  nitrate  of  potassium,  jaborandi,  polk-root, 
etc.  In  a  day  or  t«¥0,  if  it  is  not  indicated  at  the 
outset,  the  accepted  iron,  chlorate  of  potassium 
or  ammonium  with  bichloride  as  frequently  and 
as  strong  as  thought  necessary. 

I  wish  to  say  in  this  connection,  to  those 
physicians  who  have  used  the  ammonium, 
muriate  of  iron,  etc,  mixture  in  the  strength  as 
given  on  page  77-78,  of  the  March  World, 
without  protest  from  patients,  and  were  able  to 
keep  it  up  as  long  as  they  desired,  that  their  ex- 
perience has  been  different  from  mine.  I  have 
Been  some  get  well  on  it,  and  I  hav^  seen  some 
who  did  not  But  in  every  case  where  it  has  been 
used  it  has  required  very  great  urgency  to  get 
the  patient  to  take  it,  and  in  a  few,  if  you 
wanted  it  taken  it  would  have  to  be  forced 
down  the  patient.  To  me  it  seems  to  be  a  large 
and  strong  dose. 

Stimulants  may  be  found  necessary  sometimes, 
but  not  in  every  case.  One  of  the  very  import- 
ant things  in  the  treatment  of  this  disease  is 
nourishment  Unfortunately,  ofteu,  this  is  a 
difficult  thing  to  attain.  What,  with  the 
dysphagia — the  fluid  returning  through  the 
nostrils —the  loss  of  appetite  and  general 
asthenia  and,  sometimes,  the  patient  refusing  to 
take  anything,  the  physician  finds  himself, 
handicaped  in  his  effort  to  restore  the  sick 
one  to  health.  At  such  a  time  he  feels  how  lit- 
tle avail  have  been  and  are  all  his  efforts  in  be- 
half of  his  patient. 

Greenwich,  N.  J.         Dr.  S.  M.  Snyder, 


Diphtheria. 

Editor  Medical  World: — I  was  one  of 
your  contributors  upon  the  subject  of  diphtheria 
in  the  March  World,  1893.  Last  July  and 
August  a  number  of  cases  came  under  my  care 
which  appeared  to  be  genuine  diphtheria.  Un- 
der the  use  of  Dr.  Galentin's  treatment  (given 
in  March  World,  1893)  they  all  recovered  in 
a  short  time.  On  November  4th,  1893,  a  girl 
nine  years  old,  who  had  diphtheria  in  a  bad 
form,  and  should  have  been  treated  several 
dHys  before,  came  under  my  treatment  Dr. 
Oalentin's  method  of  cure  was  a  perfect  failure, 
the  disease  marching  steadily  onward  I  then 
resorted  to  the  various  methods  of  treatment  de- 
scribed in  my  article  referred  to  above,  but 
with  no  better  success.  Being  about  at  the  end 
of  my  resources  it  occurred  to  me  that  I  had 
noted  the  following  prescription  in  my  scrap 
book  some  time  before : 


"BEST  ANTISEPTIC  SOLUTION  KNOWN. 

R    Carbolic  acid 10  grammff  (160gn.) 

Salicylic  add 1  gramme  (16  gra) 

BsRenceof  mint 10  drops,  mix 

One-half  per  cent  solution  in  water  for 
microbes  of  diphtheria  and  typhoid  fever.  One- 
fifth  per  cent  for  anthrax  bacillus.  Tuber- 
culous sputa  sterilized  by  a  one  per  cent  solu- 
tion in  fifteen  minutes  "  (Author  of  prescrip- 
tion unknown  to  ma) 

I  prepared  some  of  the  above  solution,  added 
four  drops  of  it  to  one  ounce  of  water,  and  di- 
rected the  patient  to  gargle  with  one  teaspoon- 
ful  every  half  hour.  At  this  time  Dr.  Frank 
H.  Sidwell,  of  Johnsville,  Md.,  saw  the  case 
with  me  in  consultation.  He  suggested  quinine 
grs.  ij  every  four  hours,  with  one  teaspoonful  of 
whisky.  In  two  hours  Tinct  Fer.  Chlorid.  gtts. 
six.  Potass.  Chlorat  grs.  2i.  He  approved  of 
the  gargle  and  advised  its  continuance  Under 
this  treatment  the  patient  rapidly  improved  and 
in  three  days  ^  as  out  of  danger.  Discharged 
in  fifteen  days. 

I  soon  saw  a  case  of  the  same  disease  in  a 
young  man  seventeen  years  old.  A  bottle  of 
the  gargle  was  prepared  (four  drops  of  carbolic 
acid  mixture  to  one  ounce  of  water)  and  a  tea- 
spoonful  handed  to  him,  with  a  request  to  gar- 
gle, but  this  he  promptly  swallowed  With 
some  misgivings  as  to  the  effect  of  this  dose  upon 
his  interior  department,  I  advised  him  to  use 
the  gargle  every  hour  while  any  deposit  ap- 
peared upon  the  tonsils.  Information  reached 
me  the  next  day  that  his  throat  was  well  and  he 
never  felt  better.  Since  then  I  have  used  the 
gargle  in  a  number  of  cases  with  uniform  suc- 
cess. Where  the  cases  appeared  to  be  threaten- 
ening  one  drop  of  the  above  carbolic  acid  mix- 
ture has  been  added  to  one  ounce  of  water,  and 
my  adult  patients  directed  to  take  a  teaspoonful 
every  hour  or  two  while  the  deposit  remained. 
So  far  I  have  not  paid  more  than  a  second  visit 
to  any  of  my  patients.  In  children  the  throat 
is  swabbed  with  the  gargle  every  hour,  and  the 
mixture  (one  drop  to  one  ounce  of  water)  given 
internally  in  doses  proportioned  to  the  age,  the 
adult  dose  being  a  teaspoonful.  Knowing  that 
the  eradication  of  diphtheria  is  a  consunmiation 
devoutly  to  be  wished  for  by  all,  my  desire  to 
aid  in  the  good  work  has  prompted  this  commu- 
nication. John  J.  Ligget,  M.S. 

Ladiesburg,  Md. 

[Dr.  Liggett  is,  perhaps,  somewhat  over- 
cautious, as  the  solution  is  not  dangerous  if 
occasionally  swallowed  in  the  doses  given,  but 
would,  on  the  contrary,  be  beneficial,  serving 
to  combat  the  poison  that  has  passed  into  the 
stomach  and  that  absorbed  into  the  general 
system.  One  teaspoonful  of  the  solution  given 
will  contain  about  one-half  grain  of  carbolic 
acid,  which  is  a  medium  dose. — Ed.] 

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Treatment  of  Pott-Partum    Hemorrhage. 
Yawning  a  Sign  of  Hemorrhage. 

Editor  Medical  World  : — That  is  an  ex- 
cellent article  on  uterine  hemorrhage  by  Dr. 
West  I  hardly  think  he  does  full  justice  to 
the  plan  of  clearing  the  uterus  by  the  hand.  In 
many  cases  the  uterus  is  too  distended.  It  can- 
not contract  Called  to  a  case  we  may  find  the 
uterus  very  large,  not  much  blood  coming 
away,  but  great  faintnees.  We  must  empty  the 
uterus  as  soon  as  possible,  immerse  hand  and 
arm  in  hot  carboli^ed  soap  and  water,  steady 
the  uterus  with  one  hand,  pass  the  other,  turn 
out  all  clots,  large  and  small,  remove  those 
fibrinous  clots  adhering,  press  knuckles  and 
back  of  closed  finger  against  internal  surface  of 
uterus  and  in  return  you  will  get  (to  you)  a 
most  delightful  squeeze  and  possibly  your  hand 
will  be  expelled;  if  so,  carry  away  all  clots  in 
the  vagina.  I  suppose  the  uterus  has  been  well 
held  on  to  externally.  If  it  contracts  well  put 
on  firm  compress  and  good  bandage,  and  I  ad 
vise  the  young  doctor  to  put  these  on  himself 
and  most  carefully — and  to  remain  two  hours. 
No  ice,  as  cold  applications  are  too  depressing, 
and  no  chloroform. 

I  have  advised  the  removal  coagula  for  the 
reason  that  these  clots  have  very  little  effect  in 
restraining  flow  of  blood.  To  do  good  they 
must  extend  some  distance  within  the  vessel, 
and  there  would  not  be  disturbed.  They  prevent 
firm  contraction  and  they  are  the  cause  of 
severe  after  pains.  I  have  several  times  seen 
most  violent  after  pains  with  great  faintness  and 
nothing  gave  relief  till  the  hand  was  passed  into 
the  vagina  and  with  two  fingers  some  adhering 
clots  were  removed  and  the  trouble  at  an  end. 

I  may  say  I  give  stimulants — brandy  or  old 
whisky,  when  I  know  it  is  good.  There  is  one 
thing  more — never  leave  a  patient  if  she  yawns 
or  gapes.  It  is  a  certain  sign  of  impending 
hemorrhage.  I  have  proved  it  I  learnt  it  from 
my  old  father  and  I  dare  say  his  father  told  him 
and  I  have  told  my  son — four  generations,  so 
there  should  be  wisdom  somewhere  in  the  family. 

Toronto,  Canada.    T.  C.  Mewburn,  M.D. 


Hytteria.—Replies  to  December  Queries. 

Editor  Medical  World: — Who  has  not 
bfeen  annoyed  by  cases  of  hysteria?  How  many 
morphine  habitues  are  made  in  a  year  by  the 
injudicious  use  of  morphine  in  hysteria  ?  I  shall 
never  forget  how  near  I  came  to  killing  a  pa- 
tient by  giving  a  large  dose  of  morphine  and 
atropine,  hypodemically  in  a  case  of  hysterial 
intercostal  neuralgia,  and  let  me  warn  the 
younger  members  of  our  brotherhood  to  never 
give  belladonna  or  its  alkloid,  atropine,  in  hys- 


teria, and  when  the  diagnosis  is  doubtful  use 
morphine  uncombined  for  pain. 

**The  books"  unfortunately  help  us  little  in 
the  immediate  treatment  of  hysteria.  All 
writers  on  this  subject  agree  that  moral  suasion 
is  of  the  greatest  value  in  the  cure  of  thi» 
malady,  but,  unfortunately,  we  are  not  told 
where  to  get  this  remedy  or  when  and  how  to 
apply  it 

It  may  be  laid  down  as  a  fiact,  that  it  is  the 
absence  of  this  very  element  that  make  hysteria 
a  possibility.  Where  hysteria  flourishes  good 
judgment  is  a  stranger  and  ignorance  a  frequent 
guest 

The  first  impression  made  on  a  hysterical 
patient  is  of  the  utmost  importance.  If  the  case 
be  "bagged"  with  the  first  start  further  treat- 
ment is  rendered  without  trouble,  but  to  fail 
then  is  fatal. 

It  goes  without  saying  that  the  best  treatment 
comprises  power  and  harmlessness.     Here  it  is. 


..q.i. 


R    Tr.lobelU. 

Tr.  capeicuin aa 

Big.    Apply  per  rectum. 

Apomorphine  is  also  a  splendid  remedy  in  this 
malady,  but  the  above  formula  is  absolutely 
without  equal,  and  rarely  has  to  be  given  to  the 
same  person  twice.  The  mere  mention  of  Dr. 
So-and-so's  name  is  generally  sufficient 

Where  the  lobelia  is  not  at  hand,  an  infusion 
of  tobacco  and  pepper  from  the  table  will  "get 
there  just  the  same."  Alienist's  tell  us  that  in 
hysteria  the  patient  is  dominated  by  one  idea 
which  cannot  be  removed  by  the  will.  The 
above  treatment  will  remove  this  dominating 
idea  —in  hysteria  and  temporary  insanity — with- 
out injuring  the  patient  in  the  least.  I  would 
advise  Dr.  Mitchell,  who  asks  for  assistance 
with  his  cyetitis  case,  to  examine  care- 
fully for  stone.  Excluding  that,  have  pa- 
tient sleep  alone,  give  bromide  of  potassium, 
enough  to  quiet  the  nerve  centeres.  Forbid  all 
kinds  of  stimulants,  including  meat,  tea.  coflee^ 
pepper,  etc.  He  may  begin  with  the  recog- 
nized sedatives  of  the  urinary  tract,  ad- 
ding to  them  the  passage  of  steel  sounds  into  the 
bladder  if  necessary.  Prohibit  such  form  of 
exercise  as  will  tend  to  induce  pelvic  conjection. 

For  the  attack — hot  water  injection  into  the 
bladder  and  rectum.  For  drugs,  suppositoriee  of- 
cocaine,  morphine  and  atropina  Absolute  rest  in 
bed.  In  reply  to  query,  I  have  known  people 
before  now  who  didn't  think  "morning  and 
night"  was  excessive  sexual  indulgence.  Make 
your  patient  sleep  alone,  cut  ofl  the  stimulants^ 
give  potassium  bromide  gr.  iv.  t  i.  d.,  after 
meals  and  'then  see." 


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I  should  call  Dr.  Bidgood's  case  one  of  pass- 
ive congestion  at  the  base  of  the  brain  and 
-would  treat  him  by  exciting  some  distinct  part, 
the  bowels  or  the  skin  of  lower  extremities.  For 
instance,  keep  the  long  thigh  stockings  moist 
with  infusion  of  capsicum  made  strong  enough 
to  give  him  something  to  think  of  and  so  keep 
bim  awake.  Aloes,  jalap  and  colocynth  maj 
be  used  at  the  same  time  to  excite  the  intestinal 
**m.  m."  and  so  "draw  it  down"  from  the 
liead. 

I  have  just  had   additional  evidence  of  the 
value  of  salines  in  orchitis.     This  treatment  fol- 
lowed by  a  tobacco  poultice  is  very  excellent 
Db.  Clarence  B.  Davis, 

139  Friend  St.,  Providence,  R.  I. 


''Strychnine  in  Nfootine  Poisoning." 

Editor  Medical  World  : — As  I  obtain  a 
great  many  good  ideas  from  the  pages  of  your 
valuable  journal^  I  will  report  a  case  that  might 
be  of  interest  to  fcome  one. 

Gabe  M.,  age  twenty-two,  has  been  a  constant 
fimoker  of  cigarettes  for  six  years,  using  each  day 
nearly  one  ounce  of  smoking  tobacco.  Not 
long  since  I  was  called  to  see  him  and  found 
him  in  a  semi  comatose  state  presenting  the  fol- 
lowing symptoms : 

Sensation  completely  lost,  mind  wandering, 
and  part  of  the  time  unconscious,  but  would 
protrude  the  tongue  when  requested ;  aphonia 
complete,  pulse,  105  per  minute ;  temperature 
101^;  extremities  cold ;  body  in  a  cold  preepira- 
tion ;  all  reflexes  lost ;  respiration  quick  and 
labored,  lasting  only  a  few  moments,  then  it 
would  stop,  and,  by  artificial  methods,  respira- 
tion could  be  again  started  ;  pain  in  region  of 
right  nippla  Treatment :  Hot  mustard  bath  ; 
inhalation  of  Spts  camphor;  and  1-50  gr.  of 
etrychnine  sulph.  hypodermatically.  In  four 
or  five  minutes  from  the  first  dose  he  became 
perfectly  rational,  sensation  returned  and  was 
all  right  and  he  asked  for  a  cigarette,  which  was 
promptly  given  him  and  again  he  relapsed  into 
his  former  condition.  Again  the  strychnine 
was  employed  and  again  he  was  relieved.  After 
this  the  cigarettes  were  prohibited  and  the 
next  day  when  I  saw  him  he  was  feeling  quite 
well  and  has  continued  so  to  the  present.  He 
«till  smokes  occasionally  (not  believing  it  to 
<»use  this  trouble)  but  not  to  excess,  as  before. 
My  object  in  reporting  this  case  is  to  show  the 
already  known  fact  of  the  prompt  action  of  drugs 
when  given  hypodermatically  and  to  aid  some 
one  who  may  have  a  similar  case  to  treat  in  the 
future.  J,  A.  White,  M.D. 

Pineville,  La. 


A  Case  of  Acute  Laryngitis,  With  Some  Commentt 
on  the  Nature  of  that  Complaint. 

Editor  Medical  World  : — Mrs.  W.  S., 
aged  30  ;  mother  of  four  children,  and  again 
six  months  enceinte,  her  previous  health  not 
first-class,  but  subject  to  uterine  catarrh  and 
other  troubles  of  %e  uterine  appendages.  She 
has  been,  also,  subject  to  catarrhal  troubles  of 
the  throat  and  nasal  passages.  Symptomatology: 
The  case  was  taken  with  a  slight  chill,  soreness 
and  stifiTness  of  the  throat,  difficulty  of  swallow- 
ing and  a  sense  of  constriction  and  a  desire  to 
clear  the  hroat 

Following  the  chill,  febrile  reaction  came  up, 
and  was  quite  intense,  considering  the  amount 
of  inflammation.  Then  there  was  a  dull  pain 
felt  in  the  throat,  sense  of  constriction  was 
markedly  increased,  and  tenderness  of  pressure 
over  the  trachea. 

The  voice  became  harsh,  hoarse  and  stridu- 
lous,  with  a  frequent  and  dry  cough.  The 
harshness  of  the  voice  increased,  until  it  sank 
into  a  whisper,  and  the  patient  was  distressed 
very  much  in  trying  to  talk.  Attending  these 
subjective  symtoms,  there  was  a  general  aching 
of  the  bones,  restlessness  and  pervigillium.  On 
examining  the  throat  the  fauces  was  found  red 
and  tumid,  and  on  pressing  the  tongue  the 
epiglottis  was  seen  to  be  erect,  swollen  and  red. 
After  the  first  twelve  hours,  there  was  consider- 
able dyspnea,  a  piping  voice  and  great  anxiety. 
The  cough  was  strid ulcus  and  convulsive  and 
attended  by  attacks  of  spasm  of  tbe  glottis 
which  threatened  suflocation  to  the  patient  The 
attack  lasted  three  weeks,  from  first  to  last,  and 
it  seemed  that  my  patient  would  slip  through 
my  fingers  a  part  of  the  time — so  much  so,  that 
I  became  very  nervous  in  watching  the  onset  of 
the  disease  and  the  extremely  tenacious  condi- 
tion of  membrane.  But  under  the  dissolving 
influence  of  small  doses  of  calomel,  the  inhala- 
tion of  the  steam  of  vinegar  and  water,  and  the 
use  of  eucalyptol  (Sander's)  and  hydrastis 
(Lloyds),  by  means  of  the  atomizer,  the  mem- 
brane finally  began  to  yield  and  soften,  after 
which  my  patient  began  to  get  relief.  I  found 
quinine  to  answer  a  good  purpose  in  this  case, 
and  so  did  the  application  of  a  stillingia  lini- 
ment made  as  follows  : 

R.    Oilof  lobeUa 1  dr. 

Oil  of  cajeput 1  rtr. 

OUof  stUlliigla 1  dr. 

A^lcobol jdx  dre. 

m.  8ig.   Apply  to  the  throat,  or  wind  pipe,  all  along  its 
whole  extent,  as  often  as  erery  two  hours. 

I  think  the  use  of  steam  is  of  very  great  im- 
portance in  the  treatment  of  this  disease.  I 
used  calomel  in  one-tenth  grain  doses,  every  two 
hours,  having  in  view  the  softening  of  the  mem- 
brane. In  children  I  often  use  phytolacca  and 
aconite,  instead  of  calomeL     The  dyspnea  was 


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caused  by  the  narrowing  of  the  wind-pipe,  by 
the  thickening  of  the  membrane,  and,  of  course, 
anything  that  would  soften  and  break  it  down 
would  give  relief ;  even  the  expectoration  of  a 
Inmp  not  larger  than  a  pea,  would  give  relief, 
the  patient  breathing  better.  It  was  wonderful 
to  see  how  quickly  the  pale  and  anxious  counten- 
anoe,the  livid  lips,  the  starting  eyes  and  the  cold 
extremities  would  improve  in  appearance  on  the 
expulsion  of  so  little  a  particle  of  the  membrane. 

The  breathing  of  the  vapor  of  lime  while 
undergoing  the  process  of  slacking,  seemed  at 
first  to  give  relief,  but  I  had  soon  to  suspend 
the  use  of  it  on  account  of  its  irritating  effect  on 
the  lips  and  face.  I  considered  that  this  case 
was  acute  laryngitis,  identical  vrith  pseudo- 
membranous croup,  as  found  in  the  cluld.  I 
also  think  that  membranous  croup  in  the  child 
is  just  the  fame  as  laryngitis  in  the  adult  and 
should  be  treated  on  the  same  principle.  I 
know  there  is  nothing  new  in  this  assertion,  but 
consider  that  it  is  well  to  remember  this  fact 
when  we  come  to  treat  this  disease  in  either 
class  of  patients.  J.  J.  Fly,  M.D. 

Pulley's  MUl,  111. 


What  it  the  Interval  and  the  Dote  ? 

Editor  Medical  World: — If  all  contribu- 
tors to  knowledge  in  The  Medical  World 
would  remember  that  the  amount  and  frequency 
of  a  drug  given  is  as  essential  as  the  name  of 
the  drug,  it  would  save  the  inconvenience  of 
writing  individually  to  contributors.  For  in- 
stance, in  the  January  number  in  Dr.  ShotwelPs 
treatment  of  rheumatism  by  osmic  add  he  says: 
"In  my  cases  it  required  from  (6)  five  to  (7) 
seven  injections  to  complete  a  cure."  Now,  no- 
tice the  amount  is  not  given  but  he  tells  us  how 
much  morphine  he  used  as  a  dose  and  time 
given.  Of  the  two  drugs  I  think  if  the  cireum- 
stanoes  were  reversed,  viz : — the  dose  of  the 
acid  plainly  given,  we  by  our  constant  use  of 
morphine  would  easily  find  out  its  dose.  My 
idea  is  that  in  giving  a  new  remedy  it  is  import- 
ant to  state  plainly  how  much  and  how  often 
taken,  and  by  so  doing  we  have  a  definite  point 
to  work  from.  I  do  not  mean  an}  thing  personal 
to  Dr.  Shotwell  regarding  this  oversight,  for  I 
know  that  he  is  only  one  of  the  many  who  com- 
mit the  same  error.  I  was  much  pleased  with 
his  treatment  and  shall  use  it  when  opportunity 
occurs.  Waiting  to  be  enlightened  upon  the 
subject,  I  am,  etc.  G.  P.  Johnson, 

673  Sixteenth  St.,  Detroit,  Mich. 


Editor  Mepical  World: — The  World  gives  us 
the  same  help  as  of  old,  and  each  jear  it  seems  more  and 
more  of  a  friend.  P.  Bpekobr  Halset,  M.D. 

128  West  69th  8t,  New  York,  N.  Y. 


Aikaioidal  (Dotimetrio)  Medication. 

Editor  Medical  World  : — In  view  of  the 
real  desire  for  facts  along  the  line  of  the  ap- 
plied therapuetics  of  the  active  principles,  and 
fearing  that  the  letter  from  Dr.  Waugh  in  your 
January  issue  may  create  a  wrong  impression, 
I  beg  leave  to  say  that  the  foundation  principle 
on  which  Burggraeve  is  striving  to  bring  order 
out  of  chaos  through  the  the  use  of  the  active 
principle,  is  omitted.  Small  doses  frequefUly  re- 
pecUed  until  the  desired  therapeutic  effect  is  pro- 
duced.  No  where  in  the  works  of  this  illustri- 
ous man,  so  far  as  I  know,  are  therapeutic  re- 
sults attributed  to  a  single  dose  of  such  agents 
as  cited  in  this  letter.  The  application  of  the 
correct  principle  as  above  given  will  explain 
this  seeming  folly. 

Neither  is  the  granule  form  essential,  but  it 
certainly  is  the  most  elegant  and  satisfactory  to 
physician  and  patient  from  a  physical  stand- 
point in  every  instance  where  the  drug  will  ad- 
mit, as  well  as  by  far  the  best  form  from  a 
chemical  standpoint,  the  actiye  principles  and 
concentrated  chemical  products  being  better  pre- 
served in  this  than  in  any  other  way.  The 
careful  reader  of  the  works  devoted  to  this  sub- 
ject, will  find  frequent  mention  of  the  use  of 
drugs  not  in  this  form. 

The  matter  of  dosage  also  receives  criticism, 
but  the  fact  that  the  range  in  Burggraeve's 
writings  runs  from  gr.  11000  to  gr.  1-6  for  con- 
venience in  granule  form,  to  be  multiplied  as 
the  case  requires,  certainly  gives  all  needed  lati- 
tude when  the  foundation  principle  which  I 
have  quoted  is  taken  into  consideration.  It  is 
possible  that  Dr.  Waugh's  letter  does  not  carry 
the  meaning  intended  on  this  point 

Whatever  may  have  been  the  desire  of  Burg- 
graeve relative  to  a  new  system  of  medicine,  I 
do  not  know,  but  it  l^oks  to  me  like  an  honest 
effort  to  popularize  a  method  of  exact,  radical 
medication  upon  which  ground  all  true  phjrsi- 
cians  can  unite. 

I  believe,  with  Dr.  Waugh,  that  there  is  a 
weak  spot  in  all  exclusive  systems.  There  can 
be  but  one  rational  system  and  that  should  be 
as  broad  and  liberal  as  the  universe.  We 
should  pass  nothing  by  that  offers  relief  to  suf- 
fering humanity.  We  should  avail  ourselves  of 
the  best  form  of  these  measures  to  do  good,  no 
matter  what  they  are,  and  it  is  certainly  sensible 
to  use  what  is  needed  and  stop  when  we  have 
used  enough;  therefore,  I  say,  let  us  use  the 
smallest  passible  quantity  of  the  best  obtainable 
rneans  of  producing  a  desired  therapeutic  effecL 

Let  it  be  understood  that  the  above  is  in  no 
sense  a  criticism  upon  my  eateemed  friend.  Dr. 
Waugh,  but  an  honest  effort  to  set  before  your 
readers  certain  points  as  I  see  them. 


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The  works  of  Burggraeve  are  easily  obtaina- 
ble and  a  careful  perusal  will  prove  or  disprove 
my  position.  Db.  W.  C.  Abbott, 

2666  Commercial  St,  Chicago 


Clear  Solution  of  Tincture  of  Benzoin. 

Editor  Medical  World: — Dr.  Truman 
Coatee,  in  the  World  for  December,  1893, 
wishes  to  know  "if  there  is  a  way  to  mix  tincture 
of  benzoin  with  an  aqueous  solution  without 
throwing  down  a  precipitate."  He  also  wishes 
to  combine  with  it  mercuric  chloride.  There  is 
no  particular  order  in  which  to  mix  these  sub- 
stances that  will  result  in  a  clear  solution,  but 
by  calling  in  the  Bid  of  two  outside  substances 
I  think  the  desired  result  can  be  practically  at- 
toined.  Although  the  chemical  nature  of  the 
compound  will  be  altered  somewhat,  I  do  not 
think  it  would  be  changed  therapeutically,  as  I 
suppose  this  is  to  be  used  as  a  cosmetic.  While 
I  have  not  tried  this  process  on  this  particular 
compound,  nevertheless,  theoretically  it  ought  to 
produce  a  satisfactory  solution  by  a  little  ex- 
perimentation. 

The  constituente  of  benzoin  are  resin,  ben- 
zoic acid,  a  little  "  extractive  "  and  volatite  oil. 
The  reain  and  benzoic  acid  are  dissolved  by 
alkalies,  forming  a  benzoate  of  the  alkali  used, 
(potassium).  As  it  is  easier  to  prevent  precipi- 
tation than  to  redissolve  a  precipitate  after  it  is 
formed,  I  would  add  a  piece  of  solid  potassium 
hydrate,  (caustic  potash.  K  H  O)  (according  to 
the  quantity  of  tincture  of  benzoin  used)  to  the 
tincture  and  shake  until  dissolved ;  preferably 
in  a  test  tube.  Then,  to  a  small  portion  of  the 
•water,  add  the  mercuric  chloride,  and  heat  in  a 
test  tube  until  dissolved,  and  add  to  the  solu- 
tion of  HgCl  2  enough  of  a  strong  solution  of 
potassium  iodide  in  water,  until  the  red  precipi- 
tate at  first  produced  is  redissolved,  and  the  solu- 
tion is  perfectly  clear.  This  red  precipitate  is 
mercaric  iodide,  (HgCl  2+2  KI=Hg  I^+KQ) 
m\nch  k  soluble  in  excess  of  potassium  iodid& 
Add  this  latter  solution  a  Htde  at  a  time,  to  the 
^TBt  one,  (the  alkaline  solution  of  tr.  benzoin) 
-shaking  after  each  addition,  then  add  the  rest  of 
the  water  or  rose  water  in  the  same  way  to 
make  up  the  proper  volume.  In  this  way  all  the 
active  ingredients  of  the  compound  should  be 
held  in  solution,  and  I  think  the  tiierapeutical 
properties  retained,  as  I  said  before.  If  there 
is  turbidity,  it  is  from  the  •* extractive"  and 
volatile  oil  going  out  of  solution  partly,  but  as 
they  have  no  medidnal  properties,  the  mixture 
should  be  allowed  to  stand  for  two  or  three 
days  and  filtered  if  necessary  through  close 
filtering  paper.  If  a  perfectiy  clear  solution  is 
:not  obtam^  by  filtering,  shake  the  mixture 


occasionally  during  two  or  three  days  with  fil- 
tering paper  pulp  or  talcum  (purified),  then 
filter,  which  should  yield  a  perfectly  clear  solu- 
tion containing  all  the  active  ingredients.  Only 
use  enough  potassium  hydrate  to  answer  the 
purpose.  Would  like  to  hear  the  result ;  and 
"  if  at  first  you  don't  succeed,  try,  try  again." 
A.  H.  Colvard,  Ph.  a,  M.  D. 
Shawneetown,  111. 


Cystitis. 

Editor  Medical  World  : — For  Dr.  J.  C. 
Campbell's  case  of  cystitis  I  would  recommend 
irrigation  of  bladder  with  25  per  cent  solution 
of  hydrogen  peroxide,  which  should  be  accom- 
plished by  means  of  a  soft  rubber  catheter,  rub- 
ber tube  and  funnel.  Two  fluid  ounces  of  the 
solution  is  sufficient  quantity  to  begin  with  and 
after  it  has  been  allowed  to  flow  away  should 
be  followed  by  plain  sterilized  water.  The  irri- 
gation should  be  repeated  every  twelve  hours. 

Internally  give  the  patient  saw  palmetto 
m  XX,  oil  of  yellow  sandal  wood  m  x,  with 
enough  henbane  to  relieve  spasm  of  bladder. 

If  the  oil  of  sandalwood  prove  too  irritating 
to  the  bladder  or  stomach,  use  fluid  extract  of 
the  same  in  doses  of  ten  to  twenty  minims. 

Give  above  combination  every  four  hours 
and  the  diet  should  be  concentrated. 

Britton,  Mich.  P.  B.  Hardy,  M.D. 


[The  following  letter  was  sent  to  Dr.  Waugh. 
We  publish  also  his  reply.] 

Dear  Doctor  : — In  the  December  number, 
1893,  you  ask  if  any  readers  recollect  any  case 
of  hemorrhage  that  might  have  been  caused  by 
the  use  of  quinine  ;  now  I  am  wondering  if  a 
case  I  had  six  weeks  ago,  a  case  of  hemorrhage 
in  confinement,  might  not  have  been  caused  by 
the  use  of  quinine.  Some  time  ago  I  read  in 
the  World  that  small  do^  of  quinine  would 
increase  the  labor  pains,  bring  them  on  regularly, 
etc.,  etc.  This  case  was  tfutiy  and  the  pains 
growing  weaker.  I  had  given  some  ergots  but  not 
satisfieu^ry,  so  I  thought  I  would  try  Uie  quinine, 
and  everything  went  along  fine,  baby  soon  bom 
all  right,  patient  happy.  She  said  <<  Oh,  doctor, 
I  feel  so  good,  I  could  get  up  and  go  to  work." 
Several  such  remark?  were  made  while  I  was 
tying  the  cord  ;  I  laid  the  baby  to  one  side  and 
said  to  her:  "Well,  never  mind  the  work, 
this  is  now  to  be  your  resting  time,  and  I  want 
you  to  keep  quiet  for  a  week  or  two,  and  espec- 
ially for  a  few  days.  Do  not  talk  much  now, 
till  I  am  through  with  you, "  and  in  a  twinkle 
she  said :  **  Oh  doctor,  I  feel  so  queer."  I 
looked  up  in  her  face;  she  was  as  white  as 
death,  I   put  one  hand  on  the  abdomen,  the 


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other  down  for  the  cord  to  see  if  the  placenta 
was  ready  to  remove.  Can  you  imagine  my 
great  surprise  when  my  hand  went  down  into  a 
pool  of  blood,  almost  to  my  elbow  ?  I  revived 
her,  but  she  would  sink  as  fast  as  I  could  revive 
her,  all  through  the  whole  night ;  but  I  finally 
saved  her.  Now  did  the  quinine  do  that  ?  My 
physician  always  gave  me  quinine  in  my  confine- 
ments, but  I  did  not  then  know  why  he  gave  it 
to  me,  but  my  labors  were  always  slow  and  ted- 
ious, though  I  never  had  hemorrhage.  I  am 
a  brunette;  my  patient  was  a  pure  type  of 
blonde.  I  always  look  for  more  hemorrhage  in 
blondes  than  in  brunettes ;  have  always  found 
it  so.  Mrs.  Ida  O.  Wilhelm,  M.  D. 

Clay  Centre,  Kansas. 

Whether  this  hemorrhage  was  due  to  quinine 
or  not  it  is  impossible  to  say,  as  such  hemorr-' 
hages  occur  where  no  quinine  is  given.  But  in 
view  of  the  fact  that  quinine  does  sometimes 
cause  hemorrhage,  and  no  other  cause  appears 
in  the  history  of  the  case,  theie  is  at  least  a 
possibility  that  it  may  have  been  the  cause.  If 
80,  the  same  drug  will  cause  the  hemorrhage 
again,  if  given  to  this  woman. 

W.  F.  Waugh. 


[The  following  correspondence  in  the  Wash- 
ington  Star  (sent  to  us  by  Dorsev  M.  McPher- 
son,  M.D.,  1822  Fifteenth  street,  N.  W.  Wash- 
ington, D.  C.)  will  be  of  unusual  interest  to  our 
readers,  as  the  question  involved  therein  has 
been  recently  discussed  in  this  journal.] 

Cruelty  to  Children. 

People  who  traveled  Massachusetts  avenue 
between  Eleventh  and  Twelfth  streets  at  quarter 
to  nine  this  morning  saw  a  man  leading  a  little 
girl  under  conditions  nothing  less  than  inhuman. 
The  child  was  not  more  than  three  years  old, 
well  dressed  and  had  an  abundance  of  wraps, 
but  its  legs  and  feet  ,were  entirely  bare.  There 
seemed  to  be  no  possible  excuse  for  it. 

If  there  be  a  society  for  the  pre\7ention  of 
such  wantonly  cruelty  to  the  little  ones,  let  the 
case  be  investigated.  S. 


Cruelty  to  Children. 

In  last  Friday's  paper  your  correspondent, 
**S.,"  severely  criticises  the  action  of  a  man  in 
leading  a  barefooted  child  along  Massachusetts 
avenue  that  morning. 

Early  in  November  of  last  year  a  child  (it  is 
a  boy,  and  not  a  girl,  as  stated  by  "S."),  living 
in  this  country  neighborhood,  twenty  miles  from 
Washington,  was  attacked  with  membranous 
croup.  The  family  physician  was  called  in, 
and  after  two  days*  unavailiog  endeavor  to  stay 
the  progress  of  the  disease  by  ordinary  means 


he  advised  our  telegraphing  for  assistance.  We^ 
obtained  the  seiviee  of  a  skilled  surgeon  of 
Washing  on.  Tracheotomy  was  successfully 
performed  though  with  the  odds  almost  hope- 
lessly against  the  recovery  of  the  little  boy,  at 
that 'time  less  than  twenty  months  old.  For 
seven  weeks  his  life  hung  trembling  in  the  bal- 
ance. The  tireless  devotion  of  his  mother,  the 
universal  and  unflagging  kindness  of  our  rela- 
tives, friends  and  neighbors,  excellent  medical 
attendance,  and  above  all,  perhaps,  the  care  and 
skill  of  his  trained  nurse,  these  combined  efforts, 
at  length  turned  the  scale,  and  on  Christmas 
day  the  tube  was  finally  removed  from  his 
throat  and  laid  aside.  But  the  danger  was  far 
from  being  over.  His  long  coofinement  in  the 
atmosphere  of  one  highly  heated  and  artificially 
dampened  room  had  made  him  so  teiider  and 
susceptible  to  cold  that  the  slightest  draught  or 
change  in  temperature  brought  on  a  hoarse 
cough.  For  months  he  required  constant  atten* 
tion,  night  and  day,  his  mother  hardly  leaving 
the  house  for  an  hour  in  all  that  time.  Actings 
on  medical  advice  and  the  experience  of  others^ 
we  decided  to  let  him  go  barefooted,  as  strong 
testimony  was  offered  to  prove  that  "barefooted 
children  seldom  have  croup.  For  six  months  ha 
has  not  had  shoes  or  stockings  on,  and  ex- 
perience has  certainly  appeared  to  justify  our 
course,  as  he  has  not  had  a  cough  or  cold  wo^ 
mentioning  during  this  period. 

It  was  while  on  the  way  to  show  the  Wash- 
ington surgeon  what  a  year  had  done  for  his 
patient  that  "S."  met  me  between  Eleventh  and 
Twelfth  streets.  If  the  latter  had  looked  more 
at  the  boy's  face  and  less  at  his  feet  he  (or  she) 
would  have  seen  proof  of  health,  vigor  and 
childisfi  enjoyment,  that  scarcely  harmonized 
with  this  theory  of  "inhuman  cruelty."  Furth- 
ermore, if,  instead  of  waiting  to  denounce  the 
unnatural  parent  in  the  newspaper,  he  had  then 
and  there  asked  for  an  explanation  of  the  pecu- 
liar sight,  he  would  have  received  a  cour;eou» 
answer,  and,  I  think,  would  have  changed  his 
opinion  that  "there  could  be  no  possible  excuse 
for  such  conduct." 

As  I  sit  here  writing,  with  the  boy  playing 
merrily  on  the  floor  at  my  feet,  and  recall  the 
events  of  a  year  ago,  the  thought  comes  over  me: 
"How  easy  it  is  to  rush  into  print  and  blame 
other  people  without  knowing  the  facts." 

Allan  Farquhar, 

Sandy  Spring,  Md.,  Dec.  3,  1893. 

Manual  of  Treatment  with  Active  Medicinal  Prin- 
ciples and  New  Kemedies.  By  William  F.  Waugh, 
A.M.,  M.D.  Cloth,  238  nages,  price  only  $1.00.  This 
is  a  concise,  practical  worK,which  the  physician  should 
have  as  a  constant  pocket  companion.  The  inf«  rma- 
tion  in  regard  to  new  remedies,  alone  ii  worih  the- 
price  of  the  book.    Address  this  office. 


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51 


Editor  Medical  World: — I  deeire  to 
thank  Doctors  Shea,  Wilder,  Smith  and  Egbert 
through  The  Medical  World  for  their  kind- 
ness in  publishing  their  formulas  for  ''Neutral- 
izing Cordial."      Job.  G.  Holland,  M.  D. 

Holland,  Va. 

Editor  Medical  World  : — Please  ask  the 
bretheren  to  use  smaller  doses  of  sulpho  carbol- 
ate  of  zinc  in  typhoid  and  drop  into  the  capsule 
with  it  one  drop  dose  of  equal  parts  of  carbolic 
acid  and  eucalyptol.  It  has  served  me  well 
and  the  sulphocarbolate  has  not  been  well 
borne  in  larger  than  one  and  a  half  grain  doses. 

McGaheysville,  Va.      W.  A.  Conn,  M.D. 

Dr.  Ziegler  writes  in  regard  to  the  camphdr- 
menthol  mentioned  in  article  on  page  2  of  Jan. 
World  that  it  should  have  thirty  grains  each  of 
camphor  and  menthol  to  the  ounce  of  oil,  instead 
of  five  grains.  Thus  we  could  have  a  thirty  grain 
solution  throughout  for  the  different  agents  used 
in  that  article— thirty  grains  cocain  solution, 
thirty  grains  antipyrine  solution  and  thirty 
grains  each  of  camphor  and  menthol.  The 
Doctor  also  states  that  this  treatment  of  the 
nose  and  throat  is  of  great  assistance  in  many 
obstinate  cases  of  eye  inflammations.  In  many 
cases  a  recovery  will  not  take  place  without  it 

In  reply  to  inquiries  we  would  state  that  Dr. 
W.  F.  Waugh,  834  Opera  House  Block,  Chi- 
cago, has  sucessfully  performed  the  operation  of 
ligating  the  dorsal  veins  of  the  penis  for  im- 
potency  with  relaxation. 

Qui^  De|>artment. 

Qnefltkms  are  solicited  for  this  Column.  Commanicatlo&s 
oot  accompanied  by  the  proper  name  and  address  of  the 
writer  (not  necessarily  for  publication),  will  not  be 
noticed. 

The  great  number  of  requests  fbr  private  answers,  for  the 
information  and  benefit  of  the  writer,  makes  it  neceas- 
aiy  for  us  to  chMxge  a  lee  for  the  time  required.  Thia 
fee  will  be  from  one  to  five  dollars,  according  to  the 
amount  of  research  ajtd  writing  required. 

Correction. 
I  fDr.  J.  A.  Miller,  of  California,  writes  us 
stating  that  he  does  not  claim  that  his  acid 
treatment  of  diphtheria  (See  December  World, 
pages  435)  is  also  good  in  croup.  Also,  that 
he  uses  sulphuric  acid  in  preference  to  any 
other,  and  does  not  claim  that  others  are  as 
^ood.  

Editor  Medical  World  : — Would  you 
kindly  ask  through  your  valuable  paper  for  the 
formula  of  something  good  to  apply  to  the  skin 
after  taking  a  vapor  bath,  to  prevent  catching 
•cold  t  William  Dawson. 

348  South  Broadway,  Los  Angeles,  Cal. 


Editor  Medical  World: — I  wish  Dr. 
Waugh  or  others  would  help  me  in  a  case  of 
eczema  in  a  child  of  my  own,  three  years  of 
age.  The  eczematous  eruption  is  now  on  face, 
hands  and  flexures  of  joints.  Have  used  tablets 
of  Fowler's  sol.  i  gr.,  sarsaparilla  comp.,  with 
pot  iod.  internally;  externally  applied,  ung.  ox. 
zinc,  acid  carbolic  and  listeme;  also  a  wash  or 
liq.  carbonas  detrigens,  drams  ii,  aqua  oz  i,  vase- 
line and  acid  carbolic,  and  an  ointment  of  ung. 
ox.  zinc,  chthyol  and  vaseline.  Now,  the 
itching  is  almost  unbearable  at  night,  and  the 
disease  is,  I  am  afraid,  appr aching  the  eyes. 
What  is  the  most  eflectual  remedy  to  allay  the 
intense  itching  ?     I  have  never  used  mercury  as 

yet  J.  FORMAN  PiNEO. 

Chester,  Queen  County,  N.  S.,  Canada, 

Diurnal  Enuraiis. 

Editor  Medical  World  : — Boy,  aged  13, 
has  had  dribbling  of  urine  for  years;  not 
troubled  at  night  and  does  not  have  to  get  up  at 
night;  not  very  strong,  slender  and  growing 
fast;  has  been  under  treatment  of  two  physi- 
cians; had  bladder  washed  out  and  was  some 
better;  but  after  running  while  playing  ball 
was  just  as  bad  as  before.  Brother,  older,  fleshy, 
was  troubled  in  same  way  but  "out-grew  it. 
Sisters  have  never  been  afflicted  in  this  way. 
What  will  cure?  S.  J.  Smith,  M.D. 

Filley,  Neb. 

Dr.  B.  F.  Pearson,  Queensville,  Ont,  Can., 
asks :  **Can  you  give  formula  of  Pinkham's 
V^etable  Compound  ?" 

We  state  to  many  inquirers  that  there  is  no 
work  published,  so  far  as  our  knowledge  goes, 
devoted  to  the  treatment  of  corns  and  bimions, 
and  the  general  care  of  the  feet  We  have 
searched  carefully,  among  the  works  of  different 
publishers,  for  such  a  work.  Here  is  an  op- 
portunity for  an  enterprising  surgeon.  The 
only  information  now  to  be  had  on  the  subject  ii 
to  found  in  the  works  on  general  surgery. 

We  are  sorry  that  we  can  find  no  reliable  in- 
formation regarding  the  composition  of  Adam's 
Tntti  Frutti  Gum. 


E.  Hertig,  M.D.,  Galesburg,  IJl.,  wishes  the 
best  that  is  recently  known  for  the  expulsion  of 
tape  worm. 

Correction, 

In  the  prescription  for  sciatica,  page  182, 
May,  1893,  World,  the  amount  of  syrup  of 
acacia  should  be  oz.  i,  instead  of  oz.  ij,  ai 
printed.  However,  it  would  make  no  difference 
except  as  to  taste. 


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Current   Medical    Thought. 

To  Those  Who  Read  Medical  Society  Papers. 

We  ha  7e  often  seen  this  notice  over  doors  en- 
tering manufacturing  places:  keep  out,  this 
means  you.  So  we  write  this  editorial  for  the 
members  who  took  part  in  the  last  meeting  and 
for  those  who  will  engage  in  the  next,  and  we 
add  this  :  read  it,  this  means  you. 

Time  your  article  beforehand.  Boil  it  down 
until  it  can  be  delivered  in  fifteen  minutes. 
This  rule  would  have  saved  at  least  two  hours 
for  debate  in  the  recent  meeting. 

Confine  yourself  to  manuscript  strictly — in- 
terpolations and  after  remarks  are  wasteful  and 
exceedingly  tiresome. 

Be  familiar  with  your  piece,  one  of  the  best 
articles  of  the  session  lost  not  a  little  of  its  at- 
tractiveness because  the  author  wis  unable  to 
decipher  his  writing  so  as  to  read  it  in  an  easy 
manner. 

Be  brief,  others  are  anxious  to  speak  as  well 
as  you.  Enthusiasm  is  a  good  thing  but  when 
a  doctor  talks  an  hour  he  wearies  his  audience 
and  cheats  his  colleagues. 

Be  sure  you  have  something  to  say  when  you 
talk,  then  say  it  concisely,  clearly  and  but 
once. 

In  discussions  don't  repeat  the  author's  paper 
agreeing  in  all  points;  briefly  allude  to  them, 
and  dwell  only  on  something  not  yet  mentioned. 

If  a  doctor  reports  a  very  unique  case,  don't 
dampen  his  ardor  by  always  having  one  just 
like  it  If  you  habitually  do  so  you  will  be  re- 
garded as  an  hereditary  exaggerator. — South 
Gal.  Practitioner, 


The   Impending  Revolution   In   Military  Surgery 
Caused  by  the  New  Infantry  Rifle. 

1.  The  wounds  being  smaller  and  less  shat- 
tering, shock  will  be  less  and  missiles  will  gen- 
erally go  through  the  body,  and  not  required  to 
be  extracted. 

2.  The  bullet,  being  so  small,  will  have  much 
less  tendency  to  carry  in  with  it  patches  of  sep- 
tic clothing  and  skin,  and  any  bits  that  are 
lodged  in  the  track  of  the  wound  will  be  so 
minute  that  a  deep  flushing  of  the  wound  with 
antiseptics  will  often  sterilize  the  injury. 

3.  In  cases  where  there  is  actually  some 
chipping  of  a  joint  surface  it  will  be  possible  to 
open  the  joint  on  the  field,  pick  out  the  frag- 
ments, sterilize  the  cavity  and  close  it  up,  thus 
avoiding  amputation. 

4.  It  will  in  future  be  possible  to  avoid  a 
large  portion  of  the  amputations  and  excisions, 
wluoh  were  formerly  necessary. 


5.  In  perforating  wounds  of  the  abdomen* 
the  tearing  of  the  hollow  viscera  will  be  much 
diminished,  giving  a  hopeful  opportunity  to 
save  life  by  laparotomy  on  the  field. 

6.  As  prompt  antisepticism  of  the  wounds 
will  be  important,  the  hospital  corps  will  have 
to  be  instructed  how  to  do  it  before  they  bring 
in  the  patient 

7.  The  dispersion  of  the  wounded  over  wide 
areas  will  increase  the  difficulty  of  prompt  '^first 
aid." 

8.  Field  surgery  will  be  more  scientific,  and  re- 
quire a  greater  variety  of  operations,  hence  the 
poverty  stricken  little  cluster  of  instruments 
formerly  furniAed  by  the  government  to  field 
surgeons  must  have  additions  adopted  to  the 
now  exigencies  of  the  battle-field. — Conclusions 
of  Dr.  Edmund  Andrews  in  Jour  Am,  Med. 
Association, 

It  seems  cold-blooded  in  the  extreme  thus  to 
contemplate  the  deliberate  mutilation  of  the 
human  body  and  the  necessary  treatment  re- 
quired. It  has  been  hopefully  claimed  by  some 
that  the  progressive  improvement  in  the  de- 
strucdveness  of  military  weapons  will  finally 
render  war  impossible.  However,  we  can  see  a 
movement  that  is  destined  to  achieve  this  de- 
sired result  much  more  speedily  and  surely. 
It  is  the  growing  sentiment  among  the  working 
classes  (they  who  fight  all  battles)  of  all  civil- 
ized countries  that  they  all  belong  equally  to 
the  grand  brotherhood  of  man,  and  chat  they 
will  engage  in  no  more  wars.  This  is  one  of  the 
leading  principles  of  all  labor  organizations  and 
of  all  socialistic  societies.  A  French  peasant  is 
beginning  to  regard  the  German  peasant  as  a 
closer  relation  to  himself  than  a  French  noble- 
man; and  so  on  among  the  producers,  through- 
out the  civilized  world.  They  do  not  want  to 
fight  their  brothers.  It  will  soon  be  that  politi- 
cal intriguers  will  have  to  fight  their  own  wars, 
and  then  there  will  be  none.  Physicians, 
especially,  should  discourage  the  military  spirit 
as  much  as  possible.  We  do  not  want  to  bring 
up  our  carefully  trained  sons  for  wholesale 
slaughter  by  machine  guns. 

Immunity  From  Small-pox  Destroyed  by  Typhoid 
Fever. 

Dr.  William  Finder,  of  Rensselaer  county, 
N.  Y.,  has  observed  that  after  typhoid  fever 
patients  had  recovered  they  were  very  suscepti- 
ble to  vaccination.  Dr  Finder  has  verified 
this  observation  many  times  during  a  number  of 
years,  and  suggests  that  others  confirm  or  dis- 
prove the  theory.  So  satisfied  is  he  with  the 
correctness  of  the  observation,  that  he  now  re- 
vaccinates  his  typhoid  fever  patients  as  soon  as 
they  recover  from  the  fever. — Med,  News, 


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A  Form  of  Obstetrio  Reoord. 

L.   C.   Grosvenob,   M.D,,   Kansas  Qty. 

I  have  kept  for  some  years  a  eomplete  record  of  my  cases,  each  occupying  but  a  single  line,  thus : 


1 

Name. 

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1 

1 

«i 

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a 

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Remarks. 

■3 

1 

1 

Given 

Name. 

Maiden 
Name. 

Husband's 
Name. 

1 

d 

5Z5 

1 

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a 

1 

1 

Oi 

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e 
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a 

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Annie 

Gains 

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M 

9 

V 

6 

3 

1st  Child. 

17 

May 

Gaspel 

Andrew 

2 

32 

I 

0 

M 

8 

V 

8 

3 

Anasarca. 

Mar. 

1 

Caroline 

Mears 

Duffield 

1 

43 

c 

M 

7i 

V 

3 

3 

Mar. 

2 

Jane 

Haywood 

Hamilton 

1 

65 

I 

c 

F 

6  |Feet 

8 

3 

Eclainpsia. 

Apr. 

16 

JuUa 

Fremont 

Jennings 

6 

88 

I 

C     F 

10   Feet   12 

2 

For  Dr.  W 

The  wide  column  gives  full  name,  the  middle  Dame 
being  the  maiden  name. 

The  first  narrow  column  to  the  right  tells  which 
child  this  is,  as  1st,  5th  or  7th  etc 

The  next,  numbers  my  cases  and  allows  me  to  refer 
to  any  given  case  by  number  without  calling  names. 

In  the  next  column  "P'  means  instrumental. 

In  the  next  "O*  means  chloroform. 

The  next  records  the  sex,  as  "M»*  for  male  and  "F*' 
for  female. 

The  next  ^ves  weight,  taken  with  infant  practically 
naked  and  with  silver  balances,  which  are  always  in 
my  satchel. 

The  next  tells  the  presentation,  as  *^Y**  for  vertex, 
"Opl*  for  ocdpito,  posterior,  etc. 

The  next  gives  hours  of  labor,  counting  from  the 
time  when  the  intervals  are  r^;ular. 

The  next  tells  how  many  hours  I  spent  with  each 


In  the  next  we  find  a  reoord  of  any  abnormal  condi- 
tion of  the  child,  as  "St."  for  stillborn. 

The  last  and  wider  column  is  for  remarks  as 
"Eclampsia,"  "Delivered  for  Dr.  W,"  etc. 

At  the  end  of  the  year  each  column  has  its 
lesson.  For  example,  how  are  these  cases  dis- 
tributed through  the  year?  In  February  of 
one  year  I  attended  twenty-five  in  twenty-eight 
days.  If  we  count  back  nine  months  we  shall 
find  "May,"  the  time  of  springing  buds  and  the 
mating  of  birds.  In  looking  at  the  first  right- 
hand  column  I  find  sixty-nine  primiparse.  The 
next  tells  us  that  116  were  instrumental  labors 
Do  you  criticise?  I  answer  that  instruments 
are  benign  even  in  the  most  benign  cases.  The 
worst  time  in  all  the  world  to  learn  to  use  in- 
struments is  when  you  have  to.  Become 
familiar  with  them  and  learn  their  benign  posi- 


bilities  by  daily  handling.  The  next  column 
gives  us  (150)  one  hundred  and  fifty  chloro- 
form cases  in  207.  Chloroform  is  the  greatest 
blessing  which  has  come  to  womankind  in  this 
centurv — and  the  lying-in  room  is  eminently 
the  safe  place  for  its  use.  The  next  tells  of  a 
universal  law  of  an  equal  distribution  of  the 
sexes.  If  in  the  next  column  I  add  the  weights 
of  my  full  term- babies  and  divide  by  the  num- 
ber of  full-term  babies,  I  shall  have  the  aver- 
erage  weight  of  a  new-bom  infant  This  would 
be  fair  when  you  take  200  or  more  consecutive 
cases.  The  study  of  presentations  in  the  next 
line  is  full  of  interest,  showing  160  out  of  183 
cases.  The  study  of  the  hours  of  labor  has  been 
a  personal  comfort  to  me.  for  if  I  find  that  my 
hours  are  from  one  to  two  hours  shorter  than 
the  great  average  in  Europe  and  America  in 
public  institutions  and  private  practice,  I  know 
that  my  methods  are  benign.  We  are  just 
human  enough  to  need  and  enjoy  the  com- 
mendation of  the  logic  of  facts.  The  line  mark- 
ing the  hours  I  spend  with  each  case  shows  how 
knowledge  and  experience  may  shorten  and  re- 
lieve the  tedious  hours  of  waiting.  The  last 
column  gives  two  cases  of  puerperal  eclampsia — 
one  of  them  fatal — and  other  items  of  interest 
And  so  each  column  has  its  lessons,  and  the  re^ 
cord,  as  a  whole,  is  one  well  worth  preserving 
for  future  reference.  I  think  we  should  throw 
so  much  of  joy  and  enthusiasm  into  this  work 
that  we  shall  achieve  eminence  in  this  field. — 
Clinical  Reporter, 


"Man  has  been  defined  as  an  animal  ashamed 
oi  his  own  body,  and  this  will  truthfully  apply 
to  both  sexes.  As  a  result  of  this  false  modesty, 
many  girls  reach  the  age  of  womanhood  ignor- 
ant of  the  changes  about  to  take  place  in  their 


physical  economy  and  many  boys  arrive  at  the  age 
of  puberty  still  believing  in  the  nursery  stories 
of  their  origin,  viz :  that  some  kind-hearted  old 
aunty  found  them  in  an  old  hollow  log." — Dr. 
Aley,  Lincoln,  Neb.;  editorial  in  The  Counselor. 


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Administering  Chloroform  During  Sleep. 

It  ]B  claimed  bj  many  that  it  is  an  impoaei- 
bility  to  administer  any  agent  by  inhalation 
that  will  produce  complete  anesthesia  during 
natural  sleep.  It  is  thought  that  the  transfor- 
mation from  a  state  of  natural  slumber  to  that 
of  artificial  sleep  by  apsesthesia  cannot  be  pro- 
duced without  a  return  to  natural  wakening 
and  sensibility.  Dr.  O.  A.  M;  McKimmie,  of 
Washington,  D.  C,  (Nat  Med.  Review)  gives 
an  account  of  a  case  in  which  he  gave  the  well 
known  A.  C  £  mixture  during  sleep,  for  the 
purpose  of  producing  ansesthesia  preparatory  to 
amputation  of  the  tongue.  Dr.  Hamilton  K 
Leach,  the  operator  in  the  case  referred  to,  thus 
describes  it :  "The  patient,  a  boy  of  thirteen 
years,  was  to  be  operatec^  on  during  the  earlier 
part  of  the  afternoon,  and  feeling  slightly  in- 
disposed, he  had  lain  down  on  his  bed  and  had 
fallen  asleep.  It  had  been  decided  to  anaesthe- 
tize him  in  the  ward  and  carry  him  ^om  there 
to  the  operating  room.  When  I  entered  the 
ward  I  found  the  little  fellow  asleep  and  de- 
cided to  try  to  give  the  anesthetic  without 
awakening  him.  In  this  I  was  suenessful.  He 
took  the  anesthetic  quietly  and  without  strug- 
gling, having  no  appreciation  of  what  was  oc- 
curing  between  the  time  of  his  falling  asleep 
and  of  waking  after  the  operation." — Toledo 
Med.  Compend, 


How  to  Administer  Chloroform  Properly. 

Mr.  W.  J.  Cleaver  gives  the  following  valua- 
ble advice  in  regard  to  the  administration  of 
chloroform :  Take  your  folded  towel  or  cap  of 
flannel  stretched  over  a  wire  frame,  and  your 
chloroform  bottle,  graduated  if  your  like,  but 
this  is  of  no  consequ^Qce;  let  the  temperature  of 
the  operating  room  be  at  least  65°  R;  if  you 
patient  be  one  of  the  very  nervous  kind,  give 
from  half  an  ounce  to  an  ounce  of  brandy  an 
hour  beforehand;  put  your  catch  forceps  or 
your  tongue  forceps  on  the  pillow  beside  you; 
pour  a  doee  of  chloroform,  a  drachm  or  two,  on  to 
the  towel  or  cap  and  hold  it,  to  commence  with, 
two  or  three  inches  away  from  the  mouth  and 
nose  of  your  patient,  gradually  bring  it  nearer, 
but  never  so  near  sa  to  exclude  air  from  mix- 
ing with  the  chloroform  vapor;  at  the  same  time 
keeping  your  mind  and  eye  on  the  respiration 
movements  alone.  If  the  patient  shows  any 
symptoms  of  struggling,  let  assistants  take  hold 
of  his  wrists  and  allow  him  to  move  his  arms 
about  as  long  as  he  does  not  interfere  with  the 
administration.  If  he  endeavors  to  get  up  he 
must,  of  course,  be  restrained,  but  on  no  ac- 
count let  half-a-dozen  dressers  throw  themselves 
upon  him,  their  united  weight  probably  coming 


near  upon  half  a  ton.  What  chance  has  free 
respiration  in  such  a  case?  A  little  pressure  on 
the  shoulders  will  in  ninety-nine  cases  out  of  a 
hundred  be  found  to  be  quite  suflBcient;  when  a 
patient  is  forcibly  held  down  with  half  a  dozen 
big  men  on  top  of  him,  his  struggle  ends  in 
a  kind  of  nightmare,  with  perhaps  a  fatal  shock 
at  the  close  of  it  Continue  the  administration 
quietly  and  gradually,  without  being  put  out  of 
countenance  by  the  repeated  demands  of  the 
operator — ^to  know  whether  he  is  not  yet  under; 
and  such  remarks  as,  "I  never  knew  a  man  take 
such  a  lot,"  **put  it  close  to  his  nose,"  *  what  a 
time  he  is  getting  under,"  etc.  You  are  giving 
the  chloroform,  not  the  operator,  therefore  tJke 
no  heed  of  him.  When  there  is  no  conjunctival 
reflex,  and  a  pinch  on  the  skin  of  the  abdomen 
bears  no  result,  the  pupil  of  the  eye  fairly  con- 
tracted, and  the  breathing  regular  but  perhaps 
stertorous,  you  can  allow  the  operating  surgeon 
to  proceed. 

Pay  no  attention  to  the  operation,  however 
interesting  it  may  be;  watch  your  patient's 
breathing  only,  and  continue  the  chloroform 
when  you  see  any  signs  of  returning  con&^ious- 
ness.  If  you  do  this,  and  this  only,  >ou  will 
never  have  cause  to  regret  it — Sheffield  Medi- 
cal JoumaL 


Pathology  of  Influenza. 


The  author,  who  is  Prosector  at  the  Marine 
Hospital,  at  St  Petersburg,  furnishes  a  detailed 
account  of  forty  cases  of  la  grippe  on  which 
autopsies  were  performed  {8L  Petersburg  Med: 
WocL)  These  cases  were  all  of  individuals  who 
were  otherwise  healthy.  On  microscopical  ex- 
amination of  the  voluntary  muscles,  he  occasion- 
ally  found  loss  of  the  striae,  however  only  in  iso- 
lated muscle  bundles.  In  three  cases  he  dis- 
covered evidence  of  hemorrhage  in  the  muscular 
tissue,  and  the  resulting  hematomas  were  so 
large  that  entire  bundles  of  muscle-fibers  were 
involved. 

A  closer  microscopical  examination  disclosed 
the  fact  that  there  had  been  a  parenchymatous 
bleeding,  and  probable  a  bleeding  by  diapede- 
siB.  In  the  vessels  were  found  numerous  small 
micro-organisms,  and  it  may  be  inferred  from 
this  that  there  was  nutritive  disturbance  of  the 
vessels.  As  the  hemorrhages  were  invariably 
unilateral,  the  author  concludes  that  the  lesion 
involves  the  sympathetic  centers. 

Pachymeningitis  hemorrhagica  interna  he 
found  only  in  one  case,  but  in  fifty  per  cent  of 
the  cases  there  was  a  hyperema  of  the  pia,  aid 
in  two  cases  even  bloody  infiltration.  Suppura- 
tive cerebral  meningitis  was  found  in  one  case. 
In  those  cases  with  bloody  infiltration  of  the  pia. 


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65 


there  was  found  besides,  hemorrhage  into  the 
lateral  ventricles. 

As  a  general  rule,  Ku^kow  found  the  heart 
muscle  sofb,  friable  and  anemic. 

A  microscopic  examination  showed  a  classifi- 
cation of  the  muscle  cells,  with  change?  similar 
to  those  found  in  typhoid  lesions  of  the  bowels. 
Hjpeiemia  and  infiltration  of  the  phamyx  and 
larnyx,  he  found  occurred  quite  frequently. 

Careful  examinations  of  the  capillary  vessels 
of  the  lungs  and  bronchi  were  made.  The  au- 
thor calls  special  attention  to  the  frequency  of 
labor  inflammation.  In  eight  cases  he  found 
purulent  infiltration,  and  of  these  six  resulted  in 
gangrena 

The  gangrene  spots  as  well  as  the  purulent 
ones,  wtre  wedge  shaped,  with  their  bases  to- 
wards the  pleura.  Capillary  thrombosis,  such 
BB  is  described  by  Elebs  he  seldom  found,  but 
when  so  found  it  occurred  in  fibrinous  plugs. 
Venous  thrombosis  was  much  oftener  discovered, 
ae  was  also  arterial  thrombosis,  but  the  latter 
not  so  frequently  as  the  former. 

The  spleen,  in  the  majority  of  cases  was  con- 
tracted ;  only  twelve  were  found  to  be  enlarged. 
These  were  also  microscopically  examined. 
Changes  in  the  inte^inal  canal  were  often  found. 
Peritonitis  was  never  discovered,  but  the  kid- 
neys were  usually  affected. 

In  con  'lusion,  the  author  decides,  on  the 
strength  of  his  numerous  investigations,  that  in- 
fluenza may  be  divided  into  two  forms:  1, 
hemorrhagic ;  2,  pyemic  or  septico-pyemic  form, 
with  purulent  and  gangrenous  inflammation  of 
of  the  lung  tissue  and  frequent  metastases  in 
other  organs. — Jour.  Amer.  Med.  Avln, 


The  Emergency  Treatment  of  a  Toothache. 

Toothache  is  a  little  thing  in  the  boolLS,  but 
many  physicians  would  rather  meet  a  burglar 
mt  the  door  on  a  dark  night  than  a  call  to  cure 
m  bad  toothache  of  several  day's  continuance  ;  a 
hypodermic  of  morphine  only  postpones  the  evil 
day,  and  usually  the  patient  is  reepectAilly  re- 
ferred to  the  dentist  The  tooth  should  not  be 
extracted  while  the  jaw  and  gums  are  inflamed 
and  the  latter  swollen,  and  it  is  the  physician's 
duty  to  treat  the  case  until  the  above  conditions 
are  removed.  Always  keep  a  small  phial  con- 
taining the  following  mixture:  Chloroform, 
gtt  x.;  glycerine,  gtt.  x.;  eat  sol.  ac.  carbol., 
gtt.  X.;  morphine,  gr.  j.,  with  a  small  wad  of 
abaorbent  cotton.  U  the  offending  tooth  has  a 
cavity  or  decayed  surface  saturate  a  small  pellet 
•  of  cotton  with  the  above  mixture  and  put  it  into 
the  cavity  or  against  the  decayed  surface  as  the 
caae  may  be,  never  pack  the  cotton  in,  or  the 
more  is  the 'trouble — but  have  the  pellet  small 
eoough  to  enter  without  crowding.     In  most 


cases  this  will  end  the  trouble.  When  the  gums 
aro,  swollen  and  tender  paint  two  or  three  times, 
two  minutes  apart,  with  a  four  per  cent  solu- 
tion of  cocaine.  This  time  of  year  your  patient 
may  have  been  eating  a  good  deal  of  fruit.  The 
tongue  and  mucous  membrane  of  the  mouth  are 
pale  sour  stomach,  and  next  day  the  toothache 
willretum.  Give  ten  grains  of  sub-carbonate 
of  bismuth  and  ten  grains  of  phenactin  at  once 
and  a  similar  dose  before  each  of  the  three  fol- 
lowing meals,  with  a  laxative  if  needed,  and 
stop  all  fruit  for  a  few  days,  and  it  will  not  re- 
turn. The  same  powder  every  two  hours  with 
cessation  of  fruit  eating  will  stop  the  persistent 
tormenting  neuralgias  so  prevalent  at  this  sea- 
ton. — Jno.  E,  Weaver,  M.D.,  of  Rochester,  N. 
F.,  in  Med,  Ricord, 


The  Brooklyn  Method  of  Treating  True  Croup. 

The  treatment  of  pseudo-membranous  laryn- 
gitis by  the  sublimation  of  calomel,  known  as 
the  Corbin  or  Brooklyn  method,  was  originated 
and  first  used  by  our  fellow  member.  Dr.  Job 
Corbin,  in  November  1874.  The  doctor's  idea 
was  that  of  the  destruction  of  the  products  of 
inflammation  in  the  windpipe,  by  subliming  a 
mercurial,  and  compelling  the  patient  to  inhale 
it  by  loading  the  air  to  be  respired  with  the 
sublimed  material.  The  better  and  quicker  to 
accomplish  this,  and  to  protect  those  in  attend- 
ance from  the  harmful  effects,  he  caused  the 
patient  to  be  covered  by  a  temporary  tent  made 
of  sheets,  blankets,  or  other  available  articles. 
The  black  oxide  of  mercury  was  the  material 
used  in  the  first  sublimatbn,  afterwards  the 
doctor  substituted  calomel  and  had  a  special 
alcohol  lamp  made  for  subliming  it 

This  treatment,  while  calling  for  care  and 
thoroughness,  does  not,  like  tracheotomy  or  in- 
tubation, require  special  skill  in  the  operator, 
and  it  has  the  advantage  of  being  available  for 
immediate  and  repeated  application  by  those  in 
attendance  in  the  absence  of  the  physician. 

The  sublimation  of  calomel  should  be  begun 
early,  as  soon  as  a  diagnosis  of  true  croup  can 
be  made,  or  before,  if  there  is  a  strong  suspicion 
of  a  membrane  forming  in  the  windpipe,  as  evi- 
denced by  a  peculiar,  dry,  barking  cough,  the 
disturbance  and  difficulty  of  respiration,  etc. 
There  is  special  advantage  in  beginning  treat- 
ment thus  early,  as  the  object  should  be,  not 
only  to  relieve  dyspnoea,  but  to  arrest  the  for- 
mation and  extension  of  the  pseudo-membrane, 
and  to  prevent  or  lessen  systemic  poisoning. 

Preparatory  to  treatment  by  sublimation,  a 
dote  of  calomel  of  two  or  more  grains,  accord- 
ing to  a^e.  administered  early  in  the  course  of 
a  laryngeal  inflammation,  has  a  very  good  ef- 
fect,  and   I  believe  should  be  generally  em- 


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ployed,  unless  there  are  special  contra-indica- 
tious. 

The  patient  should  be  placed  in  a  large,  well- 
ventilated  iapartment,  in  which  a  temperature  of 
about  80^  F.  can  be  maintained,  and  the  air  of 
the  room  kept  well  moistened  by  steam  obtained 
by  boiling  water,  or  slacking  lime,  or  from 
steam  pipes.  Dr.  Corbin  adds  carbolic  acid  to 
the  water  being  evaporated.  Perhaps  still  bet- 
ter is  the  combination  recommended  and  used 
by  Dr.  J.  Lewis  Smith  in  diphtheria  and 
scarlet  fever.  For  several  years  I  have  used  it 
and  like  its  effects. 

It  consists  ef : 

R    A<!i(U  oarboUd 

Ol.  eucalypti  aa 1  oance 

8pt8.  terebinth 8  ounces 

''Add  two  tablespoonfuls  to  one  quart  of 
water,  in  a  tin  or  zinc  wash  basin,  or  pan  of 
broad  surface,  and  maintain  a  constant  state  of 
ebullition  or  simmering  in  the  ]^)om  occupied 
by  the  patient"  Obs^ations  in  regard  to  the 
use  of  this  vapor  indicate  it  to  be  an  efficient 
germicide. 

The  apparatus  consists  of  a  tent,  and  an  al- 
cohol lamp.  For  the  tent,  the  child's  crib  or  a 
cot  may  be  used.  The  uprights  at  the  ends 
may  be  formed  of  bed  slats,  broom-handles,  or 
plastering  laths  fastened  to  the  head  and  foot  or 
corners  of  the  crib  or  cot,  with  a  broom  handle, 
slat  or  stout  cord  to  form  a  ridge  pole.  The 
top  of  the  tent  should  be  a  foot  or  more 
above  the  child's  head,  when  sitting  up  in  the 
crib.  The  covering  of  the  tent  may  be  two  or 
more  stout  sheets,  or  light  blankets,  applied  so 
that  they  will  cover  both  ends  and  overlap  at 
the  centre.  This  will  permit  the  parent  or 
nurse  to  hold  the  little  patient's  hand  without 
uncovering  or  letting  out  the  vapor,  and  to  re- 
assure and  watch  the  child  if  necessary.  Some- 
times it  may  be  desirable  to  have  the  patient  re- 
main in  the  vapor  under  the  tent  for  some  little 
time  after  the  sublimation  has  been  finished  ; 
generally  there  is  much  relief  of  symptoms  and 
distress  and,  occasionally,  the  worn  out  little 
one  will  fall  asleep.  The  tent  may  be  opened 
by  folding  back  the  sheets  or  covering  from  the 
centre,  but  if  this  is  done  too  soon  the  moisture 
in  the  air  of  the  apartment  will  quickly  precipi- 
tate the  particles  of  calomel  suspended  in  the 
air  of  the  tent 

To  keep  the  air  in  the  tent  as  pure  as  possi- 
ble it  is  desirable  to  consume  but  little  time  in 
the  burning  of  each  powder.  This  also  avoids 
raising  the  temperature  in  the  tent  to  too  high  a 
pointy  and  charging  the  air  with  an  unneceasary 
amount  of  carbonic  add  gas. 

As  the  use  of  a  previously  used  subliming 
lamp  and  outfit  may  be  a  possible  means  of 


conveying  germs  to  others  I  have  thought  it 
safest  to  use  a  new  outfit  for  each  case.  This 
may  be  easily  and  cheaply  constructed  by  pro- 
curing a  small  alcohol  cooking-lamp  with  tripod, 
fastening  it  with  three  or  four  tacks  to  half  a 
crib  slat;  the  tin  cover  of  a  blacking  box,  or 
piece  of  sheet-iron  (the  thinner  the  better  to 
favor  rapid  sublimation)  to  fasten  to  the  top  of 
the  tripoKl  and  over  the  top  of  the  lamp.  There 
should  be  a  concavity  or  slight  indentation  at 
the  centre  of  the  tin  cover  to  prevent  the  calo- 
mel from  scattering  or  rolling  ofi  when  heated, 
and  the  edge  of  the  sheet-tin  or  iron  may  be 
turned  down,  the  better  to  restrain  the  flame  of 
the  lamp. 

The  quantity  of  calomel  used  in  each  subli- 
mation should  be  fro<ii  30  to  60  grains ;  the 
sublimation  to  be  completed  in  as  short  a  time 
as  possible.  The  intervals  of  treatment  vary. 
When  the  breathing  is  specially  labored  and 
difficult,  the  burning  of  the  calomel  may  be  re- 
quired, for  a  short  period,  half-hourly;  but 
usually,  the  treatment  is  repeated  every  two  or 
three  hours,  increasing  the  interval  as  the  period 
of  relief  extends.  In  my  experience,  the  whole 
quantity  of  calomel  used  upon  a  case  has  been 
from  one-half  to  several — and  in  one  case  the 
recovered  eight — ounces. 

As  an  auxiliary  I  occasionally  use  Turpeth 
mineral  in  one  or  two  grain  doses,  one,  two,  or 
three  times  in  the  twenty-four  hours,  especially 
when  the  character  of  the  cough  suggests  a  par- 
tial loosening  of  the  pseudo- membrane,  with  the 
view  of  aiding  or  hastening  its  separation  and 
expulsion. 

When  possible,  oxygen  should  be  available 
for  immediate  administration  ;  it  will  often  be  of 
service  and  may,  occasionally,  save  a  life. 

Special  attention  should  be  given  to  sustain- 
ing the  strength  of  the  patient  by  nourishment 
and  stimulants,  particularly  following  each  sub- 
limation. 

I  believe,  with  Dr.  Law,  that,  "while  mer- 
curial fumigation  will  not  take  the  place  of  sur- 
gical  means,  no  physician  is  justified  in  perform- 
ing intubation  or  tracheotomy  in  pseudo  mem- 
branous laryngitis,  until  fumigation  has  been 
tried,  nor,  that  failing,  is  he  justified  in  allow- 
ing a  patient  to  die  without  surgical  attention." 

After  intubation  or  tracheotomy,  when  there 
is  evidence,  or  reason  to  suspect  the  formation 
of  a  falee  membrane  below  the  tube,  the  subli- 
mation of  calomel  should  be  employed  or  con- 
tinued. Reports  received  state  that  this  has 
been  done  in  a  number  of  cajses.  Dr.  Lang- 
mann,  of  New  York,  makes  this  course  a  routine 
practice. — Wm.  Maddem,  M.  D.,  isx  Brooklyn 
Medical  JoumaL 

The  statistics  regarding  the  above  treatment 


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57 


indicate  that  from  48  to  64  per  cent  t)f  recover- 
iee  may  be  expected.  If  to  this  were  intelli- 
gently combined  other  suitable  treatment  the  re- 
sults might  be  improved. 


Kerosine  in  Alcoholism 


The  most  recent  remedy  for  alcoholism  in 
RuAoa  is  petroleum  or  parafin  oil,  to  which  the 
notice  of  the  St.  Petersburg  medical  authorities 
was  called  by  accident  It  appears  that  a 
laboring  man  who  had  been  dricking  heavily 
for  four  days  and  nights  entered  in  a  complete 
state  of  intoxication,  a  grocer's  shop.  Unnoticed 
by  the  shopkeeper,  he  staggered  up  to  an  open 
cask  of  petroleum  and  b^an  drinking  from  it. 
It  is  related  that  the  petroleum  cured  him  of  all 
the  effect  of  over-drinking;  the  nausea,  unsteadi- 
ness of  gait,  and  headache  disappeared  as  if  by 
magic — New  York  Medical  Times. 


Anesthesia  by   Cocaine   Deprived  of  Its   Disad- 
vantages. 

Dr.  Grautier  {Wiener  med.  Presse,  No.  47, 
1893)  recommends  the  addition  of  trinitnne  to 
solutions  of  cocaine  in  order  to  render  anesthe- 
sia by  this  drug  innocuous.  He  employs  the 
following  solution : 

Cocaine  muriate. grains  iij 

Alcokolio  mH.  trinltriue  (MOO gtLt.   z 

DlstiUed  water. „....dram8  Utok 

A  hypodermic  syringefiil  of  this  solution  con- 
tains i  gr.  of  cocaine  and  one  drop  of  the  trini- 
tnne solution.  He  has  used  this  solution  for 
two  years  without  the  slightest  disadvan- 
tage. 

Local  application  to  the  pharyngeal  or  lar3m- 
geal  mucous  membrane  does  not  produce  the 
well-known  sensation  of  dr3mes8,  which  is  usu- 
ally observed  with  the  use  of  cocaine,  but  an 
agreeable  feeling.  Trinitrine  does  not  appear 
to  reduce  the  ansesthetic  and  vaso-constrictive 
action  of  cocaine. — Lancet  Clinic 


Nitrate  of  silver  stains  are  easily  removed  by 
painting  the  part  with  tincture  of  iodine  and 
then  waaiMng  m  dilute  aqua  ammonia. — Pac^ 
Med^JoUK 


During  these  hard  times  the  doctor  is  among  the 
fint  ta  suffer,  as  people  generaUjr  pay  his  bill  only 
when  it  b  quite  oouTenient  to  do  so.  So,  in  the  in- 
terest of  hiniself  and  his  family  he  is  compelled  to  be 
espedally  Yiplmt  in  order  to  get  what  is  due  him. 
''The  PhyudAn  as  a  Business  Man,"  is  a  practical  book 
showing  how  this  may  most  effectually  be  done.  Price 
only  $1.00.  See  Order  Blank  page  xziv.  Address 
thIsoflEbe. 


Penetrating  Wound  of  the  Pericardium — Recovery. 

By  J.  E.  BocARRo,  l.  m.  s., 

Teacher,  Medical  School,  Hyderabad,  8ind,, 
India, 

We  commend  the  following  model    report 
from  f&roft  India,  in  the  Indian  Med.  Record^ 
as  much  for  ^ts  value  as  a  modest,  concise, 
scientific  report,  as  for  the  special  interest  our' 
readers  have  in  the  subject  at  present : 

Jan  Mahomed,  a  Sindhi  Mahomedan,  cd  42, 
cultivator  was  brought  into  hospital  on  the 
morning  of  the  16th  July,  1887  by  his  friends 
from  a  village  eight  miles  distant  from  Hydera- 
bad suffering  from  a  wound  in  the  chest,  with 
the  history  that  early  that  morning,  when  about 
to  yoke  a  bullock  to  the  plough,  the  animal 
had,  by  suddenly  throwing  up  its  head,  accident- 
ally caused  the  pomt  of  the  horn  to  gore  him  in 
the  chest  He  had  undertaken  the  journey  to 
Hyderabad  on  horse- back,  and  was  Ah  hours  on 
the  way,  arriving  at  the  hospital  at  about  10.30 

A.  M. 

Beyond  having  immediately  after  the  acci- 
dent dusted  powdered  antimony  over  the  wound 
and  ded  several  folds  of  his  puggree  around  the 
cheat  to  stop  the  hemorrhage,  the  man  had  not 
interferred  with  the  wound  in  any  way. 

On  admission  into  hospital  he  was  somewhat 
low  and  exhausted  from  the  effects  of  the  jour- 
ney, but  in  other  respects  had  borne  the  pain 
of  the  wound  and  the  loss  of  blood  very 
bravely.  As  a  matter  of  fact,  he  was  not  at  all 
conscious  of  the  seriousness  of  the  wound.  He 
was  a  man  small  in  physique,  but  possessed  a 
wiry  frame,  injured  to  hardships. 

On  examination,  the  wound  was  found  situ- 
ated in  front  of  the  chest,  some  two  inches  to  the 
left  of  the  lower  third  of  the  middle  piece  of  the 
sternum.  A  triangular  flap  of  integument, 
measuring  about  two  inches  at  the  free  margins 
and  2\  inches  at  the  attached  base,  was  torn  up 
and  reflected  upwards  and  outwards  in  the 
direction  of  the  left  shoulder,  exposing  a  deep 
wound  which  involved  the  soft  tissues,  the  cart- 
ilage of  the  fifth  rib,  the  pleura  and  opened 
into  the  cavity  of  the  pericardium.  This 
wound,  which  ran  inwards  in  the  direction  of 
the  lower  angle  of  the  left  scapula,  bore  some 
resemblance  to  a  short  truncated  cone,  and 
measured  about  \h  inches  externally  ;  its  deep 
narrow  end  being  sufSciently  patent  to  admit  of 
a  good  view  of  the  whole  apex  of  the  heart  as  it 
beat  in  its  pericardial  saa  This  rare  opportunity 
was  availed  of  me  to  give  my  pupils  a  brief  prac- 
tical instruction  on  the  rhythmical  action  of  the 
heart  and  its  impulse,  and  a  demonstration  of 
its  anatomical  position  in  the  body. 

SympUnns :~  Pain  over  the  seat  of  wound  in- 


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creased  bj  aasumiDg  the  recumbent  posture, 
and  felt  least  by  maintaining  the  sitting  posi- 
tion, with  the  chest  thrown  forwards.  The 
heart  sounds  normal ;  pulse  weak  and  quick,  90 
per  minute.  Resp.  29.  Temp.  98*^.  No  hem- 
orrhage since  admission  into  hospital.  As  far 
as  could  seen  and  ascertained  hj  signs  and 
symptoms  there  was  nothing  indicating  injury 
to  the  lung  ;  and  no  emphysema  or  pneumo- 
thorax, although,  of  course,  the  pleura  had  been 
torn  through. 

TrecUment  and  Results : — Having  carefully 
washed  the  surface  of  the  wound  with  carbolized 
nvater  without  in  any  way  interfering  with  the 
deep  structures,  the  triangular  piece  of  integu- 
ment was  as  correctly  as  possible  adjusted  to  its 
place  and  sutured.     No  chloroform  was  used. 
The  lips  of  the  wound  were  then  hermetically 
sealed  with  small  pieces  of  lint  saturated  wiUi 
Friar's  Balsam,  and  over  this   was  placed  a 
"  protector,"  well  soaked  in  carbolic  oil  with  a 
sufficient  padding  of  cotton- wool  and  a  bandage. 
The  patient  was  strictly  enjoined  to  keep  to  his 
bed  with  hb  back  well  propped  up  and  remain 
at  perfect  rest*    For  three    days  no  urgent 
symptoms    of  any  kind  showed    themselves; 
and,  barring  some  feverishness  (T.  99*^  to  100*^) 
and  a  slight  pain  at  seat  of  wound,  the  patient 
was  progressing  very  satisfactorily.     On  the 
morning  of  the  fourth  day,  without  any  corre- 
sponding   marked    rise    of    temperature    (T. 
100.2^),  there  was  a  sudden  accession  of  pain 
referred,  not  to  the  wound  but  to  the  internpace 
between  the  sixth  and  seventh  ribs  immediately 
below    the    wound.      The    character   of   this 
pain    was    different  from    the    pain    in     the 
wound       There    was    a  catch    on    the   spot, 
the  patient  said,    which  impeded  his   breath- 
ing, and  it  was  accompanied  by  a  slight  hack- 
ing cough,  (Resp.  35,  pulse  99).     On  examin- 
ation friction  sounds  (whether  pleural  or  peri- 
cardiac it  was  hard  to  tell)  together  with  crepi- 
tant rales  were  heard.     The  next  day  there 
was  some  little  expectoration ;  the  sputum  be- 
ing, occasionally  only,  tinged  red ;  the  breath- 
ing, however,  was  freer,  and  the  pain  less  acute 
than  on  the  previous  day,     Nothing  especial 
was  done  to  check  this  intercurrent  attack  of 
pleuro— or  pericardio-pneumonic  inflammation, 
if  I  may  use  the  term.     Gradual  improvement 
took  place,  and  in  the  course  of  three  days  all 
traces  of  the  inflammation  had  subsided,  and 
the  patient  was  convalescent. 

There  being  no  discharge,  no  foetid  oclor,  and 
no  constitutional  disturbance  demanding  earlier 
attention  to  the  wound,  the  dressings  were  not 
removed  until  the  eighth  day  after  the  accident, 
and  to  my  great  satisfaction  I  found  the  wound 
perfecUy  healed  by  first  intention.     After  one 


week's  further  detention  in  hospital,  i  e., 
exactly  a  fortnight  from  the  date  of  admission, 
the  patient  was  discharged  cured,  but  with  a 
defect  Although  the  external  surface  of  the 
wound  had  united  so  well  and  readily,  the  inner 
parts  had  healed  incompletely;  for  after  the 
bandages  were  removed,  it  was  observed  that 
within  an  area  of  about  H  inches,  correspond- 
ing exactly  with  the  original  site  of  the  wound, 
a  heaving  motion  was  communicated  to  the  inte- 
gument of  the  chest- wall,  to  be  distinctly  seen 
and  felt  each  timfe  the  patient  was  made  to 
speak,  and  obviously  Tlue  to  expansion  of  the 
lung 

Some  six  months  after  the  accident  the  patient 
had  come  to  the  hospital  with  a  friend  whom 
he  had  brought  to  be  operated  upon  for  stone  in 
the  bladder,  and  he  then  still  had  the  defect, 
but  stated  that  he  had  kept  good  health  al) 
along  and  was  quite  able  to  carry  on  his  usual 
avocation  without  any  trouble  or  inconvenience. 

Remarks. — To  account  for  the  lung  on  the 
affected  side  having  escaped  injury,  it  must  be 
supposed  that  it  was  either  pushed  before  the 
horn  and  slipped  out  of  harm'^s  way,  or  that  the 
horn  had  penetrated  the  pericardium  exactly  at 
the  spot  where  it  lies  uncovered  by  the  lungs, 
or  it  may  be  on  account  of  both  these  cirenm- 
stances  put  together. 

The  absence  of  pneumothorax  must  have 
been  owing  to  the  lacerated  condition  of  the 
soft  parts  and  the  coating  of  coagulum  fbrmed 
upon  them,  serving  to  effectively  shut  out  the 
air. 

There  being  no  signs  of  interference  with  the 
heart's  action,  no  syncope  nor  a  tendency  to  it, 
and  no  abnormal  cardiac  dulness ;  it  was  evi- 
dent there  was  no  hemorrhage  into  the  pericar- 
dial sac. 

Hemorrhage  from  the  intercostal  artery  waa 
probably  arrested  at  the  very  time  of  the  acci- 
dent 


Salicylio  Acid  in  Coryza. 

Dr.  Wegg,  (Med,  NeuigkeUen,  No.  48, 1893) 
advises  the  following  procedure  in  the  treatment 
of  acute  rhinitis :  A  small  quantity,  (about 
thirty  grains)  of  good,  pure  and  dry  salicylio 
acid  is  placed  in  an  ordinary  paste-board  pill- 
box, the  cover  of  which  is  pierced  with  a  num- 
ber of  holes.  The  box  is  then  shaken  so  that 
the  powder  arises  in  fine  clouds  from  the  box 
through  the  holes,  ihe  patient  holding  the  b4)x 
closely  under  his  nose  and  inhaling  deeply  the 
fine  dust  This  soon  gives  rise  to  sneezing,  the 
hyperemia  of  the  mucous  membrane  and  the 
resultant  symptoms  rapidly  disappear,  and  the 
cold  is  soon  over. — Lanctf-Clinic. 


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Consanguineous  Marriages 

Within  the  past  few  years  the  consensus  of 
statistics  and  general  investigation  have  resulted 
in  much  additional  light  upon  the  subject ;  all 
tending  in  the  direction  of  the  thought  that 
where  there  is  complete  mental  and  physical 
vigor,  there  is  no  objection  to  the  marriage  of 
Klatives,  even  so  near  as  first  cousins;  but, 
where  there  is  sickliness  or  pathological  defects, 
the  hereditary  vices  are  apt  to  be  emphasized  in 
the  posterity.  In  such  cases,  consanguinity  is 
detrimental.  In  other  words,  the  closer  the  re- 
lationship, the  greater  the  emphasis  of  the  prin- 
dple  that  like  begets  like.  If  defects  predom- 
inate, the  defect  will  be  emphasized  ;  if  the  re- 
verse, the  product  will  be  all  the  better  in  con- 
sequence of  the  consanguineous  features. — Med. 
Mirror. 

There  has  from  antiquity  been  a  general  be- 
lief, supported  by  some  physiological  considera- 
tions, that  marriages  between  near  relatives  are 
likely  to  be  followed  by  deterioration  and  de- 
generation in  the  offspring.  It  has  been  main- 
tained that  by  such  unions  ancestral  and  family 
imperfections  would  not  only  be  perpetuated, 
but  raised  to  their  highest  potency. 

That  this  holds  good  in  the  transmission  of 
nervous  diseases,  no  physician  doubts  ;  and  the 
offspring  of  parents  who  are  both  markedly  neu- 
rotic, will,  unless  favored  by  unusual  fortifying 
circumstances,  almost  certainly  be  neuropathic. 

A  similar  affirmation  may  be  made  regarding 
institutional  diseases,  such  a  gout,  tuberculosis 
and  carcinoma. 

Consanguinity  and  affinity  have  been  at  dif- 
fn^nt  times  and  in  different  parts  of  the  world, 
looked  upon  as  impediments  to  marriage  be- 
tween the  parties  related.  The  Roman  law 
prohibited  marriages  between  ascendants  and 
descendants,  between  brothers  and  sisters,  and 
at  one  time  between  cousins-German  ;  and  the 
old  canon  laW  and  early  decretals  forbade  mar- 
riages between  persons  as  far  removed  as  the 
seventh  degree  of  consanguinity.  Doubtless,  on 
the  other  hand,  in  very  early  stages  of  society, 
marriages  between  near  relatives  were  the  rule. 

The  question  has  beea  asked  whether,  when 
both  parents  are  absolutely  sound  and  healthy, 
are  consanguineous  unions  detrimental  to  the 
offspring,  entailing  constitutional  defects  ? 

DcSinety,  in  a  recent  work  on  sterility,  dis- 
cusses the  question  in  the  light  of  many  interest- 
ing fads.  *We  can,'  he  says,  only  judge  of 
the  results  of  consanguineous  marriages  by  the 
quality  of  the  progeny.  We  have  to  day,  at 
our  disposal,  to  decide  the  question,  a  certain 
number  of  examples  which  seem  to  be  exceed- 
ingly pertinent  There  are  certain  fishing 
Btfttions  on  the  coast  of  France  where  the  sea- 


faring  population  live  in  the  neighborhood  of  a 
rural  population  without  contracting  marriages 
with  them.  In  the  commune  of  Ba^z,  in  the 
Loire  Inferieure,  composed  of  3,000  inhabitants, 
there  has  been  frequent  inter-marrying  for  a 
great  many  years  among  near  relatives  of  a 
dozen  or  so  of  families.  With  regard  to  most  of 
them,  the  relationship  is  of  the  third  to  the  fifth 
degree  ;  and  yet  all,  men  and  women  alike,  are 
robust,  of  good  stature,  firm  health,  and  the 
children  are  numerous  and  healthy. 

Many  more  observations  of  a  similar  nature 
might  be  cited,  from  which  it  would  appear  that 
consanguinity  of  itself  is  not  especially  detri- 
mental to  the  progeny.  As  Sanson  says,  *  con- 
sanguinity raises  heredity  to  its  highest  power 
by  causing  to  act  in  the  same  direction,  atavwn^ 
or  the  disposition  to  revert  to  ancestral  qualities 
and  individual  peculiarities.' 

If,  then,  the  parents  are  vigorous,  well  devel- 
oped physically  and  mentally,  these  qualities 
accumulate  in  their  descendants  and  the  influ- 
ence of  consanguinity  in  such  an  event  is  favor- 
able to  the  species. 

If  the  progenitors  are,  on  the  contrary,  sickly, 
or  present  any  pathological  defect  whatever,  the 
hereditary  vices  of  the  two  families  are  trans- 
mitted to  posterity  and  the  action  of  consanguin- 
ity is  then  detrimental. — Boston  Med.  and  Surg, 
Jour. 


Dutch  Physicians  Views  on  Alooholic^Drinks. 

It  is  an  encouraging  fact,  indicative  of  the 
spread  of  temperance  truth,  that  a  medical  Tem- 
perance Declaration  has  been  issued  in  Holland, 
signed  by  six  hundred  medical  men  of  that 
country,  which  contains  the  following : 

1.  The  use,  even  in  moderate  quantities,  of 
spirituous  liquors  is  always  injurious.  Alcohol 
does  not  not  assist  digestion,  but,  on  the  con- 
trary, hinders  it  It  may  excite  moment- 
arily the  feeling  of  hunger,  but  it  does  not  in- 
crease the  digestive  powers.  We  say  further, 
that  many  affections  of  the  stomach,  which  are 
attributed  to  twenty  different  causes,  have  no 
other  origin  than  the  habitual  use  of  alcoholic 
liquors. 

2.  The  popular  opinion  that  spirits  are  stim- 
ulants, necessary  or  harmless  when  taken  dur- 
ing? the  extremes  of  cold  or  heat  by  persons  en- 
gaged in  work  requiring  great  muscular  exer- 
tion, or  by  those  exposed  to  damp  air,  or  by 
persons  working  in  water  or  in  marshes,  or  by 
those  whose  food  is  insufficient,  is  false.  These 
prejudices  are  not  only  contrary  to  experience, 
but  it  has  been  proved  that  the  habitual  use  of 
alcoholic  liquors  has  precisely  the  contrary 
effects  that  people  attribute  to  them. 

8.  In  all  diseases,  especially  those  in  which 


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the  chaoges  are  rapid,  such  as  fevers  and 
cholera,  Uio-e  who  make  an  habitual  use  of 
strong  drink  are  the  least  able  to  resist  the 
power  of  the  disease. 

4.  For  all  these  reasons  spirituous  liquors 
should  not  be  regarded  as  popular  drinks,  but, 
according  to  our  view,  should  be  looked  upon 
as  most  dangerous,  destructive  of  the  prosper- 
ity and  development,  moral  and  material,  of  the 
masses. — National  Temperance  Advocate, 


Haig's  Uric  Acid  Theory. 

The  work  published  by  Dr.  Haig  was  the  re- 
sult of  nine  years  of  research  and  study,  chiefly 
on  the  cause  and  treatment  of  headache,  from, 
which  he  was  a  periodic  sufferer.  He  found 
that  on  a  meat  diet  his  headaches  became  worse, 
while  on  non-nicrogenous  food  they  diminished 
and  disappeared.  Further  study  led  him  to  the 
conception  of  the  cloi^e  relationship  of  migraine 
to  gout,  and  he  conceived  the  idea  that  uric  acid 
was  the  cau^e  of  the  former  as  of  the  latter. 
Accordingly  he  began  to  estimate  the  amount 
of  uric  acid  elminated  from  his  own  person,  and 
found  that  a  constant  difference  existed  in  the 
quantity  excreted  during  the  period  of  headache 
and  that  before  and  after  the  attack.  By  easy 
reasoning  he  connected  the  concomitant  symp- 
toms of  the  headache,  the  slow  pulse,  the  high 
tension  of  mental  depression,  the  disinclination 
for  exertion  of  mind  or  body,  the  cold  surface 
and  extremities,  with  the  character  of  the  urine 
and  the  amount  or  uric  acid  contained  in  it  If 
these  conclusions  are  correct,  the  practice  of 
medicine  has  been  placed  at  one  bound,  in  some 
ofitsmo^t  important  relations,  upon  a  mathe- 
matical h&i^f^y  and  Haig  deserves  to  be  men- 
tioned with  Hippocrates  and  Harvey.  Further 
clinical  observations  and  careful  research  will 
be  necessary  to  determine  the  correctness  and 
trustworthy ness  of  these  observations. — Med. 
News. 


The  Value  of  Stretching   the   Fphlncter  Ani   in 
Chloroform  Collapse. 

In  the  long  sad  lists  of  deaths  from  chloro- 
form in  which  the  various  means  adopted  for 
resuscitation  (unfortunately  ineffectual)  are 
enumerated,  I  observe  no  mention  of  one  of  the 
most  valuable,  in  my  opinion,  viz.,  dilatation  of 
the  sphincter  ani. 

This  proceeding  has  been,  I  understand,  in 
use  in  America  for  some  time  past,  and  is  highly 
spoken  of  by  Dr.  Daily,  in  the  New  York  Medi- 
cal Times,  February,  1893,  as  effective  in  cases 
of  morphine  poisoning. 

I  had  lately  an  opportunity  of  putting  to  the 


test  this  plan  of  treatment  in  the  case  of  a 
patient  almost  moribund  after  chloroform  ad- 
ministration. The  usual  means  haying  failed^ 
to  obtain  any  response,  I  introduced  my  thumb 
into  anus,  and  forcibly  drew  the  sphincter 
towards  coccyx.  This  had  the  immediate  effect 
of  rousing  the  patient  sufficiently  to  gasp  and 
cry  out,  and  when  repeated  later  on  (as  she 
showed  signs  of  relapsing  into  the  former  condi- 
tion), she  so  far  recovered  as  to  protest  in  a 
marked  way  against  its  repetition. 

Dr.  Daily's  plan  is  to  use  a  bivalve  rectal 
speculum,  and  by  its  expansion  to  stretch  the 
sphincter.  As  the  speculum  may  not  be  alwajrs 
at  hand,  I  think  the  finger  (or  thumb,  being 
stronger)  will  be  found  to  effect  the  desired 
result. 

Of  course  one  case  does  not  prove  much,  but 
by  observation  of  its  immediate  effect  in  stimu- 
lating the  respiratory  functions,  as  stated  in  this 
paper,  lead  me  to  think  it  a  most  valuable  and 
harmless  proceeding. 

The  sphincter  ani  being  the  last  portion  of 
the  body  to  give  up  its  sensibility,  the  converse 
must  be  equally  true,  hence  the  importance,  to 
my  mind,  of  adopting  this  plan  when  the.  patient 
after  an  anesthetic  shows  signs  of  collapse, 

I  trust  that  trial  will  be  made  of  this  Ameri- 
can doctor's  valuable  suggestion,  as  I  am  con- 
vinced that  its  importance  is  not  known,  and 
may  be  the  means  of  saving  life  when  the  usual 
treatment  has  failed. — Alexander  Duke,  in 
Lancet,  London. 


Ergot  Unsuitable  for  Obstetric  Use. 

The  following  are  the  conclusions  from  a 
long  article  in  the  Amer.  Medico,  Surg.  Bulletin, 
by  J.  C.  Crossland,  A.  M.,  M.D.,  Zhnesville, 
Ohio: 

Ergot  is  extensively  used  to  prevent  an  imag- 
inary danger.  In  the  class  of  cases  where  its 
use  seems  most  indicated,  better  results  can  ,be 
obtained  without  than  with  it 

Its  positive  action  blinds  us  to  its  possible 
dangers.  The  evil  it  does  is  often  credited  to 
other  causes. 

Administered,  it  is  a  potential  force  over 
which  we  have  little  or  no  control 

When  the  natural  forces  are  insufficient, 
there  are  other  means,  which  are  efficient, 
harmless,  and  controllable. 

When  a//  other  means  fail,  forceps  is  the 
dernier  ressort  for  delivery  via  naturalis. 

That  the  general  professional  opinion  is  grad- 
ually tending  to  the  abandonment  of  ergot  in 
obstetrics,  is  shown  by  the  gradually-decreasing 
demand  for  the  drug,  as  evident  from  the  drug 
market  reports. 


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Rules  Qoverning  the  Management  of  Labor  Cases. 

1.  Details  of  Hand  Cleaning. — Scrub 
the  hands,  after  carefully  cleaning  the  finger 
nails,  with  green  soap  and  warm  water  for  five 
(5)  minutes,  paying  especial  attention  to  the 
finger  tips  and  free  edges  of  the  nails.  Then 
rinse  off  the  s6ap  with  clean  water  and  scrub 
with  nail  brush  in  bichloride  1-1000  for  five 
(5)  minutes.  Hands  should  be  immersed  in 
antiseptic  solution  before  every  vaginal  examin- 
ation.    No  other  lubricants  are  used. 

2.  Preparation  of  Patient. — Before  in- 
ternal examination  the  patient's  external  geni- 
tals and  thiglis  must  be  scrubbed  thoroughly 
with  green  soap  and  warm  water  suds,  rinsed  off 
with  clean  water,  then  bathed  mth  bichloride 
solution  1-1000.  No  anti-partum  nor  post- 
partum doche  shall  be  given  without  cause. 

3.  Internal  examinations  should  be  as  infre- 
quent as  safety  to  the  patient  will  permit.  One 
and  one-half  to  two  hours  apart. 

4.  For  this  reason  make  thorough  abdominal 
examination  ante-partum. 

5.  Before  any  interference  empty  bladder 
and  rectum. 

6.  Never  pull  on  the  cord.  Do  not  tie  cord 
until  pulsation  has  ceased,  unless  for  indication. 

7.  Never  introduce  fingers  or  hand  into  geni- 
tal caoal  post  partum  except  for  cause. 

8.  If  no  haemorrhage  occur  wait  at  least 
thirty  minutes  before  exciting  uterine  contrac- 
tions and  expressing  placenta. 

9.  Twist  membranes  into  a  rope  to  prevent 
tearing  and  draw  them  out  in  the  axis  of  the 
superior  strait,  waiting  until  the  active  contrac- 
tions of  the  uterus  have  subsided.  If  mem- 
branes should  tear  do  not  mthdraw  them  at 
once,  but  note  the  fact  and  give  a  hot  douche  on 
the  second  day.  If  not  brought  out  with  this 
treatment,  withdraw  them  with  aseptic  fingers. 

10.  If  hemorrhage  should  occur  before  the 
placenta  is  exposed,  express  it  at  once  and  give 
a  hypodermic  of  ergot  If  hemorrhage  persists, 
keep  the  uterus  squeezed  by  your  outside  hand 
and  give  hot  intraruterine  douche.  If  the 
uterus  remains  flabby  and  hemorrhage  persists 
tampon  the  uterine  cavity  with  iodoform  gauze, 
sending  for  assistance  in  the  meanwhile.  (To 
combat  acute  anemia,  think  of  salt  solution.) 

11.  Al^rays  examine  for  laceration  of  perin- 
eum by  inspection  before  leaving. 

12.  All  lacerated  perinei  are  to  be  repaired. 

13.  Support  of  Perineum. — Never  touch 
perineum,  always  prevent  the  head  from  sliding 
through  too  rapidly  by  pressure  upon  it,  and 
see  that  the  occipital  protuberance  is  out  from 
soft  parts  before  you  permit  forehead  or  face  to 
pass  over  perineum. 

14.  The  binder  must  be  applied  so  as  to  go 


well  over  the  hips,  not  as  a  means  of  preventing 
hemorrhage,  but  to  give  support  to  the  lower 
abdominal  walls.  It  should  fit  snugly,  not  too 
tightly. 

15.  If  head  is  not  delivered  after  being  on 
perineum  two  hours  send  for  assistance. 

16.  Always  examine  the  child's  navel  for 
bleeding  before  leaving,  as  well  as  the  child 
generally  for  any  malformation. 

17.  A  few  drops  of  argentic  nitrate  1  per 
cent  must  be  dropped  in  the  child's  eyes  as  a 
prophylactic  against  ophthalmia  neonatorum. 

18.  An  ante-operation  douche  shall  be  given 
before  any  procedure,  and  an  intra-uterine  post- 
partum douche  after  instruments  or  hands  have 
been  in  uterus,  of  carbolic  add  3  per  cent  or 
creolin  1  per  cent  N.  B.  No  bichloride  is  to 
be  used  in  the  parturient  canal. 

No  other  rule  for  operative  interference  ex- 
ists except  the  interest  of  mother  or  child.  If 
the  fetal  heartsounds  differ  forty  beats  beats  a 
minute  from  the  number  previously  heard, 
whenever  they  rise  to  180  or  fall  below  110,  if 
meconium  appears  in  a  head  presentation,  if  no 
advance  is  made  for  two  hours,  in  spite  of  good 
pains,  we  hasten  labor  in  the  interests  of  the 
child.  Of  course  we  also  accept  prolapse  of 
cord  or  hand,  malposition  of  child  or  of  placenta 
as  indications 

Beddes  the  well-known  dystocias,  a  tempera- 
ture which  keeps  rising  to  above  101,  or  a  per- 
sistent pulse  of  120  or  more  will  indicate  that 
the  mother's  state  demands  our  interference. 
Chloroform  is  administered  during  an  operation^ 
only,  ergot  is  not  used  except  hypodermically 
for  post-partum  hemorrhage.  Grarrigue's  peclu- 
sive  pad  is  always  applied. 

These  are  the  rules  of  the  New  York  Post- 
Graduate  School  and  Hospital,  in  following 
which  they  have  conducted  410  cases  without 
a  single  death.  The  author,  G.  A.  VanRam- 
dohr,  M.  D.,  (The  PosUOraduate)  concludes 
as  follows : 

When  it  is  plainly  understood  that  our 
patients  are  of  the  dirtiest,  their  surroundings 
filthy,  their  food  bad,  thdr  nursing  next  to 
nothing ;  when  it  is  understood  that  the  forty- 
two  practitioners  came  to  learn  and  to  acquire 
the  asepsis  necessary  for  such  success ;  when  it 
is  known  that  seven  months  was  the  longest 
time  a  house-physician  spent  at  our  department, 
we  can  turn  to  any  general  practitioner  and 
say  :  **  These  results  and  such  results  you  can 
have,  anybody  can  have,  by  upholding  the  two 
great  prindpak  of  modem  midwifery  :  asepsis 
and  nanrinterference  except /or  cause.** 

Editor  Medioal  WoaiiD:— The  contents  of  The 
MedioaIj  World  are  worth  ten  times  the  price  of  it 
Beading,  Pa.  Jno.  Stsphshs,  M.D. 


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Class-Room  Notes. 

(From  Coll.  and  Clin.  Record.) 

Prof.  Keen  does  not  favor  the  use  of  styptics, 
except  in  cases  of  oozing  on  the  surface. 

Dr.  Davis  says  that  in  cases  of  Eclampsia, 
no  other  drug  controls  the  convulsions  as  well 
as  chloroform. 

In  acute  lobular  pneumonia  in  children, 
Prof.  Hare  says  that  quinine  will  be  found  to 
act  almost  as  a  specific. 

According  to  Prof.  Hare  exalgine  should 
not  be  employed  with  a  view  of  reducing  the 
temperature  in  fever  cases. 

Eclampsia,  says  Dr.  Davis,  occurring  during 
the  first  stage  of  labor  is  more  fatal  than  if  it 
sets  in  before  labor  has  begun. 

Dr.  Davis  says  the  only  successful  treatment 
for  cases  of  habitual  abortion  is  actual  confine- 
ment in  bed  for  some  time  previous  to  labor. 

Prof.  Keen  says  a  good  flat  Esmarch  band- 
age can  be  applied  to  a  limb  and  left  there  for 
eight  hours,  and  not  cause  gangrene  to  set  in. 

Prof.  Hare  says  in  fever  cases  in  which  the 
temperature  is  above  103°.  Fahrenheit  digitalis 
will  be  found  not  to  have  any  good  influence. 

Prof.  Hare  says  in  attacks  of  rheumatbm 
following  the  exposure  to  cold,  great  relief  will 
be  obtained  by  the  administration  of  Dover's 
fx)wder. 

Prof.  Hare  is  of  the  opinion  that  the  peroxide 
of  hydrogen  is  the  best  remedy  that  can  be 
used  to  dissolve  the  false  membrane  in  cases  of 
diphtheria. 

Prof.  Hare  says  that  drugs  which  will  be 
found  useful  in  cases  of  articular  rheumatism 
will  prove  of  little  or  no  value  in  cases  of 
gonorrheal  rhematism. 

Dr.  Jurist  says  all  cases  of  acute  membranous 
croup  should  be  isolated  and  treated  as  a  possi- 
ble contagious  disease,  as  a  diphtheritic  case 
may  result  from  it 

Dr.  Jurist  says  that  as  a  general  rule  syphilitic 
mucous  patches  will  be  found  to  be  placed 
Bymmetrically  on  both  sides  of  the  mouth  and 
upper  air  passages. 

Dr.  Salinger  reported  a  case  of  chronic  inter- 
stitial nephritis  which,  by  slowly  increasing 
doses,  took  ^ve  grains  of  the  pure  nitroglycerine 
three  times  a  day. 

Pjt)f.  Keen  says  in  persistent  hemorrhage 
from  extraction  of  a  tooth,  the  alveoli  must  be 
emptied  of  all  blood  clots  and  then  packed  well 
with  absorbent  cotton. 


Prof.  Hare  says  the  distilled  extract  of 
hamamelis  applied  locally  in  Hemorrhoids  will 
be  found  to  be  exceedingly  valuable,  and  will 
often  yield  extraordinary  results. 

In  syphilitic  affections  of  the  upper  air  pas- 
sages, Dr  Jurist  says  patients  should  neither 
smoke,  drink  nor  chew,  nor  should  they  drink 
anything  too  hot  or  too  cold. 

Prof  Keen  says  in  probing  for  a  ball,  a  probe 
with  a  porcelain  tip  should  be  employed,  for 
when  the  probe  touches  the  ball  it  will  leave  a 
black  mark  on  it,  do  to  the  lead. 

Prof.  Keen  says  cotton  made  into  a  rope  caa 
be  used  as  a  drainage  tube  for  the  abdomen, 
but  it  must  be  changed  very  often,  as  it  readily 
takes  up  the  fluid  of  the  stomach. 

Prof.  Hare  says  the  oil  of  sandalwood  will 
often  be  found  very  useful  in  the  latter  stages  of 
broDchitiB,  in  which  the  expectoration  is  thick, 
and  the  cold  seems  to  persist 

Prof.  Keen  says  hot  water  at  120°  is  tl^e  best 
hemostat  in  cases  of  hemorrhage;  acting  by  cob- 
tractins:  the  blood  vessel,  and  the  heat  alss 
causes  little  blood  to  flow  to  the  part. 

Prof.  Hare  says  that  the  sulphides  or  sulphur 
water  are  very  useful  in  oases  of  laryngeal 
hoarseness  and  pharyngeal  a  flections,  such  as 
follow  public  speaking  and  exposure  to  cold. 

Dr.  Davis  says  in  marginal  placenta  previa, 
the  mouth  of  the  womb  will  be  found  to  be  free 
from  the  placenta,  but  the  placenta,  by  digital 
examination  will  be  found  situate  just  at  the 
edge  of  the  lumen  of  the  os. 

Prof.  Keen  says  in  cases  of  shock,  cold  water 
should  not  be  dashed  on,  as  is  done  in  a  patient 
who  has  fainted;  a  little  may  be  applied  to  tke 
forehead,  but  he  prefers  that  hot  water,  in  bot- 
tles, be  placed  on  the  patient 

Prof.  Hare  recommends  nitro-hydrochloris 
acid  in  cases  of  chronic  hepatitis,  in  full  doses 
and  continued  to  its  physiological  limit,  whick 
will  manifest  itself  by  bilious  purging  or  by 
signs  of  ga^tro  intestinal  irritation. 

Prof.  Keen  says  care  should  be  taken  in  ex- 
amining a  patient  who  receives  a  kick  in  the 
belly,  for  it  has  often  been  discovered  that  suck 
an  injury  has  caused  laceration  of  the  liver  or 
spleen,  or  sometimes  both  have  been  injured. 

Prof.  Keen  says  in  cases  of  appendicitis,  if  the 
pus  pours  out  into  the  abdominal  cavity  before 
adhesions  have  formed,  laparotomy  should  be 
performed  immediately,  without  loosing  a 
moment's  time.  The  belly  should  be  well 
washed  out  after  the  operation  and  drained. 


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Prof.  Hare  sajs  in  caaee  in  which  an  obsti- 
nate syphiloderm  is  present,  half  an  ounce  of 
the  bichloride  of  mercury  and  one  ounce  of  the 
chloride  of  ammonium  added  to  a  warm  bath 
(which  should  be  taken  every  few  days)  will 
often  be  found  very  efficacious. 

Dr.    Davis  recommends  the   following  oint- 

men  in  healing  sore  nippleb : 

R    Add,  boric,  bulv .gr.  x 

LanoUo, 

Coamollne aa   oiw.        M. 

FUt  an«[uentiim. 
8lg.~AppIy  locally. 

Prof.  Keen  says  in  all  cases  where  there  is 
cause  to  believe  that  an  internal  hemorrhage  is 
taking  place  in  the  abdomen,  ihe  latter  should 
be  opened  under  the  greatest  antiseptic  precau- 
tions, and  the  state  of  things  discovered. 

Prof.  Hare  says  that  bed-sores  may  often  be 
aborted  if  as  soon  as  the  skin  becomes  red  a 
solution  of  the  nitrate  of  silver,  of  the  strength 
of  twenty  grains  to  the  ounce,  is  applied  locally 
to  the  parts;  but  this  will  not  be  effective  in 
cases  of  paralysis. 

In  persons  of  intemperate  habit,  Prof.  Keen 
cays  secondary  hemorrhage  is  more  apt  to  oc- 
cur than  in  persona  of  temperate  habits;  and  in 
such  cases,  in  tying  an  artery  you  should  take 
part  of  a  muscle  or  some  connective  tissue  in 
with  your  stitch. 

Dr.  Davis  says  if  during  the  time  a  pati^it  is 
in  labor  dyspnea  occurs,  it  will  be  found  to  be 
best  relieved  by  the  hypodermic  use  of  either 
one  of  the  following  drugs :  Ether,  digitalis, 
strophanthus,  or  strichnia,  combined  with  in- 
hallations  of  ether  or  chloroform. 

Dr.  Davis  says  that  one  of  the  dangers  to 
which  a  child  is  exposed  when  its  presentation  is 
otherwise  than  normal  is  asphyxia,  caused  by 
the  OS  and  the  cervix  not  dilating  properly,  and 
contracting  about  the  head  of  the  fetus  jmt  at 
the  moment  when  delivery  is  taking  place. 

Dr.  Davis  says  that  placenta  parevia  is  ac- 
con  panied  by  anemia,  which  requires  immedi- 
ate and  active  treatment.  He  advises  hypoder- 
mics of  some  stimulating  drug,  or  whiskey  or 
brandy  And  for  the  nervousness  which  will 
often  accompany  it,  morphine  and  atropine  will 
be  found  useful. 

In  cases  of  chronic  lead  poisoning  which 
manifest  symptoms  of  locomotor  ataxia,  Prof. 
Hare  says  strychnine  will  ba  found  to  give  very 
good  results;  and  in  such  cases  where  it  is  aa- 
mbistered  before  the  symptoms  manifest  them- 
selves, it  will  act  almost  as  a  specific  in  prevent- 
ing their  appearance. 


Dr.  Salinger  says  in  cases  of  chronic  inter- 
stitial nephritis  hemorrhage  from  the  nose  is  of 
frequent  occurrence;  hemorrhage  from  the 
stomach  may  occur,  but  \a  not  very  common. 
The  chief  predisposing  causes  i  f  the  chronic  in- 
terstitial nephritis  are  syphilis  and  alcohol:  and 
its  occurrence  is  generailly  between  the  ages  of 
forty-five  and  sixty. 

Headache. 

Headache  is  a  symptom  arising  from  such  a 
variety  of  constitutional  and  local  conditions, 
that  to  treat  it  properly  it  is  necessary  to  arrive 
at  a  just  estimate  of  the  patient's  standard  of 
health.  For  no  other  symptom  is  it  more  im- 
portant to  carefully  ^examine  the  patient  as  to 
heredity  and  constitutional  taint.  As  to  heredity, 
the  inheritance  may  be  direct,  or  it  may  be  that 
the  neuropathic  parents,  who  may  have  been 
epileptic,  or  insane,  or  alcoholic,  have  transmit- 
ted to  their  offspring  an  instability  of  the  ner- 
vous system  which,  instead  of  being  of  the  same 
variety  as  that  of  the  par«nt,  has  manifested 
itself  as  headache  arising  on  various  pretexts,  as 
fatigue,  worry,  eye  strain,  etc. 

Having  determined  the  fact  of  inheritance  iu 
a  given  case,  the  examination  of  the  patient  re- 
quires a  correct  estimate  of  the  constitutional 
conditions  which  may  be  present,  whether  the 
patient  has  been  afflicted  with  syphilis,  malaria, 
rheumatism,  its  allied  condition,  lithemia,  or 
arterial  disease. 

A  most  careful  inquiry  should  be  made  as  to 
the  digestion  and  the  condition  of  the  alimentary 
tract,  as  in  the  disorders  of  stomach  and  bowels 
we  find  a  most  common  source  of  headache.  In- 
digestion in  its  various  forms  and  constipation 
are  respoDsible  for  a  large  portion  of  the  head- 
aches of  to-day. 

An  examination  of  the  urine  may  reveal  a 
diminution  of  excretion  of  urea,  which  often  is 
responsible  for  headache.  The  presence  of  uric 
add  crystals,  of  albumen,  of  sugar,  all  indicate 
a  line  of  treatment  which  must  be  followed  if 
we  would  relieve  the  distressing  symptom. 

After  we  have  determined  the  presence  or 
absence  of  these  conditions,  we  are  prepared  to 
study  the  headache  itself,  when  our  inquiry 
should  be  directed  to  the  history  of  this  par- 
ticular sjmptom,  the  original  attack— under 
what  circumstances  did  it  develop  ?  Often  we 
get  valuable  information  on  this  point  The 
first  headache  may  have  come  on  when  working 
in  the  sun  on  a  hot  summer's  day.  It  may  have 
developed  after  a  prolongerl  work  at  books,  in 
which  both  brain  and  eyes  are  over-taxed.  It 
may  have  followed  a  fall.  In  all  cases  the  his- 
tory of  the  first  headache  is  of  great  value,  and 
often  suggestive  of  a  line  of  treatment 


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Having  a  history  of  the  origin  of  the  head- 
ache and  its  duration,  the  fitudy  of  its  character 
naturally  follows.  It  may  be  continuous  or  in- 
termittent If  the  latter,  it  may  occur  at  stated 
regular  intervals  and  last  a  definite  length  of 
time,  or  it  may  occur  at  irregular  intervals, 
each  attack  seemingly  following  a  directly  ex- 
citing cause,  which  in  some  cases  may  be  an 
over  indulgence  in  eating  or  drinking  ;  Insuffi- 
cient sleep  ;  anxiety  ;  prolonged  mental  strain, 
or  prolonged  use  of  the  eyes,  which  may  or  may 
not  be  normal. 

Having  established  its  type  as  to  periodicity, 
the  study  of  the  pain  and  its  location  must  be 
learned.  As  to  location,  it  may  be  diffuse  over 
the  entire  head,  and  may  appear  to  the  patient 
to  be  superficial,  but  it  is  more  usually  de- 
scribed as  being  deeply  seated.  It  may  be 
localized  as  frontal,  vertical,  occipital,  or  one 
sided. 

Frontal  headache  we  sometimes  find  due  to  a 
gastric  cause  ;  to  anemia  ;  to  fever,  and  often  to 
prolonged  mental  work. 

Vertical  pain  is  often  due  to  gastric  distur- 
bances as  is  also  occipital. 

When,  however,  we  find  headaches  which  are 
not  due  to  altered  blood  states,  nor  to  any  of 
the  causes  to  which  I  have  alluded,  there  is  still 
the  great  cause  of  ocular  defects.  This  cause 
may  be  operative  alone  or  in  connection  with 
some  other,  but  wherever  found,  whatever  it 
may  be,  I  believe  that  it  should  be  corrected. 
Whether  the  error  is  one  of  refraction  or  of 
lai  k  of  muscular  balance,  it,  in  my  opinion,  is  a 
cause  which  must  be  removed. 

Having  now  thoroughly  examined  the  head- 
ache case,  how  may  we  classify  it,  for  upon  the 
proper  classification  depends  the  treatment 
adopted. 

Headaches  may  be  either  anemic  or  conges- 
tive, toxic,  neuralgic,  organic,  neurasthenic  or 
reflex. 

The  anemic  headache  is  commonly  found 
among  people  convalescent  from  disease  of  ex- 
hausting character ;  in  large  numbers  of  the 
poorly  fed,  hard  worked  young  women  in  offi- 
ces, shops  and  schools,  and  in  the  young  society 
women  of  the  day.  It  is  usually  of  the  diffuse 
variety,  but  it  is  often  more  severe  in  the  frontal 
region  and  back  of  the  eyes.  In  cases  of  chlo- 
rosis the  pain  is  sometimes  very  intense.  It  is 
not  constant,  but  attacks  are  easily  brought  on 
by  exertion  or  prolonged  reading.  This  latter 
cause  probably  operates  by  reasoa  of  the  weak- 
ened condition  of  the  muscles  of  the  eye  which 
share  in  the  general  poor  nutrition  of  the  body. 
The  diagnosis  of  this  type  is  rendered  easy  by 
the  accompanying  symptoms,  which  exist  in 
varying  degree,   of  faintness,   vertigo,  palpita- 


tion, breathlessnese,  dizziness  on  rising  sudd^y, 
and  improvement  of  the  headache  by  lowering 
the  head  and  elevating  the  feet 

The  treatment  of  the  anemic  condition  need 
not  be  described  here.  The  treatment  of  the  at- 
tack ij  often  succfssf ul  by  giving  a  diffusible 
stimulant,  as  spirits  ammonia  arom.,  one  drachm, 
to  be  repeated  if  necessary  in  one-half  hour. 
Sulphate  of  quinia  in  five  or  ten  grain  doses 
often  is  effectual  in  arresting  the  pain  or  at  least 
in  moderating  it 

The  congestive  headache  affects  the  whole 
head.  It  occurs  often  in  school  children.  It  is 
rarely  due  to  overwork — more  often  to  gastric 
and  intestinal  causes  The  pain  is  throbbing, 
increased  after  meals,  and  is  usually  worse  in 
the  latter  part  of  the  day.  Sleep  is  often  tardy, 
and  when  it  does  come  it  is  often  disturbed  by 
bad  dreams.  The  patients  are  as  a  rule  all 
children  of  neuropathic  ancestry,  and  are  liable 
to  suffer  from  other  diseaees,  as  epilepsy  and 
chorea.  As  a  rule  they  are  dull  at  school,  or 
else  bright  in  some  things,  dull  in  others,  irrita- 
ble on  the  play  ground  and  changeable  in  their 
moods.  Such  patients,  it  should  be  remembered, 
are  always  in  danger.  It  is  possible  that  these 
headaches,  in  a  limited  number  of  cases,  may  be 
forerunners  of  more  serious  mischief — tuber- 
cular meningitis.  These  children  should  be 
taken  out  of  school  and  the  entire  attention  be 
given  to  making  good  active  physical  beings, 
not  intellectual  prodigies  of  them.  They  should 
be  given  a  system  which  they  are  to  carry  out 
most  religiously.  This  should  include  mild 
gymnastics,  cold  sponging,  salt  water  rubbing, 
outdoor  plays,  but  particular  care  must  be  taken 
that  the  child  does  not  become  exhausted,  and 
to  that  end  I  make  it  a  rule  to  order  that  the 
child  come  in  at  four  o'clock  and  rest  an  hour. 
In  many  cases  we  find  such  cases  are  beet  treated 
by  the  mixed  bromides,  five  to  ten  grains,  t  L 
d.,  for  a  few  days  only. 

Regulation  of  the  diet  which  should  include 
avoidance  of  sweets,  prevention  of  over  eating, 
the  giving  of  fruits,  and  attention  to  the  bowels, 
should  complete  a  cure. 

In  adults,  congestive  headaches  more  fre- 
quently occur  in  men  and  are  often  dae  to  fre- 
quent wining  and  dining.  The  head  pain  is  de- 
scribed as  being  a  feeling  of  fullness  a  throb- 
bing, beating  head.  The  treatment  by  blue 
pill  and  salts,  with  dietary  restrictions,  is  effect- 
ual in  curtuHng  the  duration  of  the  attack.  A 
full  dose  of  bromide  of  potash,  or  of  one  of  the 
effervescent  salts  of  caffein  or  antipyrin  often  re- 
lieves the  pain.  The  English  gentleman  pre- 
scribes for  himself  on  such  occasions  the  juice 
of  half  a  lemon  in  a  glass  of  apollinaris  water. 

There  is  also  the  congestive  headache  dae  to 


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prolonged  brain  work.  It  is  perhaps  needless 
for  me  to  remind  you  that  when  an  organ  is 
functionating  it  requires  more  blood  than  when 
at  rest,  and  that  after  prolonged  mental  work 
there  sometimes  is  a  passive  cerebral  congestion. 
This  is  seen  in  lecturers,  ministers,  jury  lawyers, 
and  students  cramming  for  examinations.  It  is 
usually  accompanied  with  restlessness,  general 
fatigue  and  insomnia.  The  patients  complain 
of  a  feeling  of  pressure  on  top  of  the  head. 
There  is  also  dizziness,  ringing  in  the  ears,  and 
photophobia.  If  the  attacks  are  frequent  there 
gradually  develops  a  capillary  dilation,  due  to 
the  frequent  active  hyperemia,  and  then  a 
chronic  congestion  may  occur,  and  we  then  have 
a  chronic  headache  most  difficult  to  cure.  These 
headaches  are  made  worse  by  the  worker  taking 
stimulants  as  a  spur  to  the  flagging  energy. 

My  treatment  of  these  cases  is,  cessation  of 
work  where  possible ;  first  thing  in  the  morning 
before  rising  a  cup  of  black  coflee;  a  spinal 
douche,  40  degrees,  at  ten  or  eleven  o'clock. 

R   Tinct  naoiB  vom os. 

KUx.  gent oa.  1 

Add.  phoe.  dU o«." 

Slix.pepilQ OE.  1 

aig.    A  teaspoonfUl  in  water  three  times  a  day. 

If  the  heart  is  flagging,  give  a  little  digitalis. 
At  night  I  have  them  take  a  sponge  bath  with 
cold  salt  water  before  retiring,  well  rubbed,  in 
order  to  stimulate  the  peripheral  circulation, 
and  deplete,  if  possible,  the  engorged  cerebral 
circulation.  If,  after  being  in  bed  one  hour  th^ 
do  not  sleep,  I  give 

Ergot «, mZTX 

Pot.  bnun. gr.xxzto  Ix 

In  the  congestive  headache  of  old  people  I 
have  had  some  good  results  from  continued 
small  doses  of  ergot.  In  some  chronic  cases 
which  have  yielded  to  no  other  treatment,  pot- 
aasium  iodid  in  15  to  20  grains  a  day  relieves 
the  severity  of  the  pain. 

In  the  headache  occurring  at  the  menstrual 
period  in  which  the  pain  is  frontal,  extending 
from  the  root  of  the  nose  over  the  eyes  to  the 
temples.  Dr.  Glasgow,  of  St  Louis,  reports  that 
in  a  number  of  cases  he  has  given  immediate  re- 
lief by  pricking  the  congested  cavernous  bodies, 
and  thus  causing  free  local  blood  letting.  This 
I  have  never  tried,  as  it  requires  some  manual 
dexterity  which  I  do  not  possess. 

The  syphilitic  headache  is  marked  by  great 
violence.  The  pain  is  usually  verticel  and  may 
be  diffuse  or  localized.  Its  characteristic  ac- 
companiment of  scalp  tenderness  and  nocturnal 
increase  of  pain  make  the  diagnosis  sure  enough 
to  warrant  questioning  the  patient  as  to  his  per- 
sonal history,  and  to  treat  him  antisyphiliticaily, 
even  though  we  meet  with  a  denial  of  specific 


I  have  not  found  as  prompt  results  with  gmall 
doses  of  mercury  in  these  cases  as  I  have  with 
doses  of  potass,  iodid  of  from  15  to  20  grains 
three  times  a  day.  This  may  be  due  to  the 
fact  that  the  majority  of  my  cases  have  had  the 
headache  as  a  late  symptom. 

The  headache  due  to  cerebral  growth,  the 
toxic  headache,  arising  from  the  use  of  drugs, 
the  headache  accurring  in  the  course  of  acute 
febrile  diseases,  of  which  typhoid  fever  and  ila 
grippe  are  examples,  the  headaches  which  occur 
in  rheumatic,  gouty  and  Hthemic  subjects  form 
a  group,  the  treatment  of  which  is  a  part  of  the 
treatment  of  the  disease  of  which  it  is  a  symp- 
tom, and  will  not  therefore  receive  special  con- 
sideration hera 

The  headache  due  to  reflex  causes,  chief  of 
which  i6  some  eye  defect,  are  to  the  general 
practitioner  of  the  most  baffling  character.  This 
is  so  because,  even  though  the  patient  is  asked 
if  there  is  any  trouble  noticed  in  using  the  eyes, 
we  often  are  answered  :  "No,  ray  eyes  are  per- 
fectly strong.  I  can  see  perfectly."  An  ex- 
amination with  the  test  type,  which  is  the  only 
way  we  who  are  not  oculists  have  of  examining 
the  eyes,  often  reveals  what  we  estimate  as  nor- 
mal, or  near  enough  to  normal  vision,  and  then 
we  dismiss  the  eye  question  from  the  case.  Or 
perhapp  the  patient  may  be  wearing  glasses,  and 
will  mention  the  name  of  some  well-known  ocu- 
list who  fitted  the  glasses,  and  pronounced  them 
correct  The  general  practioner  muet  indeed 
be  bold  who  will  persist  in  clinging  to  the  idea 
that  there  is  still  an  unsolved  ocular  problem. 
But  my  experience  with  rather  a  large  number 
of  patients  of  this  class  has  forced  me  to  the 
conclusion  that  oculists  may  difler  in  their 
mathematical  calculations  as  surely  as  we  will 
differ  in  our  prescriptions  for  disease.  It  is  not 
uncommon  to  have  a  patient  examined  by  two 
different  competent  men,  and  receive  different 
glasses  from  them.  This,  I  believe,  is  not  al- 
ways because  the  measurements  taken  differ,  but 
because  oculists  differ  to  the  advisability  of  giv- 
ing full  correction  or  only  a  partial  correction.  ^ 
What  may  be  the  correct  view  to  be  taken  in ' 
case  of  fitting  glasses  for  correcting  defective 
vision  unaccompanied  by  nervous  symptoms,  is 
not  within  my  province  to  say,  but  in  those  cases 
in  which  the  defective  eyes  are  accompanied  by 
headache,  I  am  convinced  that  in  ttie  very  large 
proportion  of  chronic  cases  the  error  must  be 
fully  corrected,  and  corrected  after  the  use  of  a 
midriatic  before  we  can  eliminate  the  eyes  from 
the  case 

In  reference  to  the  cases  in  whom  we  find  loss 
of  muscular  balance,  we  must  wait  for  the  de- 
cision of  the  oculist  as  to  the  relative  value  of 
tenotomies  and  prisms. 


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In  the  cases  due  to  ocular  defects  which  have 
existed  for  a  long  time,  the  patients  will  as  a 
rule  require  treatment  for  a  considerable  time 
after  the  proper  correction  has  been  made. 

After  a  careful  study  of  all  headache  cases, 
there  still  remains  a  considerable  number  in 
whom  we  can  find  no  ascertainable  cause,  and 
where  we  meet  with  but  little  success  in  treat- 
ment It  is  these  cases  that  give  the  general 
impression  that  headaches  cannot  be  cured 
but  must  be  endured.  It  is  also  in  these  cases 
that  we  must  avoid  recourse  to  the  hypodermic 
or  other  use  of  morphia,  ior  they  become  habi- 
tues only  too  easily. 

Leaving  out  those  cases  in  whom  we  can  find 
no  definite  cause,  I  believe  that  by  careful  study 
of  individual  cases  a  large  majority  can  be 
greatly  improved,  if  not  cured. — Jaa.  W.  Put- 
man,  M.  D.,  in  Jourru  Am.  Med.  As90, 


Creasote  Treatment  of  Phthisis,  Not  Curative. 

Albu  ( Mwnchner  medicinische  Woehenschrift, 
December  6,  1892),  has  used  creasote  in  large 
doses.  The  patient  took  thirty  grains  daily. 
One  patient  took  as  much  as  6,500  grains  dur- 
ing the  time  of  observation.  He  believes  crea- 
sote to  affect  only  the  symptoms  of  the  disease — 
for  some  it  is  a  good  expectorant,  for  Others  a 
good  stomachic.  On  the  whole,  it  is  a  good 
tonic.  Recovery  did  not  take  place  in  a  single 
case.  He  believes  creasote  to  have  no  specific 
action  upon  the  process.  In  the  discussion  of 
Albu's  paper,  Furbuger  states  that  he  has  not 
used  creosote  for  the  past  two  years,  because  the 
effects  were  not  satisfactory.  In  half  of  the 
cases  in  which  it  has  been  used  it  had  no  effect, 
either  favorable  or  otherwise.  In  about  one- 
fourth  of  the  cases  it  had  a  deleterious  effect ;  it 
disagreed  with  the  stomach.  The  remaining 
fourth  of  cases  he  had  treated  improved  to  a 
certain  extent,  but  the  improvement  was  not 
greater  than  in  cases  under  good  hygiene  with- 
out creosote. —  Univerity  Med,  Mag, 


Cavazzini  (La  France  Med.)  advises  the  fol- 
lowing as  an  antiseptic  dusting  powder : 

a    lodofarm 56  parte 

SaUcTlic  iu:id 50  parte 

Suboltrate  of  bUmuU) 20  parte 

Camph6r 5  parte 

This  mixture  makes  a  light  yellow  powder 
which  is  without  disagreeable  odor.  It  is 
especially  efficacious  in  ulcerating  buboes.  It 
is  an  active  antiseptic,  hence  cicatrizes  and  pre- 
vents underm'ming  of  the  skin.  Indolent  granu- 
lations are  quickly  stimulated  and  suppuration 
rapidly  disappears. — Thera.  Gazette. 


Time  Rights  a  Wrong. 

Two  and  a  half  years  ago  two  New  Jer- 
sey druggists  were  tried  upon  a  charge  of  adult- 
eration, under  the  following  circumstances : 
The  standard  of  the  U.  S.  P.  at  that  time  for 
tincture  of  nux  vomica  was  "two  per  cent,  of 
dry  extractive."  The  druggists  sold  tr.  nux 
vom.  made  from  P.  D.  &  Go's,  normal  liquid, 
which  made  a  tincture  high  in  alkaloidal 
strength  and  therapeutic  power,  but  not  con- 
taining the  requisite  **two  per  cent  dry  extrac- 
tive." In  vain  learned  professors  and  skillful 
pharmacists  testified  that  the  value  of  the  tinct- 
ure depended  on  the  alkaloidal  strength  and  not 
upon  "dry  extractive,"  which  may  be  entirely 
inert.  The  revised  U.  S.  P.  changed  the  bam 
of  tr.  nux  vom.  from  dry  extractive  to  the  bet- 
ter basis,  alkaloidal  strength;  and  on  January  1, 
1894,  the  new  U.  S.  P.  became  a  part  of  the 
New  Jersey  law,  thus  robbing  these  cases  of 
legal  basis. 

But  the  best  part  of  it  is  that  we  now  have  a 
rational  and  definite  basis  for  this  important 
tincture,  instead  of  an  irrational  and  indefinite 
one.  We  are  progressing,  but  the  above  proves 
that  private  firms  frequently  move  in  advance 
of  the  machinery  of  authority,  whether  in  the 
shape  of  revision  of  the  U  8.  P.  or  the  action 
of  legislatures.  It  is  but  just  to  say  that  the 
strength  of  the  tincture  sold  by  the  defendants 
was  identical  with  what  is  now  the  legal  stand- 
ard.   

The  Spelling  of  Some  IMedical  Words. 

By  George  M.  Gould,  A.M.,  M.D., 

of  Philadelphia,  Pa. 

Read  at  the  meeting  of  the  American  Medical  Edi- 
tors'Association,  in  Millwaukee,  June  5, 1898. 

Of  all  the  languages  of  the  civilized  world, 
there  is  none  that  in  the  most  distant  manner 
can  rival  the  English  in  the  ludicrous  illogi- 
cality and  wretched  lawlessness  of  its  ortho- 
grophy.  In  other  languages  there  is  a  manifest 
philologic  sanity  that  evidently  seeks  to  hold 
the  written  (or  printed)  word  in  some  sort  of  re- 
lationship with  the  spoken  word.  But  in  our 
language  the  reverse  seems  to  be  the  case;  the 
more  methods  in  which  a  single  sound  can  be 
spelled  the  better  it  seemed  to  please  the  fathers 
of  the  language.  As  Professor  Lounsbury  says: 
''There  is  nothing  more  contemptible  than  our 
present  spelling,  unless  it  be  the  reasons  usually 
given  for  clinging  to  it" 

The  labor  which  this  fact  imposes  upon  the 
child's  mind,  and  upon  all  minds  that,  so  far  as 
language  learning  goes,  persist  in  the  pre  puber- 
tic  stage,  is  a  labor  that,  conceived  in  its  entirety, 
is  literally  appalling.    The  German  child  learnt 


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in  one  jear,  and  well,  what  the  English  child 
learns  in  throe,  and  poorly.f  It  is  so  tremend- 
ous a  labor  that  even  few  educated  men  reach 
mnconsciousness  and  ease  of  orthography,  and 
for  the  great  mass  of  people  it  is  a  constant  source 
of  woriy  or  chagrin.  To  a  vast  numbe^  of  peo- 
ple the  secret  consciousness  of  their  orthographic 
tailing  keeps  them  from  the  pleasure  of  writing 
and  composition,  or  prevents  them  £rom  profita- 
ble employment  To  every  person  that  writes, 
the  excess  of  labor  required  by  our  barbaric 
spelling  is  a  huge  waste  of  time  and  a  heightener 
of  the  friction  of  life.  With  the  correlated  bar- 
barism of  pronuciation,  it  is  the  greatest  obstacle 
to  the  spread  of  Eqglish  as  the  world's  great, 
sole  tongue. 

The  for^foing  facts  are  so  incontrovertible 
that  no  one  who  has  even  cursorily  looked  into 
philology  and  pedagogics  has  any  tendency  to 
deny  them.  Equally  certain  is  it  that  all  of  our 
great  students  and  masters  of  philology  are  en- 
tirely agreed  as  to  the  tremendous  importance 
of  lessening  the  burdensome  labor  of  education 
and  the  friction  of  life  by  some  approach,  great 
or  little,  toward  the  phonetic  spelling  of  English 
words.  As  succinctly  stated  in  his  preface  by 
the  learned  editor  of  the  great  Century  Diction- 
ary: 

*<The  language  is  struggling  toward  a  more 
oonsistent  and  phonetic  spelling,  and  it  is  proper 
m  disputed  and  doubtful  cases  to  cast  the  in- 
fluence of  the  dictionary  in  favor  of  this  move- 
meat,  both  by  its  own  usuage  in  the  body  of  the 
text,  and  at  the  head  of  articles  by  the  order  of 
forms  or  the  selection  of  the  form  under  which 
the  word  shall  be  treated." 

Never  has  more  capital  been  invested  in 
flimilar  enterprises,  and  never  has  more  philo- 
logic  erudition  been  gathered  to  the  service, 
than  in  the  editing  and  publishing  of  those 
splendid  lexicographic  monuments  of  American 
scholarship,  the  "New  Webster,"  the  **Century" 
and  the  Standard  dictionaries.  It  is  equally 
true  that  in  each  case  the  most  earnest  desire  of 
the  men  in  charge  of  these  works  has  been  to  go 
to  the  furthest  admissible  limit  dared  in  recom- 
moiding  the  shortening  and  rationalizing  of  the 
spelling  of  English  words.  They  have  only 
stopped  when  and  where  they  thought  further 
advance  would  result  in  a  baulking,  and  a  re- 
fusal of  the  people  to  follow. 

Words  faU  me  to  express  my  amazement  to 
hear  men  object  to  all  change  in  the  customary 

t  ProfesBor  March  says  that  *'it  has  been  computed 
that  we  throw  awa^r  $15,000,000  a  year  paying  teachers 
for  addling  the  brains  of  our  children  with  bad  spell- 
ing, and  at  least  $100,000,000  more  paying  printers 
and  pablishers  for  sprinkliog  oar  books  and  papers 
with  silent  letters." 


spelling.  To  be  sure,  they  are  but  few,  and 
those  who  have  never  given  the  matter  an  hour's 
thought  or  study,  who  thus  blindly  cling  to  the 
fetich  of  custom,  stolidly  resisting  any  change 
whatsoever.  The  changes  that  have  been  made, 
and  that  have  become  the  rule — these  they  will- 
ingly accept  They  have  grown  used  to  spell- 
ing music  and  public  without  a  final  k,  and  are 
willing  to  leave  off  this  useless  second  tail.  (The 
English  even  now  stick  to  the  final  k  in  alma- 
nac.) But  their  mental  forefathers  as  stoutly 
resisted  the  curtailing  process,  and  their  simi- 
larly-minded children  will  finally  accept  the 
changes  that  progressive  minds  are  now  forcing 
on  their  fathers.  The  stupidest,  most  disgusting 
thing  in  the  world,  is  the  brute  conservatism 
that  refuses  all  change,  good  or  not  good,  from 
stolid,  unreasoning  desire  for  things  as  they  ace. 
Better  chorea,  ay,  better  epilepsy  than  absolute 
paralysis.  Conservatism  is  the  sham  coyness  of 
liguistic  old-maidism,  the  crinolin  fig-leaf  of 
philologic  prudery,  a  fig-leaf,  too,  not  the  result 
of  too  much,  but  of  two  little  knowledge — in- 
deed, of  an  abysmal  ignorance  of  the  history  of 
the  language. 

And  most  strange  of  all  is  such  a  dead-blank 
wall  of  prejudice  on  the  part  of  medical  men. 
Their  science  is  a  progressive  one;  their  life  is 
harassed  and  hurried  with  the  crush  of  duties 
and  opportunities.  Every  hour's  experience 
teaches  them  to  ignore  precedent  and  to  cut  by 
the  shortest  route  to  the  desired  end.  No  body 
of  men  is  more  hampered,  and  in  no  calling  is 
labor  so  much  thwarted  as  in  theirs,  by  popular 
inherited  predjudices,  and  the  old  unsloughed 
snake  skins  of  quackery,  of  myth  and  of  mum- 
mery. 

The  vast  majority  of  medical  words  have  not 
grown  out  of  the  old  languages,  either  of  the 
ancient  living  Greek,  or  of  the  medievally  pre- 
served dead  Greek.  When  a  word  is  desired 
the  modem  minter  snaps  out  a  Liddell  and 
Scott,  gets  some  words  that  best  suit  his  purpose, 
and  s^kes  them  together  in  his  etymologic 
basket  until  they  cohere  into  some  sort  of  unity, 
not  infrequently  a  very  ludicrous  one. 

The  argument  most  relied  on  by  the  obstruc- 
tionists is  the  etymologic  one.  But  even  this 
poor  scarecrow  cannot  be  set  up  in  our  medical 
cornfields.  I  do  not  think  the  etymologic  argu- 
ment of  much  force,  even  in  the  general  literary 
language,  because  already  the  form  in  a  large 
portion  of  our  words  is  altogether  misleading, 
changed,  or  lost,  and  because  the  vast  majority  of 
people  never  will  and  never  can  know  anything  of 
the  etymologic  rootings  of  their  language.  But, 
fi&r  more  important  still  is  the  fact  that,  with 
printing  came  the  impossibility  of  a  coinage  ever 


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being  lost,  its  history  unrecorded,  or  its  tiniest 
rootlet  unpreserved. 

But  far  and  away  over  all  is  the  fact  that  the 
needs  and  the  help  of  the  living  millions  of 
bodies  and  minds,  present  and  to  come,  outweigh 
linguistic  and  philologic  considerations.  Jjeji- 
guage  was  made  for  man,  not  man  for  language. 

Moreover,  and  this  note  well,  despite  all  the 
literary  coxcombs  and  philologic  old  maids  of 
Christendom,  reform  is  inevitable.  The  people, 
with  unerring  instinct,  are  determined  to  mold 
their  language  into  some  better  conformity  to 
their  needs.  Slang  is  riotously  rampant,  and 
slang  is  language  in  the  making.  Some  reform 
in  spelling  is  as  certain  to  come  as  future  men 
and  women  are  certain  to  come,  and  wisdom  on 
our  part  is  to  accept  the  inevitable,  and  to  make 
that  inevitable  as  sensible  as  we  can.  As 
another  has  said:  ''The  grammarian,  the  purist, 
the  pemicketty-stickler  for  trifles  is  the  deadly 
foe  of  good  English,  rich  in  idioms  and. racy  of 
the  soil." 

All  this  is  entirely  too  long  an  overture  to  a 
very  small  opera.  I  wish  to  beg  my  brother 
editors  to  accept,  and  to  unite  in  asking  the  pro- 
fession to  accept,  certain  innocent  little  changes 
in  a  very  few  of  the  words  they  use.  Some 
time  ago  a  valued  contributor  objected  to  our 
editorial  suggestion  that  the  al  at  the  end  of 
many  of  our  adjectives  was  a  useless  length  of 
tail  that  it  were  desirable  to  lop  ofl.  He  could 
give  no  reason  except  that  wonderful  reason 
that  it  sounded  better  to  say  chemical,  biulogi- 
cal,  parasitical,  etc.,  than  to  say  chemic,  biologic 
and  parasitic.  All  argument  was  useless.  I 
asked  him  if  we  should  also,  in  his  articles,  spell 
scientifical,  basical,  thermical,  .albuminoidal, 
mesoblastical,  graphical,  metrical,  etc,  or  should 
we  leave  off  the  already  dropped,  old  simian  al. 

Another  valued  contributor  begged  to  be 
allowed  to  spell  hemorrhage,  anesthetic,  ortho- 
pedic, and  the  like,  in  the  nishion  of  his  ances- 
tors, t.  e.f  with  the  diphthong.  I  asked,  should 
we  preserve  the  Greek  diphthong  in  all  cases,  in 
sether,  for  example,  instead  of  ether,  and  in 
hundreds  of  cases  where  its  retention  would 
make  his  printed  page  the  object  of  laughter, 
even  to  the  etymologic  sticklers.  ''Analogy  to 
the  dogs  I" — and,  of  course,  logic  and  argumen- 
tation also  to  the  same  animals. 

After  four  years  of  careful  investigation  and 
great  labor,  the  American  Association  for  the 
Advancement  of  Science  has  adopted  a  set  of 
rules  for  the  spelling  and  pronunciation  of 
chemic  terms.  Among  these  rules  are  those 
advocating  the  dropping  of  the  final  e  in  all 
such  words  as  bromid,  iodid,  chlorid  and  the 
like,  and   also  in  all  such   as  bromin,   iodin, 


chlorin,  etc     Is  there  any  reason,  earthly  or 
unearthly,  for  not  following  the  suggestion  ? 

While  on  the  suicidal  subject  of  analogy,  re- 
ference may  be  made  to  the  spelling  of  program. 
There  are  people  who  will  use  the  analogic 
argument,  if  it  serve  their  purpose,  but  forget  it 
when  it  does  not  serve  them.  They  will  spell 
diagram,  anagram,  etc,  without  the  overlong 
tail,  but  they  are  horrified  at  program.  Old  Dr. 
Johnson,  in  his  Contradictionary,  spelled  some 
word  endings  our,  others  simply  or.  Some  of 
his  contradictianary  aftercomers  stick  to  his 
honour,  neighbour,  favour  and  colour,  though 
they  would  not  be  guilty  now  of  borrour,  dolour, 
emperour,  govemour,  etc  They  are  indignant 
at  meeting  meter  or  center,  but  if  you  ask  them 
to  spell  diameter,  scepter,  sepulcher,  etc,  they 
are  like  some  other  bivalves,  the  shut  up — but 
"are  of  the  same  opinion  stilL" 

To  conclude :  There  is  not  a  single  argument 
of  value  against  a  moderate  and  at  least  a  small 
beginning  of  some  kind  of  spelling- reform  of 
our  intolerable  English  orthography.  As  re- 
gards the  spelling  of  medical  words,  any  argu- 
ment has  less  weight  than  as  regards  other 
words.  We  owe  it  to  our  profession  to  be  pro- 
gressive in  this  respect,  at  least,  not  to  be  a 
dead- weight  to  the  car  of  progress,  and  at  the 
very  least,  not  to  pull  backward,  like  an  over- 
obstinate  horse,  when  the  wagon  (with  one  g !) 
is  pushed  on  to  our  heels.  Wherefore,  breth- 
ren, will  you  not  assent  to  the  little  advance 
already  gained,  and  will  you  not  assent  to  a  few 
little  timid  steps  further?  Every  argument  of 
logic  and  uniformity,  and  every  motive  of  good- 
will and  interest  in  progress,  is  on  this  side. 

Why  shall  we  not  drop  the  conjoined  letter 
diphthongs  in  all  words  ?  Let  us  spell  all  our 
words  from  the  Greek  lema,  with  the  single 
vowel  e  instead  of  se.  Let  us  say  hemorrhs^ 
hemostatic,  etc,  clear  through  the  list  The 
same  with  all  other  ai's  usually  spelled  sb,  as  in 
orthopedic,  pediatric,  anesthetic.  The  same  with 
oe :  Let  us  accept  edema,  celiotomy,  diarrhea, 
fetus,  etc 

Let  us  adopt,  with  never  a  wry  mouth,  the 
"American  spelling"  of  honor,  center,  meter 
(all  the  meters  and  liters  I),  program,  and  the 
rest 

Let  us  get  a  chart  of  the  rules  for  spelling 
chemic  terms  adopted  by  the  American  Associa- 
tion for  the  Advancement  of  Science,  and  hang 
it  infront  of  our  desks  and  never  spell  iodid, 
sulphid,  hydrid,  morphiA,  chlorin,  etc,  with 
more  e's  than  we  should.  It  is  easier  to  spell 
them  without  the  e's. 

Let  us  be  sensible  rather  than  censervative. 

[The  importance  of  the  above  subject  causes 


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us  to  give  it  more  space  than  we  usually  allow  to 
a  smgle  article.  The  Medical  World  a 
number  of  years  ago  gave  up  the  use  of  diph- 
tbcmgB.  Are  not  our  readers  ready  for  another 
step  or  two  in  the  direction  of  a  more  sensible 
spmling  of  medical  terms?  For  example, 
hemorage  instead  of  hemorrhage;  and  conse- 
quently, menoragia,  otoragia,  etc,  instead  of 
otorrhagia,  etc.;  and  diarea,  otorea,  etc,  instead 
of  diarrhea,  otorrhea,  etc.  If  we  should  decide 
in  the  near  future  to  make  such  a  step  as  this, 
can  we  depend  upon  the  good  sense  and  progres- 
sive spirit  of  the  readers  of  The  Medical 
WoBLD  to  welcome  it  ? — Ed.] 


We  would  advise  our  readers  who  are  inter-, 
ested  in  simplicity  of  language  to  send  to  the 
Bureau  of  Education,  Washington,  D.  C, 
for  a  copy  of  the  book,  •'  The  Spelling  Re- 
form, "  sent  free. 


Formulas. 


Prophylactic  Against  Frequently  Returning 
Tonsillitis. 

The  following  is  recommended  : 

Add  carbolic  cryst gmi}.5(T6grAlo8.) 

Alcohol ^ ifins.  10  (iW  drams.) 

Ol.  raenih.  pip .gti.  i. 

M.  81?.— Ten  drom  In  a  cup  of  warm  water,  a^  a  gargle, 
morning  and  evening. 

— Lancet-  Clinic, 


Local  Anesthesia. 

A  local  anesthetic  recommended  by  Dobisch, 
Prog.  Med  Woch  :— 

&   Chlorofonn parts  10 

£t  *eris ••    15 

Menthol "     1 

Thin  mixture  is  appU*d  by  means  of  Kichardson's  spray, 
and,  within  a  minute,  an  anesthesia  is  obtaiued  which  lasts 
tnm  four  to  six  minutes. 

— Canada-LaneeL 


Warts. 

Prof.  Kaposi  (Norsk  Magadn  f(yr  Lasgevi- 

denskaben.  No.  11,  1893)  recommends,  in  cases 

with  numerous  warts,  the  following  formula : 

Sublimed  sulphur dr.  y.  gms.  20 

Glycerine os.  vn,  gms.  80 

Pure  concentrated  acetic  a<id  ...dr.  iji«,>ms.  10 
Apply  local  y  each  eyening  until  the  warts  dry  up  and  fall 
off. 

— Lancet-  Clinic. 


For  Sore    Nipples. 

Ichthyol dram  1 

Lanoune ^„ «•     i^ 

ulyoeHne „ "     IjJ 

OllyeoU « ^ "     2K 

Sig.  Apply.    Wash  oir  before  nursing. 

— Med.  Record, 


Hemorrlioids. 

The  following  combination    will  usually  re- 
lieve an  ordinary  attack  of  external  piles : 

R   CocaiuflB  hydrochloratis gr.vi 

Morphinse  sulphatls ^ gr.  vi 

Extract!  bellaaonnae drams  8<< 

Liquor  plumbi  subacet drams  ss 

Ungt.  acidl  tannic oz  iii 

Ungt  stramonii drams  ▼ 

M.  Slg.^Wash  the  part  with  water,  hot  as  can  be  borne, 
for  several  minute»>:  dry  and  apply  the  ointment  flreely.  Re- 
peat four  times  daily,  and  after  each  stool. 

— Med.  Fortnightly, 


Plithisis. 

Prof.  Huchard  (2)ett<«cA6  wi^d.  Wochenschriftf 

No.  42,  1893,)  recommends  the  following   in 

phthisis : 

Bterilised  oUye  oil dr.  iijsr,  gms.  100 

(  amphor .dr.  v,  gms.  20 

Qualaool dr.  J«8.  gms.  6 

Inject  a  syringeAil  once  a  day  hypodermlcally. 

— Lancet-  Clinic 


Depilatories. 

We  ofier  several  formulae,  obtained  from 
various  sources,  which  are  regarded  as  harmless 
depilatories : 

(1)  Sulphuret  of  calcium  1  _.  ._  .. 
Quicklime                   /  ** ^^  ^ 

Reduce  v-parately  ^o  a  fine  powder;  mix,  and  keep  the  mix- 
ture in  well  stoppered  bottles. 

(2)  CHINISB   DEPILATORY. 

Quicklime oz.  vlij 

Pearl  ash os.  j 

Potassium  sulphuret oz  ] 

Powder  finely  and  pla^e  in  tightly  corked  bottles. 

(3)  RAYEB'S  DEPILATORY. 

ParU. 

Charcoal 1 

Quicklime 8 

Saltolta  tar  (dry) 16 

Reduce  to  a  fine  powder,  mix.  and  plaee  in  well  stoppered 
bottles 

(4)  Pass  a  current  of  hydrogen  sulphide  into  a  thick 
creamy  mixture  of  water  and  finely  rifled  slacked  lime,  until 
it  acquires  a  steel  blue  color  and  is  not  fhrther  darkened  by 
the  gas.    Place  in  tight  y  stoppered  bottles. 

Parts. 

(5)  Barium  sulphide 2 

Zinc  oxide I 

Starch  1 

Finely  powder  and  mix. 

Barium  sulphide  is  regarded  as  the  safest 
and  quickest  depilatory.  All  sulphides  are 
caustic  in  their  action,  a  &ult  inherent  in  all 
depilatories,  but  they  are  not  regarded  as  dan- 
gerous further  than  that  they  are  likely  to  irri- 
tate the  skin.  Frequent  applications  should  be 
avoided.  Orpiment,  or  sulphide  of  arsenic 
should  never  be  used. 

In  applying  a  depilatory,  the  part  having 
been  previously  shaved,  the  application  should 
be  made  to  only  a  small  surface  at  a  time,  care 
being  taken  to  prevent  its  spreading;  then,  after 
about  five  minutes,  it  should  be  scraped  off  with 
a  blunt  knife,  the  part  washed  with  water,  and 
an  emollient  applied. 


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All  depilatories  become  worthless  unless  en- 
tirely excluded  from  the  air,  hence  the  neces- 
sity of  keeping  them  in  tightly  stoppered  con- 
tainers. No  liquid  should  be  added  to  the  dry 
ones  until  required  for  use,  and  then  not  to 
more  than  is  required  for  one  application. — 
— Bulletin  of  Pharmacy. 

Elixir  of  licorice  comp,  for  masking  quinine 
and  other  bitter  and  nauseous  drugs : 

R.    Fluid  extract  lloorice 8  ounces. 

Spta  ammon.  aromat. 1  dram. 

Simple  elixir,  to  make 82  ounces. 

Mix. 

— Indiana  Pharmacigt. 

A  Good  Cough  Syrup. 

Paregoric, 
Glycerine, 
Syr.  ipecac, 

Syr.  Bquills. — a..a 1  ounce. 

Mix.    Dose,  a  (easpoonftU  as  required. 

—lb. 

Equal  parts  of  soap  liniment  and  oil  of  win- 
tergreen,  mixed  and  applied  to  the  affected 
parts,  affords  prompt  relief  in  acute  rheumatism. 
It  \a  only  a  relief,  not  a  cure. — lb. 

Phthisis. 

R.     Syr.  Addl  Hydriodicl,(Hostelley't) f  os.  Iv. 

Syr.  Hypophoephites  oomp" f.  os.  It. 

U.  Signa  :  Teaspoonml  to  dt^sbertcpoonlia  three  times  a  day. 
m  water.  

Dr.  W.  K.  Grayson,  Florence,  Texas,  says  as 
a  stimulating  expectorant  the  following  can 
hardly  be  surpassed : 

R.    Eucalyptol     (Sander  and  Sons) 

01.  Amygdalffi  dnlois aa. ...ounces  ss. 

M.  Slg.    Take  gtts.  x.  four  times  a  day. 

Nostrums— ''  Chemical  Compounds." 

The  followijQg  antiseptics  and  antipyretics, 
professedly  simple  chemical  agents,  have  been 
shown  up  in  MtrcJ^s  Report  to  be  only  mixtures : 

"Anticol"  is  found  to  consist  of  75  per 
cent  of  acetanilid,  17.6  of  bicarbonate  of  soda, 
and  7.5  per  cent  of  tartaric  acid. 

"  Anticylic  acid,  "  claimed  to  be  antipyretic 
and  anodyne,  is  merely  a  mixture  of  antipyrin 
and  salicylic  acid. 

"  Antidiphtherin, "  upon  examinatioo  was 
found  to  contain  potassium  chlorate  and  a  trace 
of  ferric  chloride. 

"  Antinervin, "  (so-called  aalicyl-brom-anilid) 
is,  according  to  E.  Ritsert,  a  mixture  of  one 
part  of  ammonium  bromide,  one  of  salicylic 
acid,  and  two  of  acetanilid. 

"Antiseptin"  is  also  known  as  sdric  boro^hymol- 
iodide,  according  to  Goldman  consists  of  85  parts 
of  adnc  sulphate,  2i  of  zinc  iodide,  2  J  of  thy- 
mol, and  10  of  boric  acid.  This  must  not,  how- 
ever, be  confounded  with  **  Antisepsin, "  which 
is  ch^nically  par'amono-bromrphenyl-aceL  amid  ; 
nor  with  cinchonin  iodo  sulphate. 


"  Aseptin "  is  said  to  consist  of  boric  add, 
borax  and  alum. 

"  Camphol "  to  be  merely  a  mixture  of  cam- 
phor and  salol  of  varying  proportion. 

"  Exodyne, "  according  to  F.  Goldmann,  ib 
nothing  but  a  mixture  of  90  parts  of  acetanilid, 
5  of  sodium  salicylate,  and  5  of  sodium  bicar- 
bonate. 

"  Phenolid  "  is  a  mixture  of  48  parts  of  acet- 
anilid and  42  of  sodium  salicylate. 

"  Quickine, "  according  to  the  Pharmaeeu- 
tische  2jeitung,  is  one  part  corrosive  sublimate, 
50  carbolic  add,  and  52  dilute  alcohol. 

"  Somnal "  is  reported  to  be  merely  a  solu- 
tion of  chloral  and  urethane  in  alcohoL 


Olive  Branch. 
Olive  Branch  consists  of  powdered  jequirity 
made  into  suppositories,  with  cocoa  butter  or 
white  wax. — Boston  Journal  of  Health. 


Orange  Blossom. 

Our  analysis  shows  it  to  be  about  as  follows  : 
An  oblong  body,  about  one  inch  long,  by  one- 
half  inch  wide  and  one-half  inch  thick,  weighing 
full  two  grammes  (31  grains).  A  single  fold 
of  heavy  tin  foil  surrounds  and  encloses  a  light, 
grayish-yellow,  unguentous  mass,  of  a  rancid, 
fatty  odor,  and  astringent,  metallic  taste.  The 
reaction  very  add.     The  constituents  are : 

Zino  sulphate 1  dr 

Alum « 16  er 

Coo^iabuttr 8dr 

White  wax kdr 

Oil  fcweet  llmonds 1>J  dr 

Ext.  Henbane Igr 

— New  Idea. 


J.  L.  St.  John's  Liniment, 

According  to  Eclectic  Medical  AdvooatCy  this 
preprration  is  composed  of: 

Turpentine 7  os 

Sweet  oil « 8o« 

Tinct  arnica 4oz 

Oil  origanum 1  oz 

Oil  hemlock 1  oz 

Oil  Juniper .....1  os 

Oil  Amber 2oa 

Laudnum 2  os 

Spirits  ammonia K  oz 

Camphor >i  oz 


Editor  Medical  World  :— The  World  still  cod- 
tinues  to  be  f*ill  of  valuable  information  to  a  bupj 
practitioner.  I  could  not  afford  to  do  without  it  od 
my  table  for  ready  reference. 

J.  M.  Palmer,  M.D. 

Dalton,  O. 


Gonorrhea—Latter  Stages. 

R.    Permangante  zinc gr.  \i\ 

Olycerine xlram  1  * 

AquedestU «.oz.vJ 

M.    Sig.— Use  aft  ii^ection  three  times  daily. 

— Jour.  MdL  Med, 


Digitized  by 


Google 


THB  MEDICAL  WORLD. 


Reviews. 


A  Standard  Dictionary  op  th«  English  Lan- 
OUAOS.  Price,  in  single  yolame,  $12;  in  two  vol- 
ii«)eB,$15.  Funk  and  Wagnalls  Ck>.,  18  and  20 
Astor  Place,  New  York. 
Volume  one  of  this  stupendous  work  is  now  ready. 
The  second  Tolume,  as  well  as  the  entire  single  vohime 
€dition,  will  iqspear  in  a  short  time.  This  work  has 
mlready  taken  font  years  time  and  cost  hundreds  of 
thocuandii  of  dollars  in  its  preparation.  It  was  the 
mmbition  of  the  projectors  to  make  a  dictionary  so  com- 
plete and  comict  that  it  would  at  once  take  rank  as 
the  accepted  authority  throughout  the  entire  literary 
world.  The  most  eminent  men  in  each  department  of 
learning  have  given  their  best  work  to  its  preparation. 
Other  dictionaries  have  been  small  and  unpretentious 
in  their  first  editions,  growing  from  one  edition  to 
another.  This  starts  out  at  once  as  the  greatest  dic- 
tionary, of  any  language,  in  the  world.  This  diction- 
ary gives  more  than  double  the  number — over  one  hun- 
WMand  fifty  thousandmore — of  words  than  the  largest 
other  single  volume  dictionary,  and  seventy  thousand 
more  than  a  certain  large  six- volume  dictionary.  It 
IS  more  accurate  and  complete  in  its  definitions.  It 
indicates  the  exact  pronunciation  in  a  plain,  simple 
form.  Its  illustrations  are  so  natural  and  life-like 
that  you  could  go  into  a  forest  and  identify  a  leaf  by  it. 
In  fact,  if  there  is  any  one  book  that  can  be  said  to  be 
a  complete  library  in  itself  it  is  the  Standard  Diction- 
ary. However,  as  no  words  that  we  can  say  can  give 
you  an  adequate  idea  of  this  magnificent  work  and  its 
meritfl,  we  advise  you  to  send  at  once  to  the  publishers 
for  their  announcement,  or  send  them  25  cents  for 
pamphlet  giving  many  sample  pages. 


Atlas  of  Head  Sections.    By  William  MacEwen, 
M.D.,  Glasgow,  Scotland.    Price  $21.    MacMil- 
lin  &  Co.,  New  York,    N.  Y.    Received  from 
John  Wanamaker,  Phila. 
This    magnificent  work  consists  of  fifty-three  en- 
rraved  copper  plates  of  frozen  sections  of  the  human 
bead,  the  sections  being  made  through  the  hea4  in 
every  possible  direction  for  showing  the  anatomical 
parts  in  their  normal    relations.    £ach  plate  is  ac- 
companied bv  a  key-plate,  with  appropriate  descrip- 
tive text    For   students  of  the  brain,  its  anatomv, 
physiology,  diseases  and  surgery,  it  is  a  most  valuable 
work.    It  is  a  suitable  companion  to  the  following 
volume,  by  the  same  author : 

ProoKNio  Infectivb  Disbaseb  of  the  Brain  and 
Spinal  Cord.    By   William    MacEwen.   M.D., 
Glasgow,  ScoUand.    Cloth,  854  pages,  60  illustra- 
tions, $6.    MacMillan,  &  Co.,  New  York.    Be- 
ceived  from  John  Wanamaker,  Phila. 
Complete  surgical  anatomy  of   the  head,  most  ac- 
cnrately  illustrated,  extending  over  forty-eight  pages, 
introduces  the  reader  to  the  work  of  this  volume — a 
consideration  of  the  diseased  conditions — meningitis, 
absoev  of  brain  and  infective  sinus  thrombosis.  These 
are  given  in  all  their  details  of  causation,  pathology, 

Tnptomatology,  treatment  and  results  to  be  expected, 
treatise  the  result  of  such  close  scientific  work  and 
persevering  application  should  be  prized  by  all  who 
are  interested  in  diseases  and  surgery  of  the  nervous 
system.  It  is  a  distinct  addition  to  our  scientific  wealth 
In  regard  to  the  brain  and  spinal  cord. 

Ebski^tialb  of  the  Practice  of  Medicine.  By 
Henry  Morris,  M.D.  Cloth,  price  $2.  W.  B. 
Sanndersy  925  Wahint  street,  Phila. 


This  is  the  third  edition  of  Dr.  Morris' resume  or 
"quiz-commend"  of  practice.  It  is  often  of  benefit  to 
the  practitioner  to  have  a  concise  statement  of  a  sub- 
ject when  he  wishes  to  get  a  brief  view  of  it  at  one 
time.  This  work  is  very  correct,  accurate  and  plain 
in  its  language  and  is  up  to  date  in  its  information. 

A  Syllabus  of  Surgery.  By  N.  Senn,  M.D.,  Ph.D.* 
LL.D.,  Chicago.    Flexible  cloth,  221  pa»Bs,  price 
12.     W.  B.  Saunders,  925  Walnut  street,  Phila. 
We  have  here  a  most  complete  and  comprehensive 

outline  of  all  the  principles  and  operations  in  surgery. 

A  veritable  ''mine  of  treasures*'  to  one  who  practices 

surgery. 

Ladies'  Guide  in  Health  and  Disease.  Girlhood, 
Maidenhood,  Wifehood,  Motherhood.  By  J.  H. 
Kellogg,  M.D.,  678  paf^,  illustrated,  cloth,  price 

.    Modem  Meaicine  Publishing  Ca,  Battle 

Creek,  Mich. 
Man,  the  masterpiece,   or  Plain  Truths  Plainly 
Told  about  Boyhood,  Youth  and  Manhood.    Br 
J.  H.  Kellogg,  M.  D.,   604   pages,'  illustrated, 

doth,  price .    Modem  McKlidne    Publishing 

Co.,  BaUle  Creek,  Mich. 
These  are  two  works  issued  by  subscription  and  in- 
tended for  popular  use,  regarding  the  sexual  phase  ef 
existence.  Tne  author  is  the  talented  editor  of  that 
popular  magazine.  Modem  Medicine  (formerly  asso- 
ciated with  Dr.  Paul  Paquin  in  publishing  the 
BaeUrialogieal  World)^  and  proprietor  of  a  prosperous 
sanitarium.  The  physician  is  often  asked  for  such 
books  to  place  in  the  hands  of  his  patients.  We  know 
of  no  better  books  of  this  kind  than  those  of  Dr.  Kel- 
logg, containing  much  accurate  information  and  use- 
ful instraction  in  regard  to  the  preservation  of  the 
health  in  general  and  the  proper  care  of  the  sexual 
function  in  particular.  It  is  eminently  proper  that 
youths  and  maidens  should  both  be  given  proper  moral 
and  physical  instraction  on  these  subjects  of  such  vital 
importance,  and  they  could  not  better  receive  it  than 
in  these  earnest  words  and  consdentous  teachings  of  a 
physidan  of  many  years  experience.  In  addition  to 
the  general  sexual  hygiene,  tne  doctor  has  impressed 
some  of  his  own  sensible  ideas  in  regard  to  physics  1 
habits,  as  food,  dothing,  etc  These  works  will  prove 
beneficial  to  young  men  and  young  women,  earnestly 
readmg  them  for  benefit.  Of  course,  the  physician 
will  not  want  them  for  his  own  use. 

An  Economical  System  of  Sanitary  Drainage 
FOR  City  and  Country.  By  M.  Nadien,  Cap- 
tain of  the  Russian  Army.  Price  25  cents. 
World's  Columbian  Exposition,  Chicago. 

How  Shall  we  Make  Our  Uomk  Healthy  ?  By 
Benjamin  J.  Portugalofif,  M.D.  Translated  from 
the  Kussian.  Price  25  cents.  World's  Columbian 
Exposition,  Chicago. 

Massachusetts  Association  of  Boards  of  Health. 
Official  pouraal,  September,  1893.  Subjects:  First 
'^Authority  to  Close  Schools  During  an  Epidemic." 
Second.  "Plumbing  Laws  of  Massachusetts."  Quar- 
terly, $1  per  year.  F.  P.  Chamberlain,  39  Oliver 
street,  Boston. 

Belladonna,  Illustrated. — A  beautiful  and 
highly  instructive  pamphlet,  giving  full  information 
in  regard  to  this  most  useful  plant.  The  book  con- 
tains a  full  history  of  the  plant;  a  full  account  of  ita 
various  names  and  their  meaning,  botanical  descrip- 
tion, well  illustrated  (very  complete);  geographical 
distribution  (illustratea);  its  insect  foes  (illustrated); 
its  adulterations  (illustrated);  its  medidnal  constitu- 
ents; its  chemistiy  and  pharmacy;  tests   for  purity; 


Digitized  by 


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72 


THE  MEDICAL  WORLD, 


physiological  action  (by  Prof.  H.  C.  Wood);  local 
actioM  (by  Prof.  W.  0.  Caldwell,  illustrated);  and  a 
great  deal  more  important  information  in  regard  to  its 
special  uses  by  men  of  the  highest  ability  in  their 
special  departments.  The  therapeutic  index  at  the 
close,  giving  mode  of  its  use  in  different  diseases,  occu- 
pying fifteen  pages,  is  very  complete.  This  entire 
work  may  be  had /r«€  if  you  will  address  Johnson  & 
Johnson,  New  York,  N.  Y.,  stating  how  you  like  The 
Mei^icax  World. 

An  Ambbicaw  Text-book  op  Qynboolooy,  Medi- 
cal AND  Surgical.    By  Henry  T.  Byford,  M. 
D.,  John  M.  Baldy,  M.D.,   Edwin  Cragin,  M.D., 
J.  H.  Etheridge,  M.D.,  William  Goodell,  M.D., 
Howard  A.  Kelly,  M.D.,  Florian  Krug,  M.  D., 
E.  E.   Montgomery,  M.  D.,  William  R.  Pryor 
M.D.,  George  M.  Tuttle,  M.D.;  edited  by  J.  M. 
Baldy,  M.D.    A    handsome   royal    8vo  volume, 
with  360  illustrations  in  text  and  87  colored  and 
half-tone  plates.    Cloth,  $6;  sheep.  |7;  half  Rus- 
sia, $8.    By  subscription  only.     W.  B.  Saunders. 
926  WAlnut  street,  Phila. 
In  this  volume  all  anatomical  descriptions  except- 
ing what  is  essential  to  a  clear  understanding  of  the 
text  have  been  omitted,  illustrations  being  lairoy  de- 
pended upon  to  elucidate  this  point    It  will  Im  found 
thoroughly  practical  in  its  teaching     A  clear  line  of 
treatment   has  been  laid    down    in  every  case,  and 
although  no  attempt  has  been  made  to  discuss  mooted 
points,  still  the  most  important  of  these  have  been 
noted  and  explained;  and  the  operations  recommended 
are  fully  illustrated,  so  that  the  reader  may  have  a 
picture  of  the  procedure  described  in  the  text  under 
his  eye  and  cannot  fail  to  grasp  the  idea. 

All  extraneous  matter  and  discussions  have  been 
carefully  excluded,  and  the  attempt  made  to  allow 
nothing  unnecessary  to  cumber  the  text 

The  subject  matter  has  been  brought  fully  up  to 
date  at  every  pKunt,  and  the  work  is  as  nearlv  as  pos- 
sible the  combined  opinion  of  the  ten  specialists  who 
figure  as  the  authors. 

Among  the  important  subjects  we  notice  the  follow- 
ing :  Examination  of  the  female  pelvic  organs— Em- 
braces a  description  and  illustration  of  all  the  instru- 
ments, tables  and  apparatus  used  in  the  course  of 
gynecological  examinations;  the  various  postures  as- 
sumed by  the  patient  in  examination  ana  operation, 
both  faulty  and  correct;  and  a  clear  description  of  the 
different  methods  of  examination,  with  each  one  fully 
illustrated. 

Technique  of  Gynecological  Examination.— This 
chapter  contains  the  most  recent  and  approved  methods 
of  iJreparation  of  the  operator,  assistants,  nurses  and 
patient  for  operations,  both  abdominal  and  vaginal; 
the  best  and  most  reliable  methods  of  preparation  and 
disinfection  of  sponges,  ligature^,  sutures  and  instru- 
ments. In  fact,  the  success  of  modem  gynecological 
surgery  rests  on  the  adoption  of  the  principles  and  de- 
tails described  in  this  chapter,  which  has  been  brought 
fully  up  to  date. 

Menstruation  and  its  Anomalies;  Sterlity;  Anomalies 
of  the  Female  G^enerative  Organs;  Oenital  Tubercu- 
losis; Diseases  of  the  Vulva  and  Va^na;  Inflamma- 
tory Diseases  of  the  Uterus;  Laceration  of  the  Soft 
Parts;  Genital  Fistula;  Distortions  and  Malpositions; 
Malignant  Diseases  of  the  Female  Genitalia;  Uterine 
Neoplasms,  Pelvic  Inflammation,  considered  from  an 
entirely  different  standpoint  from  that  found  in  the 
older  text- books.  The  subject  is  covered  in  a  thoroughly 
practical  manner.  The  pathology  and  etiology  are 
clearly  pointed  out,  the  results  describe,  and  the 
nianagement  and  treatment  in  all  phases  considered 
in  dAtnil.    The  old  and  confusing  nomenclature  and 


pathology  have  been  dropped,  and  the  data  ^iveD 
from  facts  as  found  to-day,  instead  of  from  theory  and 
tradition.  Salpingitis,  pyosalpinx,  hydrosalpinx, 
hematosalpinx,  pelvic  peritonitis  and  pelvic  celluliUs 
are  also  includea  under  this  chapter  heading. 

Ectopic  Gestation;  Diseases  of  the  Ovaries  and 
Tubes;  Diseases  of  the  Urethra,  Bladder  and  Ureters; 
After-treatment  in  Gynecological  Operations. 

A  Text- BOOK  of  the  Phtsiolooioal  Chemistry 
OP  THE  Human  Body,  Includiko  ah  Acoodht 
OF  THE  Chemical   Chanoss  Ogcubbino  m 
Disease.    Vol.  II.  Chbmist&y  of  Diqestion. 
By  Arthur  Gamgee,  M.D.,  F.  R.  S.,  of  England, 
528  pages,  fully  illustrated.    Cloth,  $4.60.    Mao- 
Millan  <%  Co.,  London  and  New  York.     For  sale 
by  J.  B.  Lippincott  Co  ,  Phila. 
This  book  should  be  made  a  text  book  in  all  our 
medical  colleges.     It  takes  up  this  important  subject 
in  the  light  of  the  latest  scientific  knowledge  of  the 
present  day,  giving  it  a  much    more  thorough  and 
masterful  treatment  than  can    possibly  be  given  in  the 
few  pages  allotted  to  it  in  a  general  work  on  physi- 
ology.   How  important  it  is  to  the  physician  to  have 
a  competent,  clear  knowledge   of   the  chemistry  of 
physiological  and  pathological    processes   cannot  be 
over  estimated. 

A  meager  outline  of  the  contents  of  this  valuable 
work  is  as  follows :  Saliva  and  its  action  upon  food, 
60  pages;  Gastric  digestion,  133  pages;  The  pancreas 
and  pancreatic  digestion,  78  pagefi;  The  bile,  90  pages; 
Various  considerations  of  the  oile  in  diseased  condi- 
tions ^Jaundice,  cholagog^ues,  etc.)*  18  pages;  Biliary 
calculi,  14  pages;  Analysis  of  bile  and  calculi,  6  pages; 
The  intestinal  canal,  21  pages;  Chemical  processes  of 
micro-organisms  in  the  intestinef*,  20  pages;  Chemical 
processes  of  the  small  intestine,  9  pages;  Chemical 
processes  of  the  large  intestine;  intestinal  gases  and 
concretions,  20  pagesj  Observations  in  the  animal 
kingdom,  17  pages;  with  appendices  and  indices. 

A  Clinical  Text-book  of  Medical  Diaqnosis.  By 
Oswald  Vierodt,  M.D  ,  of  Heidelburg,  Germany. 
Translated  with  additions,  by  Francis  H.  Stuart, 
A.M.,  M.D.,  Brooklyn,  N.  Y.,  700  pages,  fuDy 
illustrated.    Cloth.    $4.    by   subscription,    only. 
W.  B.  Saunders,  ^25  Walnut  street,  Phila. 
This  is  the  third  revii^ed  edition  of  a  work  of  most 
reliable   merit.    It  was  our  pleasure  to  review  this 
work  in  the  first  addition,  and  must  onl^  emphasise 
the  high  opinion  then  expressed.    The  object  of  first 
importance  in  beginning  treatment  of  a  patient  in 
disease  is  to  learn  accurately  just  what  the  disease  is. 
When  this  is  done  the  treatment  is  greatly  simplified. 
With  accurate  diagnosis,  the  single  remedy  may  gener^ 
ally  be  used  and  the  highest  practicable  degree  of  suc- 
cess attained.  This  work  is  a  standard  one  on  the  sub- 
ject of  diagnosis,  having  been  translated  into  five  dif- 
ferent languages.    So  minutely  does  the  author   go 
into  the  subject  that  fifteen  pa^es  are  required  for  an 
outline  of  the  contents  and  ninety-two  pages  for  the 
index.    A  thorough  study  of  this  scholarly  work  once 
everpr   year    would     vastly    increase   a   physician's 
efficiency  in  practice; 

Wit  and  Wisdom. 

Peanxtt  flour  has  been  introduced  into  Germany  as 
a  food,  containing  nearly  60  per  cent  of  albumen. 
Nordinger  pronounces  it  the  most  nutritious  and 
cheapest  food  in  existanoe. — N.  Y,  Med.  I^nies. 

Mellim's  Food  has  received  World's  Fair  honors. 
Being  a  superior  article  it  could  not  fail. 


Digitized  by 


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THE  liiEDICAI.  WORLD- 


78 


Wb  have  alwajrs  had  the  atmost  satisfi&ctioii  m 
dealing  with  G.  W.  Fiayell  &  firo.,  1005  Spring  Gar- 
den street,  Phila^  for  supporters,  stockings,  etc 

Mention  this  journal  and  jou  will  receive  a  free 
•ample  of  Sosoderma  (antiseptic  soap)  bj  addressing 
Hall  A  Ruckel,  216  Greenwich  street,  New  York, 
N.  Y.  ^ 

A  Pboblem.— Mr.  Daddy— I  wish  our  babj  could 
Calk  more  plainly;  Brown's  babj  is  a  month  younger. 
and  one  can  understand  almost  every  word  it  says.  1 
wonder  why  it  is?" 

Mn.  Daddv  (offdiided)— Fm  sure  1  don't  know  (To 
the  baby).  Comesey  tooty  mommy  itte  ^weety.  I>oe6 
'oo  wicked  popper  scold  'oo  dear  ittle  wopsy  dodkins?" 
— Puek 

Wb  have  used  cases  made  bv  the  Western  Leather 
Manufacturing  Co ,  81  Illinois  street,  Chicago,  and 
were  well  pleased.  It  is  surprising  how  cheap  they 
•ell  them. 

F6b  recent  literature  on  important  new  remedies 
(eorophen,  trional,  etc  )  send  to  W.  H.  Schieffelin  & 
Co.,  170  William  street.  New  York. 

CusTOKEB — Got  a  cure  for  headache?  Druggist- 
Yes  10  grains  of  capitine.  Customer— Put  me  up  20 
mins,  then.  Druggist — It's  two  doses  you  want,  eh  ? 
OuBtomer— No,  one.  It*s  for  the  two-headed  boy  at 
the  dime  show. — Life. 

Send  for  fine  sample  of  Marsh-mallow  Cream  to 
Diamond  Laboratory  Co.,  Naugatuck,  Conn. 

For  the  ideal  ''Ladies*  Perfect"  Syringe  send  to  the 
Aloe  A  Penfold  Co.,  Omaha,  Neb. 

Empty  hollow  suppositories — the  ideal  method  of 
administering  certain  remedies— are  made  by  Hall  & 
Rnckel,  218  Greenwich  street,  New  York,  N:  Y. 

T&T  Micajah's  uterine  wafers. 

Fbllows'  Syrup  is  well  known  the  world  over. 

Wk  always  use  Weinhagen's  reliable  thermometers. 

Antikaiinia  is  quite  extensively  used. 

A  aiNGUULB  REOT7E8T. 

Family  Physician — I  can  assure  you,  my  dear  lady, 
that  you  have  not  the  least  trace  of  liver  omplaint. 

Patient,  who  longs  to  go  to  Carlsbad— But,  my  dear 
doctor,  can  you  provide  me  with  it  if  I  want  it  very 
badly?— f7ie^enc(e  Blaetter, 

Did  jrou  ever  notice  how  idiotic  the  smile  of  a 
pretty  girl  is — when  it  is  directed  towards  some  one 
else? 

Haydbn's  Viburnum  Compound  is  an  old  and 
•tandard  preparation. 

Thb  Upjohn  Pill  and  Granule  Co.,  Kalamazoo, 
Mich.,  make  a  specialty  of  fine  goods. 

Fob  acid  dyspepsia  I  have  had  great  success  in  using 
Frye's  Pancreo-oismuth  and  Pepsin  advertised  in  Thb 
Mbdical  World.  The  Medical  World,  I  am 
highly  pleased  with.  I  find  instruction  and  help  in 
eirer  number.  Dr.  L.  M.  Holmbb, 

46  Union  Park,  Boston,  Mass. 

When  you  use  opium  use  the  purified  form — 
•vapnia.  Sample.  Charles  N.  Crittenton  Co.,  115 
Fulton  street.  New  York,  N.  Y. 

Hungry  Guest— How  is  this  ?  I  ordered  a  steak 
and  a  poached  egg.  I  see  the  eeg,  but  not  the  steak  " 
Table  Attendant— Dat's  all  right  sah.  De  steak  am 
onder  de  egg. 


Frov  the  Dlajiy  of  a  Quack.— Kase  230^  Mary 
An  Perkins.  Bisnes,  wash-woman.  Sickness  m  her 
bed.  Fisik,  some  blue  pile,  a  soaperifik;  aged  62.  Ped 
me  one  dollar,  1  kuarter  bogus.  Mind  get  good  koarter 
and  mak  her  tek  mo  fisik. 

Kase  281,Tummes.  Krinks  Bisnes, N Irishman.  Lives 
with  Pady  molonny  whot  keeps  a  dra:jr— Sikness  digg 
in  ribs  and  two  blak  eys.  Fisik,  to  drink  mv  mixter 
twice  a  day  of  sasiperily,  here  and  jellop,  and  fish  ile, 
with  asifedity  to  make  it  taste  fisiky.  Bubbed  his  face 
with  C^taur  Liniment  Aged  89  years  of  age. 
Drinked  the  mixter  and  wouldn't  pay  me  bekase  it 
tasted  nasty,  but  the  mixter'U  work  his  innards,  I 
reckon. 

Kase  282,'old  Misses  Boggs.  Ain't  'sot  no  bisnes, 
but  plenty  of  money.  Siknes  all  a  humbug.  Giiv  her 
sum  of  my  celebrated  ''Dipseflorikon,"  which  she  sed 
drank  like  cold  tea— which  it  was  too.  Must  put  sum- 
think  in  it  to  make  her  feel  sik  and  bad.  The  Old 
Wommen  has  got  the  roles." 

Horsford's  Acid  Phosphate  has  won  an  enviable 
position  in  the  estimation  of  the  public. 

Every  physician  should  send  to  the  Malted  Milk 
Co.,  Racine,  Wis.,  for  one  of  their  new  and  useful 
desk  tools,  a  ruler,  measure  and  paper  cutter  com- 
bined. They  are  sent  free  and  postpaid  to  any  physi- 
cian on  application.  Liberal  samples  of  Horlick'9 
Malted  Milk  ivill  be  sent  also  to  physicians  who  wish 
to  give  this  food  a  trial  in  their  practice. 

It  is  an  excellent  preparation  for  use  as  a  diet  in 
typhoid  fever  and  all  wasting  diseases,  for  debilitated 
conditions  and  digestive  troubles,  affording  as  it  does 
all  the  elements  of  nutrition  in  a  concentrated  yet  very 
pleasant  and  easily  assimilated  form.  Ask  your  drug- 
gist to  keep  it. 

When  you  want  the  medicinal  effects  of  iodine  use 
Hostelley's  Syrup  of  Hydriodic  Acid.  When  you 
want  to  prescribe  the  hypophosphites.  use  his  Com- 
pound S>  rup  of  the  Hypophosphites.  See  his  sfeciai« 
OFFER  on  back  cover  page. 

Fop  the  Teeth. 

SOME  EXCELLENT  RULES  TO  FOLLOW  IN  THE  OARS  OF 
THEM. 

One  of  the  most  skilled  dentists  in  New  York  gives 
these  rules  for  the  care  of  the  teeth : 

Use  a  soft  brush  and  water  the  temperature  of  the 
mouth.  Brash  the  teeth  up  and  down  in  the  morning, 
before  going  to  bed,  and  after  eating,  whether  it  is 
three  or  six  times  a  day.  Use  a  good  tooth  powder 
twice  a  week,  not  oftener,  except  in  case  of  sickness, 
when  the  acids  from  a  disordered  stomach  are  apt  to 
have  an  unwholesome  efiect  upon  the  dentine.  A  void 
all  tooth  pastes  and  dentifrices  that  foam  in  the  mouth; 
the  lather  is  a  sure  sign  of  soap  and  soap  injures 
the  gums,  without  in  any  way  cleansing  the  teeth. 

The  very  best  powder  is  of  precipitated  chalk;  it  is 
absolutely  harmless  and  will  clean  the  enamel  without 
affecting  the  gums.  Orris  root  or  a  little  winter-green 
added  gives  a  pleasant  flavor,  but  in  no  way  improves 
the  chalk.  At  least  a  quart  of  tepid  water  should  be 
used  in  rinsing  the  mouth.  A  teaspoonful  of  Listerine 
in  half  a  glass  of  water  nsed  as  a  wash  and  gargle 
after  meals  is  excellent;  it  is  good  for  sore  or  loose 
gums;  it  sweetens  the  mouth,  and  Lb  a  valuable  anti- 
septic, destroyiufc  promptly  all  odors  eminating  from 
diseased  gums  and  teeth.  Coarse,  hard  brushes  and 
soapy  dentifrices  cause  the  gums  to  recede,  leaving  the 
dentine  exposed.  Use  a  quill  pick  if  necessary  after 
eating,  but  a  piece  of  waxed  floss  is  better.  These  rules 
are  worth  heeding. 

Be  assured  of  the  genuine  Listerine  by  purchasing 
an  original  bottle. 


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THE  MEDICAL  WORLD. 


Mathematical  — Schnapser  (School  Commis- 
sionAr) — Uf  I  boy  meinselluf  dree  kegs  of  beer  effery 
day  vat  vill  I  haf  at  der  endt  of  one  year? 

Scholar— De  keg&.—BuUttin  of  Pharmacy, 

For  fine  pills  of  special  formulas  and  for  efierTesc- 
ing  preparaiions  send  to  William  R.  Warner  A  Co., 
PhiJk 

Wilkeb-Barrb,  Pa.,  Feb.  24, 1898 
1  am  using  Freligh's  Tablets  with  most  gratifying 
resnltR.    I  deem  there  U  no  superior  remedy  in  con- 
sumption, and  in  cases  where  a  good  tonic  is  called  for. 
Class  of  1889.  E.  H.  Stitvens,  M.  D. 

LA  GRIPPE. 

R   Benzoate  sodium K  o« 

Qlycerlne 10£ 

Liq.tong.sal....... Son 

Aqua,  raentba  pip 2  on 

M.  8ig.— Tablespoooful  every  two  to  four  hours. 

Have  you  tried  Keith's  Tinciure  of  Avena  Sativa 
for  the  morphine  habit?  Address  B.  Keith  &  Co.,  75 
William  street,  New  York,  N.  Y. 

Fqr  Hagee's  Cordial  of  Cod  Liver  Oil  send  to 
Katharmon  Chemical  Co.,  St.  Louis. 

An  ounce  of  keeping  your  mouth  shut  is  worth  a 
pound  of  explanation. — ChrUimaa  Padfe. 

Bones — What  am  de  difference  between  a  display  of 
woven  goods  and  quarantine  against  yellow  fever  ? 

Tambo— One  is  textile  fabrics  and  the  other  febrile 
tactics.— JV«c/fe 

The  Maltine  Manufacturing  Co.  has  sent  out  a  cal- 
endar to  physicians  only,  containing  excellent  por- 
traits of  leaders  of  the  profession.  We  regret  to  say 
that  one  or  two  of  the  men  whose  portraits  were  thus 
presented  objected  to  the  same,  when  the  Maltine  Com- 
pany immediately  ceased  sending  out  the  calendars. 
We  think  the  motives  of  the  Maltine  Company  were 
very  commendable  in  wishing  to  present  to  the  profes- 
sion really  good  portraits  of  the  eminent  physicians 
whose  faces  all  the  profession  like  to  become  familiar 
with,  and  we  hope  tnat  the  objection  above  referred  to 
will  be  withdrawn. 

His  Reasons.— **8till  a  bachelor,  Winters?" 
•♦Yee."  "Necessitv  or  choicer*  "Both.  Her  choice, 
my  necessity." — Christmas  Pttek, 

We  are  well  acquainted  with  Dr-  Charles  L. 
Mitchell,  1016  Cherry  street,  Phila.,  and  can  recom- 
mend his  medicated  gelatin  preparations.  They  are 
strictly  ethical. 

Dr.  W.  B.  Mask,  Flat  Creek,  La.,  uses  nanmetto 
in  cases  of  menstrual  irregularity  with  general  de- 
bility and  undeveloped  mammaries. 

Why,  of  Course. — Siivets— The  German  invebti- 
gators  are  experts  in  bacillus  huntug,  aren't  they? 

Whiffet — Well,  wouldn't  you  naturally  expect  a 
germ-man  to  cholera  microbe? — North  Ameriean  Prae- 
tUioner. 

Husband— Are  you  going  to  Miss  Twickenham's 
tea  ?  Wife — No,  I  haven't  anything  to  wear.  Hus- 
band—Why don't  you  wear  the  same  gown  you  did  at 
the  last  tea  she  gave?  Wife — I  have  too  much  re- 
spect for  you.  People  would  say  you  were  running 
down  hill. 

As  A  laxative  use  Syrup  of  Figs. 

For  your  eneierUe  patients  use  Aletris  Cordial.  Sam- 
ple free  if  you  pay  the  express.  Rio  Chemical  Co., 
St.  Louis,  Mo. 

For  fine  tablet  goods  address  the  P.  J.  Noyes 
Manufacturing  Co.,  Lancaster,  N.  H. 


An  Irishman,  struggling  to  get  on  a  new  P^i^.^f 
boots,  exclaimed :  "I  shall  never  get  *em  on  at  ail  tiU 
I  wear  em  a  day  or  two." 

High  World's  Fair  honors  were  given  to  Charles 
Marchand  for  his  Peroxide  of  Hydrog«i. 

For  fine  electrical  instruments  address  Mclntonh 
Battery  and  Optical  Co.,  141  Wabash  avenue,  Chicago. 

For  reliable  pharmaceutical  preparations  patronize 
Parke,  Davis  &  Co.,  Detroit,  Mich. 

See  ♦he  fine  "Western  Leader"  buggy  case  for  only 
$5.50  ofiered  by  Willis  H.  Davis,  Keokuk,  la. 

At  the  Codnty  Fair.— "Among  other  attractive 
features  of  this  great  fair  there  will  be  highly  amusing 
horse,  donkey  and  pig  races.  Competition  in  these 
three  contests  open  to  citizens  of  the  county  only.'* 

No  young  man  ever  climbed  the  ladder  of  success 
with  a  bottle  of  whiskey  in  his  pocket 

Solicitor  (to  Irish  client  who  has  been  arrested  for 
horse  stealing)— Now  tell  me  the  truth;  it's  no  use 
concealing  it  if  1  am  to  do  any  good  for  you.  Did  any 
one  see  you  steal  the  horse?  Murphy — Yis,  sorr. 
There  was  wan  man  seen  me  steal  the  harse  an'  he's 
goin'  to  come  into  court  and  swear  to  it,  the  low,  con- 
timptible  blackguard.  Solicitor— fn  that  case  I'm 
very  much  afraid  it'll  go  hard  against  you.  Yon  can't 
escape  with  evidence  like  that.  Murphy — But,  sorr, 
look  ye  here.  Oi  cnn  bring  twinty  men  an*  more 
that'll  swear  they  didn't  see  me  ^teal  the  harse.— Pidk- 
Me-Up. 

In  these  hard  times  you  want  to  get  cut  rates  in  sar 
gical  instruments.  Send  to  I.  Phillips,  69J  Whitehal 
street,  Atlanta,  Ga 

If  you  want  to  know  what  is  worse  in  soap  than  free 
alkali,  write  to  Bloudeau  et  Cie,  73  WatU  street.  New 
York,  N.  Y.,  proprietors  of  Vinolia  Soap. 

Free  sample  of  the  new  antiseptic  compound 
*'Pheno8alyi"  by  addressing  Schulze-Berge  &  KooehL 
79  Murray  street,  New  York,  N.  Y. 

Where  there's  a  pill  there's  a  way. — SharUmd*^ 
Journal, 

We  have  understood  that  more  than  50,000  physicians 
are  using  tablets  made  by  the  H.  K.  Mulford  Com- 
pany, of  Philadelphia,  with  most  satisfactory  results. 
This  firm  received  the  highest  medals  at  the  Colum- 
bian Exposition  for  the  superiority  of  their  tablets, 
triturates,  lotenges  and  hypoldermics.  If  you  have  not 
fdreadv  used  Mulford's  tablets  you  should  hj  all  means 
write  for  one  of  their  latest  Columbian  price  lists  and 
resume  of  winter  remedies. 

Unouentinb  is  a  good  base  for  ointm«mt.  Send  for 
sample  to  Norwich  Pharmacal  Co.,  Norwich,  N.  Y. 

Your  fat  patients  will  do  well  on  Phytoline.  Ad- 
dress Walker  Pharmacal  Co.,  St.  I»uis. 

For  your  new  suit  send  to  £.  O.  Thompson,  1888 
Chestnut  street,  Phila.,  Pa. 

Her  Preference. — '*If  I  were  to  commit  snioidet'^ 
said  young  Mr.  Spaits,  ^I  should  use  prussic  acid." 
**And  I,"  replied  the  artless  maiden,  ''would  select  the 
poison  founa  in  ice  cream — tyroioxicon,  I  think  they 
call  it."— 2/i/c. 

When  will  doctors  learn  to  make  their  prescriptiooa 
so  clear  that  they  cannot  be  misunderstood  ?  A  Ger- 
man paper  reports  this  dialogue : 

(Cbndnti^d  <m  next  leaf.) 


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Tks  knawUdt^e  that  a  man  can  use  is  the  only  real  knowledge;  tne  only  know- 

Ud^e  ikai  has  life  and  growth  in  it  and  converts  itielf  into  Radical  power.      The 

rtst  hangs  like  dust  about  the  brain,  or  dries  like  raindrops  off  the  stones, ^l^ouDjf- 


The  Medical  World. 


Mo2fTHi.Y,  by  C.  p.  Tayix>r«  M.  D. 


C.  F.  TaYW)R,  M.  D., 

J.J.  Tayi,or,  M.D., 


Editors. 


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invar^blyin  advance. 

We  cannot  alwa3rs  supply  back  numbeni.  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  ioumal  unless  publisher's 
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ADDB.B88  ALL  COMMVKICATIONS  TO 

"THE   MEDICAL  WORLD." 

1520  Chestnut  Street, 

PHILADKLPHT\   P* 


VoL  XIL 


March,  1894. 


No.  3. 


New  and  Prompt  Antidote  to  Morphine  and  Opium 
Poisoning; 

Dr.  WUliam  Moore,  of  355  Boulevard,  W., 
New  York  City,  has  recently  made  a  discovery 
which  will  prove  of  the  greatest  value  in  the 
science  of  toxicology.  It  is  nothing  less  than  a 
complete  and  rapid  antidote  for  poisoning  by 
opiam  and  its  alkaloids,  the  remedy  itself  being 
comparatively  harmless.  Heretofore  one  great 
difficulty  in  the  treatment  of  morphine  poisoning 
was  the  danger  of  poisoning  the  patient  with 
the  antidote — atropine. 

Dn  Moore  has  found  that  permanganate 
OF  POTASSIUM  is  the  long  sought  ideal  antidote 
to  morphine  and  opium.  His  theory  is  that  the 
permanganate,  which  is  ordinarily  deoxidized 
in  the  stomach  by  the  gastric  juices,  would,  if 
morphine  be  present  in  solution,  first  attack 
and  oxidize  it,  thereby  rendering  it  harmless. 


The  doctor  performed  many  experiments  upon 
animals,  his  theory  working  out  perfectly.  He 
then  performed  the  experiment  before  the  West 
Side  German  clinic,  New  York,  in  the  presence 
of  a  number  of  physicians  and  students,  of 
swallowing  three  grains  of  sulphate  of  morphine 
and  shortly  afterwards  a  solution  containing 
four  grains  of  the  potassium  salt  The  poisons 
was  completely  neutralized  and  had  not  the 
slightest  deleterious  effect  upon  the  experi- 
menter. 

Following  this  two  students  made  experi- 
ments upon  animals  with  the  drug  used  hypoder- 
mically,  the  proportion  being  about  one  and 
one-third  grain  of  the  antidote  to  each  grain  of 
the  poison.  The  animals  were  in  various  stages 
of  torpor  from  morphine  poisoning,  in  some  of 
which  it  had  been  given  hypodermically  and  i  n 
some  by  the  mouth,  and  yet  all  recovered 
promptly — in  from  two  to  ten  minutes — after 
the  hypodermic  use  of  the  antidote. 

Dr.  Moore  is  still  pursuing  further  experi- 
ments, and  will  give  a  detailed  report  to  the 
profession. 

How  far  this  fact  may  be  available  in  the 
treatment  of  the  morphine  habit,  or  whether  it 
will  be  of  any  value  at  all  in  that  field,  does 
not  yet  appear. 

Thus  permanganate  of  potassium  has  recently 
assumed  a  position  of  great  importance  among 
the  leading  drugs  in  the  matera  medica,  especi- 
ally as  an  emergency  drug,  it  having  been 
demonstrated  to  be  effective  in  snake -bite,  phos- 
phorus poisoning  and  morphine  poisoning. 

We  hope  to  give  further  details  upon  this 
subject  next  month. 


Preparation  for  IMedicai  Practice. 

In  these  days  of  active  compitition  in  all 
branches  of  human  activity  and  learning,  none 
but  those  fairly  competent  can  long   hope  to 


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THE  MEDICAL  WORLD. 


hold  a  desirable  position  in  the  ranks  of  medical 
practice.  A  thorough  educational  basis  for 
such  work  must  include  an  intelligent  knowl- 
edge of  the  natural  sciences,  followed  by  a 
thorough  study  of  the  fundamental  medical 
sciences — ^anatomy,  physiology,  pathology,  etc 
This  should  be  crowned  with  an  exhaustive  study 
of  all  the  means  recognized  by  science  for  the 
treatment  of  patients  in  disease.  This  is,  finally 
the  goal  of  all  medical  study,  and  it  is  to  give 
our  view  of  the  order  in  which  therapeutic 
study  should  be  pursued  that  this  brief  editor- 
ial note  is  written.  In  our  opinion,  this  order 
should  begin  with  the  use  of  natural  physical 
forces  and  gradually  lead  up  to  the  more  deli- 
cate and  responsible  use  of  drugs. 

In  the  beginning  of  therapeutic  study  the 
student  should  be  thoroughly  trained  in  the 
matter  of  hygiene ;  the  regulation  of  the  patient's 
diet  and  manner  of  living  in  all  respects,  to  alle- 
viate existing  disease  and  counter-act  disease- 
producing  tendencies.  This  is  a  most  important 
part  of  a  physician's  knowledge,  and  he  should 
not  be  allowed  to  proceed  farther  if  he  shows  an 
inability  to  pursue  this  branch  of  the  science 
intelligently. 

This  being  passed,  the  student  should  next 
learn  thoroughly  the  application  of  massage  and 
other  mechanical  means  so  far  as  they  are 
useful  in  the  treatment  of  diseased  condi- 
tions. 

The  next  very  great  important  subject  for 
study  is  the  uses  of  water,  and  the  applica- 
tion of  heat  and  cold  in  the  treatment  of 
disease. 

Last  of  all,  the  young  physician  should  pur- 
sue a  most  thorough  study  of  the  use  of  such 
subtle  agencies  as  electricity  and  drugs  in  med- 
ical treatment. 

A  physician  so  educated  and  trained,  by  us- 
ing drugs  only  in  those  conditions  requiring 
them,  will  do  his  patients  the  greatest  amount  of 
good  and  the  least  amount  of  harm. 


Alcohol  and  Digestion. 
Alcohol  in  any  quantity  or  in  any  form,  be- 
ing in  the  stomach  during  the  progress  of  diges- 
tion, either  retards  or  entirely  checks  that  pro- 
cess." It  does  so  mainly '  by  reason  of  its  chemi- 
cal action  in  destro3ring  the  digestive  ferments. 
To  take  alcoholic  drink  at  meal-time  on  account 
of  weak  digestive  powers  is  fallacious  to  a  redic- 
ulous  extreme.  If  you  wish  to  prove  it,  employ 
the  ordinary  test-tube  experiments  with  artificial 
forments  and  then  make  the  same  teste  with 
varing  amounts  of  alcoholic  liquors  added  ;  or, 
by  means  of  the  stomach  tube,  remove  from  the 
stomach  for  examination,  a  portion  of  a  meal 
taken  with  liberal  supplies  of  alcohol. 

NItro  Qiyoorin     and    the    Nitrites  In   Artorio- 
Soierotlt. 

Augustus  A.  Eshner,  M.D.,  reports  in  the 
Phila.  Polyclinic  good  results  from  the  admin- 
istration of  nitro- glycerin  or  the  nitrites  in  cases 
of  arterio-sclerosis,  of  which  common  symptoms 
are  apparently  causeless  shortness  of  breath, 
cardiac  palpitation  and  arhythmia,  with  accen- 
tuation of  the  second  sound  and  sometimes  a 
booming  first  sound,  tense,  resistant  and  tortu- 
ous arteries,  vertigo,  coldness  of  the  extremities, 
paresthesiae,  impaired  memory,  impaired  motor 
power,  heightened  reflexes,  tremor,  are  some- 
times quite  remarkable. 

He  gives  one  one-hundredth  grain  of  nitro- 
glycerin thrice  daily  or  two  and  one  half  grains 
of  nitrite  of  sodium  or  potassium.  The  dose 
may  be  continuously  increased.  The  doctor 
thinks  the  treatment  more  than  merely  palliatin, 
with  suitable  regimer.  He  speaks  of  one  case 
as  follows : 

''In  one  case  in  particular  the  improvement 
in  the  subjective  symptoms  following  the  taking 
of  nitro-glyerin  for  a  few  days  was  so  pro- 
nounced as  to  occasion  the  remark  on  the  part 
of  the  patient  that  he  could  not  have  realized 
that  so  much  could  be  accomplished  in  so  short 
a  time  with  so  small  a  dose  of  medicine." 


A  helpful  treatment  for  seasickness  has 
l>eeu  found  to  be  the  wearing  of  a  stout  band- 
age, extending  over  the  entire  abdomen,  with  a 
lar^'e  compress  of  cotton  underneath,  giving 
firm  pressure. 


Imperial  Oppression. 

We  quote  the  following  from  the  Jour.  Artu 
Med,  Association : 

"Two  Physicians  Expelled. — A  recent 
Berlin  cable  says  that  the  Society  of  Physicians 


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77 


in  Leipsic  have  expelled  two  members  because 
they  belong  to  the  local  executive  of  the  Social 
Democratic  party.  The  physicians  were  at  first 
requested  to  resign,  but  they  refused  to  do  so. 
The  meeting  which  resolved  to  expel  them  de- 
<nded  also  to  amend  the  society's  regulations  so 
as  to  exclude  from  membership  all  Social  Demo- 
cjats.  This  step  is  justified  on  the  ground  that 
many  members  of  the  society  who  are  army  sur- 
geons would  be  obliged  to  resign  in  case  Social 
Democrats  were  admitted." 

Thus  does  the  theory  of  the  "Divine  right" 
of  authority  and  wealth  seek  to  repress  the  ad- 
vancement of  science,  the  right  of  freedom  of 
opinion  and  the  upward  development  and  im- 
provement of  the  race.  And  the  worst  of  it  is 
that  it  has  its  oppressive  effect,  too.  While  we 
do  ultimately  triumph  in  a  measure  over  it,  yet 
it  succeeds  in  restraining  progress  some- times  for 
generations  and  centuries. 

Legislation  to  Prevent  Blindness  From  Ophthalmia 
Neonatorum. 

Many  midwives  are  grossly  ignorant  of  some 
•essential  points  in  their  profession.  It  has  been 
demonstrated  that  fully  twenty-four  per  cent  of 
all  cases  of  blindness  are  due  to  disease  or  un- 
<2leanline88  at  birth.  Prompt  work  will  save 
them  alL  Some  countries  and  some  states  in 
this  country  require  midwives  to  make  immedi- 
ate report  of  such  cases.  This  should  be  the 
law,  with  some  penalty  for  violation,  in  all  states. 


Clinioal  Teaching  and  the  Graded  Course. 

Taday  clinical  teaching  has  surpassed  all 
other  modes  of  instruction,  and  the  young  prac- 
titioner is  sent  to  the  bedside  with  an  experience 
in  the  management  of  disease  which  heretofore 
required  years  of  practice  to  obtain. 

In  adopting  the  three  years'  graded  course 
of  instruction,  the  student  escapes  the  intolera- 
ble bore  of  listening  to  the  same  set  of  lectures 
year  after  year.  I  can  never  forget  when,  as  a 
beginner  in  medicine,  the  nomenclature  of 
-di^ase  was  rolled  in  upon  me  from  the  chair  of 
practice,  and  that  nearly  the  whole  year  was 
passed  in  the  attempt  to  follow,  intelligently, 
lectures,  the  value  of  which  was  wholly  unap- 
preciated. The  gastroepiploica-dextra  and  the 
gastraepiploica-sinister  were  mixed  with  duodi- 
nal  dyspepsia,  and  the  whole  treated  by  a  sub- 
nitrate  of  bismuth. — From  address  by  Prof.  J. 
A.  Larrabee,  Louisville. 


Qriginal  Qommunioations. 


4hort  arddes  on  the  treatment  of  diseases,  and  erperience 
with  new  remedies,  are  solicited  from  the  profession  foi 
this  department ;  also  difficult  cases  for  cua^riiosis  and 
treatment. 

\rticles  accepted  most  be  contributed  to  this  journal  onfy. 
The  editors  are  not  responsible  for  views  express^  hj 
contributors. 

Copy  must  be  received  on  or  before  the  twelfth  of  th< 
month  for  publication  in  the  next  month.  Unused 
Manuscript  cannot  be  tetomed. 

Ctrtainly  it  is  exeeOeni  d£sci^ne/br  an  author  to /eel  that  he 
must  say  all  he  has  to  sav  in  the/ezoest  possible  words^  ot 
his  reader  is  sure  toshifthem;  and  in  the  plainest  possible 
words,  or  his  reader  will  certainl/  misunderstand  them. 
Generally^  also,  a  downright  fact  may  be  told  in  a  plain 
way;  and  we  want  downright  Jbuts  at  Resent  more  than 
•^y^hing  else.^KvBKUi, 


READ.     REFLECT.     COMPARE.     RECORD. 


The  New  Preparation  for  Morphinism.— Notes 
and  Replies. 

Editor  Medical  World  : — I  do  not  know 
of  anything  that  has  given  me  more  Eatiefaction 
than  my  determination  to  withhold  the  name  of 
the  drug  I  have  found  so  valuable  in  the  treat- 
ment of  the  morphine  habit.  Every  day 
^rings  me  a  lot  of  letters  from  persons  who 
want  to  misuse  it,  by  trying  to  do  what  can't 
be  done  :  treat  such  cases  at  their  own  homes, 
while  attending  to  their  business.  There  are 
several  things  that  must  never  be  forgotten  in 
relation  to  these  cases.  The  first  is  that  stop- 
ping the  morphine  is  not  curing  the  disease,  but 
only  a  preparation  for  the  real  treatment. 
People  stop  it  themselves,  or  they  go  to  various 
sanatoria  to  be  **  cured,"  but  they  don't  stay 
cured.  After  the  drug  is  discontinued  and  the 
iomiediate  effects  of  the  stoppage  have  passed 
off,  we  are  confronted  with  these  questions : 
1.  What  is  the  condition  that  led  this  person  to 
use  morphine  ?  2.  What  changes  have  taken 
place  in  his  system,  due  to  the  use  of  mor- 
phine? 3.  How  strong  is  the  force  of  habit 
with  him,  and  how  can  we  overcome  it  ? 

In  the  first  place,  we  find  back  of  the  mor- 
phine habit  an  inveterate  neuralgia,  rheuma- 
tism, neurasthenia,  insomnia,  or  one  of  those 
degenerations  of  the  cerebral  tissues  that  lead  to 
dementia,  melancholia,  what  we  used  to  call 
softening  of  the  brain — but  most  frequently, 
perhaps,  that  form  of  mental  aberration  that 
gives  the  law  such  perplexity,  paranoia.  Chorea, 
spinal  irritation,  myelitis  and  hysteria  have 
made  their  previously  unsuspected  appearance 
when  the  morphine  mask  has  been  torn  off. 
What  folly  to  think,  then,  that  all  one  has  to 
do  is  to  stop  the  morphine  to  "  cure "  the  dis- 
ease. The  fact  is,  no  mortal  man  can  tell 
whether  any  given  case  can  be  cured,  or  what  is 


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really  the  matter  until  the  morphine  has  been 
taken  away.  Sometimes,  very  rarely,  we  are  com- 
pelled to  tell  our  patient  he  had  better  resume 
the  morphine  ;  and  once  in  a  while  we  are  com- 
pelled to  advise  the  friends  to  take  him  to  a 
sanatorium  were  he  can  spend  a  year  with  a 
capable  physician,  in  combating  a  paranoia, 
seeking  to  check  the  degeneration  and  rebuild 
the  nervous  tissues.  Well  it  is  for  the  patient 
if  we  can  induce  him  and  his  friends  to  see  the 
impending  evil  and  take  the  proper  means  to 
avert  it,  before  it  is  too  late  to  arrest  the  dis- 
ease. Too  often  we  are  unable  to  obtain  legal 
control  until  some  overt  act  has  made  the  brain 
disease  evident  even  to  the  unskilled  eyes  of 
judge  and  jury. 

My  second  point  is  that  the  period  of  drunk- 
enness or  morphine  addiction  does  not  leave  the 
man  in  the  same  condition  as  it  found  him. 
This  is  the  weak  point  of  the  nostrum  people, 
whose  "  cures  "  have  a  curious  habit  of  dying 
suddenly  during  the  treatment  or  soon  after  it 
Has  anyone  noted  how  many  of  Keeley*s  peo- 
ple die  within  two  years  of  their  cure  ?  The 
physician  is  but  a  bungler  who  sends  out  his 
patients  to  take  on  themselves  all  the  burdens 
of  this  hard  battle  of  life,  just  after  throwing 
off  a  narcotic  habit.  Every  one  of  those  poor, 
benumbed  nerves  is  throbbing  with  new-found 
life ;  each  is  exquisitely  sensitive  to  noxious 
influences,  and  yet  we  expect  such  a  man  to 
rough  it  among  the  strong  men  that  run  this 
world.  I  tell  you,  after  stopping  the  drug,  the 
first  question  should  be  whether  the  man  is 
able  to  do  anything  at  all ;  the  next  one,  what 
he  can  do.  I  recollect  a  fine  young  doctor 
whom  I  sent  to  Kansas  to  cut  wood,  and  I  have 
always  regretted  I  did  not  make  it  a  year, 
since  seeing  the  benefit  he  derived  from  it  To 
be  sure,  most  patients  think  they  cannot  afford 
to  follow  sucb  advice,  and  then  we  envy  the 
Czar,  who  tells  people  to  do  and  they  do  it 

The  third  point  is  the  influence  of  habit 
When  a  man  stops  chewing  tobacco,  he  will 
chew  gum,  toothpicks,  lead  pencils,  anything  to 
chew.  How  much  discomfort  arises  from  inter- 
ference with  habits  we  are  really  unconscious  of 
possessing.  To  break  th's  influence  is  a  study 
in  every  case  of  narcotic  habit. 

Now,  do  you  see  why  I  object  to  giving  my 
remedy,  which  simply  relieves  the  suffering  of 
withdrawal,  to  those  who  neglect  every  rational 
principle  of  treatment,  and  simply  want  to  en- 
able their  patients  to  stop  morphine-taking 
easily?  I  place  such  treatment  in  the  same 
category  as  giving  old  men  aphrodisiacs  to  en- 
able them  to  use  themselves  up  quickly  and 
bring  on  dementia  paralytica. 

I   have  concluded   to  take  this  course :     I 


herewith  forward  to  the  Ekiitor  of  The  Medical 
World  a  sealed  envelope,  in  which  I  have 
placed  the  name  of  the  remedy  and  directions 
for  its  use.  This  I  ask  him  to  hold  until  we 
deem  it  proper  to  give  it  to  the  profession, 
which  will  be  done  through  the  columns  of  this 
journal.  This  is  in  harmony  with  the  custom 
in  France,  where,  when  any  one  has  an  idea 
for  which  he  desires  to  claim  precedence,  he  de- 
posits a  sealed  packet  with  the  Academy  of 
Medicine,  in  which  he  has  stated  his  project. 
He  then  goes  ahead  and  completes  his  experi- 
ments, knowing  that  if  anyone  gets  hold  of  the 
affair  he  cannot  rush  into  print  and  claim  prior- 
ity. This  saves  premature  publication ;  for 
fuller  trials  may  show  the  idea  to  be  of  no  value, 
when  the  packet  is  withdrawn. 

Dr.  Abbott,  (page  48),  calls  attention  to 
Burggraeve's  advocacy  of  the  small  dose,  fre- 
quently repeated.  I  did  not  credit  this  to  him, 
because  he  is  not  its  author.  Ringer  and  other 
therapeutists  before  him  have  advocated  this 
principle  Nor  is  it  a  generally  or  exclusively 
applicable  method,  as  the  single,  bulky,  daily 
dose,  so  favored  by  Trousseau,  has  also  its  uses. 

In  general,  for  sudden  emergencies*  or  great 
pain  the  large  dose  is  the  best ;  for  hemorrhages 
also,  when  a  sudden  and  powerful  impression  is 
needed.  A  teaspooful  of  laudanum  will  save  a 
life  in  post-partum  hemorrhage,  when  the  same 
quantity  dribbled  in  will  kill.  For  insomnia,  a 
patient  might  lie  awake  for  hours  taking  a 
granule  of  cannabin  tannate  every  five  minutes, 
when  a  single  two  grain  dose  would  produce  a 
prompt  effect  But  do  not  think  I  wish  to 
undervalue  the  dmall  dose  often  given;  I  use  it 
very  much,  but  not  exclusively.  Aconite  is 
scarcely  ever  to  be  used  in  any  other  way. 
Veratrum  is  generally  best  given  thus,  but  m 
puerperal  eclampsia  we  cannot  wait,  but  give 
full  doses  promptly.  The  fact  is,  I  value  the 
dosimetric  method  too  highly  to  be  willing  to 
have  it  leave  the  fold  of  rational  medicine  and 
form  a  new  sect 

I  wish  our  Eclectic  brethren  would  take  up 
the  cudgels  and  '*  go  for "  me  with  all  their 
might,  if  only  they  will  increase  our  knowledge 
in  regard  to  their  special  remedies. 

Let  me  ask  Dr.  W.  A.  Conn  (page  51), 
whose  make  of  sulphocarbolate  he  is  using.  I 
specify  the  best,  and  often  give  ten  grains  at 
one  dose,  without  any  irritation,  but  there  is  an 
impure  form  in  the  market  that  is  irritating  in 
the  doses  the  Doctor  names. 

Dr.  Dawson  (page  51)  will  hardly  find  any 
application  to  the  skin  equal  to  cold  water,  to 
prevent  taking  cold  after  a  vapor  bath. 

Will  Dr.  Pinne  (page  51)  apply  chloroform 
to  the  eczema  if  the  epots  are  small,  to  stop  the 


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itdiing  and  promote  cure?  If  large,  apply  the 
calomel  or  one  of  the  other  mercurial  ointments 
(not  the  blue,  however)  and  stop  the  iodide, 
which  sometimes  irritates  the  slpn.  Do  not 
wash  the  skin  any  more  than  can  be  helped,  and 
use  borax  instead  of  soap.  Give  the  arseniate  of 
^odKf  gr.  Y^^y  before  each  meal,  and  a  calomel 
purge  occasionally,  and  when  there  is  any  irrita- 
tion from  the  arsenic.  *  limit  the  diet  to  skim- 
med milk,  toa£ted  stale  broad,  a  little  lean  beef, 
fresh  orange  juice,  and  either  powdered  bone- 
dust,  or  the  laclo-phosphate  of  lime,  gr.  v, 
daily,  in  the  food. 

To  Dr.  Smith's  case  I  would  give  the  same 
lime  salt,  with  cold  liver  oil,  and  try  to  build 
hia  ccmstitution  up.  Give  them  for  a  year,  to- 
gether or  alternately.  For  the  dribbling  of 
urine,  erigeron  oil,  one-half  to  one  drop,  is  of 
value,  while  waiting  for  the  constitutional  reme- 
dies to  do  their  work.  Cantharidine  is  also  of 
value,  but  the  dose  should  be  very  small.  I 
have  known  a  granule  containing  gr.  ^^  cause 
considerable  pain.  The  tincture  of 'the  chloride 
or  the  syrup  of  iodide  of  iron,  is  often  indicated 
for  such  children. 

Dr.  Hertig  asks  for  the  best  remedy  for  tape- 
worm (page  61).  There  are  several  good 
remedies,  if  they  are  given  right  My  prefer- 
ence is  for  pumpkin  seed  :i  Two  tu  four  ounces, 
beaten  up  to  a  paste,  shells  and  all.  A  dose  of 
salts  is  to  be  taken  on  going  to  bed,  and  the 
paste  early  the  next  morning ;  two  hours  later, 
an  ounce  of  castor  oil,  with  a  half-drop  of  croton 
oily  and  the  stools  passed  into  a  bucket  of  water 
to  float  the  worm  and  prevent  it  from  breaking 
qR  and  leaving  the  head.  The  supper  the 
previous  evening  should  consist  of  milk,  cocoa- 
nut  and  tea  or  coffee,  and  no  breakfast  should 
be  taken  till  the  bowels  act  Pomegranate, 
pe)letierine  and  kousso  are  good,  but  costly; 
male  fern  is  less  certain.  Oil  of  turpentine  is 
effectual  in  doses  of  one  to  two  ounces,  but  I  do 
not  like  to  give  such  quantities,  fearing  to  irri- 
tate the  ki<fiieys  and  bladder.  If  the  worm's 
head  cannot  be  found  wait  three  months  before 
giving  another  treatment  If  the  worm  has  not 
heem  killed,  segments  will  by  that  time  begin  to 
appear  in  the  stools. 

William  P.  Waugh,  M.D., 

8724  Ellis  ave.,  Chicago. 

J  With  this  article  we  have  received  the 
ed  envelope  referred  to,  which  we  have 
dated  with  the  day  of  its  receipt  and  placed  in 
our  safe.  We  shall  keep  it  until  it  shall  be 
agreed  upon  between  Dr.  Waugh  and  oursel- 
ves that  the  proper  time  has  arrived  when  it 
■hould  be  opened  and  its  contents  published  to 
the  profession. — Ed.] 


Treatment  of  Herpes  Zoster.  ^ 

Editor  Medical  World  : — The  gratHying* 
success  repeatedly  obtained  by  the  remedial 
measure  about  to  be  described  prompts  the  pub- 
lication of  it.  The  multiciplicity  and,  commonly, 
the  uncertainity  pertaining  to  the  advice  on 
the  treatment  of  this  affection  warrants  further 
attempts  in  behalf  of  a  more  direct  and  reliable 
method. 

The  pathology  of  this  disease  is  still  mooted. 
It  is  not  yet  settled  whether  it  be  of  a  nervou» 
origin,  as  such,  or  whether  it  is  by  an  infectiouA 
germ  or  a  toxin. 

Hutchinson*  defines  three  laws  by  which  to 
recognize  skin  diseases  originating  in  some  dis- 
order of  the  nervous  system,  namely : 

"1.  The  disease  will  not  occur  in  rounct 
patches,  nor  in  oval  ones,  nor  in  streaks,  but 
will  be  arranged  according  to  the  branching- 
distribution  of  the  filaments  themselves;  it  will 
be  panniculate  or  corymbiform.  This  is  a  con- 
clusive argument  in  his  opinion  against  alopecia 
areata  being  of  nervous  orgin. 

"2.  There  will  be  no  power  of  infecting  adja- 
cent structures.  The  patches  will  not  be  ser- 
piginous. Eczema,  psorasis,  lupus  and  many 
others  tend  to  spread  by  extension.  There  i» 
no  such  tendency  in  the  case  of  herpes  or  sclero- 
derma. 

"3.  The  diseases  develope  themselves 
fully  in  the  first  instance.  The  results,, 
when  once  declared,  do  not  increase. 
From  the  fact  that  when  herpes  zoster,  if  it  occur 
a  second  time  in  a  patient,  never  affects  exactly 
the  same  area,  Hutchinson  draws  the  conclusion 
that  the  nerve  \a  disorganized  by  the  kind  of 
neuritis  which  produces  the  original  attack  of 
zoster,  and  so  is  incapable  of  being  involved  a 
second  time.  Recurrent  herpes  is  a  different 
affection,  for  it  leaves  no  scarring  behind  it,  as 
does  true  zoster.  Moreover,  it  is  curable  by 
arsenic,  whilst  arsenic  is  capable  of  producing 
an  attack  of  zoster." 

Pathological  research  has  developed  the  ex- 
istence of  an  imflammatory  process,  at  times  in- 
volving hemorrhage.  In  some  instances  the 
perineuritis  was  quite  extensive  and  destructive. 
In  rare  cases,  even,  it  eventuated  in  death.  It 
may  affect  the  peripheral  nerve  and  its  distribu- 
tion only,  or  include  its  ganglionic  center,  or 
affect  the  latter  alone.  Hemorrhage  into  the 
Casserian  ganglion,  and  the  cauda  equina  have 
been  found,  as,  indeed,  it  has  been  found  asso- 
ciated with  various  diseases  and  injuries  of  the 
spine  and  the  viscera. 

Treatises  on  this  matter  express  the  prevail- 

I^^ohb'  Annual,  1890,  extract  from  presidential  ad- 
dress to  the  Nearological  Society,  January,  1890. 


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in|?  uncenainty  of  its  pathology  by  referring  to 
it  rather  iudiscriminately  as  a  nervous  irritation, 
or  as  an  inQamraation.  The  preponderance  of 
dinical  opinion  and  accumulated  evidence  seems 
favorable  to  the  supposition  of  an  infectious  or 
toxic  agent  with  an  affinity  for  nerve  tissue.  Be 
this  as  it  may,  we  glean  little  from  our 
knowledge  of  the  palhology  that  gives  direction 
to  our  therapeutic  effort.  One  point  pertaining 
to  its  therapy  deserves  emphatic  expression, 
namely,  the  necessity  of  recognizing  that  the 
bursted,  and  even  the  intact  vesicles  afford  a 
fertile  soil  for  an  accidental  infection.  The 
treatment  should  obviate  this. 

Jn  the  absence  of  definite  knowledge,  the 
writer  would  suggest  the  possibility  that  a  per- 
sistent neuralgia  after  the  primary  eruption  has 
healed  is  from  the  cicatricial  formations  follow 
ing  an  accidental  inflammatory  complication; 
the  nerve  terminals  being  pinched  by  cicatricial 
contraction. 

The  treatment  of  herpes  zoster  as  pursued  by 
the  writer  consists  of  the  hot  application  of  a 
boiled  1  per  cent,  aqueous  solution  of  carbolic 
acid.  The  patient  is  directed  to  moisten  a  mus- 
lin cloth  in  this  solution,  appl3ring  it  as  hot  as 
can  be  bom,  and  cover  this  with  some  im- 
permeable, I  issue  (oiled  silk).  In  one  instance 
the  efficacy  of  this  measure  was  much  enhanced 
by  holding  the  diseased  part  to  a  heated  stove. 
This  method  in  my  casi»s  gave  relief  from  pain 
and  itching  shortly,  and  within  one  or  two  days 
the  vesicles  were  gone  and  unirritating  scabs 
covered  their  places. 

Carbolic  acid  has  antiseptic,  anesthetic  and 
stimulating  properties ;  it  readily  permeates  the 
skin  where  it  can  influence  the  rete  and  papill- 
ary structure*.  The  heat,  too,  adds  to  the 
relief. 

This  treatment  was  applied  irrespective  of  the 
necognized  (or  assumed)  cause  in  each  case.  It 
was  given  alone,  or  supplemented  by  such  other 
internal  treatment  as  seemed  indicated  in  each 
case.  Among  my  cases  were  such  as  had  been 
neglected  and  were  complicated  by  accidental 
infection.  One  had  been  treated  for  syphilis 
with  constitutional  remedies.  Obviously  this 
plan  of  treatment  will  apply  to  the  peripheral 
lesion  only.  In  complicated  cases  a  curative 
effect  will  be  had  less  directly,  though  the  pal- 
liative effect  is  almost  immediate  The  avoid- 
ance of  opiates  and  other  narcotics,  themseWes 
of  collateral  evil  effect,  too,  is  a  desideratum. 
H.  O.  Pantzer,  M.D., 

Indianapolis,  Ind. 


A  PHYSICIAN  writes :  "Times  have  been  hard  with 
me,  and  I  have  tried  to  do  without  The  Medical 
World,  but  I  find  it  a  necessity." 


The  Increase  of  Cancer. 

Editor  Medical  World  : — A,  contributor 
of  the  New  Review,  Prof.  Dunn,  is  right  in  as- 
suming thit  the  increase  of  cancer  is  ^of  grave 
importance;  and  it  is  profoundly  to  be  deplored 
•that  able  v/r iters  and  teachers,  like  Prof.  Dunn, 
who  assume  to  speak  authoritatively,  when  dis- 
cussing so  serious  a  question  should  content 
themselves  with  what  in  American  political 
slang  of  the  day  is  called  "threshing  over  old 
straw,"  and,  of  course,  getting  nothing  of  value 
therefrom.  A  hospital  was  endowed  a  few  years 
ago  in  New  York  to  treat  cancer;  an  able  man, 
Dr.  Flint,  who  waa  appointed  to  teach  i  he  young 
physicians  to  treat  cancer,  as  reported,  spent 
nearly  all  his  time  telling  his  hearers  that,  in 
his  opinion,  there  was  no  cure  for  cancer,  with 
scarcely  an  inquiry  as  to  prevention  or  remedy. 
Now  comes  Prof.  Dunn,  in  a  long,  able  article, 
without  a  suggestion  of  any  great  value  (unless 
some  might  suppose  that  his  suggestion  that 
s^me  zealous  bacillus  hunter  should  find  a 
microbe  which  the  chimerical  advocates  of 
microbes  in  general  may  believe  to  be  the  cause 
of  cancer,  or  which  is  utterly  improbable  in 
view  of  our  experience  with  other  diseases — 
such  should  ultimately  prove  to  be  a  fact). 
Here,  however,  Prof.  Dunn  is  unfortunately 
'threshing  over  straw,"  which  is  at  least  five 
years  old,  for  bacillus  hunters  have  beaten  this 
straw  thoroughly;  as  far  back  as  1887,  an  able 
contributor  to  the  British  Medical  Journal  gave 
us  results  of  th^rou^h  investigations  of  various 
witnesses  in  this  direction,  and  the  final  facts 
that  the  desired  bacillus  was  found,  vdth  its  de- 
scription; among  the  many  prominent  hunters 
in  this  field  we  may  mention  Kubasofi,  and  as 
long  ago  as  the  above  date,  Scheurlen  an- 
nounced with  much  poeiciveness  that  he  had 
found  the  cause  of  cancer  in  a  specific  microbe; 
later  we  have  had  others  of  equal  positiveness, 
among  which  might  be  mentioned  Armand 
Rnffer,  with  many  others  who  might  be  men- 
tioned. ''What  a  man  hath,  why  doth  he  yet 
hope  for?"  But  this  knowledge  has  not  checked 
in  any  degree  the  ravages  of  cancer,  or  materi- 
ally benefited  the  sick  world,  and  there  is  no 
more  ground  to  suppose  that  it  ever  will  than 
there  was  to  suppose  a  few  years  ago  that  that 
quintessence  of  imbecile  fancy  which  led  a 
large  proportion  of  the  profession  to  believe  that 
sulphuretted  hydrogen  would  cure  consumption 
would  do  so;  but  as  we  see,  many  found  years 
ago  what  Prof.  Dunn  still  hopes  for;  now 
"when  we  find  these  things  in  the  green  tree, 
what  shall  we  find  in  the  dry  ?** 

A  thousand  pities  that  these  men  would  not 
turn  their  attention  to  the  chemical  and  physi- 
cal aspects  of  the  question.     It  is  well  known 


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that  some  chemical  substances  largely  influence 
the  formation  of  cells.     For  instance,  cloride  of 


nnc. 


Our  old  time  friend,  Surgeon  Purcell,  of 
Brompton  Cancer  Hospital,  who  has  had  the 
best  opportunities  to  obtain  most  useful  knowl- 
edge pertaining  to  the  general  treatment  of  can- 
cer, and  who  probably  has  made  the  most  com- 
mendable use  of  the  same,  of  any  man  living, 
or  perhaps  who  evei  lived,  has  found,  as  has 
been  proved  a  thousand  times,  that  cloride  of 
dnc  exerts  an  influence  on  the  character  of 
cicatriz  formed— even  in  connection  with  can- 
cer— under  its  influence,  which  renders  the  tis- 
sue so  far  from  the  peculiarities  of  cancer  tissue 
as  to  be,  as  it  were,  a  resistive  wall,  or  under 
some  conditions  as  a  firm  island  in  an  ocean  of 
disease,  which  for  a  long  time  resists  the  onset^ 
of  the  destroying  tide,  while  cicatrix  formed  in 
the  same  tissues  under  other  influences  generally 
take  on  the  vascular  form  which  is  well  known 
to  be  exceedingly  liable  to  become  infiltrated 
and  break  down  in  cancerous  ulceration,  and 
this  influence  accounts  for  the  fact  that  cloride 
of  zinc  is  the  best  yet  known  application  for  can- 
cer. 

It  is  a  matter  of  knowledge  that  citric  acid 
destroys  life  in  man  by  acting  as  an  irritant  of 
the  ga^tro  intestinal  mucous  membrane;  it  is 
genendly  conceded  that  irritation  causes  the  in- 
filtration and  various  other  phenomena  of  can- 
cer hi  constitutions  prepared  for  its  ravages.  It 
is  also  well  known  that  oxalic  acid  causes  a  de- 
struction of  the  mucous  membrane  of  the  stom- 
ach and  other  mucous  surfaces  and  a  breaking 
down  or  softening  of  the  inner  coat  of  the 
stomach.  It  is  thus  evident  that  a  milder  solu- 
tion would  change  cell  formation  in  a  greater 
or  less  degree. 

It  is  also  a  well  known  fact  that  the  tomato, 
80  very  largely  used  as  a  food— nearly  as  an 
entire  meal  frequently  with  some  persons  — 
since  cancer  has  been  so  fearfully  on  the  in- 
crease, contains  large  quantities  ot  both  these 
acids,  as  high  as  ten  grains  to  four  quarts  of 
tomato  juice,  as  shown  in  the  American  Journal 
of  Pharmacy,  Yol.  43, 

A  noted  physician  in  western  New  York  died 
a  few  years  ago  from  disease  of  the  stomach 
who  expressed  a  conviction  that  tomatoes  caused 
the  disease  in  his  case.  Post  mortem  examina- 
tion proved  that  his  affliction  was  cancer.  The 
writer  and  many  others  have  noticed  similar 
cases  where  such  impressions  prevailed,  and 
why  not?  It  is  the  prevalent  belief  of  our  best 
authors  that  irritation  causes  the  developement 
of  cancer  in  persons  prepared  for  it;  the  tomato 
contains  laige  quantities  of  citric  acid  which  de- 
stroys life  by  irritation,  as  also  does  the  green 


stock  of  rhubarb  or  pie  plant.  Also  each  con- 
tains large  quantities  of  oxalic  acid,  which  de- 
stroys the  mucous  membrane  of  the  stomach  and 
converts  the  inner  coating  to  a  soft  pulpy  mass 
like  some  other  caustics.  Why  should  they  hot, 
in  weaker  solutions,  exert  such  influence  over 
cell  formation  or  cells  ?  For  instance,  especially 
where  an  ulcer  or  cicatrizing  wounds  exists. 

Let  all  physicians  who  have  noticed  facts  on 
this  subjiect  of  food  do  humanity  the  kindness  to 
report  them  at  onoe  through  the  journal^  that» 
as  f oon  as  may  be,  the  ravages  of  this  fearful 
scourge  may  be  checked. 

Let  those  who  tell  us  what  cancer  is,  be 
called  great;  let  those  who  cure  it,  be  called 
greater;  let  him  who  demonstrates  to  us  the 
real  cause  and  prevention,  be  called  greatest; 
let  all  try  to  speed  the  day. 

But,  fortvmately,  there  are  xsome  facts  ot 
more  or  less  value  settled  in  the  minds  of  the 
most  able  investigators,  of  which  it  would  seem 
to  be  of  great  impcH-tance  that  all  people  should 
be  informed. 

First.  Experience  has  amply  shown  that  can- 
cer is  not  contagious,  so  no  one  need  sufler  for 
want  of  care  on  account  of  fear  of  contagion 

Second.  It  seems  sufficiently  evident  that 
the  smoker  more  often  suffers  with  cancer  of  the 
upper  digestive  organs  than  any  other  class  oi 
people. 

Third.  That  a  bruke  of  a  gland  of  the 
breast,  as  by  leaning  against  a  piece  of  furni- 
ture or  other  hard  substance,  often  causes  can- 
cer of  the  breast;  also,  the  womb  often  suffers 
from  cancer  manifestly  from  injury;  these  are 
very  important  facts,  as  the  knowledge  of  them 
might  often  prevent  cancer  by  causing  people 
to  avoid  the  danger.  There  is  an  important 
question,  on  account  of  its  general  application, 
which  requires  a  careful  study,  and  that  is  that 
a  good  ground  of  belief  exists  that  the  acid 
juice  of  the  tomato  and  pie  plant,  when  eaten 
freely,  exert  an  influence  on  the  protoplasm  or 
the  production  of  cells  or  on  the  cells  themselves^ 
especially  when  new  without  walls,  which  pre- 
disposes to  that  condition  which  leaves  them 
liable  to  take  on  the  changed  conditions  we  find 
in  cancer,  and,  further,  whether  those  adds  may 
not  influence  recently  matured  cell  and  tissues 
thus  injuriously. 

One  acid  present  is  an  irritant  and  the  other 
a  caustic,  and  manifestly  may  exert  an  influence 
to  cause  the  cells  to  break  down  in  that  exuber- 
ant destruction  we  call  cancer,  especially  on 
mucous  surface),  as  of  the  digestive  organs  and 
bladder,  in  both  of  which  cancer  is  fearfully 
frequent  May  they  not  exert  an  influence  on 
cell  formation  or  even  mature  cells,  especially 
new  ones  without  walls?     More  especially  emi- 

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grantor  migratory  cells  thus  influenced  may 
implant  their  deteriorated  stock  in  the  tissues, 
and    there    multiply    themselves    indefinitely. 
These  **tramp  cells,"  as  Americans  would  ca'l 
them,  find  their  best  accommodations  in  vascu 
lar  tissues;  indeed,  this  is  the  mode  of  ciancer 
growth.     It  is  lamentable  that  able  men  could 
nor  be  induced  to  turn  tEeir  attention  to  subjects 
which  promise  so  rich  rewards.     It  is  a  perti- 
nent fact  that  the  tomato  as  a  food  has  been 
^ised  generally  largely  just  about  as  many  years 
as  cancer  has  been  so  fearfully  on  the  increase, 
4ind  the  same  is  in  a  great  degree  true  of  the 
pie    plant;  the    strange    indifference  of    some 
microbists  is  illustrate  by  a  reply  the  writer 
recently  received  from  one  of  them  in  answer 
to  an  inquiry  as  to  his  opmion  about  the  tomato 
and  the  pie  plant  when  used  largely  as  a  food 
as  a  possible  csCaae  of  cancer.     His  reply  was 
4hat  he  would  as  soon  suspect  the  watermelon 
aiid  bread;  and  yet,  that  man  as  a  noted  physi- 
<!ian,  ought  to  know  that  the  juice  of  the  tomato 
contains  a  large  quantity  of  the  deadly  oxalic 
#cid.  equal  to  ten  grains  to  four  quarts  of 
iomato  juice,  and  that  the  pie  plant  also  con- 
tains the  same  acid  in   large  quantities,  which, 
when  combined  with  a  calcareous  base  in  the 
-root,  give  a  la^  per  cent  of  oxalates,  in  some 
varieties  as   high  as   30  or  40  per  cent     It  is 
^ell  known  that  oxalate  of  lime  is  found  largely 
In  the  urine  of  persons  eating  tomatoes  and  pie 
•plant.    It  is  devoutly  to  be  hoped  that  practical 
men  will  work  this  very  promising  field,  and 
tell  us  more  particularly  of  the  effect  of  these 
•acids  on  the  various  conditions  of  tissue  in  their 
'iormation  and   history,  especially  in  connection 
with  accidental  lesions,  as  an  ulcer  or  injury.  It 
^  a  pertinent  fact,  now  well  known,  that  cancer 
prevails  most  among  more  advanced  civilized 
people,  where  the  great  luxury  of  the  tomato  is 
sised  most  largely,  while  the  savage,  who  does 
•not  eat  it,  is  comparatively  exempt  from  cancer. 
•One  noted  physician  of  whom  the  writer  made 
inquiry  replied  that  he  could  find  it  in  his  heart 
^  say  nothing  about  the  tomato  except  that  it 
was  a  beautiful  luxury.  It  is  tru6  that  the  com- 
bination of  acids  in  it  gives  a  pleasant  taste,  but 
it  is  certain  that  it  is  dangerous  when  taken 
largely  as  an  article  of  food,  as  is  done  by  many; 
and  it  is  amazing  how  phjBicians  should  take 
for  granted  without  demonstration  that  so  strong 
^  solution  of  so  deadly  an  acid  would  not  injure 
Ihe  formation  of  tissues,  and  tissues  themselves. 
There  is  still  a  difference  of  opinion  among  the 
best  observers  on  some  questions  pertaining  to 
<5ancer,  and  too  littie  positive  knowledge  exists. 
It  is  but  a  short  time  since  the  great  observer, 
Virchow,  surprised  us  by  informing  us  that  can- 


cer originally  contains  no  cell  peculiarly  its 
own. 

Prof  Dunn's  ipse  dixit  that  ''there  is  no  such 
thing  as  cancerous,  that  is  to  say,  a  caneeroua 
stomach,"  would  better  have  been  unwritten; 
our  practical  friend  Purcell  finds  cancerous  con- 
ditions and  writes  of  such  conditions  variously. 
James  W.  Huntoon,  M.D., 

Lowell,  Mass. 

[We  fear  that  our  esteemed  contributor  is 
unnecessarily  caustic  in  his  criticism  of  theories 
which  he  himself  does  not  happen  to  believe  in. 
While  it  i3  true  that  the  determination  of  the 
exact  pathology  of  a  certain  diseased  condition 
is  not  always  immediately  followed  by  the  cor- 
responding discovery  of  infallible  therapeutics  of 
'the  same,  yet  it  is  always  of  great  value  in 
therapeutic  research.  It  guides  the  direction  of 
such  research  and  shows  the  lines  into  which  it 
would  be  unnecessary  to  go.  Instead  of  meet- 
ing with  opposition  and  ridicule,  those  who 
think  they  shall  ultimately  be  able  to  demon- 
strate tne  microbic  origin  of  cancer  should  be 
encouraged  to  continue  their  investigations  until 
they  reach  a  definite  conclusion.  If  the 
microbic  etiology  is  demonstrated  it  constitutes 
an  important  advance  in  pathological  science;  if 
the  opposite  is  demonstrated  it  setties  the  ques- 
tion and  suggests  other  channels  of  investiga- 
tion. 

Again,  it  is  too  much  the  custom  to  speak 
with  merciless  ridicule  and  abuse  of  the  Bergeon 
treatment  as  recommended  for  phthisis.  The 
author  of  that  treatment,  after  a  number  of  ex- 
periments, announced  to  his  professional  breth- 
ren, in  his  enthusiasm,  that  he  thought  he  had 
found  a  cure  for  that  usually  fatal  malVdy. 
Many  others,  both  before  and  since,  have  made 
a  similar  announcement,  and  their  various 
modes  of  treatment  have  been  found  to  be  more 
or  less  beneficial,  instead  of  positively  curative. 
Begeon's  treatment  was  tried  by  competent  ob- 
servers all  over  the  world,  and  was  found  to  exert 
only  the  favorable  influence  that  a  saturation 
of  the  system  with  sulphurous  acid  usually 
exerts  over  the  process  of  suppuration.  The 
greater  majority  of  the  patients  were  benefitted 
for  a  considerable  time,  but  almost  none  were 
cured.  While  we  now  know  that  we  can~ 
introduce  the  same  agent  into  the  circulation 
more  conveniently  by  administering  sulphide  of 
calcium  by  the  mouth,  yet  Bergeon  is  entitled 
to  praise,  only,  for  his  efforts  in  the  line  of  thera- 
peutic experimantB,  rather  than  the  unthinking 
blame  he  too  often  receives  because  his  method 
has  proved  to  have  n  )t  nearly  so  much  merit  as 
he  hoped  it  would  have.     In  the  interest  of  ad- 


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'88 


vancing  adence  it  18  well  that  eucoessful  re- 
search should  be  accorded  all  due  credit  and 
ipraise,  and  that  unsuccessful  investigators,  or 
those  who  hold  views  differing  from  our  own, 
should  be  treated  with  only  the  most  delicate 
criticism,  in  order  that  they  may  not  be  dis- 
•oonraged  from  further  endeavor. 

Our  contributor's  investigations  into  the 
"disease-producing  tendency  of  tomatoes  and  pie 
{)lant  are  very  commendable,  and  we  hope  he 
will  pursue  them  to  a  complete  demonstration. 
We  believe  he  will  find  a  co-operator  in  Dr. 
Cathell,  of  Baltimore.— Ed.] 

An  Extreme  Case  of  Atoitet. 

Editor  Medical  World  ;— Mr.  G.  M.  H., 
^ed  61,  who  died  October  17,  1893,  was  the 
subject  of  ascites  for  three  and  a  half  years. 
The  case  stands  conspicuous,  if  not  unprece- 
dented in  the  number  of  times  tapped  and  the 
aggregate  amount  of  fluid. 

The  first  six  months  he  was  tapped  seven 
times,  the  amount  of  fluid  averaging  thirty 
pounds  at  a  tapping.  The  second  six  months  ten 
times.  The  third  twenty-four  times,  and  so  on. 
The  following  table  will  show  the  advance  ef 
the  case  and  compute  the  aggregate  amount  of 
4uid : 

l^me.     No.  Times  Average  Quantity 

Tapped,  of  Fluid. 

6  ma         7  30  lbs 

1  jr.        34  27 

1  yr.       65  21 

1  yr.       71  18 


ToUd  Quantity 

of  Fluid. 

210 

918 

1,155 

1,278 


3i         167  3,561 

The  table  shows  an  increase  from  year  to 
year  in  the  frequency  of  tappings.  It  shows  a 
decrease  in  the  amount  abstracted  at  the  separ- 
ate operations,  but  this  decrease  is  not  in  pro- 
portion to  the  increased  number  of  tappings,  for 
the  total  shows  that  from  year  to  year  the 
quantity  of  fluid  increased.  Summing  up  we 
have  157  operations  and  3,561  pounds  of  ac- 
cumulation abstracted.  In  addition  to  the  ex- 
traordioary  severity  and  duration  of  this  case, 
what  is  possibly  more  remarkable  is  that  the 
patient  soon  became  familiar  with  the  operation 
and  could  perform  it  himself,  which  he  did 
with  his  own  hands  more  than  one  hundred 
dmea.  What  is  the  record  on  nupaber  of  tap- 
pings ?  G  C.  Cotton,  M.D., 
Point  Isabel,  Ind. 


Editor  Medical  Wobld:— I  take  several  other 
leading  medical  joamals, 'but  I  find  that  I  refer  to. the 
iMtck  Dombers  of  The  World  more  than  I  do  to  all 
the  rest  combined  for  practical,  everj-daj  work. 

Bethel,  N.  Y.  R  C.  Paimb,  M.D. 


Antiseptic  Obstetrics. 

Editor  Medical  World  r-^-I  so  fully  con- 
cur in  the  views  expressed  by  Dr  J.  8.  Du- 
cate  in  the  January  number  of  the  Med.  and 
Surg.  Reporter,  of  Philadelphia,  that  I  will  add 
my  experience  in  confirmation  thereof.  With 
50  years'  practice,  embracing  some  2,000  obstet- 
rical cases,  with  a  loss  of  less  than  one-half  of 
one  per  cent  from  all  causes,  including  puer- 
peal  eclampsia,  placenta  previa  and  one  of 
tubal  pregnancy,  I  feel  that  my  duty  was  not 
illy  performed,  notwithstanding  neitheif  in  the 
past  nor  at  the  present  have  I  paid  any  atten- 
tion to  the  extreme  views  upon  the  subject  of 
antiseptics.  All  the  antisepsis  performed  by 
me  is  not  for  the  benefit  of  the  parturient  before 
or  during  delivery,  but  a  thorough  washing 
with  soap  and  water  for  my  own  comfort  after 
my  other  duty  is  performed. 

I  regard  cleanliness  an  essential  factor  in  the 
treatment  of  all  diseases  and  conducive  to  good 
health,  hence  I  think  it  best,  though  not  essen- 
tial in  most  oases,  to  give  the  vagina  a  few  ablu- 
tions of  warm  water,  and,  if  the  discharge  is 
more  than  ordinarily  ofiensive,  to  use  a  wash  of 
carbolic  acid,  or,  what  I  regard  as  equally  effica- 
cous  t^nd  more  pleasant,  a  wash  of  tar  water, 
after  cleansing  the  parts  with  warm  water. 

If  thorough  washing  after  each  menstrual 
.flow  were  more  generally  practiced  there  would, 
no  doubt,  be  less  womb  trouble  in  after  life. 
Sinoe  the  use  of  antiseptics  in  surgical  practice, 
operations  are  performed  which  are  wonderful 
in  their  results,  and  perhaps  the  suggestion  may 
not  be  amiss  that  thorough  cleanliness  is  a  pre- 
requisite to  the  use  of  antiseptics,  without  which 
I  presume  little  good  could  be  expected ;  there- 
fore would  ask  whether  asepsis  without  thorough 
cleansing  would  equal  thorough  washing  with- 
out the  use  of  antiseptics. 

There  is  -nothing  that  decomposes  as 
quickly  as  blood,  hence  the  necessity  of  its 
riddance.  Butchers  know  this  fact  and  are 
pleased  to  see  a  full  flow  in  view  of  the  better 
keeping  quality  of  the  meat  This  is  further 
illustrs^  in  case  of  a  beef  killed  by  lightn- 
ing, without  the  loss  of  blood,  which  in  a  very 
short  time  will  be  unfit  for  use. 

Though  not  pertinent  to  the  subject  under 
consideration,  it  may  not  be  amiss  to  give  my 
experience  on  the  obstetrical  subject  Although 
taught  to  wait  from  one-half  to  two  hours  for 
the  expulsion  of  the  placenta,  I  have  long 
since  thought  the  advice  wrong  in  theory  and 
still  worse  in  practice.  I  see  where  some  prac- 
titioner Tname  forgotten),  ''goes  for"  the  after- 
birth before  tying  the  oord.  This  I  regard  as 
'*  too  previous.^'  My  habit  is  to  proceed  to  the 
delivery  as  soon  as  the  child  is  given  to  the 

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nurse.  A  little  kneading  of  the  abdomen,  a 
slight  traction  of  the  cord,  with  the  help  of  the 
finger  of  the  otner  hand,  and  you  will  seldom 
have  any  difficulty,  and  this  early  delivery 
greatly  lessens  the  danger  of  flooding  and  in- 
sures against  hour  glass  contraction. 

I  will  further  state  that  I  have  long  since  al- 
most abandoned  the  use  of  ergot  as  a  means  to 
increase  the  inefficient  pains  of  labor,  believing 
that  it  more  frequently  does  harm  than  good. 
My  experience  with  Viseum  Album,  (Mistletoe), 
though  *quite  limited,  is  more  favorable  for  that 
purpose.  Pretty  firm  pressure  upon  the  peri- 
neum during  a  pain  is  often  of  great  advan- 
tage in  helping  the  pain,  both  in  force  and 
rger  continuance,  and  with  the  further  ten- 
icy  to  relax  the  parts  and  thereby  lessen  the 
tendency  and  danger  of  rupturing  the  perineum. 

Port  Republic,  Va.  G.  W.  Kemper,  M.D., 


Agahitt  the  Swab  in  the  Treatment  of  Diphtheria. 

Editor  Medical  World  : — I  was  much  in- 
terested in  Dr.  W  B.  Parkinson's  article  in  the 
January  World,  but  differ  widely  with  him  as 
to  'the  swab  in  the  treatment  oi  diphtheria." 

The  doctor  and  myself,  though  now  widely 
separated,  were  students  in  the  same  office  at 
Morgan,  Utah«  years  ago,  and  in  the  epidemics 
of  diphtheria  that  were  prevalent  in  that  locality 
during  that  time  the  usual  treatment  was  to 
swab  out  the  throat  wi^h  MonselFs  solution, 
hydrochloric  acid  diluted  and  solutions  of  vary- 
ing per  cent  of  argent  nitra?,  and  the  death 
rata  was  enormous  and  largely  do  to  lar3mgeal 
complications,  especially  diphtheritic  croup 

Ais  Dr.  Da  CcNsta  states,  diphtheria  is  a  con- 
stitutional disease  with  a  local  expression,  the 
expression  being  in  the  throat  I  claim  that  to 
cauterize  a  diphtheritic  ulcer  is  wrong.  Even 
after  applying  solid  nitrate  of  silver,  in  a  few 
hours  you  will  observe  the  exudation  appear 
again.  In  using  the  swab  the  danger  is  in 
abrading  the  surface  of  the  throat,  thus  furnish- 
ing a  new  field  for  the  deposit  of  an  exudate. 
By  this  means  it  has  been  claimed  by  eminent 
authority  that  the  exudate  has  been  transferred 
to  the  larynx — thd  most  formidable  danger  in 
diphtheria. 

I  agree  with  the  doctor  in  the  use  of  the  H^. 
O).  as  an  antiseptic  and  pus  destroyer,  but 
would  use  it  as  a  spray  only. 

As  to  other  treatment,  I  would  use  whiskey 
freely  and  large  doses  of  tr.  ferri  chlor.  fre- 
quently repeated.  Keep  the  bowels  open  with 
small  doses  of  calomel  If  laryngf  al  symptoms 
supervene  I  would  use  small  doses  of  hydrarg. 
chlor.  corrosive  or  hy  irarg.  chlor.  mite,  believ- 
ing in  its  preventing  foriiition  of  membrane. 


But  above  everything  I  consider  alcohol 
almost  a  specific,  given  in  large  doses,  wi  hout 
fear  of  intoxication,  as  the  virulence  of  the 
disease  counteracts  the  effects  of  the  remedy. 

Reedsville,  Pa.)       B.  R.  Kohler,  M.D., 


Methylene  Blue  for  Diphtheria. 

Editor  Medical  World: — I  will  be  pleased 
to  have  you  call  the  attention  of  the  profession 
to  the  use  of  methylene  blue  (Merck's)  in  diph- 
theria, ten  grains  to  the  ounce  of  water;  apply 
to  deposit  with  absorbent  cotton  every  hour, 
washing  the  throat  with  some  disinfectant  be- 
fore applying,  hold  the  cotton  saturated  witb 
the  blue  up  on  the  deposit  until  it  saturates  to 
the  roots.  I  have  used  this  treatment  for  nine 
months,  and  am  so  well  pleased  that  I  have  dis- 
carded all  the  old  remedies.  In  meet  cases  the 
throat  will  be  clear  of  deposit  in  forty-eight 
hours.  The  most  severe  type  of  the  disease  that 
I  have  seen  in  this  time  has  not  lasted  beyond 
the  third  day.  There  is  no  irritation  from  its 
usa  It  is  non  poisonous  and  the  germs  cannot 
grow  in  its  presence.  There  is  complete  disin- 
fection of  the  throat  Not  the  least  odor  after 
the  first  application.  Besides,  there  is  complete 
saturation  of  the  blood  from  absorbtion  from  ita 
local  use,  as  shown  by  the  urine  becoming  blue 
after  its  use  for  twenty-four  hours  I  do  not 
know  whether  this  remedy  will  save  neglected 
cases,  but  believe  it  will  arrest  the  disease  if 
used  at  once.  I  instruct  my  patients  to  keep  the 
preparation  in  the  house  and  paint  any  and  all 
deposits  they  may  see  in  the  throat  without 
waiting  to  send  for  me.  1  do  not  claim  thia 
drug  as  a  specific,  for  the  time  of  use  is  too  short; 
but  the  nine  months  of  use  have  been  so  satis- 
factory that  it  has  taken  away  in  a  great  meae- 
ure  the  dread  I  have  always  felt  for  this  moet 
terrible  and  fatal  disease. 

Denver,  Col.  N.  K.  Morris,  M.D., 


Personal  Experience  With  Diphtheria. 

Editor  Medical  World: — I  have  been 
practicing  medicine  ten  years.  For  five  years 
I  never  saw  a  case  of  genuine  diphtheria.  Then 
it  came.  A  little  girl,  five  years  old,  contracted 
it  and  for  three  months  her  life  was  despaired  of 
from  paralysis  and  albuminuria ;  but  she  event- 
ually got  well.  Fifteen  others  came  down  ia 
the  same  town.  All  got  well.  One  month  after 
all  diphtheria  had  seemingly  disappeared  froni 
the  little  village,  one  child  that  had  had  diph- 
theria, came  over  to  play  with  my  baby,  (twe 
years  old),  and  imported  the  dread  disease  from 
the  dolls  she  played  with  while  ^ick.  Mj 
baby,  after  four  dajs  of  it,  died.  It  nearly 
broke  my   heart.     I  moved   away  from  there 


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and  came  to  Port  Huron.  Here  I  met  with  it 
again.  Had  six  cases  all  at  once  on  my  hands 
in  different  families,  so  mild  that  it  was  with 
<1ifficult7  ^  impre<»sed  the  parents  it  was  diph- 
theria. Nevertheless,  it  was  so  virulent  that 
[  contracted  it  myself  two  days  after  I  had  dis- 
missed all  the  others  well. 

Now  for  an  experience.  I  felt  chilly  all 
<lay,  severe  chill  at  night ;  temperature  104  ; 
tonsils  inflamed ;  no  patches  yet ;  second  day, 
diphtheritic  membrane  maniftsted  itself.  I  was 
very  sick.  My  tongue  was  swollen  and  so  dry 
that  I  could  scarcely  move  it.  Headache, 
backache,  ache  all  over.  Third  day.  tonsils, 
uvula,  phamyx,  all  covered  with  membrane; 
urine  suppressed ;  sick  at  stomach ;  countenance 
<iu8ky;  pulse  120,  intermitting;  at  times  suffo- 
cated nearly  for  want  of  air.  Fourth  day, 
membrane  all  over  mouth,  even  to  the  covering 
of  the  gums  with  a  slight  membrane. 

Now  for  treatment  In  the  first  place, 
thorough  disinfecting  of  everything.  Oil 
etove  kept  burning  night  and  day,  generating 
steam,  with  turpeutine,  oil  eucalyptus  and  car- 
bolic acid  ;  sheets  wrung  out  of  a  strong  solu- 
tion of  corrosive  sublimate  kept  wet  all  the 
dme,  and  the  following  internal  treatment :, 

No.  1. 

R.    Tr.  ferrimur dram  v1 

Olyoerine. ~ ouuce  Iv 

U.    Qig.   swab  throat  every  S  b<>ur  to  every  hour,  nisht 
and  dAy,  and  one  teasi^oonAil  Inter ually  every  three  hoars. 

Alternate  with 
No.  2 

R.    Acid  nit  dil dram  Iv 

Aqase « qounfvjir 

M.  d.g.    Mop  membrane  ^ith  this,  alternating  wiih  No.  1. 

This  treatment  would  remove  the  membrane 
but  not  remove  the  characteristic  imflamma- 
don  resulting  from  the  poison  and  the  treatment. 
When  membrane  was  gone  or  nearly  gone  I 
would  gargle  with 

No.  3. 

R.    Add  carbolic ; 

8pca.  Oamph. at dram  i 

Amm.  mur. dranii 

Aqua. oi 

M.    8fg.    Qaigle  with  this  as  warm  as  convenient. 

Return  to  No.  1  and  2  as  soon  as  membrane 
showed  itself  Spray  nose  with  carbolized  oil,  acid 
carbolic,  minim  j  to  dram  j  of  oil  frequently.  Also 
inject  some  up  posterior  nares  every  three  hours. 
Took  all  the  liquid  nourishment  and  whiskey  I 
could  drink.  Took  injections  of  red  pepper  tea 
into  rectum  for  suppression  of  urine  afler  diur- 
etics failed,  which  had  the  desirea  result  Afler 
the  diphtheria  disappeared,  (which  lasted  ten 
days)  1  commenced  taking  strychnine  gr.  1-60 
every  three  hours,  and  infusion  of  di^talis  and 
cactus  grand  for  kidney  and  heart  weakness.    It 


was  two  months  before  I  left  the  house.  Suffered 
with  diphtheritic  paralysis,  wMch  was  finally  over- 
come by  electricity  and  strychnine.  Took  in 
all  300  pills  of  strychnine  and  50  tablets  of 
nitro  glycerine  for  symptoms  of  heart  failure.  It 
is  now  four  months  since  I  had  it,  and  every 
time  I  catch  cold  I  have  white  patches  on  my 
throat  My  heart  is  still  weak  and  I  cannot  eat 
meat,  as  the  kidneys  are  yet  weak.  Can  a  per 
son  have  true  diphtheria  more  than  once  ? 

I  might  say  in  addition,  that  I  also  gargled 
with  peroxide  cf  hydrogen  when  tonsils  and 
soft  palate  took  on  an  unhealthy  action.  The 
physicians  of  this  town  were  very  kind  ta  mev 
ten  of  them  calling  often  and  doing  all  they 
could  for  me 

In  conclusion  I  would  say :  Don't  use  harsh 
means  to  remove  the  membrane.  Don't  give 
depressants.  Don't  be  afraid  of  giving  too  much 
strychnine  where  the  heart  is  failing,  but  com- 
bine it  witli  nitroglycerine,  which  dilates  the 
capillaries  and  also  has  a  very  favorable  action 
on  the  kidneys. 

Don't  force  the  membrane  down  into  the 
trachea  with  a  swab.  Don't  confine  patient  in 
a  close  room,  but  give  plenty  of  fresh  air. 
Nitric  acid  will  dissolve  the  membrane  better 
than  an^vthing  else  I  ever  tried.  (I  tried  pa- 
poid,  ohloral,  pepsin  and  trypsin.)  Don*t  use  it, 
(the  nitric  acid)  strong,  but  well  diluted. 

Geo.  H.  Treadgoli>,  M.D., 

Immigrant  Inspector  at  Port  Huron,  Mich. 


A  Case  in  Practice. 

Editor  Medical  World  :  —About  daylight 
December  28,  1893,  I  was  called  to  Mrs.  J.  B., 
about  nine  miles  in  the  country.  Arriving 
about  9  a.  m  ,  I  found  a  miscarriage  at  six 
months,  with  child  bom  about  two  hours  before 
my  arrival.  The  mother,  rather  small,  thin 
and  of  nervous  temperment,  about  85  years 
old.  She  had  evidently  about  bled  to  death. 
She  was  pulseless,  had  the  Hippocratic  counten- 
ance and  to  all  appearance  was  beyond  the  reach 
of  medicine.  She  ii^as  still  wasting.  As  the 
stomach  would  tolerate  nothing,  and  I  did  not 
believe  would  digest  anything,  I  put  five  drops 
0^  tr.  nux.  vom.,  two  drops  fl.  ex.  belladonna 
and  eight  drops  tr.  di^ritalis  in  a  teaspoonful  of 
t'*.  viburnum  prunifolium,  and  used  the  hypo- 
dermic syringe.  Then,  placing  my  hand  on  the 
abdomen  and  finding  the  womb  about  the  size 
of  a  child's  head,  I  inquired  aflter  the  placenta 
and  was  told  by  the  husband  that  it  had  all 
come  away.  I  asked  hi  en  if  he  was  certain  of  it 
He  said  yes,  he  had  seen  them  before,  knew 
how  they  iookeil,  and  was  sure  of  it  With  the 
left  hand  still  grasping  the  uterus  I  introduced 


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THB  MEDICAL  WORLD. 


my  right,  finding  it  low  down  and  much  dis- 
tended, and  the  pla^nta  firmly  adhered.    Tear- 
ing it  loose  and  scraping  the  wall  as  clean  as 
possible  with  my  finger  nails,  the  .organ  con- 
tracted promptly  and  the   hemorrhage  ceased, 
l^ot  much  to  my  surprise,  nearly  the  whole  of 
the  placenta  except  the  cord  was  delivered  at 
this  efiort.    I  had  in  the  mean  time  ordered  hot 
applications  to  the  extremities.      All  the  above 
was  accomplished  in  less  than  five  minutes — 
less  time  than  it  has  taken  to  pen  the  above. 
The  family  and  friends  had  given  up  all  hope, 
and  it  did  look  like  a  hopeless  case.     Having 
gotten  to  where  I  could  take  a  long  breath  and 
cast  a  sober  reflection,  I  made  up  my  mind  to 
stick    to    the  hypodermic    prescription    above 
named,  as  I  could  then  see  no  room  for  im- 
provement on  it     So  I  continued  it  every  two 
to  three  hours  till  about  5  o'clock  p.  m.,  when  I 
could  feel  a  bare  thread  of  pulse  in  the  right 
wrist,  none  in  the  left     She  had  thus  fiir  been 
in  a  cold,  clammy  sweat    to  the    knees    and 
elbows,  but  warmth  had  begun  to  return,  and 
after  this  she  was  able  to  take  her  medicine  per 
orem.     Awhile  after  dark  I  heard  the  neighbor 
women,  who  had  come  in  to  watch  through  the 
night,  one  suggesting  to  the  others  that  they  had 
better  go  to  bed,  as  some  would  have  to-  sit  up 
in  the  latter  part  of  the  night.     As  usnal,  it 
seemed  that  all  proposed  to  sit  up  in  the  fore 
part  of  the  night,  and  one  good  old  lady  said 
she  was  no  hand  to  sit  up  any  way.     After 
silently  listening*  to  them  I  remarked  to  this  old 
lady,  "we  don't  need  you,"  and  then  added. 
"You  may  make  your  own  arrangements  about 
sitting  up,  but  some  of  you  must  stay  by  this 
patient  all  night,  and  the  latter  part  of  the 
night  is  the  most  important  tim&     I  shall  lie 
down  as  I  can  snatch  a  chance,  and  instruct 
you  when  to  call  me  up."     She  did  not  lack  for 
attention    through  the  night,   with  but    little 
change  in  the  treatment,  except  to  add  a  little 
nourishment  •  I  left  the  next  morning  about  10 
o'clock,  pretty  nearly  the  same  course  to  be  con- 
tinued.    She  took  two  small  doses  of  sulphate 
of  quinine— one  at  7  and  one  at  10  that    morn- 
ing and  the  next     I  saw  her  the  next  day  (the 
dOth),  about  sun-down,  and  found  that  she  had 
been  getting  along  all  right,  and  was  then  doing 
well,  except  that  she  had  slight  fever  and  nerv- 
ousness, which  I  attributed  to  an  over-dose  of 
company,  it  being  Sunday.  These  people  in  the 
country  are  very  fond  of  visiting  the  sick  on 
Sunday.     There  was  no  more  trouble  about  the 
contraction  of  the  uterus,  no  more  flooding  after 
the  first  dose  of  viburnum.     I  ordered  the  sim- 
ple tr.    viburnum  to  be  continued  every  four 
hours,  and  if  she  continued  to    improve    for 


twenty-four  hours,  then  to  give  it  three  times  a 
day,  and  to  let  me  hear  if  any  change  for  the 
worse.  I  have  not  seen  the  patient  since,  but 
her  husband  has  been  to  report  .and  get  more 
medicine.  Her  convalescence  has  b^n  very 
steady  and  satisfactory.  He  was  in  to-day,  and 
said  she  was  able  to  go  to  the  table.  There  are^ 
one  or  two  points  of  interest  in  this  case,  and 
first  I  would  like  to  impress  the  value  of  black 
haw  (viburnum).  I  use  my  own  tincture,  made 
with  four  ounces  of  the  bark  of  the  green  root, 
gathered  in  October,  to  one  pint  of  dilute  alco- 
hol. It  makes  a  beautiful  tincture,  is  more 
palatable  and  more  eflectual  in  my  hands  than 
the  fluid  extract  In  this  case  the  patient  needed 
the  stimulant,  as  they  generally  do  in  these 
cases,  for  the  patient,  as  stated,  was  all  the  time 
sick  at  the  stomach  and  would  volnit  at  the 
smell  of  whisky  or  almost  anything  else,  and  the 
vital  current  had  so  far  withdrawn  from  the  sur- 
face and  extremities,  that  she  wad  for  a  part  of 
the  time,  totally  insensible  to  the  pierce  of  the 
needle,  and  I  injected  in  the  sides  just  below. the 
axilla.  Another  point;  it  will  not  do  to  depend 
upon  anybody's  say  so,  about  the  placenta.  Ot 
course,  there  were  other  littie  items  of  treatment 
that  are  understood  by  the  profession  without 
mention  here,  such  as  attention  to  the  bowels, 
the  secretions,  proper  nursing  and  nourishment^ 
etc.  R.  L.  HiNTON,  M.D., 

Prescott,  Ark. 


Infantile  Convulsions. 

Editor  Medical  World  : — When  infantile 
convulsions  are  due  to  obstipation,  before  you 
conclude  there  is  nothing  more  to  be  done,  in- 
ject warm  water,  and  if  it  is  not  discharged  in- 
troduce your  index  finger  into  the  rectum  and 
make  pressure  against  the  anterior  wall,  which 
may  be  prolapsed  (independent  of  the  posterior 
or  lateral  walls),  so  as  to  form  a  ball  valve  over 
the  outlet,  admitting  free  injection,  but  allowing' 
no  exit  for  the  contents.  The  pressure  not  alone 
relieves  the  prolapse,  but  allows  air  to  enter  and 
relieves  the  bowel  of  the  offending  matter  on  the 
principle  of  tilting  a  bottle  containing  fluid. 

1502  North  Bond  Street,  Baltimore,  Md. 


In  regard  to  the  therapeutics  of  calcium  sul- 
phide. Dr.  W.  C.  Abbott,  of  Ravenswood,  111., 
further  writes  us  his  successful  experience  in 
cases  of  boils,  skin  eruptions,  sores  on  the  feet» 
etc,  all  of  which  were  promptly  cleared  up  by 
the  faithful  use  of  this  drug. 


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Requirements  for  Praotioing  in  Mexico. 

Dr.  Horace  C.  Pope,  of  Detroit,  Mich., 
-writea  ub  as  follows  : 

In  your  December,  1893  issue  under  the 
head  of  "  Requirements  for  Medical  Practition- 
ers, "  Mexico  you  state  no  special  requirements. 
This  is  incorrect 

The  American  physician  before  practicing  in 
Mexico,  must  go  before  a  notary  public  or 
<x>unty  clerk  who  has  a  seal,  then  the  Secre- 
tary of  State  must  certify  under  the  seal  of  the 
^tate  that  the  party  is  duly  authorized  to  admin- 
ister oaths  and  to  seal  documents,  then  this 
must  be  forwarded  to  Washington,  D.  C,  for 
the  seal  of  the  United  States  State  Department, 
and  this  again  must  be  certified  to  under  seal 
Also  by  the  Mexican  Legation  at  Washington, 


Pathogenetic  Symptoms  of  Drugs. 

Editor  Medical  World: — Dr.  Stockard 
and  Dr.  Waugh  think  that  the  hematuria  was 
caused  by  quinine  (page  4),  There  is  no 
thinking  or  uncertainty  about  it    It  is  &facL 

All  physicians  would  do  well  to  have  one  of 
the  following  works  :  The  text  book  of  Materia 
Medica,  by  A.  C.  Cowperthwaite,  M.D.,  722 
pages,  8  vo.,  $5,  Chicago,  Gross  &  Delbridge; 
or  Condensed  Mat  Med.,  by  C.  Hering,  M.D., 
968  pages,  8  vo.,  $7,  Boericke  &  Tafel,  PhUa- 
delphia;  or  Handbook  of  Mat  Med.  by  T.  F. 
Allen,  M.D.,  1165  pages,  quarto,  $16; 
Boericke  &  TafeL  The  last  the  most  exten- 
sive. 

Each  of  these  works  has  systematically  ar- 
raoged  the  symptoms  which  drugs  produce. 
They  are  obtained  by  taking  the  drugs  intern- 
ally when  in  health,  and  are  also  collected  from 
cases  of  poisoning.  It  too  often  happens,  that 
^ther  a  too  large  dose  or  a  long  continued  use 
of  a  medicine  produces  symptoms  which  do  not 
belong  to  the  disease.  A  reference  to  either  of 
the  above  works  will  clear  up  any  doubt  and 
prevent  further  injury. 

Roeeburg,  Oiegon.     F.  G.  Oehme,  M.D., 


Editor  Medical  World  : — It  is  just  recently 
that  I  have  become  a  member  of  the  World's 
family,  and  I  already  begin  to  feel  a  desire  to 
put  in  my  paddle  and  stir  up  the  turbid  waters. 
As  an  introduction  to  your  family,  I  wish  to  cast 
in  my  mite  of  experience  in  the  use  of  quinine, 
with  reference  to  its  producing  or  promoting 
hemorrhage.  I  live  in  Western  nimois,  near 
the  Mississippi  River,  in  one  of  the  worst  malar- 
ial districts  of  its  latitude,  and  here  we  are  com- 
pelled to  give  quinine  or  one  of  its  substitutes 
•n  almost  everything  we  are  called  upon  to  treat 


I  have  practiced  here  for  25  years  find  I  am 
surely  within  the  mark  when  I  state  that  I  have 
prescribed  and  dispensed  with  my  own  hand 
over  one  hundred  ounces  each  year.  (I  do  a 
country  practice  and  buy  and  dispense  my  own 
drugs).  I  believe  that  such  an  experience 
should  have  convinced  me  one  way  or  the  other 
as  1o  whether  quinine  does  or  does  not  produce 
or  promote  hemorrhage. 

There  may  be  places  on  God's  green  earth 
where  there  are  other  influences  whidi,  taken 
with  that  of  the  quinine,  may  promote  hemorr- 
hage, but  it  is  certainly  not  here.  In  all  of  my 
communications  with  my  medical  brethren, 
privately  and  in  the  county  and  State  medical 
societies,  I  have  yet  to  hear  the  first  one  state 
that  he  has  noticed  that  quinine  promotes 
hemorrhage. 

We  have  long  since  learned  that  quinine  is 
an  excitant  of  uterine  action,  and  we  are  some- 
times brought  face  to  face  with  a  most  perplex- 
ing question.  Malaria  also,  in  some  of  its  pro- 
tean forms,  near  the  end  of  the  term,  is  wont  to 
take  on  the  function  of  a  uterine  excitant 
Quinine  is  the  antidote  to  the  malarial  poison, 
but  it  may  bring  on  premature  labor.  No%  here 
is  an  apparent  dilemma.  What  would  you  do  ? 
I  give  the  quinine  and  take  the  chances.  The 
two  usually  counterbalance  each  other  and  the 
patient  is  allowed  to  go  on  to  full  term.  I  have 
long  since  ceased  to  use  ergot  in  labor  except  as 
a  hemostatic  and  have  substituted  quinine  there- 
for. I  find  its  action  rather  slower  than  ergot, 
but  quite  as  reliable  and  of  a  much  better  qual- 
ity. I  have  used  it  hundreds  of  times  and  I  have 
never  seen  it  produce  a  tetanoid  condition  of 
the  uterus,  as  ergot  sometimes  does,  neither 
have  I  ever  seen  it  cause  or  excite  hemorrhage. 
On  the  contrary,  contraction  from  the  use  of 
quinine  seems  to  be  just  as  efficacious  in  the 
control  of  hemorrhage  as  does  that  of  ergot  I 
cannot  think  that  Mrs.  Ida  O.  Wilhelm,  of 
Clay  Centre,  Kan.,  can  justly  charge  her  case  of 
hemorrhage  to  the  use  quinine.  If  this  meets 
with  grace  in  the  eyes  of  the  editor  of  the 
World  and  its  readers,  I  may  at  sometime, 
tell  her  how  she  might  have  avoided  that  hem- 
orrhage. W.  R  GiLLILAND,  M.D., 

Coatsburg,  111. 


[In  further  pursuance  of  his  investigation, 
Dr.  Waugh  has  received  the  following  letter :] 

Dear  Doctor  : — I  noticed  in  a  recent  Med- 
ical World  that  you  expressed  a  desire  to 
hear  reports  of  cases  of  hemorrhage  due  to  the 
administration  of  quinine.  The  only  case  I 
ever  had,  in  which  I  am  certain  continuous 
hematuria  existed  as  a  result  of  continuous 
quinine  dosage  occurred  as  recently  as  Novem- 


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ber,  1893.  I  waa  called  in  consultation  to  see 
a  case  of  intermittant  fever.  The  patient  had 
been  in  bed  ten  week?.  The  physician  in  atten- 
dance had  been  giving  daily,  quinine,  grs.  xxv, 
during  the  latter  part  of  the  night  and  early 
morning,  to  ward  off  the  expected  chill.  At 
the  time  I  saw  him  he  was  voiding^large  quan- 
tities of  blood  with  hia  urine.  I  suggested  the 
immediate  cessation  of  the  quinine,  put  the 
patient  on  a  mixture  of  acid  carbolic  and  tr, 
iodine,  and  in  three  days  the  hemorrhage  ceased, 
and  did  not  return.  The  patient  made  a  good 
recovery,  Ghas.  G.  Plummer,  M.D., 

Mercantile  Block,  Salt  Lake  City,  Utah. 


Eleotrioity   a   Paralyzing  Agent.— A    Correction 
and  Addition. 

Editor  Medical  World  :— Allow  me  to 
correct  for  your  next  issue,  an  error  in  my  last 
communication,  under  the  heading  of  "  Animal 
Electricity  "  (page  14).  I  wrote,  proposing  to 
show  that^  in  so  far  as  involuntary  muscles  are 
concerned,  electricity  produces  similar  effects  to 
motor  nerve  section ^  instead  of  motor  nerve 
acHofij  as  the  printer  has  made  me  to  say — a 
mistake  which  entirely  contradicts  my  meaning. 

In  justification  of  a  statement  which  at  first 
sight  may  appear  absurd,  I  will  offer  the  follow- 
ing facts,  based  on  the  highest  physiological 
authority,  though  differing  materially  from  the 
conclusions  put  forward  in  the  text  books 

1.  The  inferior  laryngeal  nerves  supply  motor 
nerve  influence  to  both  the  muscles  which  close 
and  to  those  which  open  the  glottis  If  these 
nerves  are  cut,  both  sets  of  glossal  muscles  con- 
tract  but  the  constrictors  over  power  the  dila- 
tors and  the  glottis  is  closed. 

Faradization  of  the  same  motor  nerves  pro- 
duces the  same  effects,  as  their  section;  the 
glottis  being  closed,  just  as  it  is  in  death. 

(Dr.  Burdon  Sanderson's  Handbook  for  the 
Physiological  Laboratory,  Lindsay  and  Blak- 
iston,  1878,  page  308,  318\  Here  nerve  sec- 
tion, faradization  and  death,  are  attended  by 
similar  effects  on  the  glossal  muscles.  Now  if 
electricity  be  a  stimulus,  it  is  certainly  found  in 
very  bad  company. 

The  same  results  attend  section  and  faradiza- 
tion of  the  motor  nerves  supplying  the  esopha- 
gus and  stomach,  etc.,  which,  instead  of  being 
"paralyzed,"  as  the  text  books  assert,  after  sec- 
tion of  the  vagi,  exhibit  quite  active  muscular 
contractions  in  ejecting  their  contents.  Section 
of  the  splanchnic  nerves,  which  contain  the 
great  vaso-motor  nerves  of  the  abdominal  vis- 
cera, causes  such  contraction  of  the  abdominal 
arterioles  as  to  empty  their  contained  flow  into 
the   portal   system,  "as   though  a  great  intes- 


tional  hemorrhage  had  taken  place,"  (Hand- 
book). Faradization  of  the  same  nerves  or  of 
their  roots  in  the  spinal  cord  produces  marked 
contractions  and  even  ischemia  of  the  arterioles, 
as  physiology  abundantly  testifies.  (Carpen- 
ter's Phys  ,  page  318).  These  and  other  facts 
of  similar  importance  (to  w  hich  want  of  space 
forbids  a  reference  here)  seem  to  prove  the 
proposition  made  above — ihat  in  so  tar  as  the 
involuntary  muscles  are  concerned,  motor  nerve 
section  and  faradization  produce  similar  effects  ; 
and  it  can  hardly  be  denied  that  in  both  cases 
the  effect  is  pandjzing  so  far  as  the  motor 
nerve  is  concerned. 

These  fa^^ts  would  seem  further  to  point 
strongly  to  the  conclusion  that,  in  so  far  as  the 
involuntary  muscles  are  concerned,  the  true 
role  of  motor  nerve  force  is  to  restraiuy  control 
and  CO  ordinate,  the  inherent  contracted  energy 
of  the  muscle  for  the  purposes  of  the  organism. 
Such  a  view  of  the  case  suggests  other  and  most 
important  practical  conclusions  which  cannot 
even  be  glanced  at  here.  The  subject  has  been 
discussed  at  considerable  length  in  a  paper  oi 
mine  to  be  found  in  the  Transactions  of  the 
9th  International  Congrfss,  section,  physiology, 
and  also  in  a  paper  read  before  the  first  meet- 
ing of  the  American  Electro- Therapeutic  Asso- 
ciation, and  printed  in  the  Archives  of  Oyneeol- 
ogy  for  December,  1891. 

Thomas  W.  Poole,  M.D.. 

Lindsay,  Out,  Canada. 


Animal  Eleotrioity  and  Magnetism. 

Editor  Medical  World  : — In  the  Jaauary 
number  of  the  Medical  World  is  an  article 
headed  animal  electricity  by  Thomas  W.  Poole, 
M.  D.,  in  which  the  following  sentence  occurs : 
"  It  Is  unnecessary  to  recapitulate  the  evidence 
that  nerve  force  and  electricity  are  wholly  un- 
like, and  that  neither  of  these  forces  can  be 
transformed  into  the  other."  It  is  true  that 
nerve  force  cannot  be  transformed  into  electric- 
ity for  the  reason  that  it  is  transformed  electric- 
ity. There  is  no  fact  in  organic  nature  more 
certain  than  that  magnetism  is  the  source  from 
whence  comes  innervation.  The  latest  scientific 
investigation  of  electricity  proves  it  to  be  a 
natural  elementary  substance.  It  is*  a  well 
known  fact  that  all  elementary  substances  are 
allotropic  That  is,  they  change  their  proper- 
ties and  pass  from  state  to  state,  progreiFS  and 
return  by  virtue  of  their  inherent  life  or  motion. 
For  instance,  we  have  carbon,  as  diamond,  as 
graphite  and  as  charcoal,  the  same  element  but 
different  properties.  Again  we  have  oxygen 
and  ozone,  the  same  but  very  different  proper- 
ties.    We  have  electricity,  magnetism,  animal 


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magnetieni,  heat,  light,  odyle,  thoughts;  these 
are  all  the  same  elementSy/but  in  different  states 
of  progress.  We  could  no  more  think  without 
magnetism  than  without  phosphorus.  All 
organisms  are  magnetic,  and  a  disturbance  of 
the  magnetic  equilibrium  of  the  system  invari- 
ably precedes  disease.  This  may  occur  in  a 
special  organ  or  in  the  general  system.  Local 
inflammation  is  always  preceded  by  an  ex 
tremely  magnetically  negative  state  of  the  vas 
omo  or  nerves  of  the  organ  or  part  This  causes 
engorgements  of  the  capillary  vessels,  and  is  fol- 
lowed by  the  •*  Bubar  et  tumor  cum  color  el  dolor  " 
of  Celsu^  because  the  nutrition  of  the  organ  or 
l>art  is  altered  by  a  partial  or  total  stagnation  of 
the  blood.  If  the  vasomotor  nerve  depression 
is  general  when  reaction  comes  on  we  have  in- 
flammatory fever,  but  the  nerve  depression  may 
be  Fo  great  as  to  prevent  reaction,  then  collapse 
and  death  will  be  the  result,  as  aometim.es  hap- 
pens in  cholera  and  pernicious  intermiitents. 

The  magnetic  state  of  the  system  and  the 
consequences  of  a  disturbance  of  its  equalib- 
rium  is  well  demonstrated  by  permitting  }oung 
healthy  children  te  habitually  sleep  with  very 
old  persons.  The  child  in  a  short  time  com 
mences  to  lose  vitality,  turns  pale  and  becomes 
anemic,  and  if  the  contact  is  continued  will  die 
of  inanition.  Old  persons  are  always  magneti- 
cally negative,  while  young,  healthy  persons 
are  always  po&itive.  This  fully  explains  the 
above  phenomt  non  A  number  of  years  ago  I 
made  experiments  with  animal  magnetism  as  a 
therapeutic  agent  and  the  result  was  so  encour- 
aging that  I  continued  to  use  it  in  suitable  cases 
for  six  or  eight  years.  The  result  or  a  synopsis 
of  it  with  cases,  was  published  in  the  April  num- 
ber, 1886,  of  the  Medical  A^. 

Oirdova,  HI.  J.  Hoke.  M.D., 


Replies  to  Drt.  Bronson  and  H,  L.  K. 

Editor  Medical  World:— Drs.  Bronson 
and  H.  L.  K.  report  cases  which  require  a  care 
ful  diagnosis  as  to  the  causes,  which  will  require 
a  careful  examination  of  each  case.  The  process 
of  exclusion  must  be  employed,  as  chronic 
diarrhea  and  intestional  indigestion  have  many 
causes.  If  would  be  well  for  them  to  ask  them 
selves  the  following  questions : 

Has  the  patient  Bright's  disease  ?  Is  there 
any  disease  of  the  liver,  heart  or  pancreas? 
Has  the  patient  tuberculosis?  Is  there  any 
malignant  disease  of  the  intestbal  tract  ?  Are 
there  any  ulcers  of  the  rectum  or  other  rectal 
diseases.  Wl^n  we  exclude  these  causes  we 
come  djwn  to  worms  and  malaria,  which  fre- 
quently have  only  this  one  symptouL  In  malaria 
the  spleen  is  enlarged,  but  is  often  so  soft  a)  to 


be  difficult  of  detecting,  but  an  examination  of 
the  blood  will  settle  the  question,  even  if  the 
regular  recurrence  of  the  attack  does  not 

if  we  find  nothing  of  the  above  causes,  thea 
we  may  have  a  deficient  nerve  action 
which  would  be  very  similar  to  Dr.  Bronson's 
case  and  here  I  find  the  hypophosphites  of  lime 
or  soda,  with  or  without  strychnine,  of  great 
service,  also  sometimes  small  doses  of  arsenic, 
one-half  drop  of  Fowler's  solution  three  timee  a 
day,  especially  if  there  is  some  nausea  and  the 
stomach  cannot  stand  cold  water. 

In  Dr.  H.  L.  K.'s  ca^e,  if  the  above  causes 
were  excluded  we  would  very  probably  find 
intestinal  catarrh,  in  which  one-tenth  grain  of 
calomel  before  each  meal  would  give  us  the 
best  of  results. 

I  mention  these  remedies  as  I  have  eften 
found  them  of  great  use.  I  think  that  in  these 
causes,  bismuth,  opium,  tannic  acid,  etc.,  are  of 
very  little,  and  generally  of  no  permanent  uie; 
and  in  our  books  we  hardly  ever  see  it  men- 
tioned, and  that  quinine,  santonine,  arsenic, 
hypophosphites,  strychnine  and  calomel  are  of 
use,  whereas  they  are  often  the  only  remedies 
and  all  that  is  required  I  have  found  the 
hypophosphite  of  great  service  in  treating  the 
diarrhea  in  the  aged.  I  would  advise  the  doc- 
tors to  make  a  correct  diagnosis  as  to  cause  and 
then  adopt  a  treatment  and  stick  to  it  for  a 
month  or  so.  R  C.  Paine,  M.D. 

Bethel,  N.  Y. 


ContinuedFevers.— Cystitis.— Diphtheria.— Nttrale 
of  Ammonia  for  Continued  Fevers. 

Editor  Medical  World  : — If  the  cystitis  in 
Dr.  CampbelVs  case  is  not  caused  by  stone,  I 
would  suggest  15  grs.  boracic  acid  three  or  four 
times  a  day  in  a  glass  of  water.  At  the  same 
time,  fifteen  drops  each  of  tincture  of  hyoscyar- 
mus  and  tincture  of  nux  vomica,  with  thirty 
drops  of  fluid  extract  of  uva  ursi  every  four 
hours.  I  have  gotten  excellent  results  from 
this  treatment  in  C}  stitis  where  the  urine  was 
ammooiacal,  highly  ofiensive  and  contained  a 
great  deal  of  blood  and  mucus. 

In  diphtheiia  I  have  gotten  better  results  from 
a  throat  wash  composed  of  chlorate  of  potash, 
salicylic  acid,  carbolic  acid  and  'glycerine  than 
from  any  thing  else.  I  sometimes  add  sulphur 
to  this  gargle.  Internally  I  prefer  tincture  of 
iron  and  quinine  to  other  remedies.  I  have 
found  the  inhalation  of  lime  vapor  very  valu- 
able. 

For  twelve  years  or  more  I  have  been 
using  nitrate  of  ammonia  in  the  various  forma 
of  continued  fever.     I  generally  combine  Fow- 


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lei^B  solution  with  it  When  taken  in  time  I 
have  seen  many  cases  shortened  by  this  treat- 
ment. The  nitrate  controls  delirium.  In 
some  cases,  when  there  had  been  considerable 
delirium  before  its  use,  the  mind  cleared  up 
within  twenty*  four  hours  after  beginning  it,  and 
there  was  no  further  delirium  during  the  fever. 
Fifteen  grains  of  the  nitrate  of  ammonia,  with 
five  drops  of  Fowler's  solution,  every  3  or  4 
hours  for  an  adult  may  be  given.  If  too  much 
nitrate  is  given  it  produces  vomiting.  If  there 
is  any  illeo  cecal  tenderness,  tympanitis,  with 
or  without  dry  brown  tongue,  or  any  redness 
about  tip  or  edges  of  tongue,  I  prefer  turpentine 
to  all  other  remedies.  It  may  be  given  in  capsule 
or  with  the  nitrate  and  arsenic.  In  such  cases 
occasionally  a  fly  plaster  is  necessary.  Among 
the  coal  tar  antipyretics  I  prefer  phenacetine.  If 
the  temperature  rises  over  103  degrees,  I  gener- 
ally use  it.  I  find  one  dose  in  twenty-four 
hours  sufficient.  After  the  first  dose  producing 
sweating,  I  find  it  advisable  to  decrease  the 
dose,  as  it  takes  less  to  act  on  the  system  after 
sweating  is  once  produced.  Profuse  sweating 
does  harm.  I  think  very  highly  of  cold  water 
to  reduce  high  temperature  where  appliances  are 
at  hand  for  its  use.  I  have  often  gotten  benefit 
from  sponging  the  extremities  with  ice  water. 
To  the  nitrate  and  lEirsenic  above,  I  sometimes 
add  tincture  of  aconite  with  good  results.  In 
cases  where  there  is  tendency  to  diarrhea,  I  have 
used  sulpho-carbolate  of  zinc  to  advantage. 
The  mo9t  troublesome  cases  are  those  where 
constipation  is  persistent  I  have  tried  salol, 
salicylic  acid,  tincture  of  iodine  and  a  great 
many  other  remedies,  but  I  prefer  the  nitrate 
of  ammonia  with  arsenic  as  given  above,  using 
quinine  only  as  may  be  necessary.  After  the 
first  few  days  I  get  no  benefit  from  this  drug 
except  as  a  tonic.  Of  course  I  have  not  given 
detailed  treatment,  but  only  an  outlin&  The 
intelligent  physician  must  always  supply  many 
things  in  his  treatment  of  any  disease. 

CarrsviUe,  Va.         Gavin  Rawls,  M.D., 


Why  Tapeworms  Are   Not  Expelled. 

Editor  Medical  World: — On  page  51 
Feb.  World,  Dr.  E.  Hertig  asks  for  the  best 
that  is  recently  known  for  the  expulsion  of  tape- 
worms. I  suppose  the  doctor  has  a  case  in 
which  he  has  tried  the  ordinary  remedies  and 
failed  I  have  no  new  medicine  to  ofier,  but 
fully  believe  that  if  the  doctor  will  give  this 
short  article  a  little  thought  he  will  have  no 
more  trouble  removing  tapeworms. 

Remember  that  the  so-odled  vermicides  only 
paralyze  the  worm,  and   this  paralyzed  condi- 


tion soon  passes  off  (in  two  or  three  hours),  if 
it  is  not  wholly  expelled,  and  it  returns  safelj 
into  the  bowels.  Now,  right  here  is,  in  my" 
opinion,  where  so  many  physicians  fail;  they 
give  vermicides  (?)  and  paralyze  the  worm,  and 
purgatives  to  expell  it;  the  purgative  acts  too 
slowly,  and  the  worm  recovers  before  the  pur- 
gative acts,  or  it  acts  too  lightly;  the  worm  may 
be  partly  expelled,  but  a  good  portion  of  it 
crawls  back  to  its  place  in  the  upper  bowel.  I 
do  not  believe  that  physicians  generally  fully 
appreciate  the  importance  of  staying  with  the^ 
patient  to  see  that  the  worm  is  expelled,  and  not 
allowed  to  return  after  it  is  nearly  all  out 

I  have  seen  as  much  as  three  feet  of  worn> 
crawl  back  into  the  bowel,  and  had  I  not  been 
watchihg  my  patient,  it  certainly  would  hav& 
remained  there,  but  by  giving  one  copioua 
enema  after  another  it  was  expelled. 

My  treatment  is  as  follows :  Take  three- 
ounces  bf  pomegranate  bark,  add  twelve  ounces 
of  water  to  it  and  bring  nearly  to  a  boil,  let  it 
set  several  hours  or  over  night ;  if  the  bark  i» 
dry,  after  pouring  this  off,  add  three  or  four 
ounces  more,  heat  and  pour  this  off,  and  again, 
if  necessary,  till  the  bark  is  exhausted,  then 
concentrate  the  whole  to  six  ounces  by  gentle 
heat,  and  give  in  three  doees  inside  of  one  hour, 
then  give  one  tablespoonful  of  castor  oil  every 
half  hour  till  bowels  act  very  freely,  or  till  the- 
worm  is  expelled.  As  long  as  the  worm  is  ap- 
parantly  lifeless  and  bowels  are  acting  all  i» 
well;  but  if  the  segments  that  are  expelled,  or 
the  portion  that  is  being  expelled,  commencea 
to  move  readily;  then  be  ready  to  assist  the  ex- 
pulsion by  giving  injections.  If  the  worm  is 
slow  to  come,  and  crawls  back  between  actions^ 
give  more  of  the  pomegranate  decoction  and 
castor  oil.  The  pom^ranate  and  oil,  of  course,, 
are  given  on  an  empty  stomach. 

Give  a  moderate  calomel  and  podophyllin 
purge  thirty-six  hours  before  commencing  the- 
other  treatment 

Keep  a  close  watch  on  the  condition  ot 
patient?s  boweU  and  condition  of  worm  and  see- 
that  it  is  expelled. 

Fate,  Texas.  Joe  H.  Loving,  M.D., 


Replies  to  Quiries,  Notes,  Eto. 

Editor  Medical  World: — 1.  Dr.  Bron- 
son's  case  (page  20,  January  number)  is  likely 
one  of  dyspepsia.     I  should  suggest : 

(a.)  A  cupful  of  hot  water  twenty  minutea 
before  breakfast,  continued  for  months,  (b.) 
The  use  of  rectal  injections  of  hot  water  (as  hot 
as  can  well  be  borne)  beginning  with  half  a 
pint  and  gradually,  by  *^ucation"  of  the 
bowels,  going  up  to  two  quarts.     Repeat  twioe 


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weekly  for  .two  weeks,  then  thrice  weekly,  (c.) 
Medicatioii :  Pepsin  and  muriatic  acid,  in 
large  doses  of  former,  after  meals.  Also  P.  D. 
&  Go's.  fl.  ext  boldo;  six  drops  in  water  before 
meals,  ^(d.)  The  avoidance  of  all  food  that  is 
difficult  to  digest. 

2.  Case  of  H.  L.  K.,  M.D.  (page  20,  Janu- 
ary number)  is  also  a  case  of  dyspepsia,  I  be- 
liere.     Benefit  would  likely  result  from : 

(a.)  A  cupful  of  hot  water  twenty  minutes 
before  each  meal     (b.)  Medication : 

B    Leptandrin i gr.  xl 

8*iloiu gr.  00 

FLext  boldo  (P.  D.  <fc  Co ) m.l 

Pul7.  ipecac «..gr.  v 

Oleo  renin  oapBici- gr.  ij 

M,    Et.  ft.  capeoL  N  \  LX. 

8ig.    Take  three  capsolea  twenty  minutei  befoi«  each  meaL 
▲IflQ  twenty-fl^e  giains  Lactapepdne  after  each  meal. 

3.  Skin  case  of  **Medl  us"  (page  20,  January 
number).     Give  internally : 

&   p.  D.  &  Co*8.  fl.  ext.  berberia  aquefoL oi.  U 

Syr.  tolu „ f  o«.  vj 

If.    Big.   TeaapoonAii  in  water  after  each  meal.    Shake 
well. 

4.  Case  of  periodical  retention  of  urine  for 
which  "medicus"  (page  21,  January  number) 
asks  for  relief.  This  looks  like  hysteria.  Try 
the  following,  beginning  always  one  week  before 
the  expected  period  of  distress:  three  grain 
capsules  of  valerianate  of  zinc,  one  t  i.  d.  before 
meals.  Also  tr.  ferri  mur.  and  fi.  ext  ergot  in 
full  doses  t  i.  d.  after  meals. 

The  "kneeling  posture"  in  labor  as  mentioned 
by  Dr.  Stanley,  in  the  January  number,  is 
effectiv&  It  is  certainly  a  valuable  and  much 
neglected  procedure,  which  should  be  resorted 
to  much  more  frequently  in  tedious  labors,  in 
my  opinion. 

If  Dr.  6.  will  take  the  criticism  kindly  (the 
spirit  in  which  it  is  given)  I  would  say  that  the 
ow  of  the  catheter  in  his  case  of  '^pelvic  inflam- 
mation" (page  9,  January  number)  if  not  ctbgo- 
Iviely  necesaary^  was  fraught  with  ffreat  danger 
of  producmg  a  violent  cystitis  which  might  have 
given  more  trouble  than  the  existing  condition. 
In  such  cases  (gonorrheal  infection),  when  the 
procedure  is  absolutely  necessary,  I  believe  that 
the  parts  should  be  eacposed  (the  reasons 
having  been  explained  to  the  patient)  and' 
well  cleansed  with  an  antiseptic  solution  before 
the  catheter  is  used,  which  should  (in  such 
cases)  be  done  under  the  guidance  of  the  eye  as 
well  as  the  hand.  Besides,  the  catheter  should 
be  subsequently  well  cleansed  and  disinfected 
before  the  operation  is  repeated. 

Will  Dr.  Shotwell  (page  5,  January  number) 
(who  by  the  way,  seems  a  very  candid  and  con- 
sdentious  writer,  a  trait  which  we  all  admire  so 
much)  kindly  tell  us  what  the  unfavorable  re- 
ports of  osmic  acid  are;  and  further  give  us  his 
method  of  using  the  remedy,  dose,  etc.    Is  it  in- 


jected simply  under  the  skin  or  into  thei  mus* 
cles? 

Finally,  a  little  hint,  in  which  I  think  most 
of  your  readers  concur,  if  possible  do  not  lefe 
Dr.  Waugh  cease  writing  for  your  most  valua- 
ble journal,  since  his  going  far  away  from  youF 
city.  We  can  always  learn  from  his  contribu*- 
tions.  J.  K.  Shirk,  M.D., 

Lancaster,  Pa.  ' 


Replies  to  Inquiries— Oase  of  Talipes  Calcaneoua 
—Necessity  for  Thorough  Investigation. 

Editor  Medical  World  : — I  would  say  to 
Dr.  Bronson  (page  20,  January  World)  I  had 
a  similar  case  several  months  ago,  and  obtained 
a  cure  by  the  use  of  arsenite  of  copper,  as  fol- 
lows: 

R   CuprL  an., gr.  1-20 

Aqns. « OJ 

M.   Big.   TeaapooDftil  every  hour  wiille  awake. 


Also: 

R   Ext  nuc.  Yom.  fid 

Bpt  Tin.  gall... 


«.....dr. 
OS.  yU: 


M.   fflff.    TeaimooDlal  three  times  a  day.  Also  daily  doses  off 
podophylin  gr. }%, 

Dr.  H.  L.  K's.  case  will  be  helped  by  the 
same  treatment,  with  the  addition  of  fel 
bovinum. 

To  Dr.  Smith,  page  21,  I  would  say  that 
spasmodic  croup  is  a  disease  very  seldom  dan^ 
gerous. 

Diagnosis:  Comes  on  suddenly  at  10  or  ID 
Qi'clock  at  night,  an^l  generally  leaves,  with  or 
without  treatment,  at  from  1  to  2  in  the  morn- 
ing. 

Cause — Generally  cold  or  wet  feet  in  ona 
predisposed. 

Treatment — If  you  live  close  enough  to  get 
to  the  house  before  the  attack  is  over,  give  five 
to  ten  drop  doses  of  syrup  of  ipecac  every  five 
minutes  until  vomiting  occurs;  wrap  neck  ia 
wet  towel;  give  inhaladons  of  vapor  of  turpen- 
tine, and  if  serious,  chloroform.  Sprup  of  ipecac^ 
raw  onion  or  onion  juice,  or  iodide  of  potassium 
will  prevent  reeurrenee. 

A  case  of  talipes  calcaneous  (congenital).  I 
send  a  report  of  this  case  especially  for  the 
benefit  of  the  younger  members  of  the  profession^, 
to  illustrate  that  we  need  not  fold  our  hand» 
and  wait,  in  so  many  cases,  as  some  do. 

In  the  fall  of  1890  I  was  called  to  see  a  baby,, 
one  month  old,  with  a  very  bad  talipes  calcane- 
ous. The  mother  said  she  had  been  to  one  doc- 
tor (a  young  graduate),  who  said  she  would 
have  to  wait  until  tne  baby  was  two  years  old, 
and  then  have  an  operation  performed.  I  ad- 
vised the  mother  to  hold  the  foot  in  the  opposite 
direction  all  of  the  time  she  held  the  baby^. 


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while  nursing,  etc.,  and  systematically  use  fric- 
tion and  maseage  to  the  muscles  of  the  calf  and 
inside  of  the  leg.  The  resulc  was  that  when 
the  baby  was  two  years  old  she  could  walk  as 
well  with  that  foot  as  with  the  other,  no  weak- 
ness even. 

Another  illustration :  When  I  started  in 
practice  here  one  of  my  first  patients  was  a 
young  lady  who  had  been  treated  for  several 
months  for  'female  weakness"  and  obtaining  no 
relief,  came  to  me.  She  told  me  her  symptoms 
and  I  asked  for  an  examination,  which  was  re- 
fused.    She  said  Dr.  M had  not  asked  for 

an  examination.     I  replied,    Dr    M had 

not  cured  her  either.  Several  days  after  her 
mother  brought  her  back  and,  on  examination, 
I  found — prolapsus?  No.  Right  inguinal  hernia! 
I  procured  a  truss  for  her.  She  wore  it  three 
months  married,  and  now  she  has  one  baby, 
does  Dot  have  to  wear  a  truss,  and  is  well. 
Why  she  had  not  noticed  the  small  bulging 
tumor  I  do  not  know. 

Vemonia,  Oregon.    C.  H.  Newth,  M.D., 


Conflrmation  of  Yarrow  for  Dysentery. 

Editor  Medical  World  : — I  noticed  a  com- 
munication in  The  World  for  September, 
1893,  headed  "New  Remedy  for  Dysentery," 
fey  W.  S.  Cline.  M.D.,  of  Woodstock,  Va.  In 
that  paper  the  doctor  relates  a  successs  with  the 
infusion  of  yarrow  leaves,  as  a  new  remedy. 
That  the  remedy  is  a  very  useful  one  tkere  is 
no  doubt,  but  the  doct^or  will  pardon  me  when  ^ 
«ay  that  it  is  not  new  in  California.  In  the 
«arly  fifties,  in  California,  dysentery  was  •very 
<x)mmon,  owing  to  the  scarcity  of  wholesome 
food.  By  some  means  the  miners  discovered 
the  usefulness  of  a  decoction  of  the  yarrow  tops, 
leaves  and  fiowers,  and  success  followed  in 
^most every  case,  the  remedy  taken  ad  libitum. 
Jackson,  Cal.  K  £.  Robertson,  M.D., 
[The  doctor  will  find  other  reference  to  the 
subject  in  Nov..  1893,  World.— Ed.] 


Answers    to    February    Inquirers— Tapeworm  — 
Eczema— Pruritus. 

Editor  Medical  World  i^Replying  to  Dr. 
Hertig. — During  the  past  few  years  quite  a 
number  of  memedies  have  been  added  to  the 
list  of  teniafuges  Naphthalin,  thymol,  salicy- 
lic add  and  other  intestinal  antiseptics  are 
among  the  more  recent  members  of  this  class 
Mignonette  (reseda  odoraia)  has  recently  been 
lauded  as  a  teniafuge  by  a  Franch  physician, 
while  only  a  short  time  ago  a  case  was  reported 
of  the  expulsion  of  an  entire  tapeworm  from 
the  person  of  a  young  lady  after  she  had  eaten 
m  raw  pineapple  (ancmoBsa  acUiva),  the  stomach 


having  been  previously  emptied  by  fasting.  But 
regardless  of  the  success  which  may  have  at- 
tended the  use  of  th?se  remedies  in  other  hands, 
we  have  found  them  inferior  to  certain  methods 
practiced  by  us  for  some  time  past.  Extensive 
observation  and  personal  experience  with  a 
large  number  of  cases  have  led  us  to  believe 
that  Pellttierine,  the  active  principle  of  fk)m^ 
granite  root  (punica  granatum)  is  one  of  the 
beet  teniafuges  known  at  the  present  time.  It 
may  be  administered  alone  or  in  combination. 
''Tanret*s  Pelletierine*'  is  a  most  excellent  and 
efficient  preparation  of  this  alkoloid,  and  Ib 
largely  used  by  tapeworm  specialists,  who  re 
move  tapeworm  in  sixty  minutes.  Sometimes  it 
is  well  to  combine  pelletierine  with  other  reme- 
dies possessing  similar  viirtues,  and  the  following 
formula  is  one  which  we  have  frequently  em- 
ployed with  uniform  success : 

R   PeUetierloe  Uinnatis ^ gr.  J-i^J 

oieoresiDse  felids  maris ^^ m.  xzx 

Chlunforml m.  y-x 

Syr.  Aoacise o*.  1 

M.  8iir.  The  whole  to  be  taken  In  a  liberal  quaaHtj  <A 
Bweet  milk  immediately  apon  arising  in  the  morning. 

No  breakfast  should  be  eaten  and  in  the 
course  of  an  hour  or  two  a  brisk  cathartio 
should  follow  the  above  mixture.  Here  is  a 
good  combination : 

R    OLtlglll .gtti 

01.  rtdni «.. 0S.8S 

Ol  clnnamomi m.  y 

Qlyoerine .dr.  ij 

M.  Big.    One  dose, 

We  do  not  advise  even  thirty  minims  of  ex- 
tract of  male  fern  to  be  taken  into  an  empty 
stomach,  and  so  we  administer  it  in  a  liberal 
quantity  of  sweetened  milk  and  thus  prevent  its 
undue  absorption  bj  the  general  system.  This 
method  of  treating  tapeworm  is  a  good  one. 
The  mixtures,  however,  are  not  very  palatable, 
and  are  somewhat  objectionable  on  this  seore. 
They  are  not,  of  course,  suitable  for  infants  or 
youDg  children. 

The  following  mixture  makes  a  good  .tenia- 
fuge, agreeable  to  boih  palate  and  stomach  and 
allowable  tor  children  as  well  as  adults  : 

R    Peponis  decort ..« os.  J»s 

Sacchari  albl os.  y 

Oi.gdultberie gtx  y 

HeL  despumati q.  i 

Grind  the  punpkin  seeds — which  have  been 
deprived  of  their  outer  coating — and  rub  to  a 
mass  with  the  sugar.  Then  add  the  oil  of 
wintergreen  and  sufficient  honey  to  make  a  nice 
electuary. 

This  electuary  is  to  be  taken  in  the  course  of 
an  hour,  early  in  the  morning — breakfast  be- 
iug  omitted — and  one  or  two  hours  afterward  to 
be  followed  by  a  brisk  cathartic.  Castor  oil 
alone  or  comb'med  with  extract  of  male  fern 
and  a  few  drops  of  turpentine,  usually  answers 
best     With  either  of  the  above  mixtures  the 


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tapeworm  should  be  passed  in  comparatively 
short  time — head  and  all.  By  administering 
the  teniafuge  before  breakfast  in  the  morning, 
regulate  1  fasting  becimes  unnecessary;  still,  in 
the  case  of  a  recalcitrant  paradte  it  is  some- 
times well  to  limit  the  previous  evening  meal  to 
soup  or  gruel,  and  to  evacuate  the  bowels  with 
a  saline 

Replying  to  Dr.  Pineo,  I  would  suggest  for 
the  chUd  the  internal  administration  of  one- 
tenth  grain  of  calomel  morning  and  evening. 
This  is  mostTsonveniently  given  in  tablets.  As 
a  local  application  to  the  hands  and  extremities 
the  following  will  doubtless  prove  beneficial : 

a    Acidl  Balicyllcl gr.  xxx 

Bata  Peru dr.  i\ 

Vaaellne o«.i 

Uost  pidB  liquiee,  od ^ »..oz.  i] 

U.    Hat  nngt. 

aig.    Apply  locally  to  affected  areaa. 

It  will  be  found  advisable  to  apply  the  oint- 
ment twice  daily,  rubbing  it  gently  over  the 
a£Fected  area,  and  afcerwards  smear  a  small 
quantity  on  a  light  cloth  and  bind  it  about  the 
part  This  will  doubtless  relieve  the  pruritus 
and  also  aid  in  curing  the  cutaneous  lesions. 
Should  the  ointment  fail  to  relieve  the  itching 
the  following  antipruritic  powder  may^  be 
ftnsted  over  the  troublesome  portions : 

R   Pulv.  camphone dr.  »-j 

Pulv.  amyli, 

Zinci  oxidl aa os.  n 

M.    Fiat  puWer. 
.flkr.    Apply  locally  as  directed. 

The  old  lead  and  opium  wash  is  a  good  anti- 
pruritic, especially  when  modified  as  follows : 

a  TInct  opll -o«.  8B-0Z.  i 

Bpts.  camptkons „ oz.  m 

Liquurisplambiaubaoetatlg. dr.  i-dr.  11 

01)cerini. o«. « 

Aqoffi,  q.  8.,  ad 08.  Til] 

M.    8ig.    For  external  use  only. 

This  lotion  may  be  applied  continuously  on 
gauze  or  linen,  and  is  usually  very  agreeable  to 
itching  surfaces. 

Distilled  extract  of  hamamelis  may  be  men- 
tioned as  an  anti  pruritic  of  special  value  for 
itching  about  the  eyes  and  other  portions  of  the 
face. 

For  eczema  of  the  face  and  especially  that  of 
the  eyelids  (eczema  palpebrarum)  there  is  noth- 
ing superior  to  an  ointment  of  the  yellow  oxide 
of  mercury.     It  may  be  prepared  thus : 

B   Hydrai^,  oxide  flay „ gr.  ij-iv 

VaMllne „ dr.  IJ 

Misce  bene.   Flat  ungt. 
BIjr,    Apply  locally. 

This  ointment  may  be  rubbed  upon  any  por- 
tion of  the  face,  even  into  the  eyes.  As  with  all 
mercurial  ointments  only  a  small  amount 
should  be  applied  at  a  time. 

Dr.  Dawson  will  find  diluted  alcohol  or 
whiskey  excellent  for  preventing  catching  cold 
after  taking  warm  baths.  It  should  be  rubbed 
well   into  the  skin  with  the  uncovered  hands. 

J.  HoBART  Egbert,  A.M.,  M.D.,  Ph.D., 

118  South  street,  Holyoke,  Mass. 


Medical  Mention. 

Editor  Medical  World  :— If  H.  K  K,  M. 
D.,  (page  20),  will  take  two  one  grain  tablets  of 
sulpho  carbolate  of  zinc  every  two  hours,  I 
think  he  will  be  relieved  of  liquid  stools  and 
offensive  discharges  in  a  very  short  time. 

Ten  grain  doses  of  subgallate  of  bismuth,  or 
"  dermatol,"  afrer  each  meal  will  have  the  same 
effect  The  former  is  the  cheapest  remedy. 
For  the  dizziness  and  cold  feet  he  can  take  the 
following : 

R.    Specifle  tr.  nux  vomica.  (Lloyd's) ..„ 

Specific  tr.  belladonna,  (Lloyd'8)..aa...dram  m 

Simple  svrup. ounces  v) 

M.    8ig.    Hair  teaspoonful  every  two  or  ihKehoura. 

It  should  be  continued  for  several  wee  ks  in 
order  to  obtain  the  full  benefit.  If  the  bella- 
donna causes  dryness  of  the  mouth  or  dilatation 
of  pupils,  the  dose  should  be  lessened  or  sus- 
pended until  those  toxic  effects  pass  away. 

Belladonna  in  minute  doses  is  one  of  the 
best  remedies  for  cnronic  costiveness  that  I  know 
of.  One  tenth  of  a  drop  of  the  specific  tincture 
every  two  hours  and  continued  for  from  two 
to  six  weeks  generally  results  in  success 

The  patient  should  imbibe  plenty  of  fluid 
and  should  go  to  stool  at  a  certain  hour  each 
day,  whether  Nature  calls  or  not 

I  agree  with  the  Editor,  (page  3)  when  he 
says  "  Atropine  is  the  quickest  and  most  valu- 
able remedy  known  in  surgical  shock  and  in  those 
conditions  in  disease  which  resemble  it,  in  the 
stage  of  collapse  in  cholera  and  cholera  infitn- 
tum." 

I  get  better  results  from  it  than  from  whisky^ 
brandy,  nitro-glycerine,  etc. 

Those  conditions  are  known  by  the  pale,  cold 
surface,  cold  extreme  ties  and  blueneas  of  lips 
and  nails. 

The  dose  of  Atropine  should  be  very  small 
and  given  hypodermatically  at  first,  1-200  to 
1-60  grain. 

The  belladonna  paralyzes  the  nerves  distrib- 
uted to  the  circular  fibers  of  capillaries  and 
arterioles  and  relieves  the  over-worked  heart. 

Digitalis  seems  to  have  the  opposite  effect 
and  produces  a  slower  action  and  a  stronger 
impulse  because  the  capillaries  are  more  or  less 
completely  closed  and  the  circulation  obstructed 
and  the  strong  impulse  is  mistaken  for  a  better 
pulse  in  those  cases. 

Does  gonorrhea  cause  sterility?  Certamly, 
but  only  in  those  cases  where  the  salpingitis 
closes  the  fimbriated  extremity  of  the  fallopian 
tube  and  the  ovum  does  not  enter  the  tube. 
That  is  the  reason  prostitutes  are  sterile. 

They  menstruate  r^ularly  or  irregularly 
but  they  do  not  conceive. 

Gonorrheal   orchitis  causes  sterility   in   the 


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anale  when  it  prevents  the  flow  of  seminal  fluid. 
A  good  many  marriages  are  not  fruitful,  be- 
*cause  the  husband  ate  *^  forbidden  fruit "  before 
marriage.  If  he  carried  gonorrhea  to  his  wife 
-she  might  become  sterile. 

Not  long  since  a  case  came  to  me  in  which  a 
joung  man  seduced  a  young  woman.  He  not 
only  impregnated  her,  but  he  gave  her  gonor- 
rhea. She  aborted  at  five  months.  Then  fol- 
lowed pyo-salpingitis  and  all  that  long  train  of 
<evih.  She  has  been  and  probably  always  will 
be  an  invalid.  "  The  wages  of  sin,  etc." 
Rensselaer,  Ind.  J.  B.  Washburn,  M.D., 
[In  our  experience  the  doses  of  atropine  sug- 
gested by  the  Doctor  would  not  prove  to  be 
very  small,  but  rather  fair-sized  doses,  espec- 
ially if  given  hypodermically.  Also,  while 
prostitutes  use  every  precaution  against  concep- 
tion, yet  many  of  them  do  conceive.  The  Doc- 
tor's reasoning  in  regard  to  the  action  of  gonor- 
•arheal  inflammation  is  quite  correct. — Ed.] 

Replies  to  Queries. 
Editor  Medical  World  : — If  Dr.  Bronson 
-will  view  his  case  in  the  light  of  intestinal  indi- 
gestion, use  lactopeptine  with  subnitrate  of  bis- 
muth, or  some  good  pepsin  and  bismuth  com- 
pound or  "pan  peptic  tablets,"  I  think  he  will 
-do  about  right  I  have  treated  these  chronic 
enteric  troubles  as  dyspepsia,  and  have  been 
'very  successful.  Most  of  them  originate  in  a 
lack  of  secretion  of  the  acid  of  the  stomach.  He 
will  find  the  following  a  good  form : 

Nitric  acid - }4  oz 

MuriaUoacld H  ost 

Sulphate  of  iron 40  to  50  frr 

Mix  and  let  stand  twenty-four  hours  before  dispensing. 

Sig    <^ive  ten  drops  in  one-half  glass  of  sweetened  water 
«fteT  each  meal. 

H.  L.  K.,  M.D. — I  think  this  case  is  some, 
what  of  the  same  character  as  the  above.  In  his 
<»tse  I  would  add  to  the  above  treatment  salol, 
five  grains,  three  times  a  day,  one  hour  before 
^eating,  in  capsule. 

Dr.  Manty  should  try  Dr.  Bulkley's,  of  N. 
Y.,  treatment  Paint  one  half  of  the  surface 
with  pure  carbolic  acid,  full  strength.  When 
this  has  commenced  to  peel  off,  paint  the  other 
half.  By  the  time  half  No.  2  has  peeled  off 
No.  1  will  be  ready  for  a  repetition.  Dr.  Bulk- 
ley,  in  the  article  I  read,  claims  splendid  suc- 
cess. I  tried  it  in  one  case,  the  only  one  that  I 
had,  and  it  did  well. 

''Medico"  has,  I  judge,  a  cajse  of  spasmodic 
closure  of  the  spincter  of  the  bladder  from  irri- 
tation, with,  say  about  one  and  a  half  inches  of 
the  inner  surface  around  the  sphincter,  subacute 
but  enough  to  cause  sensitiveness  of  the  neck 
and  exit  If  I  were  attending  it  I  would  inje3t 
into  the  bladder  about  four  ounces  of  the  fol- 
lowing solution  twice  a  week : 


Nitrate  sUver ^ - 10  gr 

Water  (warm) « „...«4  oz 

To  be  injected  through  a  catheter,  allowed 
to  remain  for  a  few  seconds  and  run  ofi  through 
the  catheter,  which  has  not  been  removed.  In- 
ject while  in  a  reclining  position  and  standing 
or  squatting,  when  it  passes  off.  On  each  inter- 
vening day  the  following : 

Gallic  add 1  tablespoontul 

Boric  acid 1  teaspoonfhl 

Warm  water ^ „ 4  ounces 

Let  remain  for  several  minutes — say  ten  or 
more,  and  pass  off  as  above.  She  should  be  in- 
structed to  pass  her  water  regularly  every  three 
or  four  hours,  not  to  drink  coffee,  except  at 
breakfast,  and  if  compelled  to  use  a  catheter,  to 
be  instructed  how  to  use  it  herself.  At  some  time 
she  has  allowed  the  urine  to  over  distend  the 
bladder,  and  it  has  somewhat  lost  ite  elasticity. 
Sanmetto  is  a  very  good  addition  to  the  above. 

I  will  add  that  I  am  having  good  success  with 
my  pneumonia  and  grippe  cases  with  the  fol- 
lowing : 

Chloride  of  calclam 5  gr 

Dover's  powder 1  to2gr 

Every  two  or  three  hours  in  powder  or  solution. 

The  calcium  I  saw  recommended  recently, 
and  have  treated  all  of  my  cases  this  winter, 
some  thirty  odd.  This  added  to  "anti  kamnia'' 
or  *  analgesine,"  as  a  sedative,  in  place  of  the 
old  carbonate  of  ammonia  and  morphine  treat- 
ment.   Don't  forget  to  feed  every  time. 

Brodnax,  La.       Dr.  Ben.  H.  Brodhax.  . 

Editor  Medical  World  : — On  page  19,  of 
January  World,  Dr.  Bronson  requested 
treatment  for  his  wife.  I  would  suggest  that  the 
doctor  give  her  a  teaspoon  one  quarter  full  of 
Wm.  S.  Merrell's  colorless  hydrastis  in  a  little 
water  before  each  meal,  and  a  teaspoon  quarter 
full  of  a  powder  composed  of  sub-nitrate  of  bis- 
muth and  ingluvin — three  parts  of  bismuth 
and  one  part  ingluvin  in  a  little  water  directly 
after  each  meal.     I  think  it  will  meet  her  case. 

Jefferson,  Md.  I.  I.  Culler. 

Editor  Medical  World  :--Say  to  Dr. 
Bronson  in  answer  to  his  case  related 
in  January  number,  page  18,  that  the 
cause  of  the  diarrhea  is  want  of  assimilation  and 
the  fault  is  more  than  likely  in  the  mesenteric 
glands,  and  that  cod  liver  oil  and  beech  wood 
creasote  will  benefit  his  patient  The  cause  may 
possibly  be  turbercle.  Dr.  C.  R.  Johns, 

Athens,  Tex. 

The  Best  Treatment  for  Tapeworm. 

Editor    Medical    World: — On  page  51, 

Feb.  No.,  R  Hertig,  M.D.,^  asks  for  the  beet 

treatment  for  tapeworm : 

R   So't  capsules  of  kamala  and  male  fern, 
(Parke,  Davis  &Co) I  dos 

All   the   preparation  necessary  is  that  your 


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fntient  eat  no  supper,  and  on  retiring  take  a  full 
dose  of  castor  oil.  The  next  morning,  after  the 
bowels  have  moved  thoroughly,  give  six  of  the 
above  capsules;  in  half  an  hour  give  six  more, 
followed  by  oz.  ss.  castor  oil.  In  two  or  three 
hours  you  will  have  the  tapeworm.  The  above 
treatment  has  been  successful  in  five  cases;  in 
one  case  after  six  other  physicians  had  failed. 
Only  in  one  of  the  above  cases,  did  I  have  to 
rep^  the  treatment  a  second  time,  and  that 
was  not  the  one  in  which  the  other  physicians 
iiad  faUed.  J,  H.  Travis,  M.D., 

Elsie,  Mich. 

For  Suppression  of  Urine.  * 
Editor  Medical  World  : — Please  find  en- 
closed prescription  for  the  benefit  of  my  brother 
M.D.  signing  himself  "Medico"  and  his  case  of 
euppreasion  of  urine.  I  have  a  lady  patient 
whose  ailment  is  very  similar  and  has  been  for 
some  time,  but  immediate  relief  is  always  ob- 
tained by  a  few  doses  of  the  prescription  here- 
with given.  She  is  extremely  neurotic,  especi- 
ally when  suppression  of  urine  makes  its  ap- 
pearance, but  as  she  keeps  her  little  two-ounce 
mixture  on  hand  she  finds  it  a  sheet  anchor  to 
relief. 

K   Fl.ext,  ffelteminam „ dr.  in 

Tinot.  henbane dr.  Ill 

Bi-Urt.  potass dr.  U 

PL  ext.  belladonnsB Gtt.  xvl 

PI.  ext,  bnchn „ oa.  n 

Aqua  camphor  q.  i.  ad- \oz.  11 

M.  BiK.  Teaspoonfnl  In  a  wine  glassful  of  water  three 
times  a  day  till  relioFed,  then  lest.  ' 

I  always  advise  them  to  watch  the  effects  of 
fl.  ext  gelseminum.     James  Lister,  M.D., 
Brown  City,  Mich. 

Editor  Medical  World  : — Dr.  J.  C.  Camp- 
bell, of  Albany,  Vermont,  calls  for  help.  I  will 
give  him  my  treatment,  which  has  cured  a 
great  many  cases  similar : 

R.    Santonlne viU  grs 

Granulated  sugar ij  drams 

Mix  thoroughly  by  trituration  and  divide  in  sixteen  pow- 
ders. Olve  one  powder  every  three  hoars  first  day; 
•eoond  day  give  one  powder  every  four  hours ;  third  day 
give  thret)  nowders ;  on  the  fourth  day  give  one  powder 
morning  and  night. 

At  the  same  time : 

R.   Tine,  rhus  aromatlca,  (Parke,  Davis  &  Co) 

Give  twenty  drops  three  times  each  day. 

Dr.  C.  try  it,  you  .will  be  more  t^n  pleased 
with  the  result.  Let  me  hear  from  you 
through  The  Medical  World. 

J.  B.  Mobley,  M.D., 

Wichita  Falls,  Texas. 


Editor  Medical  World  :--Yoar  new  title  design 
18  an  improvement  on  the  old.  It  is  not  the  outside 
that  I  anxiously  await^every  month,  it  is  the  valuable 
information  containedln  the  inside  that  I  appreciate. 
Ths  World  is  the  first  I  refer  to  for  sound,  practical 
information.  I  hope  it  is  of  as  much  benefit  to  all  of 
its  readers  as  it  is  to  me.  Db.  L.  B.  Bioblow, 

Globe  Villmge,  Mass. 


Cord  Five  Times  Around  the  Neok. 

Editor  Medical  World  : — I  have  noticed 
in  the  last  few  numbers  of  The  World  a  number 
of  communications  referring  to  cord  around  the 
neck,  and  in  this  connection  I  wish  to  report 
the  following  case : 

I  was  called  at  about  5  a.  m.,  January  8, 
1892,  to  attend  Mrs.  F.  in  her  fourth  confine- 
ment Patient  was  a  large,  healthy  woman, 
with  a  roomy  pelvis,  and  I  expected  to  get 
away  in  a  short  time.  The  pains  were  good, 
yet  the  labor  lingered  throughout  nearly  the 
whole  day,  and  at  4  p.  m.,  a  nice,  plump, 
healthy  eight-pound  girl  was  born,  but  with  the 
cord  wrapped  five  times  around  the  neck,  com- 
pletely filling  the  space  from  sternum  to  chin. 
The  child  was  but  partially  asphyxiated  and  ia 
ten  minutes  was  crying  lustily.  The  cord  was 
longer  than  usual  but  I  did  not  measure  it 

Wood  River,  Neb.    J.  P.  Riddile,  M.D., 


For  Diurnal  Enuresis. 

Editor     Medical    World: — Dr.    D.    G. 
Smith,  of   Filley,   Neb.    (February  World, 
page  51),  ought  to  give  the  boy  small  doses  of 
phosphate  of  potassium;  four  doses  daily  for  a 
week.  Dr.  C.  F.  Kucihler, 

Springfield,  Ul. 


Editor  Medical  World  : — Let  Dr.  H.  L. 
K  (see  January  World,  page  20)  try  the 
following,  viz: 

R   Tr  blue  flag dr.  I 

DtaUlled  water oe.  vU 

Alcohol oz  iSB 

R.    Sig.    Ttjaapoonful  every  three  hoars  in  day  time,  a«d 
1-20  grain  of  strychniae  hypo-phoephite  at  bed  time. 

If  this  fails  then  : 


R    PodophTllin. 
ohol. 


Alcohol oz.  SB 

DistlUed  water oz.  si 


Si;.  Fivedrora  every  three  hours  daring  the  day,  and  1-41 
grain  of  calomel  triturated  with  sngar  at  bed  time.  Take 
every  morning  a  oold  bath  or  sponging,  and  use  a  very  ooane 
towel  to  cause  good  reaction. 

Do  not  forget  that  secret  opium  or  morphine 
consumers  will  often  ipso  facta  suffer  from  de- 
ranged functions  of  the  liver. 

Evansville,  Ind.  J.  Pirnat,  MD., 


Eozema. 
Editor  Medical  World: — If    Dr.   Pinee 
will  treat  the  case  he  speaks  of   (page  51,  Feb. 
No.)  as  follows : 

R.    NaphthaUne 1 

Vaseline dr.  It 

M.    Mix  by  lubbing  thoroughly  In  moriar. 


Sig  AppU  over  tne  eruptions  morning  and  evening;  waah 
the  affected  parts  thoroughly  with  water  as  hot  as  can  be 
borne  and  castUe  soap  before  each  application. 


Afl^r  using  the  above  for  three  or  four  days, 
and  after  the  scaly  crusts  have  all  or  nearly  all 
dropped  off,  apply  balsamum  peruviaum,  a.  q.  s. 
each  night  at  bed  time,  washing  the  face  eaok 


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morning  with  soap  and  water  as  above.  After 
trying  various  remedies  for  years  I  hit  upon  the 
above,  and  ihey  have  never,  as  yet,  disappointed 
me.  There  is  no  need  of  internal  medication, 
unless  to  meet  special  indications. 

Geneva,  Iowa.  C.  H.  Tidd,  M.D. 


Twins. 

Editor  Medical  World  : — As  other  physi- 
cians are  giving  their  experience  to  the  craft  in 
r^ard  to  **  twins, "  I  have  a  case  in  mind  that 
may  present  several  points  of  interest 

While  I  was  practicing  in  Western  Kansas, 
A  Mr.  £.  drove  in  from  his  home  in  the  coun- 
try, a  distance  of  eight  miles,  with  a  lumber 
wagon  and  slow  team.  He  arrived  at  my 
office  at  eleven  o'clock,  a.  m  ,  and  informed  me 
that  his  wife  had  been  confined  that  morning 
and  at  eight  o'clock  was  'delivered  of  a  fine 
boy;  that  the  patient  was  resting  easily,  but 
the  afler -birth  was  not  yet  delivered  and  they 
required  my  assistance.  I  repaired  to  his  resi- 
dence with  due  dispatch,  arriving  a  little  after 
twelve  o'clock,  noon.  Two  old  ladies  were 
present  who  had  undertaken  the  accouchement. 
I  found  the  patient  resting  comfortably  with  a 
nice  boy  properly  cared  for. 

The  patient  informed  me  that  she  had  had 
but  few  pains  since  her  ehild  was  born.  Upon 
examination  I  found  there  was  another  child 
yet  to  be  bom,  and  so  informed  the  patient 
She  seemed  much  surprised.  I  gave  her  ten 
grains  of  quinine,  then  waited.  Soon  very  satis- 
factory pains  were  established  and  I  found  there 
was  a  breech  presentation.  All  the  soft  parts 
being  in  a  relaxed  condition,  I  made  no  at- 
tempt to  change  the  position.  At  two  o'clock 
another  nice  boy  was  bom,  weighing  six  pounds, 
the  first  one  weighing  seven.  There  were  separ- 
ate placentas.  The  first  was  delivered  soon 
aiter  the  second  child.  Pains  were  re-estab- 
lished, but  I  found  that  at  each  pain  the  remain- 
ing cord  receded  instead  of  advancing.  The 
patient  complained  that  each  pain  gave  her 
great  pressure  against  the  stomach.  Gentle 
traction  on  the  cord  did  not  seem  to  assist  mat- 
ters any,  then,  by  following  up  the  cord,  during 
a  pain,  I  found  an  isthmus  in  the  uterus  too 
narrow  to  even  introduce  a  finger.  Each  pain 
seemed  to  carry  the  uterus  higher.  I  found 
that  I  could  not  easily  secure  the  placenta  when 
the  utems  was  contracted,  therefore  waited  un- 
til it  was  relaxed  when  I  introduced  my  hand 
and  fore  arm  nearly  to  the  elbow.  I  found  the 
placenta  floating  very  placidly  in  the  upper 
portion  of  the  metra,  just  under  the  stomach.  It 
was  readily  removed  and  the  uterus  immediately 
contracted.     There  was  a  minimum  amount  of 


hemorrhage  at  either  birth.  The  mother  made 
a  very  satisfactory  recovery  and  the  twin» 
thrived. 

I  consider  the  case  unique  in  several  particu- 
lars :  The  lapse  of  time  betwe€n  the  first  and 
second  birth  ;  the  intervening  rest ;  the  separate 
placentas  ;  the  complete  hour  glass  contraction  ; 
the  high  position  attained  by  the  uterus  in  the 
abdominal  cavity  and  the  small  amount  of 
hemorrhage  for  such  a  complicated  and  pro- 
vacted  confinement. 

There  has  recently  been  much  discussion 
through  your  valuable  joumal,  in  regard  to  the 
use  of  the  forceps  and  vaginal  irrigation  in 
obstetrics.  For  myself,  I  can  say  that  in  a 
practice  of  many  years  I  have  rarely  found  it 
necessary  to  use  the  forceps.  I  believe  that  the 
forceps  has  more  often  been  a  source  of  harm 
than  an  instrument  of  good.  Their  use  is  often 
resorted  to,  especially  by  young  physicians,  when, 
if  the  physician  would  have  a  little  patience, 
encourage  his  patient,  lend  a  helping  hand 
wherever  he  can  assist  her,  and  manage  to  keep 
all  other  attendants  and  spectators  busy,  he  will 
not  have  need  to  resort  to  forceps.  Then  after 
delivery,  if  he  will  satisfy  himself  that  the  uterus 
is  firmly  contracted,  and  it  and  the  vagina  well 
cleared  of  all  shreds  of  the  chorion  and  decidua, 
clots  of  blood  or  other  debri?,  he  need  have  but 
little  apprehension  of  results.  This  may  be 
done  by  the  practiced  finger  without  irrigation 
or  exposure  of  patient  Of  course  the  patient 
should  be  thoroughly  bathed  with  warm  anti- 
septic water,  her  clothing  and  her  bed  made 
clean  and  comfortable,  antiseptics  applied  to  the 
vulva  on  ample  absorbent  napkins  and  the 
vagina  and  uterus  left  to  the  provinons  of 
nature.  The  practice  of  vaginal  and  uterine 
irrigation  after  parturition  is  most  pernicious 
and  has  been  the  source  of  many  cases  of 
metritis,  peritonitis  and  salpingitis.  The 
trouble  is  largely  due  to  the  teachings  of  pro- 
fessors of  obstetrics  in  the  medical  coliegea,  who 
teach  too  much  what  to  do  and  not  enough  of 
what  not  to  do.  D.  D.  Ross,  M.D., 

Davenport^  Iowa. 


Large    Twins. 

Editor  Medical  World  : — In  the  January 
World  I  noticed  F.  W.  B.  (page  11),  refers 
to  Dr.  L.  Rupert's  large  pair  of  twins,  and  dtee 
a  case  in  hisoien  practice. 

Now,  I  do  not  think  7}  and  8}  pounds  an 
unusual  weight  for  twins,  but  am  frank  to  ad- 
mit that  I  do  not  just  now  know  the  average  or 
usual  weight,  as  I  have  kept  no  record,  and 
weighed,  I  believe,  but  one  pair. 

This  was  a  case  which  I  attended  three  yean 


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ago  near  Dillsburg,  Pa.  The  first  was  a  head 
presentatioiL  In  the  second  one  the  legs  de- 
parted from  the  abdomen,  and  I  had  a  feet  pre- 
sentation. I  hastened  delivery  and  barely  suc- 
oeeded  in  rcsusitating  it  from  asphyxia. 

They  were  both  girls,  and  each  weighed  pre- 
daely  10}  pounds— twenty-one^ pounds  in  all. 
But  now  came  the  most  perplexing  trouble — in 
looks  and  form  they  were  idenficaL  We  got 
them  mixed,  and  could  not  tell  which  was  bom 
first  The  mother  guessed  at  it  and  we  tied  a 
ribbon  around  its  wrist  so  that  the  mother  could 
identify  it  It  was  months  before  the  mother 
oonld  see  any  difference.  I  see  Ihem  frequently 
and  yet  can  see  no  difference. 

Boiling  Springs,  Pa.     Dp.  M.  R.  Petebs, 

Twins. 

Editor  Medical  World: — I  see  in  The 
World  that  my  brother,  of  Rupert,  W.  Va., 
also  F.  W.  B.,  have  reported  each  a  case  of 
twins.  I  think  I  can  beat  either  of  them. 
April  23,  1892,  I  delivered  Mrs.  M.  of  twins, 
boys,  weight  8^  and  9i  pounds,  with  two  after 
births,  two  distinct  bags  of  water.  The  second 
birth  was  same  as  normal  labor  of  only  one 
child;  nothing  to  indicate  that  one  had  just  been 
bom. 

Why  is  it  said  that  an  eight  month  child  sel- 
dom lives?    I  must  believe  the  siyingatrue 
ona  from  experience  I  have  had  with  such. 
L.  P;  Rupert,  MD., 

Nuttallburg,  W.  Va. 

A  Large  Pair  of  Twins. 

Editor  Medical  World: — On  October  9th, 
1893,  my  wife  presented  me  with  a  fine  pair  of 
twin  l)oys,  both  healthy  and  beautifully  formed. 

The  first,  the  smaller,  was  a  footling  presen- 
tation and  weighed  9i  pounds,  the  other,  head 
presentation,  weighed  10}  pounds,  (after  they 
were  dressed). 

There  were  two  distinct  placentas,  one  lo- 
cated at  the  fundus  and  the  other  on  the  left 
aide.  When  contraction  came  on  after  the  sec- 
ond stage  was  over,  the  placenta  on  the  side  was 
detached  and  expelled  naturally.  Then  came 
on  a  severe  hemorrhage.  There  was  central 
or  hour  glass  contraction,  with  the  other  plac- 
enta shut  in.  By  giving  chloroform  and  the 
manual  efforts  of  Dr.  W.  R  Temple,  we  suc- 
ceeded in  its  removal  The  mother  had  a  fair 
recovery.  Both  babes  did  well  until  the  5th 
night,  when  both  were  taken  suddenly  and  S3- 
TOTely  frick.  One  died  when  ten  days  old,  and 
the  other  when  nineteen  days  old,  of  what  my- 
self and  Dr.  W.  R.  Temple  thought  to  be  men- 
ingitis. The  World  is  a  welcome  visitor  to 
mcL  '  N.  M,  Spradley,  M.D., 

Belyin,  Ind. 


Was  it  Hepatic  Absoess  ? 

Editor    Medical    World: — I   was  called 

June  15,  1^93,  to  eee  Mrs.  D .     She  gave 

me  the  following  history  of  her  case  :  She  had 
been  confined  to  bed  for  three  months  with 
severe  pains  in  right  side,  passed  a  good  deal  of 
blood  from  her  bladder  at  the  beginning  of  her 
illness,  and  had  been  visited  by  three  doctors^ 
but  was  growing  worse. 

On  examination  I  found  over  the  hepatic 
region  tenderness  and  considerable  pain.  The 
area  of  hepatic  dullness  extended  over  the  right 
hypochondriac  lumbar  and  part  of  the  iliac 
region,  reaching  to  the  linea  alba  from  the  en- 
siform  cartilage  to  the;  lower  margin  of  the  um- 
bilical r^ion.  She  haid  a  cadaveric  appearance, 
dry  skin,  torpor  of  bowels ;  had  not  sweat  any 
during  her  sickness  and  wAs  taking  but  little 
nourishment     I  gave  her  : 

R   F1.  ext.  culvers  root ce,  1 

Hyrnp  iodide  of  ifton - oi.  1 

Iodide  potaoium ^,. -ob.  % 

PI.  PTU  Mkrpftparllla <»«.  1 

Good  Whisky  to  make q.l 

Bi.  Biff.  Take  half  to  oae  tableRDOonful  half  hoar  after 
xneabithreeilmeBadav.  One  graDUle  of  calomel.  one-«4xth 
fe  f  a  grain,  before  meau.  Oave  mori  hine  and  andouea  fer 
pain  and  to  give  rest  Directed  poultice  over  hepaUc  region. 

I  saw  her  again  on  the  22d;  found  her 
boweli  in  a  lax  condition;  appetite  improving, 
and  she  was  perspiring  freely,  but  there  was  no 
improvement  in  pains  and  induration  of  the 
right  side.  In  lieu  of  the  poultice,  I  used  fly- 
ing blisters  over  the  hypochondriac  region,  and 
I  kept  up  an  irritation  for  ten  days.  At  this 
time  I  found  fluctuation.  On  introducing  ex- 
ploring needle  I  found  pus.  I  gave  her  about 
two  ounces  of  good  whisky  and  plunged  my 
lance  into  the  lower  margin  of  the  right  hypo- 
chondriac region.  There  run  from  th^  incision 
fully  one  pound  of  pus. 

In  four  or  &ve  day  s  she  turned  over  on  her 
right  side  and  rested  quietly  for  the  first  time  in 
two  months.  She  regained  her  health  rapidly 
and  was  out  of  bed  in  two  weeks. 

One  number  ot  The  Medical  World  has 
wrought  me  a  lucrative  practiee. 

J.  W.  Shemwell,  M.D.,  • 

Bumpus  Mills,  Tenn, 


Editor  Medical  World: — Mrs.  BL,  age 
22,  Primipara,  was  taken  in  labor  at  term  at  1 
A.  M.,  January  11th.  Slight  regular  pains  all 
day.  I  saw  her  at  8  p.  h.  Membrane  had 
ruptured  ;  os  had  not  dilated  ;  head  down,  but 
not  engaged;  great  sensitiveness  of  external 
genitals  and  vagina  ;  antero-posterior  flattening 
of  pelvis  to  about  2i  inches.  Pains  regular 
and  increasing  in  strength  all  night  Thirty 
grains  chloral  per  rectum  helped  dilatation  of 
cervix.     At  6  A.  m.  dilatation  was  complete, 


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pains  veiy  seveFe,  still  great  vaginal  sensitive- 
ness of  apparently  nervous  origin.  Gave  chloro- 
form during  pains  till  10  A.  m.  No  progress, 
owing  to  extreme  sensitiveness  of  vaginal  mus- 
cles causing  contraction  at  the  slightest  touch. 
I  was  not  quite  sure  of  exact  condition,  so  I 
gi^e  chloroform  to  full  anesthesia,  then,  though 
head  was  free  above  the  brim,  I  tried  forceps 
delivery.  That  failing,  I  sent  for  help,  and  at 
one  p.  IL,  assisted  by  Dr.  B.,  performed  cranio- 
tomy. After  evacuating  the  contents  of  the 
skull  and  crushing  the  bones,  the  contraction 
was  so  great  that  Dr.  £.  had  still  great  diffi- 
culty in  delivering  the  head.  A  bichloride 
1-2000  douche  was  given  before  the  operation, 
and  one  of  boiled  water  after.  Perineum  was 
ruptured,  requiring  deep  silver  sutures.  Patient 
rallied  well.  After  twenty-i  our  hours,  urinated 
while  having  a  douche,  without  catheter.  Tem- 
perature never  rose  above  99^  F.  The  breasts 
are  normal  and  fairly  well  developed.  The 
patient  has  always  been  healthy,  and  yet  there 
has  been  absolutely  no  secretion  of  milk.  Treat- 
ment consisted  of  liquid  diet,  and  bichloride 
douche,  1-6000  twice  a  day.  One  ten-grain 
dose  of  antikamnia  in  headache  the  second  day. 
January  29ih,  patient  is  as  well  as  any  woman 
after  ordinary  confinement. 

What  was  the  cause  of  no  milk,  and  is  not 
such  absence  of  secretion  uncommon,  unless 
measures  are  taken  to  prevent  the  flow  of  milk  ? 

Nashua,  N.  H.         R  Blaylock,  M.D., 


Praotfoal  Experience  With  Tonsilitis. 

Editor  Medical  World  : — I  have  been  suf- 
fering from  yearly  attacks  of  tonsilitis  for 
twenty  years,  frequently  having  it  every  fall 
and  spring.  Have  had  it  so  severely  that  the 
sense  of  suffocation  was  almost  unbearable,  and 
as  I  advance  in  years  the  attacks  are  more 
acute.  To  prevent  these  attacks  coming  on  I 
have  tried  various  remedies,  with  but  little 
effect  in  ameliorating  the  disease.  T  had  be- 
come so  familiar  with  the  prodromic  symptoms 
that,  as  soon  as  frontal  headache,  nausea,  tongue 
coated,  bowels  constipated  and  rheumatic  pains 
oame  on,  before  tlte  tonsils  became  inlarged  I 
would  say,  an  attack  of  quinsy  is  coming  on. 
About  a  month  ago  these  symptoms  made  their 
appearance  and  the  thought  occurred  to  me, 
make  an  effort  to  abort  it  with  hydrarg  sub- 
mur.  Acting  on  the  suggestion  I  took  at  night 
four  tablets,  grains  ij,  each,  and  the  following 
morning  two  more,  at  the  same  time  using  a 
gargle  of  ammoniated  tincture  of  guaiac 
and  milk.  To  my  surprise  and  joy 
the  symptoms  aborted,  engorgement  of  ton- 
sils    and      uvula      subsided,      but    I 


left  with  a  salivated  /taiouth,  gums  blme^ 
teeth  loose  and  ulceration  of  mucous  membrane 
of  the  internal  portion  of  the  mouth,  which  pre- 
vented me  from  masticating  food  for  several 
days.  This  I  cured  by  a  strong  wash  of  potas- 
sium chlorate  and  tincture  of  mynh.  Was  the 
effects  of  treatment  worse  than  the  disease?  No. 
Try  it,  all  those  who  have  Buffered  from  periodi- 
cal attacks  of  the  disease,  and  they  will  answer 
in  the  affirmative. 

Brothers  of  Thb  Medical  World,  come  te 
my  rescue,  and  give  me  the  best  treatment  thai 
you  have  tried  with  success  in  a  case  of  a  child  of 
my  own,  which  I  diagnose  eczema.  The  child  is  4 
years  of  age,  no  scrofulous  or  syphilitic  taint* 
About  one  and  a  half  years  ago  he  broke  oat 
with  red  spots  in  the  flexures  of  joints  of  arms 
and  legs,  on  the  wrists,  which  would  spread, 
coalesce,  weep  a  thin  watery  secretion,  scab  over, 
dry  up  in  the  day  time,  and  break  out  again  at 
night,  with  intolerable  itching  at  night  One 
wrist  has  suppurated.  No  eruption  on  scalp,  but 
now  some  on  ftice.  To  tell  the  remedies  I  have 
tried  would  be  to  mention  all  the  alteratives, 
washer  and  ointments  enumerated  for  eczema.  I 
can  dry  it  up  and  think  my  child  h  recovering, 
when  to  my  disappointment  it  will  break  out 
again  with  renewed  force.  I  am  going  to  use 
red  oxide  of  mercury  ointment;  have  been 
detered  from  doing  so  fearing  salivation  from 
absorption  of  the  mereury. 

You  can  see  my  interest  in  the  case,  so  I  feel 
that  all  the  readers  of  our  medided  society 
(for  The  World  is  this  to  the  busy  country 
practitioner)  wiU  come  to  my  rescue. 

Chester,  Nova  Scotia.     J.  Formaw  Pineo. 


Quii;  Qepartment. 


Quettiotis  are  adUdted  for  this  Coltmm.  Communication* 
not  accompanied  by  the  f>roper  name  and  addrvaa  of  the 
writer  (not  necessarily  for  publication),  will  not  be 
noticed. 

The  srreat  number  of  requests  fbr  priivate  answers,  for  the 
information  and  benefit  of  the  writer,  makes  it  nrcess 
ary  for  us  to  char;^  a  fee  for  the  time  required.    This 
fee  will  be  from  one  to  five  doUam,  accoidlng  to  tlie 
amount  of  research  and  writing  reqvired. 


Eclampsia. 

Editor  Medical  World: — Will  some  one 
of  the  able  writers  of  The  World,  give  me  a 
few  suggestions  of  advice.  ^T> 

A  woman  20  years  of  age,  plethoric,  had 
convulsions  fourteen  months  ago,  continuing 
twenty-four  hours,  attacks  lasting  f^m  a  second 
to  a  few  minutes  each.  Of  these  convulsive 
attacks  during  the  twenty-four  she  had  ^any. 
She  finally  gn^t  birth  to  a  seven  months  fetoa. 


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She  is  agaan  pregnant,  and  has  had  the  same 
oon vulsive  attacks  for  twelve  hours,  with  vertigo, 
aevere  headache,  and  nausea  vomiting. 

Most  of  the  time  she  is  unconscious  and  does 
not  know  what  has  transpired;  seven  days  after 
this  attack  her  urine  contained  much  albumen, 
test  lube  one-third  full.  Os  and  cervix  were 
dilated  so  as  to  admit  the  finger.  She  suffers 
headache  at  all  times  in  or  out  of  pregnancy. 
Convulsions  only  during  pregnant  state.  I  am 
anxious  in  r^ard  to  her.  Safety  should  the  con- 
vulsions come  on  in  the  first  stage  of  labor  shall 
I  induce  labor  or  shall  I  wait?  Suggestions  from 
able  men  are  highly  appreciated. 

Toronto,  8,  D.         G.  M.  Morton,  M.D., 


Editor  Medioal  World  : — Will  you  kindly 
give  me  a  word  of  advice.  I  have  a  case  of 
chronic  eczema  in  an  infant  of  9  months  which 
so  far  has  resisted  all  treatment  Just  as  I 
think  the  case  is  well  under  control  then  comes 
another  crop  of  vesicles  which  burst  and  the 
irritation  is  started  all  over  again.  Have  used 
salves,  powders,  soaps,  lotions,  etc.,  ad  nauseam. 
Treatment  now  consist  of  solution  of  chloride  of 
arsenic  and  tincture  ferri  chloride  internally. 
Vesicles  are  picked  with  a  needle,  contents  ab- 
sorbed with  sponge  as  far  as  possible,  parts 
dusted  freely  with  sub- nitrate  of  bismuth  with 
a  grain  or  two  of  menthol  and  cocaine  added 
to  each  ounce ;  parts  then  covered  with  old  soft 
cotton  doth  and  then  bandage  applied.  The 
legs,  genitals  and  abdomen  are  principally 
affected.  A  hint  in  the  case  would  be  appre- 
ciated. Wm.  T.  Hamilton,  M.  D., 

Inmaton,  Ala. 


Editor  Medical  World  : — Gan  any  of  the 
readers  of  The  Medical  World  suggest  a 
method  to  prevent  cold  feet? 

Woodley,  Pa.  J.  C.  Keller,  M.D., 


Editor  Medical  World: — I  write  to  ask 
the  opinion  of  my  fellow  practitioners  in  regard 
to  two  cases  I  have  on  hand.  I  have  had  six 
such  cases  in  the  month  of  January,  1894.  One 
has  recovered,  three  have  died. 

Symptoms :  Intense  headache,  photophobia, 
loud  ringings  in  the  ears,  nausea  and  projectile 
vomiting ;  the  pupil  of  the  right  eye  is  con- 
tracted while  the  left  is  dilated  ;  temperature 
101  to  lOS""  F. ;  the  pube  is  firm,  hard  and 
small,  varying  in  frequency  with  the  range  of 
temperature;  the  bowels  are  constipated  and 
the  abdomen  is  retracted.  There  is  restlessness, 
jactiation,  irritability,  *  sometimes  acute  mania ; 
the  eyeballs  roll  about  vaguely ;  the  head  is 
drawn  badLwards  and  to  one  side. 


My  diagnosis  is  acute  meningitis.  Treatment 
has  been  applications  of  cold  to  the  head,  (first 
shaving  off  the  hair)  ;  cupping  of  the  temples ; 
large  doses  of  calomel  to  act  upon  the  bowels, 
salme  diuretic;  hydrate  of  chloral  and  mor- 
phine ;  iodide  of  potash  ;  fly  blisters  to  back  of 
neck  and  spine.  I  am  not  satisfied  with  my  losses 
and  would  like  to  have  some  light  on  such 
cases.  Am  I  right  in  diagnosis  and  treatment? 
Earl,  Ind.  T. '  S.  F.  Milner,  M.D., 

[We  have  great  faith  in  the  salicylates  in 
the  treatment  of  meningitis.  For  appropriate 
symptoms,  the  following  will  also  be  useful : — 
aconite,  belladonna,  and  the  so-called  anti  rheu- 
matic remedies. — Ed.] 


Editor  Medical  World  : — I  have  a  case  I 
wish  to.  present  to  the  great  army  of  Thb 
World's  readers  and  ask  for  comment  and 
help.      Mr.  F.  S.,  a  carpenter  by  trade,  26 
years  old  and  single,  temperate  in  habits,  bom 
in  Wisconsin  but  came  to  this  state  at  thirteen, 
always  good  health,  had  gonorrhea  February 
1891 ;  never  had  syphilis.     In   February  or 
March  1892  was  taken  with  hematuria,  which 
appeared  on  cold  mornings;  never  excepting 
when  he  gets  cold  early  in  the  mornings,  and  S. 
he  stays  in  doors  he  has  no  hemorrhage  and 
feels  perfectly  well,   until  he  gets  cold  next 
morning,  when  his  urine  is  bloody,  and  in  an 
hour  or  two  it  is  as  clear  as  ever.     Sometimes 
it  looks  more  like  bile  than  blood,  but  the  or* 
dinary  tests  fail  to  prove  it      He  has  gone  th» 
rounds  of  the  M.D.'8,  and  just  fell  into  my 
hands  ten    days    ago.     My    prescription  was- 
nitro-glycerine    y^    grain   4  times  per  day. 
Diagnosis,  chronic  nephritis.     No  hem«  rrhage 
since  beginning  treatment,  though  he  has  been^ 
exposed  and,  as  he  expressed  it,  got  cold  sev- 
eral mornings,   and  was  surprised  to  see  hia 
urine  clear.     I  should  have  said  that  he  has- 
never  had  a  symptom  of  it  in  the  summer,  only 
in  cold  weather.    Now,  I  want  to  know  if  I 
am  correct  and  to  hear  from  some  of  my  brother 
M.  D.'s  who  have  had  more  experience  in  sucb 
ca^es  than  myself. 

Newport,  Ark.  J.  M.  Jones,  M.D., 


Editor  Medical  World  : — I  wish  treatment 
for  a  case  of  bladder  tiouble  which  appears  as 
a  case  of  cystorrhea,  as  the  deposition  in  the 
chamber  is  abundant,  and  the  calls  for  voiding 
urine  are  every  hour,  day  and  night,  and 
cannot  be  retained  longer  than  two  hours  at 
least 

Analysis  shows  nothing  but  pus  and  some 
lithiates. 

Patient  is  17  years  old,  boy  of  fair  complex- 
ion, stout  an  vigorous — an  apparent  model  of 


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healthy  and  yet  he  finds  in  the  chamber  every 
morning  about  two  ounces  of  thick,  tough,  gelar 
tinous  deposit  which  crystalizes  by  evaporation. 
This  trouble  was  contracted  two  years  ago  in 
north  Mississippi,  his  native  state,  where  there 
is  a  little  malaria. 

It  was  first  brought  on  by  a  slight  hurt  in 
the  region  of  the  kidneys  and  he  has  since 
suffered  some  attacks  of  acute  lumbar  pain  and 
fever,  but  only  for  a  day,  and  the  urine  is  not 
Appreciably  changed.  Who  will  give  a  treat- 
ment that  will  cure  the  case  ? 
Fallston,  N  C.  B.  F.  Fali^  M.D., 

[The  agent  particularly  wanted  here  is  a 
thorough  urinary  antiseptic.  The  best  are  as 
follows :  boracic  acid,  salol,  pulsatilla,  benzoic 
add  and  its. salts,  etc.  The  probability  is  that 
there  is  an  inflammatory  process  in  the  kidneys. 
—Ed.] 


Editor  Medical  World  : — What  can  be 
done,  if  anything,  for  a  fever  thermometer, 
which  will  register  but  not  stand  ?  The  needle 
falk  immediately  when  taken  from  the  mouth. 

Excelsior,  Ark.     W.  F.  Manning,  M.D  , 


Editor  Medical  World: — Will  some  of 
the  World's  family  give  me  a  remedy  for  a 
lady,  age  19.  health  moderately  good,  who  has 
exzema  of  the  scalp,  and  is  also  aflected  on  the 
face  and  especially  on  the  forehead  with  black 
heads  ?  She  is  very  anxious  for  a  remedy  to 
cure  the  black  heads  on  her  face.  She  says 
there  seems  to  be  a  little  worm  in  every  tubercle. 

Beardstown,  Tenn.  J.  H.  Stanley,  M.D., 


Editor  Medical  World:— Will  some  one 
of  the  medical  profession  give  a  preKsription 
through  the  Medical  World  for  the  cure  of 
**  goitre  "  or  swelling  at  the  throat  ? 

The  case  in  question  is  a  man  of  fifty,  who 
has  a  tumor  as  large  as  a  good  sized  orange  at 
the  left  side  of  his  throat  In  1880  he  had  an 
attack  of  tonsilitis  which  was  followed  by  said 
tumor.  A.  E.  Rhodes,  M.D., 

East  Amherst,  Erie  Co  ,  N.  Y. 


Editor  Medical  World  : — A  few  days  ago 
I  was  consulted  by  Mrs.  R.  in  regard  to  her 
little  four-year  old  girl,  who  looked  the  picture 
of  health.  She  sometimes  suffers  with  what  the 
mother  calls  articular  rheumatism,  but  about 
one  month  ago  the  child  complained  of  her 
head  and  on  looking  she  found  a  worm  making 
its  way  out  through  the  scalp.  She  pulled  it 
out  and  found  it  about  one  inch  long  and  as 
thick  as  a  knitting  needle  and  alive.     In  a 


week  or  so  another  came  out  of  the  other  aide  of 
the  scalp,  on  top  aud  a  little  to  the  right  of 
the  top  of  head,  and  a  few  days  ago  she  showed 
me  where  one  canae  out  of  the  iuner  lower  lip, 
the  lip  being  swollen  and  hard  and  a  black 
spot  as  large  as  a  No.  4  shot  where  it  came  out. 
The  child  shows  no  other  symptoms  of  the  afieo- 
tion.  The  mother  tells  me  they  are  alive  and 
crawl  about  for  a  short  time  and  die.  Thef 
are  transparent  and  contain  an  aqueous  sub- 
stance. Please  ask  through  your  journal  the 
causes  and  what  you  call  them 

A.  M.  Willey,  M.  D., 
New  Hampton,  Mo. 


Dr.  J  W.  Jones,  of  Ormond,  Fla ,  sends  us 
a  newspaper  clippit>g  of  a  woman  at  Strouds, 
McLean  Co.,  Ky.,  giving  birth  to  her  first 
baby  at  the  age  of  sixty  four,  after  a  married 
life  of  forty  years.  The  Doctor  wishes  authen- 
tic facts,  from  members  of  the  profession,  of 
women  becoming  m<«thers  after  sixty  years 
of  age. 


Editor  Medical  World: — Through  the 
columns  of  your  valued  journal,  I  wish  lo  re- 
port a  case  which  may  be  of  interest  to  some 
medical  brother. 

On  December  3d,  1893,  I  was  called  to  the 
country  to  see  a  child,  1 7  months  of  age.  On 
arriving  at  the  place  I  found  the  child  uncon- 
scious, on  its  back,  tongue  and  lips  dry  and 
parched,  fever  high,  head  hot  and  thrown  back, 
eyes  partly  open  and  pupils  dilated  to  full  ex- 
tent Previous  history  was  that  they  had  called 
a  quack  about  a  week  previous.  At  that  time 
he  pronounced  six  spasms  which  the  child  had 
as  ''worm  spisns."  His  treatment  was  fluid 
extract  of  pumpkin  seed  and  three  grains  of  quin- 
ine every  three  hours  in  powders.  As  to  the  size  of 
powders,  I  weighed  one.  Also  one- half  glaas  of 
medicine  containing,  they  said,  one  heaping 
teaspoonful  of  quinine,  and  other  medicine  not 
known.  The  child,  at  the  time  I  saw  it,  was  at 
intervals  of  about  two  minutes  screaming  with 
all  force,  a  sharp,  piercing  scream.  Pustules 
broke  out  all  over  its  head  and  neck,  and  at 
the  time  of  its  death,  four  days  later,  the  back 
part  of  its  head  was  a  complete  pulp.  I  put 
the  child  upon  bromides  and  sulphate  of  mor- 
phine, with  antipyretics;  cold  to  the  head. 
The  screaming  stopped  and  all  nerve  excite- 
ment. The  cbil  J  upon  that  treatment  seemed 
to  improve  for  a  short  time. 

What  do  my  brother  practitioners  say  to  the 
quack  treatment  of  large  doses  of  quinine  to 
help  on  a  much  congested  brain  in  this  case? 


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There  is  no  doubt  as  to  coDgeetion  of  the  brain 

after  having  six  hard  spasms. 

Butte,  Neb.         \V.  E  Bridgman,  M.D., 
[But  what  does  tbe  doctor  think  of  sulphate 

of  morphine  to  so  young  a  child  ?     He  does  not 

mention  the  dose. — Ed.] 

A  corr^pondent  wbhes  to  know  what  medi- 
cal schools  in  Toronto  were  conferring  medical 
degrees  in  1858. 

Editor  Medical  World: — Could  you  not 
devote  a  whole  number  entirely  to  catarrh  of 
the  nose  and  throat  It  would  be  a  gold  mine 
to  phjsicians.  O.  C.  Engle,  M.D., 

New  Sheffield,  Pa. 

[We  do  not  think  the  subject  sufficient  for  an 
entire  number,  but  shall  be  pleased  to  publish 
any  useful  articles  in  regard  to  it  that  we  may 
receive. — Ed.] 

Dr.  G.  K  Matthews,  of  Ringwood,  N.  C, 
wishes  to  know  the  best  treatment  for  the  **  hot 
flashes  "  of  the  menopause. 

Dr.  Field,  of  Elroy,  Wis.,  wishes  treatment 
to  remove  powder  stains  from  the  face.  The 
testimony  of  those  of  our  readers  who  have 
tried  the  many  plans  published  in  this  journal 
some  years  ago  would  now  be  in  order. 

A  writer  wishes  for  recent  advanced  informar 
tion  in  regard  to  the  treatment  of  scarlet  fever. 


Request  is  made  for  formula  of  **  Pinkham's 
Conpoond." 

Editor  Medical  World  : — Will  you  please 
insert  in  your  columns  this  case : 

Female,  age,  23 ;  one  child  5  years  old ;  then 
married  3  years  after  ;  now  has  child  4  months 
old  She  has  had  an  enlargement  of  right 
axillary  glands,  extending  or  swollen  down  the 
ride  and  across  to  the  mamary  gland ;  the  pains 
shoot  over  to  the  breast  and  down  the  ride.  She 
is  not  so  much  ematiated,  but  some,  which  may 
be  owing  to  nursing  the  child.  The  glands  of 
the  axillary  regions,  where  the  lump  is,  are  ten- 
der to  the  touch.  It  has  been  there  for  four 
yearsi  small ;  but  since  the  birth  of  the  last 
child  it  has  enlarged  very  fast  and  become  pain- 
fa).  Is  it  malignant  in  character,  or  is  it  just 
enlar^  glands?  J.  C.  Mollyneaux,  M.D., 

Woodland,  111. 

[Any  spedfic  taint? — Ed.] 

Editor  Medical  World  : — As  I  desire  to 
prepare  a  paper  on  Epistaxis  as  a  complication 
in  diphtheria  affecting  the  nasal  cavity^  I 
would  ask  any  one  who  has  had  experience  in 


the  matter  or  can  give  briefly  the  views  of 
authors  in  their  possession  to  write  me  what 
they  know  about  it,  including  treatment  I 
consider  this  a  grave  and  generally  fatal  com- 
plication and  one  but  little  discussed  in  medical 
works.  Please  write  me  personally,  and  .  I 
will  arrange  the  matter  in  a  manner  useful  to 
all,  omitting  names  if  derired,  and  if  the  editor 
of  The  World  thinks  it  worthy  of  a  place  in 
these  columns,  will  publish  it. 

Missouri  Valley,  la.    R  D.  Mason,  M.D., 


Editor  Medical  World: — I  was  called 
November  1st,  to  see  Mr.  J.  He  had  been 
troubled  since  the  early  spring  with  bead  and 
back  ache,  had  been  treated  by  various  physi- 
cians, but  on  July  Ist  had  to  give  up  work.  I 
found  him  in  bed  suflering  greatly  from  head 
ache,  pain  between  the  shoulders  and  on  each 
ride  of  the  back,  low  down  and  in  the  calves  of 
the  legs,  muscles  twitching  about  the  shoulders 
and  at  different  points  in  the  lower  limbs. 
Virion  was  perfect  I  also  found  that  he  had 
a  very  long  and  tightly  contracted  prepuce, 
which  was  swollen  and  inflamed.  He  was  pass- 
ing large  quantities  of  colorless  urine,  speci6c 
gravity  1002.  Bowels  only  moved  once  in 
seven  or  eight  days,and  then  only  a  small  slug. 
Appetite  very  poor.  Troubled  with  insomnia, 
and  very  despondent.  I  removed  the  foreskin 
and  the  wound  healed  nicely  ;  primary  union. 
After  the  first  months  treatment  urine  became 
normal,  in  quantity  and  quality,  bowels  regular, 
and  appetite  good,  painless  and  muscular 
twitching  stopped.  I  then  expected  by  the  aid 
of  tonics  to  have  my  patient  able  to  go  to  work 
in  short  order,  but  I  have  been  fooled.  His 
headache  still  continues  and  he  has  a  good  deal 
of  pain  in  various  parts  of  the  body  and  legs. 
The  least  exercise  makes  him  feel  tired  and 
languid,  and  causes  the  pain  to  return.  He  is  a 
young  man  of  exemplary  habits;  never  has 
been  intemperate ;  family  history  good ;  never 
has  been  any  syphilitic  ^sease  or  received  any 
injury.  Their  is  no  tenderness  at  any  point 
along  the  spine,  and  he  has  never  had  any 
trouble  with  the  eyes.  Readers  of  The  World, 
I  want  help.  Give  me  your  diagnosis,  treat- 
ment and  prognosis.  M. 


Editor  Medical  World: — Will  some  of 
your  readers  please  give  me  a  reliable  formula 
for  the  cure  of  the  tobacco  habit  ? 

J.  M.  F. 


Editor  Medical  World  : — T  have  been  an  uninter- 
ropted  subscriber  to  The  World  tfret  since  the  first 
number  was  pubilshed,  and  oannot  now  do  without  it. 

Sharon,  Ga.  A.  0.  Davidson. 


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Editor  Medical  World  : — Will  the  readers 
kindly  give  me  advice  iu  the  following  case: 

Mr.  A.,  32  years  of  age,  married ;  in  youth 
practiced  self-abuse  and  since  marriage  has  in- 
dulged to  excess.  He  suffers  from  nocturnal 
^paissions,  and  the  fluid  passes  when  at  stool  or 
with  the  least  pressure.  His  condition  is  such 
as  usually  results  from  excessive  indulgence. 

I  am  a  young  man  in  the  profession  and  have 
had  no  experience  with  such  cases  heretofore 
and  therefore  ask  The  World  and  its  readers 
for  information  as  the  remedies  I  have  used, 
have  had  no  effect  on  the  patients  condition. 

Advice. 


Editor  Medical  World  :— I  wbuld  like  to 
know  the  following : 

1.  Best  treatment  for  a  burn  denuding  skin 
from  entire  stomach  and  chest,  in  a  child  four 
^ears  old.     Prognosis  ? 

2.  What  medicines  can  be  given  to  a  preg- 
«iant  woman  without  injuripusly  affecting  the 
fetus  ? 

3.  What  medicines  are  absorbed  in  the  milk 
when  given  to  a  nursing  mother,  without  injur- 
ing the  baby.  For  instance,  can  tincture  of 
aconite  or  tincture  of  veratrum,  strychnine,  etc., 
be  given  to  the  mother  without  affecting  the 
nursing  babe? 

4.  What  is  the  best  treatment  for  suppressed 
or  arrested  lochial  flow? 

6.  How  many  of  The  World's  subscribers 
believe  in  the  physician's-  furnishing  his  own 
medicine,  for  profit  and  to  prevent  reduplication 
of  prescription  by  druggists,  and  for  convenience 
and  profit  to  patient  ? 

6.  What  is  the  best  formula  for  a  cough 
medicine,  basis,  syrup  and  balsam  of  fir  ? 

7.  What  is  the  best  solvent  or  vehicle  for  tar 
in  a  cough  medicine  ? 

8.  Does  the  occurence  of  menstruation  dur- 
ing a  case  of  pneumonia  lessen  the  chances  of 
recovery  ? 

9.  What  effect  does  the  occurence  of  men- 
struation have  upon  the  treatment  or  prognosis 
of  any  and  all  acute  diseases — grippe,  fever, 
pneumonia,  etc.? 

10.  What  is  the  best  and  purest  make  of 
salicylate  of  sodium  ? 

11.  What  are  the  indications  for  the  use  of 
diascorea  villosa  (mid  yam),  and  the  best  prepa- 
rations of  the  same  ?  Is  the  solid  extract  as  ac- 
idve  as  the  fluid  extract  and  tincture  ?  What  is 
tthe  dose  of  each  ? 

12.  Could  any  sequela  or  condition  of  typhoid 
or  other  fever,  in  the  eighth  week,  produce  an 
enlargement  of  the  stomach,  simulating  preg- 
nancy of  four  or  five  months  ?  That  is,  could 
tympanitis,  enlargement,   etc.,  be  mistaken  by 


an  averagely  informed  doctor,  for  pregancy?  Jt 
the  3tomach  presented  an  enlargement,  symetricsl 
and  well  defined,  the  exact  shape  of  pregnanof, 
a  firm  feeling  as  if  the  finger  pressed  upon  aM 
enlarged  uterus;  this  enlargement  and  well 
rounded  and  well  marked  line  of  firmness  extend- 
ing up  nearly  to  the  navel,  and  the  parts  between 
this  and  the  ensiform  cartilage  perfeptly  flaccid 
and  soft,  would  not  this  show  pregnancy  ?  If  it 
was  a  swelling  from  fever,  tympanitis,  etc,  would 
not  the  tension  in  an  enlargement  of  the  abov^ 
extent,  extend  to  ensiform  cartilage  ? 

Interrogator. 


Dr.  Ray,  of  C6te  St  Paul,  Montreal,  Canada^ 
wishes  formula  for  Koenig's  Nerve  Tonic. 


Current    Medical    Thought. 


Croupous  Pneumonia. 

The  following  are  the  conclusions  of  Dr,  S. 
N.  Cunningham,  of  Evsly,  Ala.,  at  the  cloee  of 
his  article  in  the  Vcl  MedL  Monthly : 

*'lst.  It  is  a  constitutional  disease,  with  a 
local  anatomical  dgn,  consisting  of  an  inflan 
mation  of    the    pulmonary   parenchyma,  aad 
caused  by  its  own  specific  materies  morbi  or 
germ,  probably  that  of  Frankel  or  Friedlander. 

2d.  That  the  special  circumstances  under 
which  this  germ  is  evolved  and  operates  are  ob- 
koown,  as  we  have  it  under  diametrically  opp^ 
site  conditions,  both  good  and  bad. 

3d.  That  the  disease  as  a  rule,  prevaib 
endemically,  rarely  epidemically,  and  still 
more  rarely  sporadically. 

4lh.  That  these  endemics  differ  in  type  i 
in  extent  of  pulmonary  inflammation,  and  ( 
sequently,  in  mortality. 

5th.  That  the  disease  is  severer  in  publie  n- 
sdtutions,  especially  prisons. 

6th.  That  the  n^ro  is  especially  predisposed 
to  the  disease,  has  less  capacity  to  resist  it,  and, 
consequently,  a  larger  mortality. 

7th.  That  coal  miners,  especially  negrea, 
while  not  predisposed  to  the  disease,  are  favorap 
ble  subjects  for  extensive  pulmonary  inflamma- 
tion, and  have  less  capacity  to  resist  the  disease^ 
owing  to  the  more  or  less  anthracosis  of  the  pul- 
monary tissue. 

8th.  That  the  mortality  is  mainly  determined 
by  the  type  of  the  disease;  first,'  in  the  primarj 
effect  of  the  germ  upon  the  nervous  system;  aad 
secondly,  the  extent  of  pulmonary  inflammation 
and  in  the  rapidity  of  its  invasion  and  develop- 
ment. 

9th.  That  the  mild,  uncomplicated  cases,  witk 
a  fairly  good  pulse  and  moderate  temperat«ie» 


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and  with  only  one  lobe,  especially  the  lower 
lobe,  inyolTcd,  intrinsically  tend  to  recovery; 
«ad  that  the  severe  cases,  complicated  or  not, 
with  fast  and  weak  pulse,  fast  or  labored  respi- 
imtion,  regardless  of  temperature  and  attended 
by  great  prostration,  intrinsically  tend  towards 
death,  and  without  judicious  treatment  will  die, 
regardless  of  the  extent  of  pulmonary  inflamma- 
tion; and  that  in  the  cases  in  which  the  pneu- 
monia is  double,  particularly  if  the  double  in- 
Tasion  is  simultaneous,  their  tending  is  to  a  fatal 
iesne;  and  finally,  that  in  the  cases  in  which  the 
inflammation  is  upiversal  by  a  simultaneous  or 
rapidly  succeesive  invasion  of  the  entire  lung 
Btaructure,  death  is  the  inevitable  rapid  result 
Therefore,  in  comparing  statistics,  all  these 
things  shsuld  be  taken  into  account;  otherwise 
they  are  worthless.  Hence  the  wide  divergence 
m  the  statistics  and  difference  in  treatment  of 
Tarious  observers. 

10th.  That  the  immediate  cause  of  death  in 
■Mmy  cases  is  ante-mortem  heart  clots. 

11th.  That  the  main  features  of  treatment 
are :  (a)  to  combat  the  shock  of  the  germ  in- 
yamoD,  best  done  by  opium,  stimulants,  and,  in 
■ay  opinion,  hypodermoclysis  or  the  subcutan- 
eous injection  of  a  saline  solution — chloride  of 
•odium  drams  j  to  the  pint  of  water.  8o  f ar  as 
I  know  this  is  absolutely  new  in  the  treatment 
itf  this  disease,  (b)  to  stimulate  freely,  the  best 
■dmnlant,  as  a  matter  of  routine,  being  whiskey 
and  strjchnine,  supplemented  in  extreme  cases 
hj  tincture  strophanthus;  (c)  to  control  tem- 
f  perature,  the  best  method  being  the  bath;  (d) 
to  prevent,  if  possible,  heart  clots,  hypodermo- 
dysis,  in  my  opinion,  being  the  most  reliable; 
(a)  t^meet  indicatiotis  as  ^ey  arrise." 

The  doctor  reported  an  endemic  of  this 
disease  among  convicts  which  subsided  immedi- 
ately after  a  thorough  antiseptic  deausing  of 
the  prison.  Speaking  of  hjrpodermoclysis,  he 
■ays :  *<In  studying  this  disease  two  facts — one 
dinical  and  the  other  pathological — were  im- 
pressed upon  my  mind  :  1st  'The  prostration 
m  this  disease  greatly  resembled  surgical  shock. 
2d.  The  chlorides  are  always  diminished  in  the 
arine,  as  the  disease  advances,  usually  in  pro- 
portion to  the  extent  of  pulmonary  inflamma- 
tion, reappearing  in  correspondingly  increasing 
quantities  during  resolution.  It  occurred  to  me, 
therefore,  that  if  this  prostration  were  treated 
after  the  manner  of  treating  shock,  and  that  if 
the  blood  were  supplied  with  additional 
chlorides,  the  heart  clots  might  be  prevented. 
Both  of  these  indications  seemed  to  be  met  by 
the  introduction  into  the  blcod  of  a  warm  saline 
I  solution.  I,  therefore,  determined  to  inject  into 
the  veins  or  arteries — after  the  manner  of  treat- 
ing surgical  shook  or  hemorrhage — a   warm, 


aseptic  salt  solution  of  the  strength  given  above. 
At  the  suggestion  of  Dr.  Jerome  Cochrane, 
State  Health  oflScer,  I  adopted  hypodermoclysis 
as  the  method,  using  a  fountain  syringe  i^nd  a 
medium- size  aspirator  needle  as  the  instruments 
and  the  subcutaneous  tissue  of  the  abdomen  aa 
the  site  for  the  injection." 


infectious  Nature  of  Croupous  Pneumonia. 

As  erysipelas  develops  in  the  lymphatic 
channels  of  the  epidermis,  typhoid  and  cholera 
localize  in  the  intestine,  pneumonia  is  limited 
to  the  lungs:  there  the  invasion  of  the  exciting 
agents  of  pneumonia  begins,  and  as  it  is  certain 
that  corpuscular  matter  can  pass  from  the  acini 
to  the  lymph  channels  of  the  lungs  in  pneumo-^ 
nia,  it  penetrates  with  facility  into  the  fluids  of 
the  body. 

Pneumonia  is  a  disease  due  to  infection,  but 
whether  purely  contagious  or  miasmatic  is  a 
question.  It  is  beyond  doubt  due  to  micro- 
organisms, and  must  be  classed  with  cerebro- 
spinal meningitis,  erysipelas,  mumps,  influenza 
and  rheumatic  fever.— Macfarlane,  in  Brooklyn 
Med,  Jour. 


Treatment  of  Renal  Insufnoienoy, 

Dr.  Rochester  (New  York  Medical  Journal) 
says: 

We  should  not  try  to  stimulate  into  activity 
an  organ  that  is  inflamed  or  degenerated,  by  the 
use  of  drugs  that  excite  functional  activity  of 
such  organ;  in  the  case  of  the  kidney  we  should 
rarely,  if  ever,  have  recourse  to  stimulat- 
ing diuretics,  or  to  diuretics  which,  like  digitalis^ 
act  by  increasing  the  arterial  'pressure,  until  we 
have  relieved  the  venous  congestion  by 
diaphoresis  or  catharsis,  or  both. 

Attention  to  diet  is  of  the  utmost  importance 
in  these  cases. 

In  order  that  the  materials  to  be  excreted  by 
the  kidney  may  come  to  that  organ  in  the  most 
unirritating  form,  the  metabolic  processes  should 
be  carried  to  completion;  this  is  to  be  accom- 
plished by  regular  systematic  exercise,  which  is 
to  be  obtained  by  massage  when  active  exercise 
is  not  advisable,  by  inhalations  of  pure  oxygen 
gas  when  it  is  evident  that  suflScient  oxygen  is 
not  obtained  from  the  air,  and  by  the  dilution 
of  the  katabolic  materials  by  drinking  large 
amounts  of  distilled  water  or  one  of  the  mildly 
alkaline  waters. 

The  anemia  that  accompanies  these  cases 
should  be  met  by  the  use  of  oxygen  and  iron. 

As  the  symptoms  indicative  of  this  condition 
are  the  result  of  toxemia  which  depends  upon 


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the  nou-elimiuatiou  from  the  body  certain  kata- 
bolic  maierials  that  should  normally  be  cairied 
off  through  the  kidneys,  and  as  these  organ?  are 
in  such  condition  that  they  cannot  do  their 
work,  all  other  avenues  of  elimination  should  be 
opened  up  for  the  escape  of  these  poisons.  This 
is  to  be  brought  about  by  exciting  the  activity 
of  the  skin  by  means  of  hot  air  or  steam  baths 
accompanied  and  followed  by  vigorous  massage; 
keeping  the  bowels  open  by  means  of  salines  and 
washing  away  the  contents  of  the  colon,  thus  keep- 
ing the  mocous  membrane  in  a  proper  condition 
for  excretion,  with  copious  enemata  of  slightly 
alkaline  water,  occasionally  followed  by  a  high 
enema  of  500  or  600  c.  c.  of  p^ire  olive  o^l,  as 
suggested  by  Fleiner  (Berliner  Klin  Woeh- 
ensckr.y  1893,  Nos.  3  and  4). — Am.  Lancet. 


Two  Easy  and  Delicate  Tests  for  Albumin  In  Urine. 

Dr.  C.  Fouchlos  (La  Progres  Medical)  recom- 
mends two  new  tests  for  albumin  in  urine,  for 
which  he  claims  utmost  delicacy  and  absence  of 
any  possibly  fallacy. 

1.  Add  to  thesuspected  urine  a  few  drops  of  a 
1  per  cent  solution  of  corrosive  sublimate;  in 
case  of  turbidity,  add  some  drops  of  acetic  acid. 
If  the  turbidity  persists  it  is  due  to  the  presence 
of  albumin. 

2.  Take  100  cc.  of  a  10  per  cent,  solution  of 
Bulpho  cyanide  of  potassium,  and  mix  it  with  20 
cc.  of  acetic  acid.  Add  a  few  drops  of  this 
mixture  to  the  urine.  If  albumin  is  present  in 
small  quantities,  an  immediate  tubidiiy  will  en- 
sue; if  in  large  quantities,  a  heavy  white  pre- 
cipitate will  appear. — K  C.  R.,  in  Med  Review. 


Cause  of  Death  From  Bullet  Wounds  of  the  Brain. 

A  London  correspondent  writes  in  the  Am. 
Prod,  and  News  that  Mr.  Victor  Horsley  main- 
tains that  the  cause  of  death  from  bullet  wounds 
of  the  cerebral  hemispheres  is  due  to  the  sud- 
den increase  of  intracranial  pressure  brought 
about  by  the  entrance  of  the  bullet  into  the 
cavity  of  the  skull,  a  cavity  which  was  closed 
and  already  full .  As  an  experimental  demon- 
stration of  this  he  showed  that  when  a  closed 
cavity  filled  with  water  and  lint  was  fired  into, 
the  increase  of  internal  pressure  manifested 
itself  by  the  bursting  of  the  canister  with  great 
violence.  The  increase  of  pressure  in  the  brain 
took  effect  on  the  respiratory  center,  which  be- 
coming paralyzed,  death  ensued. —  West  Med. 
Reporter. 


Erysipelas  and  Gonorrhea. 

Schmidt  (Contralblatt  fur  Oynako'ogie,  1893, 
^'o.  39)  reports  a  case  of  gonorrheal  vaginitis 
in  a  little  girl  in  whom  erybipleas  of  the  thigh 


developed  with  simultaneous  disappearance  of 
the  viginal  discharge.  Vaginitis  is  known  to  be 
a  peculiarly  intractable  affection  in  children, 
yet  in  this  instance  it  was  cured  within  a  few 
days  without  local  treatment,  aud  there  wa«  no 
recurrence  after  the  disappearance  of  the 
erysipelas.  The  apparent  causual  relation  be- 
tween the  latter  and  the  cure  of  the  gonorrhea 
is  analogous  to  the  efiect  of  the  inflammation  in 
cases  of  inoperable  sarcoma. — Am.  Journal  Med. 
Sciences. 

[This  is  another  example  of  the  scientific  fact 
of  disease  antagonism,  mentioued  frequently  in 
these  pages  recently. — £d.] 


The  Inoh-and-a-half  Inolsion  and  Week-and-a-half 
Confinement  in  Append  lotis. 

By  Robebt  T.  Morris,  A.M  ,  M.D. 

More  than  a  million  dollars  have  been  p^d 
to  expert  consultants  who  made  the  diagnosis  of 
typhoid  fever,  idiopathic  peiitonitis,  typhlitis,  or 
internal  strangulation  of  bowel  in  cases  in  which 
the  disease  was  really  appendices.  Conse- 
quently, that  money  was  expended  to  no  pur- 
pose by  the  patients. 

More  than  a  million  patients  have  died  of 
appendicitis  because  the  consultants  made  other 
diagnosis  at  a  time  when  prompt  operation 
woudd  have  saved  life.  Consequently,  these 
deaths  were  unnecessary. 

We  cannot  realize  how  common  appendicitis 
is  until  we  have  rubbed  our  eyes  and  looked 
about  a  bit  Within  the  past  five  years  I  have 
removed  fourteen  infected  appendicitis  for  the 
patients  of  one  venerable  physician,  wbo  in 
more  than  thirty  years  of  practice  had  not  pre- 
viously made  the  diagnosis  of  appendices,  and 
I  believe  him  to  be  a  representative  practitioner 
who  has  had  no  more  than  an  average  propor- 
tion of  the  cases  under  his  care. 

One  of  the  most  vivid  pictures  in  my  mraaory 
is  that  of  a  celelirated  German  anatomist  with 
scalpel  in  hand  making  a  postmortem  examina- 
tion and  noting  points  which  were  jotted  down 
in  tbe  record  book  by  his  assistant  The  cecam 
of  the  cadaver  was  covered  with  thick,  gray 
lymph,  The  appendix  was  not  examined  be- 
cause it  happened  to  be  buried  in  pus  and  ad- 
hesions, and  because  it  was  only  a  little  thing, 
anyway.  "Perityphlitis !"  said  the  professor. 
"Perityphlitis,''  mumbled  the  assistant  as  he  put 
the  note  where  it  would  go  on  record. 

It  was  only  a  decade  ago  that  we  began   to 
examine  infected  cecums  closely  enough  to  col- 
lect accurate  data;  and  then  followed  the  era  in    « 
which  rules  for  finding  inguinal  pus  were  elab- 
orated, in  the  intention  of  operating  for  the 


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108 


evacuadon  of  pus  when  it  was  discovered.  How 
well  we  remember  the  day  when  authorities  were 
ranged  along  the  line  ot  argument  as  to  whether 
abeoesses  in  appendicitis  were  extra- peritoneal  or 
intra-peritoneal.  Later  information  was  to  the 
effect  that  the  patient's  chances  for  recovery 
were  better  when  the  appendix  was  removed  be- 
fore pus  got  on  any  side  of  the  peritoneum. 
Then  we  tried  different  waiting  periods  before 
operating,  and  these  periods  bec^e  shorter  and 
shorter  because  we  were  often  made  sorry,  for 
when  we  waited  to  see  how  a  case  would  turn 
out  we  often  found  out.  We  found  out  that  the 
patient  was  going  to  die  because  we  had  waited 
too  long;  or  that  he  was  going  1o  recover.  But 
we  never,  pever,  never  knew  when  the  patient 
had  recovered,  and  that  was  a  sticker  for  honest 
counsellors.  By  rational  deduction  we  are 
to-day  aware  that  the  appendix  should  be  re- 
move as  soon  as  a  diagnosis  of  appendicitis  can 
be  made.  No  important  question  of  late  years 
has  received  mere  summary  treatment  than  the 
one  as  to  the  proper  time  for  operation  in  ap 
pendicitis;  and  as  the  question  is  wedge  shaped, 
with  dealhs  grouped  at  the  late  end,  we  have 
slid  quickly  down  to  the  point  which  on  my  in- 
dicator rests  at  the  words  <<no  delay."  In  the 
evolution  of  the  prompt  operation  for  removal 
of  an  infected  appendix  I  have  reached  a  posi- 
tion from  which  it  seems  best  to  ask  surgeons  to 
accept  as  standard,,  an  abdominal  incision  one 
inch  and  a  half  in  length,  which  confines  the 
patient  to  his  room  for  a  week  and  a  half.  It  is 
not  necessary  to  repeat  here  in  detail  my  theory 
of  appendicitis,  which,  briefly  stated,  describ^ 
the  disease  as  an  infectious  exudative  inflamma- 
tion of  the  appendix  vermiformis  ceci,  caused 
by  bacterial  invasion  of  a  structure  which  is  not 
well  equipped  for  self-defense.  The  reason  why 
bacteria  gain  entrance  into  the  tissues  of  the  ap- 
pendix is  because  the  guarding  mucosa  of  that 
structure  is  easily  bruised  between  a  full  cecum 
and  a  hard  pelvic  wall,  or  it  is  eroded  by  con- 
crements.  The  reason  why  the  appendix  is  not 
well  equipped  for  defense  is  because  the  inner 
tube  of  mucosa  and  adenoid  tissue  is  so  closely 
confined  within  the  outer  tube  of  muscle  and 
peritoneum  that  it  cannot  swell  much  without 
catting  off  its  own  vascular  supply  and  causing 
a  resulting  train  of  effect& 

Appendicitis  once  established  may  continue 
to  smoulder  for  years  without  causing  any  im- 
portant symptoms,  or  it  may  blaze  up  and  de- 
stroy the  patient  in  a  jiffy.  Usually  the  disease 
smoulders  for  years  and  blazes  up  from  time  to 
time.  Medical  treatment  smothers  the  blaze 
frequently,  but  the  smouldering  continues  while 
the  patient  believes  himself  to  be  welL  Some- 
times the  patient  is  not  deceived,  but  his  physi- 


cian is;  and  when  these  patients  come  to  us 
for  operation,  without  the  knowledge  of  the 
family  physician,  it  is  often  difficult  for  us  to 
persuade  them  that  it  is  best  to  have  his  coun- 
sel and  assistance  in  the  case. 

The  inch  and  a  half  incision  is  made  throtigh 
the  right  linea  semilunaris  and  all  structures 
of  the  abdominal  wall.  The  colon  is  readily 
distinguished  by  its  longitudinal  muscular 
bands.  The  direction  of  the  colon  is  determined 
by  exciting  reversed  peristalsis  with  a  crystal  of 
sodic  chloride.  The  appendix  is  always  found 
exactly  where  the  long  muscular  batids  of  the 
cecum  terminate.  Adhesions  are  separated  with 
a  finger  introduced  into  the  abdominal  cavity. 
If  pus  is  present,  or  if  adhesions  are  widely  a4r 
tached,  or  if  the  appendix  is  attached  to  the 
gall-bladder,  or  left  overy,  the  inch  and  a  half 
incision  must  be  discarded  for  a  longer  one;  but 
the  longer  incision  is  the  exception  in  the  class 
of  cases  that  I  am  getting  nowadays  The 
mesentery  of  the  appendix  is  ligated  with  fine 
cat-gut  The  base  of  the  appendix  is  ligated 
very  close  to  the  cecum  with  a  fine  strand  of 
eye  silk  to  prevent  intestinal  contents  from 
seeping  into  the  wound.  The  ligated  stump  is 
buried  with  three  Lembert  sutures,  for,  if  it 
were  not  so  buried,  perforation  occurring  under 
the  ligature  might  cause  trouble.  The  abdo- 
minal woimd  is  closed  with  separate  tiers  of 
fine  cat-gut  sutures  for  the  separate  structures 
of  the  abdominal  wall.  If  we  used  a  single  tier 
of  sutures  for  aponeuroses  which  pull  in  differ- 
ent lines  of  traction,  the  patient  would  not  be 
out  of  bed  at  the  end  of  his  week  and  a  half. 

Allow  me  to  make  one  final  request  Kindly 
fail  to  find  seeds  in  the  appendix.  It  requires 
a  strong,  sturdy,  moral  nature  to  bear  up 
against  the  wishes  of  the  patient  who  expects  to 
be  pleasantly  surprised  by  the  report  that  a  seed 
was  found  in  his  appendix.  Please  send  the 
seed-like  concrements  to  the  chemist  before 
making  a  report  — Mathews'  Med.  Quarterly. 


Treatment  of  Seminal  Incontinence. 

First  and  foremost  in  the  treatment  of  seminal 
incontinence,  I  place  moral  and  hygienic  means. 
Masturbators  who  cannot  be  wholesomely 
frightened  with  the  ultimate  results  of  their  evil 
practices,  are  indeed  hopeless  cases.  In  every 
instance  the  cause  must  be  discovered  before 
any  satisfactory  progress  can  be  anticipated.  It 
will  be  absolutely  useless  to  attempt  moral  or 
hygienic  measures  if  the  trouble  were  depend- 
ent upon  an  incipient  ataxia,  dementia  paraly- 
tica, enlarged  prostrate,  or  stricture.  A  most 
exhaustive  examination  must  be  made  for  every 


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possible  reflex  cause,  and  it  must  be  removed 
before  everything.  Where  these  reflex  causes 
are  absent  or  have  been  entirely  overcome,  my 
chief  reliance  is  upon  the  use  of  the  bath,  proper 
rest  and  exercise,  the  passage  of  the  sound  and 
the  administration  of  atropia  and  the  bromides. 
I  know  of  nothing  so  effective  as  these  meas- 
ures to  conquer  an  obstinate  seminal  incon- 
tinence. 

The  patient  should  be  instructed  to  avoid 
every  kind  of  stimulus  and  over-fatigue.  Any- 
thing that  is  likely  to  irritate  the  genital  organs, 
such  as  tight  clothing,  bicycle  and  horseback 
riding,  should  be  refrained  from.  His  food 
should  be  of  the  blandest  and  most  nutritious 
sort  Tea,  coflee,  alcohol  and  tobacco  must  be 
abandoned  for  a  time.  He  must  take  a  light, 
dry  diet,  and  abstain  from  drinking  large  quan- 
tities of  fluid  before  retiring  at  night.  It  would 
be  a  good  plan  for  him  to  set  the  alarm  clock 
to  awaken  him  a  couple  of  times  in  the  night  to 
empty  his  bladder.  He  must  sleep  in  a  cool, 
well-ventilated  room,  with  as  little  bed-clothing 
on  him  as  possible.  He  should  alwajrs  occupy 
a  bed  alone,  and  cultivate  the  habit  of  lying 
upon  his  right  side.  It  might  be  well  to  have 
the  head  of  his  bed  turned  toward  the  north, 
for  there  may  be  something  in  the  notion  that 
one  sleeps  better  when  the  electric  current  of 
the  body  and  earth  are  parallel.  A  warm  bath 
before  retiring  is  soothing  and  tonic,  while  a 
rapid  sponging  of  the  whole  person  with  cold 
water  in  the  morning  lends  vigour  for  the  day. 
Of  course,  all  literature  and  pictures  of  a  sen- 
sual nature  must  be  rigidly  eschewed;  and  to 
keep  the  thoughts  pure  and  healthful,  it  would 
be  well  for  the  patient  to  acquire  a  hobby  to 
which  he  could  turn  for  amusement  in  his  leis- 
ure moments. 

In  all  cases  of  seminal  incontinence  there  is 
more  or  lees  inflammation  of  the  prostatic 
urethra  and  irritability  of  the  whole  canal.  If 
this  be  severe  the  patient  will  describe  a  kind 
of  burning,  sore  sensation  at  the  end  of  the 
penis,  and  he  will  complain  of  the  frequency 
with  which  he  has  to  pass  his  water  on  account 
of  the  uncomfortable  sensation  of  an  over- dis- 
tended bladder.  If  these  inflammatory  symp 
toms  are  at  all  pronounced,  hot  sitz-baths,  sooth- 
ing oleaginous  injections,  and  the  free  use  of 
cathartics  would  be  advisable.  Leches  or 
blisters  to  the  perineum  are  necessary  at  times. 
I  am  convinced  there  is  no  better  treatment  for 
the  irritability  of  the  posterior  urethra,  after  the 
more  acute  symptoms  have  subsided,  than  the 
frequent  passage  of  the  sound.  At  first  this 
should  be  done  at  intervals  only  of  two  or  three 
days,  the  instrument  being  retained  for  two  or 
three  minutes.     Later  on  it  should  be  intro- 


duced daily,  and  held  in  the  urethra  for  fifteen 
minutes.  In  inexperienced  hands  a  small  soft 
sound  or  catheter  should  be  first  employed,  and 
larger  ones  used  as  the  mucous  membrane  lie- 
comes  more  tolerant.  Better,  however,  than 
the  soft  instruments  are  the  steel  sounds,  wh^i 
carefully  introduced,  since  they  are  less  painful 
to  pass  and  are  more  vigorous  in  their  thera- 
peutic action.  The  resisting  contact  of  a  solid 
body  against  ^the  mucous  membrane  of  the 
urethra  greatly  lessens  its  sensibility,  while  the 
gradual  increase  of  the  size  of  the  instrument  as 
die  treatment  proceeds,  helps  to  relieve  the  con- 
gested blood  vessels.  If.  there  be  any  strictures 
present,  as  there  are  apt  to  be  in  all  odd  casea, 
these,  as  well  as  the  exudative  thickening  of 
the  urethral  membrane,  are  more  or  less  re- 
duced. I  wish  to  recommend  most  emphatically 
the  use  of  the  bougie  in  the  treatment  of  semi- 
nal incontinence.  If  there  be  any  pronounced 
impotence  of  a  neurotic  origin,  the  passage  of 
the  feeblest  possible  electric  current  through  the 
steel  sound  while  it  is  in  sUu  will  in  some  cases 
prove  beneficial,  but  only  the  mildest  currents 
should  be  employed.  This,  however,  as  well  as 
Trousseau's  rectal  pessary,  at  one  time  as  popu- 
lar, will  rarely  if  ever  be  needed,  since  otb^ 
means  are  quite  as  efiective. 

Without  the  measures  already  recommended, 
the  use  of  drugs  alone  will  surely  end  in  failure. 
It  is  astonishing  how  few  of*  the  many  medica- 
ments suggested  for  this  trouble  are  really 
efficaciou&  Lupuline,  cimicifuga,  ergot,  cam- 
phor, conium  and  similar  remedies  have  seemed 
to  me  to  afford  only  a  temporary  relief,  if  any 
at  all.  Atropia,  the  bromides,  and  strychnia 
are  the  medicines  I  place  most  confidence  in.  Of 
these,  atropia  stands  by  all  odds  at  the  head. 
By  checking  the  activity  of  the  seminal  glands 
the  alkaloid  of  belladonna  enables  them  to  re- 
cover their  wonted  tone  and  function.  A  pill 
containing  gr.  ^  or  gr.  3^  of  atropia  should  be 
administered  every  night  at  bedtime,  so  that  the 
patient  may  sleep  through  the  unpleasant  sensa- 
tions which  this  drug  sometimes  gives  rise  to. 
So  satisfactory  have  I  found  the  use  of  atropia 
in  this  way  that  I  would  rather  discard  every 
other  medicine  than  it  Sometimes  it  is  .well  to 
exhibit,  together  with  the  night  pill,  another  is 
the  morning  containing  a  smaller  quantity  of 
the  drug,  say  gr.  ^  to  gr.  ^jg.  While  em- 
ploying this  remedy  the  attendant  must,  of 
course,  closely  watch  the  state  of  the  pupils  as 
a  guide  to  the  quantity  being  ingested.  The 
bromides  are  frequently  effective,  but  they  most 
be  given  in  massive  doses.  The  potassium 
bromide  may  be  administered  in  drachm  and  a 
half  dose  at  bedtime,  and  diminished  upon  the 
first  indication  of    bromism.     This  salt  alka- 


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Uiiizes  the  urine  and  blunts  the  reflex  irrita- 
hility  of  the  spinal  cord.  At  times  the  other 
bromides  are  admirably  borne.  Some  patients, 
especially  the  neurasthenic  ones,  tolerate  the 
moDO-bromide  of  camphor  in  five  or  ten  grain 
doeee.  I  have  no  experieace  to  confirm  the 
high  recommondf^on  by  Hecquet  of  ferric  bro- 
mide in  three  and  five-grain  doses.  In  anemic 
cases  this  would  doubdess  be  a  most  eligible 
form  in  which  to  administer  the  bromide. 
Antipyrin,  cocaine,  tincture  of  hops  and  dulca- 
mara are  all  anaphrodisiacs,  more  or  less  valua- 
ble in  neurotic  cases.  Ergot  has  been  highly 
lauded  in  the  relaxed  condition  of  the  genital 
organs  associated  with  a  continuous  discharge.  I 
have  not  seen  the  permanent  good  results,  how- 
ever, that  have  been  claimed  for  it.  Where 
there  is  a  deficiency  in  the  nervous  tone  I  find 
the  strychnia  meets  the  demand  most  completely. 
This  powerful  spinal  cord  stimulant  should  not 
be  considered  until  all  the  signs  of  inflammar 
tion  and  irritabillity  have  been  removed,  and 
ihe  patient's  general  physique  indicates  a  return 
to  its  former  vigour.  In  doses  of  gr.  ^  to  gr.  ^ 
it  then  acts  most  happily  in  restoring  the 
normal  functions  of  the  genital  glands.  Of 
course  the  use  of  iron,  especially  the  tincture  of 
the  chloride,  arsenic,  cod  liver  oil  and  corres- 
ponding systemic  tonics,  will  commend  themselves 
in  properly  selected  cases.  The  patient's  general 
health  must  be  built  up  in  every  way  so  that  a 
strong  constitutional  background  may  be  afforded 
fer  the  improvement  of  the  genital  functions. 
Electricity  is  a  valuable  agent  in  this  conneo- 
tioo,  especially  when  applied  in  the  manner  of 
general  faradization  and  central  galvanization 
with  mild  currents. 

I  have  never  found  it  necessary  to  use  other 
local  means  of  treatment  than  the  bougie;  hence 
I  will  say  nothing  of  the  various  injections  pro- 
posed containing  nitrate  of  silver,  tannin, 
hydrastis,  eta  Such  injections  ought  always  to 
be  used  wtth  the  greatest  caution,  as  strictures, 
impotence,  and  even  death  have  been  caused  by 
thrao  when  too  strong.  They  are  not  only 
troublesome  to  carry  out  peifecdy,  but  I  be- 
lieve are  less  effective  than  the  earnest,  persist- 
ent use  of  the  sound.  I  am  assured  that  with 
patience  and  perseverance  few  cases  of  seminal 
boontinence  can  resist  the  combination  of  moral, 
hygienic  instrumental  and  medicinal  measures 
outiined  above. — L.  Harrison  MetUer,  A.M., 
H.D.,  Chicago,  111.,  in  Medical  Record. 


Those  intending  to  attend  the  approaching 
International  Medical  Congress  at  Rome,  Italy, 
will  address  A.  Jacobi,  M.D.,  110  West  Thirty- 
fourth  street.  New  York,  N.  Y.,  for  information 
as  to  rates,  travel,  etc 


An  Eflloient  Depilatory. 

Butte  (Monatschr.  f.  prakt  Dermatol,  1893) 
recommends  for  this  purpose  iodine  collodium, 
applied  for  three  or  four  days  in  a  fairly  thick 
layer  to  the  hairy  part,  when  the  collodium  pel- 
licle is  removed,  the  hair  will  be  found  to  stick 
to  its  lower  surface. — N.  Y,  Medicin  MonaUchfr. 


Ipeoaouannha  Without  Emetine. 

Powdered  ipecacuannha  root,  deprived  of  its 
emetic  principle,  emetine,  is  stated  to  have 
achieved  great  success  in  the  treatment  of  dysen- 
tery. The  virtues  of  ipecacuannha  are  well 
known  in  this  direction,  but  have  hitherto  been 
marred  by  the  distressing  vomiting  that  accom- 
panies large  doses.  Merck,  of  Darmstadt,  has 
produced  a  powder  from  the  root  of  the  beet 
Brazilian  ipecacuannha,  free  from  emetine,  but 
containing  the  other  constituents  intact  This 
has  proved  of  great  service  in  British  India,  the 
chosen  home  of  acute  and  chronic  dysentery. 
Scruple  doses  may  be  taken  frequently,  without 
the  usual  vomiting.  It  is  known  as  ipecacuannha 
deemetinisata. — Dr.  Louis  Lewis,  in  Timet  and 
Register. 


Special  Exeroise  to  Correct  and  Prevent  Consti- 
pation. 

Friction,  rubbing,  or  massage  over  all  parts 
of  the  abdomen  two  or  three  times  per  day  by 
the  patient  himself,  or  less  frequentiy  by  a  good 
magnetic  operator  will  help  promote  vital  ao- 
tion  of  the  bowels.  If  not  convenient  for  the 
patient  to  walk  or  ride  for  exercise,  he  can  se- 
cure the  advantage  of  both  in  large  d^ree  by 
the  following  exercise  taken  in  his  room : 

Standing  with  the  feet  well  apart  to  broaden 
your  base,  bend  or  flex  the  lower  limbs  at  the 
knees  and  extend  the  same  about  twice  a  second, 
or  one  hundred  times  a  minute,  for  several 
minutes  at  a  time,  three  or  four  times  a  day, 
and  at  the  same  time  twist  or  turn  the  body 
above  the  hips  first  to  the  right  and  then  to  the 
left  as  far  as  you  well  can,  resting  the  hands 
upon  the  hips  or  allowing  them  to  hang  by  your 
side.  At  each  turn  of  the  body  toward  the 
right  or  left  you  will  bend  the  knees  about 
three  or  four  times.  You  thus  use  chiefly  the 
flexors  and  extensors  of  the  thighs,  and  the 
rotating  muscles  of  the  trunk.  The  motion  of 
the  body  is  meanwhile  up  and  down,  and  the 
motion  of  the  chest  and  head  is  alternately  to 
the  right  and  left  To  facilitate  the  turning  of 
the  b^y,  the  heel  of  the  limb  oppoate  the  one 
on  which  you  rest,  as  the  body  sways  from  side 

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to  side,  may  be  raised  so  as  to  allow  thn  limb  to 
turn  upon  the  ball  or  toe  of  the  foot  To  get  the 
best  efieet  of  this  exercise  the  head  must  be  kept 
well  up,  the  shoulders  back,  and  the  spine  erect 
during  the  exercise.  The  bowels  may  generally 
be  allowed  to  rise  and  fall  with  the  body,  but  at 
times  it  is  well  to  exercise  the  diaphragm  by  en- 
deavoring to  draw  up  beneath  it  the  liver  and 
viscera  of  the  abdomen. — Dr.  Dutton,  in  Jour. 
Am,  Health  Society, 

Treatment  of  Warts  and  Other  Exorescenoes. 

In  cases  of  multiple  warts  of  the  face.  Prof. 
Kaposi  recommends  the  application  of  the  fol- 
lowing paste : 

B   Sublimed  sulphur ^ drams  ▼ 

Pure  concentrated  aceUc  add drams  llss 

wlyoerlne ox  U 

Mix.— For  external  use. 

The  paste  is  applied  to  the  warts  either  with  a 
brush  or  spread  over  small  pieces  of  linen.  This 
is  done  at  night,  the  paste  being  washed  off  the 
next  morning.  The  application  is  repealed  for 
several  days  in  succession.  Under  the  influence 
of  this  treatment  the  warts  shrivel  up,  become 
blue  and  ultimately  drop  off  spontaneously. 

Another  very  simple  method  employed  with 
success  by  Prof.  Kaposi  in  the  treatment  of 
&cial  warts  consists  in  covering  the  affected 
parts  with  pieces  of  flannel  smeared  with  soft 
soap.  These  are  left  in  position  for  twenty- four 
to  forty-eight  hours,  according  to  the  d^ree  of 
sensitiveness  displayed  by  the  patient,  until  the 
skin  becomes  red  and  shrivels  up  After  re- 
moving the  flannel  the  warts  should  not  be 
washed,  nor  even  wiped;  they  become  spontane- 
ously detache  i  in  about  a  week. 

In  Prof.  Kaposi's  opinion  electrolysis  is  the 
most  efficacious  means  of  treating  nevi  mollu- 
sciformes,  a  needle  connected  with  the  negative 
pole  of  a  battery  is  introduced  into  the  tumor, 
while  the  patient  holds  the  positive  electrode  in 
his  hand.  A  current  of  from  one  to  two  mil- 
liamp^res  should  be  used  and  the  application 
should  last  about  thirty  seconds.  It  is  repeated 
at  the  end  of  a  week  or  fortnight  Large  nevi 
require  the  application  of  the  galvano-cautery 
or  some  other  caustic. — N.  A.  Practitioner, 


Atropine  as  a  Hemostatic, 
BiermertV  thinks  that  atropine  in  a  small 
hypodermic  dose  is  superior  to  all  other  reme- 
dks  as  a  hemostatic. 


Emulsion  of  Cod-liver  Oil. 

The  following  note  upon  cod-liver  oil  is  Made 
by  Dr.  J.  Madison  Taylor  in  the  Philadelphia 
Polyclinic:  *«The  best  form  is  a  cold-proMed 
oil  from  freshly  selected  livers.  The  difference 
between  this  and  inferior  oils,  both  in  taste  and 
efficiency,  cannot  be  overstate.  This  kind  caa 
always  be  given  straight.  I  devised  a  very 
economical  and  handy  form  of  emulsion,  which 
my  assistants  use  much.  .  In  an  eight  ounce  bol- 
tie  six  ounces  of  oil  are  put;  the  mother  adds  to 
this  one  raw  egg,  one  tablespoonful  of  whisky, 
and  fills  the  bottle  up  with  glycerin.  The  whole 
is  then  thoroughly  shaken  and  kept  in  a  oooU 
dark  place.  It  is  agreeable  and  well  retained.'* 
— Med,  Bulletin, 


Bean-Pods  as  a  Diuretic. 

According  to  Dr.  Ramm,  of  Preetz,  a  decoc- 
tion made  of  dried  bean-pods  has  a  powerful 
diuretic  effect,  and  is  even  capable  of  diss<>l  ving 
urinary  concretion& — DntggiM^  Circular, 


Class- Room  Notes. 

(From  Coll.  and  Clin.  Record.) 

Antipyrine,  Prof.  Hare  says,  aids  the  elimi- 
nation of  uric  acid  from  the  economy. 

Cannabis  indica.  Prof.  Hare  says,  will  often 
be  found  to  be  very  useful  in  cases  of  migraine. 

Prof.  Wilson  says  that  only  the  severe  cases 
of  rubella  or  rotheln  are  followed  by  desquama- 
tion^ 

Belladonna  locally  applied.  Prof*  Hare  ^ays^ 
will  be  found  very  useful  in  cases  of  localised 
neuritis. 

Surgical  cases.  Prof.  Keen  says,  should  be 
dressed  as  seldom  as  the  safety  of  the  patiml 
will  admit 

Prof.  Wilson  says  that  gastrointestinal  ulcers 
occasionally  develop  during  the  period  of  con- 
valescence of  an  attack  of  small  pox. 

Syphilis,  if  it  be  due  to  vaccination,  Ytof, 
Wilson  says,  will  have  the  chancre  in  all  cases 
appearing  at  the  point  of  vaccination. 

Prof.  Montgomery  says  that  the  uterus  should 
always  be  sterilized  by  some  antiseptic  after  an 
instrument  has  been  introduced  into  it 

Adenomata,  according  to  Prof.  Keen,  are 
painful  only  at  the  period  of  menstruation,  but 
sarcomata  are  painful,  independent  of  this 
period. 

The  best  treatment,  according  to  Prof.  Keen, 
in  cases  of  tubercular  peritonitis  is  to  open  the 
abdomen  and  drain  for  a  long  period. 

Prof.  Parvin  says  that  all  drugs  which  by 
their  therapeutic  action  tend  to  increase  the 
arterial  tension  will  also  increase  the  flow  of  the 
milk. 

As  a  rule.  Prof.  Keen  says,  in  eveiy  four  out 
of  five  cases  of  fistula  in  ano,  the  patient  will  be 
found  to  be  of  a  tubercular  character. 


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109 


Malarial  fever,  according  to  Prof.  WilsoD, 
wUl  be  rarely  met  with,  if  at  all,  in  those  re- 
giona  in  which  the  temperature  does  not  rise 
above  60°  F. 

Gljcerine  or  any  of  the  mineral  fats,  Prof. 
Wilson  says,  should  not  be  employed  by  inunc- 
tion in  the  skin  |in  \»8es  of  scarlet  fever,  but 
fresh  animal  fats  should  be  employed  in  mak- 
ing inunctions. 

Prof.  Hare  says  that  a  combination  of  bro- 
mide and  caffeine  will  often  cure  a  headache 
that  neither  the  bromide  nor  the  caffeine  alone 
will  relieve. 

Prof.  Parvin  says  that  two  hours  should  be 
allowed  to  elapee  before  active  measures  are  in- 
stituted toward  the  forcible  removal  of  a  re- 
tained placenta. 

Prof.  Parvin  thinks  that  the  iavolution  of  the 
sexual  organs  after  confinement  takes  place 
mor«  rapidly  and  satisfactorily  if  the  mother 
Durses  the  child. 

Prof.  Parvin  does  not  favor  the  administrar 
tion  of  ergot  during  the  third  stage  of  labor  un- 
less the  patient  be  a  habitual  bleeder,  if  hem- 
orrhage be  present 

The  hemorrhage  occurring  in  cases  of  lacera- 
tion of  the  cervix,  Prof  Parvin  has  found,  can 
generally  be  controlled  by  the  injection  of  hot 
water  into  the  vagina. 

Inability  to  nurse,  Prof.  Parvin  says,  is  often 
due  to  heredity;  brought  on  by  the  fact  that  a 
number  of  sucx^essive  preceding  generations  did 
not  nurse  their  offspring. 

Unless  during  the  existence  of  an  epidemic  of 
small  pox,  a  child  who  is  suffering  from  a 
CQtaneous  disease,  or  who  is  otherwise  in  poor 
health,  should  not  be  vaccinated. 

Fibromatous  tumors,  Prof.  Keen  says,  are 
neither  painful  nor  tender  to  the  touch;  they  are 
also  slow  in  growth.  They  may,  he  says,  by 
pressure  on  ajacent  parts,  produce  pain. 

The  eruptions  produced  by  the  inoculation  of 
vaccine  l^mph  will  manifest  themselves.  Prof. 
Wilson  says,  twenty  four  hours  earlier,  if  the 
inocolation  has  been  performed  by  human 
lymph,  than  if  performed  by  the  bovbe. 

Cannabis  indica,  acc^^rding  to  Prof.  Hare, 
will  be  found  to  be  a  very  useful  drug  in  stop- 
ping the  cough  of  phthisis,  and  it  possesses  the 
advantage  over  opium  in  that  it  is  not  so  de- 
pressant to  the  system  in  general. 

Sarcoma,  Prof.  Keen  seys,  as  a  rule,  is  a 
disease  of  youth  and  not  of  old  age.  It  makes 
its  appearance  generally  during  the  period  when 


the  tissues  are  growing.  It  generally  appears 
between  the  age  of  twenty  and  thirty,  more  so 
than  after  forty. 

Camphoric  acid,  according  to  Prof.  Hare,  is 
the  best  drug  that  can  be  used  in  controlling  the 
night-sweats  of  phthisis  It  should  be  taken  in 
doses  of  twenty  to  thirty  grains,  and  two  or 
three  hours  before  the  time  that  the  sweats  gen- 
erally come  on. 

Anteflexion  of  the  uterus,  according  to  Prof. 
Montgomery,  is  of  most  frequent  occurrence  in 
women  who  have  never  borne  children.  It  is 
also  the  displacement  which  is  found  of  most 
frequent  occurrence  in  the  sterile  woman. 

The  tumor  which  is  scrofulous  in  character, 
Prof.  Keen  says,  in  the  early  stages  will  be 
found  to  be  perfectly  movable,  but  in  the  later 
stages  it  will  be  bound  down  tight  and  will  be 
immovable,  due  to  its  having  infiltrated  into 
the  surrounding  tissues. 

Prof.  Wilson  favors  the  treatment  of  scarlet 
fever  by  chloral.  Such  doses,  he  thinks,  should 
be  administered  as  to  keep  the  patient  under  its 
hypnotic  influence  to  such  an  extent  as  to  re- 
quire wakening  at  the  time  when  food  or  medi- 
cine is  to  be  administered. 

The  recurrence  of  malignant  growth,  except- 
ing sarcoma,  according  to  Prof.  Keen,  rarely 
appears  before  six  months  after  the  operation, 
and  if  such  a  recurrence  does  not  take  place 
within  three  years  after  the  operation,  the 
chances  of  its  not  recurring  at  all  are  the  very 
best 

Prof.  Parvin  calls  attention  to  the  fact  that 
in  opening  an  abscess  of  the  breast,  the  incision 
should  always  be  made  longitudinally  and  not 
transversely.  For,  he  says,  when  the  opening 
is  made  by  a  transverse  incision  more  milk  ducts 
will  be  destroyed  than  if  the  incision  had  been 
made  longitudinally. 

Dr.  Davis  say  the  danger  of  placenta  previa 
to  the  mother  arises  from  hemorrhage  and  shock 
followed  by  collapse,  septic  infections  also  often 
setting  in.  The  danger  to  the  child,  on  the 
other  hand,  exists,  that  asphyxia  may  take 
place,  caused  by  the  placenta  being  detached 
too  rapidly,  thereby  the  supply  of  the  maternal 
blood  being  cut  off  too  soon. 

Prof.  Hare  says  if  the  salicylates  do  not 
yield  g03d  results,  in  cases  of  rheumatism,  in 
from  four  to  six  days,  their  use  should  be  dis- 
continued, and  other  drugs  tried,  as  it  will  not 
be  likely  that  any  good  results  will  follow  their 
further  use.  Nor  does  he  think  that  they  should 
be  administered  in  large  dos^s  three  or  four 
times  a  day.  He  has  had  the  best  results  follow 
from  the  frequent  administration  of  small  dosea. 


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Dr.  Davis  says  cases  of  labor  in  persons  ac- 
tively insane  often  proceed  without  any  mani- 
festations of  pain  being  given  by  the  patient. 
The  delivery  of  the  child,  he  says,  should  be 
made  under  complete  anesthesia  of  the  patient. 
In  these  cases  sedatives  will   often  be  required. 

Prof.  Hare  has  concluded,  as  a  result  of  ex- 
perience, that  in  cardiac  diseases  digitalis  affords 
relief  to  patients  below  the  age  of  twelve  to  a 
less  extent  than  in  similar  forms  of  cardiac 
diseases  in  adults,  and  that  in  children  dyspnea, 
nevous  irritability  and  cyanosis  are  symptoms 
which  often  manifest  themselves  after  the  use  of 
this  drug. 


Formulas. 


Elixir  One  Chloride. 

R   Hydrarg3rri  ohloridam  corroslTiim  (corro- 
sive mercuric  chloride) 2  gr 

Water, 

Syrup  orange aa ..„ 8  os 

M.    Big.— TeaspoonAil  after  each  meaL 

Elixir  Two  Chlorides. 

K   Tlnct  ferri  chloride 1  oz 

Solution  chloride  arsenic 2  dr 

Elixir  simplex,  to  make 16os 

M.    Big.    Teaspoonftil  after  each  meaL 

Elixir  Three  Chlorides. 

R    Mercury  bichloride 8gr 

Ammonia  chloride 2  os 

Solution  chloride  arsenic 8  dr 

SUxlr  simplex,  to  make ....16  os 

M.    Big.   Teaspoonnil  after  each  meal. 

Elixir  Four  Chlorides. 

R.    ICeronry  bichloride. .4  gr 

So  ution  chloride  arsenic 8  dr 

Hydrochloric  add,  dilute 4  dr 

Ifnot.  iron  chloride 8dr 

Simple  elixir,  to  make 16  os 

M.    Big.  Teaspoonftil  after  each  meaL 


Elixir  Five  Chlorides. 

R      Oorrosiye  sablimate 8  gr 

Solution  chloride  arsenic ..3  or 

Hydrochloric  acid,  dilute 

Tlnct.  iron  chloride    aa \J4oz 

Ammonia  chloride 8  oz 

Elixir  sim|de3t.  to  make 16  os 

M.    Big.   Ttaspoonful  after  each  meaL 

The  elixir  of  the  iodides  are  much  the  same 

tt  iodides  of  potash,  arsenic,  iron  and  sodium  in 

iiixir. — Indiana  Pharmacist. 


Anti-Diarrheic  Powder. 

In  the  SpaitluU  No.  19,  1893,  the  following 

powder  is  offered  as  an   efficient  anti  diarrheic  : 

Salicylate  of  binmuth gms  8  (dr  m. 

Benso-naphthoi gms  2  {gt.  xxx). 

Extract  of  opium.; cgmslOCgr.  J88). 

IllTide  into  10  parts,  in  capsules.    One  every  hour  or  two 
••cording  to  the  fluency  of  the  stools. 

— Lancet-  Clinic^ 


IMonsena  Bark  For  Tapeworm. 

M.  Bouchet  {Lyon  Med.,  Nov.  20,  1892)  » 
pharmacist,  recommends  to  the  Society  of 
Therapeutics  the  following  formula  :  Fast  in 
the  evening;  in  the  morning  take  three  or  four 
pearls  of  ether,  and  one  hour  later  administer 
the  following  decoction : 

Water 800gr 

Bark  jof  the  promegranaie  root 60  gr 

Momenabark 60  gr 

Beduc''  to  a  coarse  powder,  boll,  strain,  moisten  the  re8iaue> 
with  a  little  water,  and  replace  on  the  fire  and  eyaporate  to- 
about  a  glassful.  One  hour  after  taking  this  there  generally 
follows  an  abundant  eracuaiion  which  generaUy  contains 
the  entire  tenia. 

— Fwi  Wayne  {Ind.)  Med.  Magazine. 


M. 


Syphilis. 

Syr.  acidi  hydriodici  (Hostelley's) f.  ox.  vi 

Hydrarg.  blchlorid gr.  iss 

Sig.    Teaspoonful  three  times  daily,  id  water. 

Hypertrophic    Phinitit. 

OL    gaultherise ml 

Bucalvptol  (Sanders  &  Son's) dr.  J 

Camphorse grr* ' 

Uq.alboline ox.j 

Sig.    Apply  With  Dayidson's  atomiser. 

Diabetes    Meliitut, 

Lithll  carbonitis dr.  as 

Sodii  arseniatis »  gr- 1 

Extr.  gentianae gr.  xv 

Ft  Massa  et  in  pil  no  XX  diTlde. 
One  pill  morning  and  evening. 

— Annual  Univ.  Med.  Sciences. 


A  Cathartic  Lemonade. 

R    Soda  phospbatis dr.  vlK 

Splrltus  limonis gr.  xix 

Syrupi  simplicis os.  ij 

Aquae  destuiatee  ad os.  x 

MIsce  et  fiat  haustus. 

— The  Practitioner^ 


Chronio  Headache. 

Dr.  Zentler  advises : 

B   Arseniate  of  sodium 

Sulphiate  of  atropine  aa » gr.  ss 

Extract  of  aconite gr.  yij 

Powdered  cinnamon  q.  s 
Kix  and  make  into  thirty  pills.    From  one  to  four  piUv 
dally. 

— La  Rifarma  Medica — Times  and  Register. 


Hair  Dye  and  Stimulator. 

Reply  to  Dr.  Bennett,  Lima,  Ohio. 

Editor  Medical  World: — To  stimulate 
the  growth  of  hair  and  restore  gray  or  faded 
half,  use  the  following  : 

R   Plumbl  acetotls 

Lao.  sulphuris 

Pulve  sodii  boratis aa dr.  i 

Aqun  amonla. dr.  i-b 

Alcoholis 

Spiritus  myrcifld 

Glycemis 

RsB.  oergamont aa ».os.  i 

Aquffi  purse ~ oi  Iv 

M.    Filter  twenty-four  hours. 

Big.    Rub  well  into  scalp  once  to  twice  dally. 

W.  K  Bridgman,  M.D., 
Butte,  Neb, 


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Ill 


Aone  Rosacea. 

P^rini  {Riform  med,)  recommeuds  the  fol- 
lowing applioation : 

Resordxi gr.  xv 

IchthTol « dr  n 

Oollodion oz,  1 

M.    a.    Bxterpally  applied. 

Ailer  erscTiatlng  the  pustoles  thesurfltce  Is  to  be  painted 
onoe  a  day  for  throe  BucceaslTe  dayi.  An  interval  of  five  or 
six  days  without  application,  durine  which  time'  the  ooUo- 
dinm  ooating  deBquamatea.    Reappllcation  if  necenary. 

— Lancet-  Clinic, 


Reviews. 


Oxyuris. 

Minerbi  recommends  the  following  rectal  in- 

bjection  for  children : 

Kaphthalln gr.  zr-xx 

•L  oliv .^ 08.  i-of,  li 

M.    3.    Ix^ection. 

For  adults : 

Naphthalin « acr.  iv-dr.  in 

Qh  oUv oz.  ii-o«.  ill 

M.    &    Injectipn. 

—lb. 


Hemicrania. 

The  following   (Nouv,  Eemed,)    is    recom- 
mended : 

Batyl  chloral  hydrat gr.  xvi 

Ext.  cannabis  indie gr.  iv 

Mt   DiT-  in  part,  eequal  xri.    Da  in  capsni. 
8ig.   Take  two  capsules,  and  a  third  capsule  one-half  hour 
tbeieafter. 

—lb. 


Enuresis  Nooturna. 

White  {Movatshefte  /.  pract,     Demuitologie) 
gives  the  following : 

Sodlibenzoat,       i^^  m-  xvi 

Sodii  halicylat.,    {** ^'  ^^* 

Bxt  bellad.,  fl., gtts  11 

Aqusee  dnnam., ox.  iv 

M.    8.    Four  to  five  teaspoonfhls  a  day. 

—lb. 


La  Grippe. 

Sodium  sulphite  is  one  among  the  many 
things  which  are  said  to  have  been  used  with 
success.  A  teaspoonful  of  the  following  mix- 
ture in  the  same  quantity  of  water  is  given 
every  two  hours  until  relief  is  obtained  : 

Sodium  sulphate 4drs 

Water 6oz 


Tooth  Wash. 

Dissolve  two  ounces  of  borax  in  three  pints 
of  boiling  water,  and  before  it  is  cold  add  one 
teaspoonful  of  the  spirits  of  camphor,  and  bottle 
for  use.  A  tablespoonful  of  this  mixture,  mixed 
with  an  equal  quantity  of  tepid  water,  and  ap- 
plied daily  with  a  soft  brush,  preserves  and 
beautifies  the  teeth,  extirpates  all  tartarous 
adhesion,  arrests  decay,  induces  healthy  action 
of  the  gums  and  makes  the  teeth  pearly  white. — 
Pfciij.  Record, 


Sexual   Weakness  and   Impotence;  by  Edward 
Martin,    M.D.;   published    by    Gko.     S.  Davis, 
Detroit^  Mich.,  Price,  25  cento. 
This  is     a    neat    yoliime    of   102   pages;    illus- 
trated.    The     author     talks     plainly    and    clearly 
npoQ    the    subject   inyolyed,    and    which    are     the 
source  of  so  much  annoyance  and  perplexity  to  the 
practitioner.    The  ordinary  text  books  give  very  little 
satisfaction  in  this  class  of  cases.    This  little  book  fills 
the  lacking  very  acceptably.    We  recommend  it  very 
highly. 

The  Alkaloid al  Clinic,  M^  C.  Abbott,  M.D., 
editor.  Monthly,  $1  per  year.  Published  by 
the  £)ditor,  Kavenswood,  Chicago,  IlL 
We  welcome  this  journal  to  our  exchange  table  and 
to  the  sisterhood  of  medical  journals.  The  object  is 
to  give  definite  information  in  regard  to  the  progress 
of  scientific  knowledge  in  the  treatment  of  disease  by 
active  principles.  The  talented  editor  is  already  well 
and  favorably  known  to  all  our  readers.  His  work  in 
the  initial  number  of  C2mtc,  as  in  all  his  writings,  is 
very  good  indeed.  Dr.  Abbott  might  appropriately 
be  termed  the  American  champion  of  dosimetric  m(:di- 
cation.  His  journal,  being  devoted  to  a  distinct  ad- 
vance in  medic  il  science,  is  well  worth  the  subscrip- 
tion price.  J.  J.  T. 

"Mathews  Medical  Quakterly;"  a  journal   de- 
voted to  diseases  of  the  rectum,  gastro-intestinal 
disease,  and  rectal  and    gaatro-intestinal  surgery. 
Edited  by  Joseph  M.  Mathews,  M.D.,  Louisville, 
Ky.,  (P.  0.  Box  434);  |2  per  year;  single  copies 
55  ceut& 
We  have  seldom  or  never  been  so  favorably  im- 
pressed by  a  new  medical  journal  as  by  this  one.    The 
first  number  is  a  veratable  mine  of  information  upon 
the   subjecte   embraced.  '  Every  physician  comes  in 
contact  with  this  class  of  diseases,  particularly  diseases 
of  the  rectum.     Dr.  Mai  hews  was  the  first  regular 
member    of   the    profession    to  make  a  specialty  of 
diseases    of  the  rectum.    As    usual,    irregulars    first 
reaped  a  rich  harvest  in  this  field,  before  the  regular 
profession  saw  the  importance  of  devoting  special  at- 
tention   to  it.     We    owe    Dr.    Mathews  much  as    a 
pioneer  in  this  direction,  and  also  for  this  valuable 
publication.    This  first  number  is   worth  many  times 
Its  price  to  the  general    practitioner.     The   doctor 
wishes  the  names  of  all  reputable  suxgeons   in    the 
United  States,  who  limit  their  practice  to  diseases  of 
the  rectum. 

Cholbcystotomy — Report  of  six  cases;  by  Hugo 
O.  Pantzer,  M.D.,  Indianapolis.  They  are  very  inter- 
esting cas^  Many  chronic  liver  troubles  are  amena- 
ble to  treaunent  by  operation  upon  the  gall  bladder. 
We  predict  that  this  operation  will  readily  increase 
in  popularity.  We  suppose  that  the  author  will  send 
this  reprint  free  to  physicians  who  desire  it 

The  Suocjessfdl  Management  of  Inebriety  With- 
out Secrecy  in  Therapbutics.  By  C.  H. 
Hughes,  M.D.,  St.  Louis,  Mo. 

An  attractive  feature  of  the  February  Arena  is  a 
Symposiuta  on  "  Rational  Dress  for  Women,"  by  a 
number  of  well-known  American  women.  There  are 
fifteen  large  photogravures  accompanying  the  Sympo- 
sium, illustrating  the  style  of  dress  now  worn  by 
American  women.  This  issue  contains  164  pages,  and 
is  filled  with  able  pspers  from  thoughtful  men  and 
women.    Address  Copley  Square,  Boston. 


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Wit  and  Wisdom, 

Please  see  Dr.  Waugh's  card,  thb  issue,  in  regard 
to  his  private  hospital. 

Sex  pages  xxiii  and  xxv,  this  issue.  Is  there  any 
practitioner  in  this  country  who  is  not  acquainted 
with  the  venerable  Philadelphia  Medical  arui  Suraieal 
Beporter  ?  Grasp  the  offer  there  made,  and  make  it 
your  companion  for  the  remainder  of  this  year.  The 
combination  provides  that  those  who  are  already  sub- 
scribers for  The  World  this  vear  mav  have  the  Be- 
porter for  the  remainder  of  1894  and  The  World  for 
1895  for  $2.75.  To  new  subscribers,  Beporter  and 
World  for  the  remainder  of  1894  for  $2.75. 

Metabolism. — ^This  is  a  scientific  treatise  on  the  gen« 
eral  subject  of  tissue  changes,  or  the  process  of  waste 
and  repair,  with  therapeutic  sugnrestions.  Sent  free  by 
Jamee  I.  Fellows,  48  Vesey  St.,  New  York,  N.  Y. 

Brown. — Do  you  believe  there's  such  a  thing  in 
married  life  as  perfect  love  ?  A  case  where  both  are 
of  the  same  mind  ?  Fogg. — Oh,  yes;  there  are  the 
Google^s,  for  instance.  She  thinks  there  never  was 
a  man  m  the  world  like  her  husband,  and  so  does  he. 

Temporary  Tooth  Filling. 

A  filling  of  pure  beesewax  is  an  excellent  thing  for 
temporaruy  filling  an  aching  tooth  that  is  decays. 

Oakfield,  N.  Y.,  March  15, 1898. 
Freligh's  Tablets  gave  me  most  excellent  results, 
and  can  recommend  them  as  worth  of  trial  by  the 
medical  profession.  I  am  still  prescribing  Freurh's 
Tonic — original  unbroken  pack&ge— with  marked 
benefit  A.  P.  Jackson,  M.D* 

Rheumatism, 

I  have  not  only  been  surprised  but  elated  with  the 
excellent  results  from  Syrup  of  Hydriodic  acid  in  in- 
flammatory rheumatism.  While  I  have  been  using 
the  preparation  for  a  long  time,  and  with  decided  ad- 
vantage its  application  in  rheumatic  conditions  only 
recenUy  sumested  itself  to  me.  I  have  treated  a 
sufiicient  numoer  of  cases  with  the  remedy,  however, 
to  be  positive  of  its  superior  therapeutic  properties  in 
controlling  these  painful  conditions.  My  usual  pre- 
scription and  directions  are  as  follows : 

R   Symp  add  hydriodlo  (Hostelley's) f  os.  vj 

Sig.    l%n  to  twenty-five  minims  every  three  or  four  hours. 

The  dose  may  be  increased  after  a  week  or  ten  days' 
treatment,  and  as  symptoms  subside  the  dose  is  to  be 
gradually  diminished.  I  frequently  blister  in  connec- 
tion with  the  above,  and  from  this  combined  treatment 
have  observed,  in  a  number  of  cases,  almost  marvelous 
results.  Several  of  the  cases  which  have  yielded 
promptly  to  the  treatment  were  as  severe  rheumatic 
cases  as  I  ever  saw.  F.  M.  Beltz,  M.D., 

2036  N.  Broad  St.,  Phila. 

Medical  Inspector  Board  of  Health. 

An  eicellent  and  instructive  book  on  "Winter 
Remedies*'  will  be  sent  free  if  you  write  to  H.  K. 
Mulford  Co.,  Phila. 

Doctor.— There,  Patrick,  is  something  that  will 
give  you  an  appetite  for  your  dinner.  Pat— Faith, 
an'  it's  not  that  1  want.  The  great  nade  is  a  dinner 
for  me  appetite. 

The  man  who  waits  for  a  golden  harp  with  which 
to  praise  God  would  feel  very  much  out  of  place  in 
heaven. 


Fob  a  steady  thing,  the  lieht  of  a  tallow  candle  is 
better  than  th^t  of  a  sky-rocket. 

Celerina  in  combination  with  Aletris  Cordial  is 
used  with  marked  success  in  cases  of  nervous  debility 
arising  from  uterine  derangements. 

See  advertising  page  xxxv  in  January  Wobij), 
and  send  25  cents  to  the  New  York  and  Chicago 
Chemical  Co.,  96  Maiden  Lane,  New  York  CityTfor 
their  very  liberal  oflfer. 

If  you  want  to  keep  on  thinking  well  of  a  man, 
don't  go  his  security. 

I  HAVE  used  Peacock's  bromides  in  four  cases  of 
epilepsy,  and  it  is  only  fair  for  me  to  state  that  I  have 
had  good  results  in  Aach  case.  In  three  of  these  oases 
there  were  no  attacks  at  all,  while  the  medidne  was 
used,  although  the^  had  been  frequent  and  severe  in 
spite  of  the  exhibition  of  the  ordinary  bromide  salts, 
r  say  while  it  was  used  because  I  have  had  difficult 
in  convincing  some  patients  that  they  were  not  en- 
tirely cured  after  using  one  bottle,  but  where  I  have 
been  able  to  have  them  continue  the  treatment  for  a 
reasonable  time  after  the  disappearance  of  the  fits, 
there  has  been  no  return  of  them  even  after  the  medi- 
cine was  stopped.  Chas.  C.  Johnson,  M,D. 

Columbia,  S.  C. 

Mellin's  Food  is  just  the  proper  thing  for  your 
delicate  invalids  and  Infants. 

PoYEBTT  is  no  disgrace,  when  it  is  our  neighbor 
who  is  poor. 

Wild  oats  are  said  to  be  the  only  crop  that  grows 
by  gaslight 

DiDDEEBAu— Did  you  attend  the  lecture  of  Prof. 
Hardhead  on  '^Grip,  a  Malady  of  the  Imagination  V* 
Biddereau— He  did  not  lecture.  "Why  not  V*  "Down 
with  the  grip." 

Send  to  W.  H.  Schiefielin  &  Co.,  New  York,  for 
rare  drugs,  the  newest  from  the  scientific  laboratories. 

Put  your  plethoric  patients  upon  Phjrtoline. 

Send  to  the  Empire  Truss  Co.,  Lockport,  N.  Y., 
for  trusses,  elastic  bandages  and  all  woven  goods. 

Have  you  yet  tried  Micijah's  Uterine  Wafers  ? 

Send  to  I.  Phillips,  Atlanta,  Oa.,  for  surgical  in- 
struments. 

Strup  of  Figs  is  prominently  recommended  as  a 
good  family  laxative. 

Look  for  the  newest  valuable^  drug  to  come  from 
the  laboratories  of  Parke,  Davie  &  Co.,  Detroit^  Mich. 

Please  see  the  very  liberal  offer  of  Hall  A  Buckel, 
this  issue,  in  regard  to  their  soap,  Sozoderma. 

A  MAN  named  Snow,  living  in  the  suburbs,  was 
made  a  father  a  few  davs  ago,  and  he  sent  the  an- 
nouncement to  the  local  paper:  "A  little  &iow 
drifted  into  my  house  last  night'* 

The  L<ambert  Phermacal  Company  was  led  to  sus- 
pect that  substitution  was  largely  practiced  in  Chicago 
in  regard  to  their  Listerine.  A  trusted  representative 
was  sent  to  purchase  16  to  25  cents  worth  of  Listerine 
from  each  of  500  drug  stores;  479  purchases  were 
made,  and  each  carefully  tested.  Just  tnink  of  Uie  fol- 
lowing astonishing  results :  251  were  genuine  Lister- 
ine; ^4  contained  no  Listerine  whatever;  24  were 
Listerine  diluted  with  water  or  glycerine.  Judgment 
{Continued  on  next  leaf.) 


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ledge tiat  has  life  and  growth  in  it  and  converts  itself  into  practical  power.      The 

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


The  Medical  World. 

YUBLX8HBD  MONTHX.T,  by  C.  F.  TaYLOR,  M.  D. 


C  F.  Tayw)r,  M.  D., 
J.J.  Tayi^or,  M.  D., 


\  Editors. 


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k%  You  Freely  Receive,  80  Freely  Give. 

One  of  the  chief  characteristics  of  the 
readers  of  this  journal  is  that  they  frater- 
nally exchange  with  one  another  the  nseful 
ideas  they  acquire  from  their  experience  and 
research.  This  is  a  practice  which  results 
in  mutual  advantage  and  also  in  great 
benefit  to  humanity  represented  by  their 
patients.  We  have  to  record  a  notable  excep- 
tion in  the  person  of  one  who  recently  wrote  us 
that  he  had  found  a  successful  treatment  of  a 
oertain  disease,  but  that  he  would  not  give  it  to 
the  profession  nor  to  the  public — he  was  not 
^ing  to  give  away  the  results  of  his  study. 

In  response  to  this  we  would  ask  the  doctor 
where  his  medical  knowledge  came  from.  Is 
be  not  indebted  to  the  profession  at  large  for 
the  accumulated  knowledge  of  many  genera- 
tions   of   medical    investigators  who  studied, 


experimented,  observed,  recorded  and  published 
their  observations  for  the  benefit  of  others  ?  If 
the  doctor  had  been  left  solely  to  his  own  inves- 
tigations for  information  could  he,  even  in  a 
long  life- time,  have  learned  the  anatomy  of  the 
human  system,  the  details  of  physiological  pro- 
cesses, the  pathology  of  the  various  diseased 
conditions,  the  action  of  the  many  articles  that 
have  been  tried  as  drugs  and  been  either 
retained  as  valuable  or  rejected  as  worth- 
less? Could  he,  unaided,  ever  have  mastered 
a  single  disease  or  the  virtues  of  a  single 
drug?  Men  of  eminent  learning  have  de- 
voted the  concentrated  effort  of  a  life- time  to 
the  accomplishment  of  one  of  these  objects  and  at 
the  last  have  been  compelled  to  hand  the  work 
over  to  their  successors  to  take  up  where  they 
have  left  ofi.  How,  then,  can  this  doctor  say 
that  h^  has  learned  his  alleged  method  of  curing 
a  certain  disease,  when,  even  if  valuable  at  all, 
it  is  only  a  slightly  different  application  of  infor- 
mation that  has  been  discovered  and  furnished 
him  by  others  ?  If  by  publishing  to  the  profes- 
sion his  method  of  treatment,  whatever  it  may 
be,  he  could  discharge  his  obligation  to  his 
scientific  confreres  for  the  accumulated  wisdom 
of  ages  and  also  for  the  ideas  he  receives  from 
month  to  month  from  all  parts  of  the  world,  he 
would  get  off  cheaply,  indeed.  The  fact  is  that 
the  very  best,  by  giving  all  that  he  learns  by 
practice  and  research,  cannot  repay  a  tithe  of 
what  he  has  received.  He  can  only  do  his  best, 
and  no  one  can  do  better.  Truly,  we  are  none 
of  us  our  own  makers  or  our  own  educators. 
*  *  * 

As  a  recent  example  illustrating  the  senti- 
ments expressed  in  the  above  remarks  we  have 
the  action  of  Dr.  William  Moor,  of  355  Boule- 
vard W.,  New  York,  in  making  public  his  treat- 
ment of  morphine  poisoning.  Although  only 
published  a  few  weeks,  yet  already  we  have 


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114 


THE  MBDICAI.  WORLD. 


reports  from  credible  observers  that  it  has  saved 
several  lives,  some  of  which  cases  are  given 
elsewhere  in  this  number  of  The  World.  Dr. 
Moor  does  not  claim  that  he  elaborated  the 
clinical  symptoms  of  morphine  poisoning  or  that 
he  discovered  the  chemical  process  by  which 
permanganate  of  potassium  is  obtained.  These 
he  received  from  others,  in  the  course  of  his 
medical  studies.  He  only  made  the  particular 
application  in  question,  after  observing  the 
chemical  reaction  of  the  two  drugs  when  brought 
together  in  the  laboratory.  His  observation  he 
at  once  told  to  his  professional  friends,  both  as 
a  measure  of  return  for  his  general  indebtedness 
to  science  and  from  his  feeling  for  sufiering 
humanity  and  his  desire  to  save  as  many  lives 
as  possible.  Only  those  imbued  with  these  prin- 
ciples deserve  to  be  ranked  with  the  medical 
profession. 

Lilac  for  Malaria. 
Dr.  Valerius  Idleson,  of  Berne,  Switzerland, 
recommends  in  the  St  Louis  Medioal  and  Surgi- 
cal Journal  the  use  of  an  infusion  of  lilac  (six 
fresh  leaves  of  the  plant  to  a  cupful  of  hot 
water)  for  malarial  and  intermittent  fevers.  Two 
oupfuls  of  the  infusion  should  be  taken  daily 
until  the  attacks  disappear;  after  that  one  cup 
ful  daily  for  a  few  days. 

In  the  resuscitation  of  the  asphyxiated,  as 
from  drowning,  one  of  the  first  points  to  be  re> 
membered  is  to  pull  the  tongue  forward  and 
tnus  free  the  air  passages  from  the  obstruction 
caused  by  its  pressure  against  the  pharynx.  It 
is  well  to  draw  the  tongue  backward  and  for- 
ward and  thus  secure  rythmical  entrance  of  air 
into  the  passages.  Forcible  dilatation  of  the 
sphincter  ani  and  the  injection  of  some  irritable 
substance,  as  infusion  of  capsicum,  into  the  rec- 
tum will  be  of  service. 


According  to  The  Vegetarian^  the  free  use  of 
oranges,  apples  and  other  acid  fruits  will  de- 
stroy the  appetite  for  strong  drink. 

The  New  York  Herald  says  that  free  inhala- 
tions of  cologne  water  will  break  up  a  beginning 
•oryza. 

Use  iodide  of  lime  for  croup,  as  recommended 
in  these  pages  some  time  ago. 


Short  arti^des  on  fhe  treatment  of  di9easa^  and  ezperience 
with  new  remediea,  are  solicited  from  the  profeaaion  ftu 
this  department ;  alao  difficult  cases  for  <uagnoais  ana 
treatment. 

Articles  accepted  most  be  contributed  to  this  Journal  only. 
The  editors  are  not  responsible  for  views  expressed  vj 
contributors. 

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

Ctrtatnly  it  is  exeeOeni  SUd^Kme  far  an  author  tojba that  A# 
must  say  aU  he  has  to  say  in  Ou  fewest  possibm  words^  or 
his  reader  is  sure  to  sh^  them;  and  in  the  plainest  possMe 
words,  or  his  reader  will  certainly  misunderstand  them. 
Generally,  also,  a  dowmig^  fact  may  he  told  in  a  plaim 

way;  and  we  want  dowmrigtUfaeisai  present  i 

^tjihing  elsej^  " 


READ.     REFLECT.     COMPARE.     RECORD. 

Diphtheria.— Replies. 

Editor  Medical  World  : — It  seems  to  me 
that  in  the  recent  discussions  of  diphtheria  there 
is  a  good  deal  of  illogical  assertion;  of  basing- 
arguments  on  facts  that  are  exceptional,  or  are 
only  true  at  certain  times.  For  instance,  the 
statement  attributed  to  DaCosta,  that  diphth- 
eria is  the  local  manifestation  of  a  constitutional 
disease.  If  you  will  consider  the  patient 
the  local  manifestation,  and  say  thiut  the 
constitutional  disease  is  in  bad  hygienic 
surroundings,  I  will  heartily  agree;  for  diphth- 
eria more  than  any  other  disease,  is  due  to 
filth,  in  cellar,  back-yard,  alleys,  cess- pools,  gut- 
ter or'  street,  or  in  the  drinking  water.  But  I 
cannot  accept  this  doctrine  with  the  individual,, 
and  I  am  sure  it  leads  to  bad  methods  of  treat- 
ment. If  you  take  an  open  wound  or  ulcer 
and  inoculate  it  with  diphtheritic  matter 
the  disease  appears  at  the  point  of  inocu- 
lation. If  a  person  has  diphtheria  of  the  throat 
and  also  has  a  wound  or  ulcer  elsewhere,  cover 
the  latter  hermetically  with  a  watch  glass,  and 
no  diphtheria  appears  on  the  surface.  Why  are 
these  things  so,  if  diphtheria  is  not  a  local 
disease,  whose  infection  is  transmitted  througb 
the  air  and  not  by  the  blood  ?  If  it  be  not  lo(»l 
why  did  the  deposit  after  inoculation  appear  oa 
the  throat  instead  of  at  the  point  where  the 
virus  was  introduced?  I  cannot  see  how  these 
facts  can  be  explained  on  the  constitutional 
theory,  any  more  than  I  can  believe  that  any^ 
real  doctor  who  has  treated  this  disease  by  effi* 
cient  local  means  can  believe  in  the  constitu-^ 
tional  theory. 

I  would  not  say  anything  about  the  treat- 
ment of  this  disease,  were  it  not  that  the  worli> 
family  has  been  enriched  by  so  many  new  mem- 
bers since  I  last  wrote  on  this  subject,  that  my 
views  must  be  new  to  very    many.     When 


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115 


diphtheria  la  about,  the  childrens'  throats  must 
be  looked  to  carefully,  as  the  disease  is  insidious 
and  has  often  passed  the  curable  stage  before  any 
thought  of  illness  has  arisen.  Many  a  time, 
when  a  child  has  complained  of  headache,  I 
have  found  the  tonsils  covered  with  exudation, 
^ngh  both  mother  and  child  insisted  there 
was  nothing  the  matter  with  the  throat  I 
bdieve  we  are  only  safe  in  conridering  every 
cnidation  on  the  throat  as  diphtheritic ;  for  I 
have  seen  fatal  diphtheria  develop  in  a  case  I 
had  diagnosed  as  herpes.  Any  throat  affection 
is  liable  to  become  diphtheritic  if  tbe  disease  is 
prevalent  Neverless,  a  white  exudation,  with 
swelling  tenderness,  difficulty  in  swallowing  and 
and  fever,  is  less  dangerous  than  an  ashy  de- 
posit with  very  little  local  uneasiness.  I  do  not 
sk^  to  make  nice  diagnoses  that  may  be  right 
now  and  all  wrong  in  six  hours,  I  put  every 
ease  of  exudative  throat  disease  on  my  old  fav- 
erite. 

R.    Potass  chloratiB  polv dr.  J. 

Add.  hydioohloilcU.  8.  P ....dr.  Jss. 

Miaoe,etadde 

Tr.  fterlohloridl dr.  y. 

AQua.  q.  8.  ad >£.  !▼. 

8.  A  teMpoonfOl,  pare,  eyery  two  to  four  bours. 

Mixed  in  this  way,  free  chlorine  is  evolved, 
in  the  nascent  state,  and  it  is  the  best  destroyer 
ef  the  diphtheria  microbe  in  existence. 

Strong?  Very.  But  not  too  strong,  to  kill  the 
germ,  and  this  must  be  done,  be  the  patient  old 
«*  young.  In  children  under  two  years  of  age, 
and  whenever  tbe  chlorine  acts  on  the  healdiy 
tissues,  I  use  peroxide  of  hydrogen  instead. 
But  this  must  be  used  very  much  oftener.  The 
first  principle  of  treatment  is  that  the  local  re- 
medy must  be  strong  enough  to  kill  the  germs, 
and  must  be  used  very  often.  Once  every 
quarter  hour  is  none  too  often  for  peroxide,  by 
night  and  day.  Even  when  the  chlorine  is 
used,  the  peroxide  should  be  applied  in  the  in- 
tervals. I  prefer  to  have  the  chlorine  swall- 
owed, as  it  is  thus  more  thoroughly  applied  than 
hy  a  swab,  and  we  get  the  constitutional  brac- 
ing of  the  iron  and  acid.  Any  irritation  of  the 
stomach  is  prevented  by  ta^ng  a  drink  of 
water  just  before  the  dose.  These  remedies  dis- 
solve and  carry  off  the  exudation,  leaving  an 
ulcerated  surface.  This  they  keep  aseptic,  and 
it  quickly  heals.  It  may  be  that  the  microbes 
root  down  into  the  tissues,  but  these  remedies 
g«t  at  them  and  cure  the  disease,  without  being 
injected  under  the  mucous  surfaca.  Prompt 
and  vigorous  treatment  soon  puts  an  end  to  the 
attack,  and  the  disease  never  gets  bejond  its 
fint  home  on  the  tonsils.  But  if  the  doctor 
does  not  believe  in  local  treatment,  or  if  he  is 
not  called  in  time,  it  may  spread  to  the  larynx, 
ABtrum,  eustachian   tubes  and  middle  ear,  the 


nose,  the  eyes,  the  mouth  or,  rarely,  to  the  eso- 
phagus and  stomacL  If  it  gets  to  the  larynx 
spray  vigorously  and  almost  continously  with 
peroxide,  and  perform  tracheotomy  as  soon  as 
the  sign  appears — ^the  retraction  of  the  abdomen 
with  inspiration.  Then  keep  on  spraying  — and 
praying — for  your  case  is  desperate.  If  the 
disease  gets  into  the  passages  it  spreads  to  the 
whole  extended  tract;  sinuses  are  filled  with 
membrance  and  decomposing  matter;  the  stench 
is  horrible,  the  discharge  bums  the  skin  off  the 
nostrils  and  lips,  and  epistaxis  may  carry  off 
the  patient  At  the  first  sign  of  coryza  I  used 
to  inject  the  nostrils  with  nitrate  of  silver  solu- 
tion, five  grains  to  the  ounce,  every  four  hours. 
This  usually  stops  it,  after  one  to  three  injections. 
But  of  late  years  I  have  preferred  peroxide,  as  it 
is  surer,  safer,  and  less  irritant  In  the  worst 
cases  of  nasal  diphtheria  I  have  ever  seen  I 
used  a  quart  bottle  of  peroxide  every  day,  and 
and  saved  my  patient  At  first  I  diluted  to 
one  fourth,  but  soon  found  the  full  strength  of 
Marchand's  solution  was  well  borne  and  most 
effectual.  For  epistaxis  I  have  never  failed 
with  solutions  of  chromic  acid,  2  grains  to  the 
ounce,  and  stronger  if  necessary.  Now  I  find 
in  these  cases  another  proof  of  the  local  char- 
acter of  the  disease.  The  child  is  hot  and 
feverish;  his  pulse  ra^nd  and  weak,  delirious, 
forehead  burning,  toes  and  fingers  cold,  he  can- 
no/ eat  and  the  stench  is  beyond  description; 
the  secretions  pouring  from  the  nostrils  and  ex- 
coriating them.  If  ever  the  disease  is  ''consti- 
tutional,"  is  it  not  here?  And  yet  wash  the 
nasal  passages  out  thoroughly  with  peroxide, 
and  your  fever,  depression,  etc.,  are  gone ;  the 
boy  sits  up  and  asks  for  food,  and  eats  his  ice- 
cream with  the  greatest  relish.  If  the  microbes 
had  invaded  the  blood,  they  could  not  be 
reached  by  peroxide,  and  the  change  is  inex- 
plicable. If  the  disease  producers  were  located 
in  the  nose,  and  their  ptomaines  were  from 
thence  absorbed  into  the  blood,  it  is  easy  to  see 
why  the  thorough  cleansing  out  of  the  nasal 
tract  puts  a  stop  to  the  poison  production  and 
absorption.  The  only  cases  in  which  diphtheria 
is  ever  constitutional  is  when  the  local  disease 
has  not  been  efficientiy  treated  and  colonies  of 
Loeffler's  bacillus  have  penetrated  to  the  blood- 
vessels and  been  swept  away  in  the  circulation 
to  form  foci  of  septic  disease  in  the  lungs,  heart 
or  wherever  they  happen  to  lodge. 

The  history  of  this  dispute  is  notable.  Com- 
mencing when  diphtheria  was  first  recognized,  it 
was  fouod  in  Paris  that  all  the  cases  died  ex- 
cept those  treated  by  an  old  woman,  who 
applied  strong  nitrate  of  silver  solutions  ;  while 
the  doctors  considered  it  a  constitutional  disease 
and  treated  it  on  ''general  principles."     Ever 


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116 


THE  MEDICAL  WORLD. 


«mce,  there  has  been  a  persisteDt  effort  on  the 
part  of  cloeet  physicians  to  insist  on  the  same 
theory,  in  spite  of  the  fact  that  all  successful 
treatment  is  based  on  the  local  medication. 

On  page  79,  Dr.  Pantzer  speaks  of  herpes 
zoster.  For  over  a  year  1  have  treated  every 
•case  with  zinc  phosphide,  gr.  ^j^  every  4  hours, 
with  prompt  and  invariable  success.  This 
drug  is  said  to  be  not  always  efficient;  but  I  am 
particular  to  have  a  good  preparation,  and 
I  thus  escape  the  uncertainity  so  often 
spoken  of  in  regard  to  drugs.  Get  a  good 
drug  and  give  it  yourself,  and  you  will  find 
that  like  causes  produce  like  results,  and  the 
exceptions  are  most  likely  to  be  due  to  errors 
in  diagnosis. 

Dr.  Oehme  (page  87)  thinks  the  homeopa- 
thic provings  of  quinine  are  sufficient  to  prove 
the  production  of  hematuria  by  it  I  am  well 
aware  that  this  symptom,  and  also,  a  chill  fol- 
lowed by  fever,  have  been  recorded  in  these 
provings  of  quinine,  but  these  symptoms  are  very 
exceptional  indeed,  and  by  no  means  uniformly 
following  the  use  of  this  drug.  The  utmost  that 
can  be  said  of  quinine  in  its  relation  to  hematuria 
is  that  occasionally  its  use  is  followed  by  this 
symptom,  which  ceases  when  the  quinine  b  dis* 
continued  and  reappears  when  its  use  is  resumed; 
but  that,  in  the  vast  majority  of  cases  where 
quinine  is  given,  nothing  of  the  sort  ocQurs. 
Moreover,  it  seems  certain  that  all  cases  of 
malarial  hematuria  are  not  aggravated  by 
quinine,  as  a  number  of  capable  observers  have 
reported  cases  of  this  sort  that  were  cured  by 
quinine.  Aa  yet,  therefore,  we  cannot  say  that  in 
4uiy  given  case  quinine  will  cause  hemorrhage, 
unless  we  have  found  it  out  by  giving  the  drug 
to  that  particular  person. 

Dr.  Shemwell's  case  (page  97)  is  not  clear. 
If  the  pus  were  from  a  hepatic  abscess  it  should 
have  been  red  from  inter  mixture  of  blood ;  if 
from  the  bowel  (appendicitis),  it  should  have 
had  a  fecal  odor ;  while  if  it  were  located  in 
the  layers  of  the  abdominal  parietee,  the  hema- 
turia is  unaccounted  for.  Does  not  this  point 
to  the  kidney  as  the  probable  source  of  the  pus? 
A  perinephritic  abscess  may  cover  the  space 
indicated. 

Dr.  Blaylock  asks  what  is  the  cause  of  agal- 
actia (page  98)  in  his  case.  AH  women  are  not 
^ually  good  milk-givers,  and  some  are  always 
dry.  The  breast  may  be  large,  but  com  posed  main- 
Jy  of  fat,  the  glandular  structure  being  undevel 
roped  and  rudimentary;  or,  it  may  be  atrophied 
from  the  pressure  of  coriets  and  padding.  Some- 
times the  breast  remains  undeveloped  until 
stimulated  by  the  efforts  of  the  child  to  nurse. 

Why  did  Dr.  Pineo  (page  98)  take  calomel 
to  abort  a  tonsillitis?  Morell   Mackenzie,   who 


was  very  good  authority,  recommended  loaengos 
of  guaiac  resin,  two  grains  each;  one  every 
two  hours.  I  have  found  them  very  efiectuaL 
Hare  says  sodium  salicylate  is  a  specific.  I 
usually  give  it,  five  grains  every  two  honn^ 
with  the  guaiac  If  suppuration  has  already 
occurred,  however,  no  remedy  will  cause  tbe 
pus  to  be  reabsorbed. 

I  wish  my  friends  would  all  try  pure  chloro> 
form  for  eczema,  applying  it  twice  a  day,  and 
whenever  itching  occurs. 

Has  Dr.  Morton  (page  99)  examined  his 
patient's  urine  when  she  is  pregnant?  He  will 
find  albumen,  probably,  and  should  put  her  at 
once  on  the  skim  milk  and  grape  juice  diet» 
with  diuretics.  The  convulsions  demand  ver- . 
atrum  viride,  chloroform,  and  speedy  delivery. 

What  causes  cold  feet?  In  women,  the  lack 
of  exercise,  constipation,,  and  tight  shoes.  Tie 
up  the  unfortunate  little  toes  so  they  cannoi 
move,  and  no  wonder  the  circulation  is  weak. 
They  are  really  fingerp,  provided  with  the  same 
apparatus  and  capabilities,  and  the  difference  is 
solely  due  to  lack  of  education.  It  is  well  to 
let  them  out  of  prison  on  every  possible  occasion  ; 
especially  for  an  hour  before  going  to  bed« 
Then  they  can  unbend,  limber  up»  the  blood 
courses  freely  through  them,  and  they  will  be 
free  and  comfortable  when  they  go  to  bed. 
Take  off  the  shoes  and  stockings  and  have  a 
merry  romp  in  bare  feet  every  evening,  even 
taking  a  run  out  into  the  snow,  a  la  Abbe 
Kneipp.  When  I  was  younger,  I  used  to  grease 
my  feet  and  wrap  them  in  greased  paper  before 
setting  out  for  a  day's  shooting  in  winter. 

For  Dr.  Milner's  meningeal  cases  (p«ge  99) 
I  would  second  the  editor's  suggestion  of  salicy* 
lates  ;  giving  for  effect,  and  not  by  any  stated 
dose.  I  would  use  hot  water  instead  of  oold; 
and  would  let  out  enough  blood  to  relieve  tbe 
patient  Keep  the  bowels  lodse.  and  the  skin 
acting  by  means  of  elaterium  and  pilocarpine. 

Dr.  Jone's  case  (page  99)  has  hematuria 
wheaever  the  cold  drives  the  blood  in  from  the 
skin  and  increases  the  pressure  on  the  drcnla- 
tion  of  the  kidneys.  If  this  be  due  to  chronic 
nephritis,  there  will  be  albuminuria.  But  it 
only  means  that  there  is  in  the  urinary  tract  some 
where  a  tissue  with  capillary  walls  so  feeble 
that  they  will  not  bear  unusual  pressure.  Nitro- 
glycerine relaxes  vascular  tension  and  hence 
prevents  bleeding  The  blood  may  be  from 
granulation  tissue  in  the  kidney,  ureter,  bladder 
or  urethra,  as  determined  by  its  condition, 
time  of  passing  as  to  urination,  and  collateral 
symptoms.  It  may  show  tubercle,  cancer,  cal- 
culus, varicoeity  or  papilloma  as  the  pathologi- 
cal condition. 

Dr.  Manning's  thermometer  has  lost  its  index 


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117 


(page  100).  Raise  the  temperature  by  warm 
water  to  over  105,  and  then  pluDg^  the  bulb 
ioto  ice-water ;  you  may  thus  restore  the  interval 
between  the  mercury  columns.  But  you  must 
then  be  sure  to  compare  the  reading?  wiih  a 
standard  thermometer,  as  they  may  differ  from 
those  previously  made  The  trouble  is  caused 
by  lowering  the  mercury  by  jarring,  instead  of 
by  a  circular  sweep. 

For  black  heads  :  press  out  with  a  watch  key  ; 
apply  lanoline,  one  ounce,  acid  benzoic,  twenty 
grains,  oil  of  rose  three  drop?,  at  night  on  going 
to  bed,  and  wash  in  the  morning  with  borax 
water,  cold,  and  rub  well  with  towel.  Keep 
the  bowels  regular,  and  get  open  air  exercise 
daily.  ^ 

Is  Dr.  Rhode's  case  (page  100)  goiter,  em- 
physema, or  aneurism  ?  If  goiter,  give  hvdriodic 
acid  internally,  and  use  the  electrolytic  needle 
plunged  into  the  mass.  Any  other  suggestions 
would  require  personal  examination,  as  the 
nature  and  relations  of  the  tumor  must 
be  studied  before  adopting  surgical  meas- 
ures. 

I  wish  Dr.  Willey  (page  100)  would  send  us 
lome  of  those  worms  that  crawl  out  of  the  child's 
head.     1  would  give  her  iodides. 

The  ideal  treatment  for  scarlet  fever  is  per- 
fect hygiene  of  the  house  and  surroundings, 
plenty  of  ventilation,  pure  water  to  drink  in 
abundance,  very  simple  food,  say,  soup,  milk 
and  coffee,  and  no  medicine.  Of  course,  an- 
gmous  and  nasal  complications  demand  vigorous 
antisepsis,  but  they  do  not  occur  when  the  above 
suggestions  are  followed. 

Dr.  MoUyneaux,  case  is  not  very  clear.  Is 
there  a  tumor  in  the  breast  ?  If  so,  it  is  not 
likely  to  be  a  cancer  at  so  early  an  age,  but  si  ill 
this  is  not  imposible.  More  likely  it  is  an  ab- 
80688  of  the  breast,  with  secondary  involvement 
of  the  axillary  glands.  The  exploring  needle 
would  be  of  use  to  determine  the  point ; 
and  in  either  case  the  knife  is  the  best 
remedy. 

I  have  spoken  of  epistaxis  in  my  talk  on  diph- 
theria, and  will  only  add  here  that  before  I 
began  using  chiomic  acid  I  never  saved  a  case, 
and  since  I  adopted  that  remedy  I  have  never 
lost  one. 

Dr.  M.'e  case  (page  101)  has  myelitis.  The 
tight  prepuce  may  have  been  an  exciting  cause, 
and  a  tight  sphincter  ani  or  a  urethral  stricture 
may  be  now  keeping  up  the  diflSculty ;  or.  it 
may  be  persistent,  the  exciting  cause  being  re- 
moved. Look  for  the  conditions  I  mention,  and 
remove  them  if  found ;  apply  counter- irritation 
to  the  spine ;  have  him  rest  on  a  sofa,  on  his  face, 
most  of  the  time,  and  give  iodides  of  potash  and 
niercury  regularly. 


"Advice''  (page  102)  would  better  pass  a 
sound  into  his  patient's  urethra.  When  he  finds 
a  very  sen^itive  spot,  deposit  there  a  drop  of 
nitrate  of  silver  solution,  five  grains  to  the  ounce, 
and  dilate  fully  with  steel  sounds  Let  his 
patient  sleep  alone,  on  a  hard  bed,  without  too 
much  cover.  Bromide  of  potassium  will  help 
to  check  the  sexual  ardor  until  the  effects  of 
excess  have  subsided. 

I  think  I  see  the  editor's  blue  pencil  waving 
over  this  long  letter,  and  will  therefore  close 
without  tackling  **Int«rroga tor's"  list  of  in- 
quiries. William  F.  Waugh,  M.D., 

103  State  St,  Chicago,  111. 

[We  learn  by  private  correspondence  that 
Dr.  Waugh  has  been  elected  Professor  of  Gen- 
eral Medicine  in  the  Post  Graduate  College  of 
Chicago.  Also  at  the  present  time  he  is  deliv- 
ering a  special  course  of  lectures  on  therapeutics 
at  the  College  of  Phywcians  and  Surgeons,  at 
the  request  of  the  faculty.  His  private  hospital 
is  in  active  operation,  but  not  confined  entirely 
to  nervous  cases,  as  he  receives  some  also  for 
rectal  and  gynecological  treatment.  Indeed,  he 
says,  that  his  friends  simply  send  him  any 
cases  that  they  have  not  the  facilitiee  for 
handling. — Ed.] 


Also  the  following  letter: — During  the 
month  of  February  1  was  called  upon  to  answer 
over  200  letters,  received  from  fellow  physi- 
cians, asking  advice.  Nearly  three  hours  a  day 
are  thus  occupied.  About  one- fourth  of  the 
writers  enclosed  stamps  for  reply,  none  enclosed 
fee.  It  is  obviously  impossiblefor  me  to  con- 
tinue giving  so  much  of  my  time  for  nothing  ; 
and  it  has  been  suggei^ted  that  I  should  charge 
a  email  fee  when  tbe  writer  desires  an  answer 
by  mail.  But  this  I  am  unwilling  to  do,  for 
two  reasons :  First :  ^  enjoy  these  talks  with 
my  friends,  and  do  not  want  to  lo^e  them. 
Second :  no  matter  how  small  the  fee  may  be, 
there  are  times  when  the  patient  cannot  pay  it, 
and  when  the  doctor  could  not  readily  pay  it 
himself ;  for  when  times  are  hard  the  doctor 
knows  it  first  God  forbid  that  I  should  ever 
refuse  to  extend  a  helping  hand  to  my  brother 
doctor  because  he  could  not  pay  me  for  it.  Lei 
him  write  as  before,  and  I  will  help  him  out  to 
the  best  of  my  ability.  But  whenever  there  ia 
in  question  a  patient  who  is  willing  and  able  to 
pay  for  the  advice,  let  the  doctor  slip  in  a  fee 
(I  don't  care  how  small  it  is);  and  at  any  rate 
enclose  a  stamp.  Perhaps  I  may  be  able  to 
employ  a  secretary,  which  I  must  do  if  my  cor- 
respondence increases. 

William  F.  Waugh. 


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118 


THE  MEDICAL.WORLD. 


Further  Confirmation  of  Dr.  Moor's  Ditoovery  of 
Antidote  fbr  Morphine  Poisoning. 

Editor  Medical  World  : — Enclosed  please 
find  for  publication  clinical  notes  by  Prof.  J.  S. 
Buist,  of  Charleston,  South  Carolina. 

Dr.  William  Moor, 

355  Boulevard,  New  York,  N.  Y. 

CLINICAL   NOTES. 

Called  at  12  M.,  February  13th,  1894,  in 
haste,  to  see  a  healthy,  robust  young  woman 
(white)  age  nineteen,  and  upon  arriving  at  the 
residence  I  was  informed  that  the  case  was  con- 
sidered hopeless,  as  the  poison,  laudnum^  had 
entered  the  blood,  and  the  patient  was  beyond 
help.  The  following  history  was  rapidly  ob- 
tained :  About  10  o'clock  a.  m.,  by  accident, 
one  and  a  half  ounces  of  tinct  opii  (officinal) 
had*  been  taken.  The  discovery  of  the  fact  was 
made  at  about  10}  o'clock.  Evidences  of  the 
patient  having  vomited  at  some  time  existed, 
though  the  odor  of  opium  could  not  be  detected 
in  the  vomited  matter.  Condition  at  that  time : 
Extreme  lethargy,  intense  drowsiness,  insensi- 
bility to  external  impressions,  pinched  features, 
loss  of  consciousness  nearly  complete,  slow,  full 
pulse,  labored  breathing,  pupils  of  both  eyes 
contracted.  The  first  n^icaJ  aid  arrived  at 
about  eleven  o'clock.  The  above  symptoms 
had  increased  in  a  great  degree.  Strong  coffee 
was  given,  which  the  stomach  at  once  rejected. 
The  patient  was  at  once  forcibly  aroused  and 
kept  in  constant  motion.  A  solution  of  sulphate 
of  atropine  was  administered,  but  rejected  as 
soon  as  taken  into  the  stomach.  Up  to  my 
arrival  and  assuming  charge  of  the  case  nothing 
further  had  been  attempted. 

Condition  at  12  m  :  Pupils  of  both  eyes 
contracted  to  the  finest  possible  point ;  eyes  dull 
and  glassy ;  dropping  of  eyelids ;  insensibility 
to  external  impressions;  intense  drowsiness; 
pulse  slow  and  intermittent ;  heart's  action 
feeble ;  respiration  labored  and  slow ;  almost 
utter  inability  to  sustain  the  body  upon  the 
limbs.  Patient  presented  all  the  typical  symp- 
toms of  opium  poisonmg.  At  once  a  hypodermic 
injection  of  j^\  grain  of  atropine  was  given  and 
the  result  watched  with  the  utmost  interest  and 
patient  kept  in  constant  motion. 

I  ordered  as  soon  as  could  be  procured : 

Permuigauftt«  potaae «r.  vj 

Aqua  destiilate dram  J 

At  the  end  of  thirty  minutes  no  change  in 
the  patients  condition ;  pupils  more  contracted 
and  all  symptoms  aggravated.  At  12}  I  in- 
jected ten  drops  of  the  permanganate  solution 
in  the  arm.  Results  :  In  six  minutes  the  effects 
were  noticeable.  The  pupils  of  both  eyes  com- 
menced to  dilate  (observed  not  cnly  by  myself 


but  by  those  in  attendance).  In  ten  minutes 
the  patient's  locomotion  inproved.  In  fifteen 
minutes  she  spoke  and  begged  to  be  allowed  to 
sleep.  Circulation  improved,  pulse  stronger, 
respiration  more  regular.  Allowed  to  rest  in  a 
chair  for  five  minutes,  profound  sleep  coming  on. 
Pulse  eighty- two  per  minute,  intermitting  every 
sixth  boat  Ilespirations  twenty  four  per 
minute.  Patient  aroused  and  ten  drops  of  the 
permanganate  solution  introduced  in  the  other 
arm.  The  effects  in  ten  minutes  were  won- 
derfull.  Pupils  largely  dilated,  susceptibility 
to  light  manifest,  consciousness  returned.  Pa- 
tient in  fifteen  minutes  hysterical  and  crying ; 
pulse  seventy-six ;  respirations  twenty  per 
minute.  Patient  allowed  to  be  in  bed  and  at 
once  went  into  gentie  sleep,  pronounced  to  be 
out  of  danger.  By  six  o'clock  in  the  evening 
all  symptoms  had  passed  away  and  a  complete 
recovery  was  the  result — no  after  effects. 
Charleston,  S.  C.  J.  S.  Buist,  M.D., 

Prof.  Surgery,  Med.  Col.  8,  C. 

Confirmation  of  Permanganate  of  Potassium  as 
an  antidote  to  Morpliine. 

Editor  Medical  World: — There  has  been 
much  discussion,  pro  and  con,  as  to  the  efiiciency 
of  permanganate  of  potassium  in  morphine 
poisoning.  To  Dr.  Wm.  Moor,  355  Boule- 
vard W.,  New  York  City,  is  due  the  discovery, 
and  he  has  made  many  experiments  upon  him- 
self, and  animals,  to  prove  his  theory. 

A  few  days  since,  1  was  called,  by  Dr.  A.  L. 
Yocum  of  this  place,  to  assist  him  in  a  case 
where  a  man  had  taken  about  from  fifteen  to 
eighteen  grains  of  sulphate  of  morphine.  He 
hful  been  found  three  hours  aft;er  taking  it,  and 
was,  seemingly,  beyond  all  hope  of  recovery. 
We  gave  him  a  hypodermatic  ii^jection  of  ^^ 
grain  of  Atropine.  We  applied  a  strong  Fara- 
dic  current,  and  kept  up  artificial  respiration 
by  Sylvester's  method.  In  spite  of  this,  be  was 
slowly  failing,  and  death  seemed  imminent  I 
had  remembered  reading  in  the  lay  press  of  the 
use  of  permanganate  of  potassium  in  morphine 
poisoning,  and  concluded  to  try  it.  A  grain 
was  given  subcutaneously,  and,  in  not  to  ex- 
ceed five  minutes,  he  drew  up  his  legs  and 
kicked  over  a  two  hundred  pound  man,  who 
was  standing  at  his  feet :  in  fifteen  minutes,  he 
was  walking  with  the  assistance  of  two  men.  I 
then  washed  out  his  stomach  with  a  stomach 
tube,  and  then  poured  down  a  quart  of  strong 
coffee.  In  an  hour,  he  began  to  fail  again,  and 
we  gave  him  a  half  grain  of  permanganate  of  po- 
tassium; and,  in  a  few  minutes,  he  was  talking  ra- 
tionally and  smoking  a  cigar.  He  made  a  good 
recovery,  but  felt  for  two  days  as  though  he 
had  been  sobering  up  from  a  protracted  spree. 


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This  case  is  remarkable  on  account  of  the 
long  time  from  taking  of  poisan,  before  the  an- 
tidote was  administered  (some  three  hours)  and 
the  size  of  the  dose.  We  can  state  with  almost 
absolute  certainty  as  to  the  amount,  from  fifteen 
to  eighteen  grains,  which  was  taken  in  a  glass 
of  seltzer  water  at  a  bar,  in  the  presence  of  sev- 
eral persons.  He  declared  that  it  was  with  suici- 
dal intent  He  walked  out  from  the  bar,  and 
could  not  be  found  for  some  time  afterwards. 
H.  B.  McKlveen,  M.  D., 

Chariton,  Iowa. 


Another  Case. 

Editor  Medical  World: — As  "one  swal- 
low does  not  make  a  summer,''  still  it  may  be 
considered  as  an  indication,  and  if  more  should 
follow  it  ^  ill  be  a  proof  that  Dr.  Moor  has 
discovered  that  permanganate  potash  neutralizes 
the  poisonous  effect  of  morphine.  If  it  is  his 
discovery,  which  I  am  inclined  to  believe,  then 
the  world  at  large  and  the  profession  in  par 
ticular  owe  him  a  lasting  gratitude,  and  it 
should  be  extended  to  him  alone  from  now 
on  until  the  end  of  time.  80  much  for  Dr. 
Moor,  now  for  a  patient  of  my  own. 

A  youDg  man  of  2^,  a  victim  of  consumption 
who  is  only  waiting  for  the  end,  as  he  realizes 
that  it  must  come  soon.  On  Friday  night,  Feb- 
niary  15th,  I  was  called  from  bed  to  go  at  once 
to  see  Mr.  B.  who  had  taken  22  one-eighth 
grain  morphine  pills  (Parke,  Davis  &  C^'s). 
When  I  arrived  I  found  he  had  taken  them 
about  four  hours  previously.  He  was  then  in 
deep  coma,  respirations  about  eight  per  minute, 
poise  about  40  and  weak.  Now,  I  thought,  is 
the  time  to  try  Dr.  Moor's  antidote.  I  made 
a  solution  of  about  5  grains  permanganate 
potash  in  2  oz.  water  and  by  persistent  efforts 
had  him  swallow  it  Presto— change,  in  half 
an  hour  he  revived  enough  to  inquire  "What 
are  you  doing?"  I  waited  for  about  two  hours 
more  and  then  he  seemed  wide  awake  and  gave 
me  a  good  raking  over  for  having  thwarted  his 
purpose  (suicide). 

I  went  home,  called  the  next  morning  and 
as  there  seemed  to  be  some  traces  of  morphine 
still,  gave  him  about  2  gr.  more  of  the  antidote 
in  solution.  Called  on  the  17th;  he  was  up  and 
dressed  and  seemed  pleased  that  he  did  not 
socceed.  Now  if  the  antidote  did  not  save 
him,  what  did,  for  that  is  all  that  I  gave 
him? 

I  should  not  be  surprised  to  learn  in  the 
future  that  Dr.  Moor  has  builded  better  than 
he  knew,  and  that  the  permanganate  will  be  used 
as  a  cure  for  the  morphine  habit  and  thus  do 
away  with  these  institute  sharks  who  bleed  their 


victims  so  unmercifully.      This  man  had  never 
used  morphine  before. 

G.  P.  Carman,  M.D., 
142  Prince  Street,  N.  Y. 

Confirmation    of    Treatment    of   Sciatica    and 
Lumbago. 

Editor  Medical  World  : — I  wish  to  report 
a  severe  case  of  sciatica  and  lumbago  that  has 
been  greatly  relieved  by  a  formula  found  in  a 
copy  of  the  World  that  fell  into  the  patient's 
hands  by  accident 

Mr.  Sam  Hutchinson,  a  very  worthy  man  of 
our  community,  contracted  sciatica  and  lumbago 
about  a  year  ago  and  for  the  last  six  months 
was  drawn  double  and,  as  he  expressed,  had  his 
nose  on  the  ground  all  the  time.  His  suffering 
was  excruciating  and  he  was  an  object  of  pity. 
He  was  treated  by  Dr.  B.  T.  Robertson  and  my- 
self with  the  usual  remedies  without  any  ma- 
terial advantage.  He  then  fell  into  the  hands 
of  the  patent  medicine  man,  with  the  same  re- 
sults, when  he  became  discouraged  and  thought 
life  was  hardly  worth  living.  But  in  looking 
over  your  journal  he  came  across  the  following 
formula  by  Prof.  Bourget  (Lausanne),  page  26, 
Janurary  World. 

R.  'SaUcyllc  add ) 

Turpentliie >  mt  01.  h9 

LanoUne J 

Lard ot.  Iv. 

B.    Appliel  witnout  AricUon. 

And  he  immediately  resolved  to  try  it 

I  had  it  put  up  at  my  druggist  and  gave  it 
to  him  on  the  1st  day  of  February.  I  saw  him 
today,  February  10th,  and  he  is  very  nearly 
as  straight  as  ever,  and  gets  about  well  and  says 
his  sufferings  are  over ;  in  fact,  with  the  broad 
smile  on  his  countenance  I  hardly  realise  that 
he  is  the  same  stooped  individual.  He  says  the 
application  at  first  is  severe  and  almost  makes  a 
man  feel  as  if  he  was  going  to  die,  but  that  sen- 
sation does  not  last  long. 

I  write  this  in  behalf  of  suffering  humanity. 
If  it  will  cause  my  brother  Doctors  to  give 
it  a  trial  and  if*  it  will  be  the  means  relieving 
others  as  it  did  this  one,  I  will  have  accom- 
plished the  purpose  for  which  this  was  penned. 

Sherley,  Tex.  J.  M.  Speed,  M.D., 


Sometliing  About  Warts. 

Editor  Medical  World: — Common  warts 
are  rarely  dangerous  to  life  or  inimical  to 
health,  but  they  are  sometimes  painful  and  are 
often  unsightly.  Their  etiology  is  absolutely 
unknown— with  all  due  respect  to  the  hoppy- 
toad  which  is  popularly  believed  to  be  able  to 
cause  them.  While  we  know  nothing  of  the 
cause  of  their  coming,  we  are  equally  ignorant  of 
the  philosophy  of  their  going. 


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THB  MEDICAL  WORU). 


They  are  most  common  with  children  and 
young  persons,  but  adults  are  not  wholly  free 
from  them. 

Medical  writers  usually  say  that  the  treat- 
ment of  warts  is  very  simple.  They  generally 
recommend  the  use  of  caustics,  chromic  acid  be- 
ing commonly  preferred.  I  have  never  seen 
any  marked  success  with  this  method,  except 
perhaps  in  the  case  of  single  warts.  When  an 
adolescent  has  from  twenty  five  to  100  warts  of  - 
all  degrees  scattered  over  his  hands,  the  caustic 
treatment  presents  rather  an  extensive  problem, 
with  no  positive  assurance  of  immediate  and 
permanent  success. 

When  I  was  a  youugster,  ten  or  twelve  years 
of  age,  my  hands  were  disfigured  with  an  abun- 
dant crop  of  warts.  One  particularly  large 
'*8eed  wan"  on  my  right  forefinger,  was  a  source 
of  continual  troubld.  It  used  to  crack  and 
split  and  bleed  from  frequent  injury,  and  seg- 
ments of  it  were  occasionally  pulled  out  or  tied 
off,  only  to  be  reproduced  a/ain  and  a^ain.  A 
multitude  of  applications,  charms  and  incanta- 
tions for  removing  warts,  so  well  known  to  our 
grandmotherd  and  not  wholly  forgotten  in  our 
less  superstitious  day,  were  faithfully  tried  with- 
out success. 

Finally  I  was  persuaded  to  apply  to  old 
m  )ther  Fish,  who  had  a  reputation  in  that  part 
of  the  country  for  telling  fortunes,  selecting 
lucky  numbers  in  lotteries,  finding  stolen  arti- 
cles, and  dealing  generally  in  the  Black  art, 
and  who  had  also  a  great  reputation  for  curing 
warts  by  a  method  reputed  to  have  bef  n  learned 
from  the  Indians.  After  crossing  her  palm 
with  a  small  silver-piece,  she  touched  the  warts 
with  the  tips  of  her  fiager  moistened  with  a 
little  of  her  sidiva,  and  assured  me  that  my  warts 
would  disappear,  but  decliued  to  fix  the  exact 
date  of  that  important  event.  I  witched  daily 
for  the  going-away  process,  but  I  could  not  per- 
ceive that  they  grew  any  smaller 

One  day,  perhaps  four  or  six  weeks  after 
my  interview  with  mother  Fish«  I  happened  to 
think  of  my  warts,  and  on  looking  for  them  lo ! 
and  behold  1 1  every  one  had  disappeared — not 
a  vestige  remained.  The  unsightly  excrescences 
were  replaced  by  normal  skin. 

Did  she  drive  them  away  ?  I  don*t  kn^  w. 
Did  they  disappear  instantaneously — "all  at 
once'*  like  the  deacon's  one  boss  shay  ?  I  wish  I 
knew.  Was  their  going  away  at  this  time  merely 
a  coincidence  ?  If  so  it  was  a  singular  one,  for 
the  pesky  things  had  been  troubling  me  for  years. 
Then,  too,  many  persons  of  my  acquaintance  had 
lost  theirs  in  a  similar  manner. 

I  simply  give  the  fads  —let  others  if  they  can 
reconcile  the  post  hoc  with  the  propter  hoc 

1  admit  that  the  foregoing  hardly  falls  under 


the  head  of  rational  or  scientific  medicine,  but 
human  nature  is  so  perverse  tha  patients  choose 
to  be  cured  by  empiricism  or  mysticism,  even, 
rather  than  suffer  martyrdom  in  the  supposed 
interest  of  pseudo-science. 

In  recent  years  I  have  known  warts  to  quite 
promp  ly  disappear  after  taking  small  doses  of 
magnesium  sulphate— say  five  grains,  more  or 
less,  every  morning.  I  have  seen  enough  of 
these  cases  to  fully  convince  me  that  the  mag- 
nesium salt  exerts  an  influence  upon  these  ob- 
noxious growths.  They  often  disappear  within 
a  month  after  begining  treatment  I  now  re- 
call in  particular  the  case  of  a  young  lady  who 
had  three  large  di^fizuring  warts  on  one  hand. 
I  tried  caustics  in  vain,  for,  however  temporarily 
successful  I  was,  they  would  quickly  return. 
Finally  I  put  her  on  the  epsom  salt  and  speedy 
cure  followed. 

La^tyear  I  had  a  somewhat  singular  experi- 
ence. An  interesting  widow  had  several  warts 
on  her  hands.  So  large  were  they  as  to  actually 
interfere  with  her  wearing  tight-fitting  gloves. 
They  had  troubled  her  for  years.  I  advised 
magnesium  sulphate,  but  for  some  reason  she 
delayed  the  trial  of  the  remedy.  They  had 
grown  so  large  and  she  was  annoyed  at 
the  blemishes,  that  she  was  habitually  rubbing 
them  in  her  idle  moments.  Before  lon^  they 
seemed  to  become  smaller  and  the  rubbing  was 
contioued  for  a  definite  purpose.  All  the  warts 
vanished. 

Her  little  son,  seven  jears  old,  had  more  than 
three  score  of  warts  in  all  stages  of  develop- 
ment on  his  hands.  He  was  instructed  to  rub 
them  frequently,  and  in  less  than  a  mcmth 
they  likewise  disappeared  Wbat  removed 
them —mechanical  interference  with  the  trophic 
supply,  or  was  it  mental  or  nervous  suggee- 
tion  ?  However  that  may  be,  still  other  cases 
have  yielded  to  the  same  happy  treatment 

Brooklyn,  N   Y.,       Benj.  Edson,  M.D.. 


Various  Topics. 


Editor  Medical  World  : — The  new  title 
design  is  quite  an  improvement  on  the  old.  Thb 
World  continues  to  be  my  favorite  medical 
journal. 

It  is  still  a  doubtful  question  as  to  whether 
or  not  quinine  causes  hemorrhage.  Ca^es  like 
that  of  Dr.  B.  H  Broadnax  (page  4)  and 
some  others,  would  seem  to  indicate  that  it  does. 
I  have  seen  several  cases  which  seemed  to  indi- 
cate the  same 

In  one  case,  in  1876  I  was  assure!  by  the 
family  that  the  case  (a  young  la  )y)  could  not 
take  quinine  ;  that  she  had  suffered  with  hem- 
orrhagic fever  once  or  twice  before,  and  tha 


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THE  MEDICAL  WORLD. 


121 


doctors  said  if  was  caused  by  quinine.     I  cured 
her  with  quinine  used  hjpodermioally. 

Last  year  I  treatei  two  boys  (twins)  who 
had  lived  the  year  before  in  the  Mississippi 
bottoms  where  malarial  diseases  hold  high 
camiyal.  They  had  taken  no  quinine  in  six 
months.  Both  had  hemorrhage  from  the 
kidneys  when  I  saw  them,  and  that  deathly 
palor  which  is  so  characteristic  of  the  disease. 
They  were  very  poor,  and  had  suffered  for  the 
necessaries  of  life.  Both  recovered.  The  treat 
ment  wa^  principally  quinine  and  calomel  This 
is  about  the  only  class  of  fevers  or  malarial 
diseases  in  which  1  use  calomel.  Other 
casts  could  be  given— cases  which  eeemed  to 
favor  as  w  11  as  oppose  the  idea  that  quinine 
causes  hemorrhage ;  but  it  is  not  necessary. 
Long  continued  use  of  quiniie  may  cause  a  per- 
son to  have  hematuria,  when  he  hsh  taken  no 
quinine  for  many  weeks  or  even  mmths.  At 
least  I  have  seen  cases  wtich  caused  me  to  think 
so.  Hut  even  if  i .  is  true  that  it  does  cause 
hematuria,  it  does  not  necessarily  follow  that 
tie  patient  may  not  be  benefitted  by  quinine. 

If  you  have  not  already  done  S'>,  turn  back 
to  page  14  and  read  the  article  on  "Humbug 
and  Tinkering  in  Gynecology.'*  There  is  much 
truth  in  what  Dr,  Robinson  says.  Many  a 
case  which  goes  to  the  gynecologist  for  weeks 
and  months  without  beio^  benefitted  would,  if 
living  in  the  '  back-wooHs,"  (page  12;  recover 
—especially  if  poverty  or  dire  necessity  com- 
pelled her  to  labor  in  the  open  air  for  bread  and 
meat.  Though  *•  out  of  fashion,"  bleeding  may 
do  much  good  in  pneumonia  (page  16). 
Though  I  have  never  practiced  it,  I  am  of  the 
opinion  that  many  cases  would  be  benefitted  by 
it.  Of  course,  the  physician  must  be  able  to 
discriminate,  and  never  bleed  where  it  is  not 
indicated 

By  all  means  adopt  the  fpelling  reform 
(page  69).  I  am  sorry  to  see  some  medical 
journals  ridiculing  the  idea.  The  time  is  not 
distant  when  there  will  be  a  reform  in  spelling 
more  exten-jive,  perhaps,  thf»n  that  suggested  in 
The  World.  If  congress  would  adopt  it  for 
^1  public  printing  it  would  be  only  a  ehort 
time  when  all  leading  journals  would  adopt  it. 
If  a  tew  more  hading  journals  like  The 
World  will  adopt  it,  others  will  follow,  and 
by  and  by  the  political  papers  will  take  it  up 
and  soon  every  one  will  use  it  If  the  editors 
of  a  large  number  of  leading  papers  could  hold 
a  convention  for  that  purpose,  something  might 
he  accomplished  at  once. 

Kendrick,  Miss.         C.  Kendrick,  M.D., 

A  PRTSTCIAN  writes :  "Times  have  been  hard  with 
n^,  and  I  have  tried  to  do  wiihnnt  Thk  Mkdtcal 
World,  but  I  find  it  a  DecesKity." 


An  Experience  in  the  Treatment  of  the  Morpliina 
Habit. 

Editor  Medical  World  : — I  am  satisfied 
that  in  the  treatment  of  morph^ism  there  are  a 
number  of  remedies  ihat  may  be  used  with  suc- 
cess. At  present  it  seems  to  me  a  matter  of 
individual  idiosyncrasy,  rather  than  a  specific 
remedy.  My  first  case  of  Morphinism  was  a 
lady  about  fifty  years  of  age.  I  had  been  treat- 
ing  her  for  several  weeks  for  kidney  trouble, 
with  only  moderate  success.  One  day  her 
husband  called  at  my  office  and  asked  "ought 
you  not  to  know  all  the  facts  in  my  wife's 
case?'*  I  replied  "by  all  means  I  ought" 
He  then  told  me  that  for  more  than  twenty 
years  his  wife  had  been  addicted  to  the 
uke  of  morphine,  that  be  purchased  it  by  the 
ounce,  and  she  took  it  every  day.  I  advised 
him  to  wait  and  let  her  tell  me  herself  In  a 
few  days  she  made  a  confession  and  said  she 
wanted  to  be  rid  of  the  habit.  At  my  request 
sVe  placed  all  her  morphia  in  my  bands,  and 
she  promised  not  to  use  any  save  what  I  gave 
her.  I  then  went  to  the  drug  store  and  pur- 
chased quinine,  and  began  her  treatment  with 
mixed  powders  of  morphia  and  quinine,  in  pro- 
portion of  seven  to  one;  in  a  few  weeks  the  powders 
were  quinine  and  morphia  in  same  proportion, 
a  week  or  two  later  it  was  all  quinine;  afcer 
keeping  her  on  that  alone  for  some  days,  I  in- 
formed her  that  she  had  not  had  an  atom  of 
morphia  for  so  many  days,  and  that  the  other 
powders  were  not  a  necessity  and  I  should  not 
continue  them,  and  that  was  the  last  of  the 
habit  with  her.  Nearly  five  years  have  passed 
since  then  and  she  has  not  returned  to  the  drug. 
I  tried  the  same  treatment  on  a  case  later,  but 
failed..  D.  S.  Coles,  M.D., 

Wakefield,  Mass. 


Letter  from  Syria. 


Editor  Medical  WorLd  : — Recently  I  read 
in  a  French  medical  journal  a  very  interesting 
article  by  Prof  M.  ll  Lortel,  one  of  the  famous 
biologis  P  of  France.  1  will  give  the  transla- 
tion, for  some  of  your  realers  may  be  as  inter- 
ested afr  1  have  been. 

**In  a  former  communication  I  have  shown 
that  the  deposit*^  of  the  filtering  galleries,  as 
well  as  the  deep  mud  of  Lake  Geneva,  may 
preserve  alive  the  adult  forms  of  the  spores  of  a 
certain  number  of  pathogenic  microbes."  Then 
he  said  he  was  interested  tf>  know  if  the  same 
results  could  be  established  in  sheets  of  water 
subject  to  entirely  diflferent  conditions  of  tempera- 
ture, light,  and.  above  all,  of  chemical  composi- 
tion, and  with  this  in  mind  he  made  analysis  of 


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THE  MEDICAL  WORLD. 


the  mud  taken  from  the  Dead  Sea  in  PaleBtine 
by  M.  Barroia,  professor  of  the  Society  of  Medi- 
cine of  lille.  The  Dead  Sea  is  situated  at  the 
southern  end  of  the  Valley  of  the  Jordan.  It 
occupies  a  vast  badn,  which  is  certainly  the 
deepest  depression  on  the  face  of  the  earth,  as 
its  surface  is  400  metres  below  that  of  Jiie 
Mediterranean.  Eocky  walls  rise  800  metres 
on  three  sides.  This  sea  is  nourished  by  the  Jor- 
dan, a  rapid  river,  whose  waters  are,  during  a 
part  of  the  year,  charged  with  mud  and  organic 
matters  proceeding  from  its  source  and  the 
snows  of  Mt  Hermon.  The  saline,  thermal  and 
bituminous  springs  contribute  around  its  margin 
a  considerable  mass  of  water,  which  may  double 
that  of  the  Jordan.  The  density  of  the  Dead 
Sea  is  1.162,  while  that  of  the  ocean  is  only 
1.027;  so  that  the  human  body  floats  easy  with- 
out the  help  of  any  movement,  on  the  surface 
of  its  heavy  liquid.  The  water  of  this  sea  can- 
not escape  by  any  known  issue,  and  as  it  is  very 
evident  that  its  level  has  subsided  considerably, 
the  evaporation  must  raise  every  day  at  least 
6,500,000  gallons  of  water,  an  enormous  mass, 
which  is,  however,  easily  drawn  up  by  the  rays 
of  a  fiery  sun,  the  Valley  of  the  Dead  Sea 
being  one  of  the  hottest  points  of  the  globe. 
During  a  long  series  of  centuries  the  waters 
must  have  been  concentrating  more  and  more, 
and  the  inferior  beds  of  this  liquid  mass  are 
formed  only  of  mud  enclosing  an  enormous 
quantity  of  crystaline  needles  of  different  salts 
forming  a  serai-fluid  mass.  It  is  this  strange 
medium,  so  strongly  charged  with  saline  sub- 
stances injurious  to  the  highest  organisms,  that 
I  have  been  Studying  from  a  bacteriological 
point  of  view.  The  analysis  of  the  water  con- 
tains : 

Chloride  of  sodium.     .     .    60.125  gr 
Cloride  magnesium,     .     .  160.349  gr 

Potassium, 9.63 

Calcium,     ......        10.153 

Bromide  of  magnesium      .    15.04 
Lime 0.78 

A  total  of  246.077  gr.  of  saline  matter  per 
litre.  In  certain  parts  the  bromine,  which  the 
experiments  of  Paul  Bert  have  shown  to  have  a 
very  energetic  action  upon  the  vitality  of  the 
tissues,  may  reach  even  to  7  gr.  per  litre. 
Recently  M.  Barrois,  the  able  zoologist,  has 
traversed  in  a  boat  a  great  part  of  the  Dead 
Sea,  hoping  to  find  the  inferior  animalculse. 
But,  like  his  predecessors,  he  found  the  water  en- 
tirely sterile  In  consequence  of  the  statistics 
6f  some  competent  men,  I  thought  hat  the 
waters  of  the  Deal  Sea  might  well,  in  conpe 
queuce  of  their  concentration  aud  their  special 


composition,  constitute  an  aseptic  fluid  capable, 
perhaps,   of   some   useful    application.      Here 
comes    the  interesting  part  of  the  article;  the 
above  is    only  introductory.     **The  semi  fluid 
niud,  collected  with  care  by  M.  Barrois,  was 
then  diluted  suitably  and  distributed  in  many 
hundreds  of  tubes  and  flanks.    What  was  to  my 
profound  astonishment  to  observe,  afcer  forty - 
eight  hours,  that  all   the  nutritive  media  cod* 
taiaed,  especially  in  their  deep  parts,  two  micro- 
organisms perfectly  recognizable  by  their  alto- 
gether special  form;  those  of  gangrene  gazeuse^ 
characterized  by  large  bacilli  accompanied  by 
corpuscles  like  the  clapper  of  a  bell,  and  those  of 
tetanus,  so  easily  recognizable  by  their  form 
resembling  a  pointed  nail  with  a  spherical  head. 
Guinea-pigs  inoculated    with    sterilized    water 
mixed  with  a  little  of  the  mud  were  all  dead  in 
less  than  three  days  of  gangrenous  septicemia, 
with  all  the  train  of  symptoms,  in  some  degree 
intensified,   characteristic    of   this    formidable 
affection.'    Guinea-pigs  and  donkeys  have  also 
all  perished  of  the  same  affection  from  the  in- 
occulation    with  the  product   of   our    culture 
media  deprived  of  contact  with  oxygen.    In  one 
case  and  in  the  others,  numerous  bacilli  have 
always  shown  themselves  in   the  peritoneum,  in 
the  muscles  and  in  the  blood,  which  have  transmit- 
ted the  malady  to  other  subjects,  and  which,  cul- 
tivated afresh,  have  reproduced  the  bodies  like 
the  clapper  of  a  bell,  which  are  so  characteris- 
tic.    The  affliction  engendered   by  those  organ-  \ 
isms  is  the  gangrene  gazeuse  and  not  the  charban 
symptomatiquey  with  which  we  might  confound 
it.     Young  oxen  experimented  upon  have  not 
been  affected   by  our  inoculation.     Most  of  the 
guinea-pigs  inoculated  directly  wi|ii  the  mud  pre- 
sented tetanic  symptoms,  corresponding  to  the 
frequency  of   the  organisms  described  above. 
The  experiments  here  described  prove  then,  once 
for  all,  that  certain  pathogenic  microbes  may  re- 
sist for  a  long    period,  whether  in  the  adult 
state  or  in  the  form  of  spores,  prolonged  contact 
with  large  masses  of  water,  even   whilst  they 
contain,  in  considerable  quantities  salts  injurious 
to  every   other  organism,   animal    or  reptile. 
The  practical  point  is,  that   it  will  be  impracti- 
ble  to  regard  water  strongly  charged  wiih  salt 
as  an  ami  eptic   liquid  capable  of  protecting 
against  attacks  of  tetanus  and  gangrene  gazeuse. 
It  is  just  such  investigations  as  the  above  that 
have  caused  such  a  change  in  the  minds  of  the 
best  surgeons  in  Europe,  for,  instead  of  using 
vast  quantities  of  so  called  antiseptic  fluid  dur- 
ing  operations  they  now  use  nothing  but  ex- 
treme cleanliness,  and  all  instruments,  sponges, 
etc.,  must  be  encased  in  a  sterilizing  apparatus, 
for  at  least  half  fln  hour  before  an  operation. 
Tripoli,  Syria.  Ira  Harris,  M.D, 


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Solution  of  Sulphate  of  Copper  Externally  for 
Diphtheria  and  Croup. 

Editor  Medical  World: — Since  writing 
mj  communication  to  The  World  which  ap- 
peared in  the  February  number,  I  have  had  a 
bad  case  of  diphtheria  ia  which  the  carbolic 
acid  mixture  referred  to  in  that  article  failed  to 
arrest  the  progress  of  the  disease.  Believing 
that  anything  to  combat  this  dread  disease  has 
special  interest  to  the  profession,  I  repoit  the 
case  briefly,  asking  forbearance  for  its  crude- 
neas,  as  it  was  prepared  amid  the  cares  of  an 
active  practice.  Before  describing  the  case  of 
diphtheria,  I  will  mention  a  case  of  membran- 
ous croup,  as  the  treatment  of  the  latter  in- 
fluenced the  former  case  very  materially. 

I  received  a  call  at  9  p.  m.  to  visit  a  boy, 
aged  5  years,  having  membranous  croup,  and 
found  him  in  great  distress,  with  the  sign  of  defec 
tive  inspiration — the  retraction  of  the  abdomen 
during  inspiration— fully  marked,  the  parents' 
attention  being  attracted  to  it  before  my  ar- 
rival. Calomel,  ipecac  and  apomorphine  failed 
to  have  any  effect  For  the  fever  and  inflam- 
mation he  was  given  a  full  uose  of  Rochelle 
salts.  Then  aconitine,  gr.  1134  in  water,  ^ii 
(two  ounces,)  and  gi  (one  dram)  of  this  every 
two  hours.  To  support  the  heart  I  gave 
digitaline  gr.  1  67  in  water  gss  (half  ounce,) 
and  of  this  ^i  (one  dram)  thirty  minutes  after 
the  aconitine.  About  every  four  hours  I  gave 
▼eratiine  gr.  1134  in  aq.  5ss  (half  ounce,)  and 
of  this  3i  (one  dram)  thirty  minutes  after  the 
digitaline.  The  following  mixture  was  then 
prepared: 

B.   PoUsB  iodld gralnt  zv 

Spts.  Tin.  nrct. anuns  11 

Aq.  q.  8.  ad ounoeB  iv 

Mix. 

A  piece  of  muslin  folded  go  as  to  be  three 
inches  square  and  having  four  layers,  was 
saturated  and  applied  over  the  trachea,  being 
covered  by  oiled  silk.  Considerable  relief  fol- 
lowed this  application,  but  it  was  not  permanent 
During  exacerbations  I  would  apply  a  similar 
piece  of  muslin  wetted  with  water,  and  upon 
which  four  or  five  drops  of  chloroform  were 
placed.  This  treatment  exteoded  over  18  hours, 
the  patient  showing  signs  of  exhaustion  mean- 
while, and  the  breathing  being  very  laborious 
most  of  the  time.  During  a  visit  to  my  office  I 
read  an  article  by  Dr.  Missoux  in  Oct  No. 
Amer,  Jour.  Med,  Sbi.  for  1859,  page  538,  in 
which  he  advocated  the  use  of  cupri  sulph.  in 
croup.  I  prepared  a  solution  (4  grs.  cupri 
BolpL  to  water  ^iv,)  and,  upon  returning  to 
my  patient,  applied  muslin  as  above,  saturated 
with  it,  over  the  trachea.  In  ten  minutes  the 
mother  remarked  that  he  was  breathing  much 


easier,  which  was  true.  From  the  time  the 
cupri  sulph  was  applied,  the  patient's  symptoms 
improved,  and  in  24  hours  he  was  convalescent 
The  cupri  sulph.  was  removed  for  a  short  time 
if  nausea  occurred,  and  the  pot  iod.  substituted. 

I  was  called  on  Friday  to  see  a  youth,  16  years 
old,  who  had  had  symptoms  of  diphtheria  from 
the  preceding  Monday,  and  had  used  a  few  do- 
mestic remedies  in  the  meantime.  The  glands 
on  the  left  side  of  his  neck  were  very  much  en- 
larged, and  the  tonsils  were  swollen  until  they 
touched  each  other,  being  one  third  covered  by 
exudation.  He  was  given  a  solution  and  gargle 
of  the  carbolic  acid  mixture  (  R  Carbolic  acid, 
150  grains ;  salicylic  acid,  15  grains;  essence  of 
mint,  10  drops.  Mix.)  the  solution  having  the 
strength  of  one  drop  of  this  mixture  to  one 
ounce  of  water,  and  the  gargle  4  drops  of  mix- 
ture to  one  ounce  of  water.  He  took  one  dram 
of  the  solution  every  hour  for  24  hours,  and 
gargled  with  one  dram  of  the  stronger  solution 
every  hour  for  the  same  time.  At  my  second 
visit  (in  24  hours)  he  was  worse.  The  external 
swelling  greater,  if  anything,  as  was  the  exuda- 
tion. The  carbolic  acid  mixture  was  then 
stopped*  and  he  was  given  :  quin  sulph.  gr.  iv 
every  four  hours.  In  two  hours,  tinct  fer. 
chlorid.  gtts.  xii  with  pot  chlorat  grs.  vi  in  so- 
lution. Tinct.  iodine  was  applied  externally  to 
the  enlai^ed  glands.  I  directed  gargle  of 
potass,  permang.  grs.  iv  to  aq.  ^i,  and  one 
dram  of  this  internally  every  four  hours.  In 
another  24  hours  his  condition  was  v6ry  8%htly 
improved.  I  then  had  a  tubular  collar  of  muelin 
two  inches  in  diameter  prepared,  and  filled  it^ 
with  carbo  ligni,  placing  it  around  his  neck. 
In  12  hours  his  condition  was  sligbtiy  changed 
for  the  better,  the  swollen  glands  remaining  the 
same.  I  now  concluded  to  use  cupri.  sulph.  ex- 
ternally, recollecting  its  good  effects  in  croup. 
A  solution  was  prepared  :  R.  Cupri  sulph.  gr. 
iv  ;  aq.  ^i,  and  application  made  of  muslin 
folded  3  inches  square  with  4  layers  saturated 
with  it,  to  the  glands  on  each  side  of  the  neck 
above  the  charcoal  collar.  The  patient  said  he 
could  swallow  better  in  ten  minutes.  In  30 
minutes  he  Faid  the  loud  noises  in  his  ears  had 
vanished.  The  cupri  sulpL  was  applied  almost 
continuously  for  several  days  (being  removed 
when  nausea  occurred,)  and  at  the  end  of  that 
time  I  found  my  patient  enjoying  a  hearty 
breakfast  of  chicken  broth  and  crackers,  with 
but  little  of  the  diphtheria  remaining.  He  told 
me  he  believed  that  the  medicine  applied  to  his 
neck,  and  which  colored  the  muslin,  had  acted 
the  principal  part  in  his  recovery. 

Since  sending  my  article  for  the  February 
World  I  have  used  the  carbolic  acid  mixture 


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124 


THE  MEDICAL  WORLD. 


in  a  number  of  cases  of  diphtheria  in  which  the 
disease  had  appeared  hut  a  day  or  two,  and 
found  it  to  act  as  well  as  I  could  desire.  I 
have  used  it  in  three  cases  of  scarlatina  auginosa 
with  good  effect,  the  solution  being  alternated 
with  neutral  mixture  every  two  hours.  In  my 
second  case  of  scarlatina,  the  patient*s  brother, 
aged  6  years,  could  not  be  kept  out  of  ihe  room. 
As  a  prophylactic  he  was  given  20  drops  of  the 
solution  ^one  drop  to  aq.  ooe  ounce)  three 
times  daily.  A  month  has  passed  since  his 
exposure,  and  he  reinains  in  good  health 
Ladiesburg,  Md.    John  J.  Lkjget,  M.D., 


Uric  Acid   headaches. 

Editor  Medical  World:— In  the  February 
number  of  The  World,  page  HO,  is  an  article 
quoted  from  the  Medical  News  —  "  Haig*s 
Uric  Acid  Theory."  I  have  cot  seen  -the  book 
mentioned,  but  I  most  heartily  eudorse  his 
theory  as  published  in  this  short  article.  For 
years  I  have  been  convinced  that  uric  acid 
was  the  cause  of  many  ca^es  of  periodic  hea  i- 
ache.  The  rf  suits  obtained  in  the  treatment  of 
these  cases,  the  subsequent  exemption,  after 
being  placed  under  proper  restrictions  in  regard 
to  diet,  in  connection  with  the  indicated  treat- 
ment, have  been  such  as  to  warrant  me  in  the 
conclusions  at  which  I  have  arrived,  viz  :  that 
mist,  if  not  nearly  all  the  cases  of  periodic  head- 
ache which  I  meet  are  results  of  the  uric  acid 
diathesis.  It  is  on  this  theory  I  base  my  treat 
ment  and  generally  with  success. 

I  write  this  short  article  that  the  attention  ef 
physi  ians  may  be  called  to  the  subject,  hoping 
that  some  one  with  more  ample  opportunities 
than  I  may  give  the  matter  the  attention  it 
deserves  and  publish  results  in  The  World. 
W.  B.  Squire,  M.D., 

Worthington,  Ind. 

[We  hope  the  Doctor  will  give  his  principles 
•f  treatment  in  the  next  number. — Ed] 


Antagonism  Between  Vaccine  Virus  and  Phthisis. 

Editor  Medical  World: — I  have  had 
occasion  to  observe  the  effect  of  thorough  inocu- 
lation with  vaccine  virus  upon  three  cases  of 
phthisis  pulmonalis  and  have  noted  the  speedy 
remission  of  all  the  symptoms  of  phthisis. 

One  case  has  entirely  ceased  to  cough  while 
the  others  are  free  from  the  rise  of  temperature 
and  I  think  will  recover. 

You  know  that  when  one  recovers  from 
small  pox  the  system  is  thoroughly  cleansed  and 
the  patient  generally  presents  a  rugged  appear 
ence.  Do  you  think  it  possible  to  kill  out  the 
bacillus  of  consumption  this  way?  I  am  very 
much  excited  over  this  discovery,  as  I  have  for 
years  been  experimenting  and  this  shows  the 


best  results.  The  great  difficulty  is  to  get  i  he 
virus  to  work.  Steady  perseverence  and  gcKxl 
virus  will  succeed  Am  I  alone  in  this  «ii»- 
covery  ?  H.  S.  Brewer,  M.D  . 

240  Wabash  Ave.,  Chicago. 


Treatment  of  Sprains. 

Editor  Medical  World:— Immerse  in  hot 
water  twice  a  day  as  hot  as  can  be  bom  for 
thirty  minutes,  pouring  in  more  hoc  water  as  it 
gets  cooler.  Then  rub  with  the  following  lini- 
ment : 

R.     Gum  campbor , ounce  1 

Suiph  irorph. gi.  iv 

Kerosene  <  il  q.  s ounce  Iv 

M.  \pply  locHliy  twice  UaUy  five  to  ten  minutes  at  the 
time.    Tben  epply  bandage. 

I  know  the  above  treatment  is  g(x>d.  fnr  I 
sprained  my  ankle  on  the-  7th  of  FebruHry 
while  stepping  from  my  buggy  and  charged  up 
only  a  half  week  to  my  accident  policy. 

W.  S.  Robertson,  Jr  ,  M.D., 

Mount  Cross,  Va 


Higli  Temperaturt  in  Typlioid  feyer. 

Editor  Medical  World: — I  wish  to  report 
a  fatal  case  of  typhoid  fever  as  being  one  of  un- 
usual hyper- pyrexia,  and  in  tl  e  following  epi- 
tome of  the  case  I  will  very  briefly  mention  the 
salient  features  connected  therewith. 

The  patient  was  a  young  man,  23  years  of 
age  and  was  taken  sick  the  latter  part  of  last 
December;  he  died  on  the  21st  day  of  the 
disease.  There  was  mtntal  hebetude  and  de- 
lirum  from  the  very  inception  of  the  disease, 
which  continued  until  the  last  twenty-four  hours, 
when  coma  supervened.  Meteorism  was  pres- 
ent though  not  at  all  excessive.  The  deje*  ta 
were  characteristic  of  the  disease,  but  never  ex- 
ceeded three  movements  during  any  twentyf  ur 
hours,  and  after  the  fourteenth  day  became  de- 
cidedly feculent  There  was  a  strong  rheun  atic 
element  present,  which  gave  rise  to  the  only 
pain  experienced  during  the  illness  Successive 
joints  were  invaded,  but  the  left  wrist  and  dor- 
sal aspect  of  the  left  hand  weie  the  most  severe, 
being  exquisitely  tender,  red  and  edematous.  A 
strip  of  flesh  several  inches  long  on  the  lelt  arm 
and  leg,  for  awhile,  became  very  nd  and  pain- 
ful. A  slight  rigidity  of  the  musilesof  the 
arms  and  leg?  was  present  throughout  the  JK 
ness.  Until  the  fourteenth  day  of  the  sickness 
the  thermometric  range  was  from  102^  F.  to 
104f°  F.  and  the  case  in  other  respects  was 
not  unlike  typical  cases.  On  that  day  there  was 
a  complete  remission  in  the  fever,  and  in  a  few 
1  ouK  a  chill,  which  lasted  nearly  an  hour,  after 
which  the  fever  ran  rampant  After  a  few 
hoars  of  intense  fever  a  decline,  and  then  the 


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125 


chill,  followed  again  by  a  ra^og  fever.  Thus 
it  GODtiuued,  day  by  day,  until  the  close — thsre 
being  one  or  two  chills  every  twenty  four  hours, 
followed  by  unusually  higfh  fever  and  very  pro 
fuse  perspiration.  The  effect  of  energetic  treat- 
ment on  these  conditions  was  practically  nil. 
There  was  no  hemorrhage  or  evidence  of  per- 
foration Four  days  before  death  the  ther- 
mometer registered  110°  F.  in  the  axilla.  Our 
thermometers  are  only  scaled  to  110°,  and  as 
the  index  was  at  the  top  in  this  ceise  it  is  not 
known  how  much  higher  it  would  have  gone. 
A  few  hours  befoie  death  an  axillary  tempera 
tureof  108f°  F.  was  noted.  I  attribute  the 
chills  and  excessive  temperature  to  meuingeal 
complication.  I  would  be  glad  to  learn  the  ex- 
perience of  The  World's  readers  as  to  high 
temperature  in  typhoid  fever. 

Humboldt,  Neb.         L.  B.  Allen,  M.D., 


Cancer. 

Eilitor  Medical  World  : — I  notice  in  your 
March  number  an  article  on  cancer  by  Dr. 
Jamis  W.  Huntoon. 

Allow  me  to  say  a  few  words  in  reply  to  that 
article.  I  have  made  a  special  study  of  the 
cause  and  treatment  of  cancer  for  25  years,  and 
have  treated  patients  from  all  parts  of  the 
Union.  I  am  familiar  with  all  the  leading 
worlis  on  cancer  and  the  various  forms  of  treat- 
ing it  also  the  various  theories  regarding  its 
cause. 

Dr.  Huntoon  speaks  of  the  tomato  as  a  prob- 
able cause  of  cancer.  I  am  well  aware  that 
there  is  a  notion  handed  down  from  sire  to  son 
that  cancers  are  caused  by  tomatoes,  together 
with  another  that  cancers  are  alive  and  have  legs 
Hke  a  spider.  Some  of  the  old  Botanic  medic^d 
books  recommend  a  syrup  made  from  the  to- 
mato as  a  blood  purifier,  for  different  blood  and 
«kiii  diseases  and  with  good  stuscess.  In  my  own 
experience  I  know  that  many  cases  of  scrofula 
and  salt  rheum  are  always  better  during  the 
time  when  they  can  get  ripe  tomatoes  to  eat.  I 
always  advise  my  cancer  patients  to  eat  all  the 
ripe  tomatoes  they  can  get — and  as  I  have 
many  cases  of  cancer  that  I  cured  from  ten  to 
twenty  years  ago  that  have  been  eating  toma- 
toes all  these  years,  and  as  I  have  never  known 
a  person  injured  by  eating  this  fruit,  I  conclude 
it  is  safe  to  still  recommend  it  The  doctor 
seems  to  think  that  the  rapid  increase  of  cancer 
is  caused  by  tomatoes.  In  reply  to  that  allow 
me  to  say  that  New  Jersey  is  one  of  the  leading 
states  in  the  Union  for  raising  tomatoes — the 
people  eat  them  at  all  times  and  in  allformSy  yet 
out  of  a  population  of  1,278  032  only  1.762 
persons    <Ued    of  cancer    in  this    state    last 


year.  In  England  tomatoes,  if  raised  at  all, 
are  raised  in  hot  houses  ;  yet  in  1890  can- 
cer caused  one  death  in  1,480  of  the  popula- 
tion, or  1  in  28  of  the  total  mortality.  Thus  we 
see  that  tomatoes  did  not  came  rancer  in  Eng- 
land. In  regard  to  pieplant,  allow  me  to  say 
that  I  have  lived  in  New  England,  where  the 
pieplant  is  a  very  common  article  of  diet,  yet 
cancer  is  not  so  common  there  as  elsewhere. 
Patterson,  N.  J.  E.  G.  Jones,  M.D., 

[The  above  statistics  seem  to  show  a  surpris- 
ingly large  mortality  from  cancer,  both  in  New 
Jersey  and  in  England. 

This  controversy  leads  us  to  remark  that  the 
statement  of  a  curate  investigators  show  that 
can  er  is  not  on  the  increase  relatively  to  the 
number  of  patients  brought  under  observation. 
The  number  of  reported  cases  of  internal  cancer 
has  increased,  on  account  of  the  improved 
methods  of  accurate  diagnosis.  Many  cases  of 
death  from  cancer  of  various  internal  organs 
that  would  formerly  have  passed  without  recog- 
nition are  now  properly  diagnosed  and  go  upon 
record.  The  number  of  cases  of  cancer  of  ex- 
ternal parts,  where  it  has  always  been  easy  of 
diagnosis,  does  not  seem  to  be  increasing. — Ed.] 


Infant  Feeding.— Safety  Pin  Swallowed. 

Elitor  Medical  World: — The  theorethwd 
methods  of  the  feeding  of  infants,  and  the  strin- 
gent diet  rules  which  some  physicians  are  habi- 
tually imposing  upon  mothers  who  are  rear- 
ing children  naturally  or  artifically,  must  often 
strike  the  observing  and  thinking  physician  as 
absurd  and  convince  him  that  we  cannot  raise 
children  by  rule.  Tell  a  mother  to  nune  her 
baby  once  in  two  or  three  hours  and  feed  it  a 
stated  quantity  and  the  chances  are  that  she  will 
be  unable  to  follow  your  instruction,  or  if  she 
does, will  have  a  fretful  and  sickly  child.  If  an 
infant  nurses  every  hour  or  two,  as  long  as  di- 
gestion is  good  and  the  child  thrives,  that  is 
sufficient  It  is  easy  to  prescribe  a  course  of 
diet  for  anyone,  but  another  matter  to  follow  it 
A  large  majority  of  babies  grow  and  are  healthy 
who  nurse  nearly  every  hour  and  some  even 
sleep  with  the  nipple  in  the  mouth,  without 
harm.  How  senseltss  it  eeeros  to  make  a  hungry 
and  helpless  little  being  wait  one  or  two  hours, 
simply  because  the  physician  has  directed  that 
there  should  be  an  interval  of  2  or  3  hours  be- 
tween the  feeding.  Tl.eoretically,  a  strict  diet 
table  is  a  fine  thing,  but  it  is  found  valueless  in 
a  large  precentage  of  cases  in  practice.  While 
I  do  not  advocate  reckless  feeding  of  infants,  I 
advise  every  mother  to  study  her  child  ai 
regards  the  food  question,  and  I  find  that  most 
of  them  succeed  admirably. 


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A  few  days  ago  I  was  hastily  summoned  to 
see  J.  H.,  aged  2  years,  who  had  a  few  minutes 
before  swallowed  an  open  safety  pin.  The 
mother  was  positive  that  the  open  end  pointed 
upward,  as  she  tried  to  reach  it  with  her  finger 
and  could  feel  the  point  of  the  pin.  In  her 
endeavor  to  extract  it,  she  had  pushed  it 
farther  down  into  the  esophagus.  As  I  could 
not  reach  it  with  my  finger,  I  introduced  a  large 
probe  and  when  about  2i  inches  down  a  pecu- 
liar metallic  click  was  heard.  Bringing  the  boy 
into  a  good  light,  I  instructed  the  father  to 
make  pressure  upward  on  both  sides  of  the 
throat,  and,  using  a  large  tongue  depressor,  I 
could  get  a  glimpse  of  the  catch  part  of  the  pin. 
Introducing  a  curved  pair  of  uterine  forceps  I 
succeeded  in  extracting  it  The  pin  measured 
14  inch  in  length  and  i  inch  between  the  open 
ends.  Had  the  pin  slipped  beyond  reach  or 
into  the  stomach,  I  think  that  it  would  have 
caused  the  boy's  death. 

Louis  J.  Pons,  M,D., 

Roxbury,  Conn. 

[The  pin  case  wag  well  handled.  We  wish, 
however,  to  express  our  difference  of  opinion 
with  the  Doctor  in  regard  to  the  too  frequent 
feeding  of  infants.  The  child  that  is  strongest 
to  resist  disease,  especially  of  the  alimentary 
traet,  is  one  that  is  fed  not  of^ner  than  once 
every  two  hours. — Ed.] 

Castor  Oil  at  a  Lubricant. 

Editor  Medical  World  : — In  February 
number,  mention  is  made  of  an  interesting  letter 
by  Dr.  John  M.  Kitchen,  on  the  use  of  castor 
oil  as  a  lubricant 

This  practice  so  fully  coincides  with  my  own, 
for  the  past  fifteen  or  twenty  years,  that  I  feel 
emboldened  how  to  say  that  I  use  it  in  prefer- 
ence to  all  other  lubricants,  in  catheterism, 
vaginal  examinations,  etc.  I  know  of  nothing 
that  excels,  or  even  equals  it ;  and  in  my  experi- 
ence castor  oil  is  faultless  as  a  lubricant  In 
catheterism  it  is  vastly  superior  to  others  in 
common  use. 

For  the  young  practitioner,  I  would  say 
that  my  plan  before  attempting  to  insert  a 
catheter  in  the  male  urethra  is  to  inject  one  or 
two  teaspoonfuls  of  oleum  ricini,  with  the  left 
hand  holding  the  meatus  close  about  the  nozzle, 
so  as  to  prevent  regurgitation  (which  will  fol- 
low if  not  prevented),  and  with  the  right  hand 
stroke  the  urethra  backward,  so  as  to  force  the 
oil  along  the  entire  canal.  This  done,  insert  the 
catheter,  and  you  will  be  elated  with  what 
facility  the  instrument  will  glide  along  the 
canal,  overcome  obstructions  and  enter  the 
bladder,  causing  less  pain  from  friction  than  by 
any  other  means  you  have  ever  used. 


Another  commendable  feature  is  that  you 
will  almost  always  find  castor  oil  in  every  home 
in  the  country  practice.-^ 

Haleford,  Va.        J.  A.  Moorman,  M.D., 


Aikaloidal  Notes. 

Editor  Medical  World: — The  many  de- 
mands upon  my  time,  largely  increased  during 
the  last  three  months  in  which  I  have  been  start- 
ing my  journal,  the  Aikaloidal  Clinic— bo  courte- 
ously reviewed  by' the  editor  of  this  journal  in 
its  March  issue — have  prevented  my  saying  the 
many  things  to  the  readers  of  The  World 
which  come  to  my  mind  as  I  read  its  pages  from 
month  to  month.  There  are  so  many  good  things 
in  the  number  at  hand,  with  a  few  places  where  I 
would  suggest  this  or  that  in  the  aikaloidal  line, 
that  I  offer  these  notes. 

Without  any  special  regard  to  classification, 
I  will  take  the  points  up  as  they  occur ;  first, 
emphasizing  what  is  said  against  the  use  of  the 
swab  in  diphtheria  and  then  saying  that,  used 
rightly,  I  believe  it  excels  all  other  means  of 
local  application,  but  if  it  is  not  used  carefidly, 
by  skilled  hands,  with  a  clear  conception  of  what 
is  desired  to  be  accomplished,  it  can  do  much 
harm.  I  am  much  interested  in  Dr.  Morris' 
report  of  his  use  of  methylene  blue  in  diphtheria 
and  hope  it  will  not  drop  here.  The  great 
clinic  to  which  these  suggestions  are  made  has 
thousands  of  opportunities  daily  to  test  them  and 
they  should  be  carefully  tried  and  reported  for 
our  mutual  benefit 

I  can  not  refrain  from  an  expression  of  sym- 
pathy with  Dr.  Treadgold  in  the  loss  of  his 
baby. 

It  seems  to  me  that  the  children  of  physicians 
more  often  die  of  contageous  diseases  than  those 
of  the  laity.  A  dear  friend  of  mine,  in  a  recent 
epidemic  of  scarlet  fever,  staid  away  from  home 
for  weeks,  and  after  all  was  over,  dressed  anew, 
took  all  antiseptic  precautions,  came  home,  in- 
fected his  two  children  and  lost  them  both. 
With  the  defervescent  granules  to  control  the 
fever,  strychnine  arseniate  as  a  tonic  and  calcium 
sulphide  to  combat  the  materies  morbi,  I  have 
come  to  have  little  anxiety  for  my  scarlet  fever 
patients. 

I  wish  to  compliment  Dr.  Hinton  on  his  suc- 
cessful handling  of  his  case  of  hemorrhage.  Bel- 
ladonna, nux  vomica  and  digitalis  (preferably 
their  active  principles,  atropine,  strychnine  and 
digitalin)  are  the  remedies  for  this  condition. 
Digitalin  and  strychnine  tone  the  heart  and  act 
as  hemostatics,  in  the  true  sense  of  the  word,  by 
contraction  of  the  arterioles.  The  addition  of 
atropine  is  very  happy  and  has  lately  been 
especially  emphasized  for  shock  and  hemorrhage 
from  internal  congestions.     It  is  a  well  known 


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fact»  though  often  forgotten,  that  vasomotor 
dilatation  afTecting  the  akin  capillaries,  causes  a 
corresponding  contraction  of  those  of  internal 
organs.  Atropine,  therefore,  must  be  pushed 
to  its  full  physiological  effects.  I  have  just  had 
a  very  happy  experience  in  the  use  of  these 
three  remedies  in  a  case  of  collapse  from  intes- 
tinal hemorrhage  in  typhoid  fever ;  it  was  the 
moat  terrific  I  have  ever  seen.  I  found  my 
patient  in  complete  collapse  and  it  took  two 
hours  of  hard  work,  frequent  hypodermics  of  the 
above  mentioned  remedies,  with  artificial  heat, 
to  produce  the  reaction  desired.  It  finally  came 
and  my  patient  was  conducted  safely  through  to 
a  perfect  recovery. 

Much  has  been  said  in  The  World  of  late 
regarding  hemorrhage  induced  by  quinine,  but 
it  looks  to  me  in  every  instance  cited  as  if  poison- 
ous doses  were  being  given,  and  it  is  my  opinion 
that  no  such  result  would  be  obtained  from  this 
useful  drug  if  proper  physiological  doses  w^re 
adhered  to. 

The  March  issue  is  especially  rich  in  the  thera- 
peutics of  tape  worm,  a  sufficient  vanety  of  for- 
mulas being  given  to  satisfy  the  most  fastidious 
tenia.  I  have  never  found  any  thing  to  work 
better  than  the  following  prescription,  which 
was  suggested  to  me  m  this  form,  by  my  esteemed 
friend,  the  late  Dr.  M.  L.  Eaton,  an  eminent 
physician  of  Fairbury,  Nebraska  : 

R.  ^Oleo-reeiD  male  fera(Bferok*8) dr.  l     . 

Chloroform dr.  1 

Olei  ildni oz.  H  to  1 

Oiven  on  an  empty  stomach  in  the  morning. 

I  have  never  failed  but  in  one  instance  and 
then  was  able  to  demonstrate  the  fact  that  the 
castor  oil  was  poor.  The  active  principles  so 
far  offered  for  these  cases  are  both  uncertain 
and  too  expensive. 

Dr.  Ldster,  page  95,  gives  his  formula  for 
suppression  ot  urine.  This  leads  me  to  speak 
of  a  remedy  that  I  have  used  for  some  years 
with  excellent  satisfaction,  having  suggested  it 
to  many  of  my  friends  who  have  used  it  with 
like  good  results.  This  is  arbutin,  a  glucoside, 
the  active  principle,  as  you  know,  of  uva  ursL 
It  is  almost  tasteless  and  acts  in  a  minute  dose. 
A  granule  of  ^  gr.  every  twenty  or  thirty 
minutes  until  effect,  is  sufficient  for  an  adult, 
while  for  a  child  up  to  three  or  four  years,  I 
goierally  put  four  to  six  granules  in  half  a 
glass  full  of  water,  giving  a  teaspoonful  at  a 
doee.  With  this,  as  with  all  other  diuretics, 
water  should  be  given  freely.  I  am  led  to  sug- 
gest this,  it  being  so  pleasant,  handy  to  use  and 
inexpensive,  the  granules  of  the  size  above 
mentioned  being  furnished  by  various  granule 
makers  at  less  than  $1.00  per  1000.  I  believe 
we  should  be  ready  to  use  whatever  tends  to 


make  our  practice  most  successful,  agreeable, 
simple  and  inexpensive. 

Dr.  Pinep,  page  98,  and  Dr.  Hamilton  on  the 
next  page,  ask  for  suggestions  in  the  treatment 
of  infantile  eczema.  No  specific  treatment  can 
be  given  for  a  case  of  thia  kind.  The  cause 
must  be  sought  for  and  removed.  It  is  generally 
a  vitiated  condition  of  the  fluids  of  the  body 
caused  by  indigestion,  mal-assimilation  or  both. 
Local  treatment,  except  so  far  as  it  is  soothing 
and  antiseptic,  is  of  no  earthly  value,  the  local 
lesion  being  simply  an  outward  manifestation  of 
an  inward  trouble.  The  local  inflammation  be- 
comes a  septic  condition  induced  by  scratchmg, 
irritation  of  the  clothing  and  the  decomposi- 
tion of  ointments  and  lotions  mistakenly  ap- 
plied. I  have  come  to  depend  mainly  upon 
magnesium  sulphate,  sulphur  and  arsenic.  The 
former  I  use  in  small  doses  in  an  effervescent 
form,  known  as  "Seidlitz  Salt"  Of  this  I  give 
sufficient  to  keep  the  bowels  free  and  soft 
The  other  remedies  I  use  singly  or  together  in 
the  salt,  arsenic  sulphide.  Of  this,  to  these 
babies,  I  would  give  one  granule,  gr.  ^,  four 
times  a  day.  Diet  is  of  the  utmost  importance. 
In  the  former  it  should  be  bread,  milk  and 
fruit  In  the  latter,  milk  with  perhaps  a  little 
bread  and  now  and  then  the  juice  of  an  orange. 
For  local  treatment,  good  results  are  obtainable 
through  the  use  of  dilutions  of  peroxide  of  hy- 
drogen as  a  wash  and  dusting  with  dry  stearate  of 
zinc  combined  with  salicylic  acid  as  prepared  by 
McKesson  &  Robbins.  I  would  wash  the 
affected  areas  twice  a  day  with  peroxide  of  hydro- 
gen and  water,  one  to  four.  Remove  all  scabs 
and  shreds  of  decomposing  tissue  and  dust 
immediately  with  the  dry  powder  above  men- 
tioned. I  believe  that  the  above  treatment, 
faithfully  carried  out  and  modified  to  meet 
indications  as  they  arise,  will  cure  these  two 
cases. 

I  would  like  to  discuss  the  subject  of  acute 
meningitis  with  Dr.  Milner,  page  99,  but  this 
letter  is  growing  altogether  too  long.  I  can  not, 
however,  forbear  to  present  the  claims  of  the 
defervescent  principles,  aconitine,  veratrine  and 
digitalin  for  cases  of  this  kind.  I  have  loet  a 
much  smaller  percentage  since  I  have  been  able 
to  use  these  drugs  more  accurately.  If  treat- 
ment is  begun  in  season,  many  can  be  saved ; 
if  it  is  delayed  until  organization  of  effusion 
takes  place,  few  will  be.  Heat  and  cold  and 
quiet  with  free  catharsis  through  the  use  of 
salines  are  adjuvants  too  important  to  omit 
mention. 

Dr.  Jones,  page  99,  is  on  the  right  track  with 
his  patient  but  I  would  suggest  atropine  instead 
of  glonoin,  as  its  effects  are  more  permanent  and 
it  can  be  continued  longer  with  a  greater  feeling 


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THE  MEDICAL  WORLD 


of  safety.  I  would  also  give  this  patient  medium 
doses  of  strychnine  (two  to  four  granules  of  the 
arseniate  j^f  gr.)  before  meals  and  would  use 
the  atropine  between  meals  and  at  bed  time, 
combining  with  the  last  dose  aconitine  (two 
granules  of  the  amorphous  gr.  j^^f).  The  atro- 
pine should  be  given  in  large  enough  doses  to 
cause  a  slight  flush  of  the  skin  and  a  tioge  of 
dryness  in  the  throat :  this  will  take  about  y^^  gr. 
The  fact  that  he  has  never  bad  any  trouble  in 
the  summer  would  tend  to  disprove  the  doctor's 
diagnosis  unless  confirmed  by  microscopical  ex- 
amination of  the  urine,  and  would  indicate, 
rather,  passive  congestion,  of  the  kidneys. 

To  Dr.  Manning,  page  100,  I  would  say, 
throw  your  thermometer  away  and  get  a  new 
ona 

Suggestions  made  in  reference  to  eczema  may 
also  help  Dr.  Stanley  with  his  case  page  100. 

Dr.  Mathew's  question,  page  101,  should  in- 
terest us  all ;  mauy  a  woman  has  ridden  into 
eternity  on  the  "change  of  life,"  drawn  by  her 
friends  and  pushed  by  her  doctor  who  did  not 
know  what  else  to  do.  This  irritable  condition 
of  the  nervous  system  is  best  controlled  by 
Buckley's  Uterine  Tonic  assisted  by  large  doses 
of  strychnine,  with  or  without  digitalin  accord- 
ing to  the  condition  of  the  circulation. 

To  **advice,"  page  102,  I  will  say,  out  of  con- 
siderable experience  along  this  line,  that  the 
best  results  are  obtained  by  giving  such  a 
patient  sufficient  doses,  t<venty  or  thirty  grs. 
of  bromide  of  potassium,  three  times  a  day,  as 
to  efiectually  quell  sexual  desires,  with  the  ex- 
hibition of  large  doses  of  strychnine  at  meals 
to  tone  up  the  sphincters  of  these  minal  vesicles 
and  the  passage  of  cold  sounds  every  other  day. 
W.  C.  Abbott,  M.D., 

Ravenswood,  P.  O.,  Chicago,  111. 


Pott  Partum  Hemorrhage. 

Editor  Medical  World:— I  wish  to  call 
attention  to  Dr.  T.  C.  Mewburn's  article  on  post 
partum  hemorrhage  in  the  February  number. 

His  treatment  is  upheld  by  all  practical  and 
experienced  physicians. 

How  necessary  it  is  that  the  medical  atten- 
dant, when  called  to  a  ca^e  of  this  kind,  knows 
just  what  to  do,  and  how  it  should  be  done— no 
time  now  for  parley  or  consultation. 

The  point  in  the  article  which  interested  me 
especially,  is  calling  attention  to  '' yawning" 
as  a  symptom  of  impending  hemorrhage.  About 
twenty  years  ago,  when  I  was  a  young  prac- 
titioner, I  was  made  acquainted  with  this  symp- 
tom in  such  a  manner  that  the  acquaintance 
has  remained  indelibly  fixed  in  my  memory. 


Attending  a  lady  in  her  second  labor,  present- 
ing nothing  unusual,  but  somewhat  tedious  and 
in  about  one  half  hour,  or  perhaps  forty-five 
minutes,  my  attention  ^as  attracted  to  tiie 
gaping  and  yawning  of  the  patient  Being  my 
first  case  of  post  partum  hemorrhage,  1  did  not 
at  once  recognize  the  trouble.  I  then  ex- 
amined for  flowing  in  the  bed.  but  found  noth- 
ing alarming  ;  the  patient  was  now  complaining 
of  severe  after  pains.  Placing  my  hand  over 
the  abdominal  wall,  I  encouiitered  a  "tumor,*' 
and  thinking,  perhaps,  that  there  was  another 
child  in  the  womb,  I  examined  the  patient 
again,  and  in  manipulating  the  uterus,  I  waa 
frightened  at  the  large  coagulse  that  were  ex- 
pelled. I  now  understood  that  I  nad  a  case  of 
post  partum  hemorrhage  for  the  first  time.  I 
remember  distinctly  that  I  gave  ergot,  brandy 
and  aromatic  spirit  of  ammonia — the  patient 
did  well  in  recovery.  How  vividly  I  remem- 
be|r  the  facial  expression  of  that  patient  in  her 
yawning  and  gaping. 

The  above  symptoms  are  often,  but  not  al- 
ways, present  in  hemorrhage,  but  the  attendant, 
when  he  hears  them,  should  btstir  himself,  aa 
there  is  danger  to  the  patient 

N.  F  Brown,  M.D., 

243,  24th  8t,  Detroit,  Mich. 


Quinine  and  Hemorrhage. 

Editor  Medical  World  :  I  will  give  you 
my  recent  experience  regarding  quinine  and 
hemorrhage  after  seeing  Dr.  Waugh's  quota- 
tion of  the  experience  of  Drs.  Stockard  and 
Brodnax.  The  subject  is  my  father,  who  had 
a  slight  attack  of  La  Grippe  and  had  been  tak- 
ing quinine  heavily  for  forty  eight  hours  before 
1  saw  him,  4  grs.  every  3  hours.  The  urine 
was  bloody  and  abundant;  expectoration  con- 
sisted of  mucus  streaked  with  blood,  but  in  6 
or  8  hours  after  I  ordered  the  quinine  stopped, — 
which  I  did  immediately — all  hemorrhage 
ceased,  and  appeared  not  again.  The  urine 
cleared  up,  he  still  expectorated,  but  there  waa 
no  blood. 

He  had  never  passed  blood  with  his  urine 
before  this  but  once,  which  was  about  6  years 
ago,  when  he  had  chills  and  took  quinine 
heavily.  E.  E.  Thomas,  M.D., 

Horn  Hill,  Texas. 


Action  of  Quinine  Upon  the  Uterus. 

Editor  Medical  World  : — I  notice  a  letter 
in  February  number  of  World  from  Mrs. 
Ida  O.  Wilhelm,  M.  D.,  in  which  she  thought 
a  caae  of  podt  parterm  hemorrhage  occurred 
from  the  use  of  quinine.  This  is  a  subject  in 
which  I  have  been  greatly  interested  since  I 


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129 


entered  the  medical  field.  Quinine  in  large 
doses  will  sometimes  give  rise  to  epistaxis  and 
hemorrhage  from  difiereut  parts  of  the  body, 
and  perhaps  from  the  uterus  also  ;  but  my  ex- 
perience with  the  latter  has  been  just  the  op 
poeite.  It  may  be  that  large  doses,  say  twenty 
to  forty  grains,  will  cause  hemorrhage.  It  is  a 
well  known  fact  that  the  drug  produces  contrac- 
tion, and  therefore  aids  in  the  expulsion  of  the 
fetus.  In  order  to  derive  the  best  results  the 
drug  should  be  given  in  small  doses,  say  three 
or  five  grains  every  hour  until  strong  pains  fet 
in.  My  experience  has  been  that  it  is  one  of 
the  safest  drugs  you  can  administer  for  weak 
fpains.  In  a  short  while  it  tones  up  the  flagging 
uterus,  bringing  on  good  pains,  and  at  the  same 
time  is  a  prophylactic  against  post  partum 
hemorrhages  by  producing  contraciion,  expel- 
ling clots,  preventing  hemorrhage,  and  leaving 
the  uterus  in  a  firmer  condition,  even,  than 
does  ergot. 

In  a  number  of  cases  it  has  served  me  well, 
and  I  have  yet  to  see  the  bad  eflects  at  the  time, 
or  after  delivery.  I  have  never  given  more 
than  ten  grains  to  one  patient,  as  there  was  no 
cause  for  it,  while  at  the  same  time  I  thought 
larger  doses  might  cause  bad  results. 

During  the  month  of  July,  1893,  I  was 
called  to  Mrs.  J.,  and  ^pon  my  arrival  I  found 
profuse  hemonhage,  especially  during  pains, 
with  06  moderately  dilated.  The  patient  com- 
plamed  of  being  weak  and  giddy,  and  as  hem- 
orrhage had  been  going  on  for  some  time,  I 
thought  she  would  have  to  be  delivered  at  once 
with  forceps.  I  sent  for  a  brother  physician,  and 
in  the  mean  time,  gave  her  five  grains  of  sulphate 
of  quinine,  and  watched  for  results,  ^s  the 
the  brother  was  away  from  home,  I  missed  hav- 
ing him  with  me ;  but  within  a  few  minutes 
after  administering  the  drug,  pains  increased  in 
strength  and  hemorrhage  ceased.  In  due  time 
she  was  delivered  according  to  nature's  method, 
and  although  this  was  her  sixteenth  confine- 
ment, there  was  no  postpartum  hemorrhage, 
and  her  recovery  was  good. 

My  method  of  managing  labor  is  as  follows : 
Have  obstetric  bag  with  forceps,  but  let  them 
stay  in  it  Find  position  of  child  and,  if  nature 
is  doing  her  work  well,  do  not  interfere.  Should 
my  patient  suffer  too  much,  I  give  a  dose  of 
sulphate  of  morphine,  one  fourth  to  one-half 
grain.  Generally  this  will  let  her  rest  awhile, 
after  which  good  pains  will  hasten  labor. 
Should  her  pains  be  weak,  give  three  to  ^Ye 
grains  of  sulphate  of  quinine  and,  if  necessary, 
repeat.  After  delivery  of  child  and  pltuienti^ 
give  a  teaspoonful  of  ergot,  and  it  is  seldom  I 
ever  have  any  trouble. 


As  for  the  use  of  forceps,  they  are  good  when 
necessary,  but  when  a  case  is  seen  in  time  and  , 
properly  managed  there  is  no  use  for  them. 
When  used  to  hasten  labor  or  save  the  mother 
from  suffering,  I  believe  them  to  be  a  curse.  It 
was  intended  by  God  that  woman  should  give 
birth  to  children,  and  He  has  so  arranged  that 
nature,  with  her  slow,  cautious  method,  will 
bring  the  little  one  into  the  world  without  leav- 
ing such  bad  aftereffects.  I  would  like  to  hear 
from  others  on  the  use  of  quinine  during  labor, 
and  their  results.         S.  J.  Summers,  M.  D., 

Haigler,  S.  C. 

[The  doctor's  method  of  managing  labor  is 
very  good  indeed,  and  we  judge  that  patients 
are  fortunate  to  be  in  his  hands.  To  it  might, 
with  benefit,  be  added  some  form  of  relaxing 
medication  to  overcome  the  rigidity  of  the  soft 
parts,  as  gelseminum,  lobelia  or  a  few  puffs  at 
a  cig^r  or  pipe.  The  outlet  of  the  vagina  may, 
with  great  benefit,  be  paralyzed  in  the  early 
stage  of  labor  by  forcibly  stretching  it  with  the 
hands  until  it  yields.  His  last  argument  against 
the  forceps,  however,  is  not  the  best  that  can  be 
offered,  and  if  accepted  could  be  urged  against 
all  medical  and  surgical  procedures.  The 
whole  progrc  ss  of  science  and  advance  of  civil- . 
ization  is  but  man's  continued  struggle  to 
overcome  the  limits  that  nature  has  apparently 
set  to  his  achievements.  However,  we  believe 
with  the  doctor  that  the  forceps  should  not  be 
used  in  perfectly  normal  cases.  The  degree  of 
departure  from  the  normal,  however,  which 
justifies  their  use  would,  probably,  not  be 
agreed  upon  by  any  two  individual  practition- 
ers. It  is  well  to  remember  that  in  the  state  of 
civilization  we  have  very  few  perfectly  normal 
women. — Ed.]  ^ 


Viburnum  Prunifolium. 


Editor  Medical  World  : — As  my  article, 
**Case  in  practice,"  on  pages  85  and  86,  March 
World,  has  brought  forth  more  letters  than  I 
can  well  afford  to  answer  by  letter,  I  ask  space 
to  reply,  as  I  hope,  sufficiently  to  satiafy  all 
interested. 

I  have  the  root  of  vibunum  prunifolium, 
(black  haw)  gathered  in  October,  whittle  the 
bark  off  closely,  and  put  it  in  a  ten  gallon  car- 
boy, adding  one  pint  of  dilute  alcohol  to  every 
four  ounces  of  the  green  root  It  makes  a 
beautiful  tincture.  What  I  mean  by  dilute 
alcohol  is  equal  parts  of  pure  water  and  ninety- 
five  per  cent  or  absolute  alcohol.  I  begin  to 
pour  off  and  use  in  two  weeks,  if  I  need  it,  but 
let  it  stand  on  the  bark  till  I  want  to  make  a 
fresh  supply  the  next  year.     I  use  about  eight 


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gallonB  per  year  in  my  pracdoe.  It  grows 
deeper  in  color  by  standing  on  the  bark,  and 
I  tlunk  is  better.  I  have  used  the  fl.  ext.,  but 
it  was  not  as  satisfactory  in  my  hands,  and  not 
nearly  so  well  tolerated  by  delicate  stomachs, 
while  all  can  take  the  tincture,  and  the  most 
of  them  call  it  a  pleasant  bitter.  I  give  it  in 
various  combinations,  such  as  hypophospites, 
cough  syrups,  or  whatever  is  needed  to  meet 
the  indications  in  individual  cases.  Where  en- 
gaged in  cases  of  pregnancy,  I  invariably 
have  them  begin  four  to  eight  weeks  before 
time  of  confinement  and  take  three  teaspoonful- 
doses  per  day.  The  only  trouble  here  is,  that 
I  frequently  get  beat  out  of  a  ten  dollar  fee,  as 
the  labor  is  so  easy,  natural  and  rapid  that  the 
child  is  born  and  some  old  woman  does  the 
necessary  work  before  I  can  get  there,  especially 
if  it  is  in  the  country.  The  first  thing  I  do,  on 
entering  the  lying-in  room,  is  to  give  a  teaspoon- 
ful  of  the  tincture.  If  genuine  labor  pains,  the 
natural  contractions  of  the  womb  will  be 
strengthened,  the  general  system  toned  up,  and 
the  labor  will  go  on  all  right  If  not,  the 
patient  will  be  easy  in  less  than  ten  minutes, 
and  in  most  cases  fall  asleep.  If  the  case  is 
protracted  sufficiently,  I  give  ooe-half  to  one 
teaspoon ful  every  hour.  After  labor  is  over  I 
order  it  taken  in  teaspoonful  doses  every  four 
hours,  for  the  first  day  or  two,  and  then  three 
times  a  day  for  ten  days.  I  never  use  ergot ; 
never  have  any  post-partum  hemorrhages,  never 
fear  to  leave  a  case  as  soon  as  the  placenta 
is  delivered,  and  the  child  cared  for.  I  have 
relieved  many  cases  of  barrenness,  by  the  use  of 
this  remedy— at  least,  without  it,  all  other  ap- 
pliances would  have  failed.  The  fact  is,  it  has 
a  pow^ful  tendency  to  reduce  all  pathological 
conditions  of  the  womb  and  appendages,  to  a 
physiological  or  normal  state. 

When  I  found  reaction  taking  place  (in  the 
case  given  in  March  World)  I  informed  the 
husband,  an  inteligent  man.  He  smiled  and 
said  **I  never  saw  a  doctor  do  as  little  as  you 
have  seemed  to  do  in  such  a  case,  in  my  life." 
I  remarked,  this  Hnd  of  work  requiies  an  un- 
usual amount  of  fortitude,  to  sit  by  and  await 
the  usual  time  for  the  action  of  medicines.  He 
said  he  was  satisfied  he  had  seen  one  woman 
physicked  to  death,  and  I  don't  doubt  it  This 
is  for  the  benefit  of  my  younger  brethren. 
Now,  to  many  whose  eye  may  ftill  upon  the 
above  statements,  they  may  be  as  well  known 
or  better  than  to  me ;  for  such,  it  is  not  intended. 
I  am  still  open  for  any  questions  that  may 
occur  to  the  inquiring. 

Prescott,  Ark.  R.  L.  Hinton,  M.D., 


Diofoorea  Vlllota. 

Editor  Medical  World  : — In  your  issue  of 
March,  1894,  on  page  102,  information  is  asked 
for  the  use  of  dioscorea  villosa  (wild  yam).  In 
reply  I  will  say  that  there  is  a  solid  extract 
and  a  fluid  extract  The  solid  extract  possesses 
the  properties  of  the  crude  root  in  an  eminent 
degree,  and  is  undoubtedly  as  much  a  specific 
for  biliousr  colic  as  quinine  is  for  intermittent 
fever.  The  best  preparation  is  the  solid  ex- 
tract The  dose  of  the  solid  extract  is  from  one 
to  four  grains,  to  be  given  every  one  to  four 
hours,  according  to  urgency  of  case.  The  dose 
of  the  fluid  extract  is  from  one-half  to  one  dram. 
It  is  also  useful  in  fla;:ulency  and  in  cramp  of% 
the  stomach  and  spasmodic  condition  of  the 
bowels.  A.  R  Bacon,  M.D., 

Sault  Ste  Maria,  Mich. 


Dr.  J.  E.  Kilburn,  Donald,  Ark.,  writes 
as  follows : 

"In  regard  to  the  use  of  quinine  in  obstetrics, 
from  my  own  experience  it  strengthens  the  pains 
and  makes  tbem  longer  in  labor,  prevents  hem- 
orrhage afterwards,  and  controls  the  after  pain. 
I  have  never  given  anything  but  quinine  to 
control  the  after  pain  but  once,  and  have  never 
had  postpartum  hemorrhage  in  any  case  of  my 
own  and  but  one  case  of  puerperal  fever." 


Notes  and  Comments. 


Editor  Medical  World  : — On  page  4,  Janu- 
ary No.,  '94,  the  account  Dr.  Waugh  gives  of 
the  cord  one  or  more  times  around  the  neck  of 
child  is  correct  It  does  occassionally  retard 
labor.  With  many,  the  forceps  is  applied  in 
every  case  of  labor  the  least  protracteid  from 
any  cause  Time  is  precious,  which  is  often  the 
only  excuse.  If  so  many  deaths  did  not  occur 
during  or  after  child  birth  it  would  seem 
correct  practice. 

Why  is  it  I  never  lose  any  t  I  had  my  first 
case,  alone,  in  1846,  and  some  will  doubt  it, 
but  I  do  not  remember,  save  one,  a  case  of 
death  of  mother  in  child-birth  or  directly  the 
result  of  it. 

This  was  a  fine  young  primipara,  full  grown 
and  developed,  and,  instoiad  of  calling  me  as 
promised,  she  had  two  midwives  with  her  in 
active  labor  for  five  days.  I  delivered  her 
with  forceps  of  a  large,  dead,  putrid  child.  She 
died  in  two  hours.     This  was  in  1891. 

The  above  are  facts,  and  I  have  no  motive 
at  my  time  of  life  to  misrepresent 

Ramsey,  La.  J.  B.  Ramsey,  M.  D., 


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Diurnal  Enuretit— Appendicitis. 

Editor  Medical  World: — For  Dr.  8.  J. 
Smith's  case,  February  number,  page  51,  please 
allow  me  to  suggest  to  examine  the  prepuce  and 
glans  thorougUy.  Some  days  ago  I  was 
consulted  concerning  a  similiar  case.  I  broke  up 
an  adherent  prepuce  and  the  boy  was  cured  at 
once  without  a  drop  of  medicine.  Where  no  such 
condition  prevails  I  would  suggest  rhus  arom- 
atica,  belladonna  and  strychnia  in  appropriate 
doses.  Correct  too  much  acidity  or  alkalinity  of 
the  urine. 

I  enjoyed  the  short,  but  pithy  article  on  ap- 
pendicitis by  Dr.  Morris  in  March  numl)er, 
page  104.  I  should  like  to  hear  from  many  of 
the  surgeons  of  our  family  on  this  subject.  I 
know  of  at  least  seven  operations  for  appendi- 
cids  with  no  deaths,  having  been  performed  in 
my  neighborhood  the  past  year. 

J.  J.  Montgomery,  M.  D., 

Luzerne,  N.  Y. 


Miil(  8iol(net8  in  the  Land  of  the  SIcies. 

Editor  Medical  World: — I  was  pleased 
to  see  Dr.  Mellette's  article  on  milk  sickness,  in 
February  World,  page  42,  and  as  I  have  had 
considerable  experience  with  it,  in  a  practice  of 
twenty-five  years,  I  wish  to  make  a  few  remarks 
on  the  subject. 

Notwithstanding  the  Doctor's,  good  article,  I 
wish  to  say : 

1st  That  I  think  he  is  laboring  under  a 
wrong  impression,  in  that  malarial  influences  are 
io  any  way  connected  with  it,  as  it  is  quite  pre- 
valent in  this  mountainous  country  with  an  alti- 
tude of  2756  feet,  where  malaria  is  compar- 
atively unknown. 

2nd.  That  I  have  never  known  it  to  be  com- 
municated through  water;  but  according  to  my 
obeervation,  animals  get  it  from  the  dew,  which 
settles  on  the  vegetation  growing  in  shady  places. 
Also,  it  is  propagated  by  animals  eating  the 
flesh  of  those  that  have  died  with  the  poison. 
Thus  it  is  that  persons  drinking  the  milk  or 
eating  the  beef  of  animals  which  have  eaten 
this  vegetation,  are  attacked  with  the  poison. 

3rd.  Without  going  into  detail  on  the 
symptoms,  I  will  simply  state,  that  once  the 
observant  physician  sees  and  recognises  a  case 
of  milk  sickness,  he  never  can  be  deceived  or 
misled  again,  for  the  peculiar  aroma  inci- 
dental to  it  is  a  sure  guide,  notwithstanding  the 
many  prominent  symptoms  belonging  to  it, 
such  as  persistent  nausea,  obstinate  constipation, 
a  throbbing  sensation  in  left  hypochondriac 
region,  etc 

4th.  As  to  treatment,  I  wish  to  differ  from 
the  doctor  and  say,  that  the  best  treatment  I 


can  establish  consists  in  an  emetic,  followed  by 
a  purgative,  for  which  I  prefer  castor  oil.  Also 
stimulants  should  be  administered;  brandy  well 
sweetened  with  honey,  I  find  to  be  the  most 
e£Scient 

It  is  easy  to  treat     There  is  no   use  in  los- 
ing any  cases  of  milk  sickness. 

J.  M.  Mease,  M.D., 

Canton,  N.  C. 


For  Blaolc-Headt.— Ointment  for  Eczema. 
Editor  Medical  World  : — If  Dr.  Stanley, 
(page  100),  will  direct  his  patient  to  apply 
water  as  hot  as  can  be  borne  to  her  face  each 
night  for  fifteen  minutes,  then  squeeze  out  the 
black  heads  and  apply  the  following  : 

R.   LacstUpbur dr.  II 

Camphor  gum gr.  xx 

Alcohol dr.  ii 

Glycerine oz.  I 

Roee  water ox.  11 

M.   Big.  Apply  with  mop  to  face  at  Dight. 

And  if  there  are  any  pustules  give  calcium 
sulphide,  gr.  i  after  meals.  I  tMnk  he  will 
succeed  in  curing  his  case  if  he  persists  in  the 
treatment.  I  have  had  good  success  with 
eczema  with : 

R.  Europhen gr.  xy 

VasellQe oz.  i 

M.  Sig.  Apply  twice  daUy. 

Would  like  to  know  how  the  patient  gets  on 
if  Dr.  Stanley  would  be  so  kind  as  to  write  me. 
Irasburg,  Vt.      Geo.  H.  Newton,  M.I)., 


Treatment  for  Eczema  and  for  Blaok-heads. 

Editor  Medical  World: — In  answer  to 
Dr.  Wm.  T.  Hamilton,  of  Ironaton,  Ala.,  in 
regard  to  his  case  of  chronic  eczema,  I  would 
recommend  that  he  prescribe  for  the  child 
small  doees  of  the  syr.  of  hydriodic  acid — using 
a  reliable  preparation.  Give  one  third  to  one- 
half  dram  three  times  a  day,  with  oxide  of  zinc 
ointment  applied  locally  morning  and  evening 
or  more  frequently,  if  deemed  necessary  to  keep 
the  parts  protected.  I  have  observed  the  use 
of  syr.  f erri  iodide  in  appropriate  doses  with  pro- 
per attention  to  cleanliness  of  the  parts  to  suc- 
ceed admirably.  Of  course,  in  all  cases  of 
eczema,  as  in  all  pathological  conditions,  the 
cause  must  be  found  and  corrected.  Often  the 
clothing,  course  rough  cotton  or  flannel,  is  the 
exciting  cause.  The  parts  aflected  in  the  Doc- 
tor's case  would  call  for  the  utmost  punctuality 
in  attention  to  the  child,  to  keeping  it  well  and 
promptly  dried  each  time  when  water  is  passed 
or  the  bowels  move.  The  drying  should  be 
eflected  with  as  little  rubbing  as  possible, 
rather  patting  and  pressing  soft  cotton  cloth 
over  the  parts  to  dry  them.     An  ointment 


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wh'ch  I  have  found  to  give  good  results  in 
these  cases  is  as  follows  ; 

R,     Unj?t.  plc?«.  Ilquidls «1rftm  IJ 

Bi^muih  Mub.  iiit. d'am  i  to  dram  li 

Ft-irola  um  q.  8.  ad ounce  I 

To  be  applted  luCAily  twice  ur  thrtje  limes  s  day. 

If  Dr.  J.  H.  Stanley  will  give  his  patient 
full  doses  of  syr.  hydriodic  acid,  using  the  oint- 
ment of  oxide  of.zinc  locally,  'have  her  bowels 
move  daily,  press  out  the  black- heads  and 
use  friction  over  the  face,  he  will  be  amply  re 
paid  for  his  efforts  by  success. 

Scotland,  Pa.  J.  J.  Coffman,  M.D., 


Chronic  Eczema. 

Editor  Medical  World  : — My  hint  to  Dr. 
W.  T.  Hamilton  is  to  use  no  bandages.  Wet 
the  parts  every  other  day  with  this  prescription  : 

R.     A-  Id  rarbol m,  15 

8.dli  boratis ifn*  60 

G  vceriui ounce  H 

Aquae ounce  3>i 

M.    8— Apply  at  ulght 

R.     A'^ld  willcyllc gr«  6 

VdSllDe - onuce  1 

The  parts  may  be  dusted  e^ery  two  ur  three  days  with  zinc 
oxide. 

Despense  with  the  other  treatment,  both 
internal  and  external. 

Will  suggest  to  J.  Formaa  Pineo  to  try  this 
prescription  for  his  child  : 

E.     Acid  gall  yllc grs,  120 

AHd  bora*  1« Rrji  90 

BodU  b  ratis lers.  90 

Glycerine.^ - uare  IJ^ 

SpiJB  recti ouuc^4>4 

if.    8.— Apply  extermOly. 

G.  M.  Morton,  M.D., 
Toronto,  S.  Dakota. 


Eczema. 

Editor  Medical  World: — I  report  my 
case  of  chronic  eczema  as  about  well.  He  did 
best  under  this  treatment,  which  I  would  recom- 
mend to  Dr.  Pineo,  Chester,  Nova  Scotia :  care- 
fully prick  vesicles,  absorb  contents,  wash  with 
tar  soap,  dry  with  soft  towel,  use  iodide  of  sul- 
phur ointment,  or  ^^noitol"  if  itching  is  severe, 
bandage  limbs,  linen  next  to  the  skin,  perfect 
seclusion  from  the  air  and  syrup  ferri  iodide 
internally.  *'Only  this  and  nothing  more." 
W.  T.  Hamilton,  M.D., 

Ironaton,  Ala. 


Another  Case  of  Abundant  Dropsy. 

Editor  Medical   World: — Mrs.   M , 

German,  age  thirty-seven  years,  married  foar- 
teen  years,  no  children,  first  noticed  an  enlarge- 
ment of  her  abdomen  in  September  1888,  which 
was  diagntised  as  a  pregnant  uterus  at  that  time. 
At  the  end  of  three  months  she  was  seen  by 
another  physician,  who  pronounced  it  a  case  of 
ovarian  cyst,  and  introduced  an  aspirator  needle 
and  withdrew  fourteen  pounds  of  straw  colored 
fluid. 

After  that  she  was  aspirated  at  intervals 
varying  from  two  weeks  to  two  months  until 
November,  1891,  getting  about  forty  pounds  of 
fluid  each  time.  Since  November  1891,  it  has 
been  necessary  to  relieve  the  pressure  every 
fourteen  da}s.  She  became  my  patient  in 
November  last  Since  then  I  have  tapped  her 
six  times,  getting  2-16  pounds  of  fluid. 

Up  to  date  she  has  been  tapped  ninety-one 
tim^  with  a  grand  total  of  3225  pounds  of 
fluid  removed.  F.  M.  Barney,  M.D., 

Dolgeville,  N.  Y. 


Dr.  W.  S.  Newlon,  Oswego,  Kan.,  writes  that 
cases  of  goitre  are  occuring  on  the  white  soils  of 
Kansas.  This  is  due  to  the  maguesiau-cal- 
careous  water.  Iodine,  so  far  as  it  acts  as  a 
remedy,  is  mainly  a  chemical  one,  dissolving 
the  earthy  salts  The  doctor  also  writes  that 
insanity  b  on  the  increase,  especially  that  in 
•duced  by  religious  excitement 


Expulsion  of  Tape-Worm. 

Elitor  Medical  World:— As  there  are 
several  tape-wi  rm  prescriptions  in  February 
World,  I  will  say  that  I  have  been  in  practice 
2">  years  and  have  removed  several  worms 
with  the  old  treatment  with  male  fern,  pumpkin 
seed,  etc.,  always  with  trouble  in  getting  the 
head.  Some  eighteen  months  ago  I  discovered 
that  I  was  carrying  one  of  the  gents  in  my 
bread  basket.  I  concluded  that  I  would  try  a 
a  different  treatment  on  myself.  Eating  a 
hearty  supper  and  breakfast,  at  10  o'clock  a.m. 
I  commenced  with  the  following : 

R.  Cblomform drams  lit 

Mucit  tge  aoapia  q.  s  to  make oancet  vl 

Big.  Two  ounces  every  Hour. 

At  1  p.  m.  I  commenced  the  following : 

R.   8uf(arof  milk. graiiiszii 

Crot«m<iil „ drops    vl 

FiCHpsuleft  N«».  6 

Slg.  OiiO  e»«iy  half  hour. 

I  ate  cheese  and  crackers  with  each  doee  of 
medicine,  and  only  took  four  capsules.  At  four 
p.  m.  I  had  the  worm,  head  and  tail,  sixty- five 
feet  long,  in  a  bottle  of  alcohol.  I  have  re- 
moved two  since  with  the  same  treatment  with- 
out any  troible.  The  idea  of  trying  toget  the 
worm  out  of  an  empty  stomach  and  bowels  is 
too  thin  Keep  your  patients  full  of  grub  and 
when  you  get  an  action  from  the  stomach  you 
will  have  all  the  worm,  for  he  sticks  to  the 
cheese  and  crackers.       M.  8.  Moore,  M.D., 

Orlando,  Ark. 


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For  Tape  Worm. 

Editor  Medical  World  : — In  reply  to  Dr. 
Hertig's  query  in  February  number,  page  ^51, 
**tbe  best  remedy  for  the  expukion  of  tape  worm" 
I  offer  the  following : 

R.    Kxt.  fellc.  maris ^ 1.20  («r.  18) 

i  hlorof.irmi a.  H  to  (M  M) 

Ol.  ririnl 8  6«»  (M  64) 

01.  lighl 0.03  (M.  %) 

U.    ft.  capa  No.  xii.  (12). 

Sig.— Atoue  doee,  or  at  iwo  doses,  half  an  hour  apart 

My  experience  in  more  than  thirty  cases  is, 
his  wormship  appears  very  promptly  within  four 
hours,  head  tail  and  connecting  link& 

A.  F.  JUETTNER,  M.D., 

387  Ohio  Ave  ,  Cincinnati,  0. 

Treatment  After  a  Vapor  or  Hot  Bath. 

Editor  Medical  World:— In  answer  to  the 
request  of  Wm.  Dawson,  February  World, 
page  51,  for  formula  for  gkin  after  a  vapor 
bath  to  prevent  catching  cold,  I  will  give  my 
method.  Afler  the  bath  go  over  the  patient 
thoroughly  several  times  with  rough  linen  towels, 
until  the  skin  is  dry  and  rosy,  then  rub  all  over 
with  sofl  rubber  tie^h  brush,  then  with  stiff 
bristle  brush,  then  with  bare  hands.  By  that 
time  the  skin  will  be  cool,  white  and  velvety. 
Then  spray  lightly  but  thoroughly  from  head 
to  foot  with  absolute  alcohol,  and  when  the 
patient  is  dressed  he  can  go  away  about  his  busi- 
Dees  and  not  be  in  any  more  danger  of  taking 
cold  than  if  he  had  not  been  in  a  vapor  bath. 

I  always  give  galvanism  with  my  baths,  and 
it  acts  as  an  anodyne  tonic,  taking  away  that 
tired  feeling,  and  replacing  it  with  one  of  elas- 
ticity and  well  being  that  is  very  pleasant. 

Lama,  O.  H.  C.  Bennett,  M.D., 


Replies. 
Editor  Medical  World  : — I  would  suggest 
to  Dr.  Bronson,  (page  20,  present  vol.;  to 
have  his  wife  use  celerina  for  the  borborygmus, 
taking  four  drams  daily,  the  last  dose  before 
going  to  bed  at  night  Also  for  diarrhea  two  or 
three  grains  of  sulpho  carb.  of  zinc ;  as  soon  as  out 
of  bed  in  morning  sipping  a  cup  of  hot  water,  to 
which  has  been  added  10  drops  of  tiuct  capsi 
cum.  Have  her  take  only  for  breakfast 
burnt  flour  gruel,  or  hot  milk,  slowly,  in  tea- 
epoonful  doses,  being  not  less  than  20  minutes 
taking  a  pint  of  either  fluid.  If  the  gruel  is 
used,  boiled  milk  may  be  added.  This  will 
break  the  diarrhea  habit,  and,  if  strickly  fol- 
lowed marked  improvement  will  soon  be 
noticed  and  eventually  a  cure  may  be  expected. 
No  food  hard  to  digest,  euch  as  fried  meats,  fried 
cakes  or  anything  coutaning  lard,  including  pie 
CTWit  or  cookies  should  be  allowed  at  other 
meals.  Swine  flesh,  or  anything  pertaining  to 
it   must  be  entirely  discarded. 


Dr.  H  L  K.,  (same  page)  would  no  doubt 
be  much  benefited  by  ab^ttaining  entirely  from 
solid  food  for  ten  days,  taking  only  cook^  milk 
as  hot  as  can  be  sipped.  Add  one-half  teaspoonful 
of  salt  to  each  pint  Take  after  each  move- 
ment 1  or  2  grs.  of  sulpho  carb.  of  zinc.  Take 
also  each  time  before  taking  milk  ^  gr.  granule 
of  iodoform.  Keep  in  recumbent  position  as 
much  as  p  tssible.  No  tea  or  coffee.  Cold  water 
only  a  tahlespoouful  at  one  time. 

If  "Medico"  will  give  his  patient  small 
doses  of  Foivler's  solution  of  arsintc  after  each 
meal,  inceasing  dose  gridually  for  two  months, 
if  necessary,  I  feel  confident  that  those  periodi- 
cal attacks  will  be  driven  off.  Allow  her  to 
drink  no  cold  water  but  only  hot,  which  will 
reduce  obesity  some.      W.  C.  Derby,  M.D., 

White  Cloud,  Mich. 

Gistro  Intestinal  Catarrh. 

Editor  Medical  World: — Dr.  Bronson's 
case  is  evidently  one  of  gastr  >  intestinal  catarrh 
with  possible  ulceration  of  the  rectum. 

First  as  to  diet:  Let  it  be  compovd  en- 
tirely of  ppptonized  food — peptonized  mi  1  k  and 
gruels  by  the  Fairchild  process.  Next,  intes- 
tinal antiseptics,  and  I  would  impress  the 
importance  of  giving  the  antiseptics  at  short 
intervals.  For  this  purpose  I  would  use  the 
following : 

R.   R»  iiorrin  mibllm  ....«„ 

Bismuth  salicvUt.. „ „.... 

B«*nr<»>i  iirtptbjl ......jia 15  0 

Piilv.  ThPt.  rod 70.0 

Pul*.  Thiz,  ca  amt 

Sa-  ch.  alb 

SvjflQ  B  CHFo aa 6.0 

M.  Big.  Tea^p^tonftil  every  imo  hours. 

Also,  high  injections  through  lon^  rubber 
tube  twice  daily  of  one  litre  of  warm  water  con- 
taining at  the  beginning  10  grms  t.nc.  iouine 
and  increased  to  20  grms. 

Should  the  looseness  of  bowels  continue  after 
this  treatment  in  addition  use  the  fo  lo\uug : 

Orated  B  leer's  choe 'la  e tb}^ 

Kl«e  fl  ur lb  X 

Pulv.  whit«^bUKar lb>J 

Aoid  taonlc » Or.  1 

M. 

A  table^poonful  cooked  for  half  an  ho'ir  in  a 
cup  of  milk  to  be  taken  before  breakfast  Qive 
also  a  tea^poouful  of  h}  droleine  three  times  a 
day. 

Let  her  also  wear  a  broad  flannel  bandage 
over  the  bowels    C.  H.  Bacnbkidge,  M.D  , 

Po  t  CliiitO!.,  O. 

[We  publish  the  above  for  the  naFon  that, 
being  sent  privately  to  Dr.  Bronson'saildress,  it 
was  returned  without  finding  him.— El.] 

Editor  Mfdical  World  :— The  World  still  con- 
tinuen  lo  be  f  II  of  valuable  inrurnmiioii  to  a  busy 
practiti(»i)er.  1  could  not  atlbrd  to  do  without  it  on 
my  table  for  ready  refertuce. 

DaitoD,  O.  J.  M.  Palmer,  M.D. 


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THE  MEDICAL  WORLD. 


Peculiar  Parasites. 

Editor  Medical  World  : — Would  suggest 
to  Medico  to  examine  carefully  about  lower 
lumbar  vertebrse  for  spinal  tenderness  and 
counter-irritate,  if  tender;  treat  for  malaria 
with  quinine;  then  give  soda  hyposulphite, 
20  grs.,  three  times  per  day  in  half  glass 
water  4  or  5  days  till  liver  acts.  Then 
give  Aikin's  comp.  quinia  and  strychnine  pills, 
1  each  day  for  14  da}s.  Just  finished  similar 
case,  cured.  To  Medicus  I  would  suggest  suU 
pho.  ichthyolate  of  ammonium,5iv ;  glycerine, 
3iv ;  collodion,  gi ;  mix  and  apply  over 
eruption  every  night  Wash  off  next  morning 
with  solution  bicarbonate  soda. 

In  your  January  No.,  H.  L.  K.  asks  for 
opinions  on  Lis  case.  I  would  diagnosis  it 
worms — eitht^r  tape  or  the  primary  cystic- 
ercus.  I  have  treated  a  number  of  cases. 
They  are  desoibed  in  Cooper's  Dictionary 
of  Medical  Practice,  a  large  three  vol- 
ume work,  issue  i  thirty  or  forty  years  ago. 
They  are  about  three  eighths  of  an  inch  long, 
head  the  largest  part  about  them,  have  two  or 
three  rings  around  them,  are  hairy,  have  three 
booklets  at  the  mouth,  very  sharp  and  pointed. 
They  generate  by  thousands  and  look  like  grape 
seeds  mixed  with  cotton  fuzz. 

To  discover  them,  pour  water  in  the  cham- 
ber and  examine  closely. 

Destroy  them  by  using  oleo-rosin  of  male 
fern,  fluid  extract  of  pomegranate,  fluid  extract 
of  pumpkin  seed.  After  adding  sulphuric  ether, 
[Quantity  not  stated. — Ed.]  to  the  ma^e  fern, 
take  one  ounce  of  each  of  the  above  and  take 
one  and  one- half  to  two  teaspoonfuls  in  hot 
water  three  times  a  day  before  meals,  and  purge 
off  at  night  with  one  to  two  drams  of  hyposul- 
phite of  sodium  in  half  glass  of  water. 

This  treatment  will  cure  if  you  persist  in  its 
use.  I  gave  it  in  one  case  for  three  weeks  in 
teaspoonful  doses,  and  then  doubled  it  before  I 
loosened  the  worms  so  that  they  would  pass. 
The  man  was  38  or  40  years  old,  a  widower, 
and  was  just  as  you  have  described.  After  pass- 
ing a  quart  or  two  of  them  he  got  well  and 
gained  forty  pounds  in  three  months.  They 
are  as  hard  to  kill  as  tapeworms. 

J.  A.  Livingston,  M.D., 

Wortham,  Freestone  Co.,  Texas. 


Editor  Medical  World:— If  Dr.  8.  J. 
Smith,  page  51,  February,  will  use  normal 
liquid  ergot  in  ten  to  fifteen  drop  doses  three 
times  a  day  for  a  child  under  five  years  old  and 
and  larger  doses  for  older  patients,  he  will  cure 
every  case.  H.  P.  Thompson,  M.D., 

Brownwood,  Texas. 


Editor  Medical  World  : — In  reply  to  Dr. 
Willey's  query  about  larvse  of  hexapods  coming 
from  the  skin  of  a  child  at  New  Hampton,  Mo., 
I  would  answer  that  common  people  call  them 
pollywogs.  They  were  the  common  ox  warble, 
hypodenna  bovis  (De  G.,)  or  a  kindred  dipter. 
There  is  a  bot  that  is  a  human  pest  in  Central 
America.  With  us  the  rabbit,  deer,  sheep,  dog, 
squirrel  and  horse  have  each  a  bot. 

This  child  was  associated  with  some  animals 
last  summer,  cows,  dogs,  sheep  or  cats,  I  sus- 
pect, and  ate  the  ova  of  their  hexapodal  pest 
Inquiry  may  tell.        W.  S.  Newlon,  M.D., 

Oswego,  Kan. 


Dr.  John  W.  Tiffany,  of  Grand  Island, 
Nebraska,  advises  the  readers  of  The  World 
to  use  echinacea  augusttfolia  for  scarlet  fever 
and  diphtheria 


Qttortlons  are  soUdted  for  this  Colttmn.  CommunicaUona 
not  accompanied  by  the  proper  name  and  address  of  ib« 
writer  (not  necessarily  for  publication),  will  not  be 
noticed. 

The  great  number  of  requesto  fbr  private  answeiB,  for  the 
informaUon  and  benefit  of  the  writer,  makes  it  necess- 
ary for  us  to  chaii^e  a  fee  for  the  time  required.  Thto 
Me  will  be  from  one  to  five  dollars,  accoidinc  to  the 
amount  of  reaeatch  aivl  wridiiff  required. 


What  Caused  It. 

Editor  Medical  World: — On  March 
15th,  1893,  I  was  called  to  see  Mrs.  8. 
I  found  her  an  old  lady  of  Polish  nation- 
ality, 74  years  old,  extremely  emaciated 
and  apparantly  in  a  dying  condition.  The 
nurse  called  my  attention  to  a  swollen  and  very 
tender  place  on  the  left  side  posteriorly,  just 
above  the  cre&t  of  the  ilium.  I  supposed  it  a 
large  bed  sore,  as  she  had  been  confined  to  her 
bed  for  about  three  months.  She  was  suffer- 
ing excruciating  pain  and  could  not  rest  day  or 
night  I  was  informed  by  her  that  she  had 
suffered  pain  of  a  mild  nature,  gradually  in- 
creasing in  severity  in  the  left  side,  for  nearly 
four  months.  Her  bowels  were  moderately  regu- 
lar and  moved  promptly  under  the  influence  of 
a  mild  cathartic.  I  prescribed  morphine  and 
atropine  sulph.  in  sufficient  doses  to  produce 
rest  and  made  applications  of  a  solution  of 
chloride  of  ammonium  in  spts.  vini.  rectif.  and 
aqua  dest.  to  the  supposed  bed  sore.  I  moved  her 
bowels  freely  and  directed  a  cushion  to  be 
made  to  fit  and  protect  the  sore  from  pressure. 
Nevertheless  it  increased  rapidly  in  size,  redness 
and  tenderness  and  I  was  thinking  of  using  the 
lancet  on  account  of  so  much  pain,  when  on  the 
fourth  day  after  my  first  visit,  I  was  called 
hurriedly  and  found  it  had  ruptured  spontan- 


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THE  MEDICAL  WORLD 


135 


eously,  and  pus  and  feces  of  a  solid  and  liquid 
nature  were  pouring  out,  nearly  filling  an  or- 
dinary size  pot  de  chambre.  It  looked  as  if  she 
had  not  had  an  action  in  a  month.  Her  bowels 
at  this  juncture  ceased  to  move  through  the  nat- 
ural passage,  and  everything  escaped  through 
the  new  opening.  The  pain  ceased  in  severity 
and  in  two  days  ehe  had  a  good  appetite,  diges- 
tion became  good  and  she  steadily  improved. 
The  hole  decreased  in  size  and  after  a  month 
her  bowels  moved  in  the  natural  way,  only  a 
small  quantity  coming  out  the  opening  in  her 
aide,  which  continues  up  to  this  date,  February 
9ih,  1894.  There  is  a  complete  channel  formed 
by  nature,  running  downward  and  inward  from 
just  above  the  crest  of  the  ilium,  connecting 
with  the  bowel.  I  thought  when  first  called  to 
her  that  she  would  die  in  a  few  days,  but  she  is 
living  to  day  and  in  fair  health  for  a  person  of 
74  years,  with  the  opening  still  in  her  side, 
which  is,  and  seems  will  remain,  about  as  large 
as  a  quarter  of  a  dollar.  She  performs  her 
household  duties  and  a  short  time  ago  walked  a 
mile  to  see  me.  If  this  had  been  on  thf  right 
side  I  would  say  it  was  from  fecal  impaction, 
but  as  it  is.  I  am  unable  to  determine  what 
caused  it.  I  relate  the  case  thinking  it  might 
be  of  interest  to  some  of  the  readers  of  this  most 
excellent  journal.  Will  someone  please  give  an 
idea  as  to  what  caused  the  trouble? 

Harry    Brown,  M.D., 
Yorktown,  Dewitt  County,  Tex. 

[The  cause  in  this  case  seems  to  have  been 
fecal  impaction,  which  can  as  well  occur  on  the 
left  as  on  the  right  side,  although  much  more 
frequent  at  the  cecum  that  at  the  sigmoid  flex- 
ure. The  Doctor  will  now  have  to  make  efforts 
to  secure  the  closure  of  the  fistula  if  nature 
seems  to  have  reached  a  stopping  point  in  that 
process. — Ed.]  n 


Editor  Medical  World  :  —I  want  help  for 
what  we  term  a  sleepy  dbease.  There  is  a 
condition  of  somnolency  in  which  the  patient 
goes  to  sleep  on  the  slightest  occasion,  day  or 
nighty  whether  having  lost  sleep  or  no.  If  he 
sits  down  for  a  few  seconds  and  becomes  quiet 
he  falls  asleep,  and  even  sometimes  goes  fast  to 
sleep  when  walking  along  following  the  plow 
or  when  engaged  in  any  other  occupation,  and 
may  sleep  from  fifteen  minutes  to  an  hour  or 
more  if  unmolested.  At  the  same  time  they 
seem  to  enjoy  pretty  fair  health  otherwise. 
Frequently  at  night  on  retiring  the  patient  falls 
to  sleep  quickly  and  into  a  state  of  'Nightmare," 
when  there  seems  to  be  something  on  him,  or 
after  him,  from  which  he  is  powerless  to  extricate 
himself,  and  when  called  or  shaken  is  hard  to 


be  awakened,  and  after  having  slept  as  best  he 
can  all  night  is  not  refreshed. 

This  disease  seems  to  have  made  its  appear- 
ance, or  at  least  become  more  prevalent,  since 
the  appearance  of  la  grippe,  which  has  been  so 
severe  in  this  part  of  the  country.  The  patients 
are  both  white  and  colored,  but  mostly  colored 
and  mostly  young  men.  One  young  man's  at- 
tack came  on  after  an  attack  of  grip  when  en- 
gaged in  hard  study  while  attending  collega 
These  cases  have  lasted  from  1  to  2  years  with- 
out growing  much  worse,  and  with  but  little  im- 
provement, spending  a  miserable  existence  of 
suflering.  The  general  plan  of  treatment  has 
been  with  alteratives  and  nerve  tonics. 

Please,  brethren,  give  some  information  if 
you  can.  Dr.  B.  F.  Few. 

Greer  Depot,  S.  C. 


Editor  Medical  World  : — Will  some  one 
give  treatment  for  a  patient  fifty-one  years  old, 
who  complains  of  only  a  pain  in  the  pit  of 
stomach  ?  I  thought  for  a  long  time  it  was  in 
the  ensiform  cartilage,  as  the  space  involved 
was  not  larger  than  a  dime.  It  feels  more  like 
toothache  than  anything  else.  Sometimes  it 
only  lasts  a  few  minutes ;  at  other  times  for 
hours.  Bowels  regular,  tongue  normal,  excep- 
ting that  it  looks  a  little  red.  Before  the  pain 
starts  he  will  gap  and  stretch  as  if  he  was  going 
to  have  a  chill.  Alkalies  sometimes  give  re- 
lief. Hot  cloths  over  stomach  sometimes  relieve, 
and  at  other  times  morphine  in  large  doses  is 
the  only  remedy.  At  times  it  comes  every  day, 
then  some  times  he  is  perfectly  well  for  two 
months.  He  had  the  piles  several  years  ago, 
but  is  well  of  them  now.  He  formeily  suffered 
with  palpitation  of  the  heart,  but  it  is  apparent- 
ly all  right  now.  He  has  tried  various  doctors 
and  all  kinds  of  treatment,  but  all  fail. 

Orlando,  Ark.  M.  S.  Moore,  M.D., 


Editor  Medical  World: — Will  some  of 
your  readers  give  me  some  help  in  the  treatment 
of  the  following  case :  Mr.  S.,  age  85,  on  the 
16th  of  January,  1893,  was  forced  to  vacate  a 
rented  house.  At  the  time  the  weather  was 
colder  than  it  had  been  for  many  years.  He 
was  exposed  to  the  cold  all  day. 

That  night  his  wife  noticed  that  he  was  not 
as  usual  and  next  day  sent  for  me.  He  com- 
plained of  being  dizzy,  said  he  was  not  at  home, 
also  said  the  house  was  not  right  and  if  he  at- 
tempted to  leave  the  room  could  not  find  his 
way  out  When  at  the  table  he  would  slyly 
take  his  food  as  if  he  were  stealing  it  and  would 
often  miss  what  he  tried  to  pick  up.  When  I 
would  visit  him  he  would  say,  "  Doctor  I  am 
still   drunk."     He  sleeps  very  little,  says   he 


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THB  MEDICAL  WORLD; 


sees  different  objects  at  night  Often  will  go  to 
bed  and  sleep,  probably  half  an  hour,  wake  up 
very  much  excited  and  sleep  no  more  that 
night.  He  suffers  with  his  heart  I  think 
there  is  a  good  deal  of  trouble  about  the  peri- 
cardial sac.  He  suffers  much  from  shortness  of 
breath  and  at  times  thinks  he  is  going  to  die. 
His  appetite  is  good  and  his  bowels  regular.  If 
some  brother  will  help  me  in  this  T\\  be  most 
thankful.  I  have  exhausted  the  Materia  Medica 
in  his  case  and  nothing  does  him  good  for  any 
length  of  time. 

Would  also  like  a  cure  for  a  very  bad  case 
of  hemorrhoids  without  the  use  of  the  knife.  In 
this  case  the  rectum  comes  out  nearly  three 
inches.  Practitioner. 


Editor  Medical  World:— Does  The 
World  or  any  of  its  many  readers  know  an- 
other good  way  to  treat  carcinoma  of  the  female 
breast  than  by  the  knife?  Tumor  commenced 
about  eight  months  ago;  size  now  is  about  4x6 
inches,  an  inch  thick.  For  the  last  four  months 
tha  patient  suffers  considerably,  but  only  occa- 
sionally when  she  takes  cold  or  works  more 
than  usual.  Patient  is  about  49  years  old,  has 
not  passed  the  menapause  yet,  is  stout  and  fleshy; 
otherwise  in  good  condition  of  health.  She  has 
never  been  sick  to  amount  to  anything;  had 
five  children,  three  living;  her  baby  is  nine 
years  of  age.  She  does  not  want  an  operation 
performed.  P.  Mehrino,  M.D., 

Portage  Des.  Sioux,  Mo. 

[See  lecent  numbers  of  this  journal  in  regerd 
to  the  treatment  of  cancer  by  inoculating 
with  erysipelas. — Ed] 


Editor  Medical  World  : — I  would  like  to 
have  the  bretheren  give  me  the  cause  and  cure 
for  dark  circles  around  the  eyes. 

I  know  of  a  great  many  females  who  have  a 
splendid  complexion,  but  it  [is  marred  by  the 
dark  and  sunken  circle  around  the  eyes.  It  is 
not  wholly  confined  to  the  female  sex,  but  males 
are  also  afflicted,  but  not  to  the  same  extent 

Any  information  as  to  the  cause  and  cure 
would  be  thankfully  received  through  the 
medium  of  The  World. 

Willis  A.  Hammond,  M.D., 

Madison,  N.  Y. 


Editor  Medical  World  :— Your  new  title  deFi^n 
i8  an  improvement  on  the  old.  It  is  not  the  outside 
that  I  tinxionsly  await  every  month,  it  is  the  valuable 
information  contained  in  the  inside  that  I  appreciate. 
The  World  is  the  first  I  refer  to  for  sound,  practical 
information.  I  hope  it  is  of  as  much  bf  netit  to  all  of 
its  readers  as  it  is  to  me.  Da.  L.  B.  Biqklow, 

Globe  Villaee.  Mass. 


Editor  Medical  World: — I  would  ask 
some  brother  to  write  an  article  on  chronic 
catarrhal  inflammation  of  the  bladder,  with 
treatment  The  Medical  World  takfs  the 
lead  of  all  medical  joarnals  that  are  on  mj 
table  for  concise  practical  knowledge  and  for  ite 
being  right  to  the  point  in  practical  application 
of  the  knowledge  it  contains  at  the  beddde  of 
the  sick.  H.  W.  Cobb,  M.D., 

Perry,  Mich. 


Editor  Medical  World  : — Will  some  one 
of  the  medical  fraternity  give  the  modes  of  de- 
tecting impurities  and  adulterations  in  alcoholic 
liquors?  G.  M.  Morton,  M.D., 

Toronto,  &  D. 


Editor  Medical  World  : — I  have  a  patient^ 
a  clerk,  who  has  had  syphillis,  then  syphillitic 
rheumatism,  for  all  of  which  he  was  treated  and 
from  which  he  recovered  before  he  came  under 
my  car^  He  is  now  and  has  been  for  tbld  past 
six  months,  suflering  from  a  discharge  from  the 
penis,  which  I  have  diagnosed  spermatorrhea.  I 
have  used  everything  1  know  of  for  that,  with 
no  eflect  The  discharge  very  much  resembles 
the  white  of  egg.  He  says  he  has  no  involun- 
tary emissions.  Would  be  glad  if  any  of  the 
brethren  would  help  me.  I  made  this  request 
once  before  with  only  one  or  two  answers,  and 
I  got  no  benefit  from  any  of  them. 

Sicily  Island,  La.       J.  D.  Ubheb,  M.D., 


Editor  Medical  World: — I  want  to  gel 
information  from  the  brethem  on  a  subject  con- 
cerning which  little  or  nothing  is  said  in  our 
text  books,  viz :  chronic  cyanide  poisoning  as  it 
appears  among  miners  who  use  potassium  cya- 
nide in  a  prrcess  to  obtain  silver  from  the  ore. 
Will  any  of  the  Worli>  family  give  me  hints  t 
I  hear  there  are  cases  coming  up  in  mining  dis- 
tricts where  the  men  are  "cyanided"  but  I 
can't  obtain  any  intelligent  information  as  to 
symptoms,  prophylaxis  or  treatment  Any 
assistance  will  be  kindly  appreciated. 

B.  F.  HOLCOHBE,  M,  D., 

Tombstone,  Arizona. 


Editor  Medical  World: — Will  some  of 
the  World  family  give  an  article  on  the 
pathology  symptoms,  prognosis  and  treatment 
of  Malarial  Hematuria?  None  of  my  works 
on  practice  give  it,  and  some  light  on  this 
disease  will  be  appreciated. 

"Precio." 


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Dr.  J.  M.  Jones  of  Ormond,  Fla,  sends  us 
a  clipping  from  the  SL  Louis  Republic^  as 
follows : 

Seventy-Two  and  a  Mother. 

"Fairmont,  W.  Va.,  Jan.  6. — Eighteen 
months  ago,'  John  H  Garby  of  Weisel  County, 
a  bachelor  74  years  old,  was  married  to  Miss 
Sarah  Mills,  who  was  less  than  two  years  his 
junior.  Yesterday  Mrs.  Garby  presented  her 
husband  with  as  fine  a  boy  baby  as  has  ever 
been  born  in  this  section,  a  county  noted  for  its 
fine  babies.  The  mother  and  child  are  doing 
well." 

The  doctor  would  like  to  hear  from  anyone 
who  knows  of  this  remarkable  circumstance,  as 
to  its  actual  truth. 


The  formula  is  wanted  of  B.  M.  WooUey's 
cure  for  the  opium  habit. 

Walcott's  Pain  Paint  Powders. 

"Skin  Success." 

"  Viava  "  (a  vaginal  suppository. ) 

Miles'  Nervine 

H.  H.  Green' J  Dropsy  Cure. 

Low's  Worm  Syrup. 

To  the  subscribers  asking  for  powder  or  snuff 
for  nasal  catarrh  we  reply  that  we  have  never 
found  any  of  the  recommended  formulas  satis- 
factory. 

For  treatment  for  pruritus  ani  we  refer  the 
inquirer  to  the  series  of  articles  in  January, 
February  and  March  World,  1893. 

Current   Medical    Thought. 

Teoliiik|ue  in  Tenia  Treatment— Report  of  a  Re- 
markable Case. 

By  G  M,  Fenn,  M.  D.,  San  Diego,  Cal. 

In  the  absence  hitherto  of  any  unfailing  teni- 
cides  or  specifics,  it  may  be  profitable  to  inquire 
if  there  are  other  methods  available  for  the  safe 
and  certain  expulsion  of  the  various  cestodea 
Perfonally,  having  abandoned  the  search  for 
such  a  remedy,  for  the  reason  that  it  might  im- 
peril the  well  being  of  host  as  well  as  guest,  I 
find  that  some  of  the  standard  teniafuges,  if 
employed  in  adequate  doses  and  supplemented 
by  attention  to  certain  details,  to  be  noted 
&rther  on,  may  be  made  to  accomplish  all  that 
we  desire.  For  example,  during  the  local 
prevalence  of  tape-worms  whicn  followed  the 
importation  of  a  measly  herd  from  Mexico, 
some  years  ago,  I  came  to  use  kamala  in  doses 
of  8  to  12  grams  (5it  ^iii,)  and  ethereal  extract 
of  male-fern  to  the  extent  of  *4  to  10  grams  (31- 
^iisB.)  These  apparently  large  doses,  exce^- 
ing  those  recommended  by  the  authorities  of  that 


period,  were  successfully  administered  and  upon 
the  hypothesb  that  a  parasite  which  merely  im- 
bibes its  sustenance,  having  neither  mouth  or 
intestine,  and  su  kers  for  prehension  only,  must 
require  quantity  as  well  as  quality.  In  the  mat- 
ter of  details  referred  to,  jalap  was  selected  for 
the  before  and  after  cathartic,  in  preference  to 
several  others  commonly  used.  For  instance, 
castor  oil,  ^o  widely  commended  in  such  cases, 
was  believed  to  be  deficient  as  a  peristalic  per- 
suader and  practically  inert  in  the  presence  of 
mucus.  Senna  is  equally  insufficient  in'  its  ac- 
tion, and  aloes  correspondingly  tardy,  expend- 
ing its  force  on  the lovier  bowel.  Jalap,  on  the 
contrary,  besides  having  somewhat  of  an 
anthelmintic  reputation,  is  safe  and  admirably 
adapted  for  children,  to  whom  it  may  be  given 
clandestinely  in  gingerbread  or  cookies.  Fol- 
lowing the  last  dose  of  the  purgative  it  is  advis- 
able to  employ  frequent  enemata  of  cold  water, 
with  or  without  salt  or  soap.  These  appear  not 
only  to  chill  the  worm  but  to  measurably  in- 
crease peristahis. 

Of  the  three  species  of  tenise  which  mature  in 
the  human  intestine,  tenia  saginata,  tenia 
solium  and  hoihrinocephalus  laius,  the  first  is  of 
more  frequent  occurrence  in  tropical  latitudes 
like  this,  owing,  doubtless,  to  the  greater  con- 
sumption of  beef  in  comparison  with  other 
meats. 

That  tenia  solium  (pork- worm)  however,  is 
not  unknown  here  may  be  inferred  from  the  fol- 
lowing case,  which  may  also  be  considered  a 
fitting  r^sum^  of  the  foregoing  remarks  : 

A  little  boy,  on  his  first  legs,  injured  a  toe, 
to  which  his  mother  applied  a  bit  of  fresh 
pork.  A  second  application,  soon  required,  was 
about  to  disappear  as  mysteriously  as  the  first 
when  he  was  detected  in  the  act  of  eating  it 
Three  or  four  months  later,  during  a  convulsive 
seizure,  several  segments  of  a  tenia  solium  were 
expelled.  Believing  it  to  be  an  instance  of 
pod  hoc  propter  hocy  active  measures  were  taken 
to  relieve  the  child  of  his  unwelcome  guest,  and 
before  reaching  his  third  year  he  passed  through 
ten  severe  ordeals,  expelling  in  the  aggregate 
110  feet  ^  of  tape  worm  !  The  first  three  doses, 
by  homeopathic  direction,  the  parents  believe 
were  kousso  or  kamala  in  combination  with 
some  other  drug.  At  all  events,  after  each  at- 
tempt the  child  was  "sleepy,  feverish  and  a 
source  of  great  solicitude  for  twenty- four  hours." 
A  fourth  dose  by  another  attendant  was  known 
to  consist  of  15  drops  of  chloroform  and  one 
drop  of  croton  oil !  This  was  followed  a  few 
weeks  subsequently  by  an  emulsion  of  creasote. 
Still  later,  at  the  suggestion  of  friends,  two  at- 
tempts were  made  with  emulsi  >ns  of  pumpkin 

i  Measuremento  reporied  by  pareuu. 


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86ed8.  In  justice  to  all  parties,  it  is  proper  to 
state  that  in  every  instance  starvation  and  pur- 
gation with  castor  oil,  castoria,  etc.,  were  rigidly 
enforced.  This  is  confirmed  by  an  incident  in 
the  history,  when  the  little  patient  led  his  only 
sympathetic  relative  to  the  cupboard  and  with 
tears  running  down  his  cheeks  exclaimed : 
"  Grandpa,  Tse  so  hungry  !  Fse  so  hungry  I " 
Meanwhile,  reports  of  the  case  had  reached 
relatives  in  the  east,  who  immediately  sent  out 
a  quantity  of  pelletiehne  tannate,  with  assur- 
ances of  success.  Two  trials  of  this  specific  (?) 
quickly  followed,  bringing  away  a  few  feet  of 
the  worm  as  other  remedies  had  done.  A  small 
dose  of  the  pomegranate  alkaloid  remained,  but 
in  view  of  previous  failures  it  had  almost  been 
decided  to  await  the  natural  demife,  or  suicide 
(?)  of  the  parasite  at  the  end  of  four  or  five 
years. 

The  tenth  and  successful  assault  was  reluct- 
antly undertaken  by  the  writer.  Though  I 
should  have  preferred  kousso  or  koussin  for  a 
child,  the  remainder  of  the  pelletierine  was 
given. 

Without  special  restrictions  as  to  diet  a  full 
dose  of  jalap  preceded  the  teniafuge  about 
twelve  hours,  and  was  repeated  next  day  an 
hour  or  two  after  the  exhibition  of  the  anthel- 
mintic. After  thoroughly  scotching  the  para- 
site, indicated  by  the  appearance  of  large 
segments  in  the  dejections,  frequent  enemata  of 
plain  and  salt  water  were  employed.  Trac- 
tion upon  the  worm  was  interdicts  d,  but  rather 
it  was  advised  to  strap  the  protruding  extremity 
to  the  nates  and  continue  injections.  At  a  later 
hour  the  head  intact  and  erect  with  fifteen  feet 
of  the  tenia  gave  assurance  of  its  unconditional 
surrender  after  a  siege  of  nearly  twelve  months. 
— Jour.  Am   Med.  Association. 


Baby  With  a  Tall. 


who  was  chagrined  at  so  unusual  an  anomaly, 
requested  its  immediate  amputation,  which  we 
[  reluctantly  performed ;  after  which  he  ex- 
claimed :     "  Now,  mine  pig- boy  does  better." 

The  mother,  like  most  women  in  whom  I 
have  found  this  tendency  to  "spot"  their 
young,  was  of  a  very  frail  and  nervous  tem- 
perament and,  more  than  all,  was  ignorant 

But,  in  conclusion,  I  am  convinced  that  such 
mothers  can,  and  do  ofcen,  transmit  their  mental 
impressions  to  the  child  in  utero,  thus  develop- 
ing the  many  so-called  mother's  marks.  I 
could  relate  several  similar  instances. — Julian 
Berry,  M.  D.,  Mace,  Ind.,  in  Memphis  Med. 
Monthly. 


In  December  last  I  was  called  to  attend  a 
lady  in  the  country  during  her  accouchement, 
and  seeing  that  she  was  likely  to  have  a  tedious 
labor,  was  very  careful  in  eliciting  her  history 
prior  to  this  trying  ordeal.  She  stated  she  had 
not  felt  well  for  several  months — ever  since  she 
had  worried  about  some  favorite  young  pigs 
that  were  being  abused  in  the  yard.  Gk)ing 
out  she  carried  the  pigs  into  the  house,  lifting 
them  fondly  by  the  tail;  and  the  occurrence 
bore  on  her  mind,  being  much  impressed  by 
this  novel  way  of  transferring  swine. 

But  alas  I  after  labor  was  completed,  the  fond 
son  also  was  blessed  wi.h  a  tail — a  nice,  well- 
formed  tail—a  tail  just  where  a  tail  ought  to 
grow — a  five  inch  tail.  The  mother,  a  primi- 
para,  did  well,  also  the  child ;  but  the  father. 


Altitudes  and  Female  Health. 

It  is  noticeable  that  the  altitudes  of  Arizona, 
Wyoming  and  other  high  regions  are  not  favor- 
able to  a  rounded  development  Our  high 
altitudes  will  hardly  produce  the  rounded, 
plump  figures  so  common  in  any  of  the  Pacific 
islands,  neither  can  a  woman  there  retain  her 
nervous  system  in  that  quiet  and  phl^matic 
mood  so  peculiar  to  the  women  of  Holland  any 
more  than  she  could  keep  her  hair  from  standing 
out  if  on  an  insulating  stool.  A  few  years  of 
mountain  life— -in  the  extremely  dry  and  windy 
altitudes — and  a  few  child-bearings,  and  a 
woman  is  a  nervous  and  physical  wreck*  No 
thorough  duplicate  Benjamin  Franklin  can 
ever  come  from  those  dessicating  altitudes,  as 
he  was  one  of  a  family  of  seventeen  children. — 
Pacific  Med.  Jour.  ^ 

Three   Cases   of  Tetanus   Suocessftilly  Treated 
With  Ammonium  Bromide. 

By  Jagan  Nath,  L.  M.  S., 
Chief  Medical  Officer,  JamoOj  Kashmir. 

Case  1. — Rasila,  Hindu  male,  got  his  right 
thumb  blown  ofif  by  the  bursting  of  his  gun. 
On  the  fourth  .day  tetanus  appeared,  for  which 
he  sought  admission  into  the  Jamoo  Hospital. 
Wound  antiseptically  dressed ;  15  grains  of 
hydrate  of  chloral  administered  every  three 
hours  with  no  relief.  Tinctura  cannabis  indica 
in  15  drop  doses  every  four  hours  given  without 
relief ;  in  fact  the  spasms  seemed  to  be  worse 
after  it  Cannabis  repeated  in  20-drop  doses 
without  relief.  On  the  following  day  bromide 
of  ammonium  in  20-grain  doses  was  given  three 
times  a  day,  and  the  patient  was  much  better  on 
the  following  day.  The  treatment  was  con- 
tinued for  about  six  days.  Improvement  was 
every  day  apparent  and  the  patient  was  dis- 
charged as  cured  on  the  twelfth  day.       , 

Case  2. — Hazura,  a  Hindu  male,  aged  45, 
had  his  hand  wounded  with  an  axe  and  got 


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tetanuB  five  days  after.  He  was  admitted  into 
the  dispensary  by  an  order  of  the  Court  ten 
days  after  the  accident  The  wound  was  asep- 
tically  dressed.  Hydrate  of  chloral  and  tinc- 
ture belladonna  in  full  doses  were  given  every 
three  hours,  but  the  tetantic  spasms  remained 
the  same.  Bromide  of  ammonium  in  15-grain 
doses  was  now  given  three  times  a  day,  and  a 
little  relief  followed.  The  dose  was  now  in- 
creased to  20  grains,  and  the  patient  was  much 
better  in  24  hours.  This  mixture  was  continued 
with  tonics  for  about  eight  days,  and  the  patient 
was  discharged  cured  on  the  eleventh  day. 

Note. — The  above  two  patients  were  kept  in  a 
dark  room  during  treatment 

Case  3. — A  Hindu  boy,  aged  10,  son  of 
Ralla  Ram,  pleader  of  Jamoo,  got  his  foot 
seriously  injured  along  with  many  of  his  class- 
fellows  by  the  fall  of  the  Jamoo  school  building. 
He  developed  tetanus  on  the  third  day  after  the 
injury. 

Bromide  of  ammonium  was  the  only  medicine 
used  in  his  case,  and  it  entirely  stopped  the 
spasms,  and  after  two  weeks  he  was  discharged 
E!  cured. — Indian  Medical  Record. 


Abortive  and  Curative  Treatment  of  Typhoid 
Fevir. 

Dr.  John  Eliot  Woodbridge,  of  Youngstown, 
0.,  read  before  the  Mahoning,  C,  Co.,  Med. 
Society,  a  paper,  which  was  published  in 
the  Journal  of  the  American  Medical  Aasoctor 
tion,  in  several  parts,  and  which  has  attracted 
considerable  attention  throughout  the  country. 
In  this  series  of  articles  the  doctor  states  that 
for  twelve  years  past  he  has  not  had  a  death  in 
any  case  of  typhoid  fever  that  he  has  seen  and 
placed  under  treatment  within  a  reasonable  time 
after  the  inception  of  the  disease.  The  treat- 
ment seems  to  be  essentially  one  of  intestinal 
antisepsis,  although  the  doctor  only  outlines  the 
actual  treatment  of  two  cases,  promising  to 
consider  the  principles  of  the  treatment  and 
their  detailed  modification  for  particular  cases 
in  a  future  paper.  Intestinal  antisepsis  b  not 
new  to  our  readers,  as  they  have  been  familiar 
with  it  for  years  past  In  this  line  surely  lies 
the  specific  treatment  of  typhoid  fever,  as  well 
as  other  continued  fevers  whose  causation  is  not 
now  clearly  made  out. 

Dr.  Woodbridge's  treatment,  as  given  in  the 
paper  mentioned,  is  as  follows  : 

"I  conceive  that  he  will  treat  typhoid  fever 
best  who  best  measures  the  condition  of  his 
patient,  or  rather  the  extent  of  territory  over 
which  the  germs  have  spread  and  the  amount 
of  mischief  already  done,  and  having  done  this. 


to  select  and  apply  his  remedies  in  such  manner 
as  to  most  speedily  stop  their  ravages  and  most 
effectually  relieve  the  patient  of  the  ptomaines, 
tox  albumens,  injuries  to  Peyer's  glands  or 
other  ill  effects  of  their  temporary  sojourn. 
This  is  a  much  too  diflScult  task,  I  fear,  for  me 
to  undertake  to-night  Some  time  in  the  future 
I  hope  to  give  expression  to  my  views  on  these 
points,  but  at  present  I  think  I  can  do  no  better 
than  give  the  treatment  of  two  or  three  typical 
cases,  in  connection  with  their  bedside  histories. 
Case  51. — A.  McF.,  (whose  chart  you  have,) 
as  stated  before,  had  been  sick  sixteen  days 
when  I  was  first  called ;  his  temperature  was 
105  i  ;  his  bowels  intensely  tympanitic ;  he  was 
voiding  both  urine  and  feces  involuntarily. 
During  the  first  two  days  he  took  about  60 
minims  eucalyptol,  ^  15  minims  guaiacoV  30 
minims  turpentine,  and  perhaps  15  grains  of 
the  following  mixture : 

No.l. 

B.   Podophyllin nalns    1 

Hydiarff.  chlor.  mltig drams    i 

Guaiaool  carb drams  ▼! 

Thymol drams  v 

Menthol drams    1 

Sacch.  alb oanoes  ii 

Eucalyptol,  (as  much  as  ponible.) 
M.    In  very  mlnnte  doses  every  half  hour  to  one  hour. 

-  During  the  following  three  days,  he  took  2i 
minims  guaiacol  and  5  minims  eucalyptol  every 
three  or  four  hours  all  of  the  tim^  and  part  of 
the  time  double  that  quantity  with  an  occasional 
Kfdrop  dose  of  turpentine  added  ;  and  in  ad- 
dition small  doses  of  quinine  continuously  every 
three  hours ;  occasionally  a  2i  grain  tablet  of 
Dover's  powder.  Nearly  every  day  during  his. 
sickness,  and  sometimes  twice  a  day,  he  had 
rubbed  on  his  abdomen  a  mixture  of  eucalyptol 
and  guaiacol,  with  the  addition,  sometimes,  of 
turpentine.  His  kidneys  failing  to  respond  to 
the  turpentine,  there  was  given  him  a  diuretic 
as  follows : 

No.  2. 

R.   Potass  acet ounces    i 

Splr.  niiri.  dulc  ounces  ss 

Aqusedefct  q.s.ad ounces  iv 

Si^.  One  teaspoonnil  every  half  hour  In  water  or  lemonade. 

And  when  the  bowels  became  constipated 
"glycerin  suppositories"  were  used.  Whisky, 
milk,  eggnog  and  Fairchild  Brothers  and  Fos- 
ter's panopepton  were  given  freely.    This  is  the 

1.  A  word  of  caution  about  guaiacol  and  eucaljptol. 
Many  of  the  specimens  of  both,  obtained  from  highly 
reputable  houses  are  wholly  unfit  for  administration. 
In  my  earlier  experience  I  had  some  very  unpleasant 
results,  especially  from  eucalyptol,  much  of  which  is 
inert  and  some  absolutelypoisonous.  1  have  a  dozen 
or  more  samples  in  my  office  now,  all  obtained  from 
the  beet  sources,  and  yet  one-tenth  of  an  ordinary  dose 
of  some  of  these  would  act  as  a  most  violent  emetic.  I 
believe  guaiacol  carb.  to  be  the  best  of  its  class. 


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iiist  aud  only  case  in  whi  h  I  have  ordered 
thorough  and  systematic  sponging,  in  my  own 
practice,  during  the  patt  twelve  years ;  and  I 
did  so  in  this  case  only  because  he  came  under 
my  care  on  the  (sixteenth  day  of  his  sickoefis. 

Case  52.— W.  H.  took  R  No.  1  two  lays  in 
about  i  grain  doses  every  thirty  minutes. 

For  two  days : 

No.  8. 

R.   Eucalyptol ounce  as 

8pir.  re  t. ounce  i 

Quiiacol drMiii  11 

Aquse  debt.  q.  s.  ud „..  ouuce  iv 

8ig.  One-half  teaspoonful  every  three  or  foar  hours. 

For  one  day,  No.  1 ;  No.  3,  two  days  ;  No.  1, 
one  day  ;  then  No.  3  until  the  temperature  had 
been  subnormal  two  days. 

Case  55  ->T.  M.  took  No.  1  two  days  ;  euca- 
lyptol and  guaiacol  in  one  mixture,  and  thymol 
in  another  to  the  present  time.   (Feb.  12,  1894.) 

This  was  practically  the  course  pursued  with 
the  cases  reported.  I  should  have  much  pre- 
ferred giving  exact  rules  for  a  general  course 
of  treatment,  af>plicable  to  every  case,  but  do  not 
feel  competent  to  do  so ;  nor  do  I  know  how 
much  medicine  has  been  given  in  any  case  be- 
cause I  never  wrote  a  prescription  for  any  of 
these  preparations,  but  have  al^vays  carried 
them  with  me  and  I  poured  out  a  sufficient 
quantity  to  last  a  day  or  two.  and  when  ex- 
hausted replenished  it  from  my  ca«e.  Since  I 
see  my  d  lemma,  however,  I  shall  leaver 
definite  quantity  and  in  a  future  paper  write 
more  concisely  ;  and  yet  I  fear  it  will  ever  be  a 
difficult  thing  to  lay  down  fixed  rules  by  which 
to  treat  such  a  disease  as  typhcid  fever,  in 
which  the  symptoms  of  the  disease  constitute  a 
very  imperfect  criterion  by  which  to  measure 
either  its  duration  or  gravity,  and  almost  none 
for  treatment.  While  my  cases  may  have  been 
too  few  to  establish  the  value  of  my  theory  of 
treatment,  they  have  been  too  many  and  the  re- 
sults have  been  too  good  to  admit  of  longer 
silence  on  my  part 

Thus  far  in  my  private  practice  I  have  had 
no  death  from  typhoid  fever  for  twelve  years. 
I  have  been  able  to  abort  two  or  three  cases 
when  first  seen  on  the  tenth  day,  and  all  who 
came  under  my  care  on  or  before  the  eighth 
day  of  sickness.  It  may  not  be  possible  to  abort 
every  case,  beginning  on  the  eighth  day,  nor  is 
it  necessary,  for  when  the  profession  aud  the 
people  understand  that  typhoid  fever  can  in- 
variably be  cured  when  proper  treatment  is 
instituted  at  a  sufficiently  early  period,  the 
physician  will  no  longer  wait  until  his  patient 
18  covered  with  petechia,  or  has  had  one  or  more 
hemorrha^  before  making  a  diagnos's  or 
beginning  treatment 


Functions  of  Ovaries  and  Testicles. 
It  is  a  well  known  fact  that  the  "ovaries and 
testicles  have  at  least  three  distinct  actions :  the 
first,  generation  ;  second,  their  action  through 
absorption  on  the  central  nervous  system,  which 
give  to  men  and  women  their  physical,  moral 
and  intellectual  characteristics.  The  third  is  a 
special  tonic  action  which  leiufo^ces  in  a  special 
way  the  action  of  the  spinal  cord  and  brain." 
These  are  well  known  functions  which  caunot 
be  disputed. — Dominion  Med,  Monthly, 


Cinnamon  as  an  Antiseptic. 

That  "  No  living  germ  of  disease  can  resist 
the  antiseptic  power  of  essepce  of  cinnamon  for 
more  than  a  few  houis."  is  the  conclusion  an- 
nounced by  Mr.  Chamberlind  as  the  result  of 
prolonged  research  and  experiment  It  is  eaid 
to  destroy  microbes  as  effectively,  if  not  as 
rapidly,  as  corrosive  sublimate  Even  the  scent 
of  it  is  fa»al  to  mit-robes,  and  Mr.  Chamberland 
says  a  decoction  of  cinnamon  should  he  taken 
freely  by  pardons  living  in  places  affected  by 
typhoid  or  cholera.-  -Medical  Age. 


Crude   Pyroligneous    Acid    \n  the  Treatment  of 
Gonorrhea  in  Women. 

In  the  Algemeinem  Krankenhous  in  Vienna 
the  following  outlined  treatment  is  regularly 
emploved  in  the  gynecological  wards  for  tho 
cure  of  gonorrhea.  The  patient  is  placed  in  tho 
dorsal  position  and  a  c}ilndiical  speculum  in- 
troduced. When  the  os  is  thoroughly  exposed 
the  external  end  of  the  speculum  is  elevated 
and  about  an  ounce  of  crude  pyroligneous  acid 
poured  in.  This  is  allowed  to  come  in  contact 
with  the  parts  surrounding  the  os,  afler  which 
the  speculum  is  slowly  withdrawn  to  the  vulva, 
permitting  the  acid  to  come  in  contact  with  all 
part)  of  the  vagina  as  it  follows  the  speculum 
The  speculum  is  not  entirely  withdrawn,  but  is 
reintroduced  and  then  gradually  depressed  and 
the  acid  allowed  to  flow  out  through  the  cylin- 
der into  a  basin,  care  being  taken  not  to  stain 
the  linen  of  the  patient  This  is  done  every 
second  day  and  results,  in  a  large  majority  of 
cases,  in  a  cure  after  the  third  or  fourth  appli- 
cation. 

In  most  cases  the  patient  complains  of  but 
a  slight  sensation  of  warmth ;  if  the  inflamma- 
tion is  very  acute  the  pain  is  more  severe, 
though  even  then  not  extremely  so. — PiUsburg 
Med.  Review, 


Chloro  sulphate  of  quinine  has  been  intro- 
duced, especially  for  hypodermic  use,  as  it  ia 
soluble  in  its  own  weight  of  water,  and  causes 
less  pain  than  the  sulphate  or  hydrochlorate. — 
lb. 


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141 


Legal  Requirements  for  the  Practice  of  Medicine 
in  the  United  Slates. 

[Oompiled  for  the  Journal qf  ike  American  Medical  Auodation.] 

So  many  chaages  have  been  made  in  the 
legislatioQ  regulaiiag  the  practice  of  me  liciae 
in  this  couairy  during  the  past  three  years,  that 
the  Illinois  State  B  >ard  of  Health  will  include, 
la  its  forthcoming  Report  on  Medical  Eluca- 
tion,  the  text  of  all  laws  on  this  subject  in  force 
at  the  beginning  of  the  present  year  in  the  sev- 
eral states  and  territories  of  the  United  States, 
and  in  the  provinces  of  the  Dominion  of  Cana- 
da. From  this  forthcoming  report,  through 
the  courtesy  of  the  Secretary  of  the  B  jard.  Dr. 
J,  VV.  Scott,  some  data  have  been  gathered 
which  will  l>e  of  interest  to  the  spring  crop  of 
new  graduates,  and  to  medical  men  generally. 

Of  the  six  New  Eijgland  States,  Maine,  Mas- 
sachusetts, New  Hampshire  and  Rhode  Island 
have  no  legal  requirements  for  the  practice  of 
medicine.  Connecticut  has  adopted  a  medical 
practice  act  which  went  into  effect  October  1, 
1893,  and  in  Vermont  the  law  requires  the 
registry  of  a  diploma  endorsed  by  a  Board  o 
Medical  Censors  or  of  a  certificate  of  satisfac 
tory  examination  by  one  of  these  boards. 

Exclusive  of  the  four  states  first  named,  the 
other  states  and  territories  may  be  roughly 
grouped  into  the  following  three  classes  : 

In  Alabama,  Arkansas.  Florida,  Maryland, 
Minnesota,  Mississippi.  New  Jersey,  New  York 
(act  of  May  9,  1893,)  North  Carolina,  North 
Dakota,  Penn8)lvania  (after  March  1,  1894,) 
South  Dakota,  Texas,  Utah,  Virginia  and 
Washirgton,  the  diploma  confers  no  right  to 
practice  and  has  no  legal  value,  except,  in  gome 
cases  to  give  its  possessor  standing  before  an 
examining  board.  The  right  to  practice  in 
each  of  these  sixteen  states  is  determined  by  in- 
dividual examinations  before  boards  of  examin- 
ers created  by  law. 

In  California,  Colorado,  Connecticut  (since 
October,  1893,)  Delaware,  Illinois,  Iowa,  Ken- 
tucky, Louisiana,  Missouri,  Montana,  Nebraska, 
New  Mexico,  Oklahoma,  Oregon,  Tennessee, 
Vermont  and  West  Virginia,  the  diploma  is 
subject  to  the  supervision  of  some  designated 
body  vested  by  law  with  authority  to  determine 
its  validity  as  evidence  of  its  possessor's  quali- 
fications for  the  practice  of  medicine.  Failing 
the  possession  of  such  a  recognized  diploma,  the 
right  to  practice  may  be  acquired  by  pa^ising  a 
satkfactory  examination. 

In  Arizona  Georgia,  Idaho,  Indiana,  Kansas, 
Michigan,  Nevada,  Ohio,  South  Carolina, 
(eiace  the  repeal  of  the  act  nf  1888,)  Wiscon- 
sio  and  Wyoming,  the  presentation  of  any  kind 
of  a  diploma — provided  only  that  it  be  from  a 


"chartered"  medical  institution — is  the  suffici- 
ent warrant  in  law  for  county  clerks,  clerks  of 
courts,  registrars  of  deeds  and  similarly  quali- 
fied judges  of  medical  fitness  to  admit  to  prac- 
tice. 

Following  is  a  r^um^  of  the  l^al  require- 
ments for  practice  in  each  state  and  territory 
of  the  United  States,  in  foioe  Jan.  1,  1894  : 

Alabama. — A  certificate  of  successful  ex- 
amination by  the  State  (or  county)  Board  of 
Medical  Examiners.  Diplomas  confer  no  right 
to  practice. 

Arizona. — Registry,  with  a  county  recorder, 
of  an  unrevoked,  uncancelled  **  diploma  regu- 
larly issued  by  a  medical  college  properly  and 
lawfully  organized  under  the  laws  of  the  state 
wherein  said  college  shall  be  located." 

Arkansas. — A  certificate  of  successful  exam  - 
ination  by  the  State  (or  county)  Board  of 
Medical  Examiners.  Diplomas  confer  no  right 
to  practice. 

California. — A  certificate  issued  on  the  di- 
ploma of  a  college  in  good  standing  or  upon  a 
successful  examination  by  one  of  the  State 
Boards  of  Medical  Examiners — regular,  home- 
opathic or  eclectric. 

Colorado. — Similar  to  California,  except  that 
there  is  but  one  State  Board  of  Medical  Ex- 
aminers. 

Connecticut — A  certificate  of  registration  of 
the  diploma  of  a  college  *  recognized  as  reput- 
able by  one  of  the  chartered  medical  societies  of 
the  state,"  regular,  homeopathic,  eclectic  ;  or  a 
certificate  of  satisfactory  examination  by  a  com- 
mittee appointed  for  the  purpose  by  the  State 
Board  of  Health. 

Delawara — A  certificate  based  upon  the 
registration  of  a  diploma  from  "  a  respectable 
medical  collie,"  or  upon  ^'afu'l  and  impartial 
examination  by  the  State  Board  of  Medical 
Examiners." 

District  of  Columbia. — Nominally  the  in- 
dorsement of  a  diploma,  or  an  examination,  by 
a  committee  of  the  District  Medical  Society  ; 
practically  no  requiremenL 

Florida. — A  certificate  of  satisfactory  ex- 
amination by  the  State  for  district)  Board  of 
Medical  Examiners.  Diplomas  confer  no  right 
to  practice. 

Georgia. — The  registration  of  a  diploma  from 
any  "incorporated  medical  college,  medical 
school  or  university."  The  clerks  of  the  su- 
perior courts  are  the  sole  judsres  of  the  value  of 
the  diploma  as  evidence  of  fitness  for  medical 
piactice. 

Idaho. — The  record  of  a  diploma  a'  a  county 
seat 

Illinois. — A  certificate  issued  by  the  State 
Board  of  Health  upon  the  diploma  of  a  legally 


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THE  MEDICAL  WORLD. 


chartered  medic^  institution  in  good  standing 
as  determined  by  the  Board,  or  upon  a  satis- 
factory examination  by  the  Board. 

Indiana. — The  registration,  in  a  county 
clerk's  office,  of  a  diploma  **from  some  reput- 
able medical  college." 

Indian  Territory. — a.  Cherokee  Nation  :  An 
examination  by  the  Board  of  Medical  Examin- 
ers ;  6.  Choctaw  Nation :  A  certificate  based 
upon  a  diploma  or  upon  an  examination  by  the 
Board  of  Medical  Examiners ;  c.  Creek  Nation: 
Payment  of  $25  annually  as  a  license  fee. 

Iowa. — Similar  to  Illinois. 

Kansas. — The  registry  of  a  diploma  from 
'"some  respectable  school  of  medicine,"  or  of  a 
certificate  of  qualification  from  some  State  or 
county  medical  society. 

Kentucky. — A  certificate  from  the  State 
Board  of  Health  issued  upon  the  ''diploma  of  a 
reputable  and  legally  chartered  medical  col- 
lege." 

Louisiana. — The  record  of  a  diploma  from 
''any  medical  institution  of  credit  and  respecta- 
bility" after  indorsement  by  the  State  Board  of 
Health. 

Maine. — No  legal  requirement  In  1887  an 
act  to  regulate  the  practice  of  medicine  was 
passed  by  th^  Legislature  but  was  vetoed  by 
the  Governor. 

Maryland. — A  certificate  issued  upon  a  satis- 
factory examination  by  the  State  Board  of 
Medical  Examiners.  Diplomas  confer  no  right 
to  practice. 

Massachusetts.  —No  legal  requirement 

Minnesota. — Similar  to  Maryland. 

Mississippi. — Similar  to  Maryland — except 
that  the  examination  is  made  and  the  certificate 
issued  by  the  State  Board  of  Health. 

Missouri. — Similar  to  Illinois. 

Montana. — Ten  years  of  practice;  a  certifi- 
cate upon  the  diploma  of  a  college  "in  goed 
standing,"  or  upon  an  examination  by  the 
State  Board  of  Medical  Examiners. 

Nebraska. — A  certificate  issued  by  the  State 
Board  of  Health  upon  the  diploma  of  "a  legally 
chartered  medical  school  or  college  in  good 
standing,"  as  defined  in  Section  8  of  the  Act  of 
July,  1891. 

Nevada. — The  record  of  a  diploma  from 
"some  regularly  chartered  medical  fcchool." 

New  Hampshire. — No  legal  requirement 

New  Jersey. — A  license  issued  upon  a  suc- 
cessful examination  by  the  State  Board  of 
Medical  Examiners.  Diplomas  confer  no  right 
to  practice. 

New  Mexico. — A  certificate  upon  the  diploma 
of  a  legally  chartered  medical  institution  in 
good  standing,  or  an  examination  by  the  Terri- 
torial Board  of  Medical  Examiners. 


New  York. — A  license  issued  upon  a  suc- 
cessful examination  by  one  of  the  State  Boards 
of  Medical  Examimers — regular,  homeopathic, 
eclectic.     Diplomas  confer  no  right  to  practice. 

North  Carolina. — A  license  issued  upon  a 
successful  examination  by  the  State  Board  of 
Medical  Examiners.  Diplomas  confer  no  right 
to  practice. 

North  Dakota.—  Similar  to  North  Carolina. 

Ohio. — The  diploma  of  a  respectable  school 
of  medicine,  or  a  certificate  of  qualification  from 
State  or  county  medical  society. 

Oklahoma. — A  license  issued  by  the  Super- 
intendent of  Public  Health  upon  a  medical 
diploma  or  after  examination. 

Oregon. — A  certificate  on  the  diploma  of  a 
college  "in  good  standing,"  or  after  examina- 
tion by  the  State  Board  of  Medical  Exam- 
iners. 

Pennsylvania. — A  license  issued  after  exam- 
ination before  one  of  the  State  Boards  of  Medi- 
cal Examiners :  Act  of  May  18,  1893 ;  takes 
efiect  March  1,  1894.  Diplomas  will  there- 
after confer  no  right  to  practice. 

Rhode  Island. — No  legal  requirement 

South  Carolina — A  certificate  of  verification 
of  the  diploma  of  a  reputable  medical  college. 
An  Act  of  Dec.  24,  1890,  abolished  the  State 
Board  of  Medical  Examiners  created  by  the 
Act  of  1888  and  under  which  the  diploma  con- 
ferred no  light  to  practice. 

South  Dakota. — A  license  issued  by  the  State 
Board  of  Health  after  examination.  Diplomas 
confer  no  right  to  practice. 

Tennessee. — A  license  on  the  diploma  of  a 
college  "in  good  standing,"  or  after  examina- 
tion by  the  State  Board  of  Medical  Examiners. 

Texas. — A  license  issued  after  examination 
by  a  District  Board  of  Medical  Examiners. 
Diplomas  confer  no  right  to  practice. 

Utah. — A  license  issued  by  the  Territorial 
Board  of  Medical  Examiners  after  examina- 
tion.    Diplomas  confer  no  right  to  practice. 

Vermont — The  registery  of  a  diploma  in- 
dorsed by  one  of  the  Boards  of  Medical  Censors, 
or  a  certificate  of  examination  by  one  of  the 
Boards. 

Virginia — A  license  issued  after  examina- 
tion by  ihe  State  Board  of  Medical  Examiners. 
Diplomas  confer  no  right  to  practice. 

Washington. — Similar  to  Virginia, 

West  Virginia. — A  license  on  the  diploma  of 
a  reputable  college,  or  after  examination  by  the 
State  Board  of  Health. 

Wisconsin. — The  indorsement  of  a  medical 
diploma  by  the  censors  of  either  of  the  State  or 
county  medical  societies. 

Wyoming. — The  record  of  a  diploma  with  a 
registrar  of  deeds. 


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143 


The  lithium  salts  are  said  to  be  better  alka- 
liniziiig  remedies  than  the  others  of  the  alkaline 
groups.  They  render  the  urine  more  alkaline, 
and  in  the  lithemic  acid  diathesis  they  hold  the 
uric  acid  in  solution  and  its  elimination  is 
favored.  Some  cases  are  reported  where  the 
lithium  salts  (carbonate  and  citrate  are  prefer- 
able) have  disolved  uric  acid  calculi.  In  rheu- 
matism and  dyspepsia  of  fleshy  persons  these 
salts  are  efScient — Kan.  Med,  Jour. 


Atafetida  for  Habitual  Abortion. 

Dr.  Guido  Turazza,  of  Padua,  gives  his  own 
testimony,  together  with  that  of  several  other 
Italian  physicians,  in  favor  of  the  efficacy  of 
asafetida  as  a  preventative  of  abortion.  A  pill 
containing  about  a  grain  and  a  half  of  the  drug 
is  given  once  in  two  days  at  first,  and  gradually 
at  intervals,  until  finally  one  is  given  every 
tenth  day.  The  author  regards  asafetida  as  a 
good  remedy  in  nervous  derangements  of 
women,  and  remarks  incidentally  that  it  has  the 
advantege  of  regulating  the  action  of  the 
bowels. —  Woman* s  Med.  Jour. 


How  to  Avoid  Malpractice  Charges. 

''Let  the  professional  man  live  up  to  the  re- 
quirements of  his  profession  and  observe  its 
ethics.  Let  him  keep  up  with  every  advance 
made  in  his  science.  Be  careful  in  professional 
deportment^  diligent  in  studies,  exacting  even 
as  to  details — putting  whatever  skill  he  has  in 
all  he  undertakes— doing  it  well,  no  matter 
what  the  case  in  hand  may  be,  avoiding 
familiarity,  drinking  moderately  of  intoxicants, 
or  what  b  better,  not  at  all.  Let  him  earn  a 
reputation  as  a  good,  safe,  reliable  practitioner, 
and  it  will  stand  by  him.  It  will  make  impu- 
tations of  malpractice  too  improbable  to  be 
feared.  They  will  fall  like  water  upon  a 
duck's  back.  Fortified  positions  are  often  im- 
pregnable. They  are  seldom  attacked.  Like 
the  engineer  upon  a  steam  engine,  be  ever  on 
the  alert  for  danger  siguals  and  intelligent 
enough  in  vision  to  understand  their  meaning. 
Piit  down  the  brakes  in  time  to  halt  in  safety. 
K  you  have  doubts,  consult  some  professional 
brother.  Call  him  in  to  aid  if  prudent  A 
divided  responsibility  is  sometimes  desirable. 
Attack  may  be  made  on  one,  which  the  mere 
presence  of  two  will  at  once  avert.  Take  no 
onneoessary  rifeks.  Assume  no  needless  respon- 
sibilities. Never  make  other  people's  troubles 
your  own.  Assist  them  by  every  professional 
means  in  your  power.  Use  your  best  efforts. 
This  is  all  you  are  called  upon  to  do — all  you 
can    do.     You    can    exercise  no  superhuman 


agency.  You  have  no  such  power,  and  would 
be  an  impostor  if  you  claimed  to  hava  Neither 
science  is  ao  exact  one.  Neither  is  capable  of 
assured  and  exact  determination.  The  best 
men  in  the  medical  fraternity  often  disagree; 
so  do  the  best  judges  upon  the  benches  of  the 
highest  courts  in  the  land.  Lawyers  and  doc- 
tors should  never  encourage  malpractice  suits. 
They  should  be  brought  only  in  extreme  cases, 
and  then  only  against  the  unworthy.  They  sel- 
dom help  the  client,  and  are  sure  to  injure  the 
professional  man,  who,  like  Csesar*s  wife,  must 
be  above  suspicion.  Professional  men  must 
have  good  names  and  keep  them  unsullied. 
Merchants  may  fail,  and  compromise  at  twenty- 
five  cents  on  the  dollar.  The  lawyer  and  doc- 
tor must  pay  one  hundred  cents  every  time,  or 
go  down  deeper  than  any  *McGinty'  ever  read 
about  in  song  or  story.  A  merchant  may  do 
business  in  his  wife's  name.  The  lawyer  and 
doctor  must  use  their  own  and  if,  for  any  rea- 
son, it  is  not  usable,  they  are  gone,  bob-line  and 
sinker,  and  *none  so  poor  as  to  do  either  rever- 
ence.' Then  emulate  the  example  of  the  men 
who  have  made  'uame'  and  earned  'fame'  in  the 
two  professions,  and  you  will  recall  the  days 
when  it  was  a  proud  honor  to  be  called  'lawyer* 
or*doctor.'" — Judge  David  McAdam,  N.  Y. 
Superior  Court 


The  practicing  physician  comes  closer  to  the 
people  in  all  that  concerns  their  every  day  life 
and  their  march  of  improvement  than  does  any 
one  else.  If  the  development  of  civilization  is 
temporarily  retarded  he  is  generally  quickest  to 
recognize  and  appreciate  the  cause.  Hence  we 
have  seen  physicians  in  the  entire  history  of 
man's  evolution,  prominent  in  all  phases  of 
human  progress,  whether  in  the  domain  of  pure 
or  applied  science,  religion  and  ethical  culture 
political  liberty  or  economic  conveniences. 
£arly  to  see  the  defects  in  our  conditions  of  life 
and  bold  to  prescribe  the  remedy,  the  names  of 
physicians  may  be  found  frequently  in  the  list 
of  martyrs  to  the  cause  of  humanity.  They 
may  also  be  found  among  those  who  have  suc- 
cessfully led  their  fellows  in  the  path  of  better 
living.  We  uote  with  pleasure  an  address  recently 
delivered  before  the  session  of  the  American 
Public  Health  Association  held  in  the  City  of 
Mexic%  by  Geo.  Homan,  M.D.,  of  St  Louis,  on 
''The  Fundamental  Conditions  of  Public  Health 
in  CivilizatioD,"  and  to  be  obtained  by  applying 
to  the  Secretary  of  the  Association,  Concord, 
N.  H.  The  doctor  shows  that  our  system  of 
land  tenure  is  mainly  responsible  for  the  unhy- 
gienic conditions  that  exist  in  our  cities.  He 
gives  a  forcible  plea  for  humanity's  natural 
rights. 


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THE  MEDICAL  WORLD 


Clairvoyoyant  Phytioiant. 

The  following  two  letters  of   advice  from 
"  Clairvoyant  Physicians  "   are  taken  from  an 
expose  in  Uie  Nurses  of  Boston  : 
Examination  of  Mr.  B : 

Yours  to  hand,  character  of  writing  and  con- 
tents noted.  Your  writing  is  characteristic  of 
high  nervous  temperement  caused  by  indigestion 
the  food  is  not  asimilated  in  the  element iry 
canal  and  you  feel  weak  and  debilitated.  Your 
blood  b  poor  for  want  of  nourishment  and  your 
nervous  system  needs  toning  up.  Will  try  to 
help  you  Please  tend  $5  for  course  of  treat- 
ment    Consultation  and  advice  free. 

G.  M.  C. 
Medium  and  Clairvoyant. 

Henry  P 

BotanfC  and  Clairvoyant  Physician 
Ti'rms,  $0  per  munih  In  advance 
OflBoe  Uoum.  iO  to  12  a  m.  ;  I  to  10  p.  m. 
Mall  orders  promptly  answered 
Advioe  free. 


LETTER  NO.    2. 

Mrs.  P :  Dear  Madam — I  am  in  receipt 

of  yours  and  examination  find  you  suffering 
from  torpid  liver  which  makes  you  billions, 
there  is  too  much  bile  in  your  stomach  and  your 
food  cannot  digest  Your  blood  becomes  stag- 
nant and  does  not  come  to  the  surface  readily. 
Your  lungs  become  weak  and  your  kidneys 
overheated.  This  makes  you  nervous  and  down- 
hearted. I  enclose  receipt  for  the  money  sent, 
and  piescriptions  for  one  month's  treatment  If 
not  improving  rapidly  let  me  hear  from  you 
again. 

R  Resin  of  Podophylin  one- half  teaspoon,  a. 
M.,  before  breakfast 

R.  Elixer  of  Cincona  or  the  steeped  Cincona 
bark  -  one-half  wine-glass  three  times  a  day. 

Take  also— Infusion  of  parsley  root  a  quarter 
of  a  gill  and  30  drops  of  ihe  tincture  of  acidi- 
vidily.  Yours  truly, 

Henry  P. . 


Urea  is  markedly  increased  by  the  use  of 
coffee  and  tea,  hence  these  should  be  interdicted 
in  organic  and  functional  derangement  of  the 
kidnejs.— Curtman,  Med.  Era. 

The  Philadelphia  Medical  and  Suroicai  Reporter  wan 
established  way  back  in  1868.  It  has  held  a  com- 
mandiDg  position  ever  since.  Up  to  1894  its  price 
wasfS.oO  per  year.  It  is  now  reduced  to  $3  00  per 
year,  bat  has  not  chani?ed  at  all  except  in  price  If 
yoa  are  not  familiar  wit'i  it,  send  for  a  sample  copy 
(P.  O.  Box  843,  Philadelphia),  and  mention  this  notice. 

We  will  supply  both  Reporter  (weekly)  and  World 
t>  yoa  for  the  remainder  of  1894,  for  only  $2.75. 
T  le  sooner  yon  send,  the  sooner  your  suhscription 
will  begin. 

A  surprise  in  next  month's  World. 


Sanitarians  and  Politioians. 

The  medical  profession  is  expected  to  assist 
the  state  in  legislating  for  the  public  health.  In 
all  matters  pertaining  to  the  prevention  and  re- 
moval of  the  causes  producing  disease  the  doc- 
tor is  required  to  furnish  the  ordinance  and 
ammunition,  level  the  piece  and.  let  the  other 
fellows  fire  the  shot  and  gel  the  credit  for  the 
execution.  When  the  work  is  done  and  his 
services  are  no  longer  needed,  he  is  set  aside  to 
be  used  again  at  a  convenient  season. — Kan$a^t 
Med  JoumaL 


Aluminum  Foil  Money. 


One  of  the  State  Senators  of  Illinois,  Dr.  A. 
L.  Brands,  has  introduced  a  resolution  asking 
Congress  to  withdraw  paper  money  and  engrave 
a  like  amount  on  aluminum  foil,  to  prevent  the 
spread  of  cholera  and  other  iufectous  diseases  bv 
means  of  paper  money.  The  aluminum  foil,  it 
Lb  claimed,  can  be  engraved  as  readily  and  in 
any  way  would  be  as  suitable  for  money  as 
paper,  and  at  the  same  time  it  could  not  harbor 
deadly  germs.  From  this  it  may  be  assumed 
that  .sanitaticm  is  looking  up  in  the  State. — 
Texas  Sanitarian. 


Nitro-Glycerin  for  Vomiting. 

A  contributor  to  the  British  Medical  Jour 
nal  recommends  this  nitro-glycerin  as  the 
most  positive  remedy  for  controlling  vomiting 
he  has  ever  employed.  He  has  found  it  will 
control  all  forms  of  vomiting,  whether  in 
adult  or  infant,  acute  or  chronic.  He  has 
found  it  of  great  service  in  controlling  vomit- 
ing of  gastric  catarrh,  and  in  alcohol  it 
acted  almost  as  a  specific.  Also  proved  use- 
ful in  controlling  the  vomiting  of  pregnancy. 
—  Canada  Txincet. 


Formulas. 


To  Arrest  a  Cold. 

R.    Tincture  gelseminm gti.  2 

Liquid  ergot. •*   6 

Cjimplior  waar dram  4 

Mix,  and  take  every  Hour  immediately  the 
cold  is  felt.  If  this  be  taken  for  twelve  hours, 
at  the  same  time  kee  in^j:  indoors  in  the  warmth 
many  a  cold  will  becut  short — Corr.-Bl  SehvreiB. 
Aertze. —  Wonian^s  Med.  Jour. 


Sciatica  and  Other  Neurafgias. 

R.    Tlnct.  aconit, 
Tlnct.  colch.  Bern., 
Tiort.  bel.. 

Tinot  ACiea  ncem aa ....equal  parts 

8.    Six  drops  every  six  honre. 

—MeUxLlf.—Ib. 


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Whooping  Cough. 

»    AmmoDlt  bromidi dram  ill 

AmmoDli  carbonat ^ gr.  1 

Synip  tolu f  ounce  j 

Aqiuedeit.  q  n.  ad f  ounce  11) 

Mg.   Teupoomol  every  four  houTR. 

— Prof,  Oraham. 


Dipsomania. 

L   Qnlnlose  sulph 

Elncl  oxld ~. 

Scrychnlne  sulph gr. 

Acid  arsenlosl ^r  MOO 

Pulv.  capslel gr.  ij 

et  ft.  pa  No.  J.   8ig.    One  pill  tbrice  dally. 

— Dr.  Edward  C,  Afann. 


::|J:| 

T.  140 


For  the  Night-Sweatt  of  Pulmonary  Tuberculosis. 

R,    Acid  Ballcyllc dramjw 

Glvctrin - f  ounce  ilj 

Alcohol f  dram  Iv 

Aqiitedestll f  ouicej 

M.  8.    1  nirty  drop^  hypodematlcatly  ai  bedtime,  four  or 
!▼«  mghu  In  succession. 

— Bernheim,  Scttu  Mtd, 


Ely's  Cream  Balm. 
Take  of:— 

Vaseline ., 1  oz 

Th  mol ^ 3gr 

Carb.  biftmuth 15ifr 

Oil  Winiergreen  2  iniuims 

— Kilner'a  Mod&m  hormulary. 


Diphtheria. 
Hieber  recommends : 


B.    Hydrarg.  Chlorid.  mitls, 

8alnlis, 

8«cch.  alb. aa. 

M.   et  div.  in  chart,  no.  zxx. 
Big.    One  powder  every  hour. 


..dram  fs 


Heart  Tonic. 

R.   Atropis  sulphatis, 

Strycbnissu  phails aa ^t.  ^ 

Feu  bovlsinsp dram  jj 

M .  ft.  pil.  No.  zxz.    Slg.    One  three  times  a  day. 


..Rr.  y. 


-Kaiu  Med,  Jour, 


Acute  Gonorrhea. 
Balzer  preecribes : 

R.    8odll  Uoarb ., dram  x 

8odll  8alicylat.«....« « ounce  iiss 

H.    ttg.    Dose,  one  drachm  iu  a  quart  of  lemonade. 

—N.  Y.  Med.  Record. 


Liniment. 
A  good  all  around  liniment  is  made  from  : 

B.    Cotton  seed  oil, 
HasMtfrasoil, 
Aqua  ammonia, 
Chlo:oforin. 

Spts.  camphor aa X  ounce 

Turr-eittine i  ounce 

Mix.    Apply  over  the  region  of  the  pain. 

— Indiana  Pharm. 

Verdi,  Paxton,  111-  "  We  are  having  soap- 
bubble  parties  in  this  neighborhood.  What 
can  be  put  in  the  water  to  keep  the  bubbles 
from  bursting  and  allow  them  to  be  blown  very 
large  ?    Glycerine  won't  do." 

Try  the  following : 

Casdle  Foap.  powdered, 

Muci 'age  acacia aa „ 4  drams 

Glycerine « 1  ounce 

Water,  to  make 4  ounces 

Mix.     Strain,  and  use  about  an  ounce  to  a 
pint  of  warm  rain  water.     The  bubbles  can  be 
made  very  large  and  they  last  a  long  time. 
— Indiana  Pharm, 

Salicylic  add,  in  six  to  eight  grain  doses, 
given  every  hour,  fasting  until  six  doses  are 
taken,  followed  by  three  ounces  of  castor  oil, 
will  expel  tape  worm.  He  will  have  to  vacate 
the  premises  or  pay  rent. 

— Indiana  Pharm. 


This  is  said  to  cause  a  rapid  disappearance 
of  the  membrana         — N.  Y.  Med.  Record, 


Stimulant  in  Pulmonary  Phthisis. 

MIXTURE. 

R.    Dilute  phosphoric  acid 1 

Dilute  hydrochloric  add I    ao nai  «Lr ti» 

Dilute  sulphuricacid f  ^       ^^ 

Tincture  Iron  cbloride J 

Thirty  drops  In  half  a  gla»  of  sweetened  water,  during 
meata, 

— MtLys,  Pittsburgh  Med,  Rev. 


Bed  bug  poison  is  best  made  from  corrosive 
sublimate  mixed  with  salt  and  dissolved  in 
water. 

R.    Corroflve  sublimate 1  onnce 

Salt,  fine  table 4  drams 

Water 16  ounces 

Mix.  The  salt  assists  in  the  ready  solution 
of  the  corrosive  sublimate  in  water  and  saves 
the  expense  of  alcohol,  a  matter  to  be  considered 
these  hard  times.  — lb. 

Pimples  and  blackheads  may  be  removed  by 
the  use  of  a  solution  of  salicylic  acid  and 
alcohol. 

SallcTllc  add 1  dram 

Alcohol 3  ounces 

Mix.  Wash  the  affected  parts  night  and 
morning  with  hot  water  and  Castile  soap,  rub- 
bing vigorously,  dry  with  a  rough  towel  and 
apply  the  lotion  with  the  end  of  one  finger, 
rubbing  it  well  into  the  skin.  Pimples  disap- 
pear at  once  and  blackheads  after  a  few  appli- 
cations. — lb. 

Pulmonary  Tuberculosis. 
Dr.  Norman  Bridge,   late  Professor  of  Dis- 
eases of  Chest  at  Rush  Medical  Collie,  Chicago, 
111.,  recommends  the  following  as  an  inhalation: 

R.    Pot  lodldl gre  X 

Oreaaotae ...« dram  j 

Eucalyptol  (Sander  &  Sou's) drams  113 

ALohol „ ...«.omicej 

M.    Slg.    Use  as  an  luha'.aUon  twice  a  day. 


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THE  MEDICAL  WORLD. 


For  Persistent  Dry  Cough. 

The  followiDg  will  be  found  excellent  for 
those  persistent,  dry,  hacking  coughs,  which 
resist  the  usual  treatment 

R.    Syr.  pids ~ « ounce  Iss 

Syr.  pruni  verg ounce  1 

Tinct.  captiicum ounce  w 

M  noil  acacia ounce  J 

Syr.  acid  hydrodic  (Hoetelley't>) ounce  )j 

M.   Big.   Teaspoonfiii  four  times  daily. 


Reviews. 


For  the  Acute  Stage  of  Gonorrhea. 

The  following  formula  is  one  much  used  in 
the  service  of  Prof.  T.  R.  Neilson  and  I  can  say 
from  a  somewhat  extended  clinical  experience 
with  it  that  it  almost  alwa}S  accomp'ishes  the 
object  aimed  at.  namely,  affecting  the  urine  (O 
that  the  urethral  symptoms  of  the  early  stage 
of  an  acute  urethritis  are  much  modified. 

R.   PotaMii  aoetatis dram  iii 

PotaflBii  bromidi dram  m 

Addi  borli  i dram  ii  scruple  1i 

Tr.  belladonnse dram  ss 

Idq.  potass. citratii,  q.  s.  ad..... dram  viii 

M.    8.    A  tableepoonful  in  a  goblet  of  water  three  or  four 
times  a  day. 

In  giving  your  directions  to  the  patient,  it  is 

of  importance  that  he  understands  he  is  to  take 

a  liberal  quantity  of  water  with   his  medicine, 

and  I  think  the  remedy  is  better  taken  about 

two  hours  after  meals. 

— John  Lindsay,  M.D.,  in  Phiicu  Polyclinic  • 


Scarlatina  in  Children. 

Dr.  A.  Correa  (La  Semaine  M^icale,  No. 
72,  1893),  recommends  the  following  : 

B.    Nitrate  of  pilocarpine - grain  1-20 

Acouitine grain  1-20 

Sallcylae  oi  soda grains  xxx  ounce  Ji 

Alcohol .•. 1 

Syrup  of  orange  peel y  aa  ounce  iv 

DlstllUd  water « J 

A  teafpoonfbl  every  twenty  minutes  until  the  usual  efflects 
of  pilocarpine  are  manifest.  As  soon  as  this  action  disappears 
then  commence  its  administration  again. 

According  to  him,  under  the  influence  of  this 
treatment,  scarlatina,  even  if  it  be  malignant 
and  associated  with  pultaceous  angina,  rapidly 
assumes  a  benign  character. — Laiicet  Clinic, 


Phosphate  of  Soda  as  a  Purgative. 

Prof  C.  Paul  (  Wien&r  Med,  Freste,  No.  52, 
1893)  has  employed  the  phosphate  of  soda  for 
seven  years  as  a  purgative  instead  of  the  sul- 
phate, usually  used.  He  prescribes  it  as  follows  : 

Phosphate  of  soda drum  ^\ 

Diftiiled  water ounce  Tjt^s 

Simp  e  syrup ounces  ij 

Alcoholic  tinct.  of  lemon gtts.  xzv 

atricacid,                 I        ..  o^  ^^^ 

Bicarbonate  of  soda,  f ** 8^  "* 

About  two  hours  after  taking  this  purgative 
lemonade  an  evacuation  will  take  place,  which 
is  soon  followed  by  two  others.  Its  action  is 
easy  and  pleasant,  and  the  remedy  is  taken 
without  difficulty. — Translated  by  Dr.  Pritchard, 
for  Lancet  Clinic 


Direct  Legislation.    By  J.  W.  Sallivan.    Paper, 
25  oents.    The  Tnie  NatloDalist  PablishiDg  Co., 
New  York,  N.  Y. 
This  is  a  plain  and  forcible  presentation  of  the  popu- 
lar Initiative  and  Referendum  as  employed  by  the 
people  of  Switzerland  in  their  public  affairs.   In  these 
is  found  the  strong-hold  of  popular  liberty.     We  re- 
commend every  citizen  of  the  United  States  to  read 
this  little  book. 

The   Dispensatory   of  tae  United  States  op 
America.    By  Geo.  B.  Wood,  M.D.  and  Frank- 
lin Bache,  M.D.  17th  edition  with  illustrations; 
thoroughly  revised  by  H.  C.  Wood,  M.D  ,  LLuD., 
Joseph  P.  Remington,  Ph.M.,  F.  C. S.  and  Samud 
P.  8adtlcr,Ph.D.,F.  C.  8.    Cloth,  $7.00.    Sheep, 
$10.00.     J.  B.  Lippinooit  Ck).,  Phila. 
This  work  is  already  so  well  known  to  the  profes- 
sion that  we  hardly  know  what  new  to  say  in  intro- 
ducing the  seventeenth  edition.    Yet  there  may  be 
some  one  among  our  readers  who  is  not  yet  acquainted 
with  it.  That  it  has  passed  through  seventeen  editions 
is  enough  commendation  in  itself.    However,  a  care- 
ful examination  of  the  great  work  itself  will  convince 
any  one  that  no  physician  should  be  without  it.    The 
Index  of  Diseases  in  the  first  part  of  the  book  Is  a  new 
feature     This,  we  think,  is  not  very  carefully  com- 
piled. One  observation  we  note  is  that  the  author  does 
not  seem  to  know  of  the  virtues  of  aconite.     However, 
the  brevity  of  this  department  does  not  detract  from 
the  vast  fund  of  information  to  be  found  in  the  main 
portion  of  the  work.    In  this  a  vast  number  of  official 
drug^  are  treated  exhaustively.    The  National  Form- 
ulary    follows,     giving    many    very     useful    stock 
formulas.    Next  follows  the  treatment  of  non-official 
drugii.     Then    follow    tables  of   tests,  weiffhtn  and 
measures  and  other  useful  tabular  matter.    The  gen- 
eral index,  alone,  at  the  close  of  the  book,  comprises 
97  pages,  and  the  entire  work  1980  pa^^  The  thumb 
index  is  very  convenient  and  time-savmg 

An  AMBaiCAN  Text-Book  of  Diseases  of  Chil- 
dren. By  American  Teachers.  Edited  by  Louis 
SUrr,  M.D.,  assisted  by  Thomas  Weecott,  M.D. 
1190  pages.  Price,  cloth,  $7.00,  Sheep,  $8.00,  half 
Russia,  $9.00.  W.  B.  Saunders,  Phila.  By  sub- 
scription  onl^.  ^ 

This  is  pre-emmently  the  day  of  complete  systems 
and  TeKt-Books  on  special  subj<»cts.  The  handsome 
volume  before  us  represents  the  work  of  the  most 
distinguished  authors  in  the  various  special  branches 
of  diseases  of  children.  The  mformation  is  up  to  the 
present  date.  Many  subjects  in  sui^gery  are  treated  as 
incidentally  belonging  to  the  domain  of  pediatrics. 

A  Text-Book  of  the  Theory  and  Practice  of 

Medicine.     By  American  Teachers.    Edited  by 

William    Pepper,    M.D.    LL.D.     Vol.  IL  1046 

pages.    $5.  $6.  and  $7.  W.  B.  Saunders,  Phila. 

This,  the  second  volume,  is  some- what  delayed,  yet 

it  is  rendered  more  valuable  on  aooouot  of  the  reason 

of  the  delay,  namely,  the  fact  that  Dr.  Pepper  himself 

was  writing  a  good  portion  of  the  work,  (325  pages  of 

it).    This  work,  fully  illustrated,  is  one  of  which  both 

the  editor  and  publisher  may  well  be  proud. 

A  Practical  Treatise  on  the  Diseases  of  the 
Hair  and  Scalp.  By  George  Thomas  Jackson, 
M.D.,  of  New  York.  414  pages  illi:^raied ; 
cloth  ;  $2.75.  E.  B.  Treat,  No  5.  Cooper  Union, 
New  York.  N.  Y. 
This  is  the  second  edition,  completely  revised  and 

considerably  t-nlarged,  of  this  very  practical  work. 


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In  every  oommimitj  there  are  ptttients  with  diseases 
afiectioff  the  hair  and  scalp  that  mi^ht  be  cured  or 
greailj  benefitted  by  treatment,  ma(£  to  the  physi- 
cian's advantage  in  both  professional  reputation  and 
financial  reward.  For  this  purpose  it  would  be  well 
to  have  this  special  book  by  a  praciic^  worker  in  this 
field. 

A  Trbatisb  on  Headache  and  Neuralgia.    By 
J.  Leonard  Coming,  M.A.,  M.D ,  of  New  York. 
275  pages ;  illustrated ;  cloth,  $2.76.  E.  B.  Treat. 
No.  6,  Cooper  Union,  New  York,  N.  Y. 
In  this,  the  third  edition,  much  of  the  text  has 
been  rewritten.    A  useful  addition  has  been  made  to 
the  main  subject  in  the  chapters  on  Spinal  Irritation 
and  also  one  on  Normal  ana  Morbid  Sleep.    There  is 
added  an  appendix  on  Eye  Strain  as  a  cause  of  Head- 
ache, by  David  Webster.  M.D.,  Prof,  of  Ophthalmo- 
logy in  the  N.  Y.  Polyclinic 

A  Practicai*  Treatise  on  Nbrvoxts  Exhaustion 

(Neurasthenia).    By  Qeonre  M.  Beard,  A.M., 

M.D.;  edited  by  A.  D.  Rockwell,  A.M.,  M.D. 

262  pages ;  cloth ;  $2.76.  E.  B.  Treat,  5  Cooper 

Union.  New  York,  N.  Y. 

This  is  the  third  edition  of  this  very  popular  work. 

It  treats  of  this  ^great  American  disease"  thoroughly, 

in  the  lines  of  its  Symptoms,  Nature,  Sequences  and 

Treatment    A  careful  reading  of  this  work  will  pro- 

foandly  influence  the  physician  in  his  consideration 

of  almost  every  case  thereafter,  as  some  of  the  mani- 

festatioos  of  this  quite  general  condition  will  be  found 

in  almost  every  patient. 

How  TO  Use  the  Forceps     With  an  Introductory 

Account  of  the  Female  Pelvis  and  the  Mechan- 

irai  of  Delivery.    By  Henry  G.  Landis,  A.M., 

M.D.,  Columbuft,  O.    Revi^  and  enlarged  by 

Charles   H.    But-honjr.  M.D..  New  York.    203 

pages,  $1.75.    R  B.  Treat,  6  Cooper  Union.  New 

York,  N.  Y. 

The  original  work  of  Dr.  Landis  was  published  in 

1880.  The  vast  amonnt  of  information  sine<)  developed 

on  the  subject  has  been  added  by  Dr.  Bushong.    The 

thorough  technique  of  the  use  of  the  forceps  should 

be  known  by  every  obstetrician,  who  is  at  all  times 

liable  to  be  required  to  apply  this  instrument. 

Suicide  and  Insanity.    A  Physiological  and  Socio- 
logical Study.    By  S.  A.  K.  Strahan,  M.D..  Bar- 
rister-at-law,    London,  Eng.    228  pages.    $1.75. 
Swan,  F^nen"chein  /k  Co.,  London     For  sale  by 
John  Wanamaker,  Phila. 
In  this  work  we  have  a  complete  and  exhaustive 
treatise  on  the  melancholy  subject  of  self-destruction. 
The  subject  is  treated  in  a  clear,  logi(*al  manner,  his- 
torically, oomparinsr  different  ages  of  the  world  and 
dilTerenl    nationalities.     A    proper   classification    of 
suicide  is  given,  and  a  dose  analysis  of  the  probable 
canses.    The  author  attributes  the  rapid  increase  of 
suicide  to  a  cultivation,  by  marriage,  of  the  neurotic 
classes. 

Syphilis  in  the  Innocent.  (Syphilis  Insontium). 

By  L.  Duncan  Bulklev,  A.M.,  M.D.,  New  York. 

Cloth,  $8.50.    Bailey  St  Fairchild,  29  Park  Row, 

New  York,  N.  Y. 
This  treatise  was  awarded  the  Alvarenga  prize  by 
the  College  of  Physicians,  of  Philadelphia.  It  cer- 
tainly is  a  masterly  treatise  on  this  interesting  subject. 
The  bibliography  of  the  subject  alone  covers  143 
ptgeA.  The  author  details  in  full  the  vast  number  of 
ways  in  which  this  loathsome  disease  may  be  commu- 
nicated. The  authors  plan  for  the  legal  control  of  the 


disease  is  so  practical  that  we  think  it  would  finally 
result  in  its  total  extinction. 

The  Mcintosh  Battery  and  Optical  Company,  141 
Wabash  Ave.,  Chicago,  issile  a  magpifioent  illustrated 
catalogue  of  200  pages.  It  contains,  in  addition  to 
illustrations  and  prices  of  a  vast  array  of  electro-thera- 
peutic apparatus,  many  scientific  articles  upon  the 
treatment  of  disease  by  electricity.  Sent  free  if  you 
refer  to  this  review. 

Gborob  Keil,  1715  Willington  street,  Philadel- 
phia, announces  the  early  publication  (third  edition), 
of  the  "Medical  and  Dental  Register-Directory  and 
Intel liffencer,"  for  the  States  of  Pennsylvania^  New 
York,  New  Jerpey,  Maryland  and  Delaware.  It  will 
present  a  complete  list  of  all  medical  and  dental  prac- 
titioners in  the  States  named,  with  place  and  date  of 
graduation,  lists  of  professional  educational  institu- 
tions, hospitals,  societies,  etc.,  etc 

Antiseptic  Medication.  In'two  volumes,  price  26 
cents,  each. 

The  Modern  Climatic  Treatment  op  Invalids 
wrpn  Pulmonary  Consumption  in  Southern 
CaXipornia.  By  P.  C.  Bemondino,  M.D.  Price 
25  cents. 

These  are  volumes  in  the  Physicians  Leisure 
Library,  published  by  Geo.  S.  Davis,  Detroit,  Mich. 
Each  volume  u  worth  far  more  than  the  small  price 
asked  for  it 

Proceedings  of  the  Phila.  Co.  Med.  Society  for 
1898.  Lewis  H.  Adler,  Jr.,  M.D.,  Editor. 

Transactions  of  the  College  of  Physicians,  Phila- 
delphia, for  1898. 

Differential  Diagnosis  of  Common  Diseases  of 
THE  Eye.    By  W.  F.  Conners,  M.D.,  Oil  City, 
Pa.    Price  50  cents. 
This  is  arranged  as  a  chart  convenient  for  office  use. 

The  LouMUe  Medical  Monthly.  This  is  a  bright 
new  aspirant  for  honors  in  the  journalistic  field.  Price 
$1.00  per  year.  Jas.  B.  Studman,  M.D.  and  Geo.  M. 
Warner,  M.D.,  Editors.  We  wbh  the  new  journal 
abundant  success. 

Therapeutic  Notes  Published  hj  Parke,*Davis  & 
Co.,  Detroit,  Mich.  Subscription  free  by  men- 
tioning this  review. 

The  Arena  is  a  magazine,  published  in  Boston,  that 
b  battling  for  human  rights  and  advanced  scientific 
knowledge.  In  the  February  number  "The  March  of 
Uninvited  Poverty"  by  the  editor,  and  in  the  March 
number  "The  Cause  of  Financial  Panics"  by  J.  W. 
Bennett  and  ''Jesus  or  Csesar"  bv  the  Editor,  are  de- 
serving of  especial  mention.  They  are  indeed  start- 
ling articles.  Price,  $5  00  a  year  or  50  cents  a  number. 

The  Easter  Number  of  "2%<  Liteary  DigesC'  The 
whole  world  has  been  traversed  to  find  material  for 
the  Easter  Number  of  The  Literary  Digest. 
Almost  every  civilized  language  will  be  represented. 
It  will  be  superbly  illustrated,  full  of  information ; 
treating  all  questions  of  present  interest,  and  all  sides 
of  those  questions;  presenting  the  leading  articles  in 
the  formost  Magazines  and  Journals  of  the  world. 
This  number  of  The  Literary  Digeot  will  probably 
excel  anv  other  attempt  to  give  the  literature  of  the 
world  in  one  issue.  The  Easter  Number  will  be 
ready  on  Thursday,  March  22. 


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THB  MEDICAL  WORLD. 


Wit  and  Wisdom, 

Rbmembek,  World  and  PhiUufelphia  Medical  avd 
Surgical  Reixtrier  (weekly)  boih  for  ihe  remainder  of 
1894  for  only  $2.75  I  The  sooner  you  send  the  sooner 
your  subscription  wjH  begin.  ^ 

Fob  beautiful  desk  blotters,  giving  artistic  rf  presen- 
tation of  the  wild  rose,  address  Frederick  Stearns  & 
Co.,  Detroit,  Mich. 

Mellin'8  Food  will  give  you  entire  Fatisfaction  in 
the  nourishment  of  infants  and  invalids. 

Thinos  Worth  Rembhberino.    The  dose  of  the 
alkaloids  ranges  from  gr.  1-50  to  I  8,  except— 
Htrychnine  .      gr.  1-100  to  1-60 

Phybosiigmine   .    .    .    .  gr,  l-ldO  to  1-60 

Atropine gr.  1-100  to  1-50 

Digiialine gr.  l-tOO  to  1-60 

M*irpliine gr.  1-8  to  1-3 

Cocaine   .    .       -    .    .    .  gr.  1  8  to  1-3 
Pilocarpine    .    .    .    .      gr.  1-8  to  1-8 
Of  the  other  preparations  as  follows : 

Abstracts gr.  1-6  to  ij 

Solid  extracts    .    .    .    .  gr.  1-6  lo  ij 
Fluid  extracts  .  m.  i  to  x 

Tinctures m  ij  to  xx 

The  strength  of  the  variou:}  preparations  is  in  the 
following  order : 

1.  Alkaloids. 

2.  Abstracts  and  solid  extracts. 

3.  Fluid  extracts. 

4.  Tinctures. 

5.  Decoctions. 

Acids  for  internal  use  are  always  diluted  from 
eighty  to  ninety  per  cent. 

The  dose  of  the  potassium  compounds  ranges  from 
five  to  twenty  grains. 

The  dose  of  sodium  salts  ranges  from  one-half  more 
to  twice  the  dose  of  potassium  compounds. 

While  the  foregoing  is  not  absolutely  correct,  yet 
the  doses  are  within  safe  limits. 

It  should  be  remembered  that  potassium  and  sodium 
are  not  official,  but  it  is  their  compounds  that  are  used 
for  internal  use  — Kan.  Med.  Jour. 

Phtsician  :  *'I  am  tired  of  running  here  every  day 
to  see  about  that  bill  you  owe  me." 

Jones:  "Well,  doctor,  I  am  an  accommodating 
man,  and  if  you*d  rather  stay  away,  I  think  1  could 
manage  lo  do  without  you.*' 

RHEUMATIC  FEVEB. 
B.     Tlnrt.  aconite  root ^drm. 

IJq.  tong.  sal Soza. 

OlyceriDe 13^  ozs. 

S88.  pepnioe IH  oxB. 

If.    Big.— Tablespoonfal  every  two  bours. 

M.  D.  Conway,  in  his  Sacred  Anthology,  has 
among  many  of  the  striking  passages  from  the  Hindoo 
Albitis,  the  following : 

Health — Who  is  this  natural  beauty  who  advances 
with  so  much  grace  ?  The  rose  is  on  her  cheeks,  her 
breath  is  sweet  as  the  morning  dew.  A  joy,  tempered 
with  modesty,  animates  her  countenance.  It  is 
health,  the  daughter  of  Exercise  and  Temperance. — 
Journal  of  Hyyune. 

For  all  diseases  characterized  by  sclerosis,  try 
"Arsenauro" — the  bromide  of  gold  and  arsenic.  Ad- 
dress, £.  M.  Johnson  &  Co.,  38  Piatt  St ,  Kew  York, 
N.  Y. 

For  hollow  suppositories  and  glvcerine  suppositories, 
address,  Hall  &  Rnckel,  218  Greenwich  St.,  New 
York,  N.  Y. 


Old  Subscriber  (to  editor).— 'HUan  you  lend  me 
five  dollars  ? ' 

Editor. — ^**We  cannot." 

Old  Subscriber. — "Paper  not  doin*  much,  eh  V* 

Editor  —  'Well,  we're  holdin*  our  own." — Ltppin- 
eoUs. 

Mr.  Younghusband  (coming  home,  finds  his  wife 
at  the  stove):  **  ^^o  you  are  going  to  do  your  own  cook- 
ing. Tell  me  now,  what  is  that  you  are  cooking  at 
that  stove,  Molly?"  Molly:  "You  musn*t  have  so 
much  curiosity.  I  don't  know  myself  what  it  is  going 
to  be." 

For  perfect  pill  preparations  specify  W.  H.  Schief- 
felin  &  Co.'s,  ISew  York. 

Wobbler  was  just  wiggling  out  of  the  tail-end  of  a 
protracted  jag,  and  meeting  Wibbler  he  exclaimed, 
"For  the  Lor.i's  nake,  what  will  cure  this  drink  habit?" 
"Trichloride  of  gold.'*  "I  thought  it  was  bichloride 
they  used,"  said  Wobbler.  "Buy  chloride  of  gold  and 
you  will  hit  it,'*  said  Wibbler,  "for  the  other  two  are 
chemical  impossibilities." — 0.,  in  Med.  Gleaner. 

In  referring  to  Peacock's  Chionia  I  mav  say  it  is 
verv  nearly,  if  not  quite,  a  specific  remedy  for  consti- 
pation. 1  have  pre  cribed  ii  in  obstinate  cases  of  con- 
firmed constipation,  and  in  each  case  the  remedy  has 
proved  sui-cessful.  One  lady  who  had  been  afflicted 
for  years  with  the  most  obistinate  constipation,  took 
one  eight-ounce  bottle  at  my  suggestion,  this  occurred 
four  months  ago,  and  since  t^at  time  she  has  been  free 
from  any  symptoms  of  her  former  malady,  and  is  to- 
day in  the  best  of  health  and  spirits. 

Port  Samia,  Ont.  H.  Pace,  M.D., 

U.  S.  Consulate. 

We  have  noticed  that  no  matter  where  a  man  has  a 
pain,  he  is  always  satisfied  that  he  would  be  very  brave 
and  patient  if  it  was  only  somewhere  else. 

Use  Phytoline  for  your  fleshy  patients. 

collect  your  fatrb. 
When  a  young  man  appears  in  your  oflice,  Doctaire, 
And  with  a  mysterious  and  diffident  aire, 
Informs  you  that    something    is    wrong    with    him 

whaire — 
That  is — er— where  he— he  maketh  wataire, 
And  it  hurts  till  it  naturally  lifteth  his  h aire. 
And  he  further  explains  that  the  whole  sad  afifaire 
Came  of  riding  his  whed  through  a  rough  thorongh- 

faire. 
Just  say  to  him  blandly,  "Alas,  my  dear  saire, 
In  certain  precincts*  the  whole  atmosphaire 
Seems  loaded  with  microbes — I  advise  you,  bewaire 
Of  these  shady  retreats,  and  do  not  ride  thaire." 
Then  fix  up  his  "dope*'  and  colleH  a  good /aire. 
For  as  sure  as  you  trust,  though  he  be  a  preachaire. 
He'll  beat  you,  or  skip  to  some  other  doctaire. 

— Dr.  Cooper,  in  Eclectic  Medi*  al  Gleaner. 

Can  a  lawyer,  or  drctor;  or  undertaker  be  a  real 
Christian  ?  To  be  such,  he  must  consistently  pray  for 
hi<*  daily  bread.  In  praying  thus  the  lawyer  asks  for 
strife,  lawlessness  and  all  manner  of  cime.  The  doc- 
tor a>ks  for  sickness — ^for  physical  and  mental  suffer- 
ing, while  the  undertaker  asks  for  a  steady,  if  not  an 
increased  death  rate.  Can  they  do  this  cansisiently  with 
the  spirit  that  animates  the  Christian  religion  7 — Bt 
Med.  Gleaner. 

We  have  used  the  Pile  ointmeqt  made  by  Fred.  W. 
Stewart,  Oswego,  N.  Y.,  with  satisfaction. 

The  following  excerpt  may  be  familiar  to  many, 
but  it  is  worth    re-reading  :     "A  hoqse-keeper,    thf 


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149 


mother  of  eight  children,  was  raddenlj  seised  with 
insBiiity  and  confined  in  an  asyium.  The  husband, 
when  asked  as  to  the  cause  of  her  insanity,  said  he 
4X>a]d  conoeiye  of  no  possible  reason.  'She  was  a 
devoted  mother,  was  always  doing  something  for  as, 
was  always  at  home,  never  went  ont  of  the  house  even 
on  Sundays,  or  gadding  about  to  the  neighbors,  gossip- 
ing and  talking ;  she  was  the  best  of  wives ;  had  no 
ideas  outside  of  her  home.'  The  husband,'  said  the 
superintendent  of  the  asylum,  'has  furnished  a  graphic 
list  of  the  causes  of  his  wife's  insanity."  ' — N,  C  med. 
Jour, 

SEan>  to  the  Hastings'  Truss  Co.,  224  South  Ninth 
Stf  Philadelphia,  for  trusses  and  supporters. 

Ik  cholera  and  all  epidemics,  the  liquor  drinkers 
are  the  first  to  die. 


For  your 


of  vesical  irritation  use  Sanmetto. 


A  Joke  on  thk  Nubse. — ^This  story  is  about 
Philadelphia  twins.  The  nurse  was  giving  them  a 
hath.  Later,  hearing  the  children  laughing  in  bed, 
•she  said : 
"What  are  you  children  laughing  about?" 
**0h,  nothing,"  replied  Edna,  "only  you  have  given 
Edith  two  baths  and  haven't  given  me  any." 

The  Empire  Manufacturing  Co.,  Lockport,  N.  Y., 
make  a  fine  line  of  elastic  bandages,  abdominal  suppor- 
ters^umbilical  trusses  and  woven  elastic  goods  generally. 

The  Tabte  of  It. — I>octor*s  small  boy.  •*  Profes- 
sor, I  have  an  example  in  fractions  I  would  like  to 
have  you  work  for  me.  Will  you  do  it  for  me?"  "Pro- 
fnsor  of  Mathematics  (taking  out  pencil  and  paper.) — 
"  Yes,  my  boy;  what  is  it?"  Small  boy— "If  one 
bottle  holds  two  and  a  half  ounces  of  quinine— got  that 
down  ?  "  Profeesoi^"  Yes."  Small  boy—"  Well,  how 
doesittasto?" 

To  those  physicians  who  have  long  felt  the  want  of 
an  emergency  case  which  would  be  conveniently  car- 
ried in  Uie  pocket,  they  will  find  the  case  advertised 
by  H.  E.  Mulford  a  Co.,  in  this  journal  to  fill  this  want 
^mpletely. 


We  are  informed  that  the  Eclectic  Medical  Institote 
of  Cincinnati  has  many  more  students  than  any  other 
eclectic  college  in  this  country  ;  also  that  it  has  more 
students  than  any  other  medical  college  in  Cincinnati. 

The  fourth  annual  meeting  of  "  The  Association  of 
Military  Surgeons  of  the  United  States,"  will  be  held 
in  Washin^n,  D.  C.,  Ma^  1st,  2d  and  8d,  1894. 

This  national  organisation  is  composed  of  Medical 
Officers  of  the  U.  S.  Army,  U.  S.  Navy,  National 
Onard  of  the  United  States,  and  the  Hospital  Marine 
Service — in  whose  service  are  many  of  the  most  cele- 
brated and  distinguished  suigeons  of  our  country. 
Ueoboe  Hendebson, 
Chairman  Committee  of  Arrangements. 

Salo-Sbdatus  is  a  drug  that  is  usefnl  in  cases 
^laracterisHi  by  fever  and  pain.  Free  sample  by  ad- 
drearing  theSalo-Sedatus  Co.,  St.  Louis,  Mo. 

Dn>  you  notice  the  elegant  new  advertisement  of 
the  Walker  Pharmacal  Co.?  No  ?  Well,  you  are 
misnng  a  treat  if  you  do  not  refer  to  it  at  once. 

The  immense  success  that  thb  entorpriaing  firm  has 
met  with  in  the  manufacture  of  Phytoline,  and  the 
universal  commendation  accorded  them  by  the  medical 
profession,  has  induced  them  to  put  upon  the  market 
^  new  preparation  known  as  Pineoline,  made  from  the 
imported  etherial  extract  of  the  pine  needles.  It  pos- 
'"''^  not  only  a  pleasant  odor,  but  much  medicinal 


virtue.  It  has  been  used  by  some  of  the  most  promi- 
nent dermatologists  and  general  practitioners  m  this 
country  with  the  very  best  of  success. 

It  is  indicated  in  all  forms  of  skin  affections  and  in 
any  stage  in  which  they  may  be  found. 

Send  to  the  Walker  Pharmacal  Co. .  St  Louis,  for 
reports  and  clinical  cases  on  the  use  of  Pineoline  and 
Phytoline. 

Many  physicians  are  recommending  the  use  of 
Horlick*s  Midted  Milk  as  a  table  drink  in  place  of  tea. 
coffee,  cocoa,  ete.  The  evil  effects  of  long  continued 
use  of  tea  or  coffee  are  well  known,  but  the  diflicul^ 
has  been  to  provide  a  pleasant  and  satisfactory  substi- 
tute. Malted  Milk  is  a  perfect  soluble  combination  of 
pure  cow's  milk  and  an  extract  of  malted  grain,  and 
when  served  either  hot  or  iced  it  makes  one  of  the 
most  pleasant,  refreshing,  and  nutrious  drinks  imagin- 
able, little  if  any  more  expensive  than  the  ordin- 
ary drinks,  and  far  more  healthy  and  nutritious  for 
continued  use.  Does  not  stimulato,  but  aids  digestion, 
Pr(n>ared  by  simply  adding  water.  Address  the 
Malted  Milk  Co.,  Racine,  Wis.,  for  samples. 

Death  as  It  Is. — Perhaps  the  most  common  mis- 
take of  the  lay  mind  is  the  association  of  the  dramaUo 
with  the  conception  of  death.  Nothing  in  more  com- 
mon than  to  hear  from  the  pulpit,  pictures  in  words 
of  excitement,  of  alarm,  of  terror^  of  the  death-beds  of 
those  who  have  not  lived  religious  lives ;  yet,  as  a 
rule,  if  these  pictures  are  supposed  to  be  those  of  the 
unfortunates  at  the  moment  of  death,  they  are  utterly 
false.  In  point  of  fact,  ninety-nine  of  every  hundred 
human  beings  are  unconscious  for  several  hours  before 
death  comes  to  them ;  all  the  majesty  of  intellect,  the 
tender  beauty  of  thought  or  sympathy  or  charity,  the 
very  love  for  those  for  whom  love  has  filled  all  waking 
thoughtt^  disappear.  As  a  little  baby  just  bom  into 
the  world  is  out  a  little  animal,  so  the  sage,  the 
philosopher,  the  hero,  the  statesman,  he  whose 
thoughts  or  deeds  have  writ  themselves  large  in  the 
history  of  the  world,  become  but  dying  animals  at  the 
last.  A  merciful  unconsciousness  sets  in  as  the  mys- 
terious force  we  call  life  slowly  takes  leave  of  its  last 
citadel,  the  heart,  and  what  is  has  become  what  was. 
This  is  death. — Qyrus  Edson,  in  North  American  .Be- 
view. 

The  Pil.  Sumbul  Comp.  made  by  Wm.  R  Warner 
&  Co.,  Philadelphia,  is  a  good  treatment  for  the  ner- 
vous diseases  of  women. 

HoBNEUisyiLLE,  N.  Y.,  March  12, 1898. 

I  have  used  Freligh's  Tablets,  Cough  and  Constitu- 
ent, with  good  results,  and  can  recommend  them  to 
the  profession.  Freligh's  Tonic  has  always  aivea 
good  satisfaction  in  my  hands.    H.  Qilbebt,  M.D., 

Class  of  1867. 

The  Blackball. — ^This'is  a  most  troublesome  lit- 
tle globe.  It  may  present  itself  to  us  in  the  form  of  a 
black  ball,  or  in  the  answer,  no.  The  fact  is  we  use 
one  or  the  other  many  times  without  thinking  how 
serious  the  act  is..  Before  anybody  deliberately  votes 
to  deprive  a  fellow  creature  of  that  which  he  so  much 
desires  the  most  careful  thought  should  be  given.  The 
blackball  means  the  discouragement  and  sometimes 
the  ruin  of  the  man  who  receives  it ;  while  the  man 
who  gives  it  may  forget  all  about  it  in  an  hour.  We 
cannot  expect  everybody  to  think  precisely  as  we  do ; 
while  peniaps  with  our  aid  and  friendly  council  we 
may  do  the  individual  an  untold  amount  of  good.  Let 
us  be  very  careful  how  we  make  use  of  that  oangerous 
and  fatal  blackball. 

Use  Listerine  as  a  surgical  and  toilet  antiseptic 
Address  Lambert  Pharmacal  Co.,  St.  Louis,  Mo. 


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PeBF<ENA  OHEBnCAX'Co.,     > 

87  CoUege  Wace.  K.  Y.  Cit^.  / 
Gkntlbmen: — A    few    weeks    ago    I    receivcil  a 
phjsician'B  sample  of  Perpoena  from  yon ;  after  test- 
^ing  it  well  I  like  it  better  than  any  so  far  of  the  many 
coal  tar  derivatives.    Most  of  them  are  so  expensive 
(for  I  dispense  my  medicines,)  I  am  very  glad  to  find 
something  that  will  do  its  work  with  less  expense. 
Enclosed  please  find  50c.  for  one  onnce.    Yours  re- 
spectfully, Mb8.  Db.  Holmes, 
46  Union  Park,  Boston,  Mass. 
Kesidenoe,  Needham,  Mass. 

Try  Micajah*s  Uterine  Wafers.  Send  for  sample 
to  Micigah  A  Co.,  Warren,  Pa. 

Do  not  allow  yourself  to  read  a  moment  in  any 
jreclining  position,  whether  in  bed  or  on  a  sofa. 

Kennedy's  Extract  of  Pinus  Canadensis,  which  is 
DOW  made  by  the  Rio  Chemical  Co.,  of  8t.  Louis,  has 
long  been  known  in  this  country,  chiefly  from  the  en- 
dorsement it  received  from  the  late  Dr.  Marion  Sims, 
as  an  efficient  astringent  and  alterative  when  applied 
to  muoous  surfaces.  It  now  seems  to  be  coming  into 
extensive  use  in  England,  where  many  medical  men 
have  reported  excellent  results  with  it  in  various 
catarrhal  difficulties. 

Fob  ''Dyspepsia  Tablets"  and  pills  and  tablets  gen- 
erally, address,  the  P.  J.  Noyes  Manufacturing  Co., 
Lancaster,  N.  H. 

An  excellent  hair  tonic  is  made  by  scalding  two 
ounces  of  black  tea  in  a  gallon  of  boiling  water ;  strain 
and  add  three  ounces  of  glycerine,  tincture  of  can- 
tharides,  one  half  ounce,  and  bay  rum,  one  quart 
Mix  well  by  shaking  and  then  perfume. — Tex.  Health 
Jour. 

A  SIMPLE  remedy  for  a  rough  skin  is  to  first  wash 
the  face  thoroughly  at  night,  tnen  rub  it  with  about  a 
teaspoonful  of  cream,  and  let  it  dry  in.  The  skin  will 
look  shiny  and  feel  stiff*  at  first ;  but  in  the  morning 
you  will  be  surprised  to  find  how  soft  the  skin  will  be. 
— Health  and  Home, 

Fob  digestive  disturbances  use  Frye's  Pancreo-Bis- 
muth  and  Pepsin.  Sample  free.  Geo.  C.  Frye,  Chemist, 
Portland,  Me. 

Chas.  Day,  M.D.,  79  St.  Mark's  8<}uare,  London, 
•ays : — I  have  prescribed  your  preparation,  lodia,  with 
very  satisfactoiy  results.  Its  power  of  arresting  dis- 
chargee was  very  manifest  in  a  case  of  leucorrhoea, 
and  another  of  otorrhoea.  In  the  latter  case,  the  re- 
sult of  scarlet  fever  in  early  life,  the  discharge  had  ex- 
isted for  many  vears.  The  patient  could  distinctly 
feel  the  action  of  the  lodia  on  the  part,  and  the  dis- 
charge gradually  dried  up. 

Sybup  of  Figs  is  recommended  as  a  general  laxative. 

Pensions  fob  Physician's  Widows. — A  proper 
movement  has  been  undertaken  in  France,  where  it  is 

Sroposed  to  place  the  widows  of  medical  men  who  die 
unng  an  epidemic,  while  engaged  in  their  profes- 
sional duties,  upon  the  same  footing  as  widows  of 
officers  who  die  upon  the  battlefield,  with  the  inten- 
tion of  obtaining  for  the  one  the  same  compensation 
as  that  provided  for  the  other. — N.  Y.  Medtical  Journal, 

Mabohand's  Peroxide  of  Hydrogen  is  an  excellent 
antiseptic  and  disinfectant. 

Behold,  the  fool  saith,  ''Put  not  all  thine  eggs  in 
the  one  basket,"  which  is  but  a  manner  of  saying, 
'IBcatter  your  money  and  your  attention;"  but  the 


wise  man  saith  :     Put  all  thine  eggs  in  the  one  basket 

and — vxdch  that  basket, 

July  4th :  Statistics  show  that  we  lose  more  fools 
on  this  day  than  in  all  the  other  days  of  the  vear  put 
together.  This  proves,  by  the  number  left  m  stocky 
that  one  Fourth  of  July  per  year  is  inadequate,  the 
country  has  grown  so. — PtuUPnhead  WilwrCs  Oalmder 
for  1894. 

Bend  to  the  Diamond  Laboratory,  Naugatuck^ 
Conn.,  for  sample  of  Marshmallow  Cream. 

In  all  the  affiairs  of  life,  social  as  well  as  political, 
courtesies  of  a  small  and  trivial  character  are  the  ones 
which  strike  deeoest  to  the  grateful  and  appreciative 
heart. — Henry  Clay. 

Fob  all  chronic  bronchial  catarrhs  trv  fluid  extract 
of  Chekan,  prepared  by  Parke,  Davis  &  Co.,  Detroit, 
Mich. 

Tell  all  your  mothers  andjnurses  to  use  Dr.  Julias 
Fehr's  Baby  Powder. 

Send  to  J.  Phillips,  Atlanta,  Ga.,  for  fine  surgical 
instruments  at  cut  rates. 

Fob  instruction  in  the  treatment  of  the  morphine 
habit  address,  B.  Keith  &  Co.,  75  WiUiam  St.,  New 
York,  N.  Y. 

Do  YOU  need  a  good  diuretic  in  your  practice  ?  Send 
to  Schultse-Berge  St  Koechl,  79  Murray  St.,  New- 
York  for  the  new  diuretic,  Symphorol. 

Use  Vinolia  Cream  for  skin  diseases  characterised  by 
itching  and  burning. 

Fellow's  Compound  Syrup  of  the  Hypophosphltes 
is  a  standard  article. 

Removal.— We  have  removed  to  125-187  BeeA 
street,  where,  with  nearly  double  our  previous  manu- 
facturing space  but  much  lower  rent,  we  shall  be  able 
to  give  our  patrons  the  benefit  of  same.  Western 
Leather  Manufacturing  Co.,  125-187  Rees  street^ 
Chicago. 

We  have  always  had  satisfaction  with  the  supporters 
and  other  elastic  goods  we  have  purchased  of  G.  W. 
Flavell  &  Bro.,  1005  Spring  Garden  St.,  Phila. 

The  new  surgical  dressing,  Uneuentine,  manufac- 
tured by  the  Norwich  Pharmtu»d  Company  has  beei» 
introduced  to  the  profession  solely  on  its  merits.  It  ia 
now  used  extensively  in  the  laree  hospitals  and  is  oi- 
dorsed  and  prescribed  by  the  leading  surgeons  through* 
out  the  country  more  generallv  than  any  other  pre- 
paration of  its  kind  on  the  market  Thev  ask  you  to 
write  for  sample  and  literature  and  make  your  own 
personal  test. 

Send  to  Hall  &  Buckel,  216  Gr««nwich  St.,  New 
York,  for  sample  of  Sozoderma,  the  antiseptic  soap. 

Buy  your  spring  suit  of  £.  O.  Thompson,  PhiUu 

Antikamnia. — This  is  a  combination  of  elemeuta 
belonging  to  the  coal-tar  group,  and  is  an  American 
product.  It  is  a  white  crystalline  powder,  odorless, 
and  has  a  slightly  burning  taste ;  soluble  in  hot  water 
and  in  diluted  alcohol,  but  not  in  cold  water.  It  acts 
as  antipyretic*  analgesic  and  anodyne.  The  im- 
portance attached  to  this  drug,  I  think,  is  due  to  its 
anodvne  and  analgesic  power,  and  the  celerity  with 
which  it  acts.  As  an  antipyretic  in  fevers,  it  act» 
more  slowly  than  antipvrin,  but  is  not  attended  with 
as  much  depression  of  tne  cardiac  system  and  cyanoaiK. 
Whenever  a  sedative  and  an  analgesic  together  is  in- 
dicated, this  remedy  meets  the  demand.  la  severe 
{Continued  over  next  leaf. I 


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rtst  hangs  like  dust  about  the  hrain^  or  dries  like  raindrops  off  the  stones, — PROUiMt 


^YJjg    I^edicStl    ^ATorld.        ^erlt  a  continuance  of  the  lavish  praise^ that 

has  been  bestovired  upon  us,  we  should  be  satis- 
fied indeed. 


PUBUSBBD  MOXfTHLT,  by  C.  P.  TaTTOR,  M.  D. 


C  F.  Tayw)r,  M.  D., 
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Vol  xn. 


May.  1894. 


No.  5. 


Spring  18  here,  and  pardon  us  if  we  throw  off 
oar  heavy,  dark  suit  and  appear  in  a  lighter 
<me.  While  the  title  design  that  we  adopted 
banning  with  January  issue  has  been  much 
praised,  there  is  on  the  part  of  our  correspondents, 
a  commendable  inclination  toward  simplicity, 
plainness  and  distinctness  of  design,  something 
like  the  first  and  original  one,  before  any 
change  was  made.  The  present  design  is  an  at- 
tempt in  this  direction,  which  we  hope  will  be 
final.  Some  magazines  change  their  title  design 
cr^ery  month ;  for  example,  the  elegant  and 
widely^  circulated  Ladled  Home  Journal  But 
we  believe  the  title  page  should  be  like  the  face 
of  a  familiar  friend,  seldom  changing,  and  only 
for  the  better,  as  maturer  years  add  dignity  and 
expression  to  the  face.  But  after  all,  as  many 
have  written  us,  it  is  the  inside  that  determines 
the  value  of  a  magazine ;  and  if  our  effprts  can 


A  Commendable  Form  of  Speoiallamv 
One  of  the  most  valuable  facts  in  the  stild/ 
of  political  economy  is  that  of  division  of  labor^ 
whereby  each  worker  becomes  especially  skilled 
in  his  own  department  of  the  work.  In  medi* 
cine  this  has  thus  far  been  practicable  only  in 
the  cities,  where  there  is  enough  work  in  each 
specialty  to  justify  the  worker  in  devoting  hia 
time  exclusively  to*  it  Yet  we  have  long- 
thought  that  less  populous  communities  might 
enjoy  the  advantages  of  a  form  of  spedaiizing 
that  would  be  equally  as  beneficial. 

Let  us  suppose  a  town  in  which  thero  are 
seven  or  eight  physicians.  Let  each  one  retain 
his  portion,  as  he  may  succeed  in  obtaining  it» 
of  the  general  family  practice.  In  addition,  1^ 
each  one  make  special  preparation  for  the  more, 
advanced  practice  of  some  particular  specialty,, 
taking  special  course  of  instruction  and  pro- 
curing the  necessary  special  instruments  and  ap- 
paratus. Let  him,  then,  be  called  in  by  hia- 
fellow  practioners  in  all  cases  of  that  kmd  of' 
practice  presenting  difficulties  too  great  for  the 
general  practitioner,  and  charge  the  fees  usually 
received  by  specialists  therefor. 

Thus  Dr.  A.,  in  the  course  of  his  general' 
practice,  encounters  a  case  of  obfitetiics  in  which 
there  is  a  marked  deficiency  in  the  size  of  the 
pelvip.  Instead  of  sending  to  a  distant  city  for 
expert  help  or  himself  attempting  an  operation 
for  which  he  is  illy  prepared,  he  calls  in  Dr. 
B.,  the  gynecologist  of  his  community,  who  per- 
forms symphyseotomy  or  what  ever  other  major 
operation  best  suits  the  case  and  saves  two 
valuable  lives.  Dr.  A.,  in  turn,  is  called  in 
by  his  confreres  when  they  have  an  operation 
about  the  nasal  passages  or  the  throat,  requiring . 


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epecial  skill,  or  a  diffcult  ease  to  diagnose.  Dr. 
p.y  in  addition  to  his  general  practice,  cultivates 
the  special  branch  of  orthopedic  surgery .  Dr. 
D.,  operative  surgery;  Dr  E.,  skin  diseases; 
Dr.  F.,  the  eye  and  ear  ;  Dr.  G.,  nervous  dis- 
eases. 

The  advantage  of  this  method  of  organization 
of  medical  forces  would  be  many,  among  which 
we  yote  the  following : 

The  people  of  the  community  would  be  able 
to  command  better  professional  services.  When 
a  case  has  progressed  beyond  the  ability  of  the 
general  practitioner  the  patient  has  a  right  to 
the  benefit  of  the  services  of  a  trained  specialist. 

Each  physician  in  the  community  could  pur- 
sue his  practice  with  greater  confidence,  having 
the  satisfaction  of  knowing  that  he  could  readily 
obtain  the  best  of  assistance  in  cases  which  he 
could  not  successfully  manage.  ,  • 

Each  one  of  these  physicians  will  be  a  better 
specialist  because  of  the  fact  of  devoting  a  por- 
tion of  his  daily  work  to  the  general  practice, 
and  a  better  general  practitioner  by  reason  of 
his  deeper  studies  in  his  specialty. 

The  specialty  fees  and  practice  would  be  kept 
within  the  profession  of  that  community. 

The  physicians  of  a  town  in  which  such  an 
organization  of  medfcal  skill  is  effected  would 
be  able  to  extend  their  practice  farther  into  the 
surrounding  territory. 

We  hope  the  leading  spirits  of  each  town  will 
take  this  subject  up  for  consideration. 


Order  Out  of  Chaos. 
We  have  in  the  country  a  great  variety  of 
medical  laws,  in  force  in  the  different  states,  as 
shown  in  the  article  in  our  last  number  giving 
a  brief  abstract  of  those  \aw8.  This  gives  rise 
to  much  confusion,  and  often  to  injustice.  Yet 
it  merely  represents  the  endeavor  of  the  people 
to  attain  that  point  wl^re  they  may  be  assured 
that  those  who  are  allowed  to  practice  medicine, 
«urgery  and  obstetrics  shall  prove  themselves 
to  be  well  educated  in  the  fundamental  sciences 
of  the  profession.  The  result  of  these  endeavors 
is  yet  far  from  being  perfect  According  to 
these  results,  one  who  is  well  qualified  in  one 
state  is  not  qualified  at  all  in  another — and  it 
may  be  in  an  adjoining  state. 


Some  years  ago,  in  an  address  before  the 
Alumni  Association  of  the  Medico  Chirurgical 
CAll^e,  Prof.  Frank  Woodbury  expressed  the 
hope  that  the  United  States  Grovemment  would 
establish  a  medical  examining  board,  with  power 
to  examine  voluntary  applicants  for  a  degree  of 
"  Civil  Service  Physician,"  or  some  other  dis- 
tinguishing title.  This  was  intended  only  for  the 
title  of  distinction,  as  an  incentive  to  the  ambi- 
tion of  the  physician  and  to  encourage  him  to 
make  the  highest  special  preparation  for  the 
practice  in  order  to  be  ranked  among  those  who 
had  gained  the  distinction,  and  not  to  carry 
with  it  any  special  privilege.  He  was  led  to 
recommend  this  in  view  of  the  success  of  the 
government  army  and  navy  examining  boards. 

It  would  be  our  idea,  however,  to  have  a  na- 
tional examining  board,  whose  certificate  should, 
by  common  consent  of  the  authorities  of  the  dif- 
ferent states,  be  accepted  as  authority  for  prac- 
tice in  every  state  in  the  Union  without  further 
examination.  It  should  be  so  constituted  as  to 
do  justice  to  the  adherents  of  each  different 
medical  sect,  while  requiring  the  most  thorough 
scientific  knowledge  on  the  part  of  each  one  suc- 
cessfully passing  the  examination. 

In  brief,  the  advantages  of  a  national  board 
would  be: 

A  higher  standard  of  professional  attainment 
will  be  sought  by  students  at  once,  as,  finally, 
all  will  prefer  to  apply  for  this  certificate. 

A  physician  holding  this  certificate  will  not 
be  worried  as  to  state  requirements  if  he  should 
contemplate  moving  to  another  state. 

A  physician  living  near  a  state  border,  hold- 
ing this  certificate,  would  have  no  trouble  in 
accepting  calls  from  across  the  line. 

Lastly,  it  would  be  a  measure  of  great  expe- 
diency, public  policy  and  substantial  justice. 


Dr.  John  B.  Deaver,  of  the  Univermty  of 
Pennsylvania,  does  not  dilate  the  entire  urethra 
for  stricture  of  the  pendant  portion.  He  be- 
lieves that  there  is  no  use  in  disturbing  the 
prostatic  portion,  and  hence  possibly  the  proetate 
gland,  when  that  portion  is  not  involved.  For 
the  above  he  uses  short  bougies. 


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^di^riginal   (Jommunioations. 

8>"on  articles  on  tbe  treatment  of  diseaaea,  and  experience 
with  new  remedies,  are  solicited  from  the  profession  foi 
thtH  department ;  also  difficult  cases  for  diagnoais  and 
treatment 

amcles  accepted  moat  be  contributed  to  this  journal  onfy 
The  editors  are  not  responsible  for  views  expressed  by 
ccmtributors. 

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

Ortainly  it  is  exeeUeui  ditdpHntfor  an  author  to  feel  that  h4 
must  say  all  he  has  to  say  in  Uu  fewest  possible  words,  ot 
his  reader  is  sure  to  skip  them;  andin  the  plainest  possibli 
wordSt  or  his  reader  wtll  certainly  misunderstand  them. 
Generally,  also,  a  downright  faet  may  be  told  in  a  plain 
way:  and  we  want  dowmrigMJucts  at  present  more  than 
tything  «te.— Rrauif . 


READ.     REFLECT.     COMPARE.     RECORD. 


Appendicitit.—Canoer.— Replies. 

Editor  Medical  World: — As  general prac- 
titioners,  we  have  this  fault  to  find  with  the 
surgical  specialist  fraternity :  That  while  we 
may  have  treated  certain  affections  quite  satis- 
factorily before,  just  as  soon  as  the  surgeon  in- 
vades any  portion  of  the  human  body,  all  the 
previous  methods  of  treatment  seem  to  lose  their 
efficacy  and  become  valueless.  I  think  there 
are  two  explanations,  each  of  which  has  some 
truth.  Firstly,  when  we  believe  our  treatment 
is  the  very  best,  and  have  a  certain  reliance  on 
it,  that  belief  shows  itself  in  our  own  selves  and 
is  communicated  to  the  patient  But  when  we 
go  into  the  game  halfheartedly,  prescribing 
drugs  tentatively,  feeling  that  we  have  a  thera- 
peutic right  bower  up  our  sleeves  to  be  played  if 
Deeded,  the  doubt  is  also  communicated  to  the 
patient,  and  he,  too,  like  ourselves,  waits  for  the 
more  powerful  remedy  we  are  holding  back. 
How  much  effect  would  we  get  from  a  drug  if 
we  were  to  prescribe  it,  saying,  "  Til  give  you 
this  now,  and  if  it  does  not  help  you  Til  have 
to  fall  back  on  a  better  one,  which  I  have  all 
ready."  And  we  might  as  well  say  it  as  think 
it,  for  our  patients  know  it  all  the  same. 

But  sometimes  the  failure  of  old  methods  is 
due  simply  to  chance.  We  have  had  a  series 
of  cases  that  did  well ;  and  just  as  we  are  called 
upon  to  surrender  theae  cases  to  the  surgeon  we 
hive  one  of  those  that  coul  J  not  recover  without 
the  knife. 

I  have  recently  had  an  illustration  of  this. 
For  many  years  I  have  treated  all  cases  of  what 
we  called  "typhlitis,"  and  "perityphlitis"  by 
morphine,  albuminous  diet  and  hot  enemas, 
passed  as  far  up  Che  bowels  as  I  could  get  a 
tube  to  go.  I  do  not  know  how  many  cases  I 
had  during  my  23  years  of  practice,  but  there 
were  a  good  many.     All  recovered.     Not  one 


was  operated  upon.  But  in  the  summer  or 
1892  I  had  a  similar  case,  treated  in  the  same 
way.  Jtgot  better,  but  not  well.  There  re- 
mained a  painful  spot  in  the  abdomen,  becom- 
ing still  more  painful  on  exercise  or  over-eating. 
Several  slight  returns  were  controlled  in  the 
same  way,  and  then  he  had  a  sudden  invasion 
of  the  lungs  by  tubercle  bacilli,  occurring  under 
such  circumstances  as  to  convince  us  that  the 
abdominal  disease  was  really  a  focus  of  tuber- 
culosis, from  which  a  swarm  had  been  dis- 
charged into  the  lung.  So  that  I  am  now 
forced  to  r^ret  bitterly  that  I  did  not  operate 
on  this  man,  although  it  is  the  first  case  in  all 
my  practice  that  did  not  get  well  without  opera- 
tion. Is  there  any  way  by  which  a  diagnosis 
could  have  been  made,  showing  this  to  have 
been  tubercular?  Senn  does  jiot  give  any,  and 
I  do  not  know  whether  a  microscopical  examina- 
tion of  the  feces  would  have  helped.  It  might, 
and  I  shall  not  neglect  to  have  this  done  in  my 
next  case.  The  patient  was  not  tuberculous^ 
nor  was  one  in  his  family ;  but  his  mother  had 
died  of  consumption  of  the  lungs,  and  so  had 
several  members  of  the  family  who  lived  in  the 
same  house  just  before  he  moved  into  it. 

It  was  evidently  accidental  that  this  case  wa& 
my  last  Had  it  been  my  first,  I  would  prob- 
ably have  operated  on  a  majority  of  all  sub^e* 
quent  cases,  and  felt  very  little  confidence  in  any 
other  treatment 

In  regard  to  Dr.  Brewer's  observation  (page 
124)  upon  an  antagonism  between  vaccinia  and 
phthisis,  I  think  that  fuller  experience  will  show^ 
this  to  be  a  mistake.  Small-pox  itself  proved 
to  be  a  fruitful  cause  of  tuberculosis ;  many  of 
those  recovering  from  severe  attacks,  doing  so 
only  to  die  in  a  short  time  of  phthisis.  Scrofula, 
whose  relations  with  tuberculosis  are  so  intimate, 
is  much  less  frequent  since  small  pox  has  beoome 
rare.  This  power  to  arouse  to  activity  the 
latent  tendency  to  scrofula  or  tuberculosis  is 
shared  by  vaccinia,  although  I  doubt  the  lat- 
ter's  power  to  create  it,  de  novo.  In  children 
strongly  predisposed  to  such  disease  I  am  ver^ 
careful  about  vaccinating,  putting  it  of!  till  they 
are  well  grown,  and  in  the  best  health  (unless 
in  a  case  of  emergency)  and  then  vaccinating 
in  but  one  spot,  with  human  virus.  In  fact,  I 
try  to  minimize  the  danger,  realizing  that  it  is  a 
choice  of  two  evils.  Vaccination  with  the  strong 
bovine  virus  is  dangerous  in  such  cases,  as  I  have 
learned  by  experience.  I  will  add  here  that  my 
service  of  five  years  as  vaccine  physician  of 
Philadelphia,  in  which  time  I  vaccinated  over 
10,000  persons,  gave  me  an  unusual  oppor 
tunity  to  study  this  subject,  and  observe  both 
the  immediate  and  the  ulterior  effects  of  vacci- 
nation.    With  bovine  virus  there  is  a  further 


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ctanger,  in  that  the  points  are  sometimes  con- 
ilaminated  with  tubercle  bacilli.  I  have  wit- 
nessed more  than  one  case  where  localized 
tuberculosis,  followed  by  general  systemic  infec- 
tion and  death,  resulted  from  the  use  of  this 
virus.  In  fact,  one  of  the  largest  vaccine  farms 
in  this  country  was  closed  by  the  proprietors  on 
account  of  this  very  fact,  they  being  unable  to 
aid  the  premises  of  the  contaminating  bacillus. 

If  the  same  inoculation  transmits  vaccinia  and 
tuberculosis,  how  can  there  be  an  antagonism  ? 
That  there  is  such  an  antagonism  between  vac- 
cinia and  whooping  cough,  I  have  proved  re- 
f)eatedly. 

I  feel  confident  that  J)r.  Allen,  (page  124,) 
•did  not  employ  sufficient  intestinal  antisepsis  in 
jhis  case  of  typhoid  fever  with  temperature  over 
110°.  This  was  probably  due,  as  he  suggests, 
4o  meningeal  rheumatism.  In  one  such  case  I 
4ised  the  sulphocarbolate  of  zinc  and  salicylate 
of  soda  alternately,  in  full  doses,  with  the  best 
effects,  the  patient  recovering.  Ordinary  doses 
are  useless  here.  Give  20  grains  of  the  salicy- 
late every  two  hours,  and  keep  the  temperature 
•down  by  the  use  of  cold  water.  Is  there  a  fever 
that  cold  will  not  control? 

When  such  theories  are  propounded  as  that 
-attributing  cancer  to  tomatoes  (page  125),  or 
to  cider,  I  always  ask  the  question.  Why? 
What  is  the  connection  between  the  alleged 
xsause  and  the  efiect  ?  Not  that  we  can  always 
^ve  it ;  for  I  do  not  know  why  tomatoes  some- 
itimes  cause  eczema,  although  I  know  it  is  a  fact. 
But  here  there  is  a  plausible  explanation :  Per- 
•sons  who  are  liable  to  eczema,  of  the  '*  dartrous 
diathesis,''  as  the  French  say,  will  have  the 
•eruption  when  any  food  causes  dyspepsia  or 
acidity,  and  tomatoes  may  do  this.  So  will 
beer,  nuts,  cheese,  vinegar,  pie  and  iced  milk, 
lobsters  and  many  other  things.  It  is  the  di- 
gestive disturbance  that  really  sends  out  the 
eruption,  and  not  the  food  directly.  But  in 
cancer  there  is  absolutely  no  comprehensible 
connection  with  tomatoes,  and  such  a  causation 
is  opposed  to  the  little  we  know  of  the  pathology 
of  cancer.  The  most  persistent  and  enthusiastic 
bug  hunters  have  failed  totally  to  discover  a 
germ  causing  cancer ;  while  the  instances  of  its 
•development  at  the  point  of  local  injury  are 
abundant  The  best  definition  of  cancer  ever 
given  is  that  it  is  a  "  rebellion  of  cells."  The 
epithelium  on  the  skin  is  constantly  cast  ofi  and 
reproduced.  Sometimes,  instead  of  growing  out- 
wards it  turns  inwards,  and  grows  down  into  the 
«kin  and  the  tissues  underneath  ;  and  this  con- 
^tutes  cancer.  The  epithelial  cells  have  some- 
how acquired  a  vigor  disproportionate  to  the 
tissues  in  relation  to  them,  and  the  latter  give 
^my  before  the  encroachments  of  the  epithelium. 


As  to  why  and  now  the  latter  becomes  too  strong 
for  its  neighbors,  Broadbent  says  the  cause  ia 
eating  too  much  meat  My  own  observadona 
favor  this  theory.  But  what  are  any  one  man's 
observations  in  such  a  case !  Let  the  30,000 
World  children  combine  their  experience  and 
•  settle  this  matter  forever.  Let  each  one  note 
the  habits  of  any  cancer  cases  he  is  treating,  aa 
to  eating  meat  in  excess  of  the  actual  needs,  and 
combine  the  whole  in  one  grand  report.  What 
a  magnificent  jury  of  investigation. 

Dr.  Brown  (page  134)  has  recorded  a  very 
remarkable  case  of  spontaneous  lumbar  colotomy. 
If  he  is  sure  the  rectum  is  not  obstructed,  he 
would  better  allow  the  fistula  to  close  spontane- 
ously, unless  the  annoyance  is  so  great  as  to 
justify  operation. 

For  Dr.  Few's  case  of  somnolence  (page 
135)  I  would  suggest  an  eliminant  treatment, 
say,  the  iodide  and  bromide  of  pota^ium,  with 
change  to  a  mountainous  limrate,  if  possible. 

For  Dr.  Moore's  case  (page  135)  the  treat- 
ment of  gastric  ulcer.  Morphine  to  relieve  pain, 
alkalies  in  hot  water  an  hour  before  meals,  silver 
and  zinc  oxide  just  before  eating,  and  diet  such 
as  dots  not  cause  pain.  Keep  the  bowels  loose 
with  salines. 

**  Practitioner "  must  examine  his  patient's 
heart  and  see  if  there  is  pericarditis.  Otherwise 
I  would  attribute  the  symptoms  to  meningitia. 
In  either  case  give  iodide  of  potassium  in  full 
doses,  with  cathartics  ;  keep  him  in  a  cool,  dark 
room,  and  quiet,  on  1  )W  diet  For  hemorrhoids 
with  prolapsus,  inject  with  5  per  cent  carbolic 
solution,  dilating  the  sphincter  if  spas'nodic,  and 
performing  linear  cauterization ?  if  relaxed. 

Dr.  Mehring  would  better  take  that  cancer- 
ous breast  out  at  once,  and  give  his  patient  a 
chance  for  her  life. 

Dark  circles  about  the  eyes  are  due  to 
anemia,  constipation,  sitting  up  late  reading  or 
sewing,  or  to  sexual  excess  The  cause  will 
show  the  treatment  required  in  any  given  case. 

To  detect  adulterations  in  liquors.  Dr.  Mor- 
ton must  procure  a  work  on  the  subject  It  ia 
too  long  for  a  journal  article. 

Dr.  Usher  (page  136)  should  pass  a  sound 
into  his  patient's  urethra.  If  he  encounters  a 
painful  spot  in  the  prostatic  region,  inject  there 
oDe^drop  silver  solution,  one  per  cent,  and  use 
full  sized  metal  sounds  daily  till  the  tenderness 
has  disappeared. 

Will  Dr.  Holcombe  enrich  medical  literature 
by  a  description  of  the  cyanide  poisoning  in 
miners  ?  As  it  is  a  volatile  poison,  I  know  of 
no  prophylactic  but  to  keep  out  of  the  minea. 
Some  years  ago  I  investigated  some  cases  of 
poisoning  by  cyanide  fumes  in  a  print  worka^ 
Workmen  who  were  exposed  to  the  fumes  be- 


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came  iDseneible  and  were  carried  into  the  open 
air,  where  they  soon  recovered.  They  did  not 
retam  to  work  till  the  next  day,  but  this  was 
shrewdly  suspected  to  be  a  voluntary  holiday. 
No  ill  effects  were  reported,  even  with  those  who 
had  suffered  repeatesdly.  The  only  treatment 
employed  was  a  little  stimulation  with  whiskey 
or  ammonia. 

The  deluge  of  letters  continues,  and  nearly  all 
DOW  contain  postage;  a  number  enclose  fees. 
Many  are  of  such  interest  that  I  shall  send  them 
to  you  for  publication.  I  will  omit  the  writer's 
name  in  all  cases  unless  specially  requested  to 
leave  it  if  the  letter  is  published. 

William  F.  Wi^uoH,  M.D, 

103  State  St.,  Chicago,  111. 

[The  letters  referred  to  will  be  found  in 
another  part  of  this  journal. — Ed.] 


A  Large  Uterine  Fibroid  Removed  Six  Days  After 
Labor. 

Editor  Medical  World  : — On  the  night  of 
February  4th  I  was  called  to  attend  Mrs.  H., 
an  anemic  and  rather  delicate  woman  of  about 
40,  in  her  sixth  confinement  I  found  the  os 
widely  dilated,  the  child's  head  presenting  in  the 
anterior  part  of  the  pelvic  cavity,  and  a  soft, 
fleshy  body,  which  gave  to  the  examining  finger 
exadily  the  sensation  produced  by  the  placenta, 
presenting  in  the  posterior  part.  As  there  was 
no  hemorrhage  —  no  placenta  previa  —  this 
seemed  a  very  peculiar  condition  of  affairs. 
However,  to  be  candid,  I  looked  upon  this  as 
being  the  placenta,  pushed  it  up  and  endeavored 
to  get  the  head  to  take  its  place  and  fill  the 
pelvic  cavity.  I  succeeded.  Labor  progressed 
naturally,  and  the  woman  was  delivered  of  a 
medium- sized  female  child  in  the  morning. 
The  placenta  was  deKvered  without  much  trouble. 
The  uterus,  however,  presented  a  peculiar  ante- 
verled-Kke  appearance  and  was  very  prominent, 
raising  up  the  anterior  wall  of  the  abdomen. 
There  were  tronbhsome  after-pains  which  failed 
to  yield  satisfactorily  to  remedies. 

This  trouble  she  had  for  three  or  four  days 
during  her  previous  confinement  Retention  of 
orine  required  the  use  of  the  catheter.  The 
patient  complained  sometimes  that  her  womb 
was  coming  from  her,  and  while  catheterizing 
her  (which  I  did  by  exposing  her  and  endeavor 
iDg  to  cleanse  the  parts  around  the  urethral 
(Hifice,  to  prevent  the  introduction  of  discharges 
into  the  bladder;  I  noticed  a  dark  object  in  the 
vagina,  and  the  last  time  it  showed  itself 
prominently.  During  the  puerperal  period  it  is 
not  well  to  make  any  unnecessary  vaginal  ex- 
aminations, but  here  was  a  case  requiring  in- 
vestigation.    Upon  making  a  digital  examina- 


tion I  found  a  body  filling  the  vagina  and  ex- 
tending into  the  uterus.  Could  it  be  an  in- 
verted uterus  ?  Not  likely,  as  the  womb  could 
be  plainly  felt  in  the  abdomen.  I  inclined  to- 
the  theory  of  an  imperfectly  formed  child  or 
mole-like  condition.  Two  of  my  medical 
friends,  Dr.  L.  A.  Warren  and  Dr.  S.  T. 
Davis,  were  called  in  consultation.  A  inore 
careful  examination  showed  that  about  an  inch 
and  a  half  or  two  inches  above  the  margin  or 
the  OS  the  body  was  firmly  united  to  the  uterus, 
all  around,  except  in  front  for  perhaps  an  inch, 
where  there  was  an  opening  from  the  vagina 
into  the  uterine  cavity.  We  agreed  upon  the- 
diagnosis  of  a  uterine  fibroid,  though  it  was 
moscly  a  rather  soft  mass. 

I  introduced  my  hand  into  the  vagina  and 
endeavored  to  remove  the  mass.  I  succeeded 
in  partly  disintegradng  and  removing  a  small 
part,  when  the  strength  of  my  hand  gave  out ;. 
one  of  my  consultants  was  then  pressed  into* 
service,  and  after  considerable  pulling,  succeeded 
in  delivering  the  mass  outside  of  the  vagina.  It« 
was  a  huge  mass  and  presented  an  appearance 
somewhat  like  a  bunch  of  grapes.  It  was  a 
nest  of  fibroids,  varying  in  size  from  that  of  a 
hulled  walnut  or  smaller  to  that  of  a  hen's  egg. 
They  were  innumerable,  and  imbedded  in  a 
dense,  fibrous  stroma.  The  other  consultant 
now  commenced  work  and  literally  < 'dissected" 
the  mass  with  his  fingers.  Thus  this  peculiar* 
"nest"  of  fibroids  (which  half  filled  a  tin 
basin)  was  practically  removed  except  a  re- 
maining stump,  which  was  left  to  nature.  No- 
ligature  or  instrument  whatever  was  used. 
Hemorrhage  was  considerable  but  not  excessive. 
Ergot  was  prescribed  in  good  doses,  also  yaginal 
injections  of  a  teaspoonful  of  permanganate  of 
potash  to  a  pint  of  water.  The  operation  was- 
done  in  the  evening,  and  the  patient  had  a  good 
night's  rest  Moderate  fever  (now  almost  down 
to  normal)  and  a  frequent  pulse  were  about  the- 
only  symptoms  which  continued.  The  patient 
is  now  up  part  of  the  time. 

105  South  Queen  St,     Dr.  J.  K.  Shirk, 
Lancaster,  Pa. 


Uncertain  Value  of  ''  Authority." 

Editor  Medical  World  : — Some  years  ago 
a  shrewd  attorney  sought  to  embarrass  a  physi- 
cian on  the  witness  stand  in  a  medico- legal  case- 
by  first  getting  him  to  admit  that  the  writings 
of  certain  other  medical  men,  printed  in  book 
form,  were  "  authority,"  and,  later,  by  getting- 
him  to  tell  what  his  treatment  had  been  in  the 
case  then  before  the  jury,  and  proving  that  it 
was  different  from  the  ''authorities,"  to  sho^ 
that  the  doctor  had  been  guilty  ( f  malpractice. 
But  for  once  the  doctor  was  equal  to  the  occa- 


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sioD.  Foreseeing  such  a  possible  course  by  the 
attorney,  he  had  at  the  first  taken  the  broad 
ground  that  there  was  no  absolute  authority  in 
meilicine,  and  no  authority  of  any  kind  superior 
to  the  observation  and  experience  of  the  indi- 
vidual practitioner  in  any  given  case,  surgical 
or  otherwise,  that  came  into  his  hands.  This 
unexpected  stand  taken  by  the  "  medicine  man  " 
paralysed  the  little  scheme  of  the  man  of  law 
and  saved  the  doctor  from  all  embarrassment. 

So  much  by  way  of  preface. 

A  certain  physician  who  confined  his  work  to 
dermatology,  is  highly  educated  and  equipped 
by  long  experience  to  successfully  practice  his 
calling,  and  who  occupies  a  chair  in  a  college 
with  a  large  patronage,  some  years  ago  wrote  a 
rather  pretentious  work  on  diseases  of  the  skin. 
In  the  chapter  on  eczema  he  takes  the  ground 
—  while  admitting  his  ignorance  of  its  etiology 
—that  acute  eczema  will  always  be  recovered  ^ 
from  without  treatment  if  the  affected  area  is 
kept  clean  and  free  from  irritation  and  left  un- 
^  touched.  He  ridicules  the  idea  of  any  consti- 
tutional condition  being  a  causative  factor,  and 
appears  to  have  a  great  contempt  for  the  ignor- 
ant practitioner  who  gives  constitutional  treat- 
ment. 

So  much  for  the  dogmatic  attitude  of  a  "pro- 
fessor." 

Now  let  me  give  you  a  case.  Mrs.  X  was 
attacked  in  October  last  with  an  eczematous 
eruption  about  the  ears,  which  gradually  spread 
to  the  entire  scalp. 

Phjeicians  were  consulted  and  treatment 
given.  She  grew  worse  and,  five  months  after 
the  first  attack,  I  was  called  to  visit  her,  as  she 
could  not  visit  me  and  was,  in  fact,  bed-ridden. 
I  found  her  in  a  deplorable  condition.  The  skin 
was  thickened,  inflamed  and  torn  by  the  nails, 
and  in  the  axillary  spaces,  under  the  mammae, 
between  the  thighs,  about  the  waist,  in  the  flex- 
ures of  the  knees  and  elbows,  was  a  free  and 
never  ceasing  discharge  of  an  acid  excoriating 
juice  which  caused  much  annoyance  and  dis- 
tress. 

I  have  had  much  experience  with  eczema, 
acute  and  chronic,  and  at  first  did  not  know  but 
I  had  now  on  my  hands  a  very  white  elephant. 
I  did  not  commit  myself,  however,  but  made  a 
careful  investigation.  Her  great  dispondency, 
muddy  complexion,  flatulent  dyspepsia  and  red 
tongue  pointed  to  lithiasis.  I  called  for  the 
chamber  vessel,  and  the  brick  stain,  confirmed 
by  a  bit  of  litmus  paper,  proved  it,  at  least  to 
my  satisfaction. 

I  spoke  more  hopefully  to  the  down  hearted 
patient,  saying  not  that  she  would  "  get  along," 
or  *»  everything  would  be  right  in  time,"  but 
positively  assuring  her  that  she  would  soon  be 


cured,  and  at  once  put  her  upon  antilithic 
treatment.  Of  course,  I  did  not  neglect  the 
local  condition,  but  at  once  removed  her  greasy 
ointments  and  directed  cleansing  and  soothing 
applications. 

Almost  immediately  improvement  began  in 
the  general  and  local  conditions.  Her  spirits 
rose  and  she  speedily  left  her  bed.  Recovery 
from  the  eczema  was  rapid  and  unuiterrupted, 
and  now,  April  4th,  she  is  reported  by  her  hus- 
band as  doing  finely.  I  did  not  see  her  more 
than  the  one  time.  This  is  not  the  only  case  of 
the  kind  I  have  had,  even  finding  the  lithiasis 
accompanied  by  eczema  in  nursing  infants, 
where  local  treatment  did  no  good  till  the  faulty 
condition  of  the  blood  was  corrected. 

I  have  not  written  this  article  for  the  purpose 
of  reporting  cases,  but  to  inculcate  the  idea  that 
every  physician  should  pursue  his  investigations 
wholly  without  prejudice  and  entirely  unfettered 
by  the  dogmatic  claim  of  anyone  to  be  supreme 
authority,  givbg  the  views  of  any  man  only  the 
weight  that  it  can  be  proven  by  trial  to  possess. 

Oxford,  Kan.         Edward  Smith,  M.D., 


Turkey  Items. 

Editor  Medical  World  : — I  was  called 
yesterday  to  a  lying-in  patient  She  had  been 
in  labor  seven  days.  The  woman  had  suffered 
a  great  deal  during  her  pregnancy  from  remit- 
tent fever,  albuminuria,  etc  The  whole  body 
had  been  for  a  month  or  more  excessively  ed- 
ematous— ^in  fact,  at  one  time  I  thought  it  would 
be  impossible  for  her  to  recover,  so,  as  a  last  re- 
sort, I  put  her  on  large  doses  of  quinine,  when 
she  made  rapid  and  good  recovery.  She  was 
then  in  her  sixth  month,  but  went  on  to  full 
term. 

Pains  came  on  and  seemed  to  be  r^ular  and 
normal  according  to  the  report  of  the  woman 
that  was  attending  her.  The  uterus  dilated 
properly,  and  in  due  time ;  but  as  the  old 
woman  said  "the  thing  won't  come  down,  where 
I  can  get  hold  of  it"  So,  after  seven  days 
Turkish  patience  they  sent  for  me.  I  armed 
myself  with  the  obstetric  case,  a  bottle  of  chlo- 
roform and  some  carbolic  acid,  went  to  the 
house,  which  was  bed-room,  sitting  room,  parlor, 
dining  room  and  kitchen  in  one.  There  the  ex- 
pectant mother  was  sitting  on  her  bed,  on  the 
floor,  her  mother  sitting  at  her  back  supporting 
her.  While  waiting  for  hot  water  and  things 
to  be  gotten  ready — among  other  things  a  place 
to  put  her  on  for  examination,  and  application 
of  the  forceps  if  necessary — I  could  watch  her 
pains — she  only  had  one  or  two  and  they  were 
very  light,  not  of  the  nature  to  produce  rapid 
labor.     In  the  meantime  the  mid-wife  (?)  was 


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sent  for,  and  such  a  looking  thing  I  I  ques- 
tioned her  as  to  the  cause  of  the  protracted 
labor.  She  began  to  dilate  on  the  case  saying 
that  she  did  not  understand  this  one,  the  head 
would  advance  for  a  time  and  again  recede,  not 
coming  down  where  she  could  get  hold  of  it, 
how  she  had  used  her  fingers  as  a  lever,  and 
bad  applied  oil,  etc.,  all  to  no  purpose,  whereas 
she  had  never  been  baffled  before.  She  had  re- 
m3ved  many  a  child  by  piecemeal,  while  one 
she  had  cut  up  inside  the  womb  with  a  jack- 
knife  and  delivered  iL  The  woman  was  now 
ready — laid  on  a  box  in  lieu  of  a  proper  table. 
I  examined  her,  found  the  head  presenting,  but 
had  not  engaged  the  pelvis  It  was  still  within 
the  uterus,  the  fluids  had  all  passed  ofi  the  day 
before.  I  found  the  os  well  dilated  and  flaccid 
but  not  contraction  enough  to  expel  the  contents. 
The  presentation  was  occipitoanterior.  I  at 
once  applied  forceps  and  bjgan  to  make  traction, 
the  woman's  mother  giving  the  chloroform  ( I) 
The  head  was  large,  and  required  strong  pull- 
ing before  I  was  able  to  bring  it  through  under 
the  pubis,  but  after  this  was  relieved  it  was  easy 
sailing,  as  the  child  was  very  small.  They  had 
all  given  it  as  their  opinion  that  the  child  wm 
dead,  but  in  coming  in  contact  with  the  air  life 
was  evident  After  a  moment  or  two  a  feeble 
cry  showed  that  the  air  had  entered  the  lungs 
and  the  circulation  was  established. 

My  pocket  case  was  not  convenient,  so  I  called 
for  something  to  sever  the  cord.  Away  with 
your  high  toned  antiseptic  precaution  in  cases  of 
labor !  Now  you  should  have  seen  the  knife  that 
was  brought.  (I  propose  securing  it,  and  the 
bunch  of  thread  that  was  used,  for  the  Museum 
of  Fine  Arts  !)  It  was  fully  six  inches  long,  an 
inch  and  a  half  wide  and  rusted  from  handle  to 
point.  I  protested,  but  while  protesting  she  was 
sawing,  and  off  it  came,  not  a  drop  of  blood  fol- 
lowing, as  might  be  expected,  but  to  make  safety 
doubly  safe,  she  called  for  a  thread.  A  bunch 
was  picked  up  from  under  foot,  a  piece  broken 
of!  and  applied.  Then  a  candle  was  called  for 
to  scorch  the  end  of  the  stump  !  But  I  objected 
30  vigorously  that  they  desisted,  while  I  was 
there  at  least  Then  the  "old  woman"  insisted 
on  At  once  introducing  her  hand,  without  the 
least  antiseptic  precautions  and  removing  the 
the  placenta,  declaring  it  would  turn  over  on  to 
her  stomach  and  smot^ber  her !  But  I  made  her 
place  one  hand  over  the  womb  and  the  other 
grasp  the  cord  and  make  light  traction.  A  few 
seconds  only  had  passed  when  she  called  out, 
"I've  got  it"  and  came  across  the  room  with  it 
dangling  by  the  cord. 

D.  M.  B.  Thom,  M.D., 
Mardin,  Turkey  in  Asia. 


Consauguineoua  Marriages  From  a  Turkish  Point 
*     of  View. 

Editor  Medical  World  : — Every  time  I 
receive  your  most  instructive  journal,  which  I 
call  my  consultant  I  read  it  with  great  atten- 
tion and  pleasure.  In  many  of  its  numbers  I 
met  with  the  consanguineous  and  intermarriage 
question  and  read  it  with  great  interest  Al- 
though being  a  foreigner  and  not  able  to  write 
liberal  articles  concerning  the  question,  yet  I  do 
not  know  why  some  of  your  disputants  take  the 
the  trouble  of  going  to  remote  periods,  to  the 
families  of  Pharaos  and  others  for  their  help 
and  do  not  apply  to  their  contemporary  Musli- 
man  brethren,  the  vast  multitudes  of  so  many 
millions  of  Mohamedan  people,  for  the  solution 
of  this  question.  Their  religion  permits  them 
to  marry  with  their  near  relations — their  cous- 
ins, cousin- german,  generally  in  one  family, 
often  in  the  same  house,  and  still  their  offspring 
are  as  healthy  and,  physically,  as  well-made,  if 
not  more,  in  comparison  with  us  the  Christians. 
My  observation  coincides  with  the  opinion  of 
Dr.  Waugh,  that  is,  it  does  not  endanger  the 
future  generation  while  there  is  not  a  taint  of 
disease  in  either,  or  both  parties.  And  we  see 
by  our  daily  experience  that  there  is  no  more 
imbecile  production  in  those  people  whose  re- 
ligion permits  the  marriage  in  relationship 
than  in  those  among  whom  consanguineous  mar- 
riage is  prohibited  or  interdicted.  And  I  am 
of  opinion  that  the  superstition,  poverty  and 
some  other  causes  play  a  greater  action  in  this 
question  than  any  other  mentioned  in  the  arti- 
cles published  in  your  valuable  paper. 

O.  M.  Damaxion,  M.  D., 

Keghi,  Turkey,  Asia  Minor. 

Tubercular  Testicle.— Answer  to  interrogator. 

Editor  Medical  World.: — I  have  not  sent 
you  anything  for  publication  for  sometime,  but 
a  case  of  **swelled  testicle"  that  has  lately 
passed  through  my  hands  is  interesting  in 
several  ways. 

A  healthy  man,  38  years  old,  who  lost  his  wife 
about  three  years  ago  of  chronic  consumption 
(phthisis  pulmonalLs,  no  doubt  from  the  history, 
I  never  saw  her)  supposed  that  he  contracted 
gonorrhea  in  August  1893,  but  the  only  symp- 
tom was  a  burning  or  smarting  pain  in  the 
urethra.  There  was  no  discharge ;  no  pain  in 
urinating  or  any  of  the  usual  symptoms  of  clap. 
A  regular  ph)  sician  of  good  reputation  in  Min- 
neapolis diagnosed  ^'gonorrhea  sicca" — dry  clap 
—and  treated  it  with  injections.  Shortly  after 
an  abcess  formed  in  the  right  testicle  and  was 
lanced,  but  would  not  heal  and  the  swelling  re- 
mained uninfluenced  by  treatment     He  came 


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W66t  and  fell  into  my  hands  the  last  of  Septem- 
ber, 1893.  I  was  somewhat  puzzled  about  the 
diagnosis,  but  after  a  few  weeks  treatment  and 
a  more  careful  inquiry  into  the  history  of  the 
case  I  became  convinced  that  he  had  a 
tubucular  testis  and  had  never  had  gon- 
orrhea at  all.  I  then  advised  him  to  have  the 
organ  removed.  He  was  loth  to  lose  his  dear- 
est member,  but  after  several  weeks  more  treat- 
ment and  getting  the  advice  of  another  aoctor, 
who  also  advised  castration,  he  finally  submit- 
ted to  the  inevitable.  I  sent  him  to  the  Fanny 
Paddock  Hospital  in  Taooma,  and  Dr.  Yocum 
and  myself  removed  the  diseased  testicle.  It 
was  found  to  be  destroyed  by  tuberculous  de- 
posits and  the  vas  deferens  was  enlarged,  and 
probably  the  vesiculse  seminales  are  ako  filled 
with  tubercular  matter.  The  wound  healed  by 
first  intention  and  he  feels  pretty  well,  but  the 
prognosis  is  not  good. 

"Dry  clap,'*  to  my  mind,  does  not  exist.  The 
trouble  so  denominated  is  either  a  neurosis  or  a 
tuberculosis.  The  stinging,  smarting  pain  in  the 
urethra,  that  is  relieved  by  passing  water,  will 
be  found  in  cases  of  tubercular  testis,  although 
I  have  not  found  it  mentioned  in  any  of  the 
books.  If  all  the  readers  of  this  article  will 
keep  this  symptom  in  mind  for  a  year  or  two 
and  report,  we  will  find  out  whether  this  symp- 
tom is  always  present  in  tubercular  testis  and 
enable  us  to  make  a  diagnosis  earlier  than  is 
generally  done  now. 

This  patient  says  he  has  had  this  dry,  smart- 
ing, not  severe,  painful  sensation  in  the  urethra 
and  about  the  glans  penis  for  three  or  four 
years.  For  three  years  it  would  come  and  go 
irregularly,  but  after  having  one  illicit  coitus, 
two  years  after  the  death  of  his  wife,  he  was  so 
frightened  by  the  smarting  which  grew  gradu- 
ally worse,  that  he  sought  treatment,  with  the 
result  stated.  I  hope  to  keep  track  of  this  case 
and  will  report  the  final  outcome  if  I  can. 

Interrogator's  dozen  questions,  on  page  102 
of  the  March  number  of  the  World  remind  me 
of  the  query  so  oflen  heard  on  the  streets  when 
somebody  asks  an  unanswerable  question,  "Oh, 
ask  something  easy."  For  Interrogator  has 
asked  some  of  the  most  difficult  questions  in  the 
whole  range  of  medicine.  They  are  all  perti- 
nent enough,  but  who  is  able  to  answer  them 
all  ?  I  have  wrestled  with  them  for  some  days 
now  and  will  give  your  readers  what  light  I  can 
on  them,  hoping  others  will  supplement  my  re- 
marks and  by  a  united  effort  answer  them  all 
perfectly.  1  will  reply  by  the  number  of  each 
to  save  space,  and  the  reader  can  turn  to  the 
March  World  for  the  questions. 

1.  **Carron  oil" — Linimentum  calcis.  There 
is  nothing  y^t  discovered  any  better.     Use  it 


freely  on  surgeons'  lint,  so  the  air  will  be  en- 
tirely excluded  and  the  lint  prevented  from 
sticking.  If  the  oil— linseed —be  first  brought 
to  a  boiling  heat  and  the  lime  water  freshly 
made  it  will  be  antiseptic  The  prognosis,  in 
the  case  mentioned,  is  grave,  especially  if  the 
corium  is  reached  by  the  bum. 

2.  Almost  all  ordinary  drugs  in  moderate 
doses,  for  a  short  time,  but  all  powerful  medi- 
cines should  be  given  in  small  doses  and  care- 
fully watched.  I  am  not  aware  of  any  conclu- 
sive experiments  that  have  been  made  on  the 
pregnant  human  female,  to  determine  the  abil- 
ity of  the  placenta  to  prevent  poisons  circulating 
in  the  blood  of  the  mother  from  passing  into  the 
blood  of  the  fetus.  The  uterine  milk  so  called, 
which  is  found  in  the  cow  and  other  animals, 
does  not  seem  to  have  been  demonstrated  in  the 
human  placenta  and  there  may  not  be  as  much 
protection  for  the  huitaan  fetus  from  poison  as  in 
animals.  It  has  been  shown  by  Walter  that 
pregnant  animals  poisoned  by  strychnine,  mor- 
phine, veratrine,  curara  and  ergotin  had  died 
before  any  of  these  drugs  had  passed  into  the 
fetal  circulation.  While  Savory  found  that 
strychnine  injected  into  the  fetus  of  a  bitch  in 
utero  produced  tetanic  convulsions  in  the  mother^ 
Laudois.  It  has  been  shown  by  various  obser- 
vers that  many  drugs,  some  forms  of  virus  and 
miasms  pass  readily  from  the  mother  to  the  fiHus. 
Phosphorus,  lead  and  arsenic  are  dangerous  to 
fetal  life  if  taken  in  any  way  by  the  mother 
during  pregnancy.     CharpetUier. 

I  have  seen  one  case  where  a  large  dose  of 
morphine  taken  by  a  pregnant  woman  near 
term  caused  the  child  to  lie  dormant  several 
hours,  but  it  began  to  kick  vigorously  again 
after  the  morphine  had  passed  out  of  the 
mother's  circulation.  I  have  no  doubt  that 
many  a  child  is  injured  by  drugs  given  to  the 
mother  both  during  pregnancy  and  lactation. 

All  drugs  that  produce  convulsions  and  de- 
pression of  the  heart  should  not  be  given  to- 
pregnant  women  in  large  doses  or  very  frequent- 
ly for  a  long  time.  Only  harmless  medicines 
should  be  administered  during  gestation.  The 
same  rule  holds  good  in  lactation. 

8.  It  has  been  shown  that  many  drug«  are 
secreted  with  the  milk  if  ^ven  to  the  nursing 
mother.  As  this  is  a  very  important  matter 
and  many  physicians  seem  to  have  overlooked 
the  danger  of  poisoning  a  nursing  infant  by  giv- 
ing the  mother  powerful  medidnee,  I  will  go 
into  some  detail  in  this  matter.  From  various 
sources  and  observation  I  find  that  morphine  in 
large  doses,  salicylate  of  sodium,  iodide  of  pot- 
assium, ferrocvanide  of  potassium,  iodoform,  at- 
ropine, chloral  and  mercurials  are  all  more  or 
less    found    in   the  milk  when  taken    by  the 


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mother.  But  oujj  a  few  of  them  affected  the 
noraling. 

Atropine  is  very  dangerous,  all  preparations 
of  opium  somewhat  so,  iodoform  long  continued 
becomes  dangerous ;  from  the  rest  there  is  no 
serious  danger  if  not  too  long  continued. 

Aconite,  strychnine,  and  digitalis  in  small 
doses  have  not  done  barm  to  nursing  infants  so 
far  as  I  know,  still  I  always  give  them  cau- 
tiously. More  experimentation  is  required  be- 
fore we  can  know  about  all  drugs  in  this  respect 

4.  The  best  treatment  is  not  to  allow  it  to  be 
suppressed.  Most  of  such  cases  are  caused  by 
some  form  of  puerperal  fever,  and  prevention  is 
vastly  better  than  cure.     In  most  such  cases 

^  intra  uterine  douches  of  antiseptics  and  a  com- 
bination of  quinine  ergotin  and  opium  in  mod- 
erate dose)  will  work  well.  If  the  woman  has 
had  a  chill,  followed  by  sweating,  headache  and 
high  temperature,  be  sure  there  is  some  form  of 
blood  poisoning  that  presages  danger  and  re- 
quires immediate  and  very  active  treatment 
Search  for  retained  membranes,  placental  tid^ue, 
clots  or  tears  in  the  uterus  and  remove  them 
and  disinfect  the  uterus  thoroughly.  A  few 
cases  may  arise  from  cold,  fright,  etc.,  which 
will  not  need  any  special  medication,  beyond 
that  required  by  the  general  condition. 

5.  1  have  done  both,  and  like  a  combina- 
tion best.  All  bulky  medicines  should  be  writ- 
ten for  and  those  requiring  but  one  or  two  doses 
and  in  emergencies  should  be  dispensed  by  the 
physician  from  his  satchel  or  pocket  case. 

8.  Not  necessarily.  Quite  often  menstrua- 
tion will  be  brought  on  a  week  or  two  in  ad- 
vance of  the  proper  time  by  any  acute  disease, 
but  I  have  not  seen  any  serious  results  from  it 

9.  I  have  never  observed  any  marked  effect. 
12.  This  question  is  a  poser.     What  is  the 

doctor  driving  at,  anyway  ?  Does  he  not  know 
that  a  woman's  abdomen  has  more  possibilities 
of  deceiving  the  average  doctor  than  anything 
else  that  comes  under  his  scrutiny?  Indeed, 
have  not  the  very  elect  of  our  profession  been 
deceived  over  and  over  again  by  the  strange 
freaks  of  this  part  of  the  anatomy  of  the  fair  sex. 
I  think  this  question  needs  explaining.  Does 
be  mean  the  eighth  week  of  the  fever  or  the 
pregnancy?  Anyway,  anjrthing  imaginable 
may  happen  to  a  pregnant  woman  or  one  who 
supposes  she  is  pregnant  Only  by  long  and 
careful  observation  and  repeated  examinations 
can  any  one  be  sure  of  the  exact  condition  of  an 
abnormally  enlarged  abdomen  in  a  woman. 

I  hope  some  one  will  answer  the  questions  I 
have  omitted  and  also  report  any  case  of  poison- 
ing of  either  the  fetus  or  the  nursling  by  drugs 
taken  by  the  mother. 
Puyallup,  Wash.     T.  W.  Musgrove,  M.D., 


On  the  Action  of  Cabbage  Leaves  on  Uloers  and 
Diseases  of  the  SIcin. 

Editor  Medical  World  : — Dr.  Blanc  has 
published  in  some  numbers  of  Revue  de  Thera- 
peutique  a  very  long  memoir  on  the  above.  I 
have  not  space  to  reproduce  it  but  I  believe  it 
would  interest  your  readers  if  I  introduced  to 
them  at  least  his  conclusions.  Moreover,  he 
works  with  an  external  therapeutic  agent  so 
easy  to  obtain  that  its  name  alone  is  sufficient 
to  arrest  the  attention  of  medical  men.  This 
memoir.  Dr.  Blanc  says,  in  closing,  establishes 
sufficiently  how  useful  the  cabbageJeaf  is  in 
many  cutaneous  diseases,  by  actions  new  in  a 
practical  as  well  as  a  theoretical  point  of  view. 
These  facts  have  their  laws.  I  will  formulate 
them  as  I  understand  it  in  the  following  propo- 
sitions : 

1.  The  cab%age-leaf  excites  and  augments 
suppuration  or  the  secretion  of  ulcers,  ulcera- 
tions vesicles  and  pustules.  It  has  the  same 
action  on  the  integuments  affected  by  an 
erysipelatous  or  furunculous  inflammation,  but 
favors  the  recovery  of  tissue  b  a  morbid  condition. 

2.  This  augmentation  of  suppuration  is  con- 
stantly followed  by  an  amelioration  and  often 
by  a  cure.  It  is  the  condition  necessary  to  the 
result,  and  the  property  of  the  leaf  which  de- 
termines this  result  is  an  indirectly  curative 
property. 

3.  This  property  does  not  consist  in  any 
principle  which  the  leaf  yields  for  absorption, 
but  rather  in  an  affinity  which  the  leaf  has  for 
the  secretions. 

4.  The  leaf  exercises  this  affinity  on  open 
ulcers  covered  by  a  thick  or  thin  scab  or  crust , 
it  exercises  it  on  the  thickened  epidermis  or 
where  it  is  converted  into  thickened  rind  like 
membranes;  in  simple  or  confluent  variola, 
throughout  mortified  tissues,  through  the  in- 
teguments either  inflamed  or  non-inflamed, 
and  favors  the  recovery  of  tumors  capable  of  ab- 
sorption. 

5.  When  the  integumentary  affection  is  wide- 
spread or  general,  the  action  of  the  leaves  on 
the  parts  where  they  are  applied  benefits  the 
whole  disease. 

6.  The  matter  in  the  parts  not  covered  by 
leaves  is  absorbed,  and  at  once  directed  under 
the  leaves  to  be  immediately  excreted  at  that  part 

7.  Treatment  by  the  leaves  of  a  suppurative 
affection  prevents  re-absorption  and  consequent 
pyemia. 

8.  The  cure  obtained  by  this  means  is  more 
complete  and  certain  than  by  any  other,  be- 
cause it  is  brought  about  only  when  the  cause 
and  products  of  disease  are  eliminated  from  the 
system. 


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9.  This  mode  of  treatment  is  in  perfect  har- 
mony of  action  with  the  vis  medicatrix  naturm. 
This  essays  in  skin  diseases  t6  eject  from  the 
system  their  cause  and  effects,  whilst  the  leaves 
aid  this  action. 

10.  The  cure  of  an  ulcer  by  the  leaves,  how- 
ever wide-spread  and  longstanding  it  may  be, 
is  without  danger,  and  relapse  is  very  rare. 

11.  The  cicatrices  obtained  by  the  leaves 
are  remarkable  for  their  small  degree  of  de- 
formity. • 

12.  Smallpox,  measles,  and  scarlatina 
treated  by  applications  of  the  leaves  have  few 
or  no  sequelae ;  e.  g.,  phthisis  is  not  to  be  feared. 

13.  The  cabbage  which  is  employed  extern- 
ally and  in  the  natural  condition  cannot,  at  the 
time,  yield  to  the  organism  any  principle  cap- 
able of  neutralizing  the  cause  of  a  malady  and 
destroying  its  effects ;  and  since  the  cure  oper- 
ates by  suppuration  and  secretion^  induced  and 
stimulated  by  the  leaves,  we  must  conclude — 

1st.  That  in  case  of  a  cure  the  cause  of  the 
disease  has  been  excreted  by  secretion  or  sup- 
puration. 

2d.  That  some  diseases  have  for  their  imme- 
diate cause  a  vitiation  sui  generis  of  the  fluids. 

3d.  That  the  vis  medicatrix  proceeds  to  the  cure 
of  these  diseases  by  driving  the  vitiated  matters 
towards  the  integumentary  covering  where  it 
spreads  them,  eliminating  them  afterwards  by 
vesicles,  pustules,  or  the  excretory  vessels  on 
the  inflamed  or  ulcerated  surfaces. 

14.  These  operations  take  place  in  a  diseased 
body ;  they  are  then  diseased  functions,  func- 
tions which  have  the  integuments  for  organs — 
the  integuments  modified  by  the  inflammation, 
either  simple,  vesicular,  pustular,  or  serous. 

15.  The  leaves  are  the  auxiliaries  of  this 
function ;  they  attract  it  out  by  their  affinity  for 
vitiated  fluids. 

16.  This  elimination  accomplished,  the  means 
which  have  served  for  it,  I  should  say  the  modi- 
fications of  the  integuments,  being  no  longer  re- 
quired, disappear  ;  they  are  cured. 

17.  This  mode  of  cure,  this  treatment,  I 
would  call  a  cutaneous  depuration. 

Dr.  Carl  Berck, 
52  Fourth  St.,  German  Physician, 

Fl  Wayne,  Ind. 

Amputation  (?)  in  Utero. 

Editor  Medical  World  : — As  among  the 
unusual  experiences  of  the  physician  the  follow- 
ing case  is  related : 

Mrs.  S.,  aged  42,  was  married  about  two 
years  i^o.  I  was  called  March  27th  to  attend 
her  in  her  first  confinement.  When  the  baby, 
a  girl,  was  delivered  it  was  found  that  she  was 
minus  the  left  fore-arm  to  within  about  one  and 


a  half  inches  of  the  elbow  joint.  Extension 
and  flexion  of  the  stump  were  perfect.  The 
radius  was  about  one-half  inch  longer  than  the 
ulna  and  the  stump  was  conical  and  as  well 
fashioned  as  though  shaped  by  the  most  expert 
surgeon.  The  babe  weighed  nine  pounds  and 
was  plump  and  well  formed  in  every  other 
respect. 

A  thorough  examination  of  the  secundines 
was  made,  but  no  trace  of  the  severed  arm  was 
found,  which  would  go  to  show  that  if  the  arm 
was  amputated  in  utero  it  occurred  during  the 
earlier  weeks  of  fetal  life.  It  may  be  that  a 
more  plausible  supposition  would  be  that  it  was 
a  case  of  arrested  development. 

These  cases  are  of  sufficient  variety  to  make  ^ 
mteresting  the  recording  of  all  such  occurrences. 

Humboldt,  Neb.         L.  B.  Allen,  M.D., 


Placenta  Previa.— Hour  Glass  Contraction. 

Editor  Medical  World  : — I  have  two  cases 
of  obstetrics  to  report  which  may  be  of  interest 
to  y(Jur  readers : 

Mrs.  H.,  aged  35,  mother  of  5  children.  I 
was  called  at  6  a.  m.,  Jan.  3d ;  found  patient 
flowing  rapidly  and  had  been  for  over  an  hour. 
Had  no  pains ;  was  much  prostrated.  On  ex- 
amination I  found  placenta  previa  and  could 
just  make  out  the  head  of  the  child  presenting. 
I  gave  ergot  by  stomach  and  repeated  in  half  an 
hour  with  result  of  causing  vomiting,  much  de- 
bility and  increasing  flooding. 

I  then  gave  ergotine  hypodermically  and, 
after  making  careful  examinations,  introduced  a 
finger  within  the  os  and  broke  loose  the  adhes- 
sions  of  the  placenta  as  high  up  as  I  could  reach 
with  my  fingers. 

I  then  ruptured  the  membranes  at  a  point 
that  seemed  thinner  than  others  of  the  present- 
ing parts,  and  pains  came  on,  and  as  the  child's 
\x&sA  engaged  within  the  6s,  hemorrhage  ceased 
and  labor  finally  terminated  at  2  p.  m. 

The  woman  was  delivered  of  a  dead  child,  it 
having  the  appearance  of  being  dead  several 
hours. 

At  no  time  after  being  called  did  I  consider 
the  child  could  be  turned  without  the  loss  of 
the  mother,  as  she  was  so  completely  prostrated 
that  fainting  occurred  several  times.  The 
mother  has  now  completely  recovered. 

Question :  Did  the  child  die  from  the  hem- 
orrhf^e  or  had  the  ergot  something  to  do  with 
its  death  ? 

Is  there  any  other  plan  that  could  have  been 
adopted  with  prospects  of  better  results  ? 

Case  2d.  Mrs.  J.,  aged  30,  first  child,  was 
under  the  care  of  two  midwives,  and  had  been 
in  labor  36  hours  when  I  was  called.  On  ex- 
amination I  found  the  os  dilating  and  dilatable. 


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and  DO  cause  for  delay,  only  want  of  proper 
pain?.  I  gave  ergot,  pains  came  on  rapidly 
and  in  less  than  one  hour  the  woman  was  de- 
livered of  a  fine,  live  and  healthy  child. 

But  here  is  where  my  trouble  began.  After 
waiting  a  half  hour  I  undertook  to  remove  the 
placenta  by  expression  and  slight  traction.  I 
found  that  I  could  not  succeed  then.  After 
waiting  an  hour  longer  I  introduced  my  hand 
into  the  womb,  tracing  up  the  placenta,  found 
a  constriction  of  womb  and  fully  half  of  the 
placenta  above  the  constriction. 

After  a  good  deal  of  patience  and  hard  work 
I  succeeded  in  removing  the  entire  placenta, 
which  was  not  torn  or  showing  any  signs  of 
adhesions.  The  mother  and  child  are  both 
doing  well. 

I  suppose  this  was  a  genuine  case  of  hour- 
glass contraction. 

It  is  the  first  one  I  have  found  in  a  practice 
of  thirty  years.  Again,  had  the  ergot  anytbiog 
to  do  with  it?  Well,  if  we  cannot  me  ergot, 
what  can  we  use  with  any  certainty  to  increase 
and  maintain  strong  pains  and  hasten  labor  ? 
J.  A.  Huntsman,  M.D., 

Austin.  Nevada. 

[The  Doctor  very  justly  suspects  that  the 
modern  practice  will  advise  f^ainst  the  use  of 
ergot  to  hasten  the  delivery  of  either  child  or 
placenta.  The  better  drugs,  if  any  are  needed, 
are  quinine,  strychnine,  as  general  tonics,  and 
viburnum  and  other  special  uterine  tonics. 
These  drugs  have  been  discussed  considerably 
in  this  journal  during  the  past  year. — Ed.] 

Action  of  Quinine  and  Ergot  on  the  Uterus.— 

Anti-Malarial  Treatment— Treatment 

for  DipHtheria  and  Croup. 

Editor  Medical  World  : — I,  too,  with  Dr. 
Gilliland,  have  long  noted  the  fact  that  sul- 
phate of  quinine  exciter  uterine  action. 

Having  practiced  medicine  mauy  years  in 
malarious  regions,  I  learned  that  it  was  unsafe, 
to  give  curative  doses  of  quinine  to    pregnant 
women — having  seen    two  or  three   untimely 
births  from  its  exhibition. 

While  in  service  as  government  physician  at 
the  Wichita  Indian  Agency,  Indian  Territory, 
our  stock  of  quinine  having  become  exhausted, 
I  made  use  of  the  following  formula  in  all  ma- 
larial disorders,  and  found  it  very  satisfactory 
as  an  antiperiodie : 

I  no  longer  use  quinine  for  females  enceinte 
but  substitute  this,  which  I  recommend  to  Dr. 
Gilliland  and  all  others — no  need  of  running 
any  risk  with  quinine : 

R.  TiDCt.  iodine dr.  li 

Iodld«  potash dr.  i 

f^TT.  orange  peel ox.  U 

.  M.   Take  one  leaspoonfUl  In  oue-ibira  gUts  of  water  3  times 

daily. 


I  find  quinine  entirely  safe  and  efiective  to 
use  in  obstetric  practice,  and  employ  it  always 
in  preference  to  ergot  to  excite  uterine  action. 

if  I  now  ever  use  ergot  at  all  it  is  when 
necessary  to  haaUn  contraction  after  delivery  of 
child. 

In  a  20  years'  practice,  10  of  which  has  been 
in  a  malarious  region,  where  I  have  used  qui- 
nine freely,  with  exceptions  above  noted,  I  have 
never  seen  hemorrhage  in  any  form  result  from 
its  use. 

I  like  the  following  formula  for  interral 
treatment  for  diphtheria,  membranous  croup, 
etc.     I  know  of  nothing  superior  to  it : 

R.    Hydrarg.  bichiorldi gr.  1 

Ammonii  ctilorldl or.  Ifs 

Alcohol 02  ii 

Glyc«»rinl  et  aqaeeq.  s.  ut.  ft oz.  i? 

M.    8Ig.  Give  >i  to  one  teaspoon  fUl  every  2,  S  or  4  hours, 
owing  to  the  age  of  the  child  and  urgency  of  the  cate. 

I  would  precede  this  by  a  dose  of  the  mild 
chloride  of  mercury  to  freely  evacuate  the 
bowels. 

I  believe  more  injury  has  been  done  by  the 
internal  use  of  chlorate  of  potash  than  all  the 
good  it  has  ever  accomplished. 

I  wish  all  the  cases  where  kidney  complica- 
tions directly  due  to  its  use  could  be  faithfully 
reported.  I  think  it  would  revolutionize  our 
views  in  regard  to  it  I  am  satisfied  I  have 
seen  two  deaths  directly  due  to  its  use.  Sup- 
pression of  urine  and  bloody  urine  may  occur  — 
even  when  what  were  considered  medicinal 
doses  were  given. 

Fordyce  Grixnell,  M.  D., 

Pasadena,  Cal. 


The  Chronic  Cyanide  Poisoning  of  Miners. 

Editor  Medical  World  : — In  reply  to  Dr. 
Holcombe's  query  about  chronic  poisoning  by 
cyanides,  I  reply  as  follows  : 

As  to  symptoms,  they  are,  headache,  giddi- 
ness, noises  in  the  ears,  pains  in  the  region  of 
the  heart,  difficult  respiration,  loss  of  appetite, 
nausea,  obstinate  constipation,  full  pulse,  pallor 
and  offensive  breath. 

Treatment — Cold  douches,  ammonia  inhala- 
tions, chloride  of  lime  alone  or  moistened  wiih 
vinegar  and  held  to  the  nose,  friction,  elec 
tricity,  artificial  respiration.  The  be^t  anti- 
dote is  a  mixture  of  ferrous  and  ferric  sulph- 
ates, with  sodium  or  potassium  hydroxide  or 
carbonate. 

For  prophylaxip,  perfect  cleanliness  and  oc- 
casional use  of  the  antidote  iu  small  doses.  [See 
Bartley*s  Medical  Chemistry.] 

I  would  suggest  to  Dr.  M.  8.  M(  ore  to  make 
a  diagnosis  first,  and  do  so  by  exclusion.  Dis- 
eases which  may  cause  pain  in  the  stomach  are 
chronic  gastric  catarrh,  gastric  ulcer,  gastralgia, 


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carciDoma,  etc  Exclude  eaeh  disease  by  ab- 
sence of  the  characteristic  symptoms  peculiar  to 
It.  Consider  age  and  appearance  of  patient, 
occupation  and  pre^rious  history.  Location  of 
patient  must  be  considered.  Is  it  a  malarial 
district  ?  Did  the  patient  ever  suffer  with  at- 
tacks of  malaria  ?  The  history  serves  to  show 
that  there  is  a  malarial  element  present  Do 
the  attacks  of  pain  come  on  periodically  ?  I 
would  suggest,  therefore,  to  the  Doctor  to  study 
the  case  carefully,  and  if  none  of  the  above 
enumerated  diseases  can  be  diagnosed,  to  treat 
it  as  one  of  the  masked  malarial  cases,  namely, 
open  bowels  by  small  repeated  doses  of  calomel, 
follow  by  a  saline,  then  give  large  doses  of 
quinine,  either  hypodermatically  or  in  solution 
by  mouth.  If  large  doses  of  quinine  have  been 
given  to  him  and  the  syetem  is  perhaps  satu 
rated  with  this  drug,  I  would  try  Warburg's 
tincture,  arsenic,  comp.  tr.  of  ir>dine,  iron,  etc. 
Regulation  of  diet  is  of  importance. 

Max  Friedlander,  M.  D., 
126  Moore  St,  Brooklyn,  N.  Y. 


Cure  for  Incipient  Consumption,  Bronchitis, 
Laryngitis  and  otiier  Respiratory  in- 
flammations. 

[We  received,  some  time  ago,  the  following 
letter  from  a  gentleman  who  is  not  a  physician.] 

Editor  Medical  World  : — Having  a  de- 
sire to  benefit  humanity,  I  hereby  submit  for 
your  consideration  the  following  statement 

The  belief  is  entertained  that  a  specific  for 
the  cure  of  consumption  has  been  discovered 
and  tried  in  several  cases  with  the  most  gratify- 
ing results.  The  remedy  is  the  fumes  of  acetic 
acid  or  of  truit  or  mae  vinegar  (which  is  really 
the  best,  and  should  be  used  whenever  obtaina- 
ble), care  being  taken  that  the  fumes  are  used 
lightly  until  the  patient  has  become  used  to 
them.  The  treatment  is  continued  according  to 
the  condition  of  the  patient  and  may  extend 
over  a  period  of  several  months  or  be  found  suf- 
ficient in  a  few  weeks  for  effecting  a  cure.  The 
last  stage  is  not  curable  and  yet  relief  may  be 
sc^cured  to  some  extent  without  a  doubt  Asth- 
ma, bronchitia  and  laryngitis  alike  readily  yield 
to  the  remedy  and  no  physician  need  fear  a 
failure  provided  the  remedy  be  faithfully  ad- 
ministered. £.  J.  Marbters, 

Stockton,  €al. 

[Upon  receipt  of  the  above  letter  we  at  onoe 
wrote  for  further  particulars,  in  response  to 
which  we  have  just  received  the  following  :] 

Your  favor  received  and  in  answer  will  say 
that,  the  remedy  being  so  simple  that  no  one  can 
go  astray,  there  is  no  necessity  of  saying  much 
more  than  what  was  written  in  former  letter. 
The  remedy  being  non*  poisonous,  all  that  is  re- 


quired is  care  in  administering  at  the  first  so  as 
not  to  smother  the  patient,  and  thu?  allow  the 
lungs  to  becor^e  used  to  it  A  tin  half  pint  cup 
makes  a  good  inhaler,  the  cup  to  be  filled  one 
third  full  and  the  temperature  raised  until  the 
fumes  rise  freely  and  then  taken  into  the  lungs 
as  often  as  considered  necessary.  Two  or  three 
times  a  day  will  sufiSce,  but  should  a  dozen  ap- 
plications in  a  day  be  made  there  would  no 
harm  be  done — in  fact  ^  say  a  patient  could 
breathe  the  fumes  for  a  long  time  without  in- 
jurious effects  being  known. 

The  first  case  tried  was  a  case  of  chronic 
bronchitis  in  oonnec'ion  with  tuberculosis  of  a 
severe  type,  an  i  was  fully  under  control  in 
eighteen  days,  the  cough  having  ceased  and  the 
patient,  who  had  been  reduced  in  flesh,  nearly 
restored  to  normal  weight  The  treatment  was 
contiuued  for  thirty-five  days  and  the  patient 
completely  cured.  Two  years  have  passed  since 
treatment  and  no  return  of  the  disease  what^ 
ever.  The  second  case  was  acute  bronchitis  and 
was  completely  cured  in  seven  days.  The  third 
case  was  a  severe  case  of  consumption  and 
the  patient  given  up  by  two  physicians  who  had 
visited  her.  The  treatment  was  continued  for 
ninety  days  and  then  n^lected  for  two  or  three 
months,  while  in  the  meantime,  the  patient 
gained  about  fourteen  pounds  and  finally  mar- 
ried and  at  this  time  is  doing  well  The  fourth 
case  was  incipient  consumption  and  was  cured 
in  thirty  dajs,  and  the  patient  a  lady,  has  mar- 
ried. I  have  a  case  on  hand  similar  to  the  first 
spoken  of,  and  it  is  easily  controlled ;  so  you 
can  see  that  the  remedy  is  as  first  stated. 

For  sore  throat  and  common  colds  it  is  all 
that  is  required  and  no  one  need  to  be  afraid  to 
use  it.  Physicians  trying  the  remedy  will  be  kind 
enough  to  report  not  only  to  The  World  but 
also  to  myself.  E.  J.  Marsters, 

Stockton,  Cal. 

[We  should  be  pleased  to  have  a  thorough 
trial  of  this  treatment  which  is  at  once  so  sim- 
ple and  harmless  If  it  is  as  effective  as  sup- 
posed. Prof.  Marsters  has  conferred  a  great 
benefit  upon  humanity.  It  can  be  very  easily 
determined  by  trial. — Ed  ] 

Medical  Law  of  Soutli  Carolina. 

Editor  Medical  World  : — I  notice  a  mis- 
take in  April  World  in  regard  to  the  present 
medical  law  of  South  Carolina.  The  county 
board  system,  which  could  only  examine  the 
diploma  wa»^bolished  during  the  last  Legisla- 
ture and  a  State  Board  created.  One  mf  mber 
from  each  congrepsional  district  is  appointed  by 
the  Grovemor.  The  Boarl  has  full  authority  to 
examine  the  applicant's  fitnes)  to  practice  medi- 
cine, regardle^  of  diploma. 


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As  the  source  of  much  valuable  information 
I  come  to'the  World  again  for  help. 

I  am  young  in  the  profession,  and  want  some 
general  advice  as  to  the  following  questions, 
viz.:  Will  it  be  detrimental  to  a  physician's 
truest  success  if  he  should  own  a  drug  store  and 
run  it  in  connection  with  his  profession,  or  if  he 
should  connect  himself  in  any  way  with  the 
business  ? 

Qranting  that  he  is  in  so  small  a  town  that 
it  is  necessary  to  dispense  his  own  prescriptions, 
can  he  attempt  a  general  drug  store  under  the 
best  management  and  then  be  true  to  his  pro- 
fession and  reap  true  success?  Will  such  a 
<x)ur8e  pay  in  the  end,  particularly  in  small 
towns?  If  so,  please  state  in  a  general  way 
how  to  manage  the  business.  I  have  written  to 
some  excellent  physicians  who  have  had  experi- 
ence and  they  differ  very  much. 

I  would  be  glad  to  hear  from  the  Editor,  and 
feel  grateful  to  any  of  the  brethren  who  will 
write  me.  £i>gar  A.  Hines,  M.D., 

Fort  Hill,  &  C 

[We  think  that,  in  small  towns,  where  there 
is  not  professional  work  enough  to  employ  all  of 
one's  energies,  it  may  be  expedient  for  the 
physician  to  own  and  carry  on  the  drug  store. 
Id  large  towns  and  cities,  however,  one  mil  do 
better  to  concentrate  his  efforts  upon  the  practice 
and  continual  preparation  for  it,  excepting  where 
there  are  special  bdividaal  reasons  for  doing 
otherwise. — Ed  ] 


^'Mot  FlMhe**'  of  the  Menopause.— For  Nervous 
Diaturbanoes  and  Convulaiona  in  Pregnanoy. 

Editor  Medical  World  :—  In  answer  to 
Dr.  G.  R  Matthews,  of  Ringwood,  N.  C,  page 
101,  I  would  advise  giving  such  patients  tinct- 
ure of  gelseminum  in  ten  drop  doses  every  three 
or  four  hours.  This  is  probably  the  beat  possi- 
ble medicament. 

In  answer  to  Dr.  G.  M.  Morton,  Toronto,  S. 
D.,  page  99,  I  would  say  that  if  convulsions 
come  on  during  labor  do  not  wait  one  minute  but 
mtroduce  your  forceps  and  terminate  the  labor 
as  quickly  as  possible.  In  the  meantime,  if  she 
shows  a  tendency  towards  convulsions  or  a  con- 
siderable time  before  labor  is  normally  due,  I 
would  give  her  the  bromides  with  chloral. 
Bromidia  (Battle)  is,  one  of  the  best  possible 
agents  in  those  cases  either  to  prevent  or  to 
lessen  the  severity  of  a  convulsive  attack.  If 
the  patient  should  show  signs  indicative  of  al- 
bumen in  the  urine  during  the  early  months  of 
pregnancy  I  should  administer  three  or  four 
times  a  day  dram  doses  of  cream  of  tartar,  with 
bromide  of  potassium  and  closely  watch  results. 
John  L.  Brown,  M.  D., 

Jefferaonville,  Ky. 


ijditor  Medical  World  :— I  see  in  The 
Medical  World  for  March  1894,  page  101. 
an  inquiry  from  Dr.  G.  E.  Matthews,  of  Ring- 
wood,  N.  C,  as  to  the  best  treatment  for  the  hot 
flashes  of  the  menopause.  I  would  suggest  that 
the  doctor  give  his  patient  tincture  tela  aranea, 
(spider's  web),  five  drops  every  three  hours  in  a 
teaspoonful  of  water.  I  think  if  he  will  get 
a  good  tinct.  of  this  remedy  he  will  derive 
much  good  from  its  use.  I  would  like  to  hear 
through  The  Medical  World  from  any  doc- 
tor who  may  use  it  in  such  cases  as  the  above. 

Hickman,  Ky.         C.  H.  Hubbard,  M.D., 


For  Aone  and  Comedones. 

Editor  Medical  World  : — I  have  found 
by  actual  treatment  in  numerous  instances  of 
acne  or  comedones  that  an  ointment  of  red 
iodide  of  mercury  and  vaseline,  made  up  in  the 
proportion  of  2  to  10  grains  to  the  ounce,  has 
been  a  sure  cure  in  all  cafes  where  used  with 
perseverence  in  the  following  manner: 

First  wash  the  face  thoroughly  with  some 
non-astringent  soap,  and  warm  water;  after 
drying  the  flesh,  apply,  by  thorough  rubbing, 
to  all  diseased  places,  the  ointment  once  a  day. 
This  treatment  should  be  kept  up  for  at  least  a 
month  or  until  every  remnant  of  t>  e  disease 
has  disappeared.  The  ointment  should  be 
made  very  mild  for  delicate,  thin  skin,  but 
hard,  thick,  dry  flesh  will  often  require  the 
full  strength  of  10  grains  to  the  ounce.  If 
made  too  strong  it  will  blister  the  surface. 

Joseph  Spaulding,  M.D., 

Woodstock,  Conn. 


Replies. 

Editor  Medical  World  : — Dr.  J.  H.  Stan- 
ley, for  his  case  of  black-heads,  will  find  either 
of  the  following  receipts  good : 

R.  LanoUne m.  j 

Ac.  salyoUlo dr.] 

Zlno  oxide « dr.  J 

M.    Sig.  Apply  twice  a  day  after  Uioroughly  Bteamiog  Uie 
fkoe. 
Pre»  out  the  sebaoeotu  plugs  often. 

R.  Oxide  zinc dr.j 

Tr.  benxoin f  dr.  j 

Tr.  calendula... ..« „ „..f  dr.  j 

Vaaeline .«...  oi.  j 

M.    Sig.  Apply  twice  a  day. 

For  the  eciema,  oxide  of  zinc  ointment,  lead 
lotions,  ichthyol  or  the  following,  according  to 
the  indications : 

R.  BalMimPeru oz.  •« 

Retorcine... gt,  20 

Vaseline oz.  J 

M.    Big.  Apply  to  Bcalp  two  or  three  times  a  day. 

Dr.  A.  K  Rhodes  will  find  the  following 
good  treatment  for  goitre  : 

Apply  an  ointment  of  red  iodide  of  mercury, 
(the  official  ointment)  Apply  a  small  amount 
once  a  day,  until  the  surface  becomes  tender, 


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then  rest  a  few  days  and  commence  again.  jGive 
internally  3  to  5  drops  of  compound  tincture  of 
iodine,  twice  daily. 

Dr.  G.  E.  Mathews,  for  hot  flashes  of  the 
menopause,  should  apply  hot  water,  or  the  fol- 
lowing : 

Cherry-laurel  water oz.  j 

Blderflower water oz.  v 

Often  as  necessary. 

Give  internally,  sulphuric  acid,  dilute. 

Dr.  MoUyneaux,  for  enlarged  glands,  should 
give  internally  fluid  extract  of  poke  root  and 
apply  the  same  locally. 

J.  T.  Barnett,  M.D  , 

Hardinsburg,  Ind. 


Destruction  of  Diphtheria  Bacilli  by  Heat. 

Editor  Medical  World  : — In  the  January 
number,  page  20,  Dr.  Bardill  propounds  a 
query  as  to  the  degree  of  temperature  required 
to  destroy  the  diphtheria  bacillus.  lx)effler 
states  its  thermal  death  point  to  be,  in  a  moist 
meduim,  60^  C.  =  140°  F.  The  period  of  ex- 
posure  required,  30  minute. 

Oiher  observers  state  that  a  few  seconds'  ex- 
posure will  suffice  for  its  destruction. 

,  H.  L  Lock  WOOD,  M  D., 

96  Wayne  St,  Jersey  City,  N.  J. 


For  Cystitis. 

Editor  Medical  World  : — Dr.  J.  C.  Camp- 
belFs  case  of  cystitis,  page  12,  January  World, 
is  no  doubt  reflex,  caused  by  some  local  irrita- 
tion, such  as  a  lacerated  cervix,  lacerated  per- 
neum,  caruncle  of  the  urethra,  fragments  of  a 
torn  hymen,  (caruoculse  myrtiforma)  or  last, 
but  not  least,  a  diseased  rectum,  such  as  piles, 
fistula,  fissure,  pockets,  pappillse,  &c.  Any  of 
these  conditions  may  and  do  cause  cystitis.  Re- 
move the  cause.  Doctor,  and  you  will  cure  your 
case.  If  you  cure  it,  please  report  in  World. 
E.   E.  Nixon,  M.  D., 

Hot  Springs,  Ark. 


For  Tonsillitis. 

Editor  Medical  World  i — Say  to  Dr. 
Pineo,  of  Chester,  Nova  Scotia,  that  if  he  will, 
at  the  first  intimation  of  an  attack  of  tonsillitis 
apply  a  blister  about  the  size  of  a  silver  dollar 
under  the  angle  of  the  jaw,  leaving  it  there  till 
it  draws  thoroughly,  and  also  take  a  full  dose 
of  sulphate  of  magnesia,  he  will  abort  the  dis- 
ease and,  persevering  in  the  use  of  the  blister, 
he  will  surely  break  up  the  habit — at  least  I 
have  been  successful  in  not  a  few  cases  during 
the  last  thirty  years.     Thos.  G.  Farr,  M.D., 

South  Charleston,  O. 


For  Spermatorrhea. 

Editor  Medical  World  : — I  suggest  the 
following  to  J.  D.  Usher,  M.  D.,  on  page  136, 
vol.  12,  No.  4: 

Let  him  give  his  patient  cold  sitz  baths  once 
a  day,  and  direct  him  to  exercise  in  the  open 
air,  with  directions  to  sleep  on  a  hard  bed  and 
keep  off  of  his  back. 

R.   Tr.  nux  vomica. 
Tr.  beUAdonna. 
Tr,  pbyHOfttigma.  aa  oz.  5;s. 
M.   Big.  'atts20,  6liiijesadrty. 

Watch  his  bowels  and  heart 

Ophelia,  W.  Va.        P.  A.  Brown,  M.D., 


Eczema. — Headache. 

Editor  Medical  World:— I  have  written 
direct  to  Dr.  Pineo  about  his  case  of  eczema,  but 
since  Dr.  Hamilton  and  others  are  seeking  aid 
for  the  same  trouble,  I  will  send  you  my  pla» 
of  treatment 

The  various  replies  published  in  your  last  is- 
sue are  good  so  far  as  they  go,  but  no  one 
seems  to  lay  any  stress  on  the  absolute  necessity 
of  preventing  irritation  of  the  diseased  parts,  by 
clothing,  di^harges,  applicaiions  and,  ch'ef  of 
all,  by  the  child's  finger-nails.  I  always  insist 
on  having  the  child  wear  mittens,  day  and 
nightf  and  protecting  the  inflamed  surfaces  by 
proper  dressings.  Equal  parts  of  olive  oil  and 
lime  water  makes  the  best  general  application  I 
know  of — sometimes  one- half  to  one  per  cent 
carbolic  acid  added— or  the  following  : 

R.   AddlcarboL dr.  i 

Glycerlirt 

Alcobolis aa. oz.  i 

Ag.  Meoth.  pip.  q.  b i.z  vHj 

Mix.  Mop  OQ  flrequently  with  a  wal  of  absorbent  couoa. 

Another  favorite  is  : 

R.   Arlstol dr.  88  todr.  is>s 

VaseUne -  oi.  i 

Internally  I  nearly  always  give  cod- liver  oil 
and  arsenic.  I  usedt)  be  very  much  preju 
diced  egainst  cod-liver  oil,  but  have  seen  so 
many  cases  of  long  standing  begin  to  improve 
as  soon  as  the  oil  treatment  was  adopted  that  I 
now  nearly  always  prescribe  it — ^generally  us- 
ing a  good  emulsion,  combined  with  glycerine, 
and  extract  of  malt,  in  some  of  the  aromatic 
waters.  I  think  a  good  many  fail  in  not  stick- 
ing to  one  line  of  treatment  long  erough. 
Adopt  a  soothing,  inoffensive  application,  pre- 
vent further  irritation  of  the  parts,  give  cod- 
liver  oil  and  arsenic,  or  iron,  if  indicated,  regu- 
late the  diet,  habits,  <fec.,  and  stay  with  it— 
don't  change  every  two  days. 

The  article  on  headache  in  your  February 
number,  taken  from  the  Jour,  of  the  ^Am  Med. 
Asso.y  was  good,  but  I  was  surprised  to  see  so 
little  mention  of  the  latest  and  most  successful, 


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165 


to   my  notion,  class  of  remedies,  the  coal-tar 
series.     Antipyrin  is  barely  alluded  to.     I  used 
to    lose    much   valuable   time     'looking    for 
causes "  for  headaches,  and  generally   lound 
that   my   patient  did   not  care  to  completely 
change  his  manner  of  living — to  give  up  his 
business   for  another — to  change  climate — to 
starve  himself,  etc,  etc.    Perhaps  he  knew  from 
experience  that  a  blue  pill,  a  hot  foot-bath  and 
a  dose  of  Epsom  salts  would  cure  an  attack  after 
twelve  or  fourteen  hours  ;  or,  perhaps,  a  day's 
fasting  or  rest  from  business  would  prevent  it ; 
but  this  isn't  what  he  wishes.     He  wishes  to 
keep  on  with  his  work,  and  he  dosen't  care  to 
stop  eating,  and  he  is  looking  for  some  remedy 
that  will  quickly  cure  an  attack,  or.  better  yet 
when   taken  in  time,  abort  it     And  it  is  just 
here  the  coal-tar  series  comes  in.     In  my  judg- 
ment, acetanilide  is  best  of  all — cheap,  easily 
administered,  and  nine  times  out  of  ten  a  dead 
shot     1  have  cause  to  feel  confidence  in  this 
superb  remedy,  for  I  have  found  it  a  certain 
relief  in  my  own  individual  case  and  also  in  my 
father's  case.     Both  of  us  have  been  subject  to 
headaches  since  childhood — ^my  father's  of  a 
neuralgic  type,  mine  of  the  '*  nervous,  sick" 
kind.     The  attacks  have  been  more  or  less  fre- 
quenty  and  were  severe  enough  to  totally  unfit 
us  for  business  for  a  space  of  from  12  to  24 
hours,  or  longer.     Of  course  we  tried  every- 
thing.    Morphine  would  relieve  my  father,  but 
made  me  worse.     Finally  I  experimented  with 
antipyrin,   phenaoetine    and    acetanilide — that 
was  ^Ye  years  ago — and  I  soon  found  the  latter 
to  be,  in  our  own  cases,  a  sure  cure,  and  when 
taktn    soon    enough,  a    certain   preventative. 
Our  plan  is  to  take  from  6  to  8  grains  in  syrup 
or  capsule.     We  rarely   have  to   repeat  the 
dose.     If  I  feel  a  headache  coming  on,  I  take 
my  dose,  sit  or  lie  down  if  possible  for  half  an 
hour,  and  am  then  ready  for  business.     So  now 
if  a  person  comes  to  me  with  headache,  I  give 
him  acetanilide,  alone,  or  with  caffeine  in  some 
eases.     I  have  never  seen  any  ill  results  from 
it,  and  have  positively  never  failed  except  in  one 
case   since  I've  been  usmg  the  remedy.     Of 
course  I  get  the  general  history,  and  try  as  far 
as  possible  to  correct  bad  habits,  to  '*  remove 
causes,"  but  I  cure  that  attack  cm  mon  as  po^m- 
bUj  and  provide  him  with  the  remedy  to  use  at 
once  whenever  an  attack  threatens. 

I  see  by  The  World  that  many  of  its  read- 
ers appreciate  this  great  chemical  product  in 
lagrippe,  tonsillitis,  &c  I  have  never  been 
to  bed  with  the  grip  yet — took  7  grains  ace- 
tanilide night  and  morning,  and  kept  up  and 
going.  By  the  way,  tablets  of  this  drug  are 
very  convenient  and  elegant  but  I  have  found 
more  than  one  case  where  they  went  through 


the  entire  alimentary  canal  undisaolved.  So  if 
I  use  them  at  all,  I  mash  them  up. 

Nothing  further  this  time  save  to  reiterate 
my  appreciation  of  The  World.  It  comes 
nearer  a  good  clinic  than  anything  I  know  of. 

Rivera,  Cal.         W.  D.  Groton,  M.  D., 


\ 


For  Eczema. 

Editor  Medical  World  : — In  your  March, 
'94,  number.  Dr.  Plneo,  of  Chester,  Nova 
Scotia,  asks  for  help  on  a  case  of  vesicular 
eczema,  in  a  child  four  years  of  age,  at  least  I 
should  judge  it  such  from  the  description  given . 
I  have  tried  the  following  in  many  similar 
cases  with  brilliant  results  : 

First  bathe  the  parts  at  bed- time  with  warm 
water,  containing  either  one  teaspoonful  of 
baking  soda  or  sodium  hyposulphite  to  the 
pint,  then  dry  with  a  soil  towel  and  apply  the 
following  : 

R.   Addi  pbenicf gr.  ixx 

Blsmuthisub-nlt « ar.lv 

TJngt  sinoi  ozidi  beuxoaUs „ os.  ij 

FUODgt 

S'g.  Rub  on  well  with  Uie  euda  of  tlugen. 

Should  there  be  any  induration,  sponge  the 
parts  with : 

R.  Sapo  vlridlf ^ ox.  It 

SptB.  vini.  rec. oz.  Ij 

Or,  in  oUier  words,  eT>irlU  of  green  M»p,  before  bathing  with 
the  warm  water  and  soda.  In  the  morning  use  very  mild 
dusUng  powder,  such  as  lycopodium  or  a  mutnre  of  pulvur- 
ised  staioh  and  camphor  gum,  at  the  same  time  giye  intern- 
ally  ezt  berberis  aquafolium,  oz.  j. 

Sg.  Five  drops  in  water  three  times  a  day.  (For  an  adult 
15  to  20  drops  should  be  given.) 

Also: 

R.   ftulphurls. oz,  i j 

Pot.  bi-tartratis oz.  1 

Mfx  with  a  little  syrup  and  give  yi  teaftpoonflil  night  and 
morning.  The  berberfs  should  be  continued  for  seTeral 
weeks  after  all  th«  eruption  has  disappeared. 

I  am  confident  if  he  will  give  the  above  a 
fair  test  he  will  be  surprised  at  the  favorable 
results. 

I  am  inclined  to  think  the  same  treatment 
will  apply  to  the  case  of  Dr.  W.  T.  Hamilton 
in  the  same  number,  only  the  doses  of  the 
medicine  should  be  reduced  to  correspond  to 
the  age  of  the  child.         H.  S.  A  ley,  M.D., 

Lincoln,  Neb. 

Editor  Medical  World: — For  the  case  of 
eczema  in  one  of  my  own  children,  I  must  say 
the  fraternity  have  very  kindly  come  to  my  as- 
sistance and  I  sincerely  thank  Doctors  Atkin- 
son, Bangert,  Cummins,  Brodnax,  Hightower, 
Craigen,  Dean  and  Mantey,  who  so  promptly 
answered  my  request  privately. 

The  child,  I  am  happy  to  say,  has  for  the 
time  completely  recovered  from  the  severe  or- 
deal it  has  gone  through  by  the  persistent  ap- 
plication of  a  fresh  prepared  ointment  of  by- 
Digitized  by  VjOOQIC 


166 


THE  MEDICAL  WORLD. 


•drarg.  oxid.  rub.  The  World  has  become  to 
me  absolutely  necessary  in  my  daily  work.  If  I 
sm  at  a  loss  in  any  intricate  case  what  to  do,  J 
at  once  refer  to  its  pages,  always  stored  with 
useful  practical  suggestions  for  the  county  prac- 
titioner, who  is  debarred  from  the  very  many 
privilege  the  city  fraternity  have.  Long  may 
it  live  to  be  the  compass  which  steers  us  clear  of 
the  shoals. 
Chester,  Nova  Scotia.  J.  Forman  Pineo,  M.D., 


Eoleotio  Remedies. 


Editor  Medical  World  : — I  have  read 
two  articles  by  Dr.  Wm.  F.  Waugh  in  The 
Medical  World  in  which  he  speaks  of  small 
doses,  single  remedies,  and  eclectic  remedies. 
Has  Dr.  Waugh  studied  carefully  and  with  an 
unprejudiced  mind  Specific  Medication  by  Dr. 
John  M.  Scudder?  Has  he  also  studied  Dr. 
Goss'  work  on  the  American  Practice  of  Medi- 
cine ?  Has  he  used  those  remedies  according  to 
the  indications  given  in  those  two  works?  If 
be  has  not  done  so,  then  he  has  no  right  to  say, 
*<I  expected  a  good  deal  irom  them,  but  must 
confess  my  disappointment"  I  am  very  sure 
that  he  cannot  to^ay  give  the  pathological  in- 
dications of  one  single  eclectic  remedy.  For 
had  he  prescribed  these  remedies  he  calls  eclec- 
tic according  to  their  pathological  indications 
and  used  pure  medicines  he  would  never  have 
been  disappointed.  He  says  again,  **  Many  of 
the  specific  indications  are  taken  bodily  from 
homeopathy."  How  does  he  know  that  ?  Has 
he  stvdiea  homeopathy  f  Has  he  ever  used 
their  remedies  according  to  the  laws  of  home- 
opathy ?  Can  he  give  me  the  indications  for  the 
use  of  rhus  tox,  belladonna,  bryonia  and 
lachesis  ?  Has  he  ever  attended  lectures  at  a 
homeopathic  college  ?  Did  he  ever  study  that 
system  at  the  bedside  of  the  sick  with  a  physi- 
cian of  that  school  ?  If  he  has  not  done  all 
this,  then  he  has  no  right  to  condemn  that 
school  of  medicine  and  say  that  ''the  indications 
of  their  remedies  are  worthless." 

Let  Dr.  Waugh  throw  aside  all  prejudices 
Against  any  school  or  law  of  cure.     Let  him  be 

ready 

"  To  seize  on  truth  wherever  found, 
On  Christian  or  on  heathen  ground,'* 

and  never  condemn  a  thing  that  he  knows  90 
little  about  as  he  knows  about  the  remedies  of 
the  two  schools  of  medicine  he  mentions  in  his 
articles.  When  he  says  the  specific  indications 
for  remedies  *'  mentioned  in  Scudder's  work  are 
mostly  taken  bodily  from  homeopathy,"  he 
shows  his  ignorance  of  both  schools.  I  have 
had  the  hoiior  of  attending  lectures  at  both 
schools  of  medicines  m  well  as  at  the  allopathic 
school.     I  have  seen  the  eclectic  and  homeopa- 


thic remedies  administered  at  the  bedside  of  the 
sick  by  the  best  teachers  of  both  schools. 

I  have  for  25  years  used  single  remedies 
many  times  in  my  practice  according  to  specific 
indicatioos  to  meet  certain  pathological  indica- 
tions, and  I  never  failed  to  get  good  results. 

Paterson,  N.  J.  E.  G.  Jones,  M.  D., 

Dartmouth  Med.  Coll.,  71. 


Editor  Medical  World  r — In  an  article  en- 
titled '*  Dosimetry,"  in  the  January,  '94,  num- 
ber of  your  valuable  journal,  the  writer  takes  a 
pop  at  the  eclectics — with  whom,  let  me  say,  I 
am  proud  to  be  enrolled — that  does  not  seem  to 
me  quite  fair.  Near  the  middle  of  his  article 
he  says,  '^Now  for  the  other  advocates  of  specific 
medication,  the  eclectics,"  and  goes  oa  to  hit 
them  hard — real  hard  from  his  p  >int  of  view — 
with  apparently  a  little  venom  in  his  sting. 

He  '*  expected  a  good  deal  and  has  baen  dis- 
appointed." I  believe  his  disappointment  re- 
sults from  want  of  knowledge  and  fair  investi- 
gation of  eclectic  methods,  and  specific  medica- 
tioo,  as  advocated  by  them. 

Again — '*  Many  of  their  specific  indications 
are  taken  bodily  Arom  homeopathy  and  are 
worthless  to  those  who  do  not  care  to  pin  their 
faith  on  such  intangible  potencies."  Poanblj 
some  of  their  indications  are  taken  from  home- 
opathy. What  of  that  ?  Whenever  they  are, 
they  have  given  due  credit  for  them,  and  also 
any  remedies  that  may  have  come  from  the 
same  source  ;  which  is  more  than  the  regulars 
do  with  eclectics  —they  not  only  appropriate  in- 
dications and  remedies,  but  try  to  steal  what 
honor  there  may  be  in  the  discovery,  by  claim- 
ing them  to  be  recent  discoveries  of  Cheir  own  at 
great  expense — all  original — when,  in  truth, 
they  are  taken  wholly  from  eclectics,  by  whom 
they  have  been  in  successful  use  from  twenty  to 
forty  years. 

The  doctor  talks  about  intangible  potencies. 
I  confess  that  I  do  not  know  of  any  in  eclect- 
ism.  If  the  doctor  will  put  ten  drops  of  Lloyd's 
specific  tr.  aconite  in  four  ounces  of  water  and 
take  a  teaspoonful  every  half  hour,  or  hour,  I 
think  he  will  find  something  tangible  to  his 
senses  after  a  few  doses ;  or,  say,  one-tenth  grain 
of  Lloyd's  podophyllin,  repeated  once  in  three 
hours,  a  few  times,  and  see  if  it  would  be  tangible. 

Does  the  Doctor  wish  us  to  understand  that 
his  statements  under  "  Properties,"  *'  Principal 
influence,"  "Employment,"  etc,,  in  his  article 
are  from  specific  medication,  or  modem  eclect- 
ism? 

That  is  the  inference,  and  I  deny  it. 

I  ask  the  Doctor  to  make  further  and  closer 
investigations,  and  without  prejudice. 

Harvey,  HI.        A.  P.  Whitford,  M.D., 


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THE  MEDICAL  WORLD. 


167 


Our  oorrespondeDt  has  asked  some  very  per- 
tinent questions ;  for  when  one  undertakes  to 
criticise,  the  qualifications  of  the  critic  must  de- 
termine the  value  of  his  opinions.  I  will 
endeavor  to  reply  to  his  questions  : 

1.  I  have  studied  carefully  and  impartially 
Dr.  Scudder's  specific  medication.  I  have  found 
him  a  genuine  and  capable  worker,  the  best  in 
his  school,  of  any  I  have  met  I  have  learned 
from  him  a  number  of  valuable  things  in  regard 
to  the  drugs  he  has  studied.  I  find  in  his  book 
many  drugs,  the  lack  of  trustworthy  details 
concerning  which  he  regrets,  as  I  do.  He  con- 
stantly urges  his  readers  to  supply  this  informa- 
tion. I  have  also  read  the  Eclectic  Medical 
Jaumal  tor  years,  and  the  absence  of  any  jeal- 
ousy or  *'  bide  bound "  feeling  may  be  seen  in 
the  numerous  quotations  from  these  sources  in 
my  journal  and  my  books.  Dr.  Goes'  book  I 
have  never  seen.  Other  eclectic  works  I  have 
also  read,  which  I  will  not  specify  here,  as  they 
are  open  to  the  faults  I  have  already  men- 
tioned— a  weakness  as  to  pathology  and  a  lack 
of  discriminatioa  between  results  due  to  the  ex- 
cifnent,  or  to  natural  causes,  and  those  justly 
attributable  to  the  drug.  This  fault  is  not 
peculiar  to  eclectics.  Bartfaolow  himself  shows 
it  in  a  marked  degree,  as  all  other  writers  on 
therapy  do  to  some  extent 

Do  eclectics  as  a  body  pay  as  much  attention 
to  pathology  as  they  do  to  biedside  studies  ? 

2.  1  have  used  the  remedied  according  to  the 
indications  menioned  in  these  works,  and  have 
found  some  verified,  some  mistaken  and  some 
doubtful.  The  drugs  used  were  obtained  from 
eclectic  sources— in  some  cases  I  prepared  them 
myself  from  the  fresh  plants  The  disappoint- 
ment I  expressed  was,  however,  rather  because 
fo  few  of  the  eclectic  remedies  had  been  care- 
fully studied  by  competent  men  in  their  ranks, 
rather  than  at  the  conclusions  reached  by  them. 

3.  I  know  that  some  specific  indications  have 
been  taken  bodily  from  homeopathy  ;  (a)  be- 
cause I  find  them  there,  and  not  in  the  o'der 
eclectic  works ;  (b)  because  the  eclectic  writers 
say  they  have  drawn  on  homeopathy  for 
what  they  consider  of  value.  Yes,  I  have 
studied  homeopathy;  have  perused  the  Organon, 
the  ioumals,  and  have  bad  on  my  shelves 
standard  works  of  that  school,  to  which  I  have 
referred.  I  have  used  tneir  remedies,  in  the 
cases  specified,  and  according  to  the  indications 
prescribed.  I  have  found  instances  of  the  law 
of  *'  similia  similibus  curantur ; "  and  I  have 
also  found  that  this  principle  is  applicable  ex- 
ceptionally only,  not  universally,  and  that  it  is 
not  the  one  only  law  of  cure.  As  to  infinitesi- 
mals, I  must  echo  the  words  of  a  professor  in  a 
homeopathic  medical  college,  that :     **  Between 


the  effects  of  conect  hygiene,  and  faith,  plu» 
the  high  potency,  and  correct  hygiene  and  faith, 
mtmis  the  high  potency,  there  is  no  appreciable- 
difference." 

I  believe  I  can  give  with  some  accuracy  th^- 
indications  for  rhus  and  the  other  remedies- 
named.  I  have  never  attended  lectures  in  & 
homeopathic  college,  and  am  quite  willing  to 
leave  to  my  readers  the  question  as  to  whether 
I  need  to  do  so.  I  have  studied  the  effect  of 
homeopathic  remedies,  at  the  bedside,  as  giveo' 
by  the  most  illustrious  men  in  that  school,  whon> 
I  have  known  well ;  and  on  such  observations 
my  opinions  are  based.  I  have  no  prejudices 
to  throw  aside.  I  have  but  one  wish — to  find 
out  all  I  can  that  will  benefit  my  patients.  To 
the  eclectics  I  say  :  I  have  some  good  things 
for  which  I  owe  you  thanks,  and  I  would  like- 
to  owe  }ou  a  good  deal  more.  Follow  the  path 
Scudder  and  King  point  out  to  you,  and  let  us 
havea  genume  pharmacopeia  of  American  drugs^ 
with  specific  indications  for  each.  When  yot> 
give  a  bowl  of  hot  infusion  or  decoction  and 
the  patient  sweats,  it  does  not  prove  that  the 
plant  has  diaphoretic  properties.  Almost  any^ 
plant  will  do  that  under  such  circumstances^ 
except  belladonna.  If  you  tell  us  the  same 
drug  will  bring  on  the  menstrual  flow  and  also 
stop  it,  please  explain  this  singular  circum- 
stance. I  don't  deny  its  truth,  but  I  want  to 
know  when  and  why  it  does  each.  If  you  tell 
me  elecampane  cures  consumption,  I  want  to 
know  what  kind  of  consumption  and  at  what 
stage,  and  whether  it  does  so  by  poisoning  the 
bacillus  or  by  rendering  the  tissues  too  tough 
for  him  to  penetrate  ihem ;  also  why  elecam- 
pane will  not  cure  consumption  for  me.  Yoii 
see,  we  are  so  used  to  having  chronic  bronchitis 
and  pneumonia  mistaken  for  tuberculosis  that 
we  want  our  friends  to  give  us  such  details  as 
will  show  us  they  have  not  fallen  into  such 
errors.  I  don't  see  why  we  cannot  all  work 
in  our  own  way  to  the  same  end  ;  but  we  must 
not  get  affronted  at  a  little  kindly-meant  criti- 
cism or  we  will  have  no  time  left  for  work — we 
will  spend  it  all  in  quarreling. 

William  F.  Waugh,  M.D. 

[We  do  not  believe  in  controversial  journal- 
ism, and  have  always  tried  to  avoid  it  It 
rarely  leads  to  any  good,  and  frequently  to 
harm.  However,  we  wish  to  be  just  to  all.  So 
with  this  view  we  have  admitted  the  above,, 
but  this  must  close  the  controversy,  and  we  will 
try  not  to  allow  another  to  arise. 

We  regard  the  profession  of  medicine  as  a 
free  and  open  field  for  word  and  investigation^ 
and  the  physician  as  a  free  and  untrammeled 
worker  for  the  good  of  humanity  and  searcher 


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THE  MEDICAL  WORLD. 


after  truth.  Our  counsel  has  always  been,  let 
«ach  proceed  in  the  way  that  seems  best  to  him 
— the  way  in  which  he  can  do  the  best — for  we 
are  not  all  cast  in  the  same  mold.  Our  objec- 
tion to  the  sectarian  schools  is  that  they  set 
limitations  upon  themselves  ;  and  that  they  do 
not  consider  "  physician  "  a  good  enough  name 
to  work  under,  without  modifying  it  in  some 
way.  We  are  what  the  sectarians  call  "  regu- 
lars," because  non-sectarian  medicine  represents 
the  greatest  freedom.  We  do  not  accept  the 
adjective  "allopathic,"  nor  do  we  champion 
the  title  "  regular,"  except  as  it  expresses  non- 
sectarianism.  To  express  it  in  another  way, 
we  do  not  belong  to  the  homeopathic  medical 
profession,  nor  to  the  eclectic  medical  profes- 
sion, but  simply  to  the  medical  profession. 
That  is  good  enough  for  us  ;  and  it  seems  that 
it  should  satisfy  every  broad  and  free  physician. 
Thare  are  wide  differences  between  the  views 
and  practice  of  individual  physicians  ;  but  that 
is  all  right.  It  is  in  this  that  our  greatest  hope 
for  progress  lies.  Different  individuals  follow- 
ing out  different  lines,  or  using  different 
methods,  and  then  all  coming  together  and  com- 
paring results,  is  a  picture  upon  which  we  like 
to  dwell.  It  is  a  picture  presented  by  The 
Medical  World  every  month.  Those  using 
different  methods  need  not  call  themselves  by 
different  names.  The  one  banner,  **  Physician," 
or  "Medicine,"  or  **The  Healing  Art,"  is 
sufficient  No  word  should  be  adopted  or  ad- 
mitted that  will  curtail  freedom.  Under  this 
banner  every  individulal  can  claim  the  right  of 
individual  judgment —in  fact  every  physician 
must  practice  according  to  his  individual  judg- 
ment ;  but  he  need  not  separate  himself  from 
the  mass  of  the  profession,  nor  from  those  with 
whom  he  does  not  happen  to  agree.  The  other 
man  has  an  equal  right  to  his  views.  Both  may 
be  right,  in  that  each  may  be  able  to  get  the 
best  results  with  the  remedies  or  methods  with 
which  he  is  most  familiar.  We  have  nothing 
against  our  Eclectic  and  Homeopathic  brethren 
except  their  self-limitation. 

Let  us  have  a  united  profession,  without  a 
creed,  without  limitations,  without  restrictions, 
with  the  greatest  possible  liberty  to  every  indi- 
vidual to  seek  truth  in  the  widest  possible  way, 
each  contributing  his  results  to  the  sum  total  of 
experience,  and  receiving  the  results  of  all  the 
others  in  return. — Ed.] 


£«iitor  Medical  World:— I  take  several  other 
leading  medical  journals,  but  I  find  that  I  refer  to  the 
back  numbers  of  The  World  more  than  I  do  to  all 
the  reut  combined  for  practical,  every- day  work. 

Bethel,  N.  Y.  R.  C.  Paine,  M,D. 


Two  Cesarian  Sections  and  a  Symphyseotomy  Oc- 
curring in  the  Service  of  Prof.  Barton  Cooke 
Hirst,  University  of  Pennsylvania. 

Reported  for  The  Medical  Woklo  by  A.  L.  RoaseU. 

Case  1.  The  patieut  was  a  primipara,  and 
had  been  in  labor  four  days  when  she  was 
brought  to  Dr.  Hirst.  The  pelvis  was  com- 
pletely filled  by  a  fibroid  tumor  attached  to  the 
cervix.  The  woman,  of  course,  was  in  the 
worst  possible  condition.  She  had  a  shock 
temperature  and  pulse  (temperature  97°,  pulse 
140,)  when  the  operation  began.  The  child 
was  dead.  The  incision  was  carried  well  up 
toward  the  sternum.  The  uterus  was  turned 
out  and  the  intestines  held  in  place  by  sterilized 
towels  placed  inside  the  abdominal  cavity.  The 
assistant  then  digitally  compressed  the  arteries 
in  the  broad  ligament  The  uterine  incision 
was  quickly  made  and  the  child  extracted.  The 
assistant  quickly  relaxed  his  hold.  When  the 
child  was  lifted  from  the  cavity  the  umbilical 
cord  snapped  like  wet  paper — showing  that  the 
babe  had  been  dead  for  some  time.  The  uterus 
could  not  be  made  to  contract  Hence  its 
removal  was  determined  upon.  The  cervix 
was  now  transfixed  with  large  pins  and  ligated 
immediately  underneath  by  a  round  rubber 
ligature,  tied  in  a  sing'e  knot  and  clamped  with 
a  hemostat  The  uterus  was  now  removed  by 
a  circular  incision  in  the  upper  part  of  the  low- 
er uterine  segment  The  abdominal  incision 
was  sutured  by  interrupted  silk- worm  gut 
sutures.  The  stump  was  dressed  antisepticallj 
and  allowed  to  remain  undisturbed  for  seven 
days.  The  sloughing  portion  was  then  cut 
away  and  the  pUient  made  a  good  recovery. 
The  opetation  lasted  less  than  half  an  hour. 
Dr.  Hirst  uses  the  Porro  operation,  "  not  be- 
cause it  is  an  ideal  one,  but  because  the  extra 
peritoneal  treatment  of  the  stump  is  quick  and 
easy,  and  is  therefore  preferable  when  every 
moment  is  of  importance  to  the  woman.'' 

Case  2.  Unmarried  primipara,  aged  18. 
Pelvis  generally  contracted  and  fiat 

External  congugate  17i  cm.,  (6|  inches.) 
Iliac  spines,  21  cm.,  (8i  inches.) 
Iliac  crests  23  c  m.,  (9  1-20  inches.) 
Internal  conjugate  Si  cm.,  (8^  indies.) 
The  patient  was  intelligent,  and  gave  a  good 
history  of  a  ten  montha'  pregnancy.     PreviouB 
to  the  operation  manual  palpation  showed  that 
the  head  rested  on  the  iliac  bones^  and  could  not 
be  forced  into  the  **  false  "  pelvis.     The  child's 
head  measurements  were  about  1  c.  m.,  (.3937 
inches,)  in  excess  of  the  normal  in  all  direc- 
tions.    Circumference  36 i  cm.  (14|  inches.) 

The  uterus,  tubes,  and  ovaries  were  healthy, 
and  Dr.  Hirst  intended  using  the  Sanger  opera- 


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tion,  but  an  obstinate  post  partum  hemorrhage 
compelled  him  to  adopt  the  Porro.  The 
technique  of  the  operation  was  the  same  as  de- 
scribed above.  Mother  made  a  good  recover)' 
and  child  is  doing  well. 

Dr.  Hirst  advises  that  the  operator  wait  until 
labor  pains  are  well  established,  as  he  is  con- 
vinced that  failure  so  to  do  will  often  result  in 
obstinate  postpartum  hemorrhage. 

He  also  calls  attention  to  the  fact  that  the 
aortic  pulse  may  be  mistaken  for  fetal  heart 
sounds,  as,  indeed,  was  done  by  one  physician 
in  Case  1.  The  f)ul8e  was  140,  rendering  the 
difereutiation  difficult 

In  these  operations  Dr.  Hirst  does  not  use 
chemical  disbfectants  during  the  operation,  but 
after  itsoorapledon  the  abdominal  cavity  is  well 
flushed  with  bichloride  1-1000,  and  over  the  ab- 
dominal sutures  iodoform  powder  is  dusted 
generously.  The  dressing  is  completed  by  iodo- 
form gauze  adhesive  strips  and  cotton  bandages. 

Symphyseotomy. 

A  rachitic  dwarf — primapara,  4  feet  1  inch 
high  .  diagonal  conjugate,  9  cm  ;  recovery. 

At  a  glance  her  peculiar  waddle  and  short 
stature  indicated  serious  pelvic  deformity.  Her 
conjugate  was  measured  several  times  by  differ- 
ent physicians.  All  arrived  at  the  same  result. 
Consequently  premature  labor  was  induced — 
the  cervical  canal  dilated  with  Bame's  bags, 
the  symphysis  cut  and  forceps  applied — but  the 
head  fail^  to  engage.  Version  was  resorted 
to  and  the  child  extracted,  but  the  force  re- 
quired was  sufficient  to  break  the  neck  and  one 
of  the  clavicles. 

The  measurements  plainly  indicated  a  sym- 
physeotomy, while  the  case  in  reality  was  one  for 
cesarian  section.  The  pelvis  was  subsequently 
measured  by  Hirst's  new  pelvimeter  and  showed 
a  true  conjugate  of  but  6  c.  m.  scant,  (2i 
inches  ) 

[In  connection  with  the  above  it  will  be  re- 
membered that  the  approximate  measurements 
of  the  normal  pelvis  are  as  follows:  j 

External  conjugate,  20^  c.  m.  (7.9  inche^). 

Iliac  spines,  'Z^l  c.  m.  (10  inches).       .  _  . 


.I')-W  A 


Iliac  crests,  27^  cm   (11  inches).      .jw^ 
Internal  conjugate,  12^  c.  m.  (4.8  jy^lieg^j 


5    ..lli'i 

University  of  Pennsylvania  /Slji^tc^^^ 


■aj  act: 

SpeciaUy  Reported  for  The  MepicUsat&SttP.   da: 

Dr.  Ott,  of  Ea^ton,  lectur^  Wcfedtff .  i9Vflie 
combined  classes  on  his  redSH  .^ves'tigttflSn^^of 
the  centers  controlling  respificioii.""*  He^'v^-  a 
practical  demonstration-^)? Ittie  VirStfece'^oP  a 
polypneic  center,  so  Wig  sdtfj^  ^6y  ^^f^tfiSfis. 


Rabbits  were  heated  in  aa  oven  until  the 
rate  of  respiration  could  hardly  be  counted.  Dr. 
Ott  then  touched  the  center  and  immediately 
the  rate  fell  to  normal.  He  was  enthusiastically 
congratulated  by  his  audience  on  his  discovery. 

Dr.  DaCosta  recently  gave  a  series  of  lectures 
to  the  students  on  "Weak  Heart"  and  *  Lith- 
emia."  In  lithemia  the  doctor  absolutely  in- 
terdicts all  alroholic  beverages  except  claret. 
He  required  regular  systemic  exercise  and  de- 
plores the  practice  of  attempting  a  cure  by  the 
mere  resolution  of  the  acid.  In  acute  attacks 
he  says  it  is  necessary  to  dissolve  it,  and  during 
the  temporary  relief  he  seeks  out  and  treats  the 
cause  of  the  diathesis  by  a  rigid  investigation  of 
the  patients  beverages,  diet  and  exercise. «  To 
dissolve  the  uric  acid  in  acute  attacks  he  gives 
citrate  of  lithium,  gr.  xx,  or  citrate  of  potasslb^, 
gr.  XX,  well  diluted,  two  hours  after  meals,  ne 
directs  the  patient  to  take  a  glass  of  water  just 
before  retiring.  d  ma  I 

Dr.  John  B.  Deaver  calls  attestidm^orHike 
fact  that  in  operations  for  the  sui^iaal9iaarei<6f 
appendicitis,  the  appendix  is  nogiMiail  iot^e 
position  described  in  the  text  bMkscaajd  oftttu^r 
than  in  a  half  dozen  other  posiliianLaxafiH  ^&bs 
the  following  figure  to  iWidtwjm'rikB&JMBMikt 
positions:  4«q  ^di  a^dn  rio  if*d 


N.W. 


w. 


8.W. 


The  cl^ 

-the  li;p-g^ 

Prof.  Ne 


re_on  the 


U 
I 

I 

I 

*Use 
a- 
le 
n- 


}'' 


37af>4  W^jprtf^j^  t^^>g9^  <yWQrt»**8f^  a 

nasfiVkto'^wMfe^ola^fadiJ^'^^bHeflAilBMcb.ud^r. 
y^feippeaB  aknBjiiag^8aaiBim[|ba»f4jeyM 

-^ds  Dh'ai|ftci^M4>Will  sd()§^*fubli*^ri*nriwai  on 
^^ild^^?^^bgr(My«m}  ^^^tl^k^^^!l>teR)^n 
^^^^A^^'>ret^T^46  itiie4ctffieii5rlfi«|^«dr«As- 
'^^^A^^Mir^'iiii^iEnitf''  Thli  dbetor'ff^'iMi^^'Ifi^ll 
'^i^c^,'%ni  reitdif^tfie  vari^  Mo(9(>^o^ldltaig 
^  InsiMitii^Ati  %or*^ 'tliah'^s^i^.^^i^^'^^^-^  'woa) 


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THE  MEDICAL  WORLD. 


Dr.  Wood,  with  the  idea  that  the  exaggera- 
ted voluntary  movements  in  chorea  are  due  to 
failure  of  the  inhibitory  centers  to  act  properly, 
gives  large  doses  of  quinine  in  this  disease  with 
gratifyitvg  success. 

Dr.  Davis  gives  scale  pepsin  with  quinine  for 
uterine  inertia  in  labor.  He  claims  that  the 
pepsin  overcomes  the  tendency  of  the  stomach  to 
throw  out  all  drugs  during  the  throes  of  labor. 

Drs.  Daland  and  Wood  are  now  experiment- 
ing in  hypnotism  with  a  view  towards  the  treat- 
ment of  hysterical  cases  by '•suggestion"  while 
in  the  mesmeric  state.  Each  of  the  doctors  has 
had  excellent  results. 


-  fWe  give  below  some  letters  that  were  re- 
ed ved  by  Dr.  Waugh,  together  with  his  replies 
to  them.] 

Vulvitis  in  an  infant 

I  am  having  some  trouble  with  a  case  of  vul- 
vitis and  vaginitis  for  which  I  ask:  your  valua- 
ble assistance.  Maggie  S.,  age  two  years,  has 
had  a  discharge  from  the  vagina  for  a  long  time, 
but  it  has  never  caused  any  trouble  till  lately. 
The  inflammation  has  extended  to  the  vulva. 
Urine  has  always  had  a  bad  smell  and  malccHS 
her  cry  when  she  passes  it  I  have  used  the 
usual  remedies  but  have  not  received  any  bene- 
fit so  far.  Please  give  me  your  opinion  of  the 
case  and  oblige.  Family  history  good,  and  the 
people  are  very  clean.  J.  D.  B. 

[Examine  and  see  if  there  are  seat  worms  or 
a  foreign  body  to  keep  up  the  discharge.  If 
not,  wash  thoroughly  with  peroxide  of  hydrogen 
solution  and  apply  aristol  in  powder  or  petrola- 
tum oil.     Salol  internally,  gr.  v.  daily. 

W.  F.  W.] 


Locomotor  Ataxy— Morphinism. 

I  have  two  cases;  one  that  troubles  more  than 
the  other.  Ck>uld  you  suggest  anything  for  a 
chronic  case  of  locomotor  ataxia  of  twelve  years 
Branding,  that  all  the  ph}  sicians  have  tried  ?  The 
other  b  a  case  of  morphine  habit  in  a  patient  of 
65  years  taking  one  grain  per  diem.  I  shall 
not  weary  you  with  history  of  either.  I  have 
had  a  somewhat  extended  experience  in  hospit- 
als mnd  general  practice  in  the  country.  I  tried 
your  treatment  of  neuralgia  affecting  the  heart 
with  arieniate  of  strychnine  granules,  and  they 
work  well.  F.  G.  D. 

[For  chronic  ataxy  I  would  employ  the 
French  method,  of  training  the  affected  muscles 
by  exercising  them  in  all  difficult  combinations 
of  movements.  Also  give  the  iodides  persist- 
ently for  months.  Treatment  often  fails  be- 
cause elimimants  are  not  given  1  jng  enough,  or 


when  this  is  done  the  muscles  are  not  restored 
to  their  functions  by  eystematic  drilling.  Mas- 
sage and  electricity  are  of  advantage  in  so  far 
as  they  accomplish  these  indications. 

Be  very  careful  in  taking  morphine  from  a 
man  65  years  old.  The  chaoces  are  very  great 
that  some  under  lying  disease  will  show  itself. 
During  the  withdrawal  every  symptom  should 
be  watched  and  weighed  carefully.  Take  about 
ten  days  for  the  reduction.  W.  F.  W.] 

Soal>ie»? 

I  have  been  annoyed  lately  by  several  cases 
of  skin  disease  and  would  lilte  help  as  to-  diag- 
nosis and  treatment.  It  resembles  lichen,  I 
think,  but  is  undoubtedly  eommunicable.  It 
comes  out  on  the  breast,  fore  arms,  flexures  of 
the  elbows  and  more  rarely  inside  of  the  thighe. 
It  comes  as  a  small  round  pivple,  very  sKght  red- 
ness, not  confluent  and  never  becomes  vesicular 
or  pustular.  In  fact,  if  not  scratched  it  some- 
times disappears  only  to  reappear.  If  scratched, 
which  it  nearly  always  is,  a  small  speck  of  blood 
will  dry  on  the  top. 

I  have  got  the  best  results  from  black  orjei- 
low  wash  externally,  laxatives  and  arsenic  in^ 
temally.  W.  8.  IIamsey,  M.  D.. 

Coraopolis,  Pa. 

[Is  this  not  a  form  of  scabies  ?  It  seems  so 
from  the  fact  of  occurring  at  the  flexures,  and 
being  communicable.  I  would  apply  biniodide 
of  mercury  ointment,  ten  to  twenty  grams  to  the 
ounce.— W.  F.  W.] 


Injury  to  Hip  Joint. 


Will  you  kindly  give  me  your  opinion  of  the 
following  case,  as  to  diagnosis  and  treatment  ? 

A  maiden  lady  of  about  sixty-five  years, 
something  over  a  year  ago  fell  upon  her  right 
hip,  which  caused  much  pain  but  which  did  not 
prevent  her  from  walking  about  a  mile  home. 
The  pain  gradually  grew  worse  until  she  had  to 
use  crutches.  I  should  have  added  that  her 
previous  health  had  been  very  good ;  her  fitmily 
history  is  good,  and  she  was  always  used  to  do- 
ing out-door  work  more  suitable  for  a  man  than 
a  woman.  I  first  saw  her  about  January  Ist,. 
although  she  had  been  unsuccessfully  treated  by- 
two  physicians  previously.  Upon  examination 
I  found  some  little  atrophy  of  the  muscles  of 
the  thigh,  a  little  shortening  of  the  limb  and 
pain  around  the  head  of  the  femur  and  along 
the  inguinal  region.  The  pain  is  generally 
worse  at  night  which,  of  course,  is  the  case  with 
all  pain  but  at  times  there  is  considerable  pain 
in  the  other  thigh.  The  pain  in  the  eflected 
thigh  extends  down  along  the  inside  of  the  thigh 
as  far  as  the  knee.     Her  general  health  wasim- 


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-paired.  I  gave  tonics — iron,  Fowler's  solu- 
tions, also  several  bottles  of  cod- liver  oil.  I  en- 
veloped the  hip  and  thigh  in  cotton  with  sul- 
phur and  covered  mth  flannel,  which  did  not 
relieve  the  pain  any.  She  is  now  taking  Fow- 
ler's solution  in  increasing  doses,  and  acetate  of 
soda  to  neutralize  the  urine.  Since  I  am  at- 
tending her  there  is  not,  nor  has  there  been,  any 
heat  above  the  norinal  about  the  joint  nor  any 
pain  on  passive  motion.  Although  there  is  oc- 
casionally a  little  ''snap"  in  the  joint  as  though 
the  tendons  were  relaxed;  this,  upon  motion. 
From  the  above  description  if  you  can  give  me 
any  light  on  the  subject  you  will  greatly  oblige 
a  constant  reader  of  The  World  and  one  who 
appreciates  your  articles  in  the  same. 

C.  B.  McClure,  M.  D., 

Berrjrsburg,  Dauphin  Co.,  Pa. 

[Subacute  inflammation  of  the  hip  joint.  Put 
on  a  plaster-paris  dressing  to  fix  the  joint,  or  a 
brace,  and  keep  it  fixed  until  the  inflammation 
subsides.  Give  tonics,  especially  iodide  of  iron. 
If  this  does  not  relieve,  you  must  open  the  joint, 
let  out  the  pus,  clear  away  dead  tissues  and  dis- 
infect with  peroxide,  or  iodoform  in  ether ;  then 
treat  on  surgicf^  principles,  with  strict  antisepsis. 
— W.  F.  W.] 


Inveterate  Attack  of  Eczema  of  the  Face  and  Hands 

with  Conjunctivitis  and  Intense  and  Agonizing 

Pruritus. 

About  three  weeks  ago  I  noticed  an  inflam- 
matory condition  of  the  back  of  both  my  hands 
and  face,  ears  and  eyes  being  extremely  itehy, 
painful,  hot  and  tingling,  with  a  constant  desire 
to  rub.  Thinking  that  the  system  required 
medicines  to  operate,  I  took  mag.  sulph.,  pot 
bitart  and  sp.  seth.  nit,  pulv.  jalapse  co.  and  a 
mercurial  purgative.  I  applied  ung.  hydrag 
ox.  flav.  to  the  eyes,  oleate  of  zinc  ointment, 
diachylon  ointment  and  sp.  sapoius  kal.  but 
no  relief  to  the  itohing.  3&thing  in  hot  water 
with  soda  biborato  used  to  give  me  immediate  re- 
lief, but  not  lasting.  I  tried  also,  carbolic 
acid,  but  it  did  not  relieve  the  itching,  pain  and 
heat  I  finally  took  soda  brom.  grs.  xv.,  and 
applied  externally  a  powder  composed  of  pulv. 
gum  camph.  and  hydrate  of  chloral,  of  each  dr. 
i,  iocorporated  with  one  ounce  of  starch  ;  dust- 
ing and  rubbing  with  this  gave  me  the  most  re- , 
lief. 

What  do  you  suppose  brought  this  attack 
on  ?  Was  it  due  to  indigestion  and  irritation  in 
the  skin  or  caused  by  nervous  irritation  and 
worry?  I  have  had  considerable  worry  for 
the  last  six  months — otherwise  my  health  is 
ood  ;  but  my  bowels  are  inclined  to  be  slug- 
uh  a  nd  costive.     Can  you  suggest  a  remedy 


foi^  immediate  local  application  that  will  relieve 
the  distress  of  the  pruritus,  pain,  heat  and  ting- 
ling in  the  hands,  fingers  and  face  ?  Were  a 
patient  to  have  consulted  me  formerly,  I  am 
sure  I  could  not  have  realized  his  situation,  but 
my  experience  of  late  makes  me  think  its  more 
intolerant  than  the  plague  of  Job  that  we  read 
of  in  the  Bible.  Awaiting  your  opinion  and  ad- 
vice. I  remain  yours  truly, 

R  MacNeill,  M.  D., 

Stanley  Bridge,  P.  E.  I. 

[Such  eczematous  attacks  are  often  due  to 
lithemia ;  ani  this  may  be  attributed  to  excess 
in  the  use  of  nitrogenous  food.  Mental  labor 
is  exhausting,  and  the  system  naturally  craves 
the  food  that  supplies  nutriment  the  most  easily 
digested  and  assimilated.  But  as  this  requires 
exercise  to  utilize  it  properly,  for  want  of  muscle- 
work  the  blood  becomes  surcharged  with  the 
products  of  nitrogenous  waste  and  imperfect  as- 
similation. The  remedy  is  obvious  ;  less  meat 
and  more  work.  To  relieve  the  itohing,  apply 
chloroform ;  or,  if  the  pruritus  cover  very  large 
areas  and  recur  very  often,  use  a  liniment  of 
aconite  tinct,  one  drachm,  and  spirits  of  chlo- 
roform, four  to  eight  ounces.  The  bowels 
should  always  be  kept  open  by  salines. 

W.  F.  W.] 


Stricture  wtth  PalnAil  Left  Leg. 

A  tall,  slim  man,  aged  34,  married,  of  good 
habits  and  of  good  stock,  mechanic,  was  injured 
four  years  ago  by  the  frame  of  a  house  falling 
when  he  was  working^  on  it,  breaking  his  right 
femur,  injuring  his  back  quite  severely  and  cut- 
ting his  scalp  in  several  places.  He  was  well 
treated  and  made  a  good  recovery.  A  year  ago 
he  began  to  urinate  very  often,  and  have  pain 
in  his  back  and  down  his  left  thigh  and  some- 
times in  his  leg.  About  six  months  ago  he  be- 
gan to  have  great  difficulty  to  start  the  water, 
and  the  stream  grew  smaller  and  smaller  until 
the  beginning  of  January  of  this  year,  when  It 
came  in  drops  a  good  part  of  the  time.  On  the 
6th  of  January  he  came  down  with  la  grippe, 
but  soon  recovered  under  treatment,  but  his 
kidney  and  bladder  trouble  soon  grew  much 
worse  and  he  had  to  take  his  bed  about  the  25th 
of  February,  when  he  sent  tor  me  again,  and 
'  gave  me  a  history  of  his  urinary  troubles,  which 
he  had  never  mentioned  when  I  was  attending 
him  for  the  grip.  I  at  once  diagnosed  stricture 
of  the  urethra  and  found  it  impossible  to  pass  a 
No.  1  cathether.  Afcer  preparing  him  for 
catheterization  I  managed  to  get  a  filiform 
bougie  into  his  bladder  and  gradually  dilated 
the  stricture,  which  i9  in  the  membranous  por- 
tion of  the  urethra  or,  perhaps,  strictly  speak- 


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THE  MEDICAL  WORLD. 


ing,  at  the  junction  of  the  bulbous  and  mem- 
branous portions,  until  at  three  seances,  I  pass- 
ed a  No.  10  flexible  catheter,  but  the  stricture 
tends  to  contract  very  soon  after  withdrawmg 
the  catheter ;  and  after  the  second  sitting  his 
right  testicle  swelled  in  the  regulation  way  of 
such  cases,  but  he  did  not  have  a  chill  or  rise  of 
temperiture.  But  the  pain  in  his  left  leg  from 
the  hip  joint  to  the  ankle  is  agonizing  at  times, 
requiring  from  a  quarter  to  half  a  grain  of 
morphine  hypodermically  to  give  him  any  re 
lief.  As  a  sample,  yesterday  he  waa  easy.  I 
passed  several  soft  bougies  and  drew  ofi  his 
water.  He  had  no  pain  ail  night;  this  morning 
at  11,  I  passed  an  olive  pointed  No,  10  catheter 
into  his  bladder  easily;  it  gave  him  very  little 
pain.  He  was  perfectly  easy  till  2  p.  m.,  when 
his  leg  began  to  pain  him  and  grew  worse  and 
worse  till  seven,  when  a  hypo  of  half  a  grain  of 
morphine  gave  him  partial  relief.  Could  not 
start  the  water  while  the  pain  was  so  severe. 
Have  not  been  able  to  pass  a  steel  sound  yet  to 
find  if  he  has  a  calculus.  His  urine  was  highly 
albuminous  and  scanty  for  two  weeks,  but  has 
increased  in  quantity  and  decreased  in  albumen 
since  the  stricture  has  been  dilated  somewhat. 
I  have  given  him  a  number  of  drugs,  the  prin- 
cipal being  acetate  of  potash,  buchu,  saw  pal- 
metto, basham's  mixture,  spt  ether  nitrosi,  etc., 
as  his  condition  seemed  to  require.  What  puz- 
zles me  most  is  the  leg  pain,  and  why  it  comes 
on  so  irregularly  and  leaves  so  completely  after 
several  hours  of  the  most  intense  agony.  The 
morphine  does  not  remove  it  It  leaves  in  a  few 
hours  if  an  opiate  is  not  given. 

I  am  of  the  opinion  that  the  stricture  is  trau- 
matic and  the  six  months  straining  every  two  to 
four  hours  for  five  to  ten  minutes  has  caused  the 
trouble  in  the  kidneys  and  bladder. 

If  you  can  make  a  satisfactory  diagnosis  from 
my  account  of  the  case  and  suggest  some  means 
of  relief  I  will  be  greatly  obliged. 

T.  W.  M. 

[I  am  not  sure  that  we  must  associate  the  leg- 
pain  and  urinary  affections.  They  may  be  in- 
dependent But  in  these  days  of  reflexes  it  is 
good  practice  to  cure  anything  you  find  out  of 
order,  if  possible.  Dilate  the  stricture  up  to' 
the  full  extent,  with  Newman's  electric  sounds 
if  you  have  them,  with  steel  sounds  otherwise. ' 
I  have  often  found  it  useful  to  insert  the  largest 
soft  catheter  I  could,  and  leave  it  in  all  night 
Next  morning  an  instrument  two  sizes  can  be 
introduced,  and  in  this  way  a  stricture  may  be 
readily  and  painlessly  dilated.  For  the  neu- 
ralgia, inject  theioe  close  down  to  the  painful 
point,  and  put  a  little  blister  over  the  sacro- 
sciatic  articulation.  W.  F.  W.] 


Cause  or  Co- incidence  ? 

Editor  Medical  World; — I  have  ob- 
served that  of  the  fruitless  marriages  hereabouts 
the  great  majority  of  the  men  are  not  users  of 
tobacco,  whereas  the  great  majority  of  the  men 
of  the  community  do  use  tobacco.  Observations 
extending  over  a  period  of  twenty  years  in  a  rural 
community  of  about  5  000  people  shows  that, 
of  the  unfruitful  husbands,  84  per  cent,  do  not 
use  tobacco  in  any  shape.  My  cases  are  selected 
from  those  who  have  married  in  the  "spring 
time'*  of  life  and  does  not  include  those  who  have 
waited  until  the  fount  of  life  had  dried  up  in 
them.  In  support  of  the  theory  of  cause  I  may 
cite  two  cases  that  were  on  my  list  of  temperate 
men  for  about  two  years,  when  they  became 
users  of  the  weed  and  afterwards  became  par- 
ents ;  but,  I  am  not  arguing  the  question — I 
simply  wish  to  direct  the  attention  of  your  many 
thmkiog  children  to  the  matter  and  hear  from 
any  who  may  have  made  observations  in  the 
line.  NicoTiNus, 

E ,  Pa. 


Qui;;  DeI>artiTient. 


Qaestions  are  solicited  fotf  this  Colutzm.  CommuQicatioiia 
not  accompctnied  by  the  proper  name  and  address  of  the 
writer  (not  neceaaarily  for  publication),  wiU  not  be 
noUced. 

The  great  niunber  of  requests  fbr  private  answers,  for  tbe 
information  and  benefit  of  tbe  writer,  makes  it  necess- 
^  !^,"?  to  chaqre  a  fee  for  tbe  time  required.  This 
fee  will  be  from  one  to  five  doUars,  according  to  ihm 
amount  of  research  ami  writing  required. 


Editor  Medical  World  : — In  an  experi- 
ence of  thirty  years  I  never  met  with  anything 
that  in  any  way  resembles  the  following : 

At  3  a.  m.,  February  12th,  1894,  was  called 
to  see  G.  T.  B.,  aged  40,  formerly  a  blacksmith, 
but  for  the  past  four  years  has  been  working  at 
carpentry.  I  never  knew  him  to  be  sick  before. 
Up  to  four  weeks  previoui^  to  this  sickness  he 
was  in  the  habit  of  taking  his  dram  three  or 
four  times  a  day.  When  I  reached  him  he  was 
lying  on  his  back,  eyes  wide  open  and  starng 
— pupils  insensible  to  light,  breathing  very  slow 
and  labored,  twelve  to  the  minute,  pulse  sixty, 
and  jerky,  skin  a  natural  color,  but  cool,  ex- 
tremities cold  ;  body  as  rigid  as  if  frozen  stiff. 
As  the  family  had  no  mustard  in  the  house  I 
applied  chloroform  locally  to  the  spine,  full 
length,  around  knees  and  ankles  and  wrists — 
and  used  friction,  heavy  as  could  be  made.  For 
an  hour  I  could  see  that  no  impression  was 
made  for  the  better  and  at  the  end  of  an  hour 
his  eyelids  began  to  twitch  and  jerk  and  in  half 
hour  more  he  began  to  groan  and  put  his  tongue 
out  and  in  a  few  minutes  more  be  showed  Uiat 


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THE  MEDICAI.  WORLD. 


173 


he  UBdergtood  a  question,  when  I  gave  him  a 
tea8]:>oonful  every  ten  minutes,  for  three  doses  of 
the  following: 

R  Chloroform 

8pcs.  ammon.  nromflt. 

Ether  8iilph aa flram  j 

Water  swee  eued ouiiiesu 

After  taking  the  second  dose  he  was  able  to 
speak,  when  I  found  that  he  had  no  pain  and 
had  had  none.  He  did  Qot  remember  how  he 
was  first  taken.  His  wife  was  awakened  by  his 
groans  and  he  soon  became  insensible  and  rigid 
and  after  trying  all  she  koew  she  sent  for  me. 
He  was  insensible  two  and  a  half  hours.  As 
soon  as  he  could  swallow  well  I  gave  him  : 

R    Hydran?.  chlo.  mlt  jfr.  vi 

Ex.  colooTu.  CO gr.  lij 

Leptandnn gr.  ij 

Ft.  chart -No.  3  ,  sig.    One  every  two  hours. 

From  this  the  bowels  moved  at  four  p.  m., 
when  he  left  the  hou^e  to  go  to  the  water  closet 
through  a  rain,  and  at  six  p.  m.  I  was  sent  for 
agaio  and  found  him  in  the  same  condition  as  at 
three  a.  m.  At  this  time  I  had  plenty  of  as- 
sistance and  with  mustard,  frictions  and  hot  foot 
baths  we  brought  him  around  in  one  and  a  half 
hours.  From  six  a.  m.  till  he  was  taken  in  the 
evening  he  had  two  grains  of  quinine  every  two 
hours.  During  the  nighc  he  had  quinine  three 
grains  and  potass,  bromid.  five  grains  every 
three  hours  and  continued  till  noon  of  second 
day  when  I  put  him  upon  a  compound  of  iron, 
quinine  and  strychnine.  Since  he  began  to  take 
the  last  preparation  he  has  convalesced  and  is 
now  able  to  work.  Having  lived  in  Texas 
some  fifteen  years,  where  all  types  of  congestion 
are  met  with,  I  never  met  with  a  case  with 
a  single  symptom  compared  with  the  above. 
At '  first  I '  thought  he  had  been  poison- 
ed, but  by  excluding  all  poison  symptoms 
I  was  forced  to  a  conclusion  of  a  congestion 
of  the  nervous  centres  and  treated  him  for 
that  with  a  favorable  result  As  be  recov- 
ered, I  discovered  by  close  questioning  that  he 
had  strained  his  back  in  lifting,  a  week  before 
he  was  taken  aick.  D.  £.  Ruff,  M.  D., 

Junction  City,  Lane  Co.,  Or^on. 


Editor  Medical  World:— In  January, 
1891,  I  was  taken  with  nervous  spasms  and 
threatened  heart  failure.  The  spasms  h&ve 
continued  at  intervals  of  once  a  week  and  some- 
I  times  oftener.  During  the  three  years  I  have 
had  seven  attacks  of  the  heart  failure ;  one  with 
the  last  spasm.  The  only  medicine  that  re- 
lieves me  is  brandy,  and  a  mixture  of  potass, 
brom.  and  sodee  brom.  aa  dr.  j.  aqua  dr.  xvj. 
(IH),  mix.  Dose,  teaspoonful  three  times  a  day. 
In  my  case,  I  lake  one  tablespoonful,  and  repeat 
in  from  ten  to  fifteen  minutes,  which  generally 
checks  the  spasms,  and  brandy  with  hot  appli- 


cations over  the  heart  controls  it.  Doctors  have 
timed  the  discontinuance  of  the  pulsations  and 
heart  beats,  which  has  lasted  four  minutes  at 
one  time ;  all  medicines  have  failed  to  make  a 
cure  in  my  case.  The  trouble  is  attributed  to 
malaria ;  but  at  no  time  did  my  system  indi- 
cate fever.  If  any  of  the  World  readers  can 
assist  me  through  it  or  by  a  private  letter  I  will 
be  very  thankful.  F.  K  Brower,  M  D., 
813  Santa  Rosa  Ave.,  Santa  Rosa    Cal. 


Resuscitation  From  Drowning. 

Editor  Medical  World  :— I  will  report  a 
case  that  has  just  come  under  my  observation 
which  may  be  of  interest  to  your  many  readers. 

March  25th  I  was  called  to  see  a  child  two 
and  a  half  years  old,  which  had  fallen  into  an 
open  cistern  and  was  apparently  dead  when 
taken  out.  It  is  not  positively  known  just  how 
long  the  child  had  been  immersed  in  the  water, 
but  probably  not  longer  than  two  minutes. 
When  taken  out  lifeless  it  was  held  up  by  the 
feet,  head  downward  and  water  ran  out  of 
its  stomach. 

The  usual  means  for  resuscitation,  under  the 
circumstances,  were  used  with  the  result  of 
bringing  the  child  around  all  right,  as  I 
thought.  Its  respiration  was  normal  and  circu- 
lation was  good,  as  was  shown  by  the  na(ural- 
color  coming  back  to  its  face  and  lips.  It  had 
taken  about  thirty  minutes  for  these  resuhs  to  • 
be  accomplished,  and  I  thought  the  child  was 
out  of  danger  and  was  about  to  give  it  to  its 
mother  when  suddenly  it  became  cyanose  and 
all  the  symptoms  of  impending  death  arose. 
But  by  the  use  of  whiskey  and  artificial  respira- 
tion and  hot  blankets  I  was  able  to  resuscitate 
the  child  again,  but  in  about  twenty-five  min- 
utes more  the  same  condition  arose,  only  withv 
more  violence,  all  the  muscles  of  the  body  be- 
coming rigid  and  every  symptom  of  a  violent 
convulsion  coming  on.  But  by  repeating  the' 
same  remedies  the  child  was  perfectly  well  and 
playing  about  the  room  in  three  hours.  Why 
did  these  cyanotic  conditions  arise  after  the 
child  first  seemed  out  of  danger  ? 

I^uisville,  Ky.  J.  A.  Peak,  M.  D., 


Editor  Medical  World: — My  little  boy, 
20  months  old,  had  whooping  cough  It  sud- 
denly stopped  for  two  weeks.  While  standiiig 
by  the  bed  he  fell  over  on  the  carpet,  striking 
his  head  over  the  left  eye.  My  wife  picked  him 
up.  In  a  little  while  he  seemed  to  be  as  well 
as  usual.  This  happened  about  4  p.  m.  At 
6  p.  m.  he  vomited,  and  again  at  about  mid- 
night. Next  morning  at  8:30  he  was  taken 
with  convulsions,  which  lasted  till  2:30  p.  m. 

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THE  MEDICAL  WORLD. 


1 


Next    morning    he    was   a   little   better,    but 
weak. 

Tuesday  morning  he-  commenced  to  whoop 
violently,  and  kept  it  up  and  grew  weaker  and 
weaker  after  each  paroxysm.  The  night  before 
he  died  the  cough  stopped  and  he  had  another 
convulsion.  He  was  an  eight  month's  child, 
and  was  what  is  known  aa  a  *'  blue  baby."  His 
heart  w|u  weak  and  he  had  a  large  head. 
What  do  you  think  was  the  cause  of  the  vomit- 
ing and  convulsions?  He  did  not  have  any 
fever,  but  was  constipated.  He  emptied  his 
bowels  before  the  convulsions  came  on. 

Dr.  David  Coleman, 

Tottenville,  N.  Y. 

Editor  Medical  World  : — •!.  P.,  aged  23, 
height  6  feet  1  inch,  weight  160  pounds,  four 
years  ago  suffered  from  muscular  rheumatism, 
iwhich,  after  appropriate  treatment,  passed  over. 

Probably  some  two  months  after  this  a  dif- 
tfused  swelling  appeared  on  the  upper  surface  of 
Tthe  thigh  about  4  inches  below  the  crest  of  the 
ttlium.  After  several  days,  aspiration  showed 
pus  and,  after  lancing,  there  was  quite  a  liberal 
discharge.  This  (No.  1)  opening  remained 
about  one  year,  but  in  th)  course  of  about  six 
months  later  another  swelling,  resulting  in  an 
open  abscess  (No.  2)  after  lancing,  was  es- 
tablished 4  incheir  below  the  tuberosity  of  the 
great  trochanter.  Since  then  abscess  No.  3  has 
formed  on  the  inner  upper  3d  of  the  thigh.  All 
formations  thus  far  described  are  on  the  right 
aide. 

By  the  time  this  third  opening  was  estab- 
lished, openings  No.  1  and  No.  2  had  closed. 
This  was  about  two  years  after  the  commence- 
ment of  the  first  abscess.  Then  abscess  No  4 
firesented  itself  half  an  iach  to  the  right  of  the 
tinea  alba,  and  two  inches  above  the  pubic 
bone.  This  opening  is  discharging  contuiually, 
Jbut  abscess  No.  2  (below  the  tulMroeity  of  the 
great  trochanter)  opens  regularly  every  three 
months,  discharging  about  one  pint  of  pus  in 
one  week's  time.  At  the  formation  of  each 
abscess  there  was  quite  an  amount  of  sloughing 
fiimilar  to  that  in  carbuncle ;  this  would,  how- 
ever, fill  out  with  new  granulations  until  a 
email  opening  to  admit  an  ordinary  probe  would 
remain.  During  all  this  time  the  patient  was 
kept  on  cod  liver  oil  and  hypophosphites,  and 
increased  in  height  and  weight — ^in  fact,  was  in 
excellent  health  excepting  a  day  or  two  before 
abscess  No.  2  would  reopen.  Of  late  he  has 
complained  of  some  pain  in  the  prostatic  region 
while  urinating,  but  this  has  now  disappeared. 
Careful  examination  thus  far  has  failed  to  re- 
veal any  spinal  tenderness  or  curvature.  No 
possible  indication  of  hip  joint  trouble.  Probing 


has  failed  to  give  any  satisfactory  results,  as  the 
abscesses  seem  to  follow  the  muscular  sheaths. 
He  has  always  been  able  to  pursue  his  usual 
labors  upon  the  farm,  such  as  plowing,  etc., 
when  he  experiences  no  pain,  but  upon  resting 
'  he  says  he  experiences  excruciating  pain  at  the 
juncture  of  the  sacrum  and  ilium,  but  upon 
digital  pressure  no  pain  is  elicited. 

Appetite  always  good.  Bowels  r^ular.  No 
glandular  swellings.  Ko  ancestral  taint  of  any 
kind  to  be  found.  I  should  be  very  much 
pleased  to  have  some  of  the  profession  locate  the 
Eeat  of  the  trouble. 

Case  No.  2.  Little  girl,  aged  6.  A  case  of 
cerebro-spinal  meningitis.  Nothing  out  of  the 
ordinary  in  the  case  and  passing  on  to  the  sixth 
week.  The  peculiarity  about  this  case  is  that 
for  the  last  two  weeks  the  urinometer  test  has 
always  shown  a  ap.  q.  of  1.000  to  1.004  at  most 
No  trace  of  albumen,  microscopic  examinatioa 
shows  a  few  crystals  of  uric  acid.  All  other 
tests  negative. 

I  have  never  in  15  years'  practice  met  with 
so  low  a  test.  Have  any  of  my^ brethren? 
How  can  it  be  explained  ? 

St  John,  Ohio.    A.  P.  Renneker,  M.D., 


Editor  Medical  World  : — Will  some  one 
please  tell  me  how  to  cure  ulcerative  stomatitis 
or  ''canker  sore  mouth  ?"  My  wife  has  had  it 
all  her  life.  Each  menstrual  period  is  sure  to 
bring  from  two  to  six  cankers.  Our  five-year- 
old  boy  has  begun  to  have  them  Local  appli* 
cations  of  peroxide  of  hydrogen  has  given  b^- 
ter  results  than  anything  else  so  far  tried. 

Alba,  Mich  F.  L.  Kell^v,  M.D., 


Editor  Medical  World  : — I  take  the  lib- 
erty of  writing  you  about  a  man  coming  under 
my  observation  with  an  enlarged  testicle.  He 
did  not  come  to  me  for  treatment,  however,  but 
was  brought  to  my  notice  by  the  kind  sugge8> 
tion  of  Mr.  D.,  a  druggist,  as  he  had  known  the 
man  for  a  long  time,  and  as  I  have  not  beoi 
here  long  I  had  never  had  the  opportunity  of 
seeing  him  before.  The  patient  is  a  married 
man,  about  fifty  years  old,  in  apparently  good 
health,  exceptiog  the  left  enlarged  testicle.  He 
has  not  become  the  fieither  of  any  children  since 
the  commencement  of  this  trouble.  Its  com- 
mencement was  about  fifteen  years  ago,  and  it 
has  been  growing  larger  ever  since.  It  will 
measure  twelve  inches  in  circumference.  He 
does  not  give  any  information  r^arding  the 
starting  point  of  his  disease,  except  the  enlarge- 
ment of  the  testicle.  He  stated  to  me  that  he 
had  parotiditis  (mumps)  five  years  before  his 
testicle  began  to  enlarge  and  gave  a  history  of 


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m^astatic  complicadon  duriog  or  after  bis  at- 
tack. He  has  not  bad  any  pain  witb  tbis 
enlarged  testicle  during  tbe  fifteen  years,  except 
when  be  doet  not  bave  coitus  every  two  or  tbree 
days,  tben  be  complains  of  its  paining  bim. 
Why  is  it  that  it  pains  bim  tben  ?  Is  it  be 
cause  tbe  organ  is  diseased  and  has  not  the 
space  for  accumulation  of  semen  ? 

His  venereal  desiie  is  greater  now  than  it 
wae  when  be  was  a  young  man  and  did  not  bave 
enlarged  testicle.  The  enlarged  testicle  is  in- 
durated witb  uniform  surface  and  has  a  soft  like 
place  on  tbe  lower  extremity  or  caudal  extrem- 
ity of  tbe  epididym,  as  if  it  was  suppurating, 
and  causing  a  little  pain  on  pressure  at  that 
point  My  diagnosis  is  tubercular  orchitis  and 
my  treatment  is  either  to  take  tbe  testicle  out 
or  open  at  tbe  soft  place  or  when  suppuration 
takes  place  and  place  tbe  patient  on  U>ui6  rrea^ 
ment  ,  R.  A.  Toms,  M.  D., 

Milton,  N.  G 


EpHepty. 
Editor  Medical  World  :  —Can  anyone  help 
me  in  this  case  ?  Girl  thirteen  years  old,  dis- 
ease developed  itself  suddenly  eight  years  ago. 
No  history  or  cause  can  be  found.  She  is  the 
only  member  of  a  family  of  five  children  who 
sufiera  from  it  Has  been  treated  by  many,  in- 
cluding specialists;  no  benefits  bave  resulted. 
She  sometimes  passes  over  eight  days  without  an 
attack,  and  then  has  several  in  a  day.  Always 
puts  her  hands  to  tbe  sides  of  her  head  during 
an  attack.  No  history  of  blow,  nor  is  there 
any  external  scar  or  anything  to  guide.  Have 
tried  bromide  of  strontium,  atropine,  Waugh's 
nervine  granules  and  other  remedies,  but  with 
no  success.  The  clitoris  seems  normal.  She 
appears  older,  say  like  fifteen  years,  but  her 
muscular  development  only  looks  as  if  about 
eleven  years.  However,  she  has  fairly  good 
health  when  free  from  tbe^e  attacks,  but  is 
much  exhausted  and  cats  freely  on  recovery. 
No  history  of  worms.  Many  thanks  in  advance 
for  auggestions.  Enquirer. 

Editor  Medical  World:— By  your  per- 
misaion,  I  am  impeled  to  invade  your  "  quiz  " 
department  in  my  desire  to  obtain  further  in- 
formation concerning  a  recent  case  in  my  prac- 
tice, as  well  as  to  show  my  readiness  to  report 
oaaea,  that  perchance,  may,  to  some  physician, 
a£[ord  a  suggestion. 

Mrs.  W.,  cm  Sunday,  March  18tb,  felt  a  sen- 
sation in  the  b&ll  of  her  rigbt  thumb,  apparent- 
ly due  to  the  lodgment  of  a  small  foreign  body 
under  tbe  skin,  and  witb  a  needle  several  at- 
tempts were  made  towards  its  discovery,  but 
resulting  negatively. 


Next  day  her  thumb  began  to  swell  and  pain> 
her,  and  to  all  seeming  a  felon  was  shaping- 
itself.  Tbe  bu9band  called  at  my  office  on  the^ 
evening  of  the  20tb,  when  tbe  above  facts  were 
obtained,  the  swelling  in  tbe  meantime  having 
extended  so  as  to  involve  her  wrist  and  band. 
Notwitbstfinding  tbe  employment  of  tbe  usual 
measures  to  combat  tbe  diseased  process,  she 
became  worse,  and  on  ihe  morning  of  tbe  21st 
tbe  husband  asked  me  to  see  her,  which  I  did  at 
10  a.  m.  I  found  her  almost  free  from  pain, 
witb  a  little  deep  tenderness  at  tbe  wrist,  tke 
band  and  arm  being  swelled  as  far  as  tbe  elbow, 
and  pitted  on  pressure.  Her  pulse  was  120, 
but  I  found  her  nervous  over  her  arm.  Her 
temperature  was  but  little  elevated. 

Locally  were  employed  hot  fomentations^ 
witb  astringent  and  antiseptic  lotion&  rest  etc 
On  seeing  her  again  on  tbe  22d.  at  10  a.  m.,  I 
found  that  tbe  swelling  had  nearly  reached  her 
shoulder,  witb  all  sensation  in  her  hand  entirely 
gone.  Black  areas  bad  formed  on  tbe  dorsum 
of  ber  fingers  and  thumb.  We  gave  ber  small 
doses  of  quinine  witb  a  lil)eral  allowance  of 
whiskey  and  carbonate  of  ammonia  to  combat 
deprrFsion.  Locally  wp  used  antis^p'ic  and 
stimulating  liniments.  At  8  p.  ro  .  however,  I 
was  sent  for  in  haste,  to  find  ber  delirious,  the 
swelling  having  spread  to  anil  involving  ber 
shoulder.  Black  areas  bad  balf  covered  her 
arm  and  shoulder,  but  she  sufiered  but  little 
pain. 

Dr.  G.  C.  Pease,  of  Fultoa,  saw  her  with  me 
at  5  p.  m.,  hue  the  cafe  was  inevitably  fata). 
She  died  at  10  p.  m.  tbe  bame  day. 

History  ne^rative.  She  bad  alwavs  been  well 
and  strong,  and  until  tbis  sickness,  bail  assumed 
all  the  work  incidental  to  a  farmer'n  wife.  I 
did  not  have  an  oppjrtunity  to  examine  ber 
urine,  and,  aside  from  ber  arm  and  blood,  no 
disease  was  discoverable.  Who  can  mak/  a 
suggestion  as  to  etiology,  patbologv  and  diag- 
nosis ?  W.  C.  HoNTZ,  M.  D., 

Leonidas,  Mich. 

Editor  ^Iedical  World: — I  would  like 
to  have  advice  about  tbe  treatment  of  a  case 
of  albuminous  nephritis  witb  abundant  flow 
of  pale,  light  urine  (lOlO)  of  18  months  dura- 
tion. Tbe  person  is  46  years  old,  a  widow,  has 
lost  considerable  flesh  and  is  rather  weak..  She 
can  not  walk  fast  or  work  bard,  she  has  a  goo  1 
appetite  but  is  a  li:tle  costive.  The  amount  of 
albumen  is  considerable,  with  phosphates.  Tbe 
exciting  cause  bas  been  cold  and  alcohol,  but 
she  bas  been  sober  over  one  year.  I  will  be 
very  thankful  for  good  advice  and  help. 

I  8.  Archambeault,  M.  D., 

Terrebonne,  Quebec,  Canada. 


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THE  MEDICAL  WORLD. 


Current   Medical    Thought. 

The  Treatment  of  Uterine  Inertia  Without  Drugs 
or  Tonics. 

Van  Waters  {New  York  Medical  Journal, 
June  24,  1893)  remarks  that  the  beneficial  ac- 
tion of  a  suppository  in  the  rectum  in  constipa- 
tion is  widely  known.  He  asks :  Why  should 
not  the  same  good  result  follow  the  use  of  a 
suppository  in  uterine  inertia,  and  what  more 
ready  and  efiective  suppository  could  we  have 
than  the  hand  ?  Hence,  when  the  case  has  so 
far  progressed  that  we  are  satisfied  it  is  time  for 
delivery  to  take  place  and  yet  inertia  has  super- 
vened, the  hands  should  be  rendered  thoroughly 
aseptic  by  the  use  of  water,  soap  and  a  brush, 
and  afterward  immersion  in  a  creolin  solution. 
Then,  after  the  administration  of  a  little  chlo- 
roform, the  hand,  well  anointed  with  vaseline, 
should  be  gradually  and  slowly  introduced  into 
the  vagina.  As  soon  as  it  has  remained  there 
a  few  minutes  pains  will  commence  and  increase 
in  severity,  in  some  cases  to  such  an  extent  thiat 
the  hand  has  to  be  withdrawn.  In  those  cases 
in  which  Van  Waters  has  resorted  to  this  pro- 
cedure the  results  have  been  most  gratifying. — 
Univ.  Med,  Magazine, 


Oregon  Needs  No  More  Physicians. 

For  the  benefit  of  such  as  may  not  know  our 
standing  as  compared  with  other  States  in  re- 
gard to  the  relative  number  of  physicians,  the 
Sentinel  presents  the  following  table  as  food  for 
thought. 

The  states  given  are  those  upon  our  northern 
focHrder  line,  beginning  at  that  great  Western 
medical  educational  center,  Chicago,  and  con- 
tinuing west  to  the  coast : 

^        State  Physicians.     Inhabitants. 

Wisconsin 1  910 

Minnesota 1  901 

Tiortb  Dakota 1  946 

Sowih,  Dakota 1  811 

Montana        1  600 

.British  Colambia     ....    1  994 

Idaho 1      .  610 

Washington 1  472 

O^gon       1  446 

During  the  great  boom  which  the  State  of 
Washington  had  in  '88,  '89  and  '90,  a  large 
excess  of  doctors  poured  into  that  state  Since 
then  the  examining  laws  have  been  changed. 
The  profession  is  much  over-crowded  in  Wash- 
ii^lon,  but  under  present  medical  laws  there,  it 
will  take  but  a  few  years  to  give  Washington 
but  her  normal  proportion  of  physicians,  especi- 
ally if  her  present  state  examining  board,  jor 
one  equally  rigid,  remains  in  power. 
Oregon  has  finally  crowded  Colorado,  with  its 


population  of  invalids  and  doctors,  from  the  first 
place,  and  now  stands  at  the  head,  the  stare 
possessing  the  greatest  number  of  doctors  in 
proportion  to  its  population  of  any  state  in  the 
Union. — MecL  Sentinel, 


There  is  no  Real  Increase  in  the  Prevalence  of 
Cancer. 

The  increase  in  cancer  is  only  apparent  and 
not  real,  and  is  due  to  improvemeats  in  diag- 
nosis and  more  careful  certification  of  the  causes 
of  death.  This  is  shown  by  the  fact  that  the 
whole  of  the  increase  has  taken  place  in  iuac< 
cessible  cancer,  difiicult  of  diagnosis,  while  ac- 
cessible cancer,  easily  diagnosed,  has  remained 
practically  stationary. — N,  Y.  Med,  Ejcaminer, 


Treatment  of  Cauliflower  Cancer. 

Dr.  C.  R.  Earley,  of  Ridgway,  Pa,,  in  a  let- 
ter to  the  editor,  gives  some  interesting  facts  in 
regard  to  the  treatment  of  Cauliflower  Cancer  : 
"My  first  case  was  a  lady  29  years  old,  a  teach- 
er in  the  Normal  School.  She  was  first  sent  to 
Erie  for  treatment,  and  from  there  she  was  sent 
to  Buffalo,  New  York.  The  Buffalo  Professor 
sent  her  to  New  York  city  for  operation.  They 
were  all  ready  to  use  the  knife  and  the  lady 
protested,  and  was  then  sent  to  Philadelphia 
with  like  result.  She  was  sent  from  her  home 
to  me.  I  at  once  placed  her  on  the  free  use  of 
arsenic : — 

R.   Liquor,  potaseil  ar^enlUs oz.  J 

Tina,  ferri  chloridl, os  ij 

Syrup,  simp.,  q.  s.  ad oz.  xx       M 

SIg.— Take  a  dessertspoouful  three  timts  a  day  withmeflla. 

I  also  ordered  the  free  use  of  disinfectant 
washes,  and  every  three  to  four  days  the  follow- 
ing, carefully  applied  with  a  brush  : — 

R.   Eritotin dr.  iv 

TlDOL  iodi  coQip  , f  oz.  m 

Glycerini foz,  iv       M. 

The  lady  was  finally,  after  six  months,  well, 
ani  now,  ten  yeard  later,  is  perfectly  well.  I 
have  treated  nine  cases  in  the  same  way,  and 
all  are  periectly  well.  They  were  all  sent  to 
me  after  a  full  test  by  what  are  called  experts." 
—  Coll,  and  Cliru  Record, 


The  Nuisance  of  Flies  and  How  to  Cure  it. 

Thousands  of  methods  have  from  time  to  time 
been  employed  to  rid  us  of  one  of  the  most  fer- 
tile carriers  of  disease  and  infection  the 
''house-fly,*'  but  he  has  defied  us.  Sweet  peas 
have  been  suggested;  but  this  creeper  will  not 
grow  at  all  reasons,  and  lefuses  to  thrive  in 
those  districts  where  flies  are  most  abundant 
Fly  papers  are  a  boon,  and  yet  a  danger,  as 
their  poisonous  nature  precludes  their  being  left 
lying  about  where  there  are  young  children.  A 


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THE  MEDICAL  WORLD. 


177 


cold  infusion  of  quassia- wood  treated  with  a 
trifle  of  molasses  or  treacle  is  nut  only  cheap, 
easily  procurable  and  harmless  to  human  life, 
but  it  will  kill  these  marauders  by  the^  million. 
It  has  the  disadvantage  of  strewing  the  floor 
with  their  carcases. 

Take  this  advice:  Expose  a  little  oil  of  bay 
in  a  saucer  on  your  window-sills,  or  coat  your 
doors  and  windows,  with  any  color  of  paint  you 
like,  containing  as  little  as  four  per  cent  of  oil 
of  bay,  which  is  far  from  expensive,  and  can  be 
had  anywhere,  and  not  a  single  fly  will  enter 
your  house, — Indian  Med.  Record, 


The  Hypodermic  Treatment  of  Syphilis. 

**Th€n  he  [Capt  Lambkin]  obtained  from 
Savory  and  Moore  [London]  a  hypodermic 
mercurial  cream  which  had  lately  been  intro- 
duced in  London  by  Drs.  Althaus  and  Whit- 
more.     Its  composition  ia  as  follows  : 

R.    Hydraij^yrl dr.  1 

LADolin.  pur dr.  n 

OL  carbo  .  (2^) dr.  j 

It  is  injected  with  an  ebonite  syringe,  made 
by  Krohne  &  Sesemann,  London,  price  2i.  6d. 
graduated  into  minims.  Spare  needles  cost  6d. 
each,  and  they  are  necessary,  for  if  the  needle  is 
clean,  bright  and  sharp,  the  injection  causes  no 
pain.  Ten  minims  are  injected  deep  into  the 
gluteal  tissues  once  a  week,  and  the  improve- 
ment in  a  patient  is  marked  and  rapid. 

All  kinds  of  symptoms  diminish  in  severity, 
and  when  their  first  urgency  is  overcome,  the 
soldiers  are  discharged  from  hospital,  and  re- 
turn to  duty,  willingly  attending  as  out-patients 
once  a  week  for  the  injection. 

The  cure  lasts  from  two  to  eight  months,  ac- 
cording to  the  severity  of  the  attack,  but  the 
soldier  is  at  duty  most  of  the  time,  so  his  ser- 
vices are  not  lost  to  the  state. 

From  September,  1891,  to  October,  1892, 
Captain  Lambkin  treated  about  a  thousand 
cases  in  this  way,  all  of  whom  made  a  good  re- 
covery, without  any  pain  or  local  abscess, 
without  salivation,  or  any  other  inconvenience. 

Abecees  sometimes  follows  if  the  cream  is 
injected  under  the  skin  into  the  connective 
tissue,  but  if  it  is  put  in  deep  into  the  flesh,  as 
far  as  the  needle  will  go,  no  harm  ensues. 

.  Let  them  try  it  on  their  female  patients,  not 
forgetting  to  enjoin  strict  cleanliness,  and  if 
patients  are  obedieyit  to  instructions,  we  shall 
soon  hear  no  more  of  the  necessity  for  C.  D. 
Acts." — Indian  Med.  Record. 


Sulphate  of  Copper  for  the  Treatment  of  Syphilis^ 

Dr.  A.  F.  Price  of  the  United  States  Navy 
(^Medical  Record,  February  3,  1894,)  gives  his 
experience  in  the  treatment  of  syphilis '  with . 
sulphate  of  copper.  He  has  employed  the  drug 
in  various  stages  of  the  disease,  and  the  results 
obtained  lead  the  author  to  formulate  the  fol- 
lowing conclusions :  1.  Copper  exercises  a 
specific  action  in  syphilis,  which  is  especially 
directed  toVard  the  lymphatic  system.  It  is, 
for  this  reason,  more  radically  curative  than  * 
mercury.  2.  It  is  flow  in  removing  the  skin 
symptoms  of  the  secondary  stage.  3.  It  pre- 
vents the  development  of  mucous  patches  and 
throat  symptoms.  4.  It  is  a  very  active  drug». 
and  it  is  wise  to  omit  its  use  one  day  in  a  week, 
and  sometimes  more  frequently.  The  signs  of 
ita  excessive  and  injurious  action  are  first  a 
voracious  appetite,  and  this  is  rapidly  followed, 
if  the  dose  is  not  reduced  or  the  drug  tempor- 
arily discontinued,  by  prostration,  giddiness, 
pallor,  and  a  rapid  and  weak  pulse.  5.  The 
average  dose  of  sulphate  of  copper  is  ^^j^  of  a 
grain  thrice  daily.  It  is  better  to  give  it  with 
the  sulphate  of  iron.  It  can  be  given  either  in 
pill  or  solution.  6.  This  dose  is  absolutely 
dangerous  in  cases  of  syphilitie  cachexia.  It 
produces  at  once  excessive  and  alarming  pros- 
tration. If  a  sufficiently  small  dose  of  the  drug 
is  given  at  first,  a  tolerance  of  it  is  gradually 
established,  so  that  the  average  dose  may  in  time 
be  obtained.  The  author  is  inclined  to  think 
that  in  some  cachectic  cases  as  small  a  dose  as 
the  1-1000  of  a  grain  may  be  necessary,  given 
once  daily.  The  use  of  iron,  arsenic,  and 
iodide  is  also  usually  necessary  in  old  sypbilii. 
— Tex.  Med.  Jour. 


Editor  MxniCAi.  World  :— I  have  been  an  oninter- 
nipted  •obscriber  to  The  World  ever  aince  the  first 
Bomber  was  published,  and  cannot  now  do  without  it. 

Sharon,  Ga.  A.  C  Davidson. 


Plan  for  the  Eradication  of  Syph'tlis. 

[We  quote  the  following  from  Dr.  Bulkley's 
excellent  book,  "  Syphilis  of  the  Innocent," 
which  was  reviewed  in  our  last  issue. — Ed.] 

The  amount  of  damage  a  single  unrestricted 
syphilitic  patient  may  do,  can  be  judged  from  a 
recent  statement  by  Tamowsky,  *  of  St  Peters- 
burg. He  says  that  a  syphilitic  woman,  who 
had  come  under  his  observation,  had  succeeded 
in  contaminating  with  syphilis  no  less  than  300 
men,  within  a  period  of  ten  months.  This 
represents  merely  the  primary  transmission  of 
the  disease  ;  its  later  effects  on  others  can  hard- 
ly be  computed.  Imagine  one  small  pox  patient 
being  allowed  to  give  the  disease  freely  to  three 
hundred  individuals ! 

The  republican  idea  of  this  country  would 
probably  never  endorse  or  submit  to  such  sani- 

ITarno^sky.— Cited  in  N,  Y.  Med.  Reeml,  Mar.  ^, 
1889,  p.  279. 

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tary  police  iDspection  and  restraint  as  is  exer- 
cised in  certain  European  cities;  but  the 
•question  naturally  arises,  if  there  is  not  some 
way  in  which  the  end  can  be  reached,  of  arrest- 
ing the  spread  of  this  dangerous  disease  ?  Can 
there  be  no  safeguards  thrown  out  which  shall 
prevent  its  extension  here,  as  it  has  spread  in 
certain  countries  in  Europe,  notably  Russia, 
where,  as  we  have  seen,  whole  communities 
have  been  syphilized,  and  Portugal,  where  the 
disease  is  almost  universal  ? 

The  first  step  towards  accomplishing  the  legal 
control  of  syphilis  would  undoubtedly  be  found 
in  placing  it  among  other  contagious  diseases 
which  come  under  the  jurisdiction  of  the  health 
officers ;  legitimate  means  could  then  be  devised 
and  executed  to  check  its  spread,  as  in  the  case 
of  the  contagious  di^ases  ordinarly  recognized. 
The  late  J.  Marion  Sims  alluded  to  this  subject, 
in  his  address  before  the  American  Medical  As- 
sociation, ^  some  years  ago,  using  these  words : 
* '  There  can  be  no  difference  of  opinion  among 
us,  regarding  the  two  following  propositions. 
1st.  We  want  a  system  of  sanitary  inspection 
and  control,  which  will  enable  us  to  prevent  the 
importation  of  syphilis  from  abroad.  2d.  We 
want  a  system  of  sanitary  inspection  and 
<x)ntrol,  which  will  enable  us  to  take  charge  of 
the  subjects  of  syphilis  at  home,  and  prevent 
them  from  spreading  it  through  the  com- 
munity." 

The  profession  is  undoubtedly  unanimous,  in 
regard  to  the  desirability  of  haviug  such  a  re- 
straining influence  exercised  upon  syphilis,  as  is 
here  indicated.  The  only  question  is — what  is 
the  best  method  of  carrying  it  into  effect? 

If  syphilis  were  first  recognized  as  one  of  the 
great  contagious  diseases,  against  which  it  is  the 
duty  of  the  government  to  protect  the  com- 
munity, the  details  of  that  protection  would  fol- 
low with  time  ,"  and  as  the  public  became  aware 
of  the  dangers  arising  ir6m  the  disease,  and  the 
benefits  accruing  from  its  restriction,  there 
would  be  no  difficulty  in  securing  proper  laws 
relating  to  the  subject 

It  would  be  out  of  place  here  to  present  any 
detailed  plan  of  operation,  for  the  subject  is  of 
such  vast  importance,  that  it  could  not  be  com- 
pressed within  the  limits  of  this  et&say,  even  if 
the  writer  were  prepared  to  formulate  such  a 
scheme. 

The  suggestion,  however,  is  most  earnestly 
put  forward,  that  the  time  has  certainly  come, 
when  the  dangers  of  syphilis,  and  especially  the 
dangers  to  innocent  person*,  should  be  fully 
recognized.  It  is  too  late  in  the  history  of  sci- 
ence and  of  humanity  to  stigmatize  the  disease 
as  **  venereal"  and  on  that  account  to  withhold 

1  Sims.     Traufl.  Amer.  Med,  AtMOc.,  l97t>. 


scientific  protection  from  thousands  of  innoceat 
sufferers.  Among  babies,  nursing  women,  per- 
sons infected  in  dental  or  surgical  operations, 
and  in  dozens  of  other  manners,  syphilis  can  no 
more  be  described  as  a  *'  venereal "  affection 
than  any  other  contagious  disease.  The  time 
has  come  to  place  it  under  the  control  of  the 
proper  health  officers,  and  to  make  it  quite  as 
criminal  to  transmit  syphilis  wittingly  as  it  is  to 
communicate  small-pox,  scarlatina,  or  diph- 
theria. 

It  would  then  become  the  public  duty  of 
each  one  to  guard  against  the  disease,  and,  as 
now  in  the  case  of  the  other  contagious  diseases 
mentioned,  those  would  be  culpable  who  were 
the  means  of  disseminating  the  same.  The 
hotel  propri(:tor  who  wittingly  allows  a  small- 
pox patient  to  infect  others,  or  who  should  not 
exercise  due  precautions  after  a  patient  with 
scarlet  fever  had  occupied  a  bed  or  room,  would 
receive  punishment.  The  keeper  of  a  brothel, 
as  I  understand  the  existing  law,  would  be  sub- 
ject to  like  punishment,  if  his  guest  were 
allowed  to  sleep  in  a  bed  previously  occupied  by 
a  patient  afflicted  with  small- pox,  scarlatina,  or 
diphtheria,  without  subsequent  sanitary  precau- 
tions. 

If,  now,  syphilis  were  included  with  theae 
infections  or  contagious  diseases,  something 
would  certainly  be  accomplished  towards  check- 
ing its  extension  ;  for  such  a  person  would  then 
see  that  all  the  inmates  of  the  house  were  free 
from  syphilis,  and  would  also  be  very  careful 
that  no  one  entering  the  place  should  introduce 
the  disease.  If  the  males  did  not  carry  syphilis 
into  houses  of  ill-repute,  the  disease  would  not 
appear  in  them. 

The  plan  of  making  it  criminal,  or  a  misde- 
meanor, to  be  instrumental  in  communicating 
syphilis,  would  operate  favorably  in  many  ways. 

It  would  do  away  with  the  necessity  of  of- 
ficially examining,  inspecting,  or  licensing  any 
one,  for  it  would  be  for  each  one's  interest  to 
keep  free  from  the  disease,  le&t  at  any  time  legal 
action  should  be  taken  against  them.  InsteJBMl 
of  examining  the  women  publicly,  those  con- 
nected with  the  nefarious  business  would  see 
that  they  were  already  in  a  healthy  condition. 
They  would  then  examine  the  men. 

This  again  would  operate  advantageously. 
For  many  would  hesitate  against  going  to 
houses  of  ill  fame,  if  they  knew  they  were  to  be 
thus  examined ;  and  those  that  were  syphilitio 
would  exclude  themselves. 

Furthermore,  this  would  operate  more  or  less 
against  clandestine  prostitution.  For  not  only 
would  every  one  fear  lest  they  should  acquire 
the  disease  (because  it  would  be  known  i  that 
outside  women  would   be  more  likely  to   be 


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Bjrphilitic,)  but  the  men  would  fear  that,  if  they 
infected  others  outside,  they  would  be  subject 
to  legal  penalties. 

I  believe,  therefore,  that  such  a  law  would 
not  only  greatly  diminish  the  frequency  of 
syphilis,  but  would  also  be  in  the  direct  line  of 
breaking  up  licentiousnesB.  When  the  step  is 
onee  taken  of  placing  syphilis  among  the  con- 
tagious diseases,  subject  to  law,  the  details 
necessary  to  enforce  such  a  law  will  naturally 
follow.  The  force  of  the  argument  rests  on  the 
necessity  of  examining  the  men  instead  of  the 
women ;  for  any  proposition  looking  to  the  lat- 
ter has  always  met  with  resistance  at  the  hands 
of  many  classes  m  every  community,  who  urge 
the  degrading  character  of  police  inspection. 

That  a  person  may  legally  be  held  liable  for 
communicating  syphilis  is  abundantly  shown  by 
the  many  oases  occurring  in  the  literature  of 
foreign  countries  The  works  of  Tardieu,* 
Foumier,2  and  others  are  full  of  accounts  of 
legal  action  taken,  and  fines  and  imprisonment 
imposed,  for  the  wilful  or  careless  transmission 
of  syphilis  ;  and  in  some  instances  the  actions 
were  against  physicians  who  had  ezeicised 
every  possible  precaution.  In  our  own  country 
syplulis  has  sometimes  been  the  subject  of  ju- 
dicial action  ;  in  a  recent  case  before  the  Court 
of  Appeals,  of  Kentucky,^  it  was  decided  that 
syphilis  pleaded  in  answer  to  an  action  to  re- 
cover damages  for  breach  of  promise  of  mar- 
riage, is  a  complete  defence ;  this  followed 
the  decision  of  the  supreme  court  of  North 
Caiolina,  in  which  the  same  defence  was  inter- 
posed and  sustained  in  a  similar  action. 

One  of  my  own  patients  recently  received 
five  thousand  dollars  from  the  man  who  infected 
her  with  syphilis ;  in  this  instance  the  case  did 
not  come  to  court,  though  it  was  settled  through 
legal  counsel. 

How  far  the  matter  can  be  carried  in  regard 
to  the  restraint  of  syphilitics  from  exposing 
others,  cannot  now  be  decided.  Much  enlight- 
ment  of  the  community  is  yet  necessary  in  re- 
^;ard  to  this  subject,  and  much  thought  will  be 
requisite  to  determine  exactly  the  best  methods 
of  checking  the  slow  but  steady  extension  of 
syphilis  which  is  now  taking  place.  These  mat- 
ten  can  safely  be  left  to  future  consideration. 
The  first  step  is  now  to  be  taken  by  the  legal 
recognition  of  syphilis  as  one^of  the  contagious 
diseases  which  are  dangerous  to  the  life  and 
health  of  the  ni^on — as  a  pest  against  which 
society  has  the  same  right  as  in  the  case  of  other 
contagious  diseases  namely,  to  protect  itself  by 

1  T&rdiea.    Etude  Medico- legale,  etc.,  Parirt,  1879. 

2  Fournier.    Noarrioes  et  Doarribons  pjphilitiques, 

PAris,  1878. 

3  Jour,  of  the  Amer.  Med.  Abbo.,  Oct.  8,  1892,  p.  445. 


scientific  treatment  and  by  legal  penalties. 

[This  plan — making  the  communication  of 
all  such  contagious  diseases  a  criminal  ofifense- 
— has  been  advocated  by  us  in  our  editorial 
columns. — Ed.] 

1 — 

How  to  Live  Where  There  Is  Malaria. 
In  his  recent  work  on  "The  Climate  of 
Kome  and  the  Roman  Campagna,"  Professor 
Tommasi-Crudeli  devotes  a  vtduable  chapter 
to  the  subject  of  the  preservation  of  human  life 
in  malarious  countries.  Our  readers  will  be 
glad  to  have  in  a  compact  form  the  views  of  so 
eminent  an  authority  on  this  very  important 
and  interesting  topic.  We  must  be  content  to 
admit  for  the  present  we  have  no  precise  knowl- 
edge of  the  nature  of  the  malarious  poison,  or 
of  the  means  whereby  it  can  be  extirpated  from 
the  soil  of  an  infected  locality.  That  the  poison 
inheres  in  the  soil ;  that  it  is  under  the  influence 
of  season,  temperature  and  rainfall ;  that  it  is 
excited  to  fresh  activity  by  all  measures  involv- 
ing the  disturbance  of  earth  long  left  quiescent; 
that  its  ravages  have  been  much  reduced  by 
drainage,  by  the  conversion  of  naked  soil  into- 
meadow  land,  and  by  the  erection  of  houses 
and  laying  down  of  paved  streets — these  facts^ 
are  certain,  and  almost  exhaust  our  Imowledge 
on  the  subject. 

-  Professor  Tommasi-Crudeli  points  out  that, 
the  traditional  precautionary  measures  long 
adopted  in  malarious  countries  have  had  two 
ends  in  view,  viz.,  to  reduce  as  much  as  possible 
the  quantity  of  the  malaria  ferment  which  en- 
ters into  the  system  through  the  air  breathed,, 
and  to  prevent  a  lengthened  abode  of  the  same 
in  the  system.  The  first  point  is  sought  to  be 
achieved  by  avoiding  agricultural  operationa 
during  those  hours  at  winch  the  malarious  in- 
fluence is  most  potent,  viz.,  about  sunrise  and 
sunset ;  hence,  according  to  the  writer,  is  really 
explained  the  much  misunderstood  dictum  of 
the  ancient  Sybarites:  "If  you  wish  to  live 
long  and  well,  do  not  ever  see  the  rising  or  the 
setting  sun."  Another  point  of  the  greatest 
importance  is  to  avoid  breathing  the  air  in 
close  contact  with  the  soil,  as  it  can  be  shown 
that  the  malarious  poison  rises  only  a  short  dis^ 
tance  in  a  vertical  direction.  Thus  in  the  Pon^ 
tine  marshes,  an  intensely  malarious  regiooy. 
platforms  four  or  ^^je  meters  high  are  erected, 
upon  which  the  people  sleep  in  the  open  air 
with  comparative  impunity.  In  Greeee  the 
jungles  of  the  East  Indies,  and  Central  and 
Southern  America,  similar  devices  have  been 
adopted  with  beneficial  results.  Another  mode 
of  eluding  the  malaria^  laden  air  in  dose  contact 
with  the  ground  is  to  construct  the  dwellinga 
in  such  a  way  that  when  the  door  is  shut  the 


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internal  atmosphere  is  renewed  only  by  the 
strata  of  the  local  atmosphere  which  are  near 
the  roofs  of  the  houses.  This  is  managed  in 
some  localities  by  so  arranging  that  the  only 
opening  in  the  outer  wall  is  the  door,  and  all 
the  windows  open  on  an  inner  ^ard  at  a  higher 
level  than  the  ground  floor  of  the  house. 

It  is  advisable  also  to  keep  the  windows  of 
the  houses  closed  in  the  morning  and  during 
the  early  hours. of  the  evening,  especially  if  any 
excavations  should  be  going  on  in  the  neighbor- 
hood. Care  should  be  exercised  regarding  the 
effects  of  placing  vases  of  flowers  in  occupied 
rooms  ;  either  these  should  be  entirely,  ex- 
cluded from  houses  when  malaria  is  rife,  or  the 
utmost  vigilance  should  be  taken  to  secure 
thorough  ventilation. — Lancet,  in  American 
Analyst 

Phenoooll  Hydrochlorate  in  Malarial  Fevers. 

Professor  Guido  Ancona  has  employed  this 
remedy  in  various  forms  of  malarial  fever,  es- 
pecially the  typhoid  and  pneumonic  varieties, 
with  very  high  temperature.  In  regard  to  the 
dose,  he  states  that  adults  require  more  than  1 
gramme  daily,  since  Allastoni  and  others  have 
found  this  quantity  produce  no  effect.  Even  in 
children  of  5  and  7  years  of  age  it  was  necessary 
to  give  a  daily  dose  of  1  gramme.  As  a  rule, 
li  grammes  in  the  twenty-four  hours  sufficed 
for  adults.  In  cases  of  mild  recurrence  the 
remedy  should  be  given  for  two  or  three  con- 
secutive days  or  before  the  day  on  which  a 
paroxysm  should  be  expected.  Subjective  dis- 
turbances were  never  excited  by  the  drug,  but 
it  should  not  be  administered  just  before  the 
hours  of  sleep.  Of  80  cases  in  which  phenocoll 
hydrochlorate  was  used  only  2  experienced  no 
benefit,  while  in  28  cases  the  febrile  paroxysms 
were  checked  soon  after  the  exhibition  of  the 
first  dose.  Swelling  of  the  spleen,  when  pres- 
ent, was  unaffected.  The  efjfect  is  more  pro* 
found  and  more  lasting  than  that  produced  by 
quinine,  which  must,  moreover,  be  employed  in 
larger  doses.  Phenocollum  hydrochlorate  suc- 
ceeded in  many  cases  where  quinine  had  failed. 
DexUche  Med.  Zeitung, — Med,  Bulletin. 


Treatment  of  Malaria  by  Means  of  Potassium  or 
Sodium  Nitrate. 

Dr.  Peter  Buro,  of  Arva-Polhora,  who  lives 
in  a  malarial  district,  has  had  many  opportuni- 
ties of  demonstrating  the  value  of  these  salts  in 
malaria,  and  has  formed  the  following  conclu- 
aions  :  1.  The  nitrate  of  potassium  and  the 
nitrate  of  sodium  are  specific  remedies  in 
typical  malarial  intermittent,  whether  it  assumes 
the  <iUotidian,    tertian,    or   quartan  form.     2. 


Both  salts  manifest  an  exact  action,  but  the 
sodium  salt  has  the  advantage  of  being  free 
from  the  slightly  toxic  effect  of  nitrate  of  po- 
tassium. It  is  likewise  better  adapted  to  sub- 
cutaneous administration,  being  three  or  four 
times  more  soluble  in  water  than  the  salt  of 
polassium.  3.  The  usual  single  dose  for  adults 
is  from  15  to  24  grains,  and  it  may  be  given  in 
either  the  febrile  or  the  afebrile  stage.  Larger 
or  more  frequently  repeated  doses  are,  how- 
ever, oflen  requir^.  4.  Caaes  occur,  though 
rarely,  in  which  the  saltpetre  fails  to  prevent 
an  attack.  5.  A  decided  advantage  of  these 
salts  is  that  they  exert  no  ill  effects  upon  the 
digestive  organs  or  nervous  system,  nor  do  they 
produce  any  untoward  results.  They  may  also 
be  easily  exhibited  in  a  palatable  form,  which 
recommends  them  to  juvenile  patients.  — 
Deutche  Med,  Zeitung. — lb. 


Solution  of  Epsom  Salt  for  Burns, 
Dr.  N.  F.  Howard,  of  Dahlonega,  Ga.,  re- 
ports to  the  Atlanta  Med.  and  Surg.  Jour,  an 
interesting  case  of  very  severe  burns  of  both 
hands,  in  which  the  usual  applications  failed  to 
relieve  the  pain.  The  hands  were  immersed  in 
a  solution  of  one  pound  of  epsom  salts  to  two 
quarts  of  water,  when  the  pain  ceased  at  once. 
After  holding  them  in  the  solution  one  hour  the 
redness,  swelling,  heat  and  pain  were  entirely 
gone,  when  they  were  given  the  usual  dressings 
of  oil  and  oxide  of  zinc  and  the  burned  surfaces 
proceeded  to  rapid  healing.  Let  us  bear  this  in 
mind  and  make  use  of  it  in  the  next  case.  It 
is  well  known  that  bicarbonate  of  sodium  will 
give  practically  the  same  results. 


Cheap  Infant  Foods. 
There  is  no  doubt  that  several  of  the  infant 
foods  now  on  the  market,  if  properly  adminis- 
tered, can  be  substituted  efficiently  for  human 
milk.  Buf  among  the  poorer  classes,  the  ex- 
pense attending  the  use  of  these  foods  is  a  great 
tax.  Dr.  H.  D.  Chapm,  and  Dr.  &  Eiloart 
have  undertaken  a  series  of  experiments  for  the 
purpose  of  obtaining  a  cheap  substitute  for  hu- 
man milk,  using  cow's  milk  as  a  basis.  Dr. 
Chapin  advises  against  the  complete  sterilizatloQ 
of  city  milk,  but  thinks  that  its  partial  steriliza- 
tion or  pasteurization  is  necessary  in  order  to 
kill  the  miorobe  ^f  lactic  acid  fermentation.  The 
milk  used  is  the  ordinary  cow's  milk  of  the  city, 
which  is  twenty  four  to  thirty-six  hours  old. 
This  is  allowed  to  stand,  and  the  upper  half 
only  used.  This  contains,  according  to  Drs. 
Chapin  and  Eiloart,  4.9  per  cent  fat,  as  against 
3.03  per  cent  in  the  lower  half.  The  object 
sought  for  by  the  investigators  was  to  secure 
some  diluent  for  the  milk  which  would  properly 


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181 


enrich  it,  and  at  the  same  time  prevent  its 
coagulation  in  large  tough  curds.  For  this  pur- 
pose the  milk  is  diluted  with  barley,  oatmeal,  or 
wheat  flour  gruel,  and  then  diastase  in  the  form 
of  malt  added.  The  results  obtained  from  the 
use  of  this  food  on  thirjy  seven  cases  were  good. 
The  special  directions  for  making  the  food  are 
as  follows  : 

Recipe  1. — Materials. — Wheat  flour  or  bar- 
ley meal,  two  ounces  (two  tablespoonfuls  heaped 
as  high  as  posaible);  water,  fifty- six  ounces  (a 
quart  and  three-quarters);  extract  of  malt,  half 
a  teaspoonful  or  a  small  teaspoonful. 

Process, — With  thirty  ounces  (a  scant  quart) 
of  the  water  make  the  flour  into  a  gruel,  boiling 
ten  minutes  in  a  double  boiler.  Take  out  the 
inner  vessel  and  add  the  rest  of  the  water  cold, 
the  malt  extract  being  dissolved  in  the  last  few 
ounces  added.  Let  it  stand  fifteen*  minutes. 
Put  back  the  inner  vessel  and  heat  again  in  the 
double  boiler  fifteen  minutes.  Strain  through 
a  coffee  strainer  of  wire  gauze. 

If  for  any  reason  it  is  desirable,  and  in  cases 
of  diarrhea,  to  give  a  smaller  proportion  of  mal- 
tose, the  following  recipe  is  used,  and  we  get  a 
food  containifig  only  one-fourth  of  the  solid  mat- 
ter in  the  form  of  maltose : 

Recipe  II. — Materials  as  in  Recipe  I.  Pro- 
ceed as  before,  but  reserve  only  one  pint  of  the 
water  for  adding  cold.  After  adding  the  cold 
water  with  the  malt  extract  dissolved  in  the  last 
few  ounces  of  it,  let  it  stand  only  three  minutes 
instead  of  fifteen  minutes.  Then  heat  ten 
minutes  in  a  double  boiler  and  strain. 

To  make  the  gruel  well  and  quickly,  beat  the 
flour  with  very  little  water.  A  little  beating 
with  little  water  is  better  than  much  beating 
with  much  water.  Beat  smooth,  therefore, 
while  the  paste  is  still  almost  a  dough  ;  then  add 
cold  water  to  make  a  thin  paste,  and  to  this  add 
the  rest  of  the  first  part  of  the  water  boiling  hot, 
with  stirring.  If  these  directions  are  followed, 
very  few  lumps  will  remain  on  the  strainer  ;  in 
fact,  only  about  five  per  cent,  of  the  meal  need 
be  lost  in  this  way.  The  water  in  the  outer 
vessel  of  the  double  boiler  must  be  kept  boiling 
throughout.  Whichever  recipe  is  followed,  the 
food  should  be  taken  mixed  with  milk. — Med, 
Record. 

Treatment  of  Diarrhea  of  Children. 
In  treating  diarrhea  of  infants,   children  or  i 
adults,  we  should  always  remember  that  the  se-  j 
cretions  are  defective,  as  indicated  by  a  dry  or  ( 
coated  tongue,  unnatural  color  of  stools,  etc.,  j 
and  to  attempt  to  arrest  the  watery  discharges 
with  such  a  pathological  condition  present  by 
opiates  and  astringents  will  not  last — will  do  in- 
jury,harm  instead  of  good.  Therefore  firstuse : — 


R.   Hydrarg.  chlorid.miti5., if.  j 

Sodll  bicarb., ^r  v 

Pulv.  sacch.  alb  , gr.  xx       M 

Ft.  chart,  x. 
S'g.— One  eve>y  two  or  three  hours  until  discharges  are 
changed  in  color  and  consistency :  or  hydrarg.  cum  creta.  one 
part,  triturated  with  two  or  three  parts  of  sacch.  lacti.    Of  this 
powder  give  t'vo  grains  every  two  or  three  hours. 

These    powders   will  often    restore    healthy 

secretory  action,  and  cure  the  diarrhea  alone. 

If  not,  follow  with  small  doses  of  bismuth  sub- 

carb  ,  nux  vomica,  and  ipecac,  or  a  few  drops 

of  the  following : 

R.  McHun's  elixir  opil,  ' 

TInct.  rhei,  ■    aa    for.  is. 

Tinct.  camphorae      J  M 

Slg.— From  five  to  ten  drops  every  hour  or  two,  as  needed 
and  according  to  age  of  chUd. 

Or,  for  very  young  children  prescribe  : — 

R.   Svr.  rhei  aromat, oz.  j 

Tlnct.  opiicamph oz.  an 

Tinct  cardamom,  comp., ..dr.  ii 

Aquscalcis. '. oz  vj 

Slg.— Temipoonml  everv  hour  or  two,  as  D«H»ded. 

— Livezey. — Matthew^ s  Med.  Quarterly. 


Remedy  Against  Epilepsy. 

S.  A.  Siminoff  3£ed.  Obozr.,  xxxix,,  1893, 
No.  4,  pp.  391  2)  details  three  cases  of  epilepsy 
cured  by  him  by  the  administration  of  an  in- 
fusion of  common  tansy.  He  has  also  used  this 
decoction  with  good  effect  in  cases  of  neurasthe- 
nia, where  valerian  had  ceased  to  be  eflfective. 
A  glassful  of  the  infusion  of  the  herb  (either 
fresh  or  dried)  is  given  to  the  patient  at  night 
and  in  the  morning. — Scientific  American, 


The  Modern  Treatment  of  Typhoid  Fever. 
By  j.  T.  Wri(;ht,  M.  D.,  Salisbury,  N.  C. 

My  method  of  treatment  is  somewhat  as  fol- 
lows :  If  called  in  during  the  early  stages  of 
the  disease,  I  generally  prescribe  a  good  mer- 
curial purge,  which  usually  cleanses  the  tongue 
very  nicely,  and  at  once  institute  the  antiseptic 
treatment. 

If  there  is  much  pyrexia,  I  use  the  following  : 

R.   Phenacetin dr.  j 

SaloU gr.  xxiv 

Cieasote gtt.    xij 

QuinlasHlph dr.  ss— J 

M.  et  ft.  cap.  No.  xxiv. 

S.    Two  every  4  or  6  hours. 

However,  if  the  fever  is  not  very  high,  I  con- 
tent myself  with  the  external  application  of 
cold,  such  as  the  wet  pack,  sponging  with  spt. 
myrcia3,  one  ounce  to  a  pint  of  water,  and  the 
ice  bag.  I  also  use  Yeo's  chlorine  water  with 
moderately  successful  results.  When  there  is 
much  tympanitis,  or  a  more  marked  tendency 
to  delirium,  or  when  the  tongue  is  harsh  and 
dry,  I  add  from  two  to  three  drops  of  oil  of 
turpentine  per  dose  to  the  above  prescription. 

In  conjunction  with  the  above  treatment  I 
use  some  acidulous  drink,  as  nitro- muriatic 
acid,   which  allays  the  intense  thirst,   though 


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water  and  ice  are  allowed.  Alcoholic  sdmu- 
lants  are  rarely  called  for,  milk  and  the  con* 
centrated  foods  being  amply  eufficient  to  nourish 
and  maintain  the  patient's  strength.  ^  *  * 
In  conclueion,  I  would  say  that  the  antiseptic 
plan  of  treatment  is  deserving  of  attention,  for, 
while  by  the  old,  or  expectant  plan,  the  mor- 
tality is  from  15  to  20  p.  c,  by  the  antiseptic 
the  mortality  is  practically  reduced  to  insig- 
nificance.— N.  C,  Med,  Jour, 


Thyroid  Feeding  in  Exoplithalmio  Goitre. 

By   David  Owen,  M.R.C.S.,  L.S.A.,  Man- 
chester, England. 

*  Now  that  the  use  of  thyroid  gland  in  the 
treatment  of  disease  is  receiving  so  much  atten- 
tion, the  following  case  may  be  of  interest : 

W.  U.,  aged  46,  a  laborer,  came  under  ob- 
servation last  May  on  account  of  an  attack  of 
diarrhea,  which  Had  kept  him  awake  the  whole 
of  the  night  before. ,  He  said  that  for  twenty 
years  he  had  had  a  swelling  in  the  neck  and  a 
prominence  of  the  ejeballs.  Several  doctors 
had  noticed  these  peculiarities.  During  that 
time  he  had  suffered  much  from  palpitation  and 
breathlessness,  which  rendered  him  unable  to  do 
a  good  day's  work. 

His  face  wore  a  very  anxious  expression,  the 
eyeballs  were  very  prominent,  a  wide  ring  of 
sclerotic  being  visible ;  the  upper  eyelids  did 
not  accompany  the  eyeballs  in  downward  move- 
ment, and  carrying  the  hand  rapidly  in  front  of 
his  eyes  did  not  cause  blinking.  There  was 
visible  arterial  throbbing  in  the  neck,  and  a 
fullness  in  the  thyroid  region  protruding  well  in 
front  of  the  anterior  border  of  the  sterno- mas- 
toid muscles.  Pulse  126.  The  apex  beat  was 
in  the  sixth  intercostal  space  just  outside  the 
nipple  line.  The  upper  margin  of  the  cardiac 
dulness  was  in  the  thiid  intercostal  space,  the 
right  margin  at  the  left  border  of  the  sternum. 
No  murmur  was  detected.  There  was  no  albu- 
men in  the  urine.  , 

The  diarrhea  was  checked  by  opium.  Thei^ 
quinine,  iron,  digitalis,  and  arsenic  were  given 
for  a  fortnight  without  benefit.  He  was  then 
put  upon  raw  sheep's  thyroid  (a  quarter  lobe 
per  diem,)  minced  and  flavored  with  a  little 
salt  and  vinegar.  His  wife  gave  him,  through! 
a  misunderstanding,  i  lb.  daily  for  two  days.| 
This  caused  dyspeptic  symptoms—  nausea,  eruc- 
tations, vertigo,  and  insomnia.  His  face  and 
legs  swelled,  in  consequence,  he  thought,  of  the 
**  neckbergs,"  by  which  name  thyroids  are 
known  to  butchers  in  this  locality.  TIte  thyroid 
was  discontinued  for  a  week,  and  the  unpleas- 
ant effects  of  the  previous  mistake  having 
passed  off,  was  resumed  in  the  quantity  origin- 


ally prescribed.  He  steadily  improved,  and 
for  the  last  three  months  has  been  able  to  do 
heavy  work  without  the  slightest  discomfort — 
an  experience  unknown  to  him,  he  says  for 
many  years.  The  exophthalmos  is  now  scarcely- 
perceptible,  and  would  not  be.  suspected  without 
close  examination.  There  is  now  a  depression 
in  place  of  the  previous  fullness  in  the  thyroid 
region.  The  pulse  is  76.  The  area  of  cardiac 
dulness  is  unaltered.  Arterial  throbbing  has 
disappeared.  The  patient  is  greatly  surprised 
at  the  change  which  has  come  over  him,  and 
continues  to  take  a  quarter  of  a  lobe  twice  a 
week.  One  cannot  be  sure  there  is  a  connec- 
tion between  the  treatment  and  the  improve* 
ment,  though  the  patient  has  no  doubt  on  the 
matter. — BriL  Med,  Jour, 


injection  Method  of  Treating  Certain  Clatsea  of 
Hemorrhoids. 

This  method,  though  generally  condemned, 
is  sometimes  very  efficient  in  simple  hemor- 
rhoids without  ulceration,  and  where  the  sphinc- 
ter is  relaxed.  The  bowels  should  be  washed, 
out  with  enemata,  and  antiseptic  precautions 
carefully  observed.  The  tumor  is  brought  into 
view,  without  a  speculum,  if  possible,  the  parts 
thoroughly  cleansed,  and  a  needle  introduced 
from  the  base  of  the  tumor  to  the  center.  The 
blood  is  then  pressed  out  of  the  tumof  with  the 
finger,  and  great  care  taken  to  see  that  the 
needle  is  neither  in  the  cellular  tissue  beneath 
the  hemorrhoid,  or  immediately  adjacent  to  the 
mucous  membrane.  The  fluid  is  to  be  injected 
in  very  small  quantities  in  different  parts  of  the 
hemorrhoid  through  the  one  puncture  ;  two  are 
generally  sufficient — never  more  than  four 
minims.  I  prefer  the  following  modified  Shu- 
ford's  solution : 

Carbolic  a«nd dr.  j«a 

>^lcyllc  acid dr.  w 

BIboiateof  soda dr.  i 

Glycerin. q.  8.  ad  ox. } 

The  fluid  should  always  be  perfectly  dear, 
and  should  never  be  used  when  of  a  reddish  or 
yellow  color,  for  it  is  then  likely  to  cause  con- 
siderable irritation.  The  injection  causes  no 
pain,  and  does  not  interfere  with  the  patient's 
occupation.  It  is  sometimes  necessarv  to  repeat 
the  operation  on  a  large  hemorrhoid,  but  this 
should  not  be  done  for  three  weeks.  There  is 
nothing  in  the  fluid  to  produce  suppuration, 
and  when  this  occurs  it  is  due  to  faulty  tech- 
nique. I  have  never  had  death,  hemorrhage 
fistula,  stricture,  or  protracted  ulceration  pro- 
duced by  this  method  in  nearly  one  thousand 
injections,  and  I  believe  this  is  due  to  anti- 
sepsis, and  the  injection  of  very  small  quantities 
of  weak  solutions.     Some  cases  recur  in  from 


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183 


two  to  four  years,  but  the  tr^tment  cao  then 
be  repeated  satisfaotorilj ;  in  the  majority  of 
cases  thefte  is  no  return. — Am.  M.  S,  Bulletin. 


Ammonium  Embelate  as  a  Tenifuge. 

Dr.  A.  Darand  {Inaugural  Thesis;  Bordeaux,  1893.) 
The  author  has  conducted  a  serifs  of  clinical 
experiments  with  Ammonium  Embelate,  which 
prove  the  Reputed  anthelmintic  value  of  this 
remedy.  Of  eight  cases  the  tenia  were  killed 
and  completely  expelled  in  seven,  while  in  the 
eighth^  in  which  pelletierine  had  proved  of  no 
avail,  the  parasite  was  only  partially  removed. 
The  patients  were  subjected  to  the  milk-diet  for 
three  days — ammonium  embelate  being  given 
on  the  morning  of  the  second  day,  on  an  empty, 
stomach,  in  doaes  af  40  centigrammes  (6  gm.), 
taken  in  wafers  and  followed  by  a  purgative — 
preferably  castor  oil  in  30  gramme  (1  fi.  oz.) 
doses — after  24  hours.  The  author  considers 
ammonium  embelate  a  reliable  and  harmless 
tenifuge. — Amer,  Med,  Surg.  BuIUHtu 


A  Good  Recovery  From  a  Bad  Injury. 

ByT.  J.  Newland.  M.D.,  Surgeon,  N.P.R.R., 
Ellenbburg,  Wash. 

On  January  16,  1893,  Mr.  B.,  aged  about 
30  years,  while  acting  in  the  capacity  of  brake- 
man  for  the  N.  P.  R.  R.,  fell  from  the  top  of  a 
box  car  of  a  moving  train  to  the  track,  and  a 
loaded  car  passed  over  his  left  foot  diagonally 
from  the  heel  forward  across  the  arch,  inflict- 
ing a  severe  compound- comminuted  fracture  of 
the  tarsal  bones,  aod  a  greatly  lacerated  condi- 
tion of  the  soft  tissues,  almost  severing  the  foot, 
with  the  complete  distruction  of  all  the  princi- 
pal nutrient  blood  vessels— a  sickly  sight  of 
mangled  tissue. 

It  was  found  necessary  to  remove  many  frag- 
ments of  bone,  and  when  the  wound  was 
properly  cleansed  and  ready  for  the  dressing,  I 
ihite  tor  desertptioD."  uommuuiw^w  •*.*»—  -^j—  '-r  -^ 
this  bans,  and  get  the  benefit  of  his  enterprise. 

Send  your  name  and  address  to  the  Angier  Chemi- 
ealCo.,  Boston,  Mass.,  and  mention  this  notice  and 
thev  will  send  yon  free  a  card  of  excellent  pens.  They 
take  this  method  of  calling  your  attention  to  their 
emnkion  of  petroleom.  Better  also  say  that  you  are 
a  sabscriber  for  The  Medical  World,  and  tell  them 
what  yon  think  of  it. 

Have  yon  made  out  yoor  bills  for  services  during 

ISStmOntb?     If  not  nrnn*HH\  f/\  trot  i**  *^'^  *•    '--*- 

neurabthenia. 

•r.  Tr.kola. 

Tr.^ca. « aa <w.  Jss 

dtrioadd gr.xj 

Aneniate  of  sodium gr.  % 

M.  Big.  Teaspoonfol  Uiree  times  daUy. 

—El  Siglo  Medico. 


that  was  left  of  the  patient's  foot.  A  large 
piece  of  moist  sterilized  gauze  ^as  drawn 
through  the  foot,  and  all  the  openings  well 
packed  with  the  same  sort  of  material.  Grcu- 
lation  by  the  superficial  vessels  remaining  was 
encouraged  by  artificial  heat,  which  was  found 
to  be  essential  for  about  three  weeks.  It  was 
dressed  as  often  as  deemed  necessary. 

The  large  cavities  filled  but  slowly  on  ac- 
count of  the  deficient  circulation,  by  granulated 
tissue,  without  suppuration,  the  wound  remain- 
ing aseptic  tliroughout  The  foot  shortened 
some  by  contraction  of  the  remaining  tendons, 
and  in  a  couple  of  months  there  was  consider- 
able strength  in  the  foot,  and  the  patient  was 
going  about  comfortably  on  crutches. 

On  April  26th  following  he  was  transferred 
to  the  company's  hospital  at  Missoula,  where 
the  remaining  granulating  surface  was  success- 
fully covered  by  skin-grafts  by  Dr.  J.  J. 
Buckley,  chief  surgeon,  and  the  patient  soon 
discharged.  To-day,  and  for  several  weeks 
past,  only  a  little  more  than  twelve  months 
since  the  accident,  the  man  walks  as  rapidly  as 
the  average  individual.  True,  he  limps  some, 
but  the  foot  has  become  quite  strong.  The  new 
tissue  formation  has  become  dense  and  hard, 
forming  a  good  ialse  joint. 

This  case  has  been  of  great  interest  to  me, 
and  I  believe  it  should  be  to  every  surgeon,  on 
account  of  the  anatomical  arrangement  of  the 
bony  structure  of  the  foot  being  so  extensively 
disorganized,  and  yet  its  functions  so  nearly  re- 
stored. It  should  teach  us  that  conservative 
surgery  should  never  be  lost  sight  of,  and  that 
it  is  very  often  rewarded  by  flattering  results. 
— Med,  Sentinel. 


The  Sulphites  and  Hyposulphites. 


m 


In  an  interesting  and  exhaustive  article 
the  Jour  A.  M.  A.^  Dr.  Joseph  Jones,  of  New 
Orleans,  gives  some  important  facts  regarding 
this  useful  class  of  agents  (the  sulphite  and  the 
hyposulphite  of  sodium  calcium  potasium  or 
inagnesium).  In  the  treatment  of  wounds  they 
|)resent  the  following  advantages  :  1,  anesthe- 
lia  of  the  wound  ;  2,  prevention  of  nervous  ac- 
idents  ;  3,  excitation  of  granulation  and  accel- 
ration  of  cicatrization  ;  4,  diminution  of  the 
quantity  of  pus,  which  it  renders  viscid,  sweet, 
inodorous  and  neutral. 

Under  the  head  of  Physiologic  Action  the 
author  concludes  as  follows :  Giving  credit  to 
the  consciencious  experiments  of  Polli  and  of 
Burgreave  upon  animals,  it  becomes  difi&cult  to 
refuse  to  admit :  1,  that  these  salts  exercise 
upon  the  economy  a  very  marked  action,  an  ac- 
tion almost  specific  in  certain  cases ;  2,  that  their 

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THE  MEDICAL  WORLD. 


administration  is  able  not  only  to  retard  death, 
but  also  to  f^lleviate  the  symptoms  of  purulent 
infection,  produced  by  the  introduction  into  the 
circulatory  system,  in  large  doses,  of  pus,  or  of 
blood  rendered  putrid  by  divers  poisons,  and  to 
effect  a  cure  in  a  marked  number  of  such  cases. 
Purulent  infection,  purulent  diathesis  and  met- 
astasis, phlebitis,  pyemia,  putrid  infection, 
puerperal  fever,  form  a  group  of  septic  diseases 
presenting  a  special  character  of  putridity  and 
a  mixed  alterati  n  of  liquids  and  solids.  It  is 
well  known  how  grave  the  prognbsis  is  in  all 
these  affections,  and  how  powerless  and  uncer- 
tain are  all  therapeutic  means.  The  indications 
can  be  much  better  met,  and  success  becoines 
much  more  certain  with  the  sulphites. 

Under  Therapeutic  action,  they  are  recom- 
mended for  use  in  blood  poisoning  from  various 
sources,  malarial  fevers,  typhoid  fever,  the 
eruptive  fevers,  diphtheria,  and  as  a  lotion  in 
catarrhal  states  of  the  bladder  and  the  genital 
and  other  mucous  passages. 


Formulas. 


Therapeutio  Hints. 

(From  The  Medical  Record  ) 
BR0MIDR08IS. 

Internally  give  ni^viij.  tinct  belladon.  in  38s. 
fluid  extract  ergot,  three  times  a  day  ;  extern- 
ally, use  on  the  body  the  following  powder 
several  times  daily : 

R.   Salicylic  acid „ dr.   R 

Boric  add o«.   3 

Zinc  oxide oz.  % 

Powdered  starch ca.   5 

Ottarof  roeefl ms  20 


TLEURITIC    EXUDATION. 


To  prevent  extension  of  exudation :  Abso- 
lute rest  in  the  recumbent  position,  until  tem- 
perature has  been  normal  for  eight  days,  the 
heart  and  respiration  being  the  guides  as  to  in- 
crease of  fluid.  No  movement,  to  be  permitted 
for  the  purpose  of  examining  the  chest  or  for 
any  other  object.     Striking  results  reported.       ! 


PURULENT   OPHTHALMIA. 

Carefully  wash  the  eyes  first ;  then  : 

R.   Corro«lve  sablimate grm.     0  02  (gr.  l^) 

■    SyndeDham'nlaadanuji..   "        0.05  (m.  vi'ij) 

DitUlled  water ^ •♦     160.00  {oz.  v) 

A  drop  to  be  instilled  every  two  hours,  then  everv  hour. 
No  canterixation  to  be  employed.  Catarroal  symptoms  soon 
begin  to  disappear.    If  slight  conjunctivitis  remain  : 

R.   Sulphate  of  zinc... gram.    0.0o(gr.  ^) 

Bone  acid ••        0  04  (dr.  j) 

Distilled  waier ••     100.00  (oz.  Ujss) 

To  be  used  every  two  hours,  in  the  rame  manner  as  the 
previous  solution,  and  alternating  witn  it. 


CARDIAC  WEAKNESS  IN  ARTERIO-SCLER08IS. 

The  distressing  palpitation  to  which  this  gives 
rise  may  be  greacly  relieved  by  the  following : 

R.   Chloral  hydrate. 

Sodium  bromide aa gram.  4.00  (dram  1(n 

Codeine „ cent^g.O.IO  (gr.  1^^^) 

Water. 

Synip  of  oranare  pee1..aa....gr8m.  Ah  (dram  11^) 
M.    Big.  Tal^e  a  dessertspoonful  every  two  hour»  till  the 
heart  is  quieted. 


SCIATICA. 

R.   Opiipulv. 

Ipecac  pulv aa gr.  xlj 

Sodii  salicylat dr.  j 

Ext.  cascane  fl q.  a. 

M.    Div.  in  pU  No.  xij 

8.    One  or  two  pills  for  a  dose. 

— Dr.  Benjamin  Ward  Richardson. 


FERMENTATIVE   DYSPEPSIA. 

R.   Olei  crr-OBOtl.- minims  xlj 

Spts.  tennoris ounces  ss 

Ammon.  benzoa drams  1] 

Glycerin drims   vi 

Infus.  carfopbyl.  q.  s ad.  ounces  vi 

M.  S.    lablespoonful  In  a  glass  of  water. 

—Dr.  B.  W.  Richardson. 


ATROPHIC   RHINITIS. 

R.   Thymol 0.08  ctgm,  (gr.  1^) 

Alcobol. 

(Glycerine aa Cgram  (dr.  IS) 

Distilled  water tfgram  (dr.  %) 

M.  App  y  with  atomizer 

NIC.HT   SWEATS   OF   PHTHISIS. 

R.   Sulphate  of  atropine 0.0005  gram  (gr.  1-128) 

Sulphate  of  zinc 0.1^  gram  fgr.  4-5) 

Gallic  acid 0.12  gram  (gr.  4-6) 

Oeoftote lOgtts 

M.    Div.  in  pU.  No  v. 

8.    Oae  pill  thrice  daily. 


h^:moptysis. 

R.  Gallic  add. 

ErgoUne aa 1  gram  (gr.l5) 

Distilled  water. 

Syrup ~aa 25  gram  (dr.  G'4) 

M.  8.  Teaspoonful  every  two  hours,  or,  if  the  bleeding  is 
revere,  every  hour.  Better  results  follow  the  use  of  the  enro- 
tine  in  this  mixture  tban  when  it  Is  given  alone  hypodt;nnai- 
ically. 

The  fluid  should  always  be  perfectly  clear, 
and  should  never  be  used  when  of  a  reddish  or 
yellow  color,  for  it  is  then  likely  to  cause  con- 
siderable irritation.  The  injection  causes  no 
pain,  and  does  not  interfere  with  the  patient's 
occupation.  It  is  sometimes  neoessary  to  repeat 
the  operation  on  a  large  hemorrhoid,  but  this 
should  not  be  done  for  three  weeks.  There  is 
nothing  in  the  fluid  to  produce  suppuration, 
and  when  this  occurs  it  is  due  to  faulty  tech- 
nique. I  have  never  had  death,  hemorrhage 
fistula,  stricture,  or  protracted  ulceration  pro- 
duced by  this  method  in  nearly  one  thousand 
injections,  and  I  believe  this  is  due  to  anti- 
sepsis, and  the  injection  of  very  small  quantities 
of  weak  solutions.     Some  cases  recur  in  from 


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EBCHAROTIC    PASTE    FOR    CANCER,   LUPUS,  ETC. 

B.  Wheat'floiir. 7  •unoes 

StATCh » ~  2ounoet 

OorrodTe  tubliiiiAte ...^15giaini 

PnrekxloL 
Crotoii  ohlontL 
Bromide  of  obamphor. 

Crystal  caibol.  add ...4ta.. 2!<  drami 

OxidaofxlDO 7  ouBoei 

Water,  enou^  to  make  a  homogenua^  ma«  of  the  conslit- 
enoe  of  potty. 

—Felix. 
NlQoioe.    We  would  recommend  our  readers  to  nave 
this  work  at  hand  for  the  solution  of  many  of  their 
knotty  problems  in  diagnosis,  for  which  they  might 
otherwise  have  to  resort  to  the  quiz  column. 

The  International  Medical  Annual  and  Pbao- 
TITI0NBB8  Index,  for  1894.    Cloth,  704  pap^es, 
price  only  $2.75.    E.  B.  Treat,  6  Cooper  Union, 
&ew  York. 
This  work,  very  good  at  first,  is  yearly  becoming  bet- 
ter and  more  valuable.    The  number  now  just  out  is 
fun  of  valuable  and  reliable  abstracts  of  the  latest  that 
is  known  in  regard  to  new  remedies,  treatment  and 
diagnosis.    It  is  full  of  illustrations,  many  of  them  full- 
page  colored  plates.    The  wonder  is  that  it  can  be  sup- 
plied at  such  a  low  price. 

Important  Patent  Decision— The  Alien  Pump 
Patents  Sustained. 

FILARIA  SANGUINIS. 

In  chyluria  may  be  driyea  out  of  the  system 
by  thymol  gr.  j.  every  four  hoais,  with  subse- 
quent doubling  of  the  dose. — BuL  ghi  de  Ther. 


TONIC  AND  ALTERATIVE. 

B.   Uq.  potasBii  anenitis dr.  ilj 

Tlnet  mods,  vomics oz.  is 

Tlnct  gentiona  oomp ..os.  ij 

Syr.  a<^  hydrk>4ici  (Hostelly^)  q.  ■ oz.  vj 

M.   Sig.  Teaspoonfol  ter  in  die.   1N»  betaken  In  wineglaa- 
Ail  of  water. 

In  our  April  issue  the  advertisement  of  Willis  H. 
Davis,  of  Keokuk,  Iowa,  was  slightly  mixed;  the 
$6.00  in  last  line  of  his  $5.60  "Western  Leader" 
advertisement  did  not  belong  to  fhe  "  Western 
Lmder"  adv.,  but  should  have  gone  in  a  separate 
paragraph  as  follows :  *'  Western  saddle  h&gf  $6.00 ; 
write  for  description."  Communicate  with  him  upon 
this  basis,  and  get  the  benefit  of  his  enterprise. 

Sknd  your  name  and  address  to  the  Angier  Chemi- 
cal Co.,  Boston,  Mass.,  and  mention  this  notice  and 
thev  will  send  you  free  a  card  of  excellent  pens!  They 
take  this  method  of  calling  your  attention  to  their 
emulsion  of  petroleum.  Better  also  say  that  you  are 
a  subscriber  for  The  Medical  World,  and  tell  them 
what  you  think  of  it. 

Have  you  made  out  your  bills  for  services  during 
Itftjoonth  ?    If  not  Ttrrvxwa  tA  tt^-i^  *J-*  *•  *-^-  '^ 

NEURASTHENIA. 

•r.  Tr.kola. 

Tr.  Qpca. aa oz.  Jss 

Cltrifcadd gr.xv 

Arseniate  of  sodium gr.  % 

M.   SIg.  Teaspoonfol  three  times  dally. 

—El  Siglo  Medico. 


A  CATARRH  SNUFF. 

The  following  is  recommended  by  a  writer  in 
a  French  journal  as  a  useful  remedy  for  acute 
coryza: 

R.  SaloL gr.  xv 

SaUcyUo  add « gr.lH 

Boric  add „ dr.  J 

Tannin dr.  i\m 

Big.   To  be  used  as  a  snuiT  in  the  early  stage  of  an  acute 
rhinitis. 


FOR   HEMOPTYSIS. 


R.  Qallotannio  add. 

Bigottne 

Distilled  water. 

Syrap 

A  teaspoonfUl  every  hour. 


...aa......  1  gm.  (gzs.  zv> 

..4ka 2Sgm8.(dr.  tJ) 


OINTBiENT. 

Applied  to  large  joints  in  articular  rheuma- 
tism.    Anoint  joints  and  cover  with  flannel. 

R.  SaUcyUc  add *) 

Lanoiine ytA  gms.  10  (dr.  ijsi) 

Ecs.  of  tarpentine ..j 

Benaoated  laid »       gms.  80  (oz.  ^) 


ooRineA. 

In  obstinate  cold  in  the  head  the  following  is 
recommended : 

^1'^oS55?U.} «"■ '-) •*-•» 

Peppermint  water, (oz.  iij) gms.  90 

A  dessert  spoonful  every  Uiree  to  fbnr  hours,  until  the 
ears  ring. 

Alcoholic  solutions  do  not  increase  the  ab- 
sorbent power  of  the  drug ;  on  the  contrary, 
they  slow  it  It  is/less  rapid  after  eating.  A 
little  sea  salt  on  the  tongue,  before  taking,  will 
mask  the  disagreable  taste. — Lancet  Clinic 


CHRONIC  GONORRHEA  AND  GLEET. 

R.  Bncalyptol  (Sander  A  Son's) dr.  m 

Spir.  vin.rect.. ^....  ot.  i 

ZmcLsulpb » grs.xv 

Morphlnse  sulph grs.  It 

AqasB  font.  q.  s.  ad os.  Iv 

M.    Siff.  Inject  one  to  two  oz.  twiee  daily.    Shake  wdl  be- 
f&re  using. 


Correotions. 

It  is  very  difficult,  as  prescriptions  are  ordinarily 
written,  to  have  them  all  set  up  in  type  without  some 
slight  error.  Hence,  readers  of  medical  journals 
should  always  be  guided  some-what  by  their  own 
judgement  when  the  apparent  dosage  is  very  far  from 
that  ordinarily  employed. 

On  page  146,  April  World,  prescription  for  gonor- 
rhea, the  bromide  of  potassium  should  read  dram  iss 
and  the  last  ingredient  should  read  ounces  viii  in- 
stead of  drams  viii. 

In  the  prescription  for  scarlatina,  same  column,  the 
salicylate  of  soda  should  be  grains  xxx  to  drams  ii, 


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THE  MEDICAL  WORLD. 


and  the  .last  three  ingredients  should  be,  '*of  each  q, 
4,  ad  ounoes  iv.'* 


The  annual  meeting  of  the  American  Medical  Asso- 
•elation  will  be  held  in  San  Francisco,  Cal.,  on  June 
5th,  6th,  7th,  and  8th.  For  any  desired  information 
address  the  Permanent  Secretary,  Dr.  W.  B.  Atkin- 
son, cor.  Broad  and  Pine  Sts.,  Philadelphia. 

Reviews. 


In  writing  for   any   publication  reviewed  please 
^mention  Thb  Medical  World. 

Manual  of  Thebafbutics.    By  A.  A.  Stevens,  A. 

M.,  M.D.,  of  Phila.    Cloth,  486  pages,  $2.26. 

W.  B.  Saunders,  926  Walnut  St.,  Phila. 
A  yery  useful  manual,  bringing  the  subject  up  to 
•date.     The  newer  drugs,  introdu^  within  the  past '  ~ 
-few  years,  are  duly  recognized. 

A  Text-Book  op  the  Diseases  of  Women.  By  ■ 
Henry  J.  Garrigues,  A.M.,  M.D.,  of  New  York.  ; 
Price,  net,  cloth,  $4.00,  sheep,  $5.00.  W.  B.  ' 
SaunHers,  926  Walnut  St.,  Phila. 

It  is  with  pleasure  that  we  place  before  those  of  our  f 
readers  who  need  a  work  on  this  subject,  this  excellent  j 


This  is  a  work  of  great  interest  to  the  physioiaa 
especially  desiring  more  light  on  the  treatment  of  dis- 
eases of  children.  Prof.  Jacob!  is  high  authority  on 
the  subject. 

Anomalies  of  Refraction  and  of  the  Musclkb 
OF  THE  Eye.  By  Flavel  B.,  Tiffany,  M.D., 
Kansas  City,  Mo. 

This  book  is  profusely  illustrated,  and  contains,  in 
addition  to  what  is  found  in  the  ordinary  books  on  this 

sciatica. 

R.   Opilpulv. 

Ipecac  pulv aa gr.  xlj 

Sodll  nallcylat dr.  j 

Ext.  cascane  fl q.  e. 

M.    Div.  in  pll  No.  xij 

8.    One  or  two  pills  for  a  close. 


'Dr,  Benjamin  Ward  Richardson, 


FERMENTATIVE    DYSPEPSIA. 

Olei  crt-osoti.- minims  xiJ 

Spts.  tennoris ounces  ss 

AmmoQ.  bensoa. « drams  ij 

Glycerin drims   vi 

Infos,  caryopbyl.  q.  s ad.  ounces  Ti 

M.  S.    Tableepoonfui  in  a  glass  of  water. 

—Dr.  B.  W,  Richardson. 


readers  who  need  a  work  on  tnis subject,  tnis  ezoeiient  ATROPHIC  RHINITIS. 

volume  by  Prof.  Garrigues.    The  reputation  of  thisL  ■  ■li^irmSauscript  has  slumbered  in  obscuru/  .^. 


•distinguished  author  for  thorough  conscientious  work 
18  sufficient  guarantee  of  its  great  value.  The  book  is 
most  magnificently  illustratei  with  three  hundred  and 
-ten  engravings — ^many  of  them  color#i  plates. 

^UBSiNO  IN  Ets  Diseabe?.  By  C.  S.  Jeafireson,  M. 
D.,  F.  R.  C.  S.  E.,  of  Newcastle-on-Tyne.  cloth, 
90  pages^  price  two  shillings  six-pence.  John 
Wright  A  Ck).,  Stone  Bridge,  Bristol,  England. 

This  will  prove  a  most  usefu^  hand-book  to  physi- 
<dans  doing  much  work  in  disease  of  the  eye,  both  for 
the  hints  to  themselves  and  as  a  book  of  instruction 
"for  their  nurses.  The  author  gives  many  illustrations 
•showing  methods  of  bandaging,  dressing  etc.  He  gives 
detailed  nursing  directions  for  cases  after  each  one  of 
tlie  principal  operations  upon  the  eye. 

Lbctuubs  on  Auto-Intoxication  in  Disease,  ok 


Bouchard,  of  Paris,  translated  by  Thomas  Oliver, 
M.A.,  M.D.,  F.  R.  C.  P.,  of  Newcastle-upon 
Tyne,  England.  Cloth,  302  pages,  octavo,  $1.75, 
net  The  F.  A.  Davis  Co.,  1914  Cherry  St., 
Philadelphia. 

This  is  a  scholarly  and  most  important  work.  Too 
seldom  ddea  the  physician  sufficiently  recognise  the 
significance  of  self-intoxication.  In  the  future  it 
must  be  more  generally  recognized  in  estimating 
•causes,  diagnosis,  and  prognosis  and  in  determining 
treatment  The  author  treats  of  Production  and 
Elimination  of  poison ;  Toxicity  of  the  urine ;  Toxi- 
city of  the  contents  of  the  intestines ;  Chronic  gastro- 
intestinal intoxication;  Dilatation  of  the  stomach; 
Typhoid  fever;  Jaandice  and  bile-intoxication; 
^ocyanio  disease ;  Diabetes ;  Cholera ;  Oeneral  thera-^ 
peutics  of  self -poisoning. 

Clinioal  Lbotubes  on  Pediatrics.  By  A*  Jacobi, 
M.D.  Cloth,  19§  pages.  Published  by  Bailey  & 
Fairohild,  New  York,  N,  Y. 


hundred  years,  now  to  be  published  for  tbe  first  time 
by  this  enterprising  magazine. 

The  New  York  State  Medical  Bkpobter. 
Monthly,  $1.00  per  year;  edited  by  H.  Bronson 
Gee,  M.D.,  published  by  George  B.  Fuller, 
Rochester,  N.  Y. 

We  wish  the  new  journal  a  brilliant  career  in  the 
field  of  medical  literature. 

What  an  appropriate  name  has  that  matchless 
magazine — ^The  Arena,  of  Boston,  Mass.  As  in  the 
physical  Arena  of  old  were  fought  many  fierce  oon- 

"•       >  •     ,.  ^.  3  #1,^ -,^ui^.  .„^«r,«^  ^r.t. f^f 

R.   Gallic  acid.  ^  ,      ,«, 

Ergotlne aa I  gram  (gr.l5) 

pisUlied  water.  ^^    ^,  ^ 

Syrup aa 2o  gram  (dr.  GI4) 

M.  8.  Teaspoonfal  every  two  hours,  or, 


if  the  bleeding  is 


Ri8T.F.PoraoNTi7a  ow  TWR  TwuTviDHAL      Bv  Ch     evere,  every  hour.    Better  results  follow  the  use  01  iheerico- 
^^.J:^^S^^?'.l^^^J^rJ^l^-     •??:h-    ine  in  this  iixture  than  wh.n  It  is  given  alone  hy  podennai 


Ically. 

The  fluid  should  always  be  perfectly  clear, 
and  should  never  be  used  when  of  a  reddish  or 
yellow  color,  for  it  is  then  likely  to  cause  con- 
siderable irritation.     The  injection  causw  no 
pain,  and  does  not  interfere  with  the  patienrs 
occupation.     It  is  sometimes  necessary  to  repeal 
the  operation  on  a  large  hemorrhoid,  but  this 
should  not  be  done  for  three  weeks.     There  is 
LjMjiOjinirJn  the  fluid  to  produce  suppuration, 
This  paper  is  a  curiosity  in  that  it  presents  a  u» 
never  bafore  presented  to  the  public  that  we  have 
seen.    It  shows  that  no  one  condition  of  life,  or  io 
one  locality    specially,  favors   the   prolongation  of 
human  life ;  that  neither  the  rest    of  afflaeoce,  or 
the  labor  of  the  poor  man  conduce  much  to  the  at- 
tainment of  very  old  age.    The  long  list  would  flsrve 
to  show  the  helplessness  of  old  age  and  the  great  neow- 


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THE  MEDICAL  WORLD. 


19T 


utj  of  lajing  up  daring  the  early  half  of  life  the 
naeeflnxT  means  for  maintaining  the  Utter  half, 
which  18  for  the  most  part  one  of  debility  and 
dependence. 

CuNiCAX    DiAONOSES.    By  Albert  Abrams,   M.  D., 

i Heidelberg,  Germany}.  Cloth,  273  J^tges*  price, 
1.75.  E.B.  Treat,  No.  6  CJooper  Union,  New 
York. 
This  book  is  well  worth  the  attention  of  the  practi- 
tioner. The  information  is  well  classified  and  easy  for 
i«lerenoe.  We  wonld  recommend  our  readers  to  have 
this  work  at  hand  for  the  solution  of  many  of  their 
knotty  problems  in  diagnosis,  for  which  they  might 
otherwise  have  to  resort  to  the  quiz  coluom. 

Thk  Ihttsrnational  Medical  Annual  and  Paao- 
TiTioNKBS  Index,  for  1894.    Cloth,  704  pap^es, 
price  only  $2.75.    E.  B.  Treat,  6  Cooper  Umon, 
New  York. 
This  work,  very  cood  at  first,  is  yearly  becoming  bet- 
ter and  more  valuable.    The  number  now  just  out  is 
full  of  valuable  and  reliable  abstracts  of  the  latest  that 
is  known  in  regard  to  new  remedies,  treatment  and 
diaq^nosis.    It  is  full  of  illustrations,  many  of  them  full- 
page  colored  plates.    The  wonder  is  that  it  can  be  sup- 
plied at  such  a  low  price. 


Important  Patent  Decision— The  Alien  Pump 
Patents  Sustained. 

Judge  Crossup,  of  the  United  States  Circuit  Court  in 
Chicago,  has  just  rendered  a  lengthy  decision  sustain- 
ing the  validity  of  the  Allen  Patents.  The  decision 
i^  the  result  of  a  suit  brought  by  Mr.  Charles  Truax, 
Chicago,  against  W.  C.  Carroll,  Burton  F.  Hales,  et 
aL  of  the  Physicians^  National  Supply  Co.,  for  manu- 
£uturing  ana  selling  surgical  pumps  resembling  those 
manufactured  under  tbe  Allen  Patents. 

This  is  an  important  decision  and  one  of  considera- 
ble interest  to  the  medical  profession. 

V  ^^ 

Wit  and  Wisdom. 


In  our  April  issue  the  advertisement  of  Willis  H. 
Davis,  of  Keokuk,  Iowa,  was  slightly  mixed;  the 
•6.00  in  last  line  of  his  $5.50  ''Western  Leader" 
advertisement  did  not  belong  to  the  "  Western 
Leader"  adv.,  but  should  have  gone  in  a  separate 
paragraph  as  follows :  "  Western  saddle  bags  $6.00 ; 
write  for  description."  Communicate  with  mm  upon 
this  basis,  and  get  the  benefit  of  his  enterprise. 

Sknd  your  name  and  address  to  the  Angier  Chemi- 
cal Co.,  Boston,  Mass.,  and  mention  this  notice  and 
they  will  send  you  free  a  card  of  excellent  pens.  The^ 
take  this  method  of  calling  your  attention  to  their 
emulsion  of  petroleum.  Better  also  say  that  you  are 
a  subscriber  for  The  MiDiOAii  World,  and  tell  them 
what  you  think  of  it. 

Havk  you  made  out  your  bills  for  services  during 
last  month  ?  If  not  proceed  to  get  in  the  habit  of  do- 
ing this  good  turn  to  yourself  with  reenlarity.  It 
won't  offend  your  patrons  who  pay,  and  as  for  the 
others,  it  is  a  question  of  statesmanship  as  to  whether 
you  care  to  cater  to  their  business  or  not. — Lomeet 

Havc  you  seen  F.  Steams  &  Co's  advertisement  of 
a  Mw  form  of  iron  7    Send  for  aamplee  and  literature. 


Port  Gibson,  N.  Y.,  March  10th.  1898. 

Haviuff  tried  Freligh's  Tablets,  Cough  and  ConsU- 
tuent,  I  find  them,  especially  the  Cough  Tablets,  to  be 
the  best  of  any  I  have  ever  used.    A,  E.  Post,  M.  D. 

Class  of  1872. 

An  Excsllbnt  ToNia— The  following  can  he  re- 
lied upon  as  a  ^neral  tonic.  In  those  cases  where 
there  is  malnutrition,  imperfect  enervation,  etc.,  it  will 
be  found  of  great  value. 

B.  Stryoh.  Solph gr.J 

Peprin  (P.  5.  A  Go's.,) drjai 

Tr.  GeDtian  Oomp., ox.  11 

Syr.  Acid  Hydriodic  (HotteUey's) os.  UJm 

M.    Sigi—TeaspoonAil  Immediately  after  each  meal 

F.  S.WoBCB8TER,M.D.,wmTE8:— DnJ.A.McArthun 
Dear  Sir :— I  have  used  McArthur's  Syrup  Hypophoe: 
Com:  <^uite  extensively  in  the  last  few  years,  and  from 
the  satisfactory  results  obtained  I  shall  use  it  more  fre- 
quently. In  the  case  of  my  servant  girl,  who,  to  all 
appearances,  was  strongly  tending  to  consumption,  wiUi 
loss  of  a{>petite,.  loss  of  flesh,  a  snort  hacking  cough, 
sharp  pains  through  her  lungs  and  a  pallid  complex- 
ion, the  effort  to  perform  any  work  was  attended  by 
almost  complete  exhaustion.  I  put  her  on  your  prep- 
eration  of  Hypophos^hites  and  stopped  all  other  med- 
ication, and  after  talung  the  second  bottle  she  express- 
ed herself  all  well,  and  a  month  after  again  took  ser- 
vice in  a  large  family  and  feels  nicely.  I  have  used 
it  with  gratifying  results  in  cases  of  marasmus,  and  in 
the  case  of  my  own  baby  during  the  excitement  inci- 
dent upon  teething,  and  in  cases  for  which  it  is  intenui- 
ed  it  has  fully  met  my  expectation.  Peabody,  Maas., 
Dec  10. 

Mbllin's  Food  is  recognized  as  a  standard  for  in- 
fants and  invalids. 

Ejrophen  is  an  excellent  application  to  wounds, 
ulcers,  sores,  etc  It  is  especially  valuable  in  cases  of 
chancroid.  Address  W.  H.  Schieffelin  St  Co.,  New 
York. 

Have  you  used  Pineoline  for  skin  affections  ?  Ad- 
dress Walker  Pharmacol  Co.,  8l  Louis,  Mo. 

Fob  cut  rates  in  surgical  instruments  fso  very  de- 
sirable in  these  hard  times)  address  I.  Phillips,  At- 
lanta, Ga. 

Send  to  Micigah  St  Co.,  Warren,  Pa.,  for  sample  of 
uterine  wafers. 

Send  to  the  Maltbie  Chemical  Co.,  Buffalo,  N.  Y., 
for  samples  of  Nephriline,  Astmaticine  and  Dyspep- 
tine. 

Send  to  Dr.  J.  W.  Conner,  Labette  City,  Kan.,  for 
a  magnificent  physician's  cane,  and  then  we  would 
suggest  that  you  fill  it  with  granules  from  the  Phila. 
Granule  Co.,  No.  10  South  18th  St.,  Phila. 

Have  you  tried  Syrup  of  Figs  as  a  laxative  ? 

Send  for  a  sample  of  Syr.  Trifolium  Comp.  t« 
Parke,  Davis  St  Co.,  Detroit,  Mich. 

A  PoisoNons  Liquid. — Brown-Sequard  is  reported 
to  have  informed  the  French  Academy  of  Science  that 
condensing  the  watery  vapor  coming  from  the  human 
lungs,  he  obtained  a  poisonous  liquid  cabbie  of  pro- 
ducing almost  immediate  death.  The  poison  is  an  or- 
ganic alkali  and  not  a  microbe  or  series  of  microbes  . 


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THE  MEDICAL  WORLD 


RLI 


He  Bays  it  is  fully  proven  that  expired  air  contains  a 
Yolmtile  element  far  more  dangerous  than  the  carbonic 
aeid  which  is  one  of  its  constituents. 

BuffPLBB  of  Syrupus  Koborans  and  Peter's  Peptic 
Essence  (express  charges  at  your  expense^  will  be  sent 
if  you  addrcw  Arthur  Peter  &  Co.,  Louisyille,  Ey. 

Fob  the  finest  elastic  trusses,  supporters,  etc,  ad- 
dress G.  W.  Flavell  &  Bro..  1005  Spring  Garden  St, 
Philadelphia. 

Fbxb  samples  (tablets  or  powder)  of  Salo-Sedatus, 
by  addressing  the  Salo-Sedatus  Ck).,  St.  Louis,  Mo. 

Fob  improYed  treatment  of  gonorrhea  and  gleet  ad- 
drew  Charles  L.  Mitchell,  M.  D.,  1016  Cherry  St., 
Philadelphia,  Pa. 

Fob  sample  of  Perpoena  address  Perpcena  Chemical 
Co.»  87  College  Pkce,  New  York. 

DocTOBS  ABxSoLDiSBS. — A  proper  movement  has 
hem  undertaken  in  France,  where  it  is  proposed  to 
place  the  widows  of  medical  men  who  die  during  an 
epidemic,  while  enf;aged  in  their  professional  duties, 
upon  the  same  footing  as  widows  of  officers  who  die 
upon  the  battlefield,  with  the  intention  of  obtaining 
for  the  one  the  same  compensation  as  that  provided  for 
the  other. — Medical  News, 

Fob  sample  of  Soaoderma,  a  fine  antiseptic  soap,  ad- 
dress Hall  &  Euckel,  216  to  220  Greenwich  St^  New 
York. 

Fob  cure  for  the  tobacco  habit  address  F.  H.  Amlar, 
Jackson,  Mich. 

SBin>  for  literature  in  regard  to  Tri-iodies  and  Three 
Chlorides,  to  Benz  &  Henry  Pharmacal  Co.,  Louis- 
viUe,  Ky. 

Fob  bilious  conditions  try  Peacock's  Chionia.  Sam- 
ple it  you  will  pay  express  charges.  Peacock  Chemi- 
cal Co.,  St  Louis,  Mo. 

Whkn  a  lawyer  defends  a  man  for  his  life  and  by 
some  technicality  or  shrewdness  he  gains  his  case,  that 
lawyer  is  often  spoken  of  ss  **tbat  man  who  saved  my 
life.'*  When  a  person  is  stricken  down,  we  will  say 
with  strangiilated  hernia,  inst  as  sure  death  as  hanging 
unless  relteyed,  he  bends  for  the  phjsician,  who  un- 
derstands this  technicality  of  nature,  and  relieves  him, 
saves  him  from  not  the  gallows,  but  death.  He  does 
not  say  '*that  physician  saved  my  life,"  but  * 'through 
the  providence  of  God  I  escaped  death. — Charlotte  Med. 
Jeurnal. 

Fob  Elixir  Six  Iodides  addrees  Walker  Green  Phar- 
macal Co.,  Kansas  City,  Mo. 

Fgui  treatment  for  the  morphine  habit  address  B* 
Keith  &  Co.,  75  WUliam  St,  New  York. 

Send  for  free  prospectus  for  one  of  the  grandest 
works  in  the  Enfflish  or  any  other  language — Web- 
ster's Unabridged  Dictionary — to  G.  &  C.  Merriam 
Co.,  Springfield,  Mass. 

8mtrD  for  samples  of  granules  to  the  Detroit  Metric 
Granule  Co.,  15  Rowland  St,  Detroit,  Mich. 

PiiATiKTTl^  at  a  white  heat  will  consume  any  quan- 
tity of  tobacco  smoke,  and  keep  the  atmosphere  per- 
fectly clear.    Lamps  with  a  little  plate  or  platinum 


over  the  flame  are  u«ed  for  this  purpose,  bat  » 
platinum  wire  suspended  over  a  gas-jet  is  much 
cheaper,  and  really  does  its  work  better.— TA«  ifoi. 
Oleaner, 

[This  proves  true  if  you  can  catch  the  smoke  and 
bring  it  in  contact  with  the  wire. — £d.] 

Send  for  free  sample  of  Hemosine,  for  the  treatment 
of  hernia,  to  Hemosine  Chemical  Co.,  Bochester, 
Mich. 

Sbnd  one  dollar  for  one  year's  subscription  to  a 
briffht  journal— lAe  AUcalMal  CUnie—io  Dr.  W.  C. 
Abbott,  Bavenswood,  P.  O.,  Chicago,  HI. 

Wm.  K.  Wabneb  &  Co.,  Philadelphia,  make  a  fine 
line  of  specialties  as  well  as  standard  preparations. 

CsLEBiNA  is  one  of  the  most  prompt  and  efficient 
of  remedies  for  devitalized  or  broken  down  con- 
stitutions. 

Vabiottb  forms  of  neurasth«*nia  are  frequently  cured 
by  the  use  of  Ceierina,  after  the  usud  treatment  with 
nuz  vomicai  damiana,  phosphorus,  quinine,  arsenic, 
iron,  etc.,  have  failed. 

All  people  have  their  trials,  ezc^t,  perhaps,  the 
rich  rascals  who  can  suppress  the  indictments  againft 
them. 

Fbom  Pbof.  a.  C.  Bebnays,  St.  Louis,  Mo.— Sen- 
nine. — ^This  preparation  has  been  recently  introduced 
to  the  profession  by  the  Dios  Chemical  Co.,  put  up  in 
two  oa.  tin  boxes  with  inner  peforated  lid,  and  is  inade 
by  a  German  chemist  whose  qualifications!  know,  and 
I  am  glad  to  recommend  the  preparation,  because  it  is 
a  scientific  one,  and  is  put  up  in  such  a  neat  and  prac- 
tical manner,  as  to  readily  answer  the  requirements  of 
the  busy  surgeon  in  private,  as  well  as  in  hospital 
practiced 

Sakmetto  In  Cystic  And  Pbobtatic  Tboublbs 
and  in  diseases  of  the  mucous  membranes  of  a  chronic 
character.  I  have  not  been  in  the  habit  of  endorsing 
proprietary  medicines,  but  Sanmetto  is  sucj^  an  elegant 
pharmaceutical  combination,  that  I  musTmake  an  ex- 
ception in  its  favor.  I  have  used  several  bottler  of  it 
in  my  practice,  and  have  obtained  most  gratifying, 
and  I  may  say  mrnrUing  results.  Li  cystic  and  pros- 
tatic troubles  it  will  not  disappoint  the  practitioner. 
I  have  found  it  useful  in  all  diseases  of  the  mucous 
membranes  of  a  chronic  character.  I  could  not  get 
along  without  it  Iba  D.  Bbown,  M.  D., 

Weedsport,N.Y. 

The  Faith  Cube. — Make  up  your  mind  that  von 
will  be  cured  by  making  up  your  mind  that  you  will  be 
cured,  and  you  certainly  will  be  cured  of  whatever  yon 
can  be  cured  of  by  making  up  ^our  mind  that  you  biave 
been  cured  of  it — London  Hygiene, 

Two  OF  the  self-sacrificing  members  of  the  German 
nursing  sisterhood  at  the  Chicago  smail-pox  hospital 
took  small-pox.  Chie  had  been  vaodnated  in  infanqy» 
but,  because  of  prejudice,  not  since.  The  other,  be- 
cause of  the  same  prejudice,  had  never  been  vaccina- 
ted. She  died ;  the  other  sister  recovered.  A  valna* 
ble  life  was  sacrificed  to  an  absurd  prejudice — Mtd. 
Standard, 

The  Change  Affected. — **  What's  the  card  in 
your  pocket,  John?  "  asked  his  wife. 
*'  That  ?    Oh,  before  I  went  to  lunch  that  was  a  lull 

iOmUnued  on  next  leof.) 


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TJkg  kmowUdge  that  a  man  can  use  is  the  only  real  knowledge:  tne  only  know- 

Mgitkai  has  life  and  growth  in  it  and  converts  itulf  into  ffractical  power.      The 

r*st  hangs  like  dust  about  the  drain,  or  dries  like  raindrops  off  the  stones.-^TKOXJDM* 


The  Medical  World. 

PUBLOHXD  MOlfTHLT,  by  C.  P.  TaTZ^K,  M.  D. 


CP.  Taywr,  M.D., 
J.J.  Tayi^ii,M.  D., 


:  Editors. 


iiiiiljiifiiii  to  any  part  of  the  United  States  and  Canada, 
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I  publisher's 


Aix  Communications  to 
'THE   MEDICAL  WORLD," 
X520  Chestnut  Street, 

PHIIJU)BLPHIA.  PA. 


VoL  XIL 


June,  1894, 


No.  6. 


The  True  Mission  of  ths  Profession. 

The  little  outbreak  of  scarlet  fever  at  Waco, 
Texas,  was  promptly  suppressed.  The  State 
Health  Officer  visited  Waco,  and  found  the 
health  officer  ther^  vigilant  and  efficient,  and 
the  few  cases  that  had  occurred  were  promptly 
isolated. — Tex,  Med,  Jour. 

What  an  important  bit  of  information  is  con- 
veyed in  these  few  lines.  It  is  even  greater 
than  Caesar's  celebrated  "  Veni,  vedi,  vid."  It 
tells  of  the  many  families  who,  by  the  unselfish 
skill  and  watchfulness  of  the  faithful  health 
officers,  have  been  spared  the  anguish  of  seeing 
their  darling  little  ones  sufier  from  an  unneces- 
sary attack  of  this  terrible  disease.  It  tells  of 
the  many  fond  parents  who  have  been  spared 
the  heart-rendbg  grief  of  losing  by  death  one 
or  more  of  their  beloved  flock.  It  tells  of  the 
financial  loss,  invariably  incidental  to  sickness 


and  death,  saved  to  the  community  and  to  the 
heads  of  families  in  the  city  of  Waco.  It  tells 
of  the  promising  young  lives  saved  from  a  pre- 
mature close,  which,  if  correctly  trained  and 
guarded,  free  from  saloon  contamination  and 
other  corrupting  influences,  may  prove  a  bless- 
ing to  society,  state  and  nation. 

But  grander  than  all,  it  tells  of  the  noble  so- 
cialistic spirit  of  the  medical  profession — not 
shown  so  prominently  by  any  other  profession  — 
in  that  they  would  rather  serve  humanity  gra- 
tuitously by  preventing  illness  than  to  enjoy  the 
financial  advantages  to  be  gained  by  the  oppor- 
tunity of  attending  cases.  This  spirit  of  true 
socialism  distinguishes  professional  medicine 
from  quackery.  The  one  seeks  to  serve  man- 
kind in  a  heroic  manner ;  the  other,  by  holding 
so-called  secret  formulas  and  by  encouraging  or 
scaring  patients  in  their  imaginary  illness,  seeks 
only  its  own  selfish  gain. 

Finally,  this  brief  paragraph  teaches  how 
economical  and  wise  it  is,  in  the  true,  higher 
sense,  for  communities  to  give  able  support  and 
every  encouragement  to  the  authorities  of  pre- 
ventive medicine.  Dollars  spent  in  that  man- 
ner save  thousands  finally,  besides  saving  that 
which  can  never  be  estimated  in  mere  dollars. 
Since  the  development  of  health  departments 
such  occurrences  are  taking  place  almost  daily 
in  our  country,  but  too  little  notice  is  taken 
of  them. 


A  Csblnet  Minister  of  Public  Heslth. 
We  desire  to  express  our  earnest  approval 
of  the  proposed  measure  of  establishing  a  cabi- 
net position  for  the  protection  of  the  health  of 
our  people.  Such  an  important  part  of  our  pub- 
lic work  should  not  be  a  subordinate  bureau  or 
branch  of  one  of  the  existing  departments. 
There  should  be  a  Secretary  of  Public  Health, 
with   full   cabinet  privileges.     The  amount  of 


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good  which  such  an  officjer,  properly  sustained 
and  equipped,  could  do  is  beyond  calculation. 

rtuman  VivUeotion. 
A  measure  of  some  importance  to  science  has 
been  proposed  in  a  neighboring  State,  viz :  to 
provide  that  criminals  condemned  to  death 
flhall  be  the  subjects  for  physiologic  experimen- 
tation  under  anestheti^ps,  and  finally  put  to 
death  by  the  aneethetic  ratfier  than  being  exe- 
cuted in  the  ordinary  way.  There  can  be  no 
argument  agwnst  this  measure  other  than  those 
against  capital  punishment  itself. 

Medical  History. 
There  should  be  in  every  medical  college  a 
course  of  lectures  or  study  on  the  history  of  med- 
ical edence.   It  is  quite  important  to  know  what 
was  the  condition  of  medical  sdence  and  the 
medical  profession  frem  time  to  time  at  differ- 
ent ages  of  the  world.     In  taking  up  different 
diseases  it  is  valuable  to  know  something  of 
their  history — when  and  by  whom  first  made 
known,  various  theories  held  from  time  to  time 
regarding  them  and  different  methods  of  treat- 
ment in  the  past     Thus  we  could  be  better  in- 
formed  r^arding  our  sci^ce,  and  be  saved 
the  trouble  of  experimenting  to  prove  theories 
tiiat  have  in  the  past  been  shown  to  be  false. 
An  Important  Statute. 
The  law  "Against  Trusts  and  Combinations 
in  Restraint  of  Trade  and  Product,"  of  the 
.  State  of  Kansas,   forbids  the    adoption  or  use 
of  phyacians'    fee    bUls  as  "Against    public 
policy  and  unlawful,"  and  all  accounts  based 
upon  them  are  declared  void.     A  physician 
bringing  suit  to  collect  pay  for  services,  basing 
his  rate  of  charges  upon  any  such  a  fee-bill  or 
jirgeement,  loses  the  entire  account  and  the  legal 
costs  in  the  case  and,  if  prosecuted  in  turn,  is 
liable  to  fine  of  from  $100  to  $1000,  or  one 
to    six    months    imprisonment,   or    both    fine 
and    imprisonment.     The   contention    of    the 
law  IS  that  such  fee  bills  prevent  that  free  and 
fair  competition  in  all  trades,  professions  and 
callings  which  is  for  the  best  interest  of  society. 
The  law  applies  to  transportation  companies, 
manufacturers,  insurance  companies,  merchants 
and  dealers,  lawyers  and  all  who  might  think  it 
to  their  interest  to  form  such  a  combination  or 
agreement 


0ri^inal  Qommunioations. 

Short  ftitidet  ga  the  trestmcnt  of  diseaaet,  and  cxpcrieaoe 
with  new  remedies,  are  solicited  from  the  profiessioii  fci 
this  depRitment;  also  dififtcnlt  cases  for  diagnosli  mad 
treatment. 

Articles  accepted  mnst  be  contributed  to  this  journal  mUf, 
The  editors  arc  not  responsible  for  views  expiesatd  bf 
contributors. 

Copy  must  be  received  on  or  before  the  twelftb  of  tht 
month  for  publication  in  the  next  month.  tJnnaea 
Manuscript  cannot  ba  retomed. 

Cniainfy 
must 

hisrt , .  . 

words,  or  kis  reader  will  certainly  misunderstand  thetm^ 
may  be  told  in  a  flaim 


words,  or  kts  reader  will  certatnn  mti 
Generally,  also,  a  downright /def  may 
way:  and  we  want  dowmriglujaeis  M  ^ 
^%yiJUng  tfte.— RutKor. 


READ.     REFLECT.     COMPARE.     RECORD. 


Replies. 

Editor  Medical  World: — Dr.  Smith's 
case  of  eczema  (page  156)  reminds  me  how 
often  we  may  find  iithiads  underlying  allmenta, 
if  we  take  the  trouble  to  look  for  it.  Many  a 
man  nas  writhed  under  the  infliction  of  itching 
piles,  mental  despondency,  insomnia,  etc.,  be- 
cause the  doctor  does'  not  understand  this  sub- 
ject. 

Dr.  Damanion  (page  157)  is  right.  Why 
need  we  go  back  to  historical  statements,  for 
whose  autheticity  no  man  can  now  vouch,  to 
decide  questions  of  scientific  interest:  We  do 
not  know  the  conditions  that  may  have  inflii* 
enced  the  production  of  idiots  in  Pharaonie 
times,  but  we  do  know  something  of  those 
around  us.  The  broad  daylight  of  this  nine- 
teenth century  is  the  light  by  which  we  should 
view  facts.  I  will  start  the  ball  rolling.  I 
have  on  my  lists  of  patients  and  aoquaintanoes 
one  deaf  mute,  three  color  blind,  two  idiots,  two 
neuropathic  imbeciles,  three  insane  narcoman- 
iacs, three  choreics  (recurrent),  and  in  not  one 
of  these  cases  is  there  any  relationship  between 
the  parents.  All  the  narcomaniacs  are  children 
of  opium  habitues;  one  was  bom  of  parents 
both  addicted  to  this  drug.  If  each  of  us  re- 
port a^  the  cases  he  ibtoto«,  not  those  he  has  heard 
of,  we  can  get  at  the  truth  of  this  matter.  The 
deaf  mutism  came  from  scarlatma;  the  color- 
blind children  inherited  the  defect  from  a  grands 
father,  several  of  who«e  descendants  becune  in- 
sane, one  was  an  imbecile,  another  a  drunkard. 
Unfortunately  I  have  never  been  able  to  trace 
this  interesting  history  far  enough  bac|^  to  find 
the  source  of  the  neurotic  taint 

What  an  opportunity  Dr.  Allen  has  lost  I 
(page  160).  Could  not  his  patient  have  recol- 
lected breaking  somethmg,  or  seeing  or  hearing 


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191 


of  something  being  cut  off  during  pregnancy, 
to  account  for  that  amputated  arm  ?  Did  she 
not  bite  off  a  thread  even,  while  sewing  ?  Such 
an  undoubted  case  of  '* maternal  impression" 
ought  not  to  be  lost.  Perhaps  her  husband  cut 
her  off  short  when  she  wanted  the  moon  or  some 
similar  trifle. 

Dr.  Ruff  (page  172)  might  ask  his  patient 
if  he  ever  had  syphilis. 

Dr.  Brower  (page  173)  ought  to  take  iodide 
of  arsenic,  and  iron  or  potassium,  for  a  long 
time ;  and  carry  a  pearl  of  amyl  nitrite  or  a 
little  bromic  ether  in  his  pocket  for  the  paroxyms. 

In  Dr.  Peak's  case  I  think  there  must  have 
been  a  profound  impression  on  the  nervous  sys- 
tem of  the  lungs,  to  account  for  the  recurring 
oyanoeis.  How  else  could  it  be  produced  ?  If 
it  were  due  to  fluid  in  the  lungs,  would  not  the 
first  cough  have  relieved  it,  by  getting  the  fluid 
outT 

It  looks  as  if  that  **  muscular  rheumadsm  "  of 
Dr.  Beneker's  case  (page  174)  were  the  start- 
ing point  of  the  suppuration,  but  he  does  not 
tell  us  where  it  was  located.  Has  he  washed 
out  the  abcess  cavities  with  peroxide  of  hydro- 
gen ?  In  his  second  case  I  would  doubt  the 
accuracy  of  the  urinometer.  They  are  gotten 
ap  so  cheaply  now  that  I  would  not  pin  my  faith 
to  them. 

For  ulcerative  stomatitis  (page  174)  :  Let 
a  dentist  see  to  the  teeth,  filing  off  sharp  edges, 
removing  tartar,  etc.  Let  her  chew  rhubarb 
root  when  dyspepsia  or  constipation  occur. 
Wash  out  the  mouth  with  peroxide  freely, 
dry  the  surface  of  the  ulcer,  and  cover  it 
with  iodoform,  repeated  every  4  hours  till 
welL 

"  Enquirer  "  (page  175)  would  better  take  the 
treatment  for  epilepsy  as  given  in  my  little 
manual,  and  follow  it  up.  The  causation  of 
epilepev  is  often  obscure. 

In  Dr.  Toms',  case  (page  174),  whatever  the 
cause  of  the  testicular  enlargement,  it  is  quite 
natural  that  the  accumulation  of  semen  even  for 
a  few  days  should  cause  irritation.  Fiiteeu 
years  is  a  very  long  time  for  tuberculous  dis- 
ease to  linger  in  the  testicle.  The  history 
points  rather  to  hydrocele.  At  any  rate,  why 
put  off  the  operation  so  evidently  needed.  Cut 
in,  and  if  it  is  a  hernia,  replace  it ;  if  a  hydro- 
ode,  amputate  a  piece  or  all  of  the  sac ;  if  a 
solid  tumor,  remove  the  testicle. 

Dr.  Hotz'  case  presents  the  ordinary  history 
of  gangrene.  Cause,  an  unknown  microbe. 
The  thumb  should  have  been  opened  on  the 
20th,  and  aU  gangrenous  tissue  cut  away,  the 
wound  dressed  with  antiseptics,  and  quinine, 
wme  i^id  tincture  of  iron  given  in  the  fullest 
doses  she  could  take. 


For  albuminous  nephritis  (page  175),  give  a 
diet  exclusively  of  milk,  junket,  buttermilk 
and  grape  juice,  unfermented,  with  gallic  acid 
and  tincture  of  iron  to  restrain  the  loss  of  albu- 
men, and  acetate  of  potassium  for  dropsy,  if 
there  be  any.     William  F.  Waugh,  ALD., 

103  State  St,  Chicago,  111. 


Further  Details  from  Dr.  Moor  in  Regard  to  the 

Use  of  Permanganate  of  Potassium 

in  Morphine  Poisoning. 

Editor  Medical  World  : — I  have  read  with 
a  great  deal  of  interest  and  pleasure  the  reports 
of  the  successful  use  of  permanganate  of  potas- 
sium in  cases  of  opium  poisoning,  as  published 
in  the  April  number  of  your  esteemed  periodi- 
cal. Permit  me  to  add  a  few  remarks  regard- 
ing the  mode  of  administration  of  the  antidote 
in  question.  In  the  Medical  Record  ot  Feb- 
ruary 17,  1894, 1  have  pointed  out  that  one 
grain  of  morphine  is  decomposed  by  exactly 
one  grain  of  permanganate  of  potassium.  This 
should  be  the  basis  of  the  permanganate  treat- 
ment of  opium  poisoning.  No  matter  how  mucb 
time  has  elapsed  since  t^e  taking  of  the  poison^ 
a  sufficient  quantity  of  the  antidote  should  be 
given  per  os  (well  diluted),  or  if  the  patient  m 
unable  to  swallow,  the  permanganate  solution 
can  easily  be  administered  through  the  nose  by 
means  of  a  catheter,  piece  of  rubber  tubing  and 
a  funnel.  Hypodermatically,  a  1 :  15  solution 
can  be  used.  The  modus  operandi  of  hypoder- 
matic injections  of  permanganate  of  potassiun^ 
in  cases  of  morphine  poisoning  is  explained  by 
the  fact  that  the  permanganate  instdntaneously 
selects  morphine  from  amongst  albuminous 
bodies.  William  Moorj  M.D.,. 

355  Boulevard, 

New  York,  N.  Y. 


Potassium  Permanganate  as  an  Antidote  for  Snalie 
Poison. 

Editor  Medical  World:— On  the  17th  of 
April,  a  friend  and  myself  were  hunting  snipe- 
on  a  marshy  prairie  about  six  miles  from  town. 
My  dog  was  running  ahead  of  me  some  seventy- 
five  yards  or  more  when  he  came  to  a  dead 
point  directly  in  my  patL  I,  thinking  that 
game  of  some  order  must  be  near  him,  hastened 
to  learn  what  it  might  be,  with  gun  cocked  and 
ready  at  once  to  be  adjusted  to  the  shoulder. 
To  my  surprise,  when  within  a  few  paces  of 
him,  I  heard  a  sound  like  that  produced  by  » 
nest  of  bumble  bees  after  being  disturbed. 
Knowing  that  it  was  nothing  I  was  hundng  for, 
I  stepped  back  a  few  steps  and  about  the  same 
time  my  dog  moved,  but,  as  he  did  so,  a  prairie- 
rattle  snake  seized  him  in  the  inferior  maxiUry 


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\ 


region.  I  kUled  the  snake,  it  wearing  eight 
rattles  and  a  button.  Having  no  antidote  for 
snake  poison  with  us,  not  even  " Rubus  OcuR" 
which  is  generally  considered  a  great  necessity 
on  such  trips,  we  determined  to  return  to  town. 
Soon  after  reaching  home  I  gave  my  dog,  which 
is  a  Irish  Setter,  ten  grains  of  potassium  per- 
manganate. He  was  very  sick  and  very  much 
swollen.  I  expected  him  to  die  that  night,  but, 
to  my  surprise,  he  was  feeling  much  better  next 
morning,  though  the  swelling  was  as  much  as 
the  night  before.  I  made  a  sixteen  grain  to 
the  ounce  solution  of  the  potassium  permanga- 
nate and  injected  thirty-five  minims  into  the 
wound  produced  by  the  snake.  I  was  gratified 
in  a  few  hours  to  see  the  swelling  diminishing 
and  next  morning  it  was  entirely  gone.  He  is 
entirely  well  now  and  is  as  good  as  ever. 
Whether  it  was  the  permanganate  or  his  consti- 
tution I  cannot  say,  but  am  inclined  to  think  it 
was  the  permanganate.  R.  Sevier,  M.D., 
Richmond,  Mo. 

Quadruple  Birth.— Permanaanate  of  Potassium  as 

an  Anidote  to  Cyanide  of  Potassium 

and  other  Poisonous  Drugs. 

Editor  Medical  World  : — What  do  you 
think  of  the  enclosed  qvadruple  birth  f 

<<  A  recent  number  of  La  Ilvstracion  de  Cvha 
states  that  on  the  27th  of  February  last,  Ma- 
dam Buenviaje  Carillo,  wife  of  District  Attor- 
ney Don  Luciano  Jimenez,  of  Kemedios,  gave 
birth  to  four  robust  children.  All  doing  well 
at  last  accounts ;  the  little  ones  soon  to  be  bap- 
tised." 

Some  one  asks  for  on  antidote  for  cyanide  of 
potassium.  The  permanganate  of  potassium  is 
a  good  one. 

The  permanganate  of  potassium  is  an  anti- 
dote also  for  strychnine,  oxalic  »xAA^  colchicum 
and  a  good  many  other  elements. 

I  have  used  the  permanganate  of  potassium 
in  the  analysis  of  iron  ore  for  years,  and  used  it 
as  an  antidote  for  a  good  many  chemical  ele- 
ments. H.  SCHAFER,  M.D., 

San  Diego,  Cal. 


The  Only  Child.— A  Question  of  Heredity. 

Editor  Medical  World  : — Rev.  James  A. 
Miller,  Ph.  D.,  contributes  to  the  columns  of 
the  New  York  Evangelist,  of  12th  inst,  an  in- 
teresting article  under  the  caption  ''Does  an 
only  Child  Often  Achieve  Greatness?"  The 
author  of  the  article  was,  no  doubt,  to  great 
pains  in  his  research  and  says  that  "  out  of  two- 
hundred  of  the  world's  notables,  I  could  find 
only  six,  of  whom  it  would  he  safe  to  affirm 
that  they  had  neither  brother  nor  sister."     Mr. 


Miller  is  not  alone  in  the  impression  that,  as  a 
rule,  the  "only  child ''  is  not  the  most  likely  to 
attain  reputable  distindion.  He  quotes  Bev. 
Carlos  Martyn,  D.  D.,  biographer  of  Wendell 
Phillips,  as  saying,  "  There  is  scarcely  an  in- 
stance of  an  only  child's  achieving  greatness." 
It  at  first  sight  seems  like  a  strange  circum- 
stanoe,  but  yet  we  are  constrained  to  admit  that 
it  looks  as  if  there  were  something  in  it  But 
what  seems  to  us  the  most  notable  feature  of 
Mr.  Miller's  article  is  the  abseace  from  his  two 
and  a  half  columns  of  any  allusion  to  any  other 
than  educational  mediation  in  bringing  about 
this  remarkable  disparity.  He  would  explain 
it  by  saying  that  the  "only  child"  is  too  apt  to 
he  a  sort  of  hothouse  plant,  still  he  refers  to 
the  efficacy  of  the  discipline  which  is  likely  to 
follow  the  necessary  or  politic  ejectment  of  the 
one-too-many  from  the  home  nest  He  says, 
« the  chances  are  in  favor  of  him  who,  from  the 
beginning,  is  forced  to  help  care  for  himself  and 
others."  He  says  further  "  there  is  something 
akin  to  university  training  in  the  friction  of 
mindd  of  various  types  against  each  other  in 
large  families."  These  agencies  are  well  enough 
so  &r  as  they  go,  but  are  they  sufficient  to  ac- 
count for  the  fact? 

Are  there  not  other,  even  primary  causes 
operating  adversely  to  the  "only  child?"  A 
plural  progency  is  the  normal  sequel  to  average 
marriages  and  per  cantra,  is  not  the  single  birth 
to  married  parties  continuing  in  wedlock  for  a 
term  of  years  (barring  always,  in  these  evil 
days,  the  blighting  influence  of  the  anti-mater- 
nity heresy)  valid  evidence  of  conjugal  inade- 
quacy, deficient  virility  or  lack  of  vitality,  and 
is  not  the  *<only  child"  consequently  deficient 
through  inheritance? 

How  often  do  we  see  the  "  only  child  "  feebly 
struggling  through  a  period  of  months  or  jears 
amid  the  most  favorable  outward  conditions,  to 
maintain  a  bare  existence  and  finally  fading 
out,  and  no  successor  comes  to  cheer  the  chUd- 
lees  mourners.  So  far  from  the  nursery  solit- 
aire achieving  greatness,  he  should,  in  many 
cases,  be  content  simply  "  to  be."  He  is  handi- 
capped in  the  race  of  life  by  a  degree  of  unsus- 
pected invalidity.  He  is  a  congenital  subnormal. 

La  Fayette,  N.  Y.     J.  A.  Mowris,  M.D., 


Small   Pox.— Solution   of  Vaooine  as  a  Cure  o 
This  Disease  and  of  Pertussis. 

Editor  Medical  World: — In  Virchows' 
Archiv,  vol.  LI.,  No.  4  we  read : 

**  It  is  one  of  the  worst  features  of  our  pres- 
ent period  of  development  in  medicine  that  his- 
torical knowledge  is  decreasing.  It  may  be 
taken  as  a  rule  that  the  historical  knowledge  of 


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things  is  limited — f  even  with  young  physicians 
of  more  than  ordinary  knowledge  and  ability) 
— to  the  publications  of  the  past  three  or  five 
years.  That  which  has  been  published  prior  to 
that  time  does  not  exist  for  them.  This  unhis- 
torical  knowing  of  things  engenders  a  second 
deficiency,  because  many  with  but  a  limited 
scope  oi  observation  consider  it  nevertheless 
sufficient  to  the  understanding  of  all  arising 
questions.  Thus  arise  disputes  over  many  and 
i^rtain  things ;  the  reality  of  one  event  is 
called  in  question  because  they  only  know  the 
other,  and  the  exclusiveness  of  their  opinion  is 
a  mere  consequence  of  their  partiallity  of  obser- 
vation," etc,  etc. 

In  these  words  of  the  widely  known  professor 
and  celebrated  medical  teacher,  we  find  an  ex- 
planation of  the  wretched  helplessness  in  the 
present  state  of  medical  science.  Otherwise,  it 
is  not  conceivable  that  a  specific  treatment  of  a 
disease  which  is  the  horror  of  the.  world  should 
be  wholly  unknown  on  this  continent,  although 
the  originator  or  inventor  is  an  American. 

Proceeding  into  mediaa  res,  I  therefore  call 
the  attention  of  the  medical  fraternity  to  a 
treatment  of  the  small  pox,  which,  as  an  induc- 
tive discovery,  has  been  found  physiologically 
correct  and  its  practical  test  proved  entirely 
satidactory. 

In  1842  Dr.  R  Landell,  livmg  at  Porto 
Allegro,  Brazil,  communicated  to  the  Consul  of 
the  United  States  at  Rio  Grande  Sul  his  discov- 
ery of  a  new  and  successful  treatment  of  small 
pox.  This  communication,  being  sent  by  the 
Consul  to  the  Secretary  of  the  United  States, 
General  Cass,  was  published,  by  order  of  the 
latter,  in  several  medical  journals  so  as  to  en- 
able our  medical  authorities  to  pass  upon 
the  merits  of  the  new  discovery.  The  follow- 
ing is  substantially  Dr.  K.  Landell' s  treat- 
ment: 

He  took,  of  the  common  cow  pox  virus,  which 
he  had  preserved  in  small  glasses,  from  four 
to  six  drops  in  four  to  six  ounces  of  distilled 
water,  and  gave  of  this  solution,  two  to  three 
hours  apart,  a  tablespoonful.  In  1837,  for  the 
first  time,  the  Doctor  saw  from  this  treatment 
such  good  results  that,  in  1842,  when  a  horri- 
ble small  pox  epidemic  was  raging  he,  without 
fear,  treated  in  the  above  mentioned  way,  with 
remarkable  success.  He  and  his  son,  Dr.  John 
Landell,  had  such  success,  that  they  concluded 
to  communicate  their  experiences.  The  effect  of 
this  specific,  as  Dr.  Landell  states,  is  to  promptly 
decrease  the  fever  and  all  alarming  symptoms — 
delirium,  diarrhea,  hoarseness,  lung  fever,  all 
the  consecutive  symptoms  of  the  disease  soon 
disappear.  The  variola  vera  is  by  this  treat- 
ment in  two  or  three  days  so  altered,  that  it  ap- 


pears in  the  mildest  form  of  varioloid,  often  only 
varicella.  Although  the  epidermis  has  the  ap- 
pearance of  being  swollen  and  in  a  congestive 
state,  yet  in  four  or  &ye  days  it  becomes  dry. 
Dr.  Landell  opened  the  pustules  in  some  cases 
twice  and  sometimes  three  times.  In  1842  he 
treated  over  eighty  patients,  fourteen  with  very 
dangerous  and  complicated  symptoms,  and  did 
not  lose  a  single  one.  By  the  way,  I  would 
remark  that  Dr.  L.  has  often  used  with  the 
greatest  success  this  remedy  in  the  above  diluted 
form,  Hgaiu^t  purttLSsis  and  convulsions. 

To  confirm  Dr.  LandelFs  assertion,  I  take 
the  liberty  to  republish  cases  in  which  the  treat- 
ment has  been  used.  I  take  them  just  as  they 
are  in  my  mind,  and  feel  only  sorry,  that  my 
library  is  so  limited. 

Dr.  Von  Kacz  Kororosky,  of  Lembery,  Aus- 
tria, relates  two  cases,  which  were  treated  and 
cured  with  this  remedy.  One  of  these  cases  b 
very  instructive.  The  fever  had  reached  an 
abnormal  height ;  the  inflamed  epidermis,  cov- 
ered with  lymph  pustules,  exhibited  dangerous 
symptoms.  He  prescribed  three  drops  of  vaccine 
to  three  ounces  of  distilled  water,  and  ordered  a 
teaspoonful  taken  every  two  hours.  In  twenty- 
four  hours  the  inflamed  pustules  began  to 
wither,  and  in  sixteen  days  the  patient  was  dis- 
charged, without  any  marks. 

Dr.  €arl  Mueller,  City  and  District  physic- 
ian in  Brunn,  Austria,  referring  to  the  small 
pox  epidemic  of  1872,  which  was,  as  he  says, 
the  most  violent  and  murderous  one  he  had 
ever  witnessed,  says  in  the  Internatiale  Medi- 
cinisehe  Fr&^sej  Vol.  Ill,  page  592 :  "  Having 
from  1830  till  1872  as  a  phygician  of  a  large 
district,  witnessed  a  great  number  of  small  pox 
epidemics,  I  came  to  the  conclusion  and  opin- 
ion that  the  small  pox  was  not  a  dangerous 
disease,  no  matter  whether  the  patients  had 
been  vaccinated  or  not,  because,  during  that 
long  period  of  time,  not  one  fatal  case  happened 
in  the  whole  district  as  the  result  of  small 
pox. 

But  then  came  the  murderous  epidemic  of 
1872,  attacking  indiscriminately  vaccinated,  re- 
vaccinated  and  nonvaccinated.  This  eminent 
practitioner  then  was,  of  course,  much  sur- 
prised and  embarrassed,  especially  when  the  dis- 
ease communicated  to  members  of  his  own 
family  with  fatal  result  Feeling  utterly 
powerless  against  this  enemy,  he  commenced 
to  use  *'  vaccinum  powder,"  as  he  termed  it  I 
think  Dr.  Mueller  must  have  been  cognizant 
of  the  experience  and  publication  of  Dr.  Lan- 
dell, for  vaccinum  powder  is  nothing  else  than 
a  modification  of  Dr.  Landell's  prescription  or 
remedy. 

From  this  time  he  became,  by  the  use  of 


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THB  MBDICAI,  WORLD. 


**  vaccinum,"  master  of  the  disease.  Not  only 
did  he  cure  with  it  all  his  patients  down  with 
email  pox,  but  he  used  it  also  as  a  preventive. 
Dr.  Mueller  comes  to  this  resume : 

1.  Up  to  the  present  time,  there  is  no  better 
and  more  reliable  remedy'  known  to  me  than 
this. 

2.  It  is  not  only  the  remedy  par  ezcellencey  it 
is  also  the  best  preventive. 

Dr.  Dittrich,  in  Dresden,  treated  from  Feb. 
72  to  Sept  72,  209  small  pox  patients.  Of  these 
the  greatest  number  were  grave  cases  and  had  to 
be  treated  under  circumstances  which  often  pre- 
cluded the  possibility  of  recovery  on  account  of 
the  prejudices  and  bad  habits  prevailing 
among  the  people  living  in  the  country  and 
with  which  the  physician  had  to  contend.  Dur- 
ing the  severe  winter  when  the  windows  in 
many  dwellings  were  frozen  tight  and  could  not 
be  opened,  the  absolutely  necessary  ventilation 
could  not  be  had.  Often,  when  this  could  be 
done,  the  position  of  the  beds  were  such  that 
the  parients  were  there-by  expq^  to  draughts. 
In  many  cases  the  whole  family  slept,  cooked, 
«tc.,  in  only  one  room.  Very  often  the  bed  stood 
right  next  to  the  great  stove.  Surely  was  the 
temperature  and  atmosphere  in  these  rooms  in 
no  way  advantageous.  He  lost  eleven  patients, 
three  men,  two  over  60  years,  two  women,  one 
over  70  yearq,  and  six  children,  all  under  one 
year.  He  says  about  vaccine :  "  Vaccine,  if 
taken  internally,  protects  against  the  infection 
of  the  small  pox  poison.  I  had  given  vaccine 
powders  to  130  persons  as  a  preventive.  These 
persons  came  daily  in  contact  with  the  infected, 
some  of  them  even  having  members  of 
their  own  familips  sick  with  small  pox,  but  only 
two  were  taken  with  the  disease.  One,  a  gard- 
ner,  had  fever  only  one  day,  then  eight  pustules 
could  be  detected,  and  on  the  fourth  day  he 
was  out  in  the  garden  at  work  again.  The 
other  man  had  only  six  pustules  on  his  whole 
body."  Dr.  Dittrich  further  says :  "In  the 
time  of  a  small  pox  epidemic  I  would  never 
hesitate — nay,  I  would  consider  it  as  my  solemn 
duty — to  advise  everybody  to  use  vaccinum 
powder." 

In  reference  to  the  "  vaccinin  "  as  a  prevent- 
ive, I  would  say  that  in  1872,  at  Leipzig,  over 
3000  persons  had  taken  vaccin  powder  as  a  pre- 
ventive and  none  of  them  were  taken  sick  with 
the  disease,  although  many  of  them  by  their 
vocation,  as  undertokers,  nurses,  etc.,  came 
in  daily  contact  with  the  infected. 

I  could  give  more  testimony  about  the  irUer- 
nal  use  of  "  vaccin,"  but  sapientiasat. 

Now,  is  Professor  Virchows'  expostulation, 
which  I  used  as  an  introduction  to  this  essay, 
unjust  or  uncalled  for? 


As  a  practitioner  of  more  than  twenty  years, 
I  know  very  well  how  often  the  medical  press 
is  made  unpalatable  by  doctors  with  the  discov- 
ery fever  on  the  brain,  who  fancy  to  benefit 
medical  science  if  thty  discuss  per  longum  et 
latum  the  reaction  of  this  or  that  (chemical) 
stuff  upon  the  living  organism,  with  whom  it 
will  never  come  in  any  contact,  as,  for  instance, 
'  that  of  '<  borate  of  magnesia  upon  theint^ument 
cells  of  the  artificially  inflamed  web  membrane 
of  a  frog,"  but  who  do  not  know  "the  next 
nearest  and  most  important  things  in  medical 
art,  or  what  is  still  worse,  do  not  care  to  know 
it"  Dr.  SiGMUND  Lesser, 

Muscatine,  Iowa. 

A  Medioal  Treatment  for  Diphtheria. 

Editor  Medical  World  : — I  desire  to  pres- 
ent a  trustworthy  treatment  for  diphtheria.  I 
have  delayed  recording  it  for  a  long  time,  ow- 
ing to  the  fact  that  I  desired  to  satisfy  myself 
as  to  its  utility  and  advantageousness  and  be- 
cause I  felt  that  I  was  alone  in  the  use  of  one  of 
the  remedies — gunpowder.  You  will  probably 
remark  that  such  a  remedy  ought  to  give  me 
courage,  for  in  the  army  the  soldiers  took  gun- 
powder in  whiskey  to  keep  their  courage  op. 
It  is  my  success  with  the  treatment  that*  has 
encouraged  me  to  send  you  this  article.  I  appre- 
hend I  hear  some  one  say  they  would  not  like 
to  write  a  prescription  for  gunpowder  and 
honey,  so  simple  a  remedy  in  so  serious  an  ill- 
ness. I  used  to  feel  that  way  myself,  but  have 
gotten  bravely  over  it  If  sulphur  was  worth 
fifty  dollars  per  pound  more  of  it  would  be 
used.  If  you  stop  for  a  moment,  Doctor,  and 
think  what  gunpowder  is  composed  of,  you  may 
think,  afiter  all,  that  it  is  somewhat  scientific, 
and  conclude  to  try  this  treatment,  and  your 
success  will  settle  the  question  and  the  druggist 
will  be  pleased  to  put  up  the  powder  and  honey 
in  large  mouth  (sulphate  of  quinine)  bottles  in 
an  elegant  way  and  the  patient  will  take  to  it 
kindly,  for  it  is  pleasant  and  palatable. 

Whether  diphtheritic  germs  cause  diphtheria 
by  their  presence,  or  whether  they  are  carriers, 
or  whether  the  poison  passes  through  or  from 
them,  or  any  other  theory,  I  will  not  attempt  to 
discuss.  All  will  admit  that  their  presence 
quickly  causes  poisoning,  increasing  in  extent 
and  virulence  every  hour,  and  that  a  trust- 
worthy treatment  is  the  demand  of  the  times.  A 
few  years  ago  I  dreaded  genuine  diphtheria,  but 
now  with  my  powder,  not  dry  but  in  honey,  I  do 
not  hesitate  an  instant  (for  delay  is  most  perilous 
in  diphtheria)  whether  in  the  darkntes  of  mid- 
night or  in  the  fury  of  a  storm,  to  go  at  once 
and  meet  the  enemy  with  the  following  treat- 
ment: 


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B.   Gunpowder ^ drams  vl 

Honey ounce  17 

Mix. 
SlgDA.   Teaspoonfyil  eTeryhour  until  bowels  moTe  freely, 
then  erery  two  liountbrouffhout  the  case.   Tlie  inuipowder 
should  be  reasonably  fine,  the  honey  best  quality. 

The  apis  mellifica  will  act  well  upon  the  kid- 
neys, also  being  a  vehiole  for  the  remedy. 
Sulphur,  one  part,  charcoal,  one  part,  and 
nitrate  of  potash,  six  parts  is  the  composition  of 
gunpowder.  If  sulphur  will  destroy  the  insect . 
acarus  scabiei  and  its  ova  (and  you  all  know  it 
will),  and  if  soap  is  to  clean  the  skin  for  ac- 
tion, so  a  gargle  will  prepare  the  way  for  action 
in  diphtheria  and  aid  in  killing  the  dangerous 
bacteria.  The  sulphur  also  acts  as  a  laxative 
and  by  changes  passes  into  the  circulation  of  the 
blood  and  destroys  the  germs.  I  also  think  it 
increases  the  heart's  action  and  force  and  also 
promotes  perspiration.  If  the  skin  is  not  suffic 
iently  active  after  twenty- four  hours  I  add  sali- 
cylate of  soda  as  the  case  may  require.  There 
ia  in  diphtheria  a  foul  odor,  and  you  will  be 
pleased  to  find  the  disinfectant  properties  prob- 
ably due  to  the  charcoal,  which  overcomes  the 
Btench  and  also  aids  to  keep  the  stomach  in  good 
active  condition. 

T^e  nitre  acts  as  an  excellent  antiseptic  re- 
frigerant and  diuretic  and  puts  an  end  to  the 
aches  and  pains  of  the  general  system.  It  aids 
a  free  circulation  and,  if  salt,  chloride  of  sodium, 
*' corns"  micrococci,  does  not  saltpetre  "cure" 
them  ?  This  combination  acts  freely  upon  the 
bowels.  By  the  way,  use  a  bed  pan  and  keep 
your  patient  confined  to  the  bed  throughout 
treatment,  and  for  diet  give  pure  milk.  Disin- 
fect all  discharges  with  sulphate  of  iron,  one 
pound  to  a  gallon  of  water. 

I  call  thiis,  in  general,  a  (institutional  and 
local  treatment  and  it  must  be  a  sly  micrococcus 
that  escapes  when  we  use  the  following  gargle 
of  chlorine  gas  before  each  dose  of  medicine: 

B.   Potaaslum  chloride .» drams  ilss 

Huriatlo  acid,  U.  8.  P. orams  iss 

m-r  and  add. 

Alcohol....... » »dramsiy 

Hoi  water,  q.  s.» ounce  iy 

Mix. 
Shpa.  TeaspoonftU  to  K  kIam  of  hot  water  ;  gargle  every  1 
or  2  noazs,  always  Just  before  giving  the  powder  and  honey. 

It  is  necessary  to  instruct  your  druggist  how 
to  prepare  the  above,  or  the  chlorine  gas  will 
all  remain  in  the  drug  store.  The  chlorate  of 
potash  should  be  put  into  the  four  ounce  bottle, 
the  hydrochloric  acid  then  added  and  cork  the 
bottle ;  let  stand  several  minutes,  being  careful 
that  the  cork  is  not  blown  out,  then  add  slowly, 
oonce  at  a  time,  the  hot  water,  shaking 
thoroughly  with  finger  over  mouth  of  bottle  so 
as  to  wash  up  the  gas,  the  alcohol  being  added 
last  When  ready  for  dispensing  it  should  be 
a  beautiful  clear  yellow  colon     Much  depends 


upon  a  good  chlorine  gas  gargle,  for  it  will  des- 
troy bacteria  quicker  than  any  other  known 
remedy.  Bacteria  will  live  and  get  fat  in  a 
two  drachm  Bolution  containing  twenty  grains  of 

Juinine  ;  in  thirty  grains  of  camphor  and  two 
rams  of  alcohol  they  will  play  tag  for  days  and 
also  increase  in  numbers.  Ten  drops  of  car- 
bolic acid  in  two  drams  of  fluid  will  not  affect 
them  ;  they  love  solutions  of  tar  and  will  swim 
around  (like  fish  among  rocks)  for  six  days 
between  particles  of  ten  grains  of  calomel  in 
two  teaspoonsful  of  fluid;  one  dram  of  lauda- 
num in  two  teaspoonsful  of  fluid  and  supplied 
with  bacteria  will  be  a  sight  afler  five  days ;  tr. 
nux  vomica  is  an  elegant  tonic  for  them. 

Tannic  acid  will  destroy  them  after  two 
hours.  After  being  frozen,  stiff  in  ice  they  will 
come  to  life.  They  enjoy  solutions  of  chloral 
hydrate. 

Chloroform  puts  them  to  sleep  from  which 
they  awake  refreshed.  But  gunpowder  and 
honey,  with  chlorine  water  solution,  kills  them 
instantly  and  is  the  best  diphtheria  microbe 
destroyer  in  existence.  After  using  it  for  a 
short  time  the  membrane  will  become  yellow, 
when  you  may  know  that  you  are  master  of  the 
case.  The  gunpowder  will  cut  the  defunct 
membrane  loose  and  keep  it  down.  In  small 
children  that  cannot  gargle  I  use  the  atomizer, 
and  spray  the  throat  with  the  chlorine  gas  solu- 
tion full  strength,  and  I  also  encourage  them  to 
swallow  it,  then  follow  with  the  medicine,  the 
dose  being  graded  to  the  age,  of  course. 

And  now  in  regard  to  the  swab  :  it  may  be  a 
good  thing.  I  used  it  in  my  early  practice,  but  I 
arrived  at  this  conclusion :  that  theve  was  dan- 
ger in  abrading  the  surface  of  the  throat,  thus 
enlarging  the  pasture  for  the  microbes  and 
plowing  up  a  field  for  their  cultivation.  I 
learned  that  I  was  risking  my  life,  for  three  times 
I  was  inoculated  and  was  dreadfully  sick,  but 
recovered  in  spite  of  the  treament  I  had.  To 
the  swab,  though,  I  owe  my  treatment  now,  for 
I  was  anxious  to  benefit  my  patients  and  exist 
at  the  same  time,  so  I  discarded  it  and  chose  the 
treatment  I  have  presented  to  you. 

H.  John  Tillot80n,  M.D., 

1324  Ogden  ave.,  Chicago,  111. 


Diphtheria  a  Looai  Disease. 

Editor  Medical  World  : — ^I  agree  fully 
with  Dr.  Waugh  that  diphtheria  is  a  local  dis- 
ease, but  cannot  agree  with  him  that  it  is  safe 
to  rely  on  local  treatment  alone,  for  the  reason 
that  I  believe  the  disease  cannot  fasten  on  any 
case  in  sound  health  and  unimpaired  functional 
activity  of  the  system.  There  must  be  some 
impairment  of  vital  resistance  to  disease  in  the 


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system,  and  a  derangement  physiological  action 
— in  fact,  a  pathological  of  condition  on  which 
the  disease  can  become  engrafted.  If  this  is 
not  true  every  one  who  comes  in  range  of  the 
cause  should  contract  the  disease.  But  it  may 
be  said  that  some  are  more  susceptible  or  less 
resistant  than  others.  That  is  just  what  I  say, 
and  it  is  a  pathological  condition  that  makes 
them  so.    . 

Indeed,  I  think  Dr.  Waugh  believes  in  some- 
thing more  than  local  treatment  from  the  pre- 
scription he  gives,  which  is  a  most  excellent  one, 
and  almost  identical  with  what  I  have  used  for 
twenty-five  years  myself  with  good  success,  but 
I  have  never  relied  on  that  alone.  In  that 
period  I  have  lost  but  two  cases ;  one  an  infant, 
moribund  when  I  was  called,  the  other  a  young 
lady  smothered  to  death  by  her  mother  beneath 
quilts,  blankets,  wrappers,  etc.,  in  a  close  room 
with  a  fire  in  it,  in  July,  in  spite  of  the  orders 
and  remonstrances  of  myself  and  another  physi- 
cian whom  I  had  called  in  to  help  me  on  that 
point.  The  mother  insisted  that  she  knew  bet- 
ter than  the  doctors  what  was  needed  for  "  sore 
throats,"  and  her  daughter  must  be  well 
wrapped,  head  and  throat,  and  kept  from  all 
fresh  air. 

I  have  had  diphtheria  fasten  itself  on  a  case 
of  pneumonia  just  at  the  close  of  the  treatment, 
where  the  disease  was,  at  the  same  time,  passing 
through  the  family.  In  any  such  case,  evi- 
dently, the  local  treatment  is  what  demands  the 
principal  attention. 

It  would  be  a  matter  of  interest  to  know 
what  the  constitutional  treatment  was,  given  to 
the  cases  in^  Paris,  referred  to  by  Dr.  Waugh ; 
some  constitutional  treatment  of  this  disease,  as 
weH  as  others,  would  kill  a  healthy  man.  I 
generally  find  a  condition  which  warrants  me 
to  begin  with  the  following  : 

R.    Hydrarg.  ohlor.  mite 
Exi.  colocyntii  comp 

Ipec'ac,...a*. at.  j 

Sodii  blcaib gr.  lij 

Fiat  pulvls. 
S.   To  be  taken  erery  hour  till  alvlne  action  Is  produced. 
If  the  tongxie  is  fUrred  I  repeat  thi^  dose  nightly  till  it  cleans. 

I  use  strict  and  careful  local  treatment  from 
the  beginning,  using  swabs  very  carefully,  give 
careful  attention  to  uourisment,  resort  to  stimu- 
lants only  in  exceptional  cases,  and  then  tenta- 
tively, sometimes  use  quinine  for  tonic  effect, 
but  my  chief  reliance  after  action  of  the  first 
prescription  is,  as  already  said,  very  similar  to 
Dr.  Waugh's  prescription. 

I  would  say  to  Dr.  Edson  that  charms  will 
cure  warts  easier  than  anything  else ;  act- 
ing, I  suppose,  through  the  imagination.  Sev- 
eral years  ago,  in  a  spirit  of  play,  I  proposed  to 
remove  some  unsightly  warts  from  the  hands  of 
a  young  lady,  who  applied  to  me  for  their  re- 


moval, by  a  charm.  She  received  the  proposi- 
tion seriously  and  I  invented  and  applied  the 
charm  on  the  spot,  and  lo  !  the  warts  were  soon 
gone.  Through  curiousity  I  have  repeated  the 
experiment  always  inventing  the  charm  at  the 
moment,  till  I  am  convinced  it  is  not  mere  coin- 
cidence. One  case  is  now  before  me,  a  hoy 
fifteen  years  old,  who  came  into  my  own  family 
a  few  months  since^  and  from  whose  hands  the 
warts  are  now  disappearing  under  the  influence 
of  a  charm  invented  for  the  purpose,  and  of 
which  I  thought  so  little  that  I  have  forgotten 
what  it  was.  Dr.  F.  M,  Stratton, 

Metropolis,  111. 

Foroeps.— Diphtheria. 

Editor  Medical  World  : — I  have  been  ex- 
ceedingly interested  in  the  discussions  in  Thb 
World  on  the  use  of  forceps  in  delivery,  and 
on  the  nature,  cause  and  treatment  of  diph- 
theria. 

In  regard  to  the  former  I  would  say  that,  in 
my  long  experience  as  accoucheur,  I  have,  per- 
haps, used  the  forceps  in  delivery  a  dozen  times 
— not  more ;  and  in  my  practice  I  have  not  had 
a  siugle  case  of  lacerated  perineum  that  requijred 
surgical  interference,  not  a  single  case  of  ery- 
sipelas in  puerperum,  and  but  one  case  of  puer- 
peral peritonitis— this,  however,  the  result  of 
having  a  drunken  man  and  woman  having  the 
care  the  second  night  after  confinement  I  have 
used  the  forceps  when  necessary.  From  the 
above  it  will  readily  be  seen  which  side  of  the 
discussion  on  this  subject  I  would  take.  Too 
many  cases  of  ruptured  perineum,  too  many  of 
bruised  vagina,  followed  by  septicemia  and 
death,  have  occurqed  all  around  me,  from  the 
injudicious  and  unnecessary  use  of  the  forceps 
in  the  hands  of  young  and  ambitious  practition- 
ers, for  me  to  take  any  other  side. 

I  wish  to  give  my  views  of  the  nature,  cause, 
and  treatment  of  diphtheria,  drawn  from  long 
experience.  These  views  may  seem  quite  an- 
tagonistic to  the  views  expre^ed  in  the  April 
World  by  the  distinguished  and  highly  re- 
spected Professor  Waugh.  Just  here  I  would 
say  that  Professor  Waugh  belongs  to  that  class 
in  whose  favor  I  would  distrust  my  own  judg- 
ment when  coming  in  contact  with  theirs ;  so  I 
hope  I  shall  not  seem  immodest  or  dogmatic. 

In  my  preparation  for  the  degree  of  M.  D., 
most  of  the  time  from  fifty  to  fifty-three,  under 
the  private  tutelage  of  the  scholar  of  New  Eng- 
land, the  late  Professor  E.  R.  Peaslee,  the  woM 
*'  diphtheria  "  was  not  used.  It  was  not  in  the 
medical  literature  of  that  day.  The  first  cases 
I  saw  of  this  disease  (they  were  not  my  patients) 
occurred  the  1st  of  July,  1854,  in  Alton,  N.  IL, 
my  native  town.     Five  children  in  one  family 


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were  sick.  The  father  of  these  children  was  a 
well-todo  farmer,  and  the  surroundings  of  the 
house,  and  the  inside  of  the  house,  were  pure 
and  healthy.  Immediately  after  these  cases 
some  two  or  three  children  died  with  it  some 
half-dozen  miles  from  this  place,  in  the  adjoin- 
ing town  of  Gilmanton.  The  location  of  these 
cases  was  pure  and  healthy.  In  1856,  or  there- 
abouts, another  case  showed  itself  in  Alton, 
eight  miles  from  the  first  cases.  This  location 
was  on  the  southeastern  shore  of  the  beautiful 
and  pure  Lake  Winnepisogee.  I  know  the 
water  was  pure,  the  location  healthy,  and  the 
farm-house  in  a  cleanly  condition.  This  patient, 
a  boy  of  ^yq  years,  died  in  a  few  days.  He  was 
the  cBild  of  my  elder  brother,  and  the  place 
where  the  family  lived  was  my  paternal  home. 
Filth  had  nothing  to  do  with  these  cases. 
Whence,  then,  the  microbe?  And  why  did  he 
appear  for  the  fint  time  in  A.  D.  1854,  in  a 
r^ion  which  had  been  inhabited  for  nearly  a 
century  ?  This  case,  like  the  others,  happened 
m  mid-summer.  There  was  not  yet  any  name 
for  the  disease.  I  located  wher^I  now  am,  and 
where  I  have  been  ever  since,  in  November, 
1854.  My  first  case  here  occurred  in  August, 
1860.  The  patient  was  a  lad  of  16,  whose 
&ther,  an  extensive  farmer,  lived  just  over  the 
border  in  Maine,  on  a  high  elevation  of  land, 
largely  bounded  by  ponds.  The  next  day  after 
bathing  in  one  of  these  ponds,  largely  made  up 
of  cool  springs,  he  was  attacked  with  violent 
chills,  severe  angina  tonsilaris,  and  in  a  week's 
time  was  dead  of  malignant  diphtheria.  It  had 
a  name  then.  He  was  the  oldest  of  several 
children.  No  measures  of  isolation  or  disinfec- 
tion were  taken,  and  this  was  the  first  and  only 
case  that  ever  occurred  in  that  neighborhood. 
Did  all  the  diphtherial  microbes  of  that  region 
light  on  the  tonsils  of  this  lad  ?  and,  as  in  the 
case  of  Sampson,  did  the  tormentors  die  with 
the  tormented  ? 

Our  first  epidemic  was  in  the  last  fourth  of 
1864  and  the  first  fourth  of  1865.  As  an  epi- 
demic  it  did  not  prevail  very  extensively,  but  it 
was  very  fatal.  It  was  in  a  farming  commu- 
nity, and  a  community  that  is  more  than  ordi- 
narily healthy.  Singularly  enough,  the  only 
really  filthy  family  in  this  region,  where  the 
hog-pen,  hen- pen,  and  privy  and  dwelling-house 
0  were  all  under  one  roof — where  the  water  was 
bad,  the  cellar  never  cleansed,  and  the  house 
rarely — was  never  touched  by  this  disease. 
Perhaps  the  filth  was  so  strong  that  the  microbes 
died  in  the  shell.  In  this  epidemic  several 
cases  occurred,  and  I  have  seen  some  like  them 
fflQce,  that  I  could  not  account  for  on  Professor 
Waugh's  theory  of  the  nature  and  cause  of  the 
disease.     I  will  give  the  history  of  one  as  a  spe- 


cimen. Horace  W.,  a  boy  of  ten  years,  when 
first  seen  by  me  had  little  or  no  swelling  of  ton- 
sils, small  patches  of  ashen  appearance,  fetid 
breath,  furred  tongue,  anemic  condition  of  skin 
and  mucous  membrane,  normal  or  subnormal 
temperature,  and  acrid,  burning  and  glairy  dis- 
charge from  both  nostrils;  bowels  sluggish, 
pulse  slow  and  feeble,  strength  and  appetite 
partially  reduced.  After  a  week  of  what  I  con- 
sidered appropriate  treatment,  all  of  which  was 
constitutional,  the  boy  seemed  well,  excepting  a 
slight  general  weakness.  Then  he  b^an  to 
vomit  undigested  food.  He  continued  to  do  this 
for  a  week  or  more,  when,  calling  one  evening 
to  see  him,  and  seeing  no  light  in  his  room,  I 
went  to  the  sitting-room  and  inquired  for  him. 
Said  his  mother,  '*  He  went  to  bed  a  few  min- 
utes ago.  He  has  been  sitting  up  all  day,  try- 
ing to  fit  a  rivet  in  his  jackkmfe."  I  went  to 
his  bed  and  found  him  dying.  He  lived  but  a 
few  hours.  Now,  perhaps  this  would  be^  called 
heart  failure.  But  what  made  the  failure? 
During  this  epidemic  we  had  in  the  dead  of 
winter  two  cases  of  dysentery,  one  of  which 
proved  fatal.  We  thought  then,  and  we  think 
now,  that  this  was  something  of  the  nature  of 
diphtheria.  But  very  likely  the  microbes  in 
these  cases  were  a  little  crazy,  and  preferred  the 
rectum  to  the  mouth  as  an  avenue  to  their  feed- 
ing ground. 

In  regard  to  treatment,  the  Professor  and 
myself  should  not  disagree,  for  his  remedies  have 
been  mine  for  years.  But  if  I  had  his  belief  in 
the  nature  and  cause  of  this  disease,  I  should 
set  the  chlorine  free  outside  of  the  mouth,  for  I 
should  not  for  a  certainty  know  that  it  was  set 
free  if  taken  into  the  stomach ;  and  if  so,  I  could 
not  see  how  it  was  sure  to  search  out  the  mi- 
crobes. I  had  this  disease  myself  in  1864,  and 
what  I  took  at  the  outset  was  an  even  teaspoon- 
ful  of  equal  parts,  in  bulk,  of  calomel  and  pulv. 
rhei.  But  this  double-barrel  discharge  killed 
the  microbes,  though  the  shot  went  into  the 
stomach  and  acted  as  an  emetic  and  cathartic. 
Saml.  W.  Roberts,  M.  D., 

Wakefield,  Carroll  Co.,  N.  H. 

Interesting  Case  of  Cranial  Surgery. 
Editor  Medical  World  : — Willie,  aged 
five  and  a  half  years,  son  of  Dr.  J.  J.  McGahey, 
of  Columbu9  City,  Ala.,  was  kicked  by  a  mule 
on  November  6th,  1892.  the  hoof  of  the  mule 
striking  the  frontal  bone  just  at  the  union  of  the 
frontal  and  left  parietal,  driving  the  bone  into 
the  brain  substance,  of  which  about  one  ounce 
escaped.  The  wound  was  about  two  inches  long 
in  the  bone.  I  saw  him  about  four  hours  after 
he  received  the  kick.  It  being  near  night,  and 
having  to  send  seven  miles  for  my  partner.  Dr. 


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L.,  to  aesist  me,  1  made  the  wound  aseptic,  and 
let  the  child  rest  until  the  next  morning,  eight- 
een hours  after  the  wound  was  received,  when, 
under  the  influence  of  chloroform,  assisted  by 
Dr.  L.,  the  hair  being  well  retnoved  and  the 
skin  disected  back  from  the  wound,  the  bone 
was  elevated  to  its  proper  position  wiCh  an  ele- 
vator. I  will  state  that  the  child  rested  well 
during  the  eighteen  hours,  under  the  influence 
of  two  small  doses  of  morphine.  The  scalp 
wound  was  closed,  and  a  small  drainage  tube 
placed  in  it,  and  it  was  dressed  with  bichloride 
gauze.  He  rallied  nicely  from  the  operation, 
was  put  to  bed,  with  positive  instructions  for  his 
head  not  to  be  raised  above  the  level  of  his 
body ;  was  given  ^  gr.  morphine  sulph.,  and 
instructed  to  have  syrup  of  cascara  as  a  laxa- 
tive. 

November  8th.  Complains  very  much  of  pain 
in  his  stomach.  Had  a  small  action  of  hardened 
feces.  Pulse,  120  to  130;  temperature  99  J ; 
one  ounce  of  sweet  milk  every  four  hours. 
Vomits  occasionally, 

9th.  Had  small  action  from  bowels,  still  very 
hard  and  dry.  Rested  fairly  well,  but  com- 
plains  some  of  his  stomach.  Passes  his  urine 
regularly.  Gave  half  dram  of  pepsin  every 
four  to  six  hours.  Pulse  and  temperature  same. 
Vomits  occasionally. 

10th.  Condition  unchanged.  Ordered  enema 
and  got  two  good  actions  from  bowels. 

11th.  More  restless,  and  complaining  of  back 
of  head  and  neck.  Still  vomits  occasionally. 
Gave  larger  doses  of  pepsin,  with  good  results. 

12th.  Dressed  the  wound,  which  was  be- 
ginning to  suppurate.  General  condition  un- 
changed. 

13th.  More  restless.  Complaining  more  of 
his  head  and  stomach.  Pulse,  130  to  140;  tem- 
perature 101.     Gave  pepsin,  with  milk. 

14th.  Worse.  Pulse  135  to  140;  tempera- 
ture 101  J.     Tongue  heavily  coated. 

15th.  Very  restless.  Re-dressed  the  wound. 
Two  stitches  broken;  suppurating  profusely; 
cleansed  wound  thoroughly  and  dressed  with 
iodoform  gauze.  Complaining  very  much  of 
stomach.  Stomach  will  not  digest  the  milk. 
Temperature  lOlJ  ;  pulse  140,  and  intermit- 
ting. Bawels  constipated  and  distended  with 
gas.  Stopped  milk  and  gave  Wyeth's  extract 
of  beef,  fifteen  drops  every  two  hours.  Tr. 
digitalis,  one  drop  every  hour.  No  action  from 
bowels,  though  three  enemas  had  been  given. 
Castor  oil,  half  ounce  every  six  hours,  which 
acted  well  the  morning  of  the  16tL  after  three 
doses  were  taken,  working  off  the  undigested 
milk. 

17th.  Rested  better  during  the  past  twenty 
hours.     Bowels  acting.     Head  dreceed.     Pulse 


better  volume  and  not  so  rapid.     Charcoal  with 
pepsin  after  taking  food. 

19tL  Resting  fairly  well;  pulse  125;  tem- 
perature 101.  Does  not  complain  so  much  of 
his  stomach.  Increased  the  beef  j  nice  to  twenty 
drops  every  three  hours.  Three  doeee  of  syrup 
of  cascara  sagrada  in  twenty-four  hours.  Bow- 
els acted  well.  Wound  dressed  every  day,  and 
twice  some  days. 

From  the  20th  to  37th  days  improvement 
was  gradual ;  temperature  ranging  from  97  to 
99;  97  at  2  A. M,;  99 from  2  to  8  P.M.;  pulse 
100  to  120.  Beef  juice  and  eggnog  was  the 
only  diet  from  the  15th  to  22d  day,  when  he  is 
allowed  milk  again  in  small  quantities,  which 
agrees  nicely ;  from  the  25th  to  36th  da}f^  was 
allowed  a  mixed  diet  of  milk,  raw  beef,  crack- 
ers, fruits  and  oysters. 

The  wound  suppurated  most  profusely  for 
twenty  or  more  days,  and  slowly  healed  by  gran- 
ulation. 

On  the  38th  day  he  was  taken  with  la  grippe^ 
which  lasted  him  fourteen  days.  During  this 
whole  time,  up*  to  the  62d  day,  he  was  never 
allowed  to  assume  an  upright  position. 

During  the  entire  time  he  never  had  a  single 
symptom  of  paralysis  or  tremor  of  a  muscle, 
that  was  noticed.  He  made  a  perfect  recovery, 
and  is  to-day  well  and  hearty,  and  as  bright  a 
seven*year-old  boy  as  you  will  find  anywhere. 
At  no  time  during  his  sickness  did  he  seem  to 
lose  his  mental  faculties,  but  was  bright  and 
cheerful  at  all  times. 

W.  L.  Thomason,  M.  D., 

Guntersville,  Ala. 

Eczema. 

Editor  Medical  World  — At  times,  when 
I  have  been  in  a  quandary  as  to  what  should 
be  done  next  in  some  complicated  or  obstinate 
case  in  practice,  the  pages  of  The  World  have 
been  consulted,  and  there  the  new  ideas  sug- 
gested by  some  good  brother  have  furnished 
tiie  required  information  and  brought  relief  to 
patient  and  myself.  With  the  hope  that  the 
following  suggestion  may  give  relief  to  others 
in  like  manner  they  are  submitted. 

Eczema,  the  commonest  of  all  skin  diseases, 
per  86,  is  purely  a  local  disease.  True,  there  are 
often  connected  with  it  various  constitutional 
lesions  which  require  special  attention.  It  is 
usually  found  in  patients  who  have  debased 
constitutions ;  or  an  imperfect  skin  which  does 
not  properly  perform  its  secretive  functions  and 
has  not  sufiicient  resistant  power.  The  patient 
may  also  have  a  gouty  or  rheumatic  diathesis, 
or  the  disease  may  be  concomitant  with  syphilis 
— all,  or  either  of  which  should  receive  appro- 
priate   attention.     The    disease    is    extremely 


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protean  in  its  character.  No  other  skin  disease 
makes  so  many  changes  in  appearance,  depend- 
ing on  the  length  of  time  the  disease  has  existed, 
the  texture  of  fhe  skin  and  general  health  of 
the  patient.  From  these  varying  changes,  and 
from  location,  has  arisen  a  multiplicity  of 
names  calculated  more  to  confuse  than  to  en- 
lighten the  student 

Since  adopting  the  course  I  now  pursue, 
nearly  every  case  has  readily  yielded  to  persist- 
ent treatment.  I  prescribe  an  ointment  of 
quinine  sulph.  gr.  x  to  gr.  xv ;  ferri  sulph.  gr. 
X ;  lanoline  §  L  Quinine  is  one  of  our  best 
non«toxic  microbicides.  By  its  use  we  avoid 
the  danger  of  toxic  absorbtion,  as  is  too  often 
the  case  in  using  the  various  mevenvial  prepar- 
ation so  highly  recommended  by  some  writers. 
Lanoline,  as  a  base,  is  preferable  to  any  of  the 
petroleum  derivatives,  because  of  its  being  more 
readily  absorbed  by  the  skin.  Any  special 
lesion  will  require  appropriate  treatment  If 
there  is  severe  itching  add  carbolic  add  to  the 
unguent,  if  there  are  burning  sensations,  add 
camphor  or  hamamelis ;  if  syphilitic  conditions, 
add  plumbi  iodidi,  etc.  Occasionally  a  case 
with  fermentative  conditions  may  be  found 
when  the  addition  of  salicylic  acid  may  be  of 
service.  But  the  main  dependence  in  all  cases 
is  the  quinine  and  iron  locally.  Of  course  the 
general  conditions  want  to  be  looked  after.  The 
diet  should  be  bland  ^and  easy  to  digest,  the 
bowels  relaxed  by  some  agreeable  saliae  and  a 
diuretic  given  if  necessary. 

The  ointment  should  be  spread  thickly  upon  a 
soft  cloth.  The  parts  affected  thoroughly  bathed 
with  some  non*  irritating  soap  and  water  as  hot 
as  the  patient  can  comfortably  bear,  so  as  to 
thoroughly  macerate  and  cleanse  the  surface  of 
all  inspissated  exudations  and  scales.  As  soon 
as  possible  ftfter  bathing  and  drying  the  surface 
by  patting  with  a  soft  cloth,  the  ointment  should 
be  applied  and  thoroughly  pressed  down  to  ex- 
clude all  air.  The  dressing  should  not  be  done 
more  frequently  than  once  each  day,  and  then 
the  diseased  surface  exposed  as  little  as  possible. 

I  shall  be  pleased  to  hear  from  others  who 
may  try  this  method.        D.  D.  Robe,  M.D., 

Davenport,  Iowa. 

Carbolic  Aoid  in  tlie  Treatment  of  Carbuncles 
and  Other  AfTeotiont. 

Editor  Medical  World  :— In  your  Janu- 
ary issue,  I  notice  an  article  on  "  Carbuncles 
treated  by  Carbolic  Acid  Crystals."  It  reminds 
me  of  a  case  I  treated  successfully  about  twelve 
years  ago.  In  the  month  of  June,  1882,  I  was 
called  to  the  house  of  G.  R.  B.,  a  man  about 
50.  He  had  eleven  carbuncles  on  his  neck 
and  back,  was  suffering  fearful  agony  and  he 


told  me  he  had  not  slept  for  six  nights  and  days. 
H^  was  covered  with  poultices  and  he  would 
not  allow  anybody  to  come  near  him  or  touch 
him.  We  were  not  acquainted  with  cocaine 
then  and  we  were  not  using  the  sulphide  of  cal- 
cium very  much  either ;  but  knowing  the  anes- 
thetic property  of  carbolic  acid,  I  persuaded 
him  to  let  me  try  to  relieve  his  sufferings. 

I  then  injected  4  or  5  drops  of  pure  carbolic 
acid  into  eight  of  the  carbuncles  (ihe  3  others 
had  commenced  to  suppurate),  with  the  happiest 
results.  The  pain  subsided  in  a  few  minutes 
and  the  poor  fellow  went  to  sleep.  I  performed 
the  "  operation "  at  8  p.  m.,  and  my  patient 
slept  soundly  until  6  in  the  morning.  He 
awoke  greatly  refreshed  and  the  pain  never  re- 
turned. Of  the  8  carbuncles  injected,  7 
aborted ;  the  others  went  on  to  suppuration  and 
complete  cure  followed  in  two  or  three  weeks. 

I  have  experienced,  and  I  have  heard  many 
reports  made  by  some  other  physicians,  of  the 
good  effects  obtained  by  the  hypodermic  injec- 
tions of  strong  carbolic  acid  in  the  cure  and 
removal  of  ulcers,  carbuncles,  poisonous  bites 
and  hemorroids. 

I  have  been  a  subscriber  to.  The  World 
since  1886 ;  this  excellent  paper  is  like  the  gen- 
erous wine,  it  grows  better  with  age  and  I  enjoy 
its  **  bouquet "  very  much. 

Dr.  H.  P.  MONTBORNE, 

Spokane,  Wash. 


Practical  Points  In  the  Use  of  Water. 

Editor  Medical  World: — Water  has  a 
wide  therapeutic  range  in  its  application  to  the 
human  body.  It's  action  is  remarkably  diverse 
according  to  its  method  of  application.  It  is 
tonic,  relaxant,  detergent,  stimulant,  deferves- 
cent,  aperient,  diuretic,  sudorific.  One  method 
of  its  application  has  been  referred  to  in  The 
World  recently  by  Drs.  Dawson  and  Bennett, 
(See  page  133,  April  World).  This  method 
is  of  great  importance  too,  and  it  ought  to  come 
into  more  general  practice.  Dr.  Bennet  kindly 
comes  to  the  assistance  of  Dr.  Dawson,  detailing 
his  manner  of  treating  the  pati«it  after  coming 
out  of  the  vapor  bath.  The  plan  is  laborious,  nec- 
essitating **  going  over  "  the  patient's  body  half 
a  dozen  times.  I  submit  a  plan  which  is  both 
simple  and  efficacious:  Douche  the  entire 
body  with  cold  water,  the  patient  himself  rub- 
bing down  his  body  and  limbs  briskly.  Dry 
rapidly  with  large  towels  using  all  the  friction 
that  is  comfortable.  If  the  skm  is  healthy  no 
lotion  will  be  needed  to  keep  him  from  "  taking 
cold."  The  constringing  effect  of  the  cold  exhil- 
orates  the  body  and  increases  its  power  of  re- 
sistance.    Not  all  cases  are  suited  to  the  vapor 


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THE  MEDICAL  WORLD. 


bath.  I  should  not  expect  to  meet  with  **  that 
tired  feeling"  following  the  bath  in  well 
selected  cases.  Tried  in  a  case  of  aching 
limbs,  the  pains  will  generally  take  their  leave 
during  the  bath.  Frequently  an  aching  head 
will  be  relieved  and  a  beginning  cold  aborted. 
Indeed,  the  vapor  bath  is  a  valuable  aid  in 
practice. 

To  reduce  hyper-pyrexia  the  cold  bath  is  un- 
rivaled, but  I  think  it  probable  that  our  contin- 
ued fevers  would  neither  reach  so  high  a  tem- 
perature, nor  continue  so  long  if  the  hot  vapor 
bath  were  used  from  the  beginning  of  the  attack. 
I  have  tried  this  treatment  in  only  two  cases  of 
continued  fever.  One  patient  was  up  in  two 
weeks,  the  other  not  quite  so  early,  as  treatment 
was  delayed  a  few  days.  The  disease  ran  a 
mild  course  in  both  cases.  Internal  antisepsis 
was  used,  however.  I  also  recommend  the 
vapor  bath  as  a  prophylactic  against  disease.  I 
like  its  effects  myself,  and  frequently  substitute 
this  for  the  old  fashioned  tub  bath  and  sleep 
well  afterwards.  •  But  Dr.  Dawson  wishes  a 
formula  for  a  lotion  to  be  used  after  the  vapor 

bath.     I  offer  the  following : 

B.  Water  of  ammonia »..oaoce  ta 

Chloride  of  soda dram  11 

Soft  water .^.ounoe  xvl 

Mix. 

Those  whose  skins  are  harsh  and  dry  may 
use  with  good  effect  a  weak  ammonia  liniment 
with  a  base  of  some  bland  oil. 

If  the  skin  is  diseased  I  would  have  the 
patient  wash  thoroughly  in  a  tub  of  water  as 
hot  as  could  be  borne,  both  before  and  after  the 
vapor  bath,  when  the  ointment  appropriate  to 
the  case  should  be  immediately  well  rubbed  in 
and  the  patient  put  to  bed.  In  these  cases  it  is 
undesirable  to  close  the  pores  with  cold  applica- 
tions. John  F.  Neal,  M.D., 

Coperas  Cove,  Tex. 

[We  are  in  hearty  accord  with  the  free  and 
intelligent  use  of  heat  and  of  water  both  hot 
and  cold  to  re-establish  the  equilibrium  of  the  cir- 
culation and  break  up  a  beginning  attack  of  in- 
flammatory or  febrile  disease. — Ed.] 

A  Plea  for  Older  Remedies. 

Editor  Medical  World  : — In  the  flood  of 
the  newer  antipyretics,  coal  tar  derivatives,  syn- 
thetically prepared  remedies,  it  becomes  us  not 
to  drop  the  study  of  the  more  ancient  and,  I 
dare  say,  more  valuable  remedies.  The  prepara- 
tion I  wish  more  particularly  to  call  the  atten- 
tion of  your  readers  to  is  aconite — the  plain 
extract  of  aconite  or  its  alkaloid  aconitine.  I 
prefer  an  accurately  prepared  fluid  extract.  As 
is  well  known,  it  is  an  arterial  depressant,  low- 
ers the  action  of  the  heart  and  diminishes  its 
beat,  affects  the  sensory  nerve  strongly,  followed 
by  minor  action  on  the  motor  nerves,  in  lethal 


doses  paralyzing  the  functions  of  the  nervous 
system,  and  arrests  the  heart's  action  in  diastole. 
It  opens  the  pores  of  the  skin  by  reducing  arte- 
rial tension,  quiets  the  lung  movement  to  a 
marked  degree,  increases  the  various  secretions 
of  the  human  economy.  As  these  forces  are 
well  marked,  its  applicability  to  febrile  disease, 
respiratory  affections,  and  all  forms  of  inflam- 
matory troubles,  is  self-evident.  None  of  the 
newer  remedies  can  replace  aconite  in  its  prompt- 
ness of  action  its  certitude  of  effect,  reliability, 
safety  of  administration,  and  last,  but  not  least, 
reliable  preparations  can  be  obtained  at  small 
cost,  as  compared  with  other  febrifuges.  In  the 
intoxication  of  typhoid,  coal  tar  preparations  are 
positively  dangerous,  and  where  large  quantities 
of  drugs  are  contra-indicated,  aconite  acts 
charmingly,  and  is  the  classical  preparation  to 
combat  fever,  keeping  the  skin  moist,  increasing 
buccal  secretion,  and  insisting  on  prompt  kidney 
action;  quieting  the  usually  rebellious  heart 
and  respiratory  functions,  and  reducing  or  at 
least  keeping  the  temperature  in  statu  quo.  In 
nasal  and  faucial  catarrhs,  tonsillitis,  fibrinous 
pneumonia,  ephemeral  fevers,  the  disquamative 
diseases,  febrile  troubles  of  infants  and  chil- 
dren— in  fact,  in  all  febrile  affections — ^it  is  pre- 
eminently adapted,  and,  if  properly  adminis- 
tered, will  delight  the  user. 

Now  a  caution  in  its  use.  Minute  doses,  fre- 
quently administered,  is  the  classical  method  of 
using  it ;  for  adults,  an  eighth  to  one  drop  every 
half  hour  is  proper  dosage ;  children  will  usu- 
ally require  a  one-sixteenth  to  one-quarter  of  a 
drop  every  half  hour  until  effect  is  obtained, 
when  the  tonic  may  be  lengthened.  When  the 
heart's  action  is  very  much  excited,  veratrum 
viride  may  be  combined  with  it  in  ^  to  1  drop 
doses,  which  beneficially  heightens  its  effects. 
This  remedy  will  bear  careful  usage  and  study 
by  the  profession,  as  it  has  not  been  having  its 
due  from  practitioners  these  latter  years.  In 
my  practice,  after  an  extendve  trial  of  antifeb> 
rine,  antipyrine,  and  other  coal-tar  preparations, 
I  have  found  them  in  sufficient  doses  to  be  dan- 
gerous, and  in  smaller  doses  inoperative,  and  in 
the  diseases  of  children  almost  useless.  Another 
remarkably  prompt  action  for  aconite  is  in  the 
nervous  prostration  following  drunkenness, 
where  it  gives  brilliant  results,  quieting  the 
nervous  excitement,  reducing  the  buccal  dry- 
ness, and  relieving  the  offensive  headache.  In 
maniacal  delirium,  as  in  mania-apotu,  gelsemi- 
num  is  to  be  preferred. 

Glandorf,  Ohio.  Dr.  A.  Bormam, 


Is  Aoetanilid  So  Dangerous? 
Editor  Medical  World  :— In  reading  the 
communications  from  many  of  your  writers  we 


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hear  a  good  deal  about  the  dangers  of  aceta- 
nilid,  in  causing  heart-failure,  collapse,  etc,  and 
do  not  recall  but  one  writer  coming  to  the  de- 
fense of  the  drug.  I  have  prescribed  and  dis- 
pensed pounds  and  pounds  of  it,  and  have  failed 
to  ever  see  any  of  the  fearful  effects  we  are  told 
it  produces ;  but,  on  the  contrary,  have  never 
found  anything  its  equal,  in  drugs,  to  quickly 
reduce  fever.  It  is  not  only  prompt,  but  in 
many  cases  seems  curative  as  well,  and  will  in 
many  cases  bring  the  temperature  to  normal  in 
a  few  hours,  and  it  will  remain  so.  I  give  it  in 
all  pyrexias,  let  the  patient  be  a  month  old  or 
eighty  years,  and  if  the  fever  is  above  104*^  F. 
in  heavy  doses,  because  it  will  reduce  excessive 
body-heat  more  quickly  than  anything  else,  ex- 
cept the  cold-bath,  and  I  have  never  seen  any- 
thing but  the  most  benign  effects  in  all  the  years 
I  have  used  it.  I  sometimes  think  that  surely 
those  that  declaim  so  loudly  against  it  have  never 
used  it,  or  else  they  would  not  be  so  emphatic 

If  any  practitioner  is  being  influenced  by 
those  pictures  of  its  action,  and  is  not  using  it, 
he  is  oiscarding  one  of  the  promptest  rem^al 
agents  in  the  whole  materia  medica. 

Imperial,  Neb.  D.  Boswell,  M.D., 

Medicinal  Cure  for  Cancer; 

Editor  Medical  World  :— I  have  treated 
a  melanotic  cancer  successfully.  It  is  entirely 
cured,  nothing  remains  but  a  withered  scab, 
which  could  be  easily  removed  now,  but  I  set 
out  not  to  touch  the  cancer,  and  have  not  I 
deem  it  a  duty  to  report  the  matter,  particularly 
to  you,  hoping  that  it  may  be.  of  benefit  to  the 
Buffering,  knowing  that  you  can  bring  it  to  their 
notice  in  a  few  days,  which  I  could  not  do  in  a 
lifetime  I  am  giving  the  same  treatment  to 
several  others,  in  various  stages  of  disease,  two 
of  whom  have  cancer,  and  all  are  improving 
rapidly.  I  will  give  the  treatment,  and  you 
can  make  what  use  of  it  you  think  proper. 

Last  February  I  was  treating  a  wart  on  my 
hand,  by  dieting,  and  \  gr.  doses  of  calcium 
sulphide,  which  wart  gradually  disappeared ; 
also  a  com  on  my  foot,  which  had  been  there 
for  thirty  years  or  more,  the  only  one  I  was 
ever  troubled  with.  I  also  took  aconite  and 
podophyllin  granules,  as  I  felt  the  need  of  them 
once  in  awhile  during  the  time  of  treatment. 
Seeing  the  success  on  the  wart,  I  asked  one  of 
my  neighbors  (Jno.  L.  Holder,  now  of  Sherman 
Heights,  Tenn.),  who  was  suffering  with  a  mul- 
atto colored  cancer,  in  the  secondary  stage,  if  he 
would  let  me  try  an  experiment,  and  related  to 
him  my  success  with  the  wart.  He  agreed, 
and  took  at  once  ^  gr.  calcium  sulphide,  ^  gr. 
aconite,  ^  gr.  ,  podophyllin,  his  bowels  being 
costive.    The  dose  of  calcium  sulphide  was  re- 


peated 3  times  a  day ;  the  aconite  and  podo- 
phyllin when  needed.  We  took  exact  measure- 
ment of  the  cancer.  It  was  about  the  size  of  a 
silver  quarter,  and  looked  angry  and  defiant. 
At  the  end  of  forty- eight  hours  the  pain  had 
subsided,  at  the  end  of  fourteen  days  it  was 
only  half  the  former  size,  and  appeared  to  be 
withered.  At  the  end  of  three  weeks  it  was 
still  smaller,  and  seemed  pinched  and  dry,  and 
at  the  end  of  five  weeks  from  the  time  of  taking 
the  first  dose  of  calcium  sulphide,  nothing  re- 
mained of  it  but  a  dry  scab.  The  inflammation 
in  the  flesh  around  the  cancer  subsided  within 
three  days  from  the  first,  and  the  costiveness, 
which  dated  more  than  a  year  back,  was  greatly 
relieved,  and  my  friend  is  delighted.  Others 
being  treated  report  the  pain  to  be  relieved, 
which  indicates  that  the  growth  of  the  cancer 
is  arrested.  Mr.  Holder's  father  died  with  the 
same  species  of  cancer  some  jears  ago,  and  I 
have  no  doubt  he  was  infected  from  his  father. 
The  matter  of  diet  is,  I  think,  very  important 
Alcoholic  liquors,  coffee,  pork,  onions,  pepper, 
horse  radish,  turnips,  radishes,  pickles,  vinegar, 
rich  puddings,  cake  and  mince  pies  are  to  be 
excluded  from  the  bill  of  fare,  and  a  light  diet 
used.  Eat  beef,  mutton,  game,  fresh  fish  spar- 
ingly but  eat'  enough.  Common  vegetables 
may  be  used  freely  such  as  beans,  peas,  cab- 
bage, lettuce,  greens,  bread  and  butter,  or  bis- 
cuits made  with  milk  and  baking  powder,  not 
shortened,  fresh  and  canned*  fruits,  dried  fruits, 
sugar,  butter  milk,  sweet  milk,  rice,  hominy, 
corn  meal  mush,  potatoes,  cambric  tea,  or 
<' store  tea,''  etc  So  far  as  my  observation 
goes^  cancer  yields  to  treatment  more  readily 
than  common  warts.  Wm.  H.  Burgess, 

Chattanooga,  Tenn. 

Authority  to  Practice, 

Editor  Medical  World: — Much  is  being 
written  about  the  regulation  of  the  practice  of 
medicine  in  the  different  States,  and  there  are 
many  who  advocate  the  examination  of  each 
applicant  for  practice  before  he  is  licensed. 
While  it  should  ever  be  the  aim  of  every  medi- 
cal man  to  lend  a  helping  hand  to  the  advance- 
ment of  the  medical  profession,  still  I  think  the 
medical  laws  of  some  of  our  States  are  working 
a  great  injustice  to  those  old  war-horses  who 
have  graduated  years  ago,  and  have  become 
gray  in  the  profession.  There  are  many  phy- 
sicians in  country  practice  to-day  who,  when 
they  graduated,  could  have  passed  the  examina 
tions  of  the  State  Boards,  but  years  of  hard, 
practical  work  has  kept  them  from  keeping  up 
with  all  the  new  ideas  that  are  being  advanced. 
They  learned  theory  at  school ;  they  have  since 
learned  the  practical  part,  to  the  neglect  of  the 


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theoretical.  A  graduate  of  medicine  who  has 
been  in  continuous  practice  for  ten  years  should 
be  allowed  to  practice  anywhere  in  this  free 
country. 

I  believe  that  the  best  way  to  regulate  the 
practice  of  medicine  so  that  a  physician  who  is 
qualified  in  one  State  will  be  in  all,  is  for  Con- 
gress to  add  another  member  to  the  cabinet — 
that  of  Secretary  of  Health.  I  would  give  the 
Secretary  of  Health  pover  to  appoint  a  United 
States  Board  of  Health,  and  to  this  Board  of 
Health  I  would  give  the  power  to  regulate  the 
practice  of  medicine  in  the  United  States.  I 
would  have  this  Board  appoint  non-interested 
examiners  for  all  medical  schools  thfit  required 
a  four  years'  course  of  study,  and  to  those  who 
received  the  degree  of  M.D.,  and  who  passed 
the  Board  of  Health  examination,  I  would  give 
a  license  to  practice  medicine  in  the  United 
States,  and  that  no  State  be  allowed  to  admit 
any  one  to  practice  except  licensed  physicians 
and  those  already  in  practice.  I  would  also 
authorize  this  Board  to  license  all  graduates 
who  have  taken  a  three  years'  course  in  medi- 
cine, and  all  those  who  have  been  in  practice 
ten  years  since  graduation.  This  license  would 
be  presented  to  the  State  Board  in  the  State  in 
which  the  physician  desired  to '  practice,  and 
they,  upon  his  proving  his  rightful  ownership 
and  paying  required  fees,  would  be  granted  a 
State  certificate.  I  would  revoke  this  license 
when  the  holder  was  convicted  of  unprofessional 
conduct,  drunkenness  and  the  like.  In  this 
way  I  believe  the  profession  of  medicine  could 
be  regulated  satisfactorily  to  all — the  old,  be- 
cause they  would  be  recognized,  and  the  new 
could  be  regulated  to  suit  the  profession,  since 
all  schools  would  be  expected  to  comply  with 
Board  of  Health  rules  or  be  shut  out  from  ex- 
aminations, and  thus  from  practicing  medicine. 

Doniphan,  Neb.  T.  H.  Line,  M.D., 


Professor  Hirst's  Palvimeter. 

[Reported  especially  for  The  Medical  World.] 
The  new  pelvimeter  contrived  by  Professor 
Barton  Cooke  Hirst,  of  the  Univ.,  of  Pa.,  entirely 
does  away  with  the  possibility  of  error  in  pelvic 
measurement,  due  to  variations  in  the  conjugate, 
symphyseal  angle,  and  theheight  of  the  sym- 
physis. 

The  instrument  measures  accurately — 

(1)  The  thickness  of  the  symphysis. 

(2)  The  conjugate,  plus  the  thickness  of  the 
symphysis. 

(3)  The  distance  between  the  outer  edge  of 
the  symphysis  and  the  promontory  of  the  sa- 
crum. 

The  fatal  error  of  the  old  Bandelocque  mea- 


surements in  the  symphyseotr  my  case  referred 
to  in  last  issue  caused  Dr.  Hirst  to  construct 
this  instrument. 

The  measurements  are  taken  in  the  lithotomy 
position.  Tip  A  is  placed  firmly  against  the 
middle  line  of  the  promontory  of  the  sacrum. 
Tip  B  is  brought  to  the  proper  position  in  the 
symphysis,  and  the  arm  secured  fast.  Measur- 
ing between  the  tips,  we  have  the  true  conjugate 
plus  the  thickness  of  the  symphysis.  The  latter 
is  found  as  in  Fig.  2.  Deducting  this  thickness, 
we  have  an  accurate  conjugate  measurement. 


Arm  A  is  removable,  and  is  replaced  by  Arm 
C  in  measuring  the  thickness  of  the  symphysis. 
(Fig.  2.) 


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203 


Oxide  of  Zino  for  the  Morphine  Habft. 

Editor  Medical  World  : — I  had  a  patient 
whom  I  was  treating  for  the  morphine  habit 
So  I  went  to  Dr.  Waugh's  book  on  Doeimetric 
Treatment,  and  looked  over  bis  list  of  drugs 
used  in  the  treatment  of  the  morphine  habit  and 
selected  oxide  of  zinc  as  being  the  most  likely 
to  be  successful,  and  put  my  patient  on  it,  but, 
as  he  knew  something  of  drugs,  I  told  him  of 
my  hopes  in  the  matter,  which  may  have  had 
an  influence  in  the  way  of  *  suggestion,  as  the 
hypnotists  would  say.  However  that  may 
be,  it  was  successful,  and  if  it  is  not  the  drug 
Dr.  Waugh  referred  to  in  his  recent  letter  in 
The  World,  then  I  have  discovered  another, 
which,  if  used  in  doses  of  from  2  to  6  grs.  every 
3  hours  with  some  capsicum  and  a  minute  quan- 
tity, say  from  the  -^  to  -^  of  bl  grain  of  ipecac 
to  prevent  nausea,  will  be  found  of  wonderful 
benefit  in  quitting  the  use  of  morphine. 

Spanish  Camp,  Tex.     Dr.  C.  B.  Palmer, 


Treatment  of  the  Opium  Habit. 

Editor  Medical  World: — I  see  that  the 
formula  of  B.  M.  Woolley's  cure  for  the  opium 
habit  is  wanted. 

I  send  you  what  I  believe  it  is,  and  I  think 
any  doctor  can  cure  the  opium  habit  without 
much  trouble.  Several  years  ago  I  had  a 
patient  that  took  Woolley's  treatment  and  was 
cured.  The  first  thing  that  the  doctor  did  was 
to  get  the  exact  dose  of  opium  that  the  patient 
took,  and  how  often  during  the  twenty-four 
hours. 

His  direction  to  his  patients  was  not  to  take 
opium  or  anything  that  contained  opium  while 
they  took  his  medicine. 

That  convinced  me  that  it  was  nothing  but 
morphine  in  water  colored  with  lavender. 

Let  each  teaspoonful  contain  the  exact  dose 
the  patient  takes  at  a  dose,  and  prescribe  about 
four  or  six  ounces  at  a  time.  Reduce  the  dose 
gradually,  as  a  new  bottle  is  prescribed,  until 
thepatient  gets  no  morphine. 

Me  makes  his  patients  believe  that  they  are 
not  taking  opium,  and  that  is  the  secret  in  treat- 
ing a  case. 

I  saw  another  case  where  the  remedy  failed 
on  account  of  the  patient  finding  out  the  secret. 
Wm.  C.  Stirling,  M.D., 

Sulphur  Springs,  Tex. 


The  Opium  Habit. 

Editor  Medical  World  : — I  have  written 
at  the  opium  habit  several  times,  but  never  a 
full  account  of  this  dreadful  disease.  I  have 
concluded  to  do  this  now,  partly  on  account  of 


hundreds  of  letters  asking  for  it,  partly  because 
no  book  I  have  seen  gives  a  satisfactory  account 
of  it,  and  finally  because  I  learn  that  several 
physicians,  themselves  morphinomaniacs,  are 
trying  to  convince  people  that  the  habit  is  harm- 
less. The  fable  of  the  fox  that  had  lost  his  tail 
is  appropriate.  I  would  no  more  take  the  word 
of  a  habitue  than  1  would  that  of  a  sexual  per- 
vert or  a  maniac,  that  they  were  right  and  the 
world  wrong.  In  this  I  will  also  announce  the 
name  of  the  new  remedy,  when  I  describe  the 
treatment 

The  opium  habit,  long  prevalent  in  Asia, 
was  rarely  known  in  Christendom  until  within 
recent  times.  It  is  becoming  of  increasing  fre- 
quency. The  reasons  for  this  are  to  be  found 
in  the  conditions  of  modem  life,  and  consist  of 
the  causative  factors  of  suicide  and  insanity. 
As  the  demands  on  the  human  intellect  increase, 
as  the  struggle  for  existence  grows  sterner,  the 
minds  that  give  way  under  the  strain,  or  seek 
assistance  from  outside  sources,  must  necessarily 
increase.  It  is  the  price  we  pay  for  our  modem 
civilization— one  example  of  the  law  of  compen- 
sations. 

An  enormous  impetus  has  been  given'' to  the 
use  of  morphine  by  the  introduction  of  the  hy- 
podermic syringe.  He  has  much  to  answer  for 
who  teaches  his  patient  the  use  of  this  instru- 
ment When  the  charms  of  morphine  have 
been  once  experienced,  it  is  ea^y  to  find  an  ex- 
cuse for  a  repetition  of  the  dose.  A  doctor  who 
fir^t  took  opium  for  diarrhea,  used  to  take  a 
cathartic  at  night  to  give  him  an  excuse  for  a 
do^e  of  opium  in  the  morning.  Behind  such 
paltry  refugcMS  of  lies  will  poor  human  nature 
seek  to  hide  its  weakness ! 

etiology. 

It  is  certain  that  all  persons  are  not  equally 
liable  to  become  morphine  habitues.  To  many 
the  effects  of  the  dmg  are  disagreeable;  to 
others,  singularly  attractive.  Conditions  pre- 
disposing to  narcomania  are :  the  nervous  tem- 
perament, hysteria,  neurasthenia,  uterine  pain, 
neuropathy,  with  pains,  as  in  ataxia,  neuralgia, 
etc  Above  all,  is  the  production  of  euphoria : 
when  this  has  been  experienced,  morphine 
should  never  again  be  given  that  person.  Nar- 
cotics are  also  taken  to  drown  remone  or  de- 
spair ;  to  enable  the  nser  to  accomplish  tasks 
otherwise  beyond  his  power;  to  h&a\ah  care; 
Irom  idleness,  vice,  morbid  curiosity,  bad  exam- 
ple ;  to  increase  the  sexual  vigor  or  the  conver- 
sational powers.  The  greatest  number  is  said 
to  be  supplied  by  those  who  handle  dmgs — 
physicians,  druggists,  nurses,  students  and  their 
relatives.  This,  however,  may  be  due  to  the 
fact  that  these  classes  supply  the  larger  part  of 


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those  who  apply  for  cur  3,  as  the  statistics  are 
based  on  the  reports  of  sanatoria.  It  may  be 
that  these  classes,  conscious  of  their  danger, 
are  more  likely  than  others  to  seek  to  escape. 

CLASSIFICATION. 

The  habitual  takers  of  narcotics  may  be  di- 
vided into  several  classes.  Regnier  classifi^ 
them  as  justifiable  consumers  and  morphinoma- 
niacs.  The  first  group  comprises  those  who  are 
subject  to  incurable  disease  -  canceV,  tuberculo- 
sis, etc.,  who  employ  morphine  solely  to  render 
conscious  existence  endurable.  Morphinoma- 
niacs  are  they  who  take  the  drug  to  secure  the 
pleasurable  sensation  denominated  euphoria. 
A  large  number  in  this  class  claim  to  be  in  the 
former,  as  they  first  took  the  drug  to  relieve  the 
pangs  of  disease  that  has  since  passed  off — as 
rheumatism,  or  that  is  not,  as  they  claim,  incu- 
rable. Sometime  narcotics  are  taken  to  ward 
off  attacks  of  periodic  dipsomania,  or  to  replace 
the  habitual  use  of  alcohol. 

All  these  are  to  be  distinguished  from  those 
whose  feebleness  impels  them  to  seek  in  mor- 
phine a  shelter  from  all  unpleasant  sensations, 
and  from  the  rude  jars  of  a  hurrying,  struggling 
world ;  still  more  from  those  in  whom  morphin- 
ism is  but  one  expression  of  a  defective  organi- 
ization,  inherited  from  a  neurotic  ancestry. 
This  disease  we  should  denominate  the  narcotic 
habit,  rather  than  morphinomania,  for  chloral, 
cocaine,  chloroform,  and  alchohol  habitues  in- 
terchange their  drugs  readily — representing 
simply  varieties  of  a  single  neuro-psychic  mal- 
ady— Narcomania.  The  dipsomaniac,  "cured" 
by  some  secret  procees,  returns  to  his  home 
quite  comfortable  with  the  morphine  habit; 
while  the  morphinomaniac  rids  himself  of  this 
drug  by  substituting  codeine,  chloral,  cocaine  or 
cannabis  indica.  The  real  disease  remains  un- 
cured — the  dependence  upon  narcotics.  Those 
who  employ  morphine  from  i^ecessity  ma]f  long 
continue  to  obtain  relief  from  the  ordinary  medi- 
cinal dose,  but  morphinomaniacs  push  the  doses 
up  as  rapidly  as  they  are  able,  the  tolerance  in- 
creasing with  the  rise.  Regnier  believes  that  this 
is  because  larger  doses  are  required  for  the  pro- 
duction of  euphoria,  but  I  think  this  is  a  mis- 
take. Every  patient  I  have  questioned  has 
acknowledged  that  he  increased  the  dose  because 
he  wanted  viore  of  the  pleasure.  Indeed,  there 
is  sometimes  a  remarkable  sensitiveness  to  the 
action  of  morphine  in  habitues,  and  I  have  pro- 
duced euphoria  with  ^^  grain,  in  a  man  who 
had  been  taking  15  grains  daily  only  ten  days 
before. 

CLINICAL   HISTORY. 

Regnier   pictures  the  genesis  of  morphino- 
mania as  follows:  Take  a  hysteric,  to  whom 


morphine  has  been  given  to  arrest  the  paroxysm 
The  sense  of  calm  is  accompanied  by  a  comfort- 
able consciousness  of  well  being,  of  peculiar 
superactivity.  She  is  alert,  her  memory  quick, 
her  wit  keen.  Tasks  previously  fatiguing  be- 
come easy.  Good  humor  pervades  her,  the 
cares  are  forgotten,  she  is  optimistic,  her  face  is 
rosier,  the  eyes  bright,  the  pulse  and  respiration 
stronger.  But  when  the  morphine  is  discern- 
tinned  she  finds  herself  possessed  by  a  strange 
malaise,  oppression,  inquietude,  even  anguish. 
The  mind  is  dull,  sluggish,  weighed  down  by  a 
sense  of  powerlessness.  Yawns,  coughing  fits, 
irritate  her;  icy  sweats  appear,  with  palpita- 
tions The  pulse  may  become  very  feeble,  and 
she  languishes,  incapable  of  exertion,  pale  and 
meager,  or  red  and  cyanotic,  assailed  by  pains 
over  the  whole  body,  chilled,  trembling,  know- 
ing not  to  what  to  attribute  her  malady,  and 
anxious  as  to  its  outcome.  Let  her  then  have 
an  opiate,  and  like  magic  the  symptoms  disap- 
pear, and  warmth  and  gayety  pervade  her  be- 
ing. Every  pang  is  gone,  and  health,  strength, 
imagination,  power  to  work,  return  on  the  in- 
stant But,  sooner  than  at  first,  this  magic 
state  passes  away,  and  the  malaise  returns  more 
pronounced,  more  accentuated  than  before. 
But  now  she  comprehends  the  true  nature  of  the 
malady,  she  recognizes  the  imperious  need  for 
morphine,  and  after  a  brief  resistance  she  de- 
mands the  drug.  This  sense  of  need,  intense, 
imperious,  irresistible,  constitutes  morphinoma- 
nia. From  this  day  her  life  is  divided  into  two 
periods,  dietinctiy  alternated — the  state  of  eu- 
phoria from  morphine,  the  state  of  need  when 
the  effects  of  the  dose  are  spent,  the  former 
lessening  its  duration  unless  the  doses  are  in- 
creased in  size  or  in  frequency.  Insomnia  fur- 
nishes another  excuse  for  increasmg  the  daily 
dose,  and  in  time  every  excuse  is  seized  upon 
for  augmenting  it  As  this  is  done,  the  symp- 
toms of  intoxication  ensue,  and  these  may 
frighten  the  victim  into  moderation;  but  the 
reappearance  of  that  dreadful  need  drives  her 
back  to  it  If  she  be  resolute  enough  to  attempt 
a  stoppage,  the  frightful  suffering  and  the  terri- 
fying sjrmptoms  arising  force  the  patient  back 
to  the  drug,  and  only  result  in  inspiring  her 
with  such  a  dread  of  discontinuing  it  that  she 
can  hardly  be  persuaded  to  resort  to  legitimate 
treatment. 

Sometimes,  if  the  habit  has  not  had  time  to 
rivet  its  hold,  the  victim  may  break  his  bonds, 
but  generally  he  fails.  Some  who  succeed  re- 
main free  for  months,  when  some  emergency 
arises  for  which  opium  is  taken,  and  a  single 
dose  is  enough  for  that  dreadful  need  to  reappear 
in  all  its  force,  and  in  a  very  short  time  the 
habit  is  re-established,  and  the  second  stage  of 


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205 


the  malady  open^  Euphoria  cannot  be  main- 
tained, even  by  thirty  or  more  injections  daily. 
The  pupils  are  unequal,  the  pulse  small,  filiform, 
or  tense  and  intermittent  Palpitations  are 
common.  Slight  exertion  causes  pasting  and 
sweating.  Cramps,  pains,  nocturnal  gastrie- 
crises  appear  and  increase  in  severity.  Profuse 
sweats  occur  without  apparent  cause.  Terrors 
afflict  the  patient,  quaking  at  the  least  noise  or 
at  hallucinations.  Insomnia  alternates  with 
frightful  nightmares,  so  that  the  invalid  takes 
to  late  reading.  When,  worn  out  completely, 
she  closes  her  eyes,  clonic  convuleions  awaken 
the  wretch.  After  several  such  shocks  she  falls 
asleep,  but  the  slumber  is  unrefreshing,  and  in 
a  few  hours  she  awakes,  wretched,  incapable  of 
exertion,  until  an  injection  has  restored  the 
power.  She  becomes  indifferent  to  all  but  the 
satisfaction  of  the  need  for  morphine,  neglecting 
every  duty.  Extreme  irresolution  and  coward- 
ice characterize  the  habitue.  Everything  un- 
pleasant is  avoided,  the  least  pain  exaggerated. 
Emaciation  becomes  marked,  the  wrinkled  skin 
hanging  loosely  over  the  projecting  bones.  The 
appetite  is  lost,  though  spells  of  ravenous  hun- 
ger occur.  Constipation  alternates  with  diar- 
rhea. The  menses  cease ;  in  men,  the  sexual 
power  is  lost ;  the  mind  weakens,  memory  fails, 
judgment  becomes  imbecile,  and  a  sluggish  in- 
difierenoe  comes  on,  resembling  paretic  demen- 
tia, though  never  so  complete.  The  moral 
sense  is  weakened,  and  a  tendency  to  lying 
arises.  Ko  credence  whatever  is  to  be  given  a 
confirmed  morphinomaniac,  especially  as  regards 
their  habit,  and  the  reduction  they  are  making 
in  the  dose.  Much  ingenuity  is  manifested  by 
tbem  in  secreting  the  drug  and  syringe.  They 
have  been  found  in  the  hollow  leg  of  a  chair, 
in  the  Ibing  of  clothes,  and  snugly  hidden  away 
in  the  hair,  or  in  the  vagina.  No  matter  what 
has  been  the  previous  life,  they  will  not  hesitate 
to  resort  to  robbery,  prostitution  or  murder,  to 
obtain  the  drug.  Melancholy  gradually  settles 
down  upon  the  victim,  who  bitterly  regrets  his 
infatuation,  so  that  suicide  is  often  the  end.  If 
he  is  to  be  cured,  he  must  be  placed  beyond  all 
possibility  of  obtaining  the  drug,  and  kept  in 
restraint  as  long  as  the  sense  of  tieed  is  felt 
The  tendon  reflexes  of  the  knee  are  abolished ; 
the  nutrition  has  experienced  a  profound  im- 
pression ;  the  teeth  and  hair  fall,  and  he  looks 
prematurely  aged.  Nevertheless,  even  yet  he 
may  be  rescued,  at  the  price  of  suffering,  by 
skillful  management  If  not,  or  if  he  quickly 
relapses,  we  see  the  symptoms  of  the  final  stage. 
Here  there  is  no  more  euphoria,  no  matter  how 
large  the  dose  taken.  The  cachexia  advances, 
the  emaciation  reaching  a  point  shown  in  no 
other  malady.     The  slmi  and  mucosa  are  cyan- 


otic, dropsy  supervenes,  with  breathleesness  on 
the  least  exertion ;  complete  anorexia,  fetid 
breath,  hallucinations,  delirium  in  the  form  of 
lypemania,  and  finally  complete  dementia  or 
brutishness,  ending  in  terminal  mara&lbus.  In 
this  period  there  is  an  increase  of  cardiac  dull- 
ness, weakness  of  the  apex  beat,  with  extreme 
smallnesB  and  irregularity  of  the  pulse.  The 
heart  sounds  are  feeble,  but  usually  normal. 
The  urine  is  scanty,  and  often  albuminous. 

He  is  then  hopelessly  lost.  The  changes  in 
the  nervous  system,  heart  and  kidnejs,  are  su^h 
that  there  is  more  danger  for  the  patient  in  sup- 
pressing the  morphine  than  in  continuing  it 
We  can  only  diminish  it  slightly,  to  prevent  the 
intoxication  making  such  rapid  progress,  and 
postpone  as  long  as  possible  the  fatal  end.  But 
death  is  inevitable,  and  not  far  off. 

In  my  next  letter  I  will  discuss  the  prognosis 
and  treatment 

William  F.  Waugh,  M.D., 
103  State  street,  Chicago. 

[It  will  be  remembered  that  the  new  remedy 
referred  to  was  spoken  of  on  page  78,  March 
World,  and  the  plan  of  the  French  Academy 
of  Medidne  adopted,  viz  :  The  description  of 
the  remedy  was  deposited,  in  a  sealed  envelope, 
with  the  editors  of  this  journal,  to  be  opened 
and  made  public  when  the  author's  experiments 
have  proceeded  so  far  as  to  demonstrate  the 
value  of  the  treatment  It  will  be  made 
public,  probably,  in  July  or  August  World. — 
Ed.] 


Children's  Ailments.— Some  of  the  Direct  Causes, 
with  Suggestions  as  to  Treatment 

Editor  Medical  World: — Some  of  the 
causes  of  children's  disorders  are  as  follows : 

1st  Feeding  with  flour  pap,  com  starch  and 
other  starchy  foods,  and  with  sour  milk 
and  other  unsuitable  articles.  These  all 
bring  disorders    of  digestion,   with  attendant 


2d.  Children  are  neglected  when  they  should 
have  drink.  They  often  cry  for  water,  but  they 
are  given  food  instead.  Some  mothers  have  the 
idea  that  children  should  not  have  water  to' 
drink ;  they  give  anything  for  drink  almost  ex- 
cept water.  Consequently  the  child  suffers,  and 
all  the  functions  are  retarded  thereby. 

3d.  Inexperienced  persons  are  permitted  to 
handle  children,  and  thus  they  are  tossed  about 
up  and  down,  turned  upon  their  heads,  and, 
worse  than  all,  they  press  their  lips,  oflen  filthy, 
into  the  child's  ikce,  mouth  and  eyes,  and  so 
convey  contagion  to  them ;  and,  not  the  least  of 
all,  is  the  bumping  of  their  tender  heads  till 


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their  brains  are  literally  shaken  into  diseased 
conditions. 

4th.  Drugging  mothers  fill  the  children  with 
soothing  syrups,  lozenges,  powders  containing 
opium,  lead,  mercury,  zinc,  bismuth,  exchanging 
prescriptions  with  others  from  other  doctors, 
pre3cribed  for  other's  children  ;  often  druggists' 
prescriptions  are  wormed  out  of  them  by  the  im- 
portunities of  ignorant  mothers.  Is  this  not 
enough  to  cause  wholesale  sickness,  with  nothing 
else  ?  It  is  bad  enough  when  doctors  prescribe 
fliese  poisons. 

5th.  Accidental  poisoning  by  cakes,  candies, 
ice  cream,  bananas,  strawberries,/&nd  other  food 
stufis,  also  the  careless  way  some  have  of  allow- 
ing children  to  eat  paper,  blue,  green,  and  all 
poison  colors,  to  say  nothing  of  the  dangers  from 
the  common  toys. 

6th.  Exposures  to  sun's  heat,  heated  rooms, 
exposing  their  heads  to  heated  stoves,  grates, 
etc.;  their  heads  buried  in  hot  pillows  for  hours 
at  a  time ;  trusting  to  stockings  to  warm  the  feet 
when  hot  baths  and  hot  applications  should  be 
used.  Many  times  I  have  instructed  mothers 
and  nurses  to  warm  the  child's  feet  with  either 
a  hot  foot  bath  or  jugs  of  hot  water,  when  they 
neglected  it,  satisfying  themselves  with  stock- 
ings, shawls  or  blankets. 

7th.  Diarrhea  and  teething.  Diarrhea  should 
not,  in  most  cases,  be  checked  suddenly  by  opi- 
um, lead,  and  other  astringents,  especially  when 
there  is  trouble  with  the  head,  of  a  congestive 
character.  Where  anemia  of  the  brain  exists, 
of  course  the  risk  is  not  so  great,  but  even  here 
the  secretions  should  not  be  suppressed,  but  cor- 
rected. In  either  of  these  cases  the  dosimetric 
seidlitz  salts  will  be  found  useful  and  safe. 
They  prepare  the  way  for  the  dominant  treat- 
ment, which  will  be  mentioned  presently.  In 
these  delicate  cases  the  physician  should  always 
aim  to  combine  potency  with  safety,  and  mild- 
ness with  efficiency. 

Having  thus  mentioned  some  of  the  proximate 
and  direct  causes  of  the  various  maladies  of 
children,  which  are  at  work  in  producing  among 
them  suffering  and  death,  we  will  next  attempt 
to  show  how  these  causes  produce  disease,  and 
what  means  should  be  used  to  restore  health 
when  deranged. 

Before  proceeding  to  give  treatment,  we  will 
remark,  that  probably  the  most  fertile  cause  of 
the  summer  diseases  of  children  is  crude  irir 
{/esta. 

The  next  has  always  been  considered  to  be 
dentition. 

However  this  may  be,  we  know  that  they  are 
both  concerned,  to  an  extent,  in  their  causation. 
Teething  being  a  natural  or  physiological  pro- 
•cess,  it  would  be  natural  to  expect  no  trouble 


from  that  source.  The  great  variety  of  circum- 
stances, however,  attending  the  eruption  of  the 
teeth  in  different  diinates  and  under  different 
hygienic  conditions,  greatly  change  the  natural 
conditions. 

By  some,  reflex  symptoms,  especially  in  chil- 
dren, are  ignored.  By  others  the  doctrine  is 
strongly  advocated.  I  am  decidedly  in  favor 
of  the  theory  of  reflex  action  when  the  two  ner- 
vous systems  are  taken  into  consideration — the 
ganglionic  or  sympathetic,  and  the  cerebro-spinaL 
The  first  energizes  £^e  circular  fibres  of  the 
tubes,  and  the  second  energizes  the  longitudinal 
fibres  of  the  same.  Through  these,  diseased  ac- 
tion is  manifested  and  produced,  and  through 
these,  also,  are  cures  wrought  by  a  proper  selec- 
tion of  remedies,  and  a  proper  administration  of 
the  same. 

Case. — A  little  child,  aged  seventeen  monthfly 
had  been  feeling  cross  and  irritable  for  two  or 
three  days ;  appetite  poor,  coated  tongue,  slight 
feverish  condition,  all  apparently  from  slight 
cold  from  being  too  long  on  the  cold  floor. 
Craving  food  from  the  table,  she  was  given  the 
'<  least  little  bit  of  sausage,"  a  hard,  mdigeetible 
substance,  at  breakfast.  That  afternoon  she 
was  taken,  at  about  four  o*clock,  with  a  slight 
spasm.  At  seven  o'clock  she  had  another.  I 
was  sent  for,  but,  being  absent,  I  did  not  arrive 
there  until  eight  o'clock.  She  was  then  in  a 
sleep,  but  fever  was  raging.  I  ordered  aconi- 
tine  and  hyoscyamine,  two  granules  of  each,  fo 
be  dissolv^  in  six  teaspoonfuls  of  water,  one 
teaspoonful  to  be  given  every  half  hour  until 
defervescence.  At  nine  and  a  half  o'clock  I  left» 
with  directions  to  continue  the  medicines  from 
one-half  to  one  hour  apart,  until  fever  had 
abated.  I  also  left  with  them  three  powdera, 
each  containing  ^  gr.  calomel  and  1  gr.  of  soda 
bicarb.,  well  triturated  together,  one  of  which 
was  to  be  given  every  two  hours,  and  to  assist 
in  the  movement  of  the  bowels  an  enema  of 
warm  water  was  ordered.  When  I  arrived 
next  morning  instructions  had  all  been  followed 
out,  and,  with  the  exception  of  a  slight  tremor 
at  midnight  or  near  one  o'clock,  nothing  unto- 
ward had  happened.  On  my  arrival  there  on 
the  following  morning  convalescence  had  set  in, 
fever  greatly  lessened,  a  brighter  general  appear- 
ance m^ifested.  Bowels  had  moved  from  the 
calomel,  aided  by  the  warm  water  into  the 
bowels. 

Certain  symptoms  call  for  certain  medicinesy 
and  this  being  understood,  we  make  our  selec- 
tion accordingly.  The  original  trouble  with 
this  child  being  anemia  from  faulty  nutrition, 
we  now  directed  our  remedies  to  this  condition. 
We  have  treated  other  children  of  this  family. 
They  all  exhibit  the  same  characteristics — ^large 


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207 


bonee,  large  eyes,  pale  skin,  light  hair,  large 
belly.  These  are  of  a  hydrocephalic  nature  or 
tendency,  and  they  require  carbonate  of  lime, 
carbonate  of  magnesia,  and  also  the  phosphates 
of  the  same,  as  the  state  of  their  secretions  are 
generally  acid,  especially  until  the  glandular 
system  has  become  more  fully  developed.  After 
two  or  three  years  of  age  the  medicines  oftener 
required  are  the  potassiuku  and  sodium  salts. 
For  instance;  the  potassium  sulphate  stands  in 
relation  now  to  the  epithelia  and  the  epiderm  is 
— eruptions  with  sticky  exudations.  Sodium 
sulphate  is  a  remedy  for  the  chronic  state — the 
diseases  of  the  lymphatic  system  ;  it  acts  on  the 
renal  and  hepatic  cells.  Symptoms,  tension  in 
the  right  hy  pochondrium,  diarrhea,  thin,  whitish, 
liquid  stools,  much  flatulence,  tongue  coated 
yellow.  W.  C,  Buckley,  M.D., 

723  Berks  street, 
Philadelphia,  Pa. 


Alkaloldal  Granules.— Sulpho-Carbolate  of  Zinc 
in  Typhoid  Fever. 

Editor  Medical  World  : — For  some  time 
I  have  kept  a  small  supply  of  alkaloidal  gran- 
ules on  my  o£5ce  shelves,  waiting  for  a  favora- 
ble opportunity  to  try  them  tn  some  acute,  pain- 
ful case,  but  had  used  none  except  as  tonics 
until  a  few  days  ago  I  was  called  to  the  country 
to  see'a  lady  who  presented  about  the  following 
train  of  symptoms :  A  multipara,  in  the  seventh 
month  of  her  twelfth  pregnancy,  was  taken  sick 
during  the  morning  hours  with  a  severe  pain  in 
the  back,  extending  into  the  hypogastric  and 
pelvic  regions.  She  had  no  elevation  of  tem- 
perature, and  from  all  I  could  learn  about  the 
case  I  readily  pronounced  it  a  case  of  threatened 
miscarriage.  She  told  me  that  she  had  already 
taken  two  small  doses  of  morphine  before  I  ar- 
rived, and  she  was  then  suffering  from  nausea 
and  vomiting,  and  also  complained  of  smother- 
ing and  palpitation  of  tlie  heart  I  concluded 
to  give  her,  at  one  dose,  two  granules  of  digita- 
lin,  to  correct  the  action  of  the  heart  and  relieve 
the  dyspnea,  and  two  granules  of  atropine,gr.  ^^ , 
to  antagonize  the  action  of  the  morphine  on  the 
cerebrum,  and  two  granules  each  of  macrotin,  ^ 
gr.,  and  cannabine  tannate,  ^  gr.,  to  relieve 
Uie  lumbar  and  pelvic  pain,  making  in  all  eight 
granules.  I  put  them  all  in  a  teaspoon,  with  a 
little  water,  and  gave  them  to  her,  which  she 
readily  swallowed  without  complaining  of  any 
disagreeable  taste.  I  waited  one  hour,  and  at 
that  time  she  said,  that  her  head  felt  a  great 
deal  better,  and  the  palpitation  of  the  heart  had 
dkappeared,  and  that  she  was  suffering  very 
little  pain.  I  then  gave  her  one  granule  each 
ef  macrotin  and  cannabin  tannate,  and  in  ten 


minutes  she  was  asleep.  I  then  left  ten  or  twelve 
granules  each  of  macrotin  and  cannabin  tan- 
nate, and  told  her  husband  if  she  complained 
any  more  to  give  her  one  of  each  every  half 
hour  until  easy,  and  then  two  of  each  every 
three  hours.  I  saw  her  husband  the  next  day, 
and  he  told  me  that  she  rested  well  all  night, 
and  had  not  required  any  more  medicine,  and 
felt  as  well  as  ever  that  day.  I  was  never  bet- 
ter pleased  with  the  effect  of  any  medicine— ^not 
even  the  hyperdomatic  injection  of  morphine 
and  atrop'me,  for  acute  painful  maladies.  Since 
the  above  occurrence  I  have  used  them  in  many 
cases,  and  always  with  satisfactory  results.  It 
is  certainly  more  scientific  to  use  the  alkaloids 
than  the  crude  drugs,  with  all  their  component 
parts.  But  I  believe  they,  as  Professor  Waugh 
says,  require  a  more  careful  aim ;  but  there  is 
much  more  certainty  of  hitting  the  mark.  I 
have  just  recently  dismissed  two  cases  of  typhoid 
fever  treated  with  adnc  sulpho-carbolate  through- 
out the  course  of  the  disease,  and  from  its  use 
in  these  two  cases,  and  the  use  of  other  antizy- 
motics  in  other  cases  of  typhoid  fever,  I  am  pre^ 
pared  to  say  that  I  am  more  than  pleased  with 
their  effects  in  this  disease.  They  certainly 
mitigate  the  symptoms  of  the  disease,  and  it  runs 
a  much  milder  course  throughout  than  those 
cases  in  which  they  are  not  used. 

I  have  used  iodine  and  carbolic  add,  giving 
two  minims  of  tine,  iodine  and  one  of  carbolic 
acid,  in  a  little  water,  immediately  after  taking 
some  milk  to  protect  the  mucous  membrane  of 
the  stomach.  I  gave  it  every  two  or  three 
hours.  I  had  the  satisfaction  of  seeing  a  great 
reduction  in  the  temperature  and  number  of 
stools  per  diem ;  also  an  amelioration  of  all  other 
symptoms  present  But  after  using  sulpho-car- 
bolate of  zinc  and  iodine  and  carbolic  acid,  I 
greatly  prefer  the  former,  as  I  have  never  had 
any  bad  results  from  the  zinc  preparation,  which 
is  more  than  I  can  say  for  the  carbolic  acid  and 
iodine,  as  one  patient  I  had  vomited  every  time 
it  was  given  him,  and  complained  of  a  burning 
sensation  in  the  stomach,  and  vomited  some 
blood.  It  was  discontinued,  and  the  zinc  sul- 
pho-carbolate substituted  without  any  further 
vomiting.  I  cannot  say  that  I  have  ever  seen 
any  bad  effects  from  the  sulpho-carbolate  of  zinc, 
unless  it  is  a  factor  in  producing  a  subnormal 
temperature  in  the  third  stage  of  typhoid  fever. 
I  have  had  a  subnormal  temperature  in  three 
cases  of  late,  but  the  most  marked  one  was  a 
case  in  which  no  antiseptic  had  been  given.  The 
temperature  suddenly  dropped  from  1024®  F. 
to  93|°  on  the  evening  of  the  twenty-first  day. 
He  had  profuse  sweats  and  coldness  of  extremi- 
ties, with  a  weak,  very  oompresrible  pulse  of 
40.    Under  the  use  of  large  amounts  of  whiske7 


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208 


THE  MEDICAL  WORLD. 


and  external  warmth,  with  the  regular  adminis- 
tration of  liquid  nourishment,  his  temperature 
reached  the  normal  in  six  days.  Then  he  had 
a  slight  elevation  of  temperature  for  a  day  or 
two,  then  became  normal  again,  and  remained 
80.  The  above  symptoms  occurred  in  a  young 
man  eighteen  years  of  age.  He  took  from  two 
to  three  ounces  of  whisky  every  two  hours  dur- 
ing the  subnormal  temperature  period,  without 
ever  feeling  any  symptoms  of  intoxication. 

I  knew  of  no  other  way  of  elevating  the  tem- 
perature of  the  body  than  careful  stimulation, 
with  plenty  of  nourishment  of  proper  quantity 
and  quality,  and  external  warmth. 


Dixon,  Ky. 


C.  M.  Smith,  M.D., 


Dosimetric  Chips. 

CLINICAL   REPORTS. 


Editor  Medical  World: — I  have  had 
a  series  of  cases  the  past  week  that  have  been  of 
great  interest  to  me,  accustomed  as  I  am  to  such 
experiences,  as  illustrating  the  remarkable  effi- 
cacy of  the  active  principles  in  aborting  or  mat- 
erially modifying  disease. 

1st  A  lady  of  twenty- five  with  tonsilitis,  had 
been  sick  twenty  four  hours,  is  subject  to  such 
attacks  which  usually  last  one  or  two  weeks, 
fever  104,  throat  badly  swollen,  deglutition 
very  painful.  Gave  aconitine  amor.,  gr.  1-134 
and  calcium  sulphide  gr.  ^  every  half  hour. 
This  was  kept  up  during  the  afternoon  and 
when  awake  at  night,  gargling  meanwhile  with 
a  solution  made  by  dissolving  three  *'  Seiler's 
tablets"  in  a  cup  of  hot  water.  The  next 
morning  she  was  better,  had  less  fever  and  the 
swelling  of  the  throat  was  materially  modified. 
Treatment  continued.  The  third  day  fever 
was  nearly  gone  and  a  granule  of  the  "  dosi- 
metric trinity"  wag  given  every  two 
hours  along  with  one  of  calcium  sulphide.  The 
•following  day,  fever  and  swelling  having  en- 
tirely disappeared,  a  granule,  gr.  ^,  of  potas- 
sium bichromate  was  ordered  every  two  hours, 
with  three  of  strychnine  arseniate  to  be  taken 
before  meals  and  the  case  dismissed. 

2d.  A  man  in  the  same  family,  high  fever 
with  headache,  temperature  103,  bowels  loose, 
tongue  clean.  Treatment,  aconitine  amor.,  gr. 
1-134  every  half  hour  when  awake.  Next  day 
better,  less  fever  and  less  pain;  '* dosimetric 
trinity"  in  hourly  doses.  The  follow- 
ing day,  temperature  being  normal,  the  case 
was  dismissed.  No  diagnosis,  as  no  organic 
lesion  had  taken  place. 

3d.  Little  girl  aged  3  years,  was  brought  to 
my  office  with  spotted  tongue,  fever  and  malaise. 


I  gave  a  teaspoonful  of  seidlitz  salt  and  one 
granule  of  aconitine  amor.  1-134,  to  be  dissolved, 
at  home,  in  a  glass  half  full  of  sweetened  water, 
the  whole  to  be  taken  at  intervals  during  the 
afternoon.  Visiting  the  child  the  next  day,  I 
found  less  fever  and  a  better  looking  tongue. 
Four  granules  of  aconitine  and  half  a  grain  of 
calomel  were  now  dissolved  in  twenty-four  tea- 
spoonfuls  of  sweetened  water  to  be  given  in  tea- 
spoonful  doses  hourly,  every  half  hour  if  fever 
should  increase,  with  a  teaspoonful  of  seidlitz  salt 
for  the  following  morning.  The  next  day,  I  found 
my  little  patient  broken  out  all  over  with  a  raah 
resembling  measles.  As  I  had  adready  treated 
this  child  in  measles  and  scarlet  fever,  I  could 
assure  the  anxious  parents  that  it  was  an  erup- 
tion from  stomach  derangement  which  would 
likely  disappear  in  twenty-four  hours.  No  change 
was  made  in  the  treatment  and  the  next  day  all 
signs  of  illness  had  passed  away  and  my  little 
patient  was  dismissed  with  a  few  granules  of 
quinine  arseniate,  gr.  ^,  one  to  be  taken  every 
four  hours.  I  wish  to  emphasize  the  use  of  thu 
drug  as  a  tonic  reconstructive,  especially  for  our 
little  friends. 

4th.  A  boy  of  eight  was  seen  at  noon,  delir- 
ious, a  splitting  heacjache  and  temperature  105. 
A  large  dose  of  castoria  had  been  given  shortly 
before  I  was  called.  I  gave  aconitine  amor.,  gr. 
1-500,  one  granule  every  fifteen  minute^  for 
six  times  and  then  every  half  hour.  At  my 
evening  visit,  his  temperature  was  101  and  he 
announced  that  "  he  was  well."  The  treatment 
was  suspended  at  ten,  and  he  slept  well  during 
the  night  but  awoke  with  a  high  fever  again  in 
the  morning.  I  now  gave  the  "  defervescent 
compound"  No.  2  (aconitine  amor.,  gr,  1-500, 
digitalin,  gr.  1-250  and  veratrine,  gr.  1-500) 
with  the  same  directions  as  given  before  and 
ordered  a  seidlitz  powder.  The  family  reported 
that  he  "  threw  up  the  seidlitz  powder "  so  I 
gave  him  the  seidlitz  salt  which  he  took  nioelj. 
At  night  his  temperature  was  again  down,  even 
lower  than  before.  The  treatment  was  kept  up 
until  midnight,  six  granules  of  calomel,  gr.  \ 
each,  being  given  with  the  evening  medicine. 
The  seidlitz  salt  was  given  the  following  morn- 
ing and  the  defervescent  granule  continued  in 
hourly  doses.  There  being  no  fever  during 
the  day,  the  case  was  dbmissed.  No  diagnosis 
was  made  as,  thanks  to  prompt  and  efficient 
treatment,  no  organic  lesion  took  place. 

When  physicians  come  to  realize  how  much 
sickness  can  be  saved  by  the  abortive  treatment 
of  acute  diseases,  they  will  teach  their  patrons 
to  call  them  early  and  then  we  will  be  miniaters 
to  nature  indeed. 

In  cases  like  the  above,  never  omit  to  impress 


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THE  MEDICAL  WORLD, 


209 


upon  the  family  the  fact  that  you  have  prob- 
ably saved  them  from  a  long,  serious  and  ex- 
pensive illness,  and  that  you  could  have  done 
even  better  had  they  called  you  earlier.  The 
public  is  not  slow  to  see  the  point  when  bodily 
ease  and  dollars  and  cents  are  concerned. 

W.  C.  Abbott,  M.D., 
2666  Commercial  St,  Chicago,  111. 


On  the  Treatment  of  Cholera. 

Editor  Medical  World  : — There  are  three 
methods  of  treatment,  all  of  which  are  partly 
successful : 

1st.  Antiseptic  treatment 

2d.   Sulphuric  acid  treatment. . 

3d.  Rectal  injection  and  peroxide-of-hydro- 
gen  internally. 

The  first  treatment  may  be  administered  in 
the  following  manner : 

R.  Phenaoetlne , ins.xy 

Acid  salicyl « gre.  xiv 

Add  carbdl drs-ss 

Em.  month,  pip ni.z 

Aqa»  deetil ozs.IJ 

M .  TeftBi>o)iiAil  in  watei  until  symptoms  abate. 

2d,  or  sulphuric  acid  treatment,  is  adminis- 
tered as  a  prophylaxis  in  an  epidemic  and  at 
the  first  appearance  of  symptoms,  alternately 
with  antiseptic  treatment 

&.  DiL  acid  salphurlc gtt.  ziy 

Aqua  destil oz.  Ti 

ChloTofonn gtt.  x 

Laudanum gtt.  v 

3d.  The  treatment  of  cholera  by  cleaning  out 
the  colon  and  lower  intestines  has  met  with  great 
approval. 

The  method  is  to  give  the  patient  a  rectal  in- 
jection of  luke-warm  water  and  tannic  acid. 
This  injection  must  be  given  in  a  manner  so  that 
the  intestines  will  be  washed.  Meanwhile,  the 
patient  is  to  take  internally  the  following : 

E.  Hydrogen  peroxide oz.  Ij 

Soda  bicarb gr.  zxy 

Aque  destil       oz.  iy. 

M.   TeeApoonflil  eyery  hour. 

The  author  hopes  we  shall  soon  come  to  a 
time  when,  by  public  prophylaxis  and  energetic 
enforcement  of  medical  law,  cholera  will  be 
effaced.  Fred.  M.  Werner,  M.D., 

26  East  8l8t  St,  New  York,  N.  Y. 
i^^ 

Editor  Medical  World:— The  Medical  World 
binden  to  hand  and  yolumes  bound.  Thanks.  Be- 
sides making  a  handsome  addition  to  the  library, 
tbej  make  it  so  convenient  when  referring  to  the 
joonals.  I  wonld  not  be  without  them  now  tor  many 
times  their  cost.  W.  J.  Cooper,  M.D. 

Crockett,  Miss. 


Inhaling  Acetic  Aold  for  Respiratory  Inflamma- 
tions. 

Editor  Medical  World  : — A  patient  took 
cold  Saturday  night,  was  badly  stopped  up, 
showing  all  kinds  of  rales  and  whistles.  Bi- 
chromate \of  potash  relieved  finally  causing 
vomiting  at  2  a.  m.  After  that  the  patient 
went  to  sleep  and  slept  the  balance  of  the  night. 
Previous  to  this  time  he  had  been  obliged  to  sit 
up  in  bed  a  part  of  the  time  in  order  to  get 
breath.  Sunday  he  commenced  inhaling  acetic 
acid.  Dyspnea,  whistling,  etc ,  by  night  was  re- 
lieved, so  that  he  went  to  bed  and  slept  well. 
He  continues  the  inhalations^  The  patient  will 
continue  the  use  of  it  for  some  time,  and  I  will 
report  later.  It  certainly  has  accomplished 
wonderful  results  in  the  short  time  it  has  been 
used. 

The  natient  has  been  subject  to  these  spells 
after  taking  cold  in  warm  weather  for  some 
years,  and  never  found  anything  to  give  such 
quick  and  marked  relief. 

S.  J.  Smith,  M.D., 

Filley,  Neb. 

Goitre  and  Calculi  Prevalent  In  Alkaline  Regions. 

Editor  Medical  World  : — I  was  peculiarly 
impressed  with  Dr.  W.  S.  Newlon's  article, 
on  page  132,  April  World,  in  reference 
the  frequent  "cases  of  goitre  occuring  on 
the  white  soils  of  Kansas."  I  find  that 
this  is  my  experience.  Formerly,  in  Illinois, 
we  would  not  have  a  case  of  goitre  to  treat,  per- 
haps,  in  many  years'  practice.  I  have  been  in 
Western  Kansas  since  1885,  and  find  these 
cases  quite  numerous,  more  especially  among 
the  older  settlers,  and  more  common  among  the 
middle-aged  females.  I  am  now  treating  four 
cases  of  goitre — two  more  than  I  had  treated  in 
ten  years  preceding  the  time  I  came  to  Kansas. 

I  also  find  more  numerous  cases  of  renal  and 
biliary  calculi.  I  never  saw  but  one  case  of 
biliary  calculi  before  I  came  to  this  country ; 
but  here  it  is  quite  common,  and  I  notice  a  rapid 
increase  in  this  class  of  cases. 

The  question  is,  what  causes  so  many  of  this 
class  of  cases  ?  I  am  unable  to  comprehend, 
unless  it  is  the  vast  quantity  of  magnesia  water 
consumed.  There  is  scarcely  any  water  in  this 
country  but  that  is  more  or  less  impregnated 
with  magnesia.  This  country  is  well  supplied 
with  the  finest  quality  of  building-stone,  princi- 
pally magnesia.  In  many  places  die  water  flow- 
ing through  this  material  is  rendered  unfit  for 
use.  I  have  seen  it  in  many  places  so  impreg- 
nated with  magnesia  that  you  could  not  drink 
it  or  wash  your  hands  with  it,  even  if  you  would 
use  the  best  soap  extant.     I  have  long  since 


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come  to  the  condufiion  that  this  conditioD  of  the 
water  produces  calcareous  deposits  in  the  system. 
And  now  I  come  to  The  World  family  for 
proper  remedies  to  eradicate  or  prevent  these 
deposits. 

Brethren,  do  not  advifee  us  to  migrate — we 
can't  do  this.  What !  leave  this  country!  This 
fine  climate,  good  roadp,  improved  and  improv- 
ing country!  Oh,  no,  Doctor !  Please  give  us 
the  theiapeutical  remedies,  and  let  us  remain 
here.  J.  N.  Page,  M.D., 

Ellis,  Kan. 


"^  Replies. 

Editor  Medical  World; — To  Dr.  More, 
April  Ko.,  page  135,  I  would  suggest  that  the 
trouble  with  his  patient  may  be  due  to  chronic 
malaria,  which  impresses  the  nervous  ^system 
profoundly,  and  induces  periodical  spells  of 
neuralgia.  This  patient's  condition  may  be  ag- 
gravated by  reflexes,  from  a  constricted  sphinc- 
ter ani,  an  elongated,  tight,  or  adherent  pre- 
puce. Examine  for  these,  and  remove  any 
such  condition  if  found.  Examine  urine  also, 
for  uric  acid.  If  found  in  excess,  treat  accord- 
ingly, as  recommended  in  former  numbers  of 
The  World.  If  any  such  abnormal  conditions 
are  not  found,  then  rely  for  treatment  on  altera- 
tives containing  iodine,  such  as  iodide  of  potash, 
syrup  of  iodide  of  iron,  or  hydriodic  acid. 
Granules  containing  strychnine  arseniate,  gr. 
y^,  two  every  three  or  four  hours,  are  often 
useful  in  such  cases,  and  don't  interfere  with 
iodine  treatment  Examine  for  enlarged  spleen, 
and  a  possible  sensitive  spot  over  the  spine  in 
the  dorsal  or  lumbar  region.  If  such  spot  is 
found,  draw  several  minute  blisters  over  its  seat. 
Don't  draw  blisters  larger  than  half  an  inch  in 
diameter,  and  separate  half  an  inch  apart,  in 
perpendicular  relation  along  the  spine. 

I  would  say  to  "  Practitioner,"  page  1 35  ; — 
For  a  case  like  his— of  rectal  prolapsus — I  have 
found  nothing  equal,  as  a  palliative,  to  Prof. 
Waugh's  treatment  with  dosimetric  granules 
of  strychnine,  piperine  and  podophyllin,  viz. : 
dissolve  20  granules  of  strychnine  sulph,  gr.-p^, 
20  granules  of  piperine,  gr.  ^,  3  granules  of  po- 
dophyllin, gr.  ^.  in  water  1  ounce.  Dose,  half 
teaspoonful  before  meals.  This  appears  to  be 
curative  in  prolapsus  of  young  children,  and  for 
adults,  if  persevered  in,  a  great  relief. 

W.  C.  Derby,  M.D., 

White  Cloud,  Mich. 


A  PHYSICIAN  writes :  "Times  have  been  hard  with 
me,  and  I  have  tried  to  do  without  Thb  Mkdioal 
WoBLD,  but  I  find  it  a  necessity." 


Quinine  and  Hemorrhage. 
Editor  Medical  World  : — In  response  to 
the  question,    "  Does   Quinine  Cause  Hejpor- 
rhage  ? "   I  wish  to  state  the  following :     In  the 
Spring  of  1892,   sufiering  from  slight  disturb- 
ances of  health,  I  took  about  15  grs  of  quinine 
at  bed-time.     I  was  awakened  in  the  night  by 
agonizing   pains  in  hypogastrium,  whi  h  I  at 
first  mistook  for  disturbances  of  the    bowels. 
However,  the  bowels  did  not  move  but  there 
was  a  discharge  of  quite  a  quantity  of  blood 
from  the  vagina  or  uterus.    The  pain  was  finally 
controlled  by  ^  gr.  moiphine.     I  was  greatly 
prostrated  for  a  couple  of  days  afterwards.     I 
was  at  a  loss  to  account  for  i^  as  I  had  taken 
equally  large  doses  of  quinine  the  previous  fall 
and  as  I  had  used   some  H9  CI2  as  a  nafal  ap- 
plication I   thought  that  might  have  been,  by 
absorption,  the  cause  of  it,  as  I  was  also  in  some 
doubt  then  that  the  hemorrhage  had  proceded 
solely  from  the  WQmb.     So  I  was  beguiled  into 
taking  another   like  dose  some  weeks  after- 
wards with  similaf  results,  this  time  leaving  no 
doubt  as  to  cause  and  effect  even  that  the  uterus 
was  alone  concerned  in  the  hemorrhage.    There 
were,  though,  loose  boweis  the  next  morning, 
and  it  and  the  prostration  continued  longer  than 
the  first  time.      We  blamed  now   the   special 
bottle  of  quinine  for  the  e£Pects,  all  the  more  as 
my  husband,  who  took  a  small  dose  on  trial, 
did  not  escape  abdominal  pains.     Some  months 
later,  having  tried  in  vain  to  break  up  an  at- 
tack of  malaria  by  quinine  arseinate,  1  took  5 
grs.  ef  quinine  from  a  different  bottle  with  the 
effect  of  producing  leuoorrhea  without  pains.  In 
the  summer  of    1893,   I  had  taken  repeated 
doses  of  quinine  of  the  same  size  (16  grs  )  with- 
out any  such   result.     So,  if  quinine  does  pro- 
duce hemorrhage,  what  condition  of  the  organ- 
ism makes  such  action  possible  ?    Menstruation 
had  nothing  to  do  with  these  hemorrhages,  it 
was  not  even  interrupted  in  its  regularity. 
Emmett,  Idaho.    G.  H.  McGahey,  M.D., 

Quinine  Versus  Ergot  in  Obstetrics. 

Editor  Medical  World  : — I  wish  to  make 
a  few  comments  on  the  first  case  in  the  article 
in  the  May  number  of  your  journal  written  by 
Dr.  J.  A.  Huntsman,  of  Austin,  Nevada, 

"Found  patient  flowing  rapidly  and  had 
been  for  over  an  hour.  Had  no  pains ;  "was 
much  prostrated.''  He  gave  ergot  (doesn't  say 
how  much),  and  repeated  in  half  hour,  causing 
vomiting.    Then  gave  ergotine  hypodermically. 

In  eight  hours  after  he  was  called  the  woman 
was  delivered  of  a  dead  child. 

"  Question  :  Did  the  child  die  frem  the 
hemorrhage  or  had  the  ergot  something  to  do 
with  its  death." 


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Now  in  my  mind,  ergot  is  as  potent  a  factor 
in  producing  still  bom  babes  as  hemorrhage. 
Don't  understand  me  to  say,  Dr.  Huntsman,  ^ 
that  the  ergot  killed  this  child,  for  it  might 
have  been  still  bom  had  you  used  quinine  in- 
stead of  ergot,  but  I  would  have  used  the 
former  instead  of  the  latter — my  preceptors 
advice  to  the  contrary  notwithstanding. 

1  will  give  my  experience  with  my  first  still 
bom  babe.  About  eight  years  ago,  shortly 
after  I  commenced  practising,  I  was  called  to  a 
primipara.  I  found  a  midwife  in  attendance. 
She  told  me  the  woman  had  been  in  hard  labor 
for  about  forty-eigbt  hours  until  about  three 
hours  previous  to  my  arrival,  when  all  pains 
ceased.  I  examined  her  and  found  considerable 
progress  in  labor,  membranes  ruptured,  with 
complete  uterine  inertia  from  exhaustion,  a  re- 
sult, I  thought,  of  the  forty-eight  hours  of  hard 
pains,  for  she  had  previously  been  in  robust 
health.  As  this  was  my  first  case  of  this  charac- 
ter I  thought  I  had  a  ''  white  elephant  *'  on  my 
hands.  I  had  had  several  obstetric  cases  be- 
fore this,  but  none  in  which  a  special  uterine 
tx>iiic  was  indicated.  I  will  say  just  here  that  I 
never  use  a  uterine  tonic  unless  I  think  it  is 
needed. 

I  saw  in  this  case  that  something  had  to  be 
done  and  that  at  once.  I  proceeded  to  act  upon 
the  advice  of  my  preceptor  and  contrary  to  that 
of  Prof.  Lewis,  of  Tulane,  hence,  I  gave  her  * 
about  40  minims  fl.  ext  ergot  It  certainly 
had  the  desired  effect,  for  in  due  time  the  pains 
commenced,  feeble  at  first  but  continuing  to  in- 
crease in  severity  for  about  an  hour,  when  a 
well  developed,  dead  male  child  was  delivered. 

The  patient  and  the  other  woman  present 
eeemed  well  satisfied  with  the  result,  but  I  was 
not.  I  decided  then  to  abandon  the  use  of 
ergot  and  try  quinine  in  such  cases.  I  did  so 
and  it  rarely  ever  fails  to  have  the  desired 
effect  If  I  am  called  to  a  case  and  the  pains 
are  weak,  the  head  pressing  down  and  the  os  in 
a  di'atable  condition,  I  proceed  at  once  to  give 
10  to  15  grains  of  quinine,  r^ulating  the  size 
of  the  dose  to  suit  the  case,  never  giving  less 
than  10  grains.  I  rarely  ever  have  to  repeat 
the  dose,  this  one  usually  having  the  desired 
efiect  in  twenty-five  or  thirty  minutes.  How- 
ever, if  the  pains  are  not  strong  enough  in  fifty 
or  sixty  minutes  I  repeat  with  a  smaller  dose — 
about  seven  or  eight  grains. 

Swan,  Tex.  A.  R  Swann,  M.D., 


As  two  of  the  pregnancies  were  twin  pregnan- 
cies, there  were  102  children  bora. 

The  average  duration  of  "labor"  after  I 
ruptured  the  membranes  and  inserted  the  tube, 
which  I  always  do  as  soon  as  the  os  is  dilated 
to  two  inches,  was  an  hour  and  a  half.  Several 
of  the  cases  were  completed  within  twenty  min- 
utes after  the  insertion  of  the  tube,  while  one 
was  prolonged  for  five  hours.  The  latter  was  a 
fleshy  primipara,  and  her  child's  head  measured 
14}  inches  in  circumference  when  bort. 

There  were  three  brtech  cases,  two  face  cases, 
one  occipito-sacral  presentation,  and  ninety- six 
occipito-anterior  presentations. 

I  employed  the  forceps  in  the  occipito  sacral 
case,  and  in  one  of  the  face  cases  and  in  three 
of  the  occipito-anterior  cases.  The  atmospheric 
tractor  was  employed  in  fourteen  cases. 

The  uterine  safety  tube,  as  previously  stated 
was  employed  in  all. 

There  were  no  still  births,  no  maternal 
deaths,  nor  any  accident  in  any  of  the  "  labors." 

Six  of  the  children  died  at  various  ages  be- 
tween three  and  six  months  from  infantile  com- 
plaints. The  remaining  ninety-six  are  alive, 
healthy  and  bright.  There  were  no  cases  of 
ophthalmia,  and  the  hearing  of  many  of  them  is 
unusually  acute.  Three  of  them  in  particular 
noticed  every  loud  sound  before  the  third  week 
of  age. 

There  was  no  case  of  pastpartum  hemor- 
rhage, sub-involution  or  convulsion  among  the 
mothers.  The  recovery  of  all  was  rapid  and 
free  from  unpleasant  complications,  with  the 
exception  of  one  patient  who  manifested  the 
usual  symptoms  of  typhoid  fever  several  days 
before  delivery,  and  who  subsequently  devel- 
oped a  typical  case  of  that  disease,  from  which 
she,  however,  completely  recovered. 

Many  of  the  mothers  were  up  and  around  on 
the  fourth  day,  and  one  went  to  the  front  door 
before  the  baby  was  twenfy-four  hours  old  to 
stop  her  husband  from  quarreling  with  a  neigh- 
bor. No  vaginal  or  uterine  douches  were  used 
or  needed  at  any  time. 

The  residual  liquor  amnii  withdrawn  by  the 
safety  tube  varied  in  quantity  from  half  a  cup 
to  over  two  quarts.  P.  McCahey,  M.D., 

1413  South  Tenth  st,  Philadelphia. 


The  Uterine  Safety  Tube  in  One  Hundred  Ob- 
stetric Cases. 

Editor  Medical  World  : — During  the  past 
thirty  months  I  have  employed  the  uterine 
safety  tube  in  one  hundred  cases  of  *^  labor." 


Abortion.— Replies. 

Editor  Medical  World: — Please  permit 
me  a  little  space  in  your  valuable  journal  for 
the  purpose  of  asking  the  many  brethren  about 
a  certain  case.     On  March  1st  I  was  summoned 

in  haste  to  see  Mrs. ,  of  our  city.     On 

arriving  the  husband  informed  me  that  his  wife 
was  flooding  profusely.  Examination  revealed 
that  the  os  uteri  was  dilated  to  the  size  of  a 


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silver  quarter.  I  at  once  proceeded  to  tampoon 
and  gave  the  patient  proper  medicatioDs,  such 
as  was  indicated  in  her  case,  but  in  spite  of  me 
labor  proceeded  and  the  fetus  was  expelled  in 
two  hours  after  my  arrival.  I  questioned  the 
patient  and  compelled  her  to  tell  me  how  she 
came  to  the  accident,  as  §he  called  it.  I  told 
her  that  I  must  know  the  truth,  otherwise  she 
would  be  lia^ble  to  go  overboard,  and  she  came 
right  out  with  the  story  and  said : 

"  Doctor,  I  did  not  want  any  more  children, 
and  my  neighbor  lady  told  me  that  I  should 
take  three  tablespoonsful  of  date  seeds  and  make 
tea  from  them,  about  three  cupsful,  and  drink 
one  cupful  every  half  hour,  which  I  did,  and  in 
two  hours  after  taking  the  first  cup  of  tea  the 
hemorrhage  began."  Now  the  question  arises, 
did  the  date  seeds  produce  the  abortion  or  not  ? 
I  would  like  to  hear  from  the  many  readers. 

In  reply  to  Dr.  Mthring's  request  I  would 
say,  please  read  The  World  of  1890,  page 
450  and  you  will  be  pleased  to  find  a  way  in 
which  to  remove  the  carcinoma  without  the  use 
of  the  knife.  I  have  tried  the  treatment  and 
found  it  successful. 

If  Dr.  Usher,  of  Sicily  Island,  La.,  will  give 
his  patient  20  pieces  of  the  following  mixture 
about  the  size  of  No.  1  capsule,  he  will  have 
his  patient  cured : 

R.    Oil  copaiba ounce  vj 

Pow'd  mAgnesIa  carb.  a.  b.  to  mske  paste. 
Add      Pow'd  cubebs  ounce  j,  (or  more  if  desired).  • 

Pow'd  ODium ^.  vii 

Dried  sulpii.  Iron gr.  C. 

5f .  Slg.  One  piece  as  abive  described  Stimejj  daily  after 
meals  and  b.for^  going  to  bed 

The  above  was  published  by  Dr.   Hyatt  in 
The  Medical  World  some  time  ago. 
La  Crosse,  Wis.  I.  W.  Cohen,  M.D., 

^  

Hernia.—Remarks. 

Editor  Medical  World  : — Doctor,  did  you 
ever  try  to  reduce  a  hernia  that  had  suddenly 
stolen  a  march  on  the  patient  while  he  was  not 
on  the  alert,  and  found  it  a  tedious  process  ? 
The  next  case  you  get  try  ether.  Place  the 
patient  in  a  recumbent  position  and  then  allow 
the  ether  to  trickle  down  over  the  hernia  slowly, 
at  the  same  time  make  gentle  taxis,  and  you 
will  find  yourself  and  patient  pleased.  The 
ether  acts  by  relaxing  tension  and  the  majority 
of  cases  will  yield  to  this. 

I  am  pleased  to  read  Dr.  Waugh's  state- 
ment, that  he  believes  in  constant  spraying  with 
peroxide  in  diphtheria.  I  was  attending  two 
cases  here,  when  another  doctor  was  called  in 
consultation  and  condemned  the  use  of  the  at- 
omizer, saying  he  did  not  care  about  the  forma- 
tion of  the  membrane,  but  that  it  was  a  consti- 
tutional disease,  and  that  he  could  reach  the 
germs  by  internal  treatment     The  parents  were 


ignorant  enough  to  believe  him,  and  took  his 
treatment  and  he  actually  stole  my  patients  with- 
out professional  courtesy.  The  cases  recovered, 
as  they  were  not  serious,  and  he  got  the  credit. 

Now,  I  think  I  am  correct  and  justifiable 
when  I  refuse  to  consult  with  a  doctor  who  acted 
as  he  did.     I  know  my  treatment  was  right 

I  would  like  to  ask  Dr.  Waugh  through  the 
columns  of  The  World  the  best  treatment  for 
congenital  hydrocele,  whether  to  use  local  ap- 
plications to  cause  absorption  or  to  evacuate. 
Also,  if  he  thinks  chronic  alcoholism  can  be 
cured  by  internal  treatment  without  hypodermic 
injections.  I  have  a  patient  under  treatment 
who  does  not  wish  me  to  use  the  hypodermic 
medication  if  I  cannot  efiect  a  cure  otherwise. 
He  seems  to  be  doing  well  thus  far. 

I  will  ^  ive  my  way  of  removing  wens.  I 
make  a  free  opening,  evacuate  the  contents  and 
then,  with  a  cotton-covered  probe,  dipped  in  a 
solution  of  equal  parts  of  camphor,  carbolic  acid, 
and  chloral,  I  insert  it  into  the  sac  and  twirl  it 
around  in  every  part.  Repeat  several  times 
and  then  insert  a  piece  of  antiseptic  gauze  to 
keep  the  sac  open  and  for  drainage.  Treat 
this  way  daily  for  several  weeks  until  exudate 
ceases  or  is  healthy  and  then  allow  it  to  heal 
up.  It  must  be  kept  open  until  the  inside  is 
healthy  and  the  sac  destroyed.         Medicus. 

Malarial  Hematuria. 

Editor  Medical  World: — I  see  in  The 
World  of  April  a  request  signe«1  "Precio," 
for  an  article  on  malarial  hematuria.  Now,  I 
don't  think  that  a  physician  who  is  ashamed  to 
sign  his  n»me  to  his  request  for  assistance  de- 
serv  es  to  receive  it  Beside-  if  "  Precio"  had 
been  a  rea  '^r  of  The  World  some  years  back 
(as  he  should  have  been)  it  would  have  been 
unnecessary  for  him  to  ask  this  help,  as  the 
subject  was  fully  discussed.  But  I  have  re- 
ceived so  many  good  things  from  **the  breth- 
ren "  through  The  World,  and  having  a  kind 
feeling  for  his  patients,  J  will  try  and  help  him 
if  I  can. 

As  to  pathology,  although  I  have  treated 
thirty  four  cases,  losing  only  two,  I  do  not  feel 
competent  to  write.  Symptoms  are,  fever,  soon 
followed  by  hemorrhage,  and  in  the  majority  of 
cases  with  bronzed  skin.  Prognosis,  if  seen  in 
time  and  treated  properly,  is  no  worse  than  in 
bilious  or  malarial  fever ;  in  fact,  I  consider  it 
nothing  more  than  an  aggravated  attack  of  ma- 
larial fever. 

As  for  treatment,  there  is  quite  a  difierence 
of  opinion  as  to  the  proper  method.  Some  ad- 
vo  ate  quinine  in  large  doses,  alleging  that,  as 
quinine  is  the  antidote  above  all  others  for  ma- 
laria, it  must  be  best     But  my  experience  lith 


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quinine  has  been  bad — that  is,  with  the  sulphate 
of  quinine.  You  will  find  almost  always  in  these 
cases,  sick  stomach,  the  liver,  spleen  and  bowels 
mactive — almost  impossible  to  get  an  action 
from  bowels.  My  plan  has  been  to  give  calo- 
mel, grs.  four  (4)  every  four  hours,  until  a  bil- 
ious action  was  produced,  or  until  twelve  (12) 
grains  were  taken.  If  no  action  within  two 
hours  after  last  dose  of  calomel,  I  give  Epsom 
salts,  a  teaspoonful  every  two  hours,  until  bow- 
els act  freely.  I  give  tincture  of  aconite,  tinc- 
ture of  gelseminum,  and  tincture  of  digitalis,  to 
reduce  the  fever  and  continue  while  fever  lasts. 
At  the  same  time  I  give  fluid  extract  of  buchn, 
one  dram  and  in  two  hours,  spirits  turpentine, 
ten  (10)  drops,  with  spirits  nitre,  twenty-fiva 
(25)  drops,  alternating  these  every  two  hours, 
untU  hemorrhage  and  fever  cease,  and  then 
lengthening  the  intervals  until  only  three  dosee 
are  taken  daily  for  several  days.  Also,  I  give 
Fowler's  solution  of  arsenic  every  four  hours 
for  four  or  five  doses  (five  (5)  drops  each  dose), 
when  I  lengthen  intervals  to  three  doses  each 
day.  After  the  fever  and  hemorrhage  have 
been  stopped,  a  good  iron- arsenic  tonic  will  set 
the  patient  up  agaiii,  and  prevent  a  return.  All 
my  cases  have  been  treated  after  this  plan  ex- 
cept one,  which  I  treated  on  the  Dosimetric 
method.  This  case  I  cured,  but  don't  care  to 
take  space  to  describe  it  The  trouble  is  with 
the  liver,  spleen  and  bowels.  The  kidneys  are 
doing  their  best  to  perform  the  duty  of  all,  and 
it  not  assisted,  and  assisted  properly  and 
promptly,  being  overtaxed,  they  will  break 
down.  The  plan  or  object  is  to  restore  the  ac- 
tion of  the  liver,  and  at  the  same  time  sustain 
the  kidneys,  if  you  wish  to  save  your  patient. 
J.  D.  Usher,  M.D., 
Bicily  Island,  La. 

For  the  Somnolent  Diseate.—For  Hemorrhoids. 

Editor  Medical  World  : — I  would  recom- 
mend Dr.  B.  F.  Few,  page  135,  April  World, 
to  use  ten  drops  tr.  belladonna  to  half  a  glass 
of  water,  a  teaspoonful  every  two  hours ;  also 
salix  nigra  aments,  a  specific  tincture  put  up  by 
Uoyds  Bros.,  Cincinnati,  O.  Dose,  ten  drops 
every  two  hours,  alternating  with  the  bella- 
donna. 

If  "Practitioner,"  page  136,  will  use  the  fol- 
lowing prescription  for  piles,  he  will  be  pleased 
with  the  results : 

Clean  gun  powder,  two  ounces;  old  rye 
whisky,  one  pint ;  work  the  powder  into  a  paste 
with  a  littie  hot  water,  then  mix  with  the 
whisky ;  shake  it  well,  and  give  one  teaspoonful 
before  meals,  gradually  increasing  the  dose  to 
two  or  three  teaspoonfuls.  This  has  cured  many 
obstinate  cases  for  me. 


Lloyd  Bros,  specific  tincture  of  collinsonia^ 
gtts  X ;  water,  ounces  iv  ;  mix,  and  give  a  tea- 
spoonful of  the  dilution  four  times  a  day,  is  ex- 
cellent where  there  is  a  sense  of  constriction  in 
the  anus.  J.  G.  Wheat,  M.D., 

Inwood,  Iowa. 

Fraternal  Exchanges.—Quinine  in  Labor— Replies. 

Editor  Medical  World  : — I  was  very  much 
pleased  with  your  able  editorial,  •*  As  you  freely 
receive,  so  freely  give,"  in  April  World.  As^ 
yet  I  have  done  little,  but  from  now  on  will  da 
all  I  can  to  help  out  my  brother  practitioners. 

I  was  recendy  called  to  attend  a  woman  in 
her  fifth  confinement  She  had  been  having 
labor  pains  for  three  days  previously.  I  found 
the  OS  dilated  about  the  size  of  a  fifty  cent  piece. 
She  had  been  yawning  all  day,  and  was  doing 
so  when  I  arrived  (6  p.  m.)  As  she  was  quite 
weak,  I  gave  her  ten  grains  of  quinine  to  hasten 
labor.  The  pains  at  once  became  strong  and 
regular,  and  at  11  p.  m.  she  was  deliver^  of  a 
fine  baby  girl.  As  she  kept  continually  yawn- 
ing, I  feared  hemorrhage ;  so,  just  as  the  second 
stage  of  labor  was  being  completed,  I  gave  her 
^  gr.  sulph.  atropine  (hypodermatically)  to 
prevent  it.  There  was  no  hemorrhage  to  speak 
of,  and  she  made  a  slow  but  good  recovery. 

For  the  "Sleeping  Disease,"  Dr.  Few  will 

find  this  prescription  of  great  value : 

R.    strychnine  nit gr.  ss 

Tr.  capsicL drams  11 

Ac.  pho6.cll] ounce  Ij 

Yin.  coca  q.  p ounce  Uy 

M.    Slg.    Teaspoonitil  In  water  after  meals,  and  brom.  soda 
PiJ,  fl.  ext  gelsem.  m  y.  to  be  taken  at  night. 

In  reply  to  Dr.  Hammond,  dark  circles 
around  the  eyes  are  caused  by  nerve  exhaustion 
or  disease  of  the  generative  organs.  Diagnose 
disease,  then  give  proper  treatment. 

I  would  advise  Dr.  Usher  to  use  deep  ureth- 
ral injections  of  nitrate  of  silver  (10  to  20  grs. 
to  1  oz.  water)  every  second  or  third  day,  as 
indicated.  I  have  cured  many  cases  this  way 
that  had  gone  the  rounds  of  several  doctors. 

Dr.  Cobb  will  find  good  results  witii  P.  D.  & 
Co.'s  Tablets  (cystitis  No.  2)  for  chronic  in- 
flammation of  bladder,  along  with  10  to  15  gr. 
doses  of  muriate  of  ammonia  three  or  four  times 
a  day.  H.  C.  Nepf,  Ph.C.,  M.D., 

Hamden,  N.  Y. 


Treatment  of  Whooping  Cough.-^nufr  Powder  for 
Catarrh. 

Editor  Medical  World:— Information  is 
asked  for  the  treatment  of  whooping  cough. 
The  best  treatment  I  have  found  is  vaccination, 
where  the  patient  haa  never  been  vaccinated, 
and  you  are  sure  it  is  whooping  cough. 

I  think  that  bismuth  sub-nit  drams  x ;  iodo- 
form drao^  ij  ;  boric  acid  drams  ij ;  mix ;  used 


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THB  MEDICAL  WORLD. 


with  a  glass  tube  makes  a  good  powder  for 
nasal  catarrh.  H.  K.  Tefft,  M.D/, 

212  West  Eighth  Avenue,  Topeka,  Kan. 


Vaccine  vs.  Phthisis  and  Respiratory  Affections.— 
Liberalism  in  Medical  Science. 

Editor  Medical  World  : — Dr.  Waugh's 
contention  that  vaccine  is  not  antagonistic  to 
phthisis  and  scrofulous  conditions,  but  rather 
induces  them,  does  not  hold  good  in  my  experi- 
ence. Out  of  190  cases  which  have  been  noted 
that  had  smallpox  here  in  the  West,  over  90 
per  cent  made  a  good  recovery  and  became  in 
robust  health.  He  agrees  that  vaccine  is  an- 
tagonistic to  whooping  cough,  as  he  has  wit- 
nessed the  result 

Of  course,  I  am  not  ready  to  maintain  that 
Taocinating  one  with  bovine  virus  will  cure  him 
of  phthisis  every  time.  I  only  claim  that  in 
every  case  but  one  it  has  proven  a  success,  and 
that  one  was  almost  gone  when  the  attempt  was 
made.  I  have  used  it  on  fourteen.  Dr.  Waugh 
'is  a  gentleman  whose  opinions  I  regard  very 
highly.  I  do  not  think  a  more  liberal  and 
i)etter  informed  physician  writes  for  any  of  the 
journals.  His  way  of  getting  down  to  business 
and  plain  facts  indicates  that  there  is  no  non- 
sense about  Dr.  Waugh. 

I  like  your  comments  on  the  term  "physi- 
cian "  very  much.  I  have  been  a  homeopathic 
physician  and  belong  to  the  eclectic  school.  I 
find  that  there  is  good  in  all  schools,  but  the 
necessity  for  sectarianism  I  fail  to  see.  I  wish 
that  all  medical  men  could  work  in  harmony. 
And  yet  the  Baptists,  Methodists,  and  other  re- 
ligious sects  fight  and  hardly  ever  agree.  And 
medicine  is  largely  a  sentiment,  as  is  religion ; 
some  men  require  a  devil  to  keep  them  good ; 
we  of  the  sectarian  schools  require  an  allopath — 
we  say  old-school — bogey-man.  Men  are  but 
children,  after  all.  Dr.  H.  8.  Brewer, 

1309  Chamberlain  Building,  Chicago,  111. 

[We  admire  Dr.  Brewer's  liberal  spirit,  but 
we  differ  from  him  on  two  points,  viz : 

Ist.  We  do  not  regard  medicine  as  a  senti- 
ment In  proportion  as  the  study  of  its  princi- 
ples advances,  it  becomes  more  and  more  exact 
knowledge. 

2d.  We  have  never  yet  seen  such  a  thing  as 
an  "  allopath/'  In  science  it  is  not  accurate  or 
fair  discussion  to  use  nick  names.  Inasmuch  as 
we  have  never  yet  found  any  two  physicians — 
of  the  broad  profession  or  of  any  sect — who 
practice  alike,  and  as  we  have  often  found  two 
of  different  sects  to  practice  more  nearly  alike 
than  two  others  professedly  of  the  same  sect,  the 
self  assumed  distinctions  of  sects  might  now  be 
supposed  to  have  entirely  subserved  its  purpose 
— if  it  ever  had  any — and  that  all  true,  educa- 


ted and  progressive  physicians  might  appropri- 
ately discard  all  distinctive  tides  (as  they  reilh 
do  in  the  columns  of  The  Medical  World), 
and  come  together  for  broad,  universal,  scientific 
study,  consultation  and  practice. — £d.] 

[The  following  letters  have  been  received  by 
Dr.  Waugh,  and  are  submitted  to  us  with  ap- 
pended replies. — Ed.] 

Peculiar  Epidemic  in  Texas. 

Little  children  here  are  now  having  a  very 
serious  time  with  the  following  condition  : 

Trouble  comes  on  as  an  ordinary  cold,  with 
or  without  fever,  and  a  hoarse,  croupy  cough, 
fever  comes  on  gradually,  with  perhaps,  an  in- 
termission of  a  day  or  two.  Pulse  and  re6i»n- 
tion  both  very  rapid  from  beginning,  regardless 
of  fever. 

Tongue  heavily  coated,  brown  or  white,  broad, 
anemic.  Stomach  very  irritable  from  b^in- 
ning  and  in  many  cases  there  is  inceasant  vomit- 
ing. Tenderness  always  present  over  stomach 
and  along  margin  of  ribs.  Vomited  matter  is 
always  large  quantities  of  tenacious  mucus  with 
an  occasiomEd  lot  of  green  or  yellow  bile.  Longs 
are  loaded  with  mucus,  seemingly  so  tough  that 
it  can  hardly  be  coughed  up.  If  medidne 
fails  to  act  promptiy,  as  a  rule  pneumonia  de- 
velops early.  Respiration  very  rapid  and  of  a 
snubbing  character — short  inspiration  with 
long  eipiration — half  way  between  a  snub  and 
a  hiccough.  Bowels  obstinately  constipated, 
but  no  soreness  or  tympanitis.  Purgatives  have 
Jitde  effect  on  the  bowels  and,  when  trnwels  do 
move,  the  discharges  are  loaded  with  mucos 
and  particles  of  undigested  food;  color,  green  or 
black— usually  green.  Some  discharges  seem 
to  be  entirely  of  green  ropy  mucus.  Kidney sare 
very  sluggish  and  urine  is  highly  colored.  Per- 
spiration usually  free,  regardless  of  fever.  Ear- 
ache, followed  by  discharge  from  ears.  Lb  very 
common.  There  is  often  catarrhal  conjuncti- 
vitis. In  short,  the  entire  system  seems  to  be 
suffering  from  a  catarrhal  condition. 

Remember  that  one  of  the  first  symptoms  of 
illness  is  the  very  rapid  pulse  and  respiration 
and  sick  stomach ;  and  perhaps  the  first  indica- 
tion of  convalescence  is  the  slowing  of  the 
pulse  and  respiration. 

Treatment  is  usually  very  unsatisfactory. 
Perhaps  salol,  pepsin  and  colorless  hydrastia 
have  done  as  well  as  any  other  treatment  Give 
me  a  line  of  treatment  that  will  give  relief 
promptiy  and  be  satisfactory  to  alL     Texas. 

[This  is  a  singular  epidemic,  undoubtedly 
due  to  some  unknown  microbio  cause.  As  a 
preventive,  I  would  wash  out  the  nose  and 
throat  with  peroxide  of  hydrogen  solution,  used 
with  an  antomizer,  so  as  to  reach  as  far  aspos* 


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215 


dble  down  the  air-pasBages.  This  would  be  my 
suggestion  for  treatment  at  the  beginning  of  the 
attack,  also  giving  camphor  and  quinine  in 
small  doses.  The  hygiene  of  the  house  and 
premises  should  be  looked  to,  as  bad  forms  of 
all  such  diseases  are  associated  with  unhealthy 
sarroundings.  K  the  attack  becomes  confirmed, 
I  would  give  i  grain  of  calomel  every  2  hours, 
and  small  doses  of  zmc  sulpho-carbolate  every 
half  hour  to  keep  the  stomach  aseptic.  The 
tough  mucus  would  be  improved  by  small  doses 
of  lobelia,  if  the  state  of  the  stomach  and  the  gen- 
eral strength  permitted.  The  vaporization  of 
some  voladle  disinfectant,  as  sanitas  oil,  in  the 
room,  has  seemed  to  be  of  value  in  the  eruptive 
feveis,  and  I  would  add  this  to  the  other  sug- 
gestions.—W.  F.  W.] 


dase  for  Diagnosis; 


Editor  Medical  World  : — I  have  a  case 
on  hand  for  which  I  would  like  to  have  your 
advice  in  regard  to  the  best  manner  of  treat- 
ment    The  history  is  as  follows  : 

Mrs.  M.,  age  50,  married,  mother  of  eight 
children ;  commenced  menstruating  at  the  age 
of  15  ;  had  itching  of  the  vulva  from  the  first 
time  the  menses  made  their  appearance,  but  not 
bad  enough  to  require  her  to  consult  a  physician. 

After  the  menses  had  been  fully  established 
five  months,  she  caught  cold,  which  caused  her 
periods  to  be  absent  about  five  months.  After 
their  re-establishment  she  had  pain  in  the  stom- 
ach, headache,  rush  of  blood  to  the  head,  flushed 
face,  painful  menstruation,  especially  before  the 
menstrual  discharge,  which  lasted  2  or  3  days, 
for  about  thirteen  years.  She  has  also  had 
pain  in  her  stomach,  and  eructation  of  odorless 
gas,  with  constipation  for  the  last  five  years,  all 
the  symptoms  of  the  stomach  have  been  worse 
with  pain  and  nearly  constant  belching  and  itch- 
ing burning  sensations  of  the  vulva ;  so  much 
80  that  it  nearly  deprives  her  of  rest,  and  when 
the  menses  came  on,  it  would  nearly  drive  her 
mad.  She  has  to  take  medicine  to  keep  her 
bowels  moving ;  has  tenderness  of  the  uterus,  a 
muco-bloody  discharge  on  usin^  the  sound, 
which  is  extremely  painful.  She  has  within 
the  last  few  days  developed  boih,  four  or  five, 
on  the  liibia  majora,  which  is  swollen  from  irri- 
tation. There  is  no  broken  surface  on  the 
mucous  membrane  that  I  can  find,  but  a  slight 
redness,  perhaps  more  than  usual.  §he  is  a 
brunette,  black  hair,  weight  a  bout  125 ;  her 
urine  is  normal  in  color,  she  has  to  get  up  occa- 
sjonally  at  night  to  maike  water,  not  so  much 
rince  I  have  been  treating  her.  Specific  gravity 
of  urme,  1020;  slightly  acid  reaction,  no  al- 
bumen ;  on  using  Heller's  cold  test  there  is  a 


slight  yelbw   zone  where  the  urine  comes  in 
contact  with  the  acid. 

No  albumen  on  using  heat  and  nitric  acid. 
On  using  Fehling's  test,  the  urine  throws  down 
a  dirty  flocculent  deposit,  I  judge  about  10  per 
cent  of  volume.  She  has  been  married  twenty- 
nine  years. 

Restricted  diet  makes  no  difierence  in  regard 
to  the  stomach  trouble.  Her  tongue  is  smooth, 
as  if  it  was  stripped  of  its  epithelma.  She  has 
what  she  calls  nervous  chills  occasionally.  She 
is  still  menstruating  occasionally.  About  three 
months  ago  she  came  around  afler  an  absence 
of  four  months.  The  menopause  is  working  6n 
her.  She  is  not  very  hysterical  as  one  would 
imagine,  but  is  a  very  sensible  woman,  though 
of  course  she  has  nervous  spells  and  palpitation 
of  the  heart  at  times.  She  has  been  a  very 
busy,  industrious  woman,  in  fact,  too  much  so  . 
for  her  own  good. 

She  has  been  treated  by  three  or  four  difier- 
ent  physidans,  each  one  became  disgusted  and  > 
told  her  that  they  could  not  help  her.     She  was 
treated  by  one  for  two  years,  steadily. 

[There  may  be  some  uterine  affection,  prob- 
ably stenosis  of  the  internal  os ;  else  why  the- 
dark  discharge  after  the  sound  ?  This  should 
be  remedied  first;  the  os  dilalfed,  the  uterus 
washed  out  and  europhenaristol  in  liquid  petro- 
latum freely  applied  to  the  cavity.  This,  with 
the  regulation  of  the  bowels  and  the  adminis- 
tration of  macrotin,  are  the  only  indications  I 
can  see,  without  personal  examination  of  the 
case.— W.  F.  W.] 


A  reader  recommends  the  application  of 
grated  nutmeg  as  a  successful  remedy  in  cases 
of  bleeding  navel  in  infants. 

Qui;  D^tx^ptment 


Qnestiona  are  soUdted  for  thia  Column.  CommunicatioM 
not  accomiMiiied  by  the  proper  name  and  address  of  the 
writer  (not  neceMarlly  for  publication),  will  not  be 
noticed. 

The  great  number  of  requeaU  fbr  private  answers,  for  the  ' 
information  and  benefit  of  the  writer,  makes  it  necesa- 
aiy  for  us  to  chaise  a  fee  for  the  time  required.    TWa 
fee  will  be  from  one  to  five  doUara,  according  to  the 
amount  of  reaearch  ai*d  writio^  requiiitd. 

Editor  Medical  World  : — I  have  recently 
had  a  case  in  practice  which  I  wish  to  report,  as 
I  am  not  positive  as  to  my  diagnosis,  and  hope 
that  it  may  prove  of  sufficient  interest  to  some 
of  the  many  readers  of  The  World  to  call 
forth  some  response  from  which  I  may  become 
better  satisfied  as  to  the  exact  trouble. 

On  the  morning  of  Feb.  17th,  my  partner 
and  I  were  called  to  see  a  Mrs.  L.,  age  42, 
blonde,  of  slight  build,  mother  of  9  children, 
the  youngest  two  months  old.     Previous  history 


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fair.  Her  husband  stated  Ihat  on  the  morning 
of  the  16th  she  was  taken  with  a  very  severe 
headache,  lasting  all  day  and  till  midnight. 
There  was  some  vomiting  and,  as  she  had  been 
subject  to  sick  headache  for  years,  it  was  thought 
to  be  one  of  her  periodic  attacks,  though  the 
pain  was  much  more  severe  than  at  any  pre- 
vious time.  About  midnight  the  pain  in  her 
head  became  less  severe  and  she  went  to  sleep, 
but  waked  near  morning  and  called  for  a  drink 
of  water.  When  the  husband  brought  it  she 
asked  why  he  did  not  light  a  lamp,  as  she  could 
not  see  him,  and  as  he  had  a  lighted  lamp  in 
his  hand,  the  discovery  was  made  that  she  was 
totally  blind. 

We  found  her  with  temperature  at  100,  res- 
piration 30,  pulse  120,  moderately  strong  on  the 
right  side,  but  could  detect  no  radial  or  temporal 
pulse  on  the  left  side,  whatever.  Pupils  slightly 
dilated  and  symmetrical,  responding  sluggishly, 
but  otherwise  perfectly,  to  light.  Pain  in  occi- 
pital region,  but  not  nearly  so  severe  as  it  was  be- 
fore she  went  to  sleep.  We  had  no  ophthal- 
moscope, but  by  careful  external  examination 
of  the  eyes  could  detect  no  abnormal  appearance 
whatever,  though  she  could  not  distinguish 
even  the  bright  light  from  a  laryngoscopic 
mirror,  except  that,  as  she  said,  she  could  feel 
it  She  complained  of  slight  numbness  and 
coldness  of  extremities.  Urine  scanty  and 
rather  highly  colored.  No  albumen  or  sugar. 
In  about  twenty-four  hours  her  sight  gradually 
returned,  the  first  change  she  noticed  being  a 
sensation  of  bright  changing  colors — "calico 
colors,"  as  she  described  it—  passing  before  her 
eyes.  In  two  or  three  hours  she  could  distin- 
guish the  bulk  of  a  person's  hand  held  between 
her  eyes  and  the  light,  and  at  the  time  of  our 
next  visit,  about  10  o'clock  on  the  morning  of 
the  18th,  her  sight  had  completely  returned. 
From  the  18th  to  the  22d,  she  had  every 
twenty- four  hours  from  one  to  two  attacks  of 
excruciating  pain  in  the  head,  principally  in 
the  cccipital  region  and  ranging  down  the  back 
of  the  neck,  with  stiffness  and  soreness  of  the 
muscles  of  the  neck  and  marked  tendemees  on 
pressure  as  low  as  the  vertebral  prominences.  The 
attacks  lasted  from  2  to  4  hours  whether  any- 
thing was  given  to  relieve  her  or  not,  and  in  the 
intervals  between  the  attacks  she  was  very 
stupid,  with  a  tendency  to  sleep  all  the  time,  and 
when  aroused  would  be  "  flighty  "  for  a  short 
time.  From  the  22d  to  the  28th,  the  attacks  of 
headache  gradually  became  lees  frequent  and 
severe  and  the  stupor  less  pronounced.  On 
March  1st,  she  was  delirious  for  a  short  time 
and  on  the  night  of  March  2d  was  wildly  delirious 
nearly  all  night  All  this  time  her  temperature 
had  ranged  from  99i  to  101  and  pulse  120  to 


130.  At  times  we  could  barely  detect  the 
radial  pulse  in  the  left  side,  but  seldom.  There 
was  complete  anorexia  and  marked  emanciation, 
slight  tendency  to  constipation,  readily  over- 
come by  purgatives.  From  this  time  on 
(March  2d  or  3d)',  she  had  very  little  headache 
but  the  circulation  rapidly  became  weaker,  and 
from  the  5fh  to  the  7th  was  very  irregular, 
varying  at  times  from  60  to  130  in  the  course 
of  2  or  3  minutes,  with  missed  beats,  eta  Then 
for  the  next  week  her  circulation  gradually  be- 
came better  and  became  perceptible  with  regul- 
arly increasing  strength  in  the  left  side,  her 
appetite  began  to  return  and  she  improved  in 
every  way.  Since  then  there  has  been  nothing 
of  special  interest  connected  with  the  case.  She 
has  been  slowly  convalescing  and  is  now  able 
to  be  up  most  of  the  time.  He^  circulation  is 
as  strong  in  the  left  as  in  the  right  side  and  she 
has  had  no  further  trouble  with  her  vision. 

Now,  as  to  the  treatment  employed  :  On  our 
first  visit  we  gave  her  a  brisk  calomel  purge 
and  pustulated  the  back  of  the  head  and  neck 
with  croton  oil  and  gave  her ; 

B.   PoUss.  bromide gr.  xv 

FL  ext.  ergot .gUa.  x 

Fl.  ext.  cUgltalls gtts.  v 

every  3  hours.  Next  day  we  changed  the  in- 
terval to  4  hours  and  continued  it  for  about  a 
week,  when  we  left  off  the  digitalis  and  added 
potass,  iodide  gr.  x  to  the  above  and  also  gave 

B.    Stt.  hypophoshites  oo.  (Fellows) diam  i 

Liq.  potaes  arseuitis gtui 

every  4  hours.  For  the  headache  we  tried 
antikamnia,  chloral  hjdrate,  morphia  and  large 
doses  of  poti^.  brom.  without  any  appreciable 
efiect  and  finally  left  them  off,  as  the  attacks 
seemed  to  be  self  limited.  When  the  circula- 
tion became  bad  we  gave  digitalis  and  strophan- 
thus. 

We  gave  other  remedies  to  meet  different  in- 
dications as  they  arose,  but  the  above  is  the 
main  line  of  treatment  followed. 

Now  I  have  tried  to  give  a  tolerably  full 
description  of  the  case,  but  feel  that  in  some 
way  I  have  fallen  short  of  it  However,  as 
this  is  my  first  attempt  at  reporting  a  case,  I  will 
let  that  be  my  apology  for  my  short  comings. 

In  my  case-book  I  have  **  labeled  "  this  case 
congestion  of  brain  with  serous  effusion,  fol- 
lowed by  meningitis.  Now  I  want  some  of  the 
rest  of  you  to  guess  at  it. 

What  caused  the  sudden  and  total  blindnesi 
and  its  almost  as  sudden  disappearance  ?  What 
was  the  cause  of  the  difference  in  strength  ol 
the  pulse  on  the  right  and  left  side  ? 

W.  L.  DUNKEBON,  M.D., 

Exeter,  Mo. 

[We  referred    the    above  very  interesting 


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217 


case  to  Dr.  Fox,  Professor  of  Ophthalmology  in 
the  Medico-Chirurgical  Collie  of  Philadelphia, 
who  has  kindly  given  his  opinion  as  follows : 
—Ed.] 

Editor  Medical  World  : — The  absence  of 
an  ophthalmoscopic  examination  in  the  above 
case  precludes  us  from  venturing  a  diagnosis 
on  the  intra-ocular  conditions  which  might  pos- 
sibly have  existed  and  throvm  much  information 
on  the  condition  of  the  brain.  Assuming  that  the 
ophthalmoscope  would  show  no  change  in  the 
optic  nerves  or  retina,  then  the  lesion  must  have 
been  around  the  sight  centres  of  the  brain. 
Meningitis  over  the  cortical  region,  suddenly 
threw  out  serous  effusion  and,  owing  to  the 
prompt  and  very  excellent  treatment,  as  rapidly 
preventing  an  excess  of  the  effusion  and  as 
rapidly  provoking  absorption,  thereby  a  restor- 
ation of  vision  was  effected. 

In  like  manner  we  can  explain  the  disturb- 
ance in  the  vasomotor  centres,  causing  the 
unilateral  arterial  tension. 

A  patient  came  under  my  care  recently  at 
the  Medico-Chirurgical  Hospital,  wholtad  nearly 
all  the  conditions  described  by  Dr.  £)unkeson. 
The  blindness,  however,  was  limited  to  the  right 
eye,  came  on  suddenly  but  did  not  return  quite 
as  rapidly.  The  ophthalmoscope  revealed  a 
general  retinitis  with  minute  hemorrhages 
limited  to  the  macula  region,  pupils  slightly 
myotic.  The  arterial  tension  was  enormously 
mcreased  throughout  the  right  side  of  the  body 
with  an  increase  in  temperature  on  this  side. 

The  right  sub  clavian  artery  stood  out  like  a 
whip-cord  and  throbbed  with  every  beat  of  the 
heart. 

The  left  eye  ground  was  found  normal  and 
vision  perfect  The  urine  was  carefully  examined 
from  day  to  day  apd  always  found  free  from 
sugar  or  albumen.  The  pain  in  the  head  was  very 
severe  at  times.  The  patient  was  promptly  put  to 
bed,  and  large  doses  of  nitro  glycerine  given  and 
simple  diet.  After  the  second  day,  in  addition 
to  the  nitro-glycerine,  pota^.  brom.  and  potas. 
iodide  in  ten  grain  doses  four  times  daily.  The 
conditions  of  the  brain  responded  to  the  treat- 
ment In  three  weeks  the  patient  went  home, 
practically  well.  The  vision,  however,  did  not 
gain  more  than  two-thirds  of  the  normal.  For 
the  general  treatment  I  had  the  assistance  of 
my  colleague  Prof.  James  M.  Anders. 

There  was  no  doubt  meningeal  disturbance  in 
this  patient  involving  the  deeper  structures  of 
the  brain.  I  feel,  therefore,  that  from  the  sim- 
ilarity of  the  symptoms  in  these  two  cases.  Dr. 
Dunkeson  is  correct  in  his  diagnosis. 

L.  Webster  Fox,  M.D., 

1304  Wakiut  street,  Philadelphia. 


Editor  Medical  World  : — Have  just  been 
perusing  youv  April  number  and  find  it,  aa 
usual,  filled  to  overflowing  with  many  good  ar- 
ticles, especially  the  one  from  our  old  contribu- 
tor, Dr.  Waugh,  on  diphtheria,  which  I  fully 
endorse,  as  to  the  disease  being  local  exclusively 
in  its  incipient  ^tage,  becomiug  constitutional 
as  it  advances,  and  why  treat  it  locally,  if  it  is 
not  a  local  disease  ? 

Let  me  again  thank  all  those  of  my  brethren, 
who  so  kindly  came  to  my  rescue  in  the  case 
of  eczema  of  n\y  own  child. 

We  are  passing  through  a  very  severe  epi- 
demic of  la  grippe,  many  cases  resulting  in 
pneumonia,  single  and  double,  ending  in  the 
aged,  fatally,  in  the  greater  number  of  cases. 
My  treatment  has  mainly  been,  salol,  grs.  v., 
antifibrin,  grs.  x.,  every  four  hours  until  pain 
and  soreness  has  subsided,  and  when  the  lungs 
become  involved,  quinine  sulph.  (Howard's), 
grs.  iii,  ammonia  carb.,  grs.  v,  every  three 
hours,  hot  poultices  to  chest,  changed  every  two 
hours,  plenty  of  beef  tea,  the  white  of  an  egg 
beaten  up  with  milk,  with  brandy  added  if 
necessary.  Feed  your  patient  ;  keep  up  his 
strength.  Treat  symptoms  as  they  occur, 
watch  the  heart,  and  in  the  young,  in  99  per 
cent.,  you  will  have  the  satisfaction  to  tide  your 
patients  safely  through. 

For  the  neuralgia,  attending  cases  of  La 
Grippe,  I  have  found  nothing  to  equal  phenac- 
tine  Bayer,  in  grs.  v,  repeated  if  necessary  in 
four  hours.  I  have  also  found  this  of  great 
benefit,  combined  with  salol  and  antikamnia  in 
articular  rheumatism. 

The  readers  of  our  family  journal  came  so 
promptly  and  so  kindly  to  my  rescue  in  the 
case  of  eczema,  that  I  will  again  solicit  their 
aid  in  the  case  of  a  patient  now  under  treat- 
ment. The  patient  is  a  female,  age,  forty  six, 
(not  passed  the  menopause),  slight  build,  ner- 
vous temperament,  the  mother  of  five  children, 
the  oldest  21,  the  youngest  three  years  of  age, 
no  trouble  in  confinements,  excepting  that  they 
are  tedious,  is  troubled  very  much  after  men- 
struating with  leucorrhea.  About  two  years 
ago  she  commenced  to  complain  of  some  diffi- 
culty of  swallowing  solid  food,  and  at  one  time 
came  near  choking  trying  to  get  down  a  pill. 
This  difficulty  gradually  increased,  until  about 
eight  weeks  ago,  it  became  impossible  to  swal- 
low any  solid  food.  Since  that  time  she  has 
subsisted  on  soaked  Christey's  biscuits,  beef- 
tea,  Leibig's  extract  of  beef,  and  beaten  up  egg 
and  brandy.  She  has  became  emaciated,  ex- 
tremely nervous,  melancholy,  wishing  often  for 
death  to  terminate  her  existence.  Her  friends 
at  first,  importuned  her  to  eat,  saying  that  it 
was  only  nervousness  caused  by  being  afraid 


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THB  MBDICAI,  WORLD,      f 


that  ahe  would  choke,  but  she  would  answer, 
"  Would  I  not  eat,  if  I  could-onlj  swallow  ?** 
She  does  .not  regurgitate  her  food,  but  if 
she  tries  to  swallow  oatmeal  or  rice  in  broth, 
it  goes  so  far  and  sticks  there,  then  she  is 
compelled  to  keep  swallowing,  and  after  some 
time  the  kernels  of  rice  or  oat  meal  pass  down. 
If  worried  with  the  cares  of  the  family,  or  tired, 
then  it  becomes  more  difficult  to  swallow. 

With  the  eye  I  can  discern  nothing  abnormal 
in  the  throat  She  has  not  been  examined  with 
•the  laryng  scope  (being  at  present  too  nervous 
and  excitable).  The  constitutional  treatment 
has  been  nux  vomica,  tinct.  iron,  aloin,  and  fid. 
extract  caseara  sagrada.  The  bowels  were 
constipated,  but  since  taking  the  mixture  have 
become  more  r^ular.  She  complains  of  being 
cold,  feet  always  so,  hands  the  same.  She  can- 
not sleep.  The  urine  is  clear,  no  albumen  or 
casts,  and  normal  in  quantity.  She  is  not 
thirsty  and  no  dizziness  or  double  vision. 

Now,  gentlemen,  can  you  give  me  diagnosis, 
prognosis  and  treatment  from  the  above  symp- 
toms ?  I  am  very  anxious  to  make  a  cure  or 
some  change,  for  if  there  is  not  soon  some  amel- 
ioration in  her  condition,  she  will  die  from  gen- 
eral debility.  The  result  of  treatment  I  will 
give  in  The  Medical  World. 

J.  FORMAN  PiNEO,  M.D., 

Chester,  Nova  Scotia,  Can. 


Eyesight  of  one  eye  totally  destroyed  when  a 
child,  through  some  unknown  poison  carried  to 
the  eye.  Grew  up  to  manhood,  ball  unsightly 
and  enlarged,  but  only  suffering  once  or  twice 
with  it  (and  severely),  in  exposure  to  cold  and 
wet  H>ul  Prof.  Geo.  Reuling  remove  it  before 
our  class,  Sept.,  1891.  Cavity  rapidly  healed, 
and  within  three  weeks  inserted  artificial  eye. 
Since  then  have  never  been  free  from  a  dis- 
charge of  matter,  adhering  to  the  glass,  and 
necessitating  frequent  removal  and  cleansing. 
Cavity  at  times  red  and  inflamed  from  use  of  the 
glass  eye,  always  removed  at  night 

Dr.  0.  W.  Sadler,  of  Pittsburgh,  prescribed 
the  following : 

R.    ZiD08ulph(Hsarbolate ^.  iii 

Bichloride  of  mercury gr.  m 

Rose  water „ ounce  1 

M.  Slg.  Drop  in  eye  night  and  morning. 

This  failed  to  check  the  morbid  secretion.  Be- 
gan the  use  of  hydrogen  peroxide,  of  varied 
strength,  followed  immediately  by  small  bit  of 
absorbent  cotton  dipped  in  glycozone,  and  left 
in  the  cavity  for  some  time.  I  thought  this  was 
doing  thi  work  effectually,  but  in  seven  or  ten 
days  timtf  matter  again  appeared,  and  here  we 
have  halted.  What,  if  anything,  can  be  done 
for  such  a  case  ?  I  have  never  tried  exelmve 
rest  from  glass  eye,  except  during  treatment  as 
above.  Dr.  Chas.  Gilbert, 

Glenelg,  Md. 


Editor  Medical  World  : — A  gentleman 
living  near  me  gave  me  the  history  of  his  case 
when  a  young  man.  His  case  was  diagnosed 
tubercular  ooneumption.  He  applied  to  Prof. 
Paul  F.  Eve,  of  Nashville,  Tenn.,  who  treated 
him  for  awhile,  but  he  was  called  to  New  York 
City,  on  business.  While  there,  he  met  an  old 
friend.  This  friend,  learning  of  his  condition 
recommended  that  he  go  to  see  a  doctor  there,  by 
name,  Howard  Green,  a  specialist  in  lung  dis- 
eases. Treatment  began  by  inserting  a  rubber 
tube  down  the  broncial  tubes,  and  irjecting  an 
ounce  of  water  with  twenty  grains  of  nitrate  of 
silver.  After  it  remain^  in  there  15  to  20 
minutes,  he  began  to  expectorate  and  his  double 
hand-full  of  mucus  was  thrown  up.  He  says 
that  was  5  o'clock  in  the  evening.  He  went  to 
bed,  and  the  sweetest  and  beet  night's  rest  he 
ever  had  was  that  night  This  happened  in 
the  year  1856.  Did  you  ever  hear  of  this  doc- 
tor, or  have  you  any  knowledge  of  such  treat- 
ment ?  I  can't  find  any  such  treatment  recom- 
mended in  any  of  the  text  books. 

Woodbum,  Ky.    J.  R  Thompson,  M.D., 


Editor  Medical  World: — The  following 
history,  and  appeal  for  aid,  is  that  of  the  writ- 
er's own  case : 


Editor  Medical  World  : — It  seems  to  me 
that  the  cause  of  vomiting  of  pr^nancjisa 
sympathetic  condition,  or,  in  other  words,  a  re- 
flex effect  upon  the  stomach,  caused  by  the  dila- 
tation of  uterus,  by  the  growth  and  accommo- 
dation of  the  commencing  fetus  within  the 
uterus,  and  nervous  impression.  I  would  like 
to  ask  yonr  readers  if  Aey  have  noticed  that 
idiopathic  phlegmonous  erysipelas  of  the  face 
commences,  or  at  least  exerts  first  its  violence, 
on  the  left  side  of  the  face  ?    K  so,  why  ? 

How  soon  after  a  physician  has  attended  a 
case  of  erysipelas  and  discharged  the  case,  would 
it  be  safe  for  him  to  attend  an  obstetrical  case 
without  danger  of  infecting  the  woman  ?  What 
is  the  best  means  of  disinfecting  the  person  and 
clothing  of  the  ph3rsician  before  going  to  an  ob- 
stetrical case? 

Speaking  of  the  vomiting  of  pr^^ancy,  I 
wish  to  add  another  very  important  question  : 
After  all  treatment  fails,  how  near  death's  door, 
by  exhaustion  and  starvation,  shall  the  physi- 
cian allow  the  patient  to  go  before  he  produces 
abortion  ?  When  abortion  is  necessary,  what 
is  the  best  means  to  produce  it  ? 

Please  push  the  point  of  the  eradication  of 
syphilis.     I  approve  of  the  article  on  that  sub- 


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THB  MEDICAL  WORLD. 


ject  in  the  May  number  of  The  World,  though 
I  think,  besides  doing  all  therein  mention^, 
that  we  should  also  examine  the  women— cut 
the  disease  off  at  both  ends.  Query. 

[Doctor,  why  do  you  not  authorize  us  to  sign 
your  name?  There  is  nothing  of  a  personal 
nature  in  your  questions  why  you  should  not  be 
known.  By  presenting  your  own  name  to  the 
readers  you  establish  an  acquaintance  and  a  fel- 
lowship with  a  large  number  of  most  excellent 
gentlemen.  When  you  hide  behind  a  pseudonym 
each  physician  who  might  wish  to  reply  to  it 
does  not  know  whether  he  is  replying  to  his  near 
neighbor  or  to  some  one  in  foreign  lands,  or  even 
to  some  arrant  quack. — Ed.] 


Editor  Medical  World  : — I  have  an  ugly 
case  of  noma,  or  malignant  ulcer  of  a  cancer- 
ous nature.  It  occupies  the  entire  left  cheek, 
from  the  comer  of  the  mouth  back  to  the  throat 
and  spreading  on  the  upper  roof  of  the  mouth, 
and  at  the  comer  of  the  mouth  it  has  grown  out 
between  the  lipe  one-half  inch  or  more.  I  first 
treated  it  with  aveloz,  painted  over  it  every 
other  day,  and  kept  the  mouth  washed  with  a 
solution  of  four  grains  of  permanganate  of  pot- 
assium to  one  ounce  of  water,  for  over  one  week, 
but  did  not  see  much  improvement  I  stopped 
that  and  used  chloride  of  cromium  twice  a  day, 
and  washed  with  boro-glyceride,  listerine,  and 
pinus  canadensis.  It  is  sloughing  nicely  now, 
and  getting  thin  to  what  it  wa<i.  If  you  can  in- 
struct me  in  any  way  further  I  will  be  grateful 
to  you.  Wm.  F.  Small,  M.D., 

Augusta,  Ga. 


Dr.  Morgan,  of  Phenix  City,  Ala.,  wishes  to 
know  what  will  remove  blue  spots  caused  by  the 
hypodermic  syringe  in  the  habitual  use  of  mor- 
phine in  a  patient  who  is  now  cured  of  the  habit 


Dr.  Smith,  of  Filley,  Neb.,  wishes  for  a  good 
treatment  for  catarrh  that  does  not  require  ex- 
pensive apparatus,  and  also  wishes  to  know  of 
any  climate  which  is  beneficial  or  curative  in 
catarrh. 


As  railway  authorities  seem  to  be  supported 
by  the  courts  in  the  stand  they  take  that  the 
companies  are  not  legally  responsible  for  the 
payment  of  bills  for  medical  or  surgical  services 
rendered  to  employes  or  passengers  injured  by 
railroad  accidents,  unless  authorized  by  a  high 
official  of  the  company,  even  though  the  physic- 
ian be  called  by  a  person  in  the  service  of  the 
road  at  the  place  where  the  02currence  takes 
place,  we  wish  to  call  upon  our  readers  for  any 


219 

information  they  may  have  in  regard  to  anj^ 
cases  involving  this  question. 

Editor  Medical  World  : — I  have  a  patient,, 
a  little  girl,  eight  years  of  age,  who  practices 
masturbation.  She  contracted  the  habit  about 
three  years  ago.  She  accomplishes  the  act 
about  once  a  day  by  rubbing  her  person  against 
a  chair,  table  or  bedstead. 

Her  general  health  is  good.  Both  parents^ 
are  moral  and  in  good  health. 

I  would  like  to  know  what  treatment  would 
cure  the  patient  R.  T.  Stoby,  M.D., 

[We  suggest  a  fly  blister  on  the  mous  vene- 
ris.—Ed.] 


Editor  Medical  World: — I  have  a  lady 
patient,  Mrs.  6.,  who  has  been  afflicted  with 
nervous  trouble  for,  say,  twenty  years,  and  has 
been  under  treatment  of  several  physicians  but 
derives  no  benefit  I  was  called  to  see  her 
about  six  months  ago  and  found  her  very  ner- 
vous, complaining  of  but  little  or  no  pain,  and 
with  a  little  tenderness  in  the  right  inguinal 
region.  I  have  seen  her  several  times  since 
and  find  her  sometimes  almost  wild,  then  again 
sometimes  perfectly  composed.  Anything  she 
happens  to  centre  on  seems  to  almost  worry  the 
life  out  of  her.  She  talks  the  dark  side  of 
everything  and  will  worry  over  it  until  she  can 
scarcely  stand,  then  the  troubles  will  pass  off 
and  she  will  feel  all  right  for  from  two  to  six  days, 
then  she  will  centre  on  something  and  it  will 
worry  her  almost  to  death  again.  However,  if 
something  occurs  to  draw  her  mind  for  several 
days  she  is  all  right  and  able  to  do  her  house 
work.  For  instance,  her  husband  had  a  lot  of 
building  carried  on  last  Winter  for  twenty-five 
or  thirty  days;  during  that  time  the  noise 
seemed  to  keep  her  perfectly  quiet  But 
when  the  work  was  done  she  relapsed  into  the 
same  condition.  Now  she  has  a  daughter  which 
has  the  (so^called)  typhoid  malarial  fever,  and 
she  is  all  right  and  has  been  ever  since  her 
daughter  has  been  sick.  She  is  able  to 
wait  on  her  and  do  most  of  the  nursing.  What 
can  I  do  to  relieve  my  patient?  Any  assistance 
will  be  gladly  received. 

Gann,  Tenn.  T.  N.  Cochran,  M.D., 


Editor  Medical  World: — In  the  case  of  a  patient, 
mother  of  two  children,  in  fair  health  with  the  excep- 
tion of  the  litherine  diathesis  and  slight  chronic  bron- 
chitis, a  very  annoying  symptom  is  present,  viz:  when- 
ever she  coughs  or  sneezes  violently  the  vesical  sphinc- 
ter proves  to  be  insufficient,  and  an  escape  of  urine 
occurs.    What  is  the  meet  ready  method  of  relief? 

Inquibemdo. 


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THB  MBDICAI.  WORLD. 


Current   Medical   Thought. 

Means  of  Preventing  the  Spread  of  Consumption, 

[The  following  most  excellent  directions  have 
been  issued  in  pamphlet  form  by  the  Pennsyl- 
vania State  Board  of  Health.  We  commend  it 
to  physicians,  boards  of  health,  and  hygienists 
generally.  The  wholesale  prevention  of  disease 
is  our  highest  mission. — Ed.] 

All  cases  of  tuberculous  disease  of  the  lungs 
(consumption)  take  origin  directly  or  indirectly 
^om  other  cases.  This  is  now  an  established 
fact  Infection,  however,  is  easily  provided 
against  if  certain  simple  precautions  are  taken. 

The  chief  modes  of  infection  are : 

First,  and  foremost — By  inhaling  dry  'and 
pulverized  expectoration. 

This  is  apt  to  occur  when  an  ordinary  pocket 
handkerchief  is  used  by  a  tuberculous  person 
for  expectoration.  When  such  a  handerchief 
is  opened  the  dried  expectoration  is  likely  to  be 
pulverized  and  diffused  through  the  air.  Thus 
it  may  be  inhaled  by  others  as  well  as  by  the 
patient  himself,  who  is  likely  to  suffer  from 
drawing  disease  germs  into  portions  of  lung  pre- 
viously unaffected. 

Another,  and  the  most  common  source  of  pul- 
verized expectoration,  is  the  habit  of  spitting 
carelessly  and  indiscriminately,  as  on  the  floor 
or  ground.  The  expectoration  becomes  dried 
and  mixed  with  dust,  and  then  is  easily  carried 
into  the  air,  and  is  breathed  into  the  lungs  or 
swallowed.  The  habit,  therefore,  is  not  merely 
offensive,  but  dangerous. 

(2.)  By  using  spoons,  cups,  and  other  articles 
of  the  kind,  which  have  not  been  properly  washed 
after  having  been  used  by  tuberculous  per- 
sons. 

(3.)  By  kissing. 

This  source  of  infection  is  especially  to  be 
guarded  against  in  the  case  of  children. 

Self  infection  may  occur,  in  addition  to  the 
ways  mentioned,  by  swallowing  the  expectoration. 
The  habit  is  likely  to  lead,  sooner  or  later,  to 
infection  of  the  intestines  with  tuberculous  dis- 
ease. 

There  are  other  modes  of  infection,  as,  for 
example,  by  consuming  the  flesh  and  milk  of 
animals  having  the  disease.  But  this  source  is 
less  common,  and,  as  prolonged  high  tempera- 
ture  destroys  the  germ,  if  we  cook  our  food  (in- 
cluding milk)  thoroughly,  there  will  be  no  risk 
of  becoming  infected  in  this  way. 

Knowing  the  channels  of  infection,  we  can 
easily  take  effective  precautions. 

(1.)  The  sjrutwn  must  he  destroyed,  and  must 
not  he  allowed  to  hecome  dry.     A  spitting  cup  or 


flask,  containing  just  enough  disinfectant  solu- 
tion to  cover  the  bottom  of  the  vessel,  should 
always  be  used  for  the  expectoration.  Out  of 
doors  a  pocket  spitting-flask,  such  as  Dettweill- 
er's,  should  be  employed. 

In  the  house  it  would  be  well  to  use  a  paste- 
board or  paper  cup,  which  should  set  in  a  china 
or  metallic  *  holder,  as  represented  in  the  cut. 
This  cup,  with  its  contents,  should  be  burned  at 
least  once  a  day,  but  if  the  expectoration  is  con- 
siderable, much  oftener. 


Pieces  of  linen  or  calico,  about  ten  (10)  m- 
ches  square,  may  also  be  carried.  These 
should  be  used  in  case  of  absolute  necessity 
only,  and  should  be  burnt  as  soon  as  possible 
afterward.  No  piece  should  be  used  more  than 
once. 

(2.)  Bed-rooms  that  have  been  occupied  by 
tuberculous  patients  should  he  thoroughly  disin- 
fected before  they  are  occupied  by  other  persons, 
and  a  declaration  or  assurance  on  the  point 
should  always  be  demanded. 

If  the  previous  occupant  of  the  room  never 
allowed  the  furniture,  hangings,  or  carpets  of 
the  room  to  be  contaminated  with  the  sputom, 
there  would  be  little  need  of  this  precaution. 
But  as  people  ordinarily  of  cleanly  personal 
habits  sometimes  show  a  surprising  amount  of 
ignorance  or  carelessness  in  this  respect,  the  fol- 
lowing points  should  be  insisted  on : 

(a.)  Carpets,  curtains  and  bed-coverings 
should  have  been  exposed  to  superheated  steam 
under  high  pressure. 

(h. )  The  floor  and  walls  of  the  room  should 
have  been  properly  disinfected.  Rubbing  with 
new  bread,  followed  by  the  application  of  corro- 
sive sublimate  solution  (a  tablet  of  7^  grains, 
added  to  a  pint  of  water),  is  probably  the  most 
effective  practical  method. 

There  is  no  danger  of  infection  from  the  mere 
hreath  of  a  tuberculous  patient.  The  risk  is 
from  the  dried  expectoration.  Danger  of  social 
intercourse  arises  from  the  neglect  of  the  pre- 
caution described. 

Fresh  air  is  of  the  highest  importance  for  tu- 
berculous persons.     Hot  and  stuffy  rooms  have 

*  Cup  and  holder  can  be  procured  at  the  apothect- 
lies.  The  paper  cup  can  be  easily  made  at  home  from 
the  original  sample. 


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221 


an  evil  influence  over  the  disease.  Except  in 
special  circumstances,  the  bedroom  window 
should  be  kept  open  by  night,  as  well  as  by 
day. 

I^OTE. — The  disinfection  of  rooms  that  have 
been  occupied  by  the  tuberculous  patients,  and 
of  beds,  bedding,  curtains,  carpets,  etc.,  will  be 
promptly  attended  to  upon  a  notice  sent  to  the 
Health  Officer,  Gty  Hall.  The  Board  of  Health 
has  erected  a  most  extensive  and  complete  dis- 
infecting plant  for  the  disinfecting  of  such  arti- 
cles as  have  been  mentioned,  and  upon  notifica- 
tion will  send  for  them  and  return  them  after 
thorough  disinfection,  at  a  cost  merely  nominal. 

By  order  of  the  Board  of  Health. 

WiLiJAM  H.  Ford,  M..D., 

President 

A.  A.  Hirst,  Secretary. 


Suooeuful  Management  of  Inebriety. 

The  first  essential  to  the  cure  of  inebriety  is  the 
substitution  of  a  less  harmful  support  to  the 
shattered  brain,  nerves,  and  damaged  vital  or- 
gans, than  alcohol ;  and  I  name  them  in  theii) 
order  of  preference  :  The  morphias  or  opium, 
strychnia,  the  quinias  and  cinchonas,  valerian- 
ates, cocas,  the  ammonium  bromide,  etc.,  etc. 

The  second  and  concomitant  essential  is  water 
— plenty  of  water  or  its  equivalent,  milk.  The 
tissues  must  have  water,  the  blood  must  have 
it,  emunctories  and  the  skin  must  have  it 

The  third  and  concomitant  essential  is  rest. 
Normal  nature  tired  prescribes  it  for  every  bod- 
Uy  or  mental  overtax.  Exhausted  abnormal 
nature  always  needs  it,  and  demands  it  often. 
The  machinery  of  the  human  organism  in  all 
its  parts — psychical  or  physical — must  be  put  at 
rest  for  the  best  repair. 

The  chief  essential  for  rest  is  a  new  and 
proper  environment,and  subsidiary  to  this  are  the 
chemical  restraints  therapeutics  may  place  on 
over-acting  cells :  Chloral,  sulphonal,  the 
bromides,  the  vegetable  narcotics,  old  and  new, 
the  valerianates,  the  opiates,  cephalic  galvani- 
zation, and  soothing  music  and  the  bath. 

The  fourth  essential  is  the  removal  of  the  de- 
bris of  the  last  and  previous  drunks,  and  of  the 
interim  and  organic  torpidity  and  depressed  vit- 
ality. The  scavenger  cells,  diminished  in  num- 
ber or  absent  as  they  are  in  toto  from  the  blood, 
and  the  emunctories  have  failed  in  their  physio- 
logically appointed  work ;  tbe  congested  brain, 
liver,  stomach,  intestinal  tract,  mucous  mem- 
branes generally,  torpid  liver,  bowels,  and  skin, 
are  to  be  relieved  and  set  at  their  p^per  work 
agam. 

Here  water,  saline  laxative    water  without 


stint,  is  the  remedy  par  excellence.  It  flushes 
the  intestinal  tract  and  the  excreting  organs. 
Nature  suggests  it  first  of  all  after  the  rest  she 
enforces  after  a  prostrating  spree. 

I  need  not  here  dwell  on  the  proper  therapeu* 
tic  blendings  for  this  hydrotherapy  to  give 
more  special  direction  to  liver,  kidney,  skin,  or 
bowels. 

My  preference  is  for  an  etfervescent  saline 
that  clears  out  the  alimentary  tract  and  tran* 
quillizes  the  brain  and  nerves  at  the  same  time 
(though  mercurials  are  oflen  not  amiss),  and  then 
to  properly  start  all  the  pumps  of  the  system 
that  may  not  be  acting  well,  and  maintain  them 
in  moderate  activity  till  there  remains  no  path- 
ological clogging  of  the  wheels  of  physiological 
activity ;  but  I  do  not  approve  of  over-active 
catharsis.  Moderation  and  not  violence  in  this 
regard  is  my  motto. 

The  fifth  and  concomitant  essential  is  recon- 
struction of  the  undoubtedly  damaged  cerebro- 
spinal centres  and  the  several  affected  organs  of 
vegetable  life.  A  drunkard  is  more  or  less 
damaged  in  many  parts  of  his  anatomy  at  the 
same  time.  He  comes  more  nearly  to  being  af- 
fected all  over  in  spots  than  most  patients  we 
have  to  treat 

We  begin  reconstruction  with  the  beginning 
of  treatment  It  begins  with  rest,  and  sleep, 
and  food,  and  change  surroundings,  if  neces- 
sary, special  nutrition,  phosphates,  hypophoshites, 
reconstructive  haematics  and  other  rebuilders  of 
the  blood.  Milk,  beef-tea,  and  ca))6icum  and 
other  ston;iachic9.  Early  in  the  treatment  the 
wines  of  coca,  the  beef,  wine,  iron,  and  strych- 
nine compounds,  calisaya  cordials,  egg  phos- 
phates, and  stimulant  tonics  are  temporarily  ad- 
missible. 

When  the  patient  is  cured  of  his  recent 
attack  of  delirium  tremens,  or  recuperated  from 
his  last  debauch,  then  the  hypodermatic  medi- 
cation that  is  to  hold  him  from  further  relapse, 
to  retone  his  system,  and  break  him  of  his 
taste,  must  be  instituted,  if  we  have  not  begun  it 
sooner. 

The  sixth  and  final  essential,  to  which  all  our 
previous  efforts  lead  us,  is  destruction  oj  the 
drink  craving ;  and  this  is  done  on  physiolog- 
ical principles.  The  drink  craving  is  patholog- 
ical perversion  of  physiological  cell  action,  and 
lies  in  the  realm  of  the  cerebral  cortex.  This 
part  of  our  subject  belongs  to  psychiatry  and 
psychical  suggestion,  the  therapy  of  which 
directed  to  these  morbidly  act  ng  centres  of  the 
brain,  accomplishes  our  purpoae.  When  the 
drink  craving  comes  on,  having  in  the  mean- 
time rebuilt  the  shattered  brain  and  nervous 
system  and  restored  the  mental  tone  as  much 
as  possible,  we  do  not  absolutely  inhibit  the  use 


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THB  MEDICAL  WORLD. 


of  the  accustomed  drink,  but  train  the  drink 
victim's  own  inhibitions,  first,  by  suggestion, 
second,  by  moderate  indulgence  properly  treated. 
We  do  not  say,  "  You  shall  not  drink, "  but : 
"  You  would  better  not  drink.  You  know  it  is 
poison  to  you  and  you  are  its  slave.  You 
should  resist  Your  treatment  has  made  you 
strong.  You  can  resist  Whiskey  no  longer 
tastes  80  good  to  you.  You  no  longer  need  it. 
You  have  the  power  now  and  should  assert 
your  manhood."  And  with  these  suggestions, 
perhaps  the  victim  will  try  the  liquor  ;  we  give 
him  ^ritua  frumenti  f  S  ij,  cum  vin  antinwnii 
f  3  j,  and  repeat  ad  libitumy  or  we  have  pre- 
viously given  him  apomorphia  with  aurum  bi- 
chloride for  psychical  effect — Dr.  C.  H.  Hughes, 
in  Quar,  Journal  of  Inebriety. 


Points  on  Etiology  of  Canoer. 

Dr.  Rubert  Boyce  (London  Lancet)  groups 
the  questions  for  investigation  concerning  can- 
cer thus : 

Theory  of  Cohnheim, — Cohnheim  took  the 
broad  view  of  growths  in  general ;  he  watched 
the  growth  of  the  congenital  tumor  and  ob- 
served that  it  frequently  started  from  places 
where  peculiarities  of  development  were  known 
to  occur,  and  suggested  that  forces,  some  of 
which  we  may  picture  to  ourselves  as  allied  to 
those  which  occur  at  puberty  and  the  menopause, 
acted  upon  these  developmental  freaks  and 
started  their  growth.  Examples  may  be  seen 
in  the  branclpogenous  epitheliomata,  chondro- 
mata,  dentigerous  cysts  and  warts,  the  tumors 
derived  from  the  accessory  thyroids  and  supra- 
renal rests,  and  the  numerous  vestigial  struc- 
tures in  the  vicinity  of  the  ovary.  It  is  very 
difficult  to  persuade  ourselves  that  these  out- of- 
the  way  "  rests  "  or  remnants  would  have  been 
especially  singled  out  by  a  locally  acting  irri- 
tant, be  it  parasitic  or  otherwise.  The  histologi- 
cal peculiarities  of  these  congenital  growths  may 
be  thus  tabulated,  and  they  are  striking  :  (1) 
origin  from  a  minute  point ;  (2)  architectural 
regularity  ;  (3)  encapsulation  ?  (4)  character- 
istic stroma;  and  (5)  absence  of  leucocytic  infil- 
tration. 

Sigrdficance  of  Metastasis,  —  The  secondary 
growths  are  stamped  to  a  great  extent  with  the 
characters  of  the  primary  ;  in  the  case  of  the 
epithelioma  of  the  skin  there  may  be  the  typical 
homy  nests  in  the  nearest  lymphatic  glands. 
The  same  repetition  of  structure  is  brought  out 
in  the  remarkable  cases  of  multiple  thyroid 
tumors.  A  great  deal,  however,  still  remains 
to  be  done  in  order  to  make  sure  that  we  are 
dealing  with  true  dissemination  of  the  original 
growth.  The  spreading  tumor,  or  secondary 
growth,  causes  atrophy  of  the  surrounding  struc- 


tures ;  it  does  not  infect  them  or  possess  any 
"apem^tic"  icfluence  over  them  so  far  as  we 
are  aware.  The  secondary  growth  is  a  graft 
of  the  primary  ;  compared ,  with  the  microbic 
granulomata,  it  is  here  a  question  of  the  living 
bacillus  setting  up  new  tissue  reactions  where- 
ever  it  lodges.  It  is  not  the  reaction  of  tissue 
or  tumor  produced  by  the'  bacillus  which  is 
comparable  to  the  cancer  graft ;  it  is  rather  the 
living  cancer  cell  itself  which  is  locally  multi- 
plying that  is  comparable  to  the  bacillus — in- 
deed, the  reaction  produced  in  the  tissues  by 
the  cancer  cell  is  often  quite  similar  to  that  pro- 
duced by  a  bacillus  or  other  foreign  parasite. 
In  the  cancer  cell,  as  in  the  bacillus  the  prop 
erty  of  multiplication  resides,  only  it  is  assumed 
by  8ome  that  in  the  former  a  something  foreign 
resides — a  parasite — which  stimulates  it  to 
growth. 

Relationship  of  Irritation  to  Cancer, — This  re- 
lationship is  surely  established,  much  being  due 
to  Thiersch,  Suchard,  Volkmann,  Butlin,  and 
others.  Examples  are  :  the  skin  cancers  in  the 
case  of  soot-sifting  tar  and  paraffin  working,  in 
lupus  and  syphilis.  Further,  most  important 
examples  are  famished  by  the  pre-cancerous 
conditions — psoriasis  linguali^  psoriasis  laryn- 
gis,  seborrhcea  senilis,  etc. — and  the  cancers 
starting  in  the  lung,  stomach,  liver,  kidney, 
breast,  etc.,  in  chronic  inflammatory  conditions 
of  those  organs.  Animal  parasites  may  arouse 
by  their  long  irritating  presence  pre-cancerous 
and  even  cancerous  changes,  just  as  in  the  case 
of  the  pipe  and  lip-carcinoma ;  examples  may 
be  seen  in  the  case  of  coccidia,  distoma,  bilhar- 
zia,  and  even  echinococcus.  In  none  of  these 
cases  are  we  in  a  position  to  state  how  the  long- 
standing irritation,  producing  at  first  a  reactive 
hyperplasia,  finally  leads  to  malignant  over- 
growth. There  is  no  evidence.  The  irritation 
tumors  are  thus  characterized :  (a)  wide  origin, 
(6)  irregularity,  and  (c)  production  of  consider- 
able tissue  reaction  around  them,  such  as  the 
formation  of  granulation  and  scar  tissue  and 
leucocytic  migration. 

SiginHcance  of  Primary  Cardnomata, — The 
multiple  primary  carcinomata  may  be  divided 
into  two  classes :  (a)  those  of  the  same  type, 
arising  in  the  same  organ,  as  in  the  breast,  skin, 
stomach,  etc. ;  and  (6)  those  of  different  type?, 
arising  primarily  in  different  organs.  In  the  * 
first  class  may  be  included  the  so-called  **  can- 
cers by  contact"  There  are  very  numerous 
examples  of  multiple  primary  cancers,  and  that 
this  is  so  will  be  readily  understood  from  the 
preceding  paragraph  on  the  relationship  of  irri- 
tation to  n^plasis.  Thus  a  wide  area  is  afr 
fected  by  the  precancerous  change,  and  from 
more  than  one  point  in  that  area  a  cancer  pro- 


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223 


ceeds.  This  explains  a  bilateral  carcinoma  of 
the  tongue  following  psoriasis  linguae.  Its  sig- 
nificance is  perhaps  the  most  important  of  all 
from  a  surgical  standpoint  It  was  long  ago 
pointed  out  by  Langhans  that  cancer  of  the 
breast  may  originate  at  many  points ;  it  may 
originate  primarily  in  both  breasts.  The  meaa- 
ing  of  this  is  seen,  for  instance,  where  a  tumor 
is  completely  removed,  so  called  ^*  recurrence  " 
taking  place  months  or  years  afterwards,  not 
from  cancer  which  was  left  behind,  but  from 
epithelium  which  was  pre-cancerous  (local  pre- 
disposition of  Thiersch).  The  tumor  and  the 
conditions  around  in  which  the  Krankheit-erreger 
flourish  must  be  removed.  A  large  number  of 
the  '* cancers  by  contact"  are  readily  explained 
by  the  pre-cancerous  change,*  and  the  rest  by 
complex  metastasis. 

bigniftcanee  of  Inoculatian  Experiments — The 
experiments  of  Novinsky,  Wehr,  Hanau,  Klebs, 
and  others  only  demonstrate  that  grafting  may 
be  performed.  They  are,  however,  exceed- 
ingly interesting  and  of  wide-reaching  import- 
ance. The  graft  of  normal  tissue,  in  the 
majority  of  cases,  atrophies  ;  the  cancer  graft 
may  increase. 

The  Significance  of  Gidiivating  Experiments, 
The  results  of  these  experiments  prove  very  little 

Nature  and  ibignificanee  of  the  Appearances 
Found  in  Cancer  Cells* — This  very  interesting 
side  of  cancer  has  been  taken  up  with  much 
vigor,  and  both  the  nucleus  and  the  cell  con- 
tents have  attracted  much  careful  attention. 
Laveran's  corpuscle  and  the  coccidium  of  the 
rabbit  have  done  much  towards  turning  the 
attention  of  observers  to  the  presence  of  animal 
parasite  in  cancers.  Animal  parasites  are  now 
coming  to  occupy  their  important  place  in  path- 
ology :  we  need  only  mention  surrah,  amoeba, 
and  Plasmodium  malari^e.  Very  much  has 
been  written,  the  last  set  of  observers  very  oflen 
contradicting  the  first  set ;  it  is  thus  in  mollus- 
cum  contagiosum  *  and  Paget's  disease.  More 
careful  work  has,  however,  demonstrated  num- 
erous irregularities  in  the  cancer  nucleus,  in- 
crease and  decrease  of  nuclear  substance,  frag- 
mentation, etc.  In  the  cancer  cell  itself  numer- 
ous perinuclear  bodies  have  been  described, 
striking  enough  to  be  considered  by  some  most 
careful  workers  as  genuine  parasites,  and  by 
others  explained  away  as  derivatives  of  the 
nucleus — endogenous  cells.  The  photographs 
(exhibited)  show  that  it  is  no  easy  question  to 
solve ;  there  is  no  reason  why  parasites  like 
bacilli  should  not  be  present  in  cancer,  and  it 
will  be  a  great  gain  for  those  who  succeed  in 
placing  it  beyond  doubt  that  we  are  dealing, 
with  parasites  — Amer.  Lancet, 

«Bocher,  18M. 


Quinine  as  an  Oxytocic. 

I.  Quinine  dops  not  exert  its  influence  direct)- 
ly  upon  the  uterus,  but  does  act  indirectly. 
When  inertia  is  due  to  depression  of  the  vital 
forces,  quinine,  in  small  doses,  becomes  a  valu- 
able stimulant 

II.  When  given  to  promote  uterine  contrac- 
tion it  does  not  produce  unnatural  and  persist- 
ent pains  that  are  so  often  produced  by  ergot, 
which  endanger  both  the  life  of  mother  and 
child. 

III.  The  same  eflect  can  be  obtained  by  ad- 
ministering it  in  much  smaller  doses  than  was 
formerly  given,  thereby  not  causing  the  patient 
any  unpleasant  symptoms. 

IV.  That  patients  who  take  quinine  as  an 
oxytocic  where  it  is  needed,  have  but  little 
trouble  during  its  parturition.  C.  W.  Canan, 
M.D.,— -4wi.  MS.  Bulletin. 

Therapeutic  Hints. 

(Prom  Oro88  Med.  CM.  BuUeUn.) 

Picrotoxine  1-40  gr.,  at  bedtime,  is  sufficient, 
according  to  Dr.  Cauldwell,  to  control  the 
nightsweats  of  consumptives. 

My  experience  warrants  this  statement :  Can- 
nabis indica  is  often  a  safe  and  successful 
anodyne  and  hypnotic. — Mattison. 

Balsam  of  Peru  is  frequently  used  by  Dr. 
Nicholas  Senn  in  the  treatment  of  tuberculous 
affections  of  the  bones  and  joints. 

Ten  to  twenty  drops  of  the  fluid  extract  of 
hyoscyamus  administered  at  bed-time,  is  an  ex- 
cellent remedy  in  cases  of  seminal  loss,  due  to 
irritation  or  muscular  atony. 

Cocaine  should  not  be  applied  to  the  mam- 
mary gland  during  lactation,  as  experience  has 
proven  it  to  have  the  power  of  arresting  the  se- 
cretion of  milk. 

Camphoric  Acid  in  Nightsweats. — Dr.  How- 
ard, Jr.,  of  Baltimore,  Md.,  finds  that  ten  to 
twenty  grains  of  camphoric  acid  given  at  night, 
controls  nightsweats,  when  atropia,  sulphuric 
acid,  etc,  fail. — Ran.  City  Med.  Record. 

Nitrate  of  silver  stains  are  easily  removed  by 
painting  the  part  with  tincture  of  iodine  and 
then  washing  in  dilute  aqua  ammonia. — Pacific 
Med.  Jour. 

Atropine,  says  Dr.  R  H.  King,  will  as  cer- 
tainly dilate  the  os  as  it  will  the  iris.  He  uses 
fortius  purpose  hypodermic  injections  of  1-100 
grain ;  a  second  injection  is  seldom  needed. 

Asthma. — A  capsule  containing  two  grains 
of  phenacetine,  one  of  quinine,  three  of  muriate 
of  ammonia,  one-eighth  of  capsicum,  and  one 
twenty  fourth  of  strychnine,  given  four  times 
daily,  will  often  relieve  an  attack  of  this  dis- 
tressing malady. — Mays  in  Med.  Record. 

Meynier  recommends  hourly  doses  of  salicy- 


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THE  MEDICAL  WORLD. 


late  of  soda  up  to  ten  grammes  (150  grains) 
daily  for  acute  gonuorrheal  inflammation 
about  the  neck  of  the  bladder. — Brook,  Med. 
Jour, 

Viburnum  for  Threatened  Abortion. — Polak 
(N,  F.  Jour,  of  Gyn.  and  OhsL)  advises  rest  in 
bed,  morphia  or  opium  per  rectum  and  dram 
doses  of  the  fluid  extract  of  viburnum ;  or  four 
grain  doses  of  the  solid  extract  in  pilL  Of 
thirty-two  cases  treated  in  this  way,  none  re- 
sulted in  miscarriage. 

Professor  Da  Costa  dees  not  believe  that 
the  true  cause  of  the  relapse  in  persons  con- 
valescing from  an  attack  of  typhoid  fever 
has  been  discovered  yet  He  is  of  the  opinion 
that  it  is  due  to  a  repoieoning  of  the  patient 
by  the  germs  still  contained  in  the  intes- 
tines. 

Hiccough. — This  troublesome  complaint  is 
said  to  be  relieved  almost  instantly  by  washing 
out  the  stomach  with  from  two  to  four  quarts 
of  warm  water. — Jour.  Mat.  Med. 

Be  cautious  in  giving  atropia  to  flaxen 
haired,  light  complexioned,  nervous  women. 


— Dr.  Fitch,  {Charlotte  Med.  Jour.y)  recom- 
mends the  following  in  summer  complaint : 

B.   Add.  hydrochloric,  dllut m  XTj 

Pepsin,  par drams  s 

BismuUi.  Bubnltrat drams  ij 

Syrup f  drams  ii 

Aquse  destillat f  ounces  i] 

M.  Sig.  Shake  the  bottle,  and  give  a  teaspoon ful  before 
each  feeialng  or  nursing  to  an  infant  one  year  old,  half  the 
dose  to  an  in&nt  of  six  months. 

This  mixture  must  be  made  fresh  every 
second  day  and  kept  in  a  cool  place,  as  it  is 
prone  to  fermentation  and  would  therefore  be 
unfit  to  use. 

As  a  spray  to  the  membrane  of  Diphtheria, 
which  will  act  as  a  solvent,  Prof.  Wilson  rec- 
ommends : — 

R.   del  eucalypti f  dr.  11 

Sodil  benzoatls dr.  j 

Sodli  blcarbonatls dr.  Jj 

Glycerlnl, foz.  l] 

Aqunoalds,  q.  s.  ad, OIJ 

Big.— Apply  as  a  spray  to  the  membranes  every  half  hour 
for  trom  three  to  five  minutes  at  a  time. 

Prof.  Parvin  says  in  doubtful  cases  where  it 
is  not  positively  known  whether  tJie  membranes 
have  ruptured  or  not,  an  examination  should  be 
made  during  the  time  of  a  pain,  for  no  matter 
how  closely  the  membranes  are  applied  to  the 
head  when  the  uterus  is  at  rest,  during  a  pain 
if  they  be  not  ruptured  some  fluid  will  be  found 
interposed,  and  die  membranes  will  be  projected 
but  care  must  be  exercised  in  making  the  ex- 
amination that  the  membranes  are  not  ruptured. 


— Epilatory  liquid : 

B.   Pure  Iodine gr.    xJJ 

Essence  of  turpentine m.  xx 

Castor  oil « f  dr.  n 

Alcohol « ....f  dr.  ijfls 

Collodion f  ox.j 

M.    Sig.  Apply  once  dallv  for  three  or  four  days ;  when  the 
collodion  comes  away,  a  clean  surfkce  will  be  left.* 

— In  asthma,  a  capsule  containing  two  grains 
of  phenacetine,  one  of  quinine,  three  of  muriate' 
of  ammonia,  one  eighth  of  capsicum,  and  one 
twenty-fourth  of  strychnine,  given  four  times 
daily  ,  will  often  relieve  an  attack  of  this  dis- 
tressing malady. — Mays. 


The  Arkansas  State  Board  of  Health  has 
been  given  power  to  revoke  the  license  of  any 
physician  who  is  guilty  of  habitual  drunken- 
ness. 


Formulas- 


DRY,  SCALY  CONDITIONS  OF  THE  EPIDERMIS. 

Dr.  Gordon  Sharp  (Leeds),  for  the  preven- 
tion and  treatment  of  chapped  hands,  and  as 
an  antiseptic  and  deodorizer  for  the  hands 
advises : 

R.   spirit  of  camphor. 
Spirit  of  nitrous  ether, 

St'ong  acetic  acid,  of  each 1  part 

Mix  and  add  glycerine 18  parts 

Wash  the  parts  with  warm  water;  dry,  and 
rub  in  the  liniment  at  bed-time.  This  appli- 
cation dries  in  a  few  minutes.  It  may  be  ap- 
plied again  in  the  morning,  and  washed  oS  in  a 
few  minutes. .  Owing  to  the  production  of  acetic 
ether,  the  application  has  an  agreeable  odor. 
— BriL  Med.  Jour. 


FETID  DIARRHEA  IN  CHILDREN. 

Dr.  R  Tompkin  (La  Semxiine  MedicaU,  No. 
73,  1893)  praises  the  following  formula  in  the 
fetid  diarrhea  of  children  as  an  intestinal  anti- 
septic : 

R.  Calomel ^..mlnaiss 

Sulphocarbolate  of  dnc drams  ijss 

Bismuth  subnltrate .....ounces  IJ 

Pepsin grains  zzz 

Divide  Into  twelve  powders.    Three  powders  daily  in  a 
child  one  year. 

— Pritchard,  in  Lancet-Clinic 


SCABIES. 

R.  Glycerin ounces  t! 

Qum  tragacanth ..grains  Izzt 

Flowers  of  sulphur ounces  iU 

Subcarbonate  of  potassium ounce  i 

Essence  of  mint drams  is 

Essence  of  lavender drams  si 

Essence  of  cinnamon drams  ss 

Essence  of  cloves  ....dramssi 

M. 

— Prof.  Foumier,  in  La  Tribune  Medieale, 


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CHRONIC  MALARIAL  POISOiaNO. 

B.  Qaininsd  Bulph drams  jss 

llnct.  captlclun ouncet*  ij 

Ext.  dDEiberte  fld ounces  lliS 

Syr.  addhydiiodic  (HosttUey's) 

^ q.  8.  ad  ounces  y1 

M.    Siff.    Teaspoonltil  aAer  each  meal.    To  be  taken  in  a 
wlneglassml  of  water. 


SEBORRHEA  ECZEMA  OF  SCALP,    PSORIASIS  AND 

FAVU8. 

R.  Alnmnol « 0.5 

Aquae  dest 15 

Glycerin ^ 3 

Lanoline  pomade 15 

— Chotzen,  Med,  Record, 

PRURITUS. 

B.  Acetate  of  lead grams    1 

Dilute  hydiocyanle  add.......;. *•        5 

Rectified  spirits "       15 

Distilled  water "     250 

Big.    Use  as  a  lotion. 

— Med,  Record, 


INJECTION  IN  GONORRHEA. 

R.  Permanganate  of  zinc grams    1 

DiitiUea  water ••      700 

— Hertz,  Med.  Record. 


LUPUS. 

Inject 'one  or  two  drops  of  the  following  into 

each  tubercle.     Ten  injections  can  be  made  at 

a  sitting : 

R.  Add  dnnamylio, 

OooainsB  muriat aa grams  I 

Spir  t.  vini « "    18 

— Landerer,  Med.  Record, 

[In  all  the  above,  it  will  be  remembered  that 

a  gram  is  15  grains.] 


A  CARBONATED  LAXATIVE. 

R.  Sodii  phosphat....A.. ». ............ounces  j 

Aquae  destil » „ f  ounces  x 

Syrup  simplids f  ounces  ij 

Tlnot.  limonia. gtt.  xxr 

Add  dtriC )  .|.  Ann/>4M  M 

Sodll  bicarbonate....  / -**• ®^^  " 

M. 

Sig.   Two  tablespoonitls,  or  more,  as  required. 

— Paul,  Les  Nouv.  RenL^  Med.  News, 


FOR  PRURITUS. 

B.  Add.  carbolic dram  J— dJams  ii 

Liq.  potaasee » f  dram  1 

Old  lini ad  f  ounce  j 

M.    Ft.  linlmentum. 

Big.    Apply  with  a  soft  dotb. 

— Practitioner;  Med,  News, 


CHRONIC  CYSTITIS. 

R,  Tr.  collinsonis ....drams  vl 

OopaibcB * ..drams  llj 

liq.  morphinsB ~ drams  ss 

Liq.  potasssB ounces  ss 

OLmentb.  pip minims  lij 

Aq.  camphors q.  s.  ad  ounces  vl 

Big.    A  teaspoonfbl  to  be  taken  every  four  hours. 
— Dr.  Chevers,  in  Med,  Press  and  Oir, 


HEMATURIA. 

R.  Tinct  secat  corniit.,  . 

Tinct.  digital.. 

Tinct.  ferri  chlorat aa ounces  ss 

M.    • 

Sig.   Twenty  drops  three  times  a  day. 

— Med,  Review, 


R. 


M. 

Sig. 


ACNE  ROSACEA. 

Lac  sulphur ounces  J 

Gum.  arable » ounces  ss 

Aq.  rocuB fi  ounces  iv 

Tinct.  benzoes ....fl  drams  ii 

Glycerin fl  ounces] 

Apply  locally. 


M. 
Sig. 


-J6. 


BRUISES. 

Tinct.  belladonnse, 
Tinct  aoonlti, 

Tinct  opll MtL fl  ounces  ss 

Chloroform fl  ouncesj 

Spirit  campfaorat fl  ounces  fl 

Menthol drams  ] 

,    Use  locally. 

—lb. 


CHRONIC  CYSTITIS. 

R.  Bucalyptol  (Sander  A  Sons) drams  ill 

Liq.  pot. drams  tys 

Fl  ezt  tritid  repentla. 

Tinct  opii  camphorata..*.......aa ounoes  J 

Syr.  acacisd. .\ q.  s.  ad  ounces  iy 

Sig.  One  teaspoonfSU  in  water  three  times  daily.  The 
fiUmuiacing  and  antiseptic  effact  of  the  eucalyptol  will  efltet  a 
speedy  and  perfect  cure,  surprising  both  physician  and 


A  ONCE  FAMOUS  "  PATENT  MEDICINE." 

Dr.  F.  K  Stewart  writes  that  before  he 
graduated  in  medicine,  he  for  a  time  superin- 
tended the  laboratory  of  the  Helmbold  Buchu 
0)mpan7,  and  received  from  Mr.  H.  T.  Helm- 
bold  the  formula  for  "  Helmbold's  Buchu,"  as 
follows : 

Buchu «.... 8  4-7  OSS. 

Cubebs „ 3  4*7  ozs. 

DiglUUs « 1  OS. 

Alcohol » 1  %  pts: 

Water  enough  to  make 1  gil 

Liquorice loa. 

Caramel l}i  ozs. 

Bsience  of  peppermint 820  aroi-s 

,  Molasses 6  ozs. 

During  the  height  of  its  popularity,  says  Dr. 
Stewart,  the  sales  of  the  "buchu''  were  30 
gross  a  day,  at  $95  per  gross,  the  cost  being 
about  $12 — a  not  inconsiderable  margin  of 
profit  — DruggisCs  Circular. 


PASKOLA. 


The  manufacturers  of  this  article  state  that 
it  is  an  artifically  digested  starch  food  in  which 
trypsin  is  exhibited.  They  do  not  claim  that 
it  will  fatten  naturally  lean  people,  but  it  will 


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THB  MBDICAI.  WORLD. 


restore  the  flesh  to  those  who  have  beoome  thin 
through  disease.  The  foripula  by  which  it  is 
prepared  has  not  been  made  public. 

— Druggiais  Circular. 


FOR  EPILEPSY. 

B.  Potassli  bromldl drams  !▼ 

Ttnccura  belladooutf} f  drama  ill 

Inftud  TOQtianse  oompoiiituit  ad f  ounces  vil] 

IL    S.    A  tablespooDfUi  thrioe  aaily. 

B.  Camphoro  monobromat grains  xlvilj 

Est.  genUais « q.  s. 

Ft.  Massie  ei  dir;  la.  pU.  no.  zlj. 

S.    One  at  bedtime. 

— Black,  in  Brit,  Med.  Jour. 


MIXTURE  FOR  INSTILLATION  IN  ACUTE  OTITIS. 
DR.   80LT. 
B.  Iohth7ol drams  ss 

g^SSJSViSir:::::::::::::::: }" <>"»«— 

Mix.  A  few  drops  of  this  mixture  to  be  indtUled  into  the 
car  three  times  a  day. 

Dr.  Solt  (Mitau)  was  induced  to  try  ichthyol 

in  the  treatment  of  acute  otitis  in  view  of  the* 

excellent  results  obtained  with  this  substance 

in  cases  of  peri-  and  parametritis.     The  favorable 

influence  of  ichthyol  on  the  inflamed  tissues  of 

the  ear  is  manifested  by  the  rapid  disappearance 

of  the  pain  followed  by  the  gradual  subsidence 

of  the  inflammatory  phenomena. 

— Columbus  Med.  Jour. 

RevJewsT 

Ambo-Thebapbutics  :  ob  the  Tbbatment  of  Lung 
Diseases  by  Climate.  By  Charles  Theodore 
Williams,  of  Brompton  Hospital,  London,  Eng- 
land. Price  12.00  Maomillan  &  Co.,  London 
and  New  York.  For  sale  in  this  city  by  J.  B. 
Lippinoott  Co.,  715  Market  street,  (^hiUdeiphia. 

This  work  is  a  series  of  lectures  upon  the  rarioas 
phases  of  the  influence  of  climate  in  the  treatment  of 
disease  of  the  respiratory  passages.  Its  treats  of  "The 
Elements  of  Climate,*'  ^Temperature  and  Moisture," 
^Barometric  Pressure,"  "High  Altitudes  of  Colorado." 
and  many  minor  topics  connected  with  the  main  sub- 
ject   The  subject  is  treated  in  a  masterly  manner. 

Methods  op  Pathological  Hibtolooy.  By  (J.  Von 
Eahlden,  of  Freiburg,  Oermany.  Translated  by 
H.  Moriey  Fletcher,  M.A.,  M.D.,  M.R.C.P.. 
London.  |1.40.  Macmillan  A  Co.,  London  and 
New  York.  For  sale  in  Philadelphia  by  J.  B.. 
Lippincott  Co. 

The  science  of  medicine  has  been  greatly  advanced 

Sthe  Microscope,  and  yet  too  fsw  physicians  take 
vantage  of  its  assistance  in  their  studies  and  prac- 
tioe.  In  this  work  the  student  or  practicing  physician 
can  find  complete  and  plain  directions  for  procedure. 
Would  it  not  be  a  good  idea  for  some  enterprising 
physician  in  each  community  to  make  4i  specialty  of 
microscopical  examinations,  charging  his  profestdonal 
oonfrer^  a  moderate  fee  for  the  examination  of  speci- 
)  submitted  for  the  purpose  ? 


Im  1776  the  members  of  the  medical  profession  were 
in  the  front  ranks  of  humanity's  progress.  The  lives 
•f  the  signer,  0r.  Benjamin  Rush,  and  the  early 


martyr.  Dr.  Warren,  the  hero  of  Bunker  Hill,  gires^ 
illustrative  testimony  to  thb  fact.  In  1894  the  mem- 
bers of  the  profession  are  equally  patriotic  and 
humanitarian.  To  keep  constantly  informed  on  the- 
great  issues  of  the  pres«|it  stirring  times  they  should 
be  regular  readers  of  tlie  Twentieth  Centubt,  » 
weeklj  magazine,  price  |2  00  per  year,  published  by 
the  Humboldt  Publishing  Company,  19  Astor  Plmoe^ 
New  York,  K.  Y.  Send  10  cents  for  sample  copy 
(mentioning  this  review),  and  judge  for  yourselves. 
For  the  same  reasons  they  should  also  read  Ths 
Akena   (Magazine),  Copley  Square,  Boston. 

Wit  and  Wisdom. 

Send  for  samples  of  soluble  elastic  capules  to  Parke, 
Davis  &  Co.,  Detroit,  Mich.,  as  per  their  adv. 

Fob  the  new  nervd  sedative,  Patsifiora  /noomala, 
write  to  John  B.  Daniel,  wholesale  druggist,  84  Wall 
St,  Atlanta,  Ga. 

This  is  the  season  when  your  debilitated  patients 
cannot  get  along  well  without  Horseford's  Acid  Phoe- 
phate. 

Fob  Colden's  Liquid  Beef  Tonic  or  Svapnia  fthe 
purified  opium),  address  the  Charles  N.  Crittenton  Co.^ 
116  and  117  Fulton  St.,  New  York,  N.  Y. 

Fob  fine  batteries,  address  the  Mcintosh  Battery 
and  Optical  Co.,  141-143  Wabash  Ave.,  Chicago. 

**Tbe  homeopathic  profession  has  some  lessons  to- 
learn,  and  it  needs  to  learn  them  quicklv.  In  these 
latter  days  of  grace  the  public  is  noting  that  in  puUi» 
affiiirs  the  homeopathic  school  is  invisible  or  nearly  to. 
It  expresses  no  opinions  on  sanitary  matters,  it  solvee 
no  hygienic  problems,  it  gives  no  public  instruction,  it 
is  interested  in  few  public  institutions,  in  short,  it  has 
little  as  a  school  to  do  with  public  medicine.  Thir^ 
years  ago  there  was  public  spirit  enough  manifested;, 
there  were  giants  in  those  days.  But  now  there  i» 
stagnation  and  there  is  scarcely  a  ripple  to  disturb  the 
placid  surface  of  affiurs.'' — North  American  Journal  of 
MomeopcUhy. 

Chab.  Marehand,  the  enterprising  manufacturer  of 
Peroxide  of  Hydrogen,  has  now  placed  upon  the 
market  a  new  preparation—Hydrozone. 

Fob  Pills,  Tablets,  Triturates  &c,  adden  the  P.  J. 
Noyes  Co.,  Lancaster,  N.  H. 

Fob  biliousness  and  allied  disorders,  use  Peacock** 
Chionia. 

Be  sure  to  send  for  rample  of  Sozoderma,  the  anti- 
septic soap.  Address  Hall  &  Bucket,  216  Greenwich 
St,  New  York. 

Get  your  spring  suit  from  E.  O.  Thompson,  1339 
Chestnut  St.,  Phila.,  Pa. 

Fob  the  morphine  habit  try  Keith's  Avena  Sativa^ 

We  have  entire  satisfaction  in  the  use  of  the  pile 
ointment  made  by  Fred.  W.  Stewart,  Oswego,  N.  i. 

Fob  the  '^Common  Sen^e"  Medicine  case,  send  to 
the  Western  Leather  MTg;  Co.,  125  Bees  St.» 
Chicago. 

We  select  the  following  verses  from  the  very  wiuy 
song  brought  out  at  a  banquet  of  medical  exaoi- 
iners  for  life  insurance^  by  Col.  George  N.  Cvpeuter, 


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THE  MEDICAL  WORLD. 


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and  published  in  the  N.  T.  MecL  Examiner, 
:  to  the  imae  oi  The  Prodigal  Son. 


It  was 


Thioughoiit  the  feast  we'll  sing  this  songi 

All  sing,  all  sing. 
The  Doctor* A  Night  to  help  along; 

ByjinelbyjinK! 
mie  Yery  best  medicine  known  on  the  earth 
Is  mosic  for  meala  and  a  metre  for  mirth; 
80  join  in  the  chorus  for  all  you  are  worthi 

Sing  tra  la,  la,  la,  la,  la,  la; 

Sing  tra  la,  la,  la,  la,  la,  la. 

There  was  once  an  examiner — Tre  heard  tell — 

There  was!  there  wasi 
Who  -declined  every  case  that  to  him  fell — 

But  pause;  O,  pause. 
They  all  had  consumption — ^there  was  no  hope 
^iU  they  found  a  big  fly  in  his  stethoscope; 
The  company  **fired^that  doctor,  I  hope. 

Chartu. 

I  once  ^  knew  another — he  made  me  laugh — 

He  could,  he  could; 
Always  took  the  pulse  with  a  sphygmograph, 

YOU  should,  YOD  should; 
Then  from  the  ^'tracings"  he'd  lay  down  the  law — 
The  least  of  his  phrases  would  break  your  jaw — 
The  'Hracings*'  they  looked  like  an  old  hand  saw. 

Chorus, 

Heredity  is  somewhat  of  a  medical  fad, 

A  fad.  by  sad, 
A  man  gets  lots  that  don't  come  from  his  dad; 

80  sad, — too  bad. 
A  man  was  declined  as  a  thief,  I  vow. 
The  doctor  inquired  and  learned  somehow 
He  was  raised  on  the  milk  of  a  hooking  cow. 

Chorui. 


When  yarn  examine  a  man,  take  off  his  - 

Take  oS[  take  offi 
He  may  tiave  barnacles  on  his  chest, 

Or  cough,  oreongh. 
Men  have  been  known  to  live  a  good  while 
With  their  bilia^^  duct  surchar^  with  bile. 
Then  suddenly  die  and  leave  a  big  pile. 


ChoruB, 


.  Akt  physician  who  needs  on  his  desk  a  neat  and 
attractiye  desk-tool,  combining  a  ruler,  measure  and 
paper  cutter  should  send  to  the  Malted  Milk  Co., 
KMine,  Wis.,  for  one  of  their  new  metallic  rulers,  also 
for  samples  of  Malted  Milk  as  described  in  their 
adrertisement  on  page  opposite  editorials. 

Tbt  Syrup  of  Ilgs  for  a  &mily  laxative. 

Elsqakcs  in  small  as  well  as  great  things  has  to 
be  considered  now-a-days,  and  both  patient  and  physi- 
cian may  profit  by  this  condition,  when  the  manufao- 
tnrer  of  pharmaceutical  preparations  carries  it  out  in 
his  biwinees;  that  is  if  he  does  not  sacrifice  quality  to 
apperance.  The  H.  E.  Mulford  Company,  of  Phila- 
delphia, stand  among  the  best  with  their  tablets,  tablet 
triturates  and  other  convenient  and  reliable  products 
of  their  laboratory.  For  the  convenience  of  their 
western  business  a  branch  house  has  been  establbhed 
in  Chicago,  112-114  Dearborn  St.,  where  a  full  and 
complete  stock  of  goods  is  carried. 

Msllh^s  Food  carried  eff  the  honors  at  the  Chicago 
World's  Fair. 

UflB  Ajsenaoro  when  yon  want  a  powerful  tonic 
Send  for  literature  to  £.  M.  Jehoson  A  Co.,  88  Piatt 
6^  New  York,  1!L¥, 


The  Marshmallow  Cream  made  bv  the  Diamond 
Laboratory  Co..  Naugatuck,  Conn.,  is  a  fine  Ussue- 
buiider.    Send  tor  sample* 

The  Maltine  M'fg.  Co.,  168  Duane  St.,  New  York, 
will  seud  sample  of  Mai  one  if  you  will  pay  expreas 
charges. 

For  samples  of  fine  hollow  suppositories  address 
Hall  A  Buckel,  216  Greenwich  St.,  New  York. 

Your  old  hernia  cases  can  be  cured  by  the  process 
advertised  in  this  journal  by  the  Sthavara  Co.,  1338 
Walnut  St.,  Phila. 

We  have  entire  confidence  in  the  supporters  and 
elastic  goods  made  by  O.  W.  i«lavell  &  Bro.,  1005 
Spring  Garden  St.,  Phiia. 

^  The  horse  that  does  not  need  feeding  and  is  never 
sick  or  tired.  (Sometimes  gets  pneumatic  tired,  though). 
For  particulars,  write  to  the  Warwick  Qrcle  M'fg. 
Co.,  Springfield,  Mass. 

For  a  coal-tar  antipyi^c  use  Labordine. 

W11.LIB  H.  Davis,  Keokuk,  Iowa,  has  been  an  ad- 
vertiser in  The  World  for  several  years.  He  is  an 
enterprising  dealer  in  surgical  instruments,  saddle- 
bags, medicine  cases,  druggists'  sundries,  trusses,  etc. 
For  example,  you  can  purchase  of  him  a  Deoiison's 
Stethoscope  (binaural)  tor  $4.00,  all  transportation 
expenses  prepaid.  Look  over  your  stock  and  see 
what  instrument  or  case  you  particularly  need,  and 
send  to  him  for  it.  Perhaps  his  catalogue  will  help 
you  to  find  out  just  what  you  want  See  his  adv.  in 
this  issue.  Send  a  trial  order,  and  if  that  convinces 
you  that  it  pays  you  to  patronize  him,  self  interest 
will  lead  you  to  continue. 

THE  better  WAT. 

Better  than  rising  with  the  lark, 

And  sweeter  thiui  its  aria, 
Is  to  lie  a-bed  till  eight  o'clock 

And  thus  escape  malaria. — Pmdi^a  Librarjf. 

FERMENTATIVE  DT8PBF8IA. 

For  this  form  of  dyspepsia  Professor  Austin  Flint 
prescribes  bismuth  subgallate,  in  ten  ^rain  doses,  eUher 
m  capsules  or  tablets,  three  times  daily  after  eatiiig.. 

SHORTEN  THE  KOKENCLATUREl     ,        'j., 

"Who  says  convolution,  '' 

When  he  might  say  gyre,        '   ' 

Would  cry  conSagrationI         „^    j_.-y. 
When  he  might  shout  firel"  L^n 

— MedioalNiwi, 

Dr.  Granville  L.  Fox,  Slate  Springs,  14^  ^sjrs: 
"I  have  used  Papine  in  two  cases  of  ^phoi^J  feir^ • 
In  all  my  practice  of  four  years  iJj^i^^Qi  m^yef  jjat 
found  any  preparation  or  combination  that  actedf  so 
admirably  as  an  anodyne.  Sometimes  J^  ooml^ine  it 
with  Bromiilia  and  get  the  best  of  results,  .  I  e^pfoi 
to  keep  it  on  hand  from  now  on  s^I  do  not  ;)ui^if.  of 
an3rthing  that  would  exactly  replaoeJL^  intJ^f^^^e^peri- 
ence  I  live  had  with  it."        ,  .^  >  .l.  '   -/I » .!?  j 

IN  HiB  NATIVE  iLEiribrr.^* '  -       *'^-^ 

•"  '  ■•.ic-j  .-♦in,..  .K"  I 
Attendant — Prof.  Pithon,i  the  MaUuniiaL  hsa  got 
the  d.  t.'s  to-night.    Imagines  tke-S) sartoomled  h|^ all 
sorts  of  queer  snakes.        tn   ^^rMva)  m.   isis  a^u^ 
Head  Physician — ^Is  he*greatly  terrifiadtf      }». :.  j- 


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228 


THB  MBDICAI.  WORLD. 


Attendant — Not  at  all;  he's  setting  there  with  a 
sweet  smile  on  bis  face,  classifying  them. — Puck, 

L.  F.  Warner,  M.D.,  writes:  "I  wish  to  give  my 
testimony  to  the  value  of  Dr.  McArthur's  Symp  of 
Hypophosphites.  I  have  used  it  and  am  now  giving 
it  in  what  I  call  a  typical  case  of  phthisis  with  a  most 
excellent  result  I  bn^lieve  the  value  of  the  syrup  can- 
not be  over-rated,  as  it  supplies  the  elements  of  nerve 
nutrition  in  an  easily  assimilable  form. 

Hotel  Pelham,  Bo6ton,  Mass. 

"  DOC." 

If  it  has  been  your  misfortune  to  be  called  ''doc," 
and  if  this  recognition  has  become  at  all  general 
among  your  friends  you  might  as  well  move  to  some 
other  place.  A  man  may  be  called  a  thief,  a^  liar  and 
a  dead  beat,  and  yet  he  may  prosj^er  and  live  upon 
the  fat  of  the  land.  But  once  let  him  be  called  "doc" 
and  his  professional  success  is  at  an  end.  We  would 
prefer  to  spend  a  night  in  the  station  house,  so  far  as 
Its  effect  on  our  professional  success  is  concerned 
rather  than  to  have  our  friends  notice  our  approach 
by  saying,  **There  comes  dSc"  If  a  man  calls  you 
*'doc"  you  ne^  never  expect  a  penny  from  him  for 
any  professional  services  you,  oould  render.  His 
answer  is  sure  to  be,  *'A11  right,  doc,  in  a  few  days  that 
will  be  all  righl.'*  "Doc''  means  disaster.  "Doc"  is 
the  culmination  of  all  calamity.  '*Doc"  is  a  catas- 
trophe ffiven  at  one  stroke.  "Doc\  is  th»  warning 
that  we liave  reached  the  extreme  limit  of  our  useful- 
ness. "Doc"  is  the  hand  which  points  us  to  the  next 
town.  Shun  it,  my  young  friend^  as  you  would  flee 
from  a  Kansas  cvclone  or  a  praine-iire.  Knock  the 
man  down  who  first  dares  speak  it  to  you;  and'  call 
upon  I  he  whole  medical  profession  for  vindication  of 
your  righteous  deed.— -AToi.  Med.  Review. 

Dios  Chemical  Co.,  St.  Louis,  Mo. 

Homestead,  Pa.,  Feb.  24, 1894. 
Gentlemen. — Have  used  Sennine  in  a  variety  of 
diseases,  and  find  it  particularly  effective  in  Eczema, 
Croup,  Diptheria  and  Gonorrhea.  Its  antiseptic 
qualities  are  unquestionable,  and  being  odorless,  it 
recommends  itself  to  the  profession.    Very  Truly, 

N.  J.  BiGLEY,  M.D 

Frank  A.  Ruf,  of  the  Antikamnia  Chemical  Com- 
pany, has  recently  been  in  New  York  and  Chicago, 
and  states  that  he  has  made  arrangements  for  a  thor- 
ough system  of  investigation  throughout  the  country, 
and  that  counsel  has  been  employed  to  prosecute,  both 
civilly  and  criminally,  all  who  persist  in  furnishing  a 
substitute  as  and  for  antikamnia. 

Once  the  man  ate  the  cream ;  now  they  cremate  the 


It  gives  us  pleasure  to  state  that  Wm.  R.  Warner 
&  Co.,  of  Philadelphia,  have  received  a  silver  medal 
for  fine  pharmaceutical  specialties,  at  the  late  Inter- 
national Medical  Congress  at  Rome. 

Habitual  Mihcareiaoe.— R.  Reece,  M.  R.  C.  S. 
Eng.,  1851,  L.  S.  A.,  1882,  Walton-on-Thames.  Eng- 
land, says :  "  I  used  Aletris  Cordial  in  a  case  of  pain- 
ful menstruation.  It  was  most  valuable.  The  wife  of 
a  minister  suffered  much,  and  had  had  three  miscar- 
riages. Prescribed  Aletris  Cordial.  She  has,  for  the 
first  time,  gone  her  full  time,  and  was  safely  confined 
with  a  male  child.  I  also  prescribed  it  to  a  relative, 
•offering  with  leucorrhea  for  years.  Great  relief  from 
pain,  and  the  discharge  much  lees,  in  the  first  ca^e 
related  it  was  truly  a  God-send  to  her." 


MYALGIA. 

R.    Salophen « Idrun 

Liq.  long  sal »..  8  ounces 

Qlycerlue l\C   •* 

Spts.  ftumenti ijj   •* 

M.    8ig.    Tablespoenfol  every  four  hooiB. 

Try  Fhytoline  for  your  corpulent  patient  For 
skin  diseases  use  Pineoline.  Address  Walker  Phai^ 
macal  Co.,  SL  Louis,  Mo. 

I.  Phillips,  Atlanta,' Ga.,  dealer  in  first-class  sur- 
gical instruments,  at  cut-rate  prices.  Send  for  price- 
list. 

The  old  original  house  of  Hastings — the  Hastings 
Truss  Company,  224  South  Ninth  Stieet,  Philadelphu. 
will  supply  you  with  what  you  need  in  the  line  of 
trusses  and  supporters. 

Try  Sanmetto  in  disorders  of  the  genito-nrinaxy 
system. 

Juuus  Fehr's  Baby-Powder  is  a  thoroughly  relia- 
ble article. 

Send  to  Micajah  &  Co.,  Warren,Pa.,  for  sample  of 
their  uterine  wafers. 

We  use  Weinhagen's  thermometers  with  entire  sat* 
isfaction. 

Mortality  of  Black  Death.— During  the  year 
1346  this  dread  and  much  mooted  malady  carried  off 
24,000,000  people  in  Europe,  more  than  30,000  towns 
and  villages  being  entirely  depopulated.  Even  as  late 
as  1350,  ships  were  enoonntered  at  sea  with  all  the 
crew  dead  on  board  from  this  cause. — Med.  Age. 

AvA,N  Y..  April  10th,  1893. 
I  used  Freligh's  Cough  and  Constituent  Tablets  in 
advanced  phthisis  (two  cases),  with  very  satisfactory 
results.    I  can  confiaently  recommend  them  as  worthy 
of  trial  by  the  profession.       S.  A.  Russell,  HJD. 

That  seventeen  hospitals  in  New  York  City  and 
Brooklyn  have  adopted  the  use  of  Unguentine,  a  surgi- 
cal dressing  recently  intro  luced  by  the  Norwich  Fhu- 
macal  Co.,  Norwich,  N.  Y.,  attests  the  efficacy  of  this 
remedy  in  the  treatment  of  external  inflammatory  a^ 
fections.  It  is  composed  of  alum,  which,  by  a  chemi- 
cal process,  is  made  non-irritating,  with  carbolic  aci3 
and  ichthyol  added. 

W.  H.  HOSTELLEY  &  Co. 

Gentlemen : — Your  preparation  of  the  Compound 
Syrup  Hypophosphites  has  given  me  most  eminent 
satisfaction  in  every  case  in  which  I  have  used  it 
The  results  have  be^n  much  better  than  I  had  hoped 
for.  C.  H.  Gibson,  M.D., 

Hagerstown,  Md. 

A  Doctor's  Trouble.—**  My  dear  fellow,"  said  my 
doctor  to  me,  **you  have  no  idea  what  we  have  to  pot 
up  with.  If  I  call  to  see  a  patient  frequently,  I  am 
'trying  to  run  up  a  bill;'  if  I  don't,  *  it  is  shameful 
neglect.'  If  I  manage  to  get  to  church,  and  am  called 
out,  I  hear  afterward,  'Working  the  Bob  Sawyer  dodge 
on  Sundays,  eh,  Doctor? '  If  1  am  so  busy  that  I  can- 
not go,  I  am  sure  to  be  asked,  *How  is  it  that  you  doc- 
tors are  all  atheists? '  If  my  wife  calls  on  people^  *it 
is  because  she  is  trying  to  get  patients  for  me,' oat  if 
she  doesn't,  it  is  because  she  is  'too  stock  up.'  If  I 
cure  9  patient  quickly — get  credit,  vou  say?  Oh,  detfi 
no! — the  patient  'wasn't  naif  as  bad  as  the  doctor  tried 
to  make  out;  why,  he  was  quite  well  in  a  week;'  but, 

{Continued  on  next  iea/,) 


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The  MedicalWorld 

71#  kmamUd^e  that  a  man  can  use,  is  ths  onlf  real  knowledgt;  the  only  knauh- 

Mge  tsai  has  life  and  growth  in  it  and  converts  itself  into  practical  power.      The 

rtst  hangs  like  dust  about  the  brain,  or  dries  like  raindrops  off  the  stones.^lfROjnm. 


iThe  Medical  World.  ©Piginal  Qommumootions. 


MoirrHi.Y,  by  C  p.  Tatz^k,  M.  D. 


J.J.  Tayw)1l,  M.D., 


?Bdztors. 


I  to  toy  part  of  tlie  United  SUtct  and  Canada, 
Omt  DOLLAK  per  year.  To  Bngland  and  the  British 
Coioaiea,  Prvx  ISBZXXiifoa  per  year.  Poctaire  free. 
•ingle  copies,  Tbm  Cxzrra.  Theae  ratea  moat  be  paid 
eimtmriBbfyiH  adtfanee* 

KCBBSot  alwaya  anpply  back  nnmberi.  Should  a  num- 
ber Ua  to  rnch  a  aubacriber,  we  will  anpply  another, 
ir  BetUcd  before  the  end  of  the  month. 

^  urn  momef  to  agents  for  this  Journal  nnlcaa  pttbliaher*s 
flvuipt  is  gi^en. 

MBttBM  AZX  COlClCUinCATXONS  TO 

"THE  MEDICAL  WORLP/' 
1520  Cbestnut  Street, 

rmiMDKLPHIA.  PA. 


VoL  XH 


July,  1894. 


Na  7. 


Danger  of  Loud  Noito*  to  the  Very  Siek. 
Dr.  C  B.  MorriMe»  of  Central  Station  Hoepi^ 
tal,  Trimulgheny,  India,  reports  to  the  Indian 
Med,  Bee.  two  caaee  of  patients  in  a  low  state 
who  expired  immediately  upon  the  occurrence 
(rf'a  sadden 'load  noise.  We  have  no  doubt 
that  there  are  manj  patients  whose  cases  are  ren- 
dered distinctly  worse  bj  the  various  loud 
noises  incident  to  city  life,  such  as  steam  whistles, 
yehiclee  on  rough  streets,,  hucksters'  cries,  the 
ringiDg  of  bells,  etc.,  most  of  which  disturbance 
18  unnecessary.  We  believe,  also,  that  many 
well  persons,  especially  women  and  children, 
are  rendered  very  nervous  by  these  causes. 

On  account  of  the  unusually  urgent  import- 
ance, of  our  original  communications  this  month 
we  are  compelled  to  omit  the  usual  extent  of 
editorial  articles.  '  In  this  we  believe  that  our 
leaden,  when  they  peruse  the  following  pages, 
win  find  themselves  distinct  gainers. 


Short  artidea  on  the  treatment  of  dJacMea,  and  experience 
with  new  remedies,  are  aolidted  fiom  the  profinrion  foe 
this  department;  also  difficult  cases  for  ffiagnoaia  waif 
treatment 

Artidea  accepted  muat  be  oontribnted  to  thia  journal  omfy. 
The  editors  are  not  responsible  for  iriews  ezpiased'  vif 
contributors. 


or  before  the  tweUUt  of  thf 

lusetf 


Unu 


Copy  must  be  received 

month  for  publication  in  the  next  montli; 
Manuscript  cannot  be  rctomed. 

Ctrtainly  it  it  eJtttOtni  ihdpUmfMr  am  auikor  ioJMtkai  A» 
musisayuUktkattomyimiktfetimsipattiiAwordt^op 
hu  rtaatr  it  turt  i»  tkMtksm/  mndin  tk4  pia^uti  itptrihU 
mordtt^kitrrndtr  wnU  etrUinly  wtitundentmmd  Mmr. 
Gentry,  mho,  a  domrnH^  Jkcfmay  bt  toidima  pimim 

way:  and  w§  mmui  iowm  igkijkHtmiprtmmt  t 

'^jMM|f  ate,— aus 


READ.     REFLECT.    OOMPARE.     RECORD. 

Varieties  of  Pain.— Replies  and  Oommentt.' 

Editor  Medical  World  : — A  younff  physi^ 
dui  consulted  me  for  an  affection  of  uie  lem 
It  began  with  pain,  worst  in  the  firont  of  £ei 
thighs,  not  severe,  worse  (m  rising,  and  gettmg; 
better  towards  evening.  This  was  followed  by- 
anesthesia,  not  complete,  worst  in  the  feet  The* 
legs  were  weak,  and  this  to  such  a  degree  as  to- 
interfere  with  his  attending  to  practice.  There- 
was  some  pain  in  the  hips,  about  the  saore-iltac 
articulation,  but  none  along  the  course  of  the- 
sciatic  nerves.  On  stooping,  the  patient  said  he^ 
felt  as  if ''chords  of  his  legs  were  too*short'^ 
The  general  condition  good,  digestion  normal^ 
reflexes  perfect,  no  ataxic  symptons  and  no  his^ 
tory  of  syphilis,  alcoholic  or  other  excesses.  Thi» 
case  appeared  to  me  to  be  one  of  a  mild  grade- 
of  peripheral  neuritis,  due  to  exposure  to  cold^.. 
while  riding.  The  arms  and  upper  part  of  the 
body  get  some  exercise  while  riding,  while  the- 
legs' and  feet  get  but  little ;  hence  the  latter  are^ 
likely  to  be  cUlled,  and  this  is  one  result  that 
may  ensue.  This  case  had  been  called  "  rheu- 
matism," and  as  being  due  to  exposure  to  cold- 
There  is  a  certain  appropriateness  in  the  term, 
i)till  it  is  wrong,  for  rheumatism  is  a  disease  ot 
the  fibrous  structures  of  the  joints,  with  local: 
inflammation,  fever,  acid  sweating  and  urine, 
and  a  tendency  to  shift  from  one  joint  to* 
another.  Nothing  else  is  rheumatism ;  but  with 
some  persons  ''anything  that  hurts,"  receives* 
this  name,  and  under  it  we  find  the  following :; 


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230 


THB  MEDICAL  WORLD. 


1.  Neuralgia:  Painful  poiDts  where  nerve 
passes  through  foramen,  paroxismal  pains,  eon* 
fined  to  the  course  of  one  or  more  nerves,  re- 
•curring  in  thei  same  nerves  and  gradually 
implicating  others,  with  anesthesias,  trophic 
'changeB,attaek8 induced  by  depressing  influences. 

2.  Myalgia,  confined  to  muscles,  in  a  state 
of  degeneration  from  strain,  overwork,  disuse, 
•or  inflamed  by  "  catching  cold ;"  relieved  by 
stretching. 

3.  Spinal  irritation,  diffuse  tenderness,  with 
pain  on  deep  pressure  over  some  vertebrse,  in  the 
•epigastrium  and  in  the  left  hypochondrium,  ar- 
terial pulsations,  reflex  neuroses  of  the  hysteric 
type. 

4.  Hypochondria:  Pains  periodic,  afiectmg 
•certain  nerves  but  flying  ofi  to  any  point  to 
which  attention  is  directed,  boring  or  burning 
.pains,  hyperesthesia  to  slight  pressure,  relieved 
by  deep  pressure 

5.  Locomolor  ataxia :  Lightning  pains,  with 
•ocular  palsies,  altered  gait,  incoordination,  crises 
of  stomach,  kidneys,  bowels,  heart,  brain  <&c. 

6.  Cerebral  abscess:  Head  pains;  paroxys 
mal  or  a  fixed  burning,  with  convuJsioLS,  verti- 
go, paralysis,  coma,  cerebral  votniting. 

^7.  Alcoholism:  Pains  not  confined  to  same 
nerves,  bilatferaU  not  eadily  relieved  by  mor- 
phine, but  speedily  by  alcohol,  cord  like  pains 
around  ankjeg  or  wrists,  a  "  shifty  plausibility  " 
of  temper,  and  digestive  ti  oubles. 

8.  Syphilis:  Bone-pains  symmetrical,  worse 
at  night,  pain  on  firmly  pressmg  sternum,  sen- 
sitive shms^  painful  points  where  nodes  are 
forming. 

9.  Morphine:  Abstention  pains,  attacking 
yrefik  ^pots  of  superlative  intensity,  relieved  by 
morphine  in  any  dose,  however  small. 

10.  Gout:  Pains  in  small  joints,  in  meat- 
waters  of  sedentary  habits,  with  tophi  and  other 
goutv  symptoi  s. 

11.  L^:  Colic,  twinges  of  pain  in  fore- 
jurms,  lead- line  on  gums. 

12.  Uricemia:  Frontal  or  occipital  bilat* 
«ral  headaches,  gat  trie  catarrh,  aching  and 
drawing  sensations  in  limbs,  stiffness,  despon- 
dency, malaise. 

13.  Peripheral  neuritis:  Severe  pain  in 
one  or  many  nerve  endings,  paroxysms  of 
needle-like  stabs,  tingling,  formication,  burning, 
trophic  chai  ges  in  region  supplied  by  affected 
nerves. 

When  we  call  all  these  rheumatic  or  neural- 
gia, how  much  we  lose  of  the  nicety  of  medical 
practice.  The  treatment  of  these  conditions  is 
90  various  that  they  cannot  be  lumped  together. 

The  neurotic  condition  underl)ing  several 
requires  nerve  reconstructives,  but  these  are 
^orse  than  useUss  in  uricemia  or  myalgia. 


In  the  case  of  the  young  doctor,  I  attitbutod 
the  svmptoms  to  a  mild  peripheral  neoritis,  for 
which  I  recommended  iodide  of  iron  and  aiae- 
nic,  faradism  and  massage  of  the  limbs  with 
hot  oil,  hot  bathing,  moderate  exercise  and  a 
good  diet. 

Dr.  Tillotfon's  remedy  (page  194),  for  diph- 
theria contains  two  useful  ingredients — nitre  and 
sulphur,  but  why  not  give  these  in  the  ordinaiy 
form  ?  Sulphur  blown  into  the  mouth  is  highly 
valued  by  many  authorities. 

The  condition  described  by  Dr.  Stratton 
(page  196)  is  not  peculiar  to  diphtheria  or  a 
part  of  that  disease.  If  any  other  infectious 
germs  had  come  along,  scarlatina,  measles,  or 
typhoid,  the  same  depressed  ph}  siological  condi- 
tion would  have  proved  the  open  door  to  them 
as  well  as  to  diphtheria.  The  iron-ehoirine 
mixture  is  indeed  useful  as  a  systemic  stimu- 
lant tonic,  and  in  so  far  Dr.  Stratton  is  right. 
The  point  I  wished  to  emphasize  in  my  letter 
was  the  neglect  of  local  treatment  induced  by 
the  belief  in  the  constitutional  nature  of  the  dis- 
ease. 

Dr.  Roberts  (page  166).  raises  some  very  in- 
teresting questions.  I  may  say  that  a  healthy 
location  is  not  necessarily  synonymous  with  good 
hygiene.  Cyrus  Edson  says  there  is  not  a  wall 
or  spring  in  the  United  States  where  ^ater  is  fit 
to  drink.  A  mountain  town  in  Pennsylvania 
was  attacked  with  malignant  diphtheria.  I  was 
assured  by  the  doctors  that  the  hygiene  was 
faultless,  but  the  State  Sanitary  Inspector  found 
the  drinking  water  contaminated  with  sewage. 
However,  I  do  not  wish  to  intimate  that  the  doc- 
tor was  mistaken  in  his  belief  of  the  healthy 
nature  of  the  place,  for  that  is  not  neoessuy. 
Country  children  are  far  more  liable  to  the 
poison  of  infectious  diseases  than  those  who  are 
inured  to  the  polluted  air  of  cities.  CauseB 
that  would  produce  a  mild  case  in  the  city  child 
would  develop  the  malignant  form  in  the 
country  cousin.  So  that  the  hygiene  of  Ae 
house  may  have  been  fully  as  good  as  the  doc- 
tor claims,  and  still  we  can  underhand  why  the 
people  have  died.  As  to  the  cause  of  the  out- 
break in  these  isolated  localities,  it  is  one  of  the 
inexplicable  mysteries.  In  all  my  ezparienoe 
there  was  never  a  case  of  smallpox  that  I  failed 
to  trace  to  its  source.  Nor  were  there  many 
casee  of  scarlatina  whose  origin  we  failed  to  dis- 
cover, but  with  diphtheria  there  were  many 
whose  coming  remained  a  mystery.  We  could 
see  the  causes  of  malignancy,  but  whenoe  came 
the  contagion  we  could  rarely  tell.  I  am  fofoed 
to  the  conclusion  that  the  germs  of  diphtheria 
are  widely  scattered  and  retain  their  vitality  for 
an  unusual  period,  reproducing  outside  the  body 
wherever  a  favorable  nidus  is  found,  and  par- 


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haps  carried  to  a  distance  by  the  wind.  In  re- 
gard to  Dr.  Roberts'  case,  Horace  W.:  This 
was  diphtheritic  endocarditis.  The  bacilli  pene- 
trated to  the  blood-vessels,  were  carried  away  in 
the  circulatbn,  lodged  on  the  valves  of  the 
heart,  aad  there  set  up  the  pathological  process 
that  resulted  in  the  boy's  death.  This,  how« 
ever,  is  totally  diflterent  from  the  theory  that 
looks  on  the  disease  as  constitutional  from  the 
first,  and  the  pharyngeal  disease  as  only  a  local 
manifestation.  The  dysenteric  cases  may  also 
have  been  diphtheritic.  I  think  the  chlorine 
sots  locally  on  its  way  down  the  throat,  and  I 
use  it  thus  instead  of  with  a  swab  because  it  is  a 
better  way  of  reaching  the  whole  pharyngeal 
tract,  lem  unpleasant  to  the  child,  and  the  ^^ste- 
mic  efleot  ts  also  secured. 

Dr.  Page  asks  a  remedy  for  calculi  and  gdter 
(page  204),  caused  by  the  magnesio  calcic  water 
of  Kansaa.  If  people  will  drink  this  water  they 
may  expect  to  suffer.  I  would  ad  visa  the  use 
of  distilled  water,  were  I  not  afraid  the  Kansas 
farmer  might  utilize  his  still  for  the  production 
of  agents  more  dangerous  than  magnesia  water. 

On  page  211  Medicus  asks  about  the  treat- 
ment of  congenital  hydrocele.  I  would  let  it 
alone  until  some  time  had  elapsed,  some  years, 
infact,  unless  there  is  some  reason  for  immedi- 
ate operation.  For  some  years  I  have  treated 
all  hydroceles  by  dndnage,  tapping  with  a  fine 
trocar  and  leaving  the  little  silver  canula  in  the 
wound  until  adhesive  inflammation  has  obliter- 
ated the  sac. 

Today  I  received  a  letter  from  a  patient  in 
Pennsylvania  who  sajs  the  medicine  I  sent  him 
for  chrcmic  alcoholism,  works  like  magic;  the 
craving  has  disappeared  and  he  is  sleeping  and 
eating  like  a  coal  heaver. 

Dr.  Pimo's  case  (page  217)  looks  like  one  of 
bulbar,  or  as  we  used  to  call  it,  glofso-laryngo* 
pharyi^^eal,  paralysis.  If  so,  she  will  die,  and 
no  treatment  will  give  relief. 

Dr.  Thompson  (page  218)  has  resurrected 
that  wonderful  man,  Howard  Green,  who  had 
the  misfortune  of  being  bom  many  years  too 
soon.  When  he  described  his  method  of  intra- 
laryngeal  applications,  his  competitors  cooly  con- 
diKled  that  he  lied,  as  the  laryngoiogical 
specialty  was  not  then  bom.  In  the  old  text- 
books you  will  find  mention  of  him. 

As  disinfectants  before  going  to  the  obstetric 
room,  I  prefer  sanitas  for  the  clothes  and  per- 
oxide for  the  hands.  But  the  old  fashioned 
(dilorinatedaola  is  excellent  In  fact,  it  is  not 
so  much  the  choice  of  antiseptic  as  its  perfect 
application  and  perfect  cleanliness,  that  are  es 
wntial.  I  have  never  yet  known  a  case  of 
vomiling  of  pregnancy  that  required  abortion. 
I  have  known  many  wom^i  who  would  not  have 


got  any  relief  from  other  treatment  if  they^ 
thought  that  they  could  have  abortion  perform- 
ed as  a  last  resort.  Quite  recently  I  dilated 
the  sphnicter  ani  and  thus  curei  an  obstinate 
case. 

For  lupus  exedens,  described  by  Dr.  Small 
(page  21^),  I  would  apply  trikresol  locally  and 
give  theiosinanine  by  hypodermic  injection, 
dressing  with  permanganate  and  earth  or  char- 
coal. 

Dr.  Smith  will  not  find  an  albolene  atomiaer 
expensive,  and  if  he  uses  it  w»th  Dobell's  solu- 
tion and  then  with  compound  albolene spray»  he 
ought  to  cure  his  catarrhs  quite  nicdy. 

For  such  oases  as  Dr.  Cochran's  (page  219), 
there  is  but  one  remedy,  the  rest  cure,  with  it» 
acoeasoriei,  as  carried  out  in  a  well-conducted 
sanitorium.        Wiluam  F.  Wauoh,  M.D., 

103  State  St,  Chicago.  / 


intestinal  Obttruction. 


Editor  Medical  World  : — By  this  is  meant 
a  complete  stoppage  of  the  passage  of  the  con- ' 
tents  of  the  bowels,  by  tumors  or  other  matters 
inside  of  the  bowel  or  around  it  and  inside  of 
the  cavity  o£  the  peritoneum  The  books  give 
many  causes,  but  many  of  them  have  not  been 
apparent  to  all  practitioners^  such  as  floating 
Udneys—a  very  rare  oeourrence — displaced 
spleen,  mesenteric  and  ovarian  tumors,  cancers, 
but  not  entangflement  in  peritoneal  openings  aa 
hernia,  constricting  bands  of  connective  tissue, 
incarceration  of  bowel  or  by  apertuns  in 
omentam  mesentery  or  diaphragm,  suspensory 
ligament  of  the  liver,  broad  ligament  of  the 
uterus,  Ac  Many  other  causes,  but  these  are 
enough.  The  balance  can  be  referred  to  in  the 
books  on  the  sul]ject 

Symptoms  :  The  most  prominent  is  pan^ 
(though  some  times  it  is  not  very  acute,  thereby 
misleading  the  practitioner),  colicky  and  in- 
creased by  pressure ;  wmiting,  first  of  the  con- 
tents of  the  stomach — then  of  bile,  some  times 
very  slight  when  the  obstruction  is  in  the  rec- 
tum or  colon,  which  allows  the  fecal  matter  to 
be  thrown  up  by  continued  vomiting ;  tympaniies 
— occurring  as  the  disease  progresses.  Exami- 
nations ought  10  be  made  under  anesthetics, 
either  ether  or  chloroform.  Owing  to  the  rigidity 
oi  the  musdes  of  the  abdomra,  anesthetics  are 
absolutely,  lecessary  unless  the  other  symptoms 
leave  no  mistake  in  making  the  diagnosis. 
Sometimts  exammation  by  the  rectum  is  neces- 
sary. In  case  of  intussusception  it  may  hap- 
pen that  the  discharge  of  blood  may  make  it 
difficult  to  distinguish  from  dysentery.  For 
more  particular  and  extended  symptoms  I  would 
refer  to  Dr.  Ashurst's  valuable  report  in  the 


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THB  MBDICAX  WORLD. 


PolycUnie  and  copied  in  the  Epitome  to  Braith- 
waiie  of  1886. 

The  face  is  pale  and  has  an  anxious  expres- 
;«ion ;  features  pinched  as  in  violent  diarrhea 
4Uid  cholera ;  eyes  sunken  in  the  sockets ;  pulse 
rapid  and  feeble  ;  tongue  dry ;  urine  scanty  and 
'high  colored.  In  chronic  obstruction  from  im- 
paction of  feces  these  symptoms  are  milder  and 
•sometimes  without  any  vomiting.  When  from 
tumors  pressing  on  the  bowel  a  change  of  poti- 
don  may  temporarilv  relieve  the  obstruction, 
but  it  generally  enos  in  debilitated  health, 
Anonia&c. 

DiagnosiB.  This  is  som^mes  difScult,  from 
bemia — ^not  very  prominent — ^from  stricture  or  a 
stumor  or  tube  of  the  sigmoid  flexure.  A  case 
of  the  latter  was  reportei  at  the  Johns  Hopkin's 
Hospital.  The  operation  revealed  no  obstruc- 
tion of  the  bowel  but  a  pancreatic  tumor  around 
the  bowel.  Bilroth  reported  a  case  of  cancer  of 
the  bowel  in  which  six  inches  of  it  was  removed 
:and  the  ends  of  the  bowel  stitched  together, 
with  reooveiT  to  the  patient  The  diagnosis  is 
•difficult  as  of  the  particular  lesion,  as  uie  same 
symptoms  generally  are  found  in  obstructions 
{generally,  but  more  certain  in  strictures  and  in 
invaginations  of  the  bowel.  If  volvulus,  it  is 
•comddered  impossible,  but  more  probable  in 
strangulation.  I  had  a  case  in  which  one  part 
•of  the  bowel  passed  over  another  part,  before 
the  days  of  treatment  by  Laparotomy,  and  only 
revealed  by  a  post  mortem.  A  writer  in  the  Bos- 
ton Medical  and  Surgical  Journal  says  that  the 
•diagnosis  of  the  seat  of  the  obstruction  is  rather 
less  difficult  than  its  nature.  It  is  based  on 
«the  determination  of  the  capacity  of  the  colon, 
which,  under  anesthesia,  may  be  made  to  con- 
tain six  quarts,  a  pressure  of  a  column  of  water 
in  adults  of  twenty  feet,  in  children  of  twelve 
feet,  bemg  probably  safe.  It  should  be  remem- 
bered that  the  rectum  alone  may  contain  one 
and  a  half  quarts.  If  four  to  six  quarts  can 
be  introduced,  the  obstruction  is  almost  certainly 
«t  or  above  the  cecum.  The  earlier  the  pro- 
cedure is  resorted  to  the  less  likely  is  gaseous  ex- 
tension to  prevent  its  full  application  or  injury 
to  fdlow  its  imploymeut  On  the  other  hand, 
^he  more  likely  is  it  to  be  of  therapeutic  ser- 
irice,  as  in  intussusception. 

2.  The  situation  of  the  tumor,  if  such  be 
present,  may  throw  lights  on  the  seat  of  the  ob- 
struction. 

3.  But  litUe  reliance  is  placed  on  the  symp- 
toms. It  may  perhaps  be  stated  that  the  higher 
the  seat,  other  things  being  equal,  the  less  the 
urine  and  the  tympanitis.  When  tenderness 
^nt  appears,  its  location  may  have  some  value 
as  indi^Uing  the  advent  of  peritonitis,  which  is 
apt  to  start  at  or  about  the  lesion. 


The  presumable  value  of  the  obstruction  has 
some  bearing  on  the  eeat  of  the  obfltroction. 
Irdusmsoeption  involves  the  large  intestine  in  90 
per  cent,  of  the  cases.  Strangulation  of  the 
small  intestine  in  same  proportion.  Gall  stones 
and  foreign  bodies  obstruct  the  small  intestines 
alone.  AH  other  kinds  are  much  more  com- 
mon in  the  large  intestines,  and  all,  save  fecal 
impaction,  are  more  apt  to  involve  one  or  the 
other  end  of  that  portion  of  the  canal.  Satastics 
show  that  four  fifths  of  all  acute  obstructiooB 
are  found  in  the  lower  abdomen. 

First  in  importance  is  the  diagnoos  of  the 
condition,  that  purgatives  may  be  avoided  and 
surp^ioal  interference  (if  necessary)  may  be 
resorted  to  before  the  patient's  chances  are  im- 
periled by  notable  pentonitis  or  changes  in  the 
nutrition  of  the  gut  itself.  Next  in  importance, 
though  not  in  procedure  from  pain,  is  the  nature 
of  the  obstruction.  Intussusception  alcme  ofiers 
much  chance  of  medical  or  expectant  treatment 
A  determination  of  the  seat  dietermines  also  the 
point  of  elimination,  of  comparatively  subordi- 
nate importance. 

1.  Orter  reports  34  out  of  295  obstructiooB 
to  be  of  strangxdoiiion  as  analvzed  by  Fitz.  Of 
101  cases— there  were  68  adhenons — ^villettine 
remained  at  71.  Seventy  per  c&oL  are  m 
males ;  30  per  cent  in  females,  showing  that 
muscular  work  produces  most  cases.  Ninety 
per  cent  are  in  the  small  bowel ;  57  per  cent 
in  the  right  iliac  fossa  and  83  per  cent  in  the 
lower  abdomen. 

2.  Intuseeqdion  varies  from  half  an  inch  to 
a  foot  or  more.  Ninety-three  out  of  295  cases 
of  acute  intestinal  ob6b*uction  were  due  to  tlua 
cause  ;  57  in  males  and  27  in  females.  Thirty- 
four  per  cent  were  under  one  year  of  age  and 
55  per  cent,  under  10  years  of  age.  Forty- 
two  were  uncertain  as  to  causes. 

3.  Of  tvdsts  and  knots  were  there  42  out  of 
255  cases  ;  68  in  males  and  generally  between 
30  and  40  years  of  age.  Fif^  cases  were  in  the 
sigmoid  flexure. 

4.  Of  strictures^  fifteen  out  of  295  were  in 
the  large  intestine  and  four  congenital  stricture- 
two  smgle  stenosis,  four  ulceration  fta;  three 
new  growths,  epethelioma  &c.;  four  compression 
and  traction  of  tumors  of  neighboring  organs. 

5.  Abnormal  contents,  foreign  bodies,  fruit 
stems,  coins,  pins,  needles,  false  teeth. 

6.  Round  worms. 

7.  Accumulation  of  medicines,  magneoa 
bismuth,  feces,  gall  stones,  enteroliths,  23 
cases  of  gall  stones  in  eight  years,  18  in  women 
and  5  in  men  and  17  after  the  fiftieth  year  of 
age; 

The  obstruction  from  worms  mav  be  difficult 
to  detect  from  intussusception,  as  the  symptoms 


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THE  MEDICAX  WORLD. 


23a 


Are  fliiiiilar.  I  had  a  caae  in  which  the  knot  wite 
a  large  one.  ,  Several  worms  had  passed  before 
the  obetruotion  took  place.  Gave  all  sorts  of 
worm  medicines — ^injections  of  hot  water — with- 
oat  effect  till  the  eighth  day.  When  about  to 
resort  to  laparatomy,  worms  commenced  passing 
and  in  three  days  160  passed,  some  of  them  very 
large  tape  worms.  One  death,  reported  by  Dr. 
Leonard,  occurred  after  the  bowels  were  opened 
and  ob^ruction  removed,  and  the  death  was 
attributed  to  heart  failure,  caused  by  the  patient 
getting  up  too  soon.  Had  a  dmilar  death 
twenty  four  hours  after  the  obstruction  was  re- 
moved without  operation  from  the  same  cause, 
though  strict  orders  were  given  to  use  the  bed-pan 
for  the  first  twenty-four  hours.  Another  death 
from  twisting  of  die  bowel,  occurred  in  my  own 
practice  which  was  alluded  to  before.  An  oper- 
ation might  possibly  have  saved  the  patient's  life. 
Another  death  in  my  practice  was  from  impac- 
tion of  sand.  The  patient  a  negro  woman,  fan- 
cied this  sort  of  diet  and  came  near  dying  from 
this  cause  the  first  time  I  attended  her.  Large 
quantities  of  sand  were  removed  by  continued 
iojectioop  of  warm  water,  but  at  the  last  time 
the  obstruction  continued  till  death. 

Another  death  occurred  in  a  child  from  a 
large  tumor  in  the  rectum,  coming  on  very  grad- 
aally  and  only  known  from  a  post  mortem. 
Another  case  was  from  a  tumor  an  inch  below 
the  cardiac  orifice  of  the  stomach,  filling  the 
whole  bowel.  The  patient  was  sev^teen  days 
without  any  thing  passing  the  tumor.  A  case  is 
reported  by  a  German  physician  in  1888  ;  the 
obstruction  being  produced  by  worms  and  pro- 
ducmg  death. 

The  post  mortem  indicated  that  the  large  ball 
of  worms  had  been  killed  by  worm  medicine  and 
sour  krout,  and  had  rolled  down  and  filled  the 
whole  bowel,  producing  the  obstruction  in  the 
ileo-cecal  valve.  This  may  be  the  case  often 
times,  which  could  be  prevented  by  giving  small 
doses  of  worm  medicine  and  gradually  remov- 
ing the  worms.  As  a  rule,  when  death  occurs  a 
post  mortem  should  be  made. 

Tttaimtfd.  Formerly  this  affection  was  not 
80  well  understood  as  at  present,  and  the  treat- 
ment was  limited  to  violent  purging,  which 
aome  times  produces  obstruction.  At  present  it 
is  pretty  well  agreed  that  mild  aperients  are  the 
most  sucoevfnl,  aided  by  large  quantities  of 
warm  water.  Also  hot  baths,  hot  cloths. 
Fountain  syringes  are  better  than  bulb  eyringes 
as  the  fiow  is  more  uniform  and  the  pain  not  so 
great  Bv  putting  several  bricks  under  the  feet 
^  the  bedstead,  about  ten  or  twelve  inches  in 
height,  the  injections  are  more  easily  made  and 
the  water  passes  higher  up  the  bowel.  The  injeo- 
tioDS  should  contain  flax  seed  emuldon. 


Linseed  oil  is  also  a  good  remedy  to  be  taken 
by  the  mouth  if  the  vomiting  is  not  violent. 
Impactions  of  the  bowel  by  feces  are  very  ofteD 
relieved  by  continued  injections  of  water  with- 
out medicines. 

Dr.  Semola  reports  a  case  successfully  treated 
by  electricity,  the  obstruction  being  produced 
by  intestinal  paralysis ;  one  pole  of  the  battery 
being  applied  ten  inches  up  the  rectum  and  the 
other  over  the  abdomen,  the  pole  being  covered 
by  a  cloth  moistened  by  a  solution  of  common  salt. 

In  Praetieey  of  Ridimond,  Va.,  are  reported 
two  successful  cases  of  injection  of  bowels  to  re< 
move  the  obstruction  by  sulphuric  ether  com- 
bined with  a  little  alcohol  and  fennel  wattr 
passed  through  a  long  tube.  The  relaxation  of 
the  bowel  by  the  ether  was  doubtless  the  cause 
of  success,  as  by  belladonna,  opium  and  similar 
remedies.  When  obstruction  is  apparent  from 
a  protuberance  a  towel  saturated  with  sulphuric 
ether  and  laid  over  it  will  often  reduce  the 
strangulation  and,  in  cases  of  hernia,  has  become 
an  efficient  remedy. 

Treatment  by  injections  of  lur.  Two  suc- 
cessful cases  are  reported  in  the  medical  jour- 
nals by^the  use  of  a  common  hand  bellows  after 
the  failure  of  other  means.  Fitz  reported  83 
cases  and  111  deaths  from  injections  of  air. 
Injections  of  soda  water,  which  contains  a  large 
quantity  of  carbonic  add  gas,  have  also  been 
successful,  and  one  case  is  reported  in  which 
the  patient  tasted  the  gas  in  her  mouth,  showing 
that  the  gas  did  pass  entirely  through  the  ob- 
struction. 

Treatment  by  kerosine  oil.  A  successful 
case  was  reported  happening  Nov.,  1889.  The 
usual  treatment  by  purgatives  and  injections 
having  failed,  four  ounces  of  kerosine  oil  were 
injected  through  a  long  rectal  tube — the  oil  be- 
ing mixed  with  a  little  warm  water. 

Another  case  of  a  boy  very  ill  after  three 
days  obstruction  from  swallowing  a  mixture  of 
wheat,  cabbage  and  fish,  being  forced  in  his 
mouth  by  several  bad  boys.  The  first  injection 
of  eight  ounces  of  kerosine  was  followed  in 
fifteen  minutes  by  four  ounces  and  diluted  with 
six  ounces  of  warm  water.  The  results  were 
speedy  and  copious  discharges  of  what  he  had 
swallowed.  Another  case  was,  an  old  man  who 
had  eaten  largely  of  opium  and  his  bowels  were 
locked  up  by  accumulation  in  the  lower  boweU 
resembling  an  ear  of  com.  An  injection  of  a 
quart  of  kerosine  resulted  an  hour  afterwards 
in  large  discharges. 

Cases  are  reported  where  simple  inversion  of 
the  body  and  shaking  briskly  mth  three  quarts 
of  warm  water  injected  into  the  rectum — which 
operated  mechanically  by  its  own  weight  in  re- 
moving the  obstruction. 


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THE  MEDICAL  WORLD. 


Another  oaae  of  obstructioQ  of  &ve  days  dur- 
<atioii  in  a  child,  was  treated  sucoeesfully,  by 
<»al  oiL 

Belladonna  treatment  One  case,  obstruc- 
tion lasting  seven  days  was  treated  without  sue 
<;ess  by  injections.  Belladonna,  in  doses  of 
three-fifths  of  a  grain  every  hour  until  patient 
took  five  dosesi  resulted  in  removing  the  ob- 
struction. Patient  passed  a  gallon  of  impacted 
fecal  and  gaseous  matter.  Recovery  followed 
without  any  signs  of  belladonna  poisoning,  al- 
"though  when  this  treatment  was  commenced 
patient  was  almost  in  a  dying  condition,  with 
feeble  pulse  and  cold  ekin.  Three  other  cases 
treated  with  belladonna  with  one  death  are 
reported. 

A  diet  of  Irish  potatoes  has  been  recommended 
•as  successful  in  relieving  obstructions— operat- 
ing mechanically  in  expanding  the  bowel  so  as 
fto  allow  the  passage  of  the  contents.  It  is  ques- 
tionable whether  an  irritable  stomach  could  re- 
tain any  solid  food  like  Irish  potatoes. 

Aspiration.  Dr.  Giolio  Davis  in  the  Venice 
Medical  Journal  reports  a  case  of  obstruction 
from  watermelon  seeds  in  an  old  woman  of 
seventy  years  of  age.  The  tympanites  was  very 
^reat.  After  vainly  trying  injections  and  pur- 
gatives, he  aspirated,  making  four  punctures  in 
<Ufierent  localities,  from  which  issued  a  large 
•quantity  of  gas.  A  dose  of  castor  oil  was  given 
— resulting  in  copious  discharges.  Dr.  Demores, 
•of  Bordeaux,  France,  reported  six  successful 
-cases  treated  by  punctures.  <<He  believed  the 
obstruction  to  be  due  to  peritineal  bands  of  in- 
fflammation  of  the  sub  peritineal  tissue." 

The  danger  of  extravasation  of  feces  into  the 
peritoneum  appears  to  be  small  if  a  fine  needle 
be  used ;  but  a  case  of  Sir.  William  Jenner's 
shows  that  the  operation  has  certain  special 
dangers.  In  that  case,  which  was  an  instance 
•of  malignant  stricture,  each  point  of  puncture 
was  found  to  have  become  the  seat  of  a  second- 
>ary  cancerous  deposit  Reported  by  a  mono- 
.graph  of  Dr.  J.  W.  Vogle  and  copied  in  the 
Medical  Age,  of  Detroit,  Michigan.  * 

Another  successful  report  of  a  very  unfavor- 
ishle  case  was  made  by  Dr.  Wild,  of  Australia. 
He  used  a  common  hypodermic  syringe,  and  as 
•soon  as  the  gas  passed,  the  strangulation  of  the 
bowel  terminated,  and  the  patient  in  a  week 
was  walking  about  Such  cases  are  rare  where 
the  strangulation  can  be  localized,  but  where  it 
•can  be  the  hypodermic  needle  should  be  resorted 
to  after  the  failure  of  injections. 

Tobacco  treatment  The  old  treatment  of 
•over  100  years  ago  by  Dr.  William  CuUen,  of 
Edinburg,  Scotland,  by  the  use  of  tobacco  in- 
fusion by  the  mouth  or  bowel,  seems  to  have 
been    more    successful  than    other   modes  of 


treatment,  but  it  has  lost  ground  and  is  only 
used  as  a  last  resort.  Owing  to  its  relaxing 
properties' it  should  be  among  the  first  used. 
The  infusion  is  made  by  fifteen  grains  of  tobacco 
to  one  pint  of  hot  water.  After  steaming  off 
the  tobacco— the  decoction  should  be  given  in 
ounce  doses  eyefj  half  hour  by  the  mouth 
'  and  by  enema  till  the  whole  system  is  re- 
laxed— as  indicated  by  sick  stomach  and 
free  perspiration.  Several  successful  cases 
are  reported.  One  case  was  my  wife,  in  which 
the  obstruction  had  lasted  over  five  days.  After 
the  surgeons  arrived  to  perform  laparotomy, 
I  enggeeted  one  more  trial  by  tobacco — which 
soon  removed  the  obstruction.  The  relaxation 
and  sick  stomach  was  extreme. 

Tobacco  smoke  has  also  been  used  suocesfully, 
chiefly  by  the  old  doctors,  and  in  cases  whm 
every  thmg  else  had  failed. 

Laparotomy.  Professor  Leon  reported  a 
case  originating  u^  perit<mitis,  which  continued 
more  or  less  three  years  with  abdominal  pains 
and  resulted  in  perfect  obstruction  of  the  bowel 

Patient  was  almost  moribund  when  the 
operation  was  performed.  Incision  was  made 
from  unbilicus  to  pubis,  and  after  considerable 
exploration  a  ring-like  band  was  found,  con- 
stricting the  small  intestine  close  to  the  cecum. 
The  band  was  cut  several  times  and  the  intes- 
tines released.  Copious  fetid  excretions  followed, 
and  in  spite  of  the  unruliness  of  the  patient  he 
recovered.  Dressings  of  camphorated  alcohol 
were  employed  externally. 

A  case  of  obstruction  of  the  bowels  from 
stricture  of  the  colon  is  reported  by  Dr.  R  P. 
Hurd  in  the  Medical  Age  of  May  11th,  1891. 
The  stricture  originated  from  dysentery,  and 
resulted  in  occlusion  of  the  bowel,  coming  on 
gradually  during  two  years,  with  great  difficulty 
in  having  evacuations.  Finally,  no  passage 
could  be  forced,  and  laparotomy  in  the  median 
line  was  resorted  to.  The  colon  at  the  seat  of 
obstruction  was  withdrawn,  stitched  together 
below  the  obstruction  and  to  the  walls  of  the 
abdomen  just  below  the  umbilicus.  When  the 
colon  was  opened  a  large  discharge  of  feces 
came  away.  A  rubber  plug  was  introduced 
and  patient  is  enjoying  great  relief  since.  The 
operation  by  laparotomy  should  be  speedily 
done,  as  shock  may  be  too  great  for  recov^. 
Half  an  hour  is  sufficient  for  the  length  of  an 
operation.  An  interesting  discussion  (m  tins 
subject  is  reported  in  the  sixth  volume  of  the 
Epitome  of  Braithwaite,  before*  the  British 
Medical  Assodation.  Surgeon  Treves'  proce- 
dure is  fully  explained.  A  speedy  operation, 
with  only  twenty-four  hours'  delay,  is  generally 
successful.  When  long  delayed,  septicemia  has 
degenerated  the  blood  so  that  death  ensues.  In 


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235 


Dr.  Bairs  report  from  the  New  York  Hospital, 
he  sajs  that  over  half  the  casee  operated  upon 
die.  In  Schramn's  cases,  one  hundred  and 
ninety  in  all,  the  mortality  was  sixty-four  per 
cent.  Dr.  B.  F.  Cartes,  England,  r^rts  three 
hundred  and  fifty  cases  operated  on,  with  sixty- 
eight  per  cent  of  mortality.  He  advocates  that 
operations  should  not  be  deferred  beyond  forty- 
eight  hours.  ^ 

The  conclusion  reached  is  this :  That  violent 
drastic  purgatives  like  croton  oil,  aloes,  etc, 
are  uncalled  for,  and  do  more  harm  than  good. 
*  Mild  purgatives  with  large  injections  of  hot 
water,  inverting  the  body,  and  shaking  a  few 
minutee,  is  the  best  treatment.  This  should  be 
continued,  with  the  hips  raised  at  least  ten 
Inches  higher  than  the  head.  If  these  fail  then 
tobacco  injections.  After  that,  rectal  iojections 
of  kerosine  oil,  sulphuric  ether,  inflation  with 
air,  belladonna  by  the  mouth,  etc,  may  be  suo- 
ceasfully  tried.  If  these  fail,  aspiration  by  by- 
pordemic  needle,  and  as  the  last  resort,  laparo- 
tomjywhich  should  not  be  delayed  over  forty- 
eight  hours.  Dr.  C.  R.  Cullen, 

Richmond,  Va. 


Treatment  of  Cobra  Bite  by  Strychnia. 

Editor  Mjsdical  Wobld  : — A  woman  named 
Keonda  Bai,  aged  twenty-two,  was  bitten  by  a 
cobra  about  four  feet  long  and  three  inches  thick, 
of  brownish  white  color,  on  the  22d  April,  1894 
at  3  p.  M.  near  the  tomb  of  Ismail  Khau,  situ- 
ated about  three  miles  from  Aurangabad, 
Deooan,  India.  The  part  injured  by  the  bite 
was  the  dorsal  eurface  of  the  first  metatarsal 
bone  of  the  great  toe  Her  companions  saw 
the  cobra  when  it  crawled  away  after  biting 
the  woman.  The  patient  was  well  for  an  hour 
but  afterwards  she  felt  giddy  and  became  in- 
sensible, there  being  at  the  same  time  a 
profuse  discharge  of  saliva  from  the  mouth.  In 
this  state  her  relatives  brought  her  to  the  city 
and  put  her  under  native  treatment,  as  well  as 
charms,  without  any  effect  The  case  was  re- 
ported to  me  at  10  p.  m.,  nearly  seven  houra 
after  the  bite,  and  I  immediately  prescribed  for 
her.  liqr.  strychnia  (strength  4  grs.  to  1  oz.)  1 
drachm  and  water  4  ounces,  to  be  divided  into 
four  doses,  directing  the  first  two  doses  to  be 
given  at  the  interval  of  fifteen  minutes  and  the 
remaining  two  doses  at  the  interval  of  thirty 
minutes.  After  administering  the  third  two 
doses,  she  came  gradually  to  her  senses  and, 
seeming  to  be  perfectly  restored,  continued  in 
her  usual  health  that  night  and  the  whole  of 
the  next  day.  However,  at  6  p.  m.  on  the 
23d  of  April,  all  the  symptoms  returned,  the 
saliva  running  from  the  mouth  as  copiously  as 


before  and  she  passed  the  whole  night  in  a  state 
of  perfect  unconsciousness.  Her  relatives  at- 
tributing her  temporary  restoration  to  health  to 
the  channs  and  spells  they  had  used  and  not  to 
the  mixture  adininistered  by  me,  resorted  to 
the  same  superstitious  remedy  again,  without, 
of  course,  any  effect.  So  they  called  on  mo 
again  on  the  24th  of  April  at  10  a.  m.  When 
I  examined  the  patient  I  found  her  as  bad  as 
she  had  been,  the  copious  discharge  of  saliva 
continuing  all  the  wlule;  her  whole  body  was 
insensible  except  the  cornea,  pulse  weak  and 
thready,  respiration  slow — three  times  per 
minute— and  every  two  or  three  minutes  she 
was  getting  convulsions,  the  power  of  degluti- 
tion being  lost.  The  injured  part  was  little 
swollen,  the  marks  of  the  teeth  of  the  reptile 
were  apparent  Then  I  gave  her  a  tonce  hypo- 
dermic injection  of  liqr.  strychnia,  twenty  drops 
in  the  epigastric  region,  waited  for  ten  minutes, 
but  the  medicine  did  not  seem  to  take  effect ; 
so  again  another  injection  of  twenty  drops  of 
liqr.  strychnia  was  tried  and  afterward  I  pre- 
scribed forty  minims  of  liqr.  strychnia  in  two 
doses,  to  be  administered  at  the  interval  of 
half  an  hour.  They  tried  the  mixture,  but  she 
could  not  drink  it. 

At  4  30  p.  M.  I  called  again,  but  I  found 
her  in  the  same  state;  the  pulse,  however,  was 
strong  enough.  I  gave  her  hypodermic  injec- 
tion of  liqr.  strychnia  in  twenty  drops  immedi- 
ately. In  ten  minutes  she  was  restoied  to  her 
senses,  but  could  not  speak,  only  making  signs 
with  her  hands  when  she  was  asked  any  ques- 
tions. After  fifteen  minutes  another  twenty 
drops  of  liqr.  strychnia,  given  hypodermically. 
Three  hours  after  I  called  again  and  found  her 
perfectly  conscious,  but  still  unable  to  speak. 
Again  I  injected  twenty  drops  of  Uqr.  strych- 
nia and  prescribed  fifteen  minims  of  the  same 
solution  to  be  given  internally  at  10  p.  m.  that 
very  night.  Next  morning,  that  is,  on  the  25th 
of  April,  at  6  a.  m.,  in  the  morning,  I  went 
there  and  saw  the  case.  She  was  improving 
vastly  but  she  could  not  speak.  Then  I  pre- 
scribed four  doees  of  liqr.  strychnia  each  con- 
taining twenty  minims,  to  be  given  every  third 
hour.  At  2  p.  m.  the  power  of  speech  was  re- 
stored. When  I  went  to  see  her  at  4  o'clock^ 
all  the  symptoms  had  left  her,  but  she  com- 
plained of  a  dull  pain  all  over  the  body.  On 
the  26th  of  April  I  prescribed  for  her  two 
doses  of  liqr.  strychnia  containing  twenty 
minims  and  I  continued  the  same  mixture  for 
four  days  three  times  a  day,  each  dose  contain- 
ing ten  minims  of  liqr.  strychnia  and  now  she 
is  well,  in  her  usual  health. 

Mazhar  Husain,  Qvil  Surgeon^ 

Aurangabad,  Deccan,  India. 


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THE  MEDICAL  WOkLD. 


A  Plea  for  Aoetaniiid. 

Editor  Mkpical  World  : — As  I  have  de- 
rived more  benefit  from  Tete  World  and  its 
family  of  oontributors  than  from  all  other  medi- 
cal works  and  journals  combined,  it  occurred  to 
me  that  with  my  experience  with  acetanilid  I 
could  perhaps  say  a  word  to  allay  the  fears  of 
«ome  ot  the  fraternity ;  for  from  what  some 
have  said  of  it  one  would  expect  a  patient  who 
had  been  so  unfortunate  as  to  employ  a  doctor 
who  would  give  him  a  dose  to  die  without  fail. 

I  have  used  this  febrifuge  for  several  years 
with  the  most  happy  results — and,  although  I 
am  not  prone  to  discard  our  old  and  tried 
remedies,  I  was  so  pleaeed  with  its  action  that, 
after  a  few  trials  with  acetanilid  in  febrile  af- 
fections, I  was  compelled,  in  justice  to  my  patient, 
to  continue  its  use,  at  least  till  I  had  seen  cause 
f(Mr  stoping,  which  I  have  failed  to  see  yeL 

I  have  in  many  cases  brought  a  pulse  of  130 
and  a  temperature  104  to  normal  within  from 
thred  to  six  hours,  and,  in  my  way  of  using  it, 
have  never  yet  seen  one  dangerous  or  bad 
symptom.  I  give  small  doses,  say  two  to  five 
grains,  in  solution,  every  hour,  more  or  less,  as 
the  case  requires.  At  this  time  I  should  hardly 
know  how  to  do  without  it,  for  in  my  hands  it 
ha&  been  as  superior  to  the  old  remedies  for  all 
febrile  conditions  as  mercury  is  to  sulphate  of 
magnesia  for  a  sluggish  liver.  Why  some  of 
our  fraternity  have  pictured  its  effect  in  such 
gloomy  colors  is  to  me  quite  hard  to  understand. 
My  own  experience  is  in  direct  opposition  to 
what  they  claim,  and  I  have  certainly  given 
this  drug  a  thorough  and  extended  trial,  after 
which  I  can  bear  out  the  statement  of  Dr.  D. 
Boswell  in  June  World. 

It  occurs  to  me  that,  perhaps,  those  who 
epeak  so  disparagingly  of  it  have  either  given 
too  large  doees  or  have  failed  to  extend  its  use 
long  enough  to  be  competent  of  judging,  at  least 
to  the  extent  of  condeming  it  in  terms  so  strong 
as  are  used  by  some. 

I  want  to  give  the  brother  M.D.'s  a  com- 
pound for  asthma  which  to  some  may  be  of 
great  benefit 

R.     lod.  potass. gr.  iq 

Fowlers  Bol - gtt  llj 

Yin.  ipecac gtt.  v 

M.    Simple  ebz.q.  s.. dram  JJ 

a  For  one  dote;  repeat  every  8,  4  or  5  hours  till  patient 
breathes  easily  then  give  three  or  four  times  daily. 

I  have  found  this  a  fine  thing  and  in  four 
out  of  five  caaes  relief  is  sure. 

Yours  for  The  World  everytime 
Ashland,  N.  H.  Dr.  A.  R.  Garry, 


A  FHTSioiAK  writes :  'Times  have  been  hard  with 
me,  and  I  have  tried  to  do  without  The  Medical 
World,  but  I  find  it  a  necessitj.'' 


Notes  and    Comments.— State    Medical  Laws.— 
Goiter.— Hemorrhoids.— Ergot 

Editor  Medical  World:— In  llie  May 
number  of  The  World  on  page  16?  on 
"Order  Out  of  Chaos,"  also  on  page  201, 
June  number,  Dr.  Line  has  an  article  on 
''Authority  to  Practice  Medicine."  Both  these 
articles  point  out  some  of  the  defects  of  state 
examining  boards.  Both  suggest  a  national 
law.  This  is  what  we  ought  to  have  b/  all 
means.  I  live  near  enough  to  state  lines  to 
practice  in  three  states.  I  know  something  ci 
the  hardships  of  having  to  have  llcenae  from 
three  medical  boards.  There  is  one  obstacle,  I 
can  see  no  way  to  remove  at  present,  that  is  a 
ccmstitutional  one.  the  right  Qt  a  state  to  r^u- 
late  its  own  affairs.  Should  the  national  gov- 
ernment pass  such  a  law  as  The  World  sug- 
gests, the  states  would  not  be  bound  to  abide 
by  it  I  am  no  lawyer,  but  merely  suggest  this 
as  a  matter  to  be  investigated  beifore  we  com- 
mit ourselves  to  such  plan.  I  decidedly  favor 
the  idea  and  have  no  doubt  ail  would  sooner  or 
later  favor  it.  But  there  is  one  thing  we  can 
do,  and  ought  to  do :  permit  those  residing  out- 
side the  state,  but  practicing  in  the  state,  to  do 
so  without  being  examined,  by  having  the 
license  from  the  state  of  residence  recorded  in 
the  state  when  the  physician  proposes  to  prac- 
tice. There  can  be  no  reasonable  objection  to 
this  plan.  Mississippi,  so  fitr  as  I  know,  is  the 
only  state  that  has  done  this.  She  reoogniaes 
the  license  of  the  border  states,  though  they 
have  not  yet  recognized  hers.  A  state  can  or 
not,  as  it  pleases,  recognize  the  license  of  a  bor- 
der state  shoiild  the  physician  move  into  it 
This  law,  it  seems  to  me,  ought  to  be  adopted 
by  all  the  states.  It  is  reasonable  and  just, 
and  in  keeping  with  the  liberality  of  our  noble 
profession. 

On  page  209,  Dr.  J.  V.  Page  writes  of  the 
frequency  of  goitre  in  Kansas.  This  is  not 
often  seen  here,  but  proves  to  be  a  difficult  dis- 
ease, or  symptom,  to  treat  Iodine  locally  and 
internally,  and  some  of  the  preparations  of 
mercury  locally  and  internally,  also  tincture  of 
Phytolacca  and  arsenic,  is  the  treatment  usually 
followed.  Some  years  ago  this  subject  was 
briefly  discussed  in  The  World.  If  any  one 
has  a  satisfactory  treatment,  a  treatment  which 
will  make  some  impression  in  a  short  time,  I 
would  be  glad  to  know  it  I  refer,  of  oouise,  to  • 
simple  forms  of  goitre. 

Those  who  have  to  do  manual  labor  for  a 
living  never  are  afflicted  as  is  Dr.  T.  N.  Coch- 
ran's patient  (page  219).  If  she  could  be 
made  to  believe  that  some  steady  employment 
was  necessary,  not  for  health,  but  for  meat  and 
bread,  she  would  soon  be  well. 


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THE  MEDICAL  WORLD. 


237 


I  hope  Prof.  W.  F.  Waugh,  (page  205)  will 
withhold  the  publication  of  his  remedy  for 
opiam  habit  until  it  is  thoroughly  tested.  We 
are  so  prone  to  follow  where  our  leaders  mark 
out  the  way,  that  we  are  not  always  competent 
judges  of  a  remedy  that  has  the  stamp  of 
authority  on  it  This  is  why  8^  many  remedies 
are  yery  popular  for  a  time,  then  pass  into  for- 
getfulness. 

Let  any  physician  recommend  any  remedy 
ibr  any  diseiftse,  I  do  not  care  what  it  may  be ; 
and  in  a  little  while  we  will  see  it  highly  lauded 
all  oyer  the  land.  A  little  longer  time  passes, 
and  it  is  forgotten.  Let  us  ''hasten  slowly"  to 
laud  or  condemn  any  new  remedy. 

Dr.  Wheat's  remedy  for  piles  (page  213), 
gun  powder  and  rye  whisky,  is  certainly  very 
simple.  Why  not  the  powder  do  as  well  by 
itself?  It  is  a  very  effectual  remedy  in  some 
forms  of  colic.  Whether  it  is  the  nitrate  of 
potash,  the  charcoal  or  the  sulphur  that  gives 
relief,  I  do  not  know.  Strange  and  ridiculous 
as  it  may  seem,  I  have  often  thought  the  influ* 
euoe  of  the  mind  has  sometning  to  do  in  reliev- 
ing the  pain  in  some  cases  of  hemorrhoids.  Of 
coarse  it  will  not  remove  a  long  standing  pile 
ttiiDor,  but  it  will  frequently  give  relief. 

Indeed,  there  are'very  few  diseases  or  symp- 
toms that  are  not  influenced  more  than  many  of 
08  think,  by  the  thoughts  and  emotions  of  the 
mind.  There  are  few  things  causing  more  ez- 
cmdatiBg  pain  than  toothache,  yet  the  ma^c 
relief  given  by  a  view  of  the  dental  forceps  is 
imown  of  all  men.  Like  Dr.  Swann,  (page 
211)  I  have  never  been  a  very  strong  believer 
in  ergot  as  a  poison.  In  fact,  I  have  never 
had  much  faith  in  it  as  a  medicine.  Twenty 
years  ago  I  used  it  frequently,  but  seldom  use 
it  new.  If  it  ever  did  any  good  or  harm  in  my 
bands  I  do  not  know  it  When  I  was  in  the  great- 
est need  for  something  to  contract  the  womb  it 
nraally  faili-d,  or  was  too  slow  in  its  action  to 
be  relied  on.  While  I  do  not  r^ard  it  as  a 
very  dangerous  remedy,  I  think  we  may  very 
easily  dispense  with  it  altogether.  The  same 
may  be  said  of  many  other  drugs  in  constant 
w.  C.  Kendrick,  M.D., 

Kendrick*  Miss. 

'    Fttrtber  Details   of  the  Treatment  of  Typhoid 
Fever. 

Editor  Medical  World  : — In  reply  to  Dr.  J. 
0.  Sterver,  of  Knoxdale,  Pa.,and  others  in  r^ard 
to  my  article  in  the  June  World,  I  will  say 
that  I  have  never  succeeded  in  aborting  typhoid 
fever  with  sulpho  carbolate  of  zinc  or  any  other 
remedy.  But  I  am  fully  satisfied  that  cases 
under  its  use  run  a  much  milder  course  than 
Aow  in  which  it  is  not  used.     I  am  as  strongly 


of  the  opinion  that  the  antiseptic  treatment  of 
typhoid  fever  is  the  ideal  treatment  as  I  am 
that  0(num  is  our  sheet  anchor  in  pmtonitis, 
or  quine  the  sine  que  non  for  malaria.  But  I 
would  not  lead  you  to  believe  that  asepsis  alone 
is  su£Scient  in  all  cases.  My  plan  of  treatment 
has  been  a  combination  of  the  symptomatic  and 
antiseptia  As  early  in  the  case  as  the  symp- 
tons  will  justify  a  probable  diagnosis  of  typhoid 
fever,  I  begin  to  give  my  patient,  if  an  adult, 
2}  gr.  pills  of  sulpho-carbolate  of  zinc,  one 
every  two  hours  until  the  alimentary  canal  has 
been  ^rendered  aseptic,  which  is  shown  by  the 
stools  losing  their  characteristic,  bad  odor.  It 
will  generally  take  twenty-four  to  forty-eight 
hours,  according  to  the  condition  of  the  bowels. 
When  the  stools  no  longer  have  the  bad,  ofien- 
sive  odor,  I  then  give  one  pill  every  three  or 
four  hours,  or  enough,  as  my  observation  of  the 
case  may  show,  to  keep  the  stools  and  bowels  in 
a  constant  aseptic  condition.  It  has  been  my 
practice  to  continue  the  zinc  throughout  the 
course  of  the  disease,  never  missing  a  dose,  but 
lengthening  or  shortening  the  intervals  between 
the  doses  according  to  the  condition  of  the 
bowels,  always  tr3ring  to  give  just  enough  and 
no  more  than  was  necessary.  And  here  I  will 
say  that  I  have  never  once  had  any  bad  effects 
upon  the  stomach  from  the  zinc  salt 

In  addition  to  the  above  antisep^c  medicatioii, 
my  trei^ment  has  been  purely  symtomatic,  ever 
bearing  in  mind  a  few  cardinal  points  viz: 

First.  That  we  are  dealing  with  a  self-limit- 
ing disease  and  we  should  do  nothing  that  would 
retEurd  the  recovery  of  the  patient 

Second.  That  most  patients  die  of  asthenia 
or  perforation  of  the  bowel.  Consequently  we 
must  maintain  our  padenf  s  strength  by  the 
regular  administration  of  liquid  diet  from  tte 
banning,  and  the  judicious  administration  of 
stimulants  when  there  is  any  symptons  of  heart 
failure,  and  continued  as  long  as  necessary  and 
in  quantities  sufficient  The  patient  must  never 
be  allowed  to  get  out  of  bed  for  any  cause  what- 
ever, for  fear  of  rupture  of  internal  organs 

Third.  That  a  continued  high  fever  is  ot 
bad  omen,  which  I  combat  most  readily  by  a 
single  dose  of  acetanilid  given  in  whiskey,  when 
the  daily  exacerbation  of  fever  has  about  reach- 
ed its  height,  five  or  six  grains  at  a  dose,  to 
be  repeated  in  two  hours,  if  there  has  been  little 
or  no  dimution  of  temperature.  I  always  leave 
a  thermometer  and  instruct  the  nurse  in  its  use 
and  never  give  antipyretics  except  when  fever 
is  above  103.  I  like  the  cold  bath  but  find 
great  difficulty  in  its  inforoement  in  country 
practice. 

Fourth.  The  diarrhea  is  very  exhaustive,  and 
when  bowels  move  more  than  two  or  three  times 


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THB  MEDICAL  WORLD. 


in  the  course  of  twenty-four  hours  I  give  1  gr. 
powd.  opium  with  10  grs.  of  bismuth  subnitrate 
and  1  gr.  lead  acetate,  after  each  evacuation  of 
the  bowels.  But  when  using  the  sulpho-carbo- 
late  of  zinc  my  patients  are  not  troubled  much 
with  diarrhea.  Of  course  I  see  that  my  patient 
has  plenty  of  fresh  air,  pure  cold  water  and 
various  little  details  which  may  add  to  his  im- 
mediate comfort,  position  changed  frequently 
to  prevent  bed  sores  eta  There  are  many  other 
things  I  might  mention  but  I  have  already 
written  more  than  I  intended. 

Dixon,  Ky.  C.  M.  Smite,  M.p., 


The  Danger  of  Unskillftii  Vaocination. 

Editor  Medical  World: — The  following 
case  being,  in  my  opinion,  exceedingly  interest- 
ing, on  account  of  the  possible  effects  of  vacci- 
nation when  the  vaccine  lymph  may  be  contam- 
inated with  foreign  bacteria,  I  subjoin  a  full 
history  of  the  case,  hoping  that  if  any  of  your 
readers  have  had  a  similar  case  they  will  kindly 
publish  the  same: 

C.  W.  8.,  a  boy  aged  eleven  years,  and  in 
previous  good  health,  was  vaccinated  by  one  of 
the  vaccinators  appointed  by  our  Board  of 
Health,  on  March  10th.  Soon,  or  immediately 
afterwards,  the  boy  presented  alarming  symp- 
toms, such  as  great  pain  along  the  arm,  exten- 
sive inflammation  reaching  from  the  finger  tipe 
to  shoulder,  irritability,  fever,  and  general  ma- 
laise. The  family  applied  home  remedies,  such 
as  vaseline,  etc,  and  the  inflammation  gradu- 
ally subsided,  but  the  pains,  fever  and  restless- 
ness increased,  and  on  March  28th  I  was  sent 
for,  and  found  my  little  patient  with  pain  in 
right  knee,  temperature  103,  coated  tongue, 
pale  skin,  and  diagnosed  acute  articular  rheu- 
matism, following  vaccination.  I  placed  him 
under  the  salicylates,  eta,  Fuller's  lotion,  and 
within  two  weeks  the  symptoms  abated,  but  only 
for  a  few  hours,  for,  to  the  symptoms  present 
throughout  the  disease,  dow  there  were  added 
petechial  hemorrhages  under  the  skin,  and  pro- 
fuse epistaxis  aod  bloody  oozing  from  the  gums, 
which  could  not  be  checked  by  any  known 
means.  This  continued  for  one  week  longer, 
and  the  boy  died  on  April  19th,  from  exhaus- 
tion. An  autopsy  was  ordered,  and  these  were 
the  anatomical  characters  found :  Body  emacia- 
ted, skin  slightly  yellow,  petechial  spots  here 
and  there,  abdomen  prominent.  On  opening 
the  abdomen  the  liver  was  foimd  greatly  en- 
larged, extending  almost  to  the  descending 
colon,  and  infiltrated  with  fat.  Intestines  were 
shrivelled  and  yellowish  (probably  from  action 
of  embalming  fluid  injected  into  cavity  by  the 
undertaker).     Kidneys  enlarged  and  yellowish; 


bladder  full  of  clear  urine  and  petechial  spoto 
on  bladder ;  spleen  small,  dry,  and  very  daiki 
red ;  lungs  normal ;  heart  normal  in  size,  but 
full  of  petechial  spots ;  valves  normal.  Bndn 
not  examined. 

That  there  is  danger  in  vacdnation  is  a  fact 
which  cannot  be  disputed,  for  we  can  cite  nu- 
merous instances  in  which  it  has  caused  deatL 
The  question  is,  Which  ib  the  best  way  to  obviate- 
the  possible  bad  effects  of  a  quite  reliable  pre- 
ventive of  small  pox.  Would  it  not  be  better 
to  have  the  vaccine  farms  imder  competent 
medical  and  government  control,  so  that  we 
could  rely  on  good,  reliable  lymph  at  any  and 
all  times?  I  do  not  believe  in  indiscriminate- 
vaccination,  and  it  should  only  be  resorted  tO' 
in  case  of  direct  exposure. 

Alfbed  Cobtales,  M.D., 

439  Evergreen  Ave.,  Brooklyn,  N.  Y. 


The  Protection  Period  of  Vaooination. 

Editor  Medical  World  : — In  these  days  of 
vaccination  and  small-pox  scare  the  questions' 
are  often  put  to  me :  ''  Doctor,  how  often  ought 
one  to  be  vacdnated  ?  Does  vaccination  fidly 
protect  ?  Do  you  believe  it  will  run  out  every 
seven  years?"  &c.,  &c  Now,  these  questions 
are  somewhat  perplexing  to  me,  as  I  cannot 
answer  them  satisfactorily,  for  opinions  ot 
physicians  differ  so  much  on  these  points  and  I 
can  not  answer  from  experience.  Does  vacci- 
nation fail  to  protect  after  a  number  of  years? 
I  have  a  few  cases  I  would  like  to  report  in 
answer  to  this  question.  In  the  year  1860 
small-pox  broke  out  in  my  father's  family,  then 
residing  in  the  city  of  Albany,  N.  Y.  There- 
were  four  children  who  had  never  been  vacci- 
nated ;  they  all  had  the  genuine  small-pox,  one 
having  the  confluent  form.  There  were  two 
children  18  and  21  years  old,  respectively,  that 
had  been  vaccinated  in  infancy.  My  father 
was  then  52  jears  of  age.  He  was  vacdnated 
when  a  lad  of  8  or  10  years.  My  mother  wa» 
then  45  years  of  age.  She  was  vaccinated 
when  a  child  of  4  years.  The  above  four  per> 
sous  took  care  of  the  four  children  during  the- 
whole  time  they  were  sick  and  not  one  of  theo» 
took  the  disease.  Full  forty  years  had  elapsed 
since  my  father  had  been  vaccinated,  and  yet 
he  seemed  to  be  fully  protected. 

My  mother  says  she  had  some  headache  an<f 
her  bones  ached  as  if  she  had  taken  a 
severe  cold;  these  symptoms,  however,  lasted 
only  a  couple  of  days,  when  she  was  as  well  afr 
ever.  The  two,  18  and  21  years,  had  no  symp- 
toms whatever  of  the  disease. 

What  shall  we  say  to  patients  who  ask  us: 
"Does  vaccination  run  out  every  seven  or  four* 


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239 


teen  years  f     Can  it  be  possible  that  every 

person  is  a  law  onto  himself  in  this  matter,  or 

18  there  some  general  rule  that  we  may  go  by  ? 

Elroy,  Wis.  F.  T.  Field,  M.D., 


Confirmation  of  the  Antidotal  Power  of  Potassium 
Permanganate  Against  Opium. 

Editor  Medical  World  : — I  have  a  case 
which  I  wish  to  report,  which  may  be  both  of 
interest  and  benefit  to  my  brother  physicians 

On  May  18th,  1894.  8  p.  m.,  I  was  hastily 
summoned  to  the  home  of  Henry  £.,  who  made 
a  desperate  effort  to  commit  suicide  by  taking 
laodsudum.  He  purchased  ten  cents  worth  of 
the  drag  from  a  near-by  grocery  store,  and 
drank  it  all.  This  was  all  done  with  suicidal 
intent  After  some  little  time  of  excitement  of 
the  faunily,  one  of  them  summoned  me,  and 
produced  the  empty  bottle.  My  first  thought 
was,  "  I  will  now  try  the  new  chemical  anti- 
dote, potassium  permanganate."  On  my  arrival 
at  the  bedside  the  patient  appeared  apparently 
lifeless,  but  upon  examination,  the  slan,  lips, 
mouth  and  tongue  were  as  dry  as  parchment, 
pupils  contracted  to  the  size  of  a  pin's  head,  and 
insNisible  to  light;  pulse  imperceptible  at  the 
wrist;  sterterous  respiration,  with  mouth  wide 
open;  unconscious,  and  he  could  not  be  aroused 
at  all.  It  seemed  a  hopeless  case,  but  I  em- 
ployed the  new  antidote,  potassium  permangan- 
ate, and  in  one  hour  after  I  began  the  treat- 
ment I  pronounced  the  case  free  from  danger. 
Dr.  D.  M.  KooNTz, 

Poplar  street,  Johnstown,  Pa. 


Bare  Feat  in  Asiatic  Turkey. 

Editor  Medical  World: — four  items 
under  the  heading,  "  Cruelty  to  Children,"  on 
page  50  of  the  February  number,  I  have  read 
with  much  interest  It  is  a  subject  I  have 
given  a  good  deal  of  thought  to,  but  I  have  not 
been  able  to  come  to  any  satisfactory  conclusion 
in  r^ard  to  it,  viz.:  Why  are  barefooted  chil- 
dren so  free  from  throat  affections? 

In  this  country,  where  barefeet  is  the  rule, 
and  shoes  and  stockings  the  exception,  ^'8" 
would  be  horror-stricken,  and  as  there  is  no 
society  in  this  country  for  the  "  prevention  of 
cruelty  to  children,"  he  would  still  be  in  a 
greater  quandary.  Children,  for  the  first  three 
or  four  months,  are  kept  tied  up  in  their  swad- 
dling clothes,  neither  hands  nor  feet  exposed. 
After  that,  summer  and  winter,  feet,  hands  and 
legs  are  exposed  to  all  kinds  of  weather,  al- 
though the  head  is  wrapped  up  in  a  dozen  of 
handkerchiefs.  Sometimes  their  legs  and  feet 
are  black  and  blue,  and  swollen  from  the  cold. 
Like  "S,"  I  feel  awfully  over  it,  and  scold 


right  and  left,  but  they  only  laugh  at  me.  You 
may  think  it  is  because  they  are  poor  that  they 
do  so.  By  no  means  ;  the  richest  are  no  better. 
And  to  pay  for  it,  not  a  case  of  croup  will  you 
find.  When  I  say  I  have  not  seen  one  first- 
class  case  of  membranous  croup  in  eighteen 
years'  practice  here,  you  will  be  surprised.  Yet 
it  is  a  fact  It  may  not  all  be  from  *•  barefeet," 
but  I  am  sure  I  am  not  so  much  opposed  to  their 
being  barefooted  as  I  used  to  be,  notwithstand- 
ing it  makes  the  chills  run  over  me  sometimes 
to  see  them.  D.  M.  B.  Thom,  M.D., 

M&rdin,  Turkey-in-Asia. 

Inflammation  and  Qangrane  of  Scrotum  following 
La  Grippe, 

Editor  Medical  Wobld: — While  reading 
article  of  T.  W.  M.  in  The  Medical  World 
for  May,  I  thought  perhaps  I  oould  add  some- 
thing to  the  inteirest  of  the  family  of  readers  by 
reporting  a  case  treated  by  me  this  season. 

K.  W.  W.,  a  man  about  60,  was  taken  with 
la  grippe  on  the  19th  of  March,  1894.  He  had 
quite  a  severe  attack,  and  was  making  a  good 
recovery  when  he  went  out  and  caught  cold. 
He  then  had  severe  chills,  with  temperature 
103,  and  complained  of  swelling  and  pain  in  the 
scrotum,  with  retention  of  urine.  I  used  the 
catheter  without  any  trouble.  The  urine  was 
rather  scanty  and  high  colored.  The  scrotum 
continued  to  swell  (it  being  in  an  edematous 
condition)  until  it  was  as  large  as  his  head,  and 
gave  him  great  pain,  so  that  it  took  large  quan- 
tities of  morphine  to  keep  him  quiet  After 
about  a  week  of  swelling,  with  a  high  tempera- 
ture and  repeated  chills,  the  scrotum  commenced 
to  gangrene  in  three  places,  a  line  of  demarka- 
tion  soon  formed,  and  suppuration  conmienced, 
the  largest  place  being  about  three  inches  in 
diameter,  discharging  from  these  holes  about  a 
teaspoonful  of  terribly- smelling  pus.  One  of 
the  gangrene  holes  be^me  so  deep  that  it  in- 
volved the  urethra,  so  that  the  urine  passed 
through  the  holes  instead  of  the  natural  chan- 
nel. About  this  time  the  fever  went  down,  the 
swelling  subsided  somewhat,  and  morphine  was 
taken  away  from  the  patient  He  commenced 
to  eat,  and  improved.  The  sore  healed  up,  the 
urine  commenced  to  flow  naturally,  and  on  the 
25th  of  April  I  discharged  the  case. 

Now  he  has  gone  to  work  again,  cured,  ex- 
cepting that  when  he  has  an  erection  the  penis 
points  toward  the  right  elbow,  instead  of  in  a 
vertical  line,  as  before.  He  says  that  at  his 
age  he  will  try  and  put  up  with  this  inconve- 
nience. 

I  have  had  this  season  two  cases  of  senile 
gangrene  following  the  grippe,  and  both  died. 
The  treatment  in  these  cases  was  locally  anti- 


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septic,  bemdes  treating  oonstitutioDal  symptoms 
and  keeping  the  bowels  loose  with  saline  cathar- 
tics.                         Olin  F.  Buell,  M.D., 
Henderson,  N.  Y. 

For  the  Expulsion  of  Tape  Worm. 

Editor  Medical  World:— For  tenia  (of 
any  kind)  I  recommend  the  followbg  treat- 
ment: 

R,    Cblorofonn  (C.  P.) dram! 

Castor  oil.^  .....^.q.  s.  to  fill  a  one  oanoe  bottle  « 

Duplicate  this.  That  is,  you  want  two  such 
bottles.  Direct  the  patient  to  eat  a  light  supper 
and  take  the  contents  of  one  of  these  bottles  at 
daylight  the  next  morning.  If  the  entire  worm 
is  not  expelled  in  two  hours,  take  the  contents 
of  the  other  bottle.  If  that  does  not  have  the 
desired  effect  in  two  hours,  or  does  not  produce 
a  copious  action,  administer  a  heaping  table- 
spoonful  of  Epsom  salts.  I  have  never  failed 
of  OMnplete  success  with  this  treatment,  even  in 
cases  where  all  the  leading  remedies  had  failed, 
and  that,  in  the  hands  of  good  physicians.  I 
have,  in  a  few  cases  that  had  baffled  all  skill 
and  were  almost  given  up  as  hopeless,  given  a 
moderate  dose  of  calomel  and  Dover's  powder 
at  bedtime.  My  object  in  doing  this,  is  to  ren- 
der the  worm  as  uncomfortable  as  possible,  by 
stimulating  the  liver  to  fill  the  intestines  with 
billious  matter,  which  is  very  offensive  to  his 
highness.  This  treatment  is  harmless,  simple, 
prompt,  and  effectual  In  fact,  has  never  failed, 
in  my  hands.  The  last  case  1  had  was  thought 
to  be  a  hard  one,  occurring  in  a  boy  of  13  years. 
The  worm  came  away  at  about  10  o'clock  a.  m. 
He  ate  a  litde  dinner,  and  was  out  in  the  yard 
shooting  marblf  s  in  less  than  one  hour,  witii  no 
visible  effects  of  the  trtatment  I  was  asked  to 
explain,  the  modus  operandi  of  the  remedy.  It 
was  done  in  a  few  words.  ''Make  him  drunk, 
and  push  him  out" 

I  most  frequently  sttcceed  with  the  first  doee, 
(or  bottle,)  it  doing  the  work  before  time  to 
repeat.  I  do  not  claim  originality  excepting  in 
the  dosage  and  managem.  nt,  and  only  give  pub- 
licity to  it  from  a  sense  of  duty  and  with  the 
hope  that  it  may  be  of  advantage  and  interest, 
at  least  to  my  younger  brethem  of  the  profes- 
sion. In  the  last  case  I  had  the  worm  was  alive, 
after  being  washed  in  three  waters,  was  still 
saturated  with  chloroform,  as  evidenced  by  the 
strong  odor.     1  he  fact  is,  he  was  still  drunk. 

Prescott,  Ark.  R.  L.  Hinton,  M.D., 

Fruit  Vinegar  for  Phthsisis. 
Editor  Medical  World: — The  tberaputical 
effect  of  vinegar  or  acetic  acid  inhalations  as 
recommended  by  K  J.  Marsters,  is  no  farce.  I 
have  a  patient,  Arthur  L.,  who  is  afflicted  with 
consumption.     He   became  ill   last  May,  one 


year  ago.  He  had  traumatic  pneumonia,  < 
ed  by  a  fall  while  coasting  upon  roller  akates 
(upon  the  hard  floor);  had  very  high  fever  for 
two  weeks,  but  finally  the  fever  subdded,  but 
he  never  regained  his  former  health,  remaining 
in  a  feeble  condition  but  was  able  to  be  aroand 
till  in  February,  when  he  had  several  severe 
hemorrhages,  but  did  not  become  confined  to 
his  bed.  He  had  night  sweats,  frequently 
chilled,  followed  by  very  high  fever.  The  tiist 
of  May,  while  cutting  sod,  he  was  again  attacked 
with  a  severe  hemorrhagd  from  the  lung- and 
has  since  had  repeated  attacks  as  often  as  every 
five  to  eight  days. 

He  has  tried  the  Amick  cure,  which  helped 
his  cough  some  but  did  not  agree  with  his 
stomach;  cod  Lver  oil  was  of  no  avail,  and 
other  remedies  have  been  tried,  even  the  crea- 
sote  treatment,  which  I  give  some  credit  Upon 
reading  the  article  in  The  World,  I  hastened 
to  the  bedside  of  my  patient,  who  was  then 
weak  from  loss  of  blood  and  from  fever.  I 
procured  some  grape  vinegar  and  he  was  advis- 
ed to  use  it  by  inhalation  every  three  hours. 
It  loosened  the  cough  and  promoted  expectora- 
tion, relieved  the  hemorrhage  and  lessened  the 
fever.  I  had  used  vinegar  inhalations  in  croup 
and  asthma,  but  never  had  I  used  them  in  con- 
sumption.    The  patient  is  using : 

R.    Sherry  wine ounces  ▼! 

Tr.  Iodine. -..96  gtts. 

Tannin 48  grs. 

A  tAbte^poonftll  after  meas. 

And  syrup  of  lactucarlum  for  sleep  and  for 
cough,  and  vinegar  inhalations  every  three 
hours.  In  the  last  seven  days  he  has  gained 
^ve  pounds  and  has  a  good  appetite. 

Roachdale,  Ind.  Dr.  N.  8.  Wood, 

Report  Your  Cases. 
Editor  Medical  World  : — It  is  not  every 
country  doctor  who  has  a  hundred  authorities^ 
to  whom  he  can  refer,  on  any  one  subject 
Many  of  them  have  not  that  numbei"  on  aU 
subjects  combined.  This  thought  was  brought 
out  by  an  ariicle  by  W.  Thorton  Parker, 
M.D  ,  in  the  N.  Y.  Med,  Times,  on  '<  Rectal 
Alimentation,"  the  hi  biographical  references 
being  sixty-eight,  different  author?.  The  article 
is  well  worth  a  good  reading  and  hard  study. 
I  have  also  thought  that  perhaps,  not  having 
large  libraries  et  cetera  to  refer  to,  and  not  be- 
ing able  to  write  in  a  very  scientific  style,  is  the 
reason  why  very  many  of  the  fifty  thousand 
country  doctors  do  not  give  their  ideas  and 
difficult  ca8(s  to  their  brethren.  .  Without  a 
doubt,  many  of  them  have  cases  which,  though 
of  a  common  character,  do,  by  some  complica- 
tion of  constitution  or  heredity,  present  symp- 
toms which  '^  put  them  up  a  stump,''  yet  a  care- 


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241 


fa]  report  of  these  cases  with  the  treatment, 
whether  successful  or  not,  would  help  them  and 
their  brethren.      They  think,  "Well,  every 
doctor  has  cases  which  puzzle  him,  and  which 
he  has  to  treat  on  genera]  principles.     What's 
the  use  f     Well  the  use  is  this ;  the  fact  that  we 
<i//  liaye  such  cases  and  the  knowledge  of  the 
difficulties  and  failures  we  have  had.  should 
lead  to  a  feding  of  sympathy  and  to  a  denre  to 
help.     Very  lew  of  us  (I  am  spealung  to  the 
country  doctor),  know  it  al],  and  in  spite  of  our 
wise   looks,  we  have  a  "sense  of  emfptinesB" 
creep  over  us  when  we  ni  down  betide  a  six  or 
eight  months  old  baby  and  can  find  but  little 
to  tell  us  the  "as  why  "  it  is  sick,  except  a  lit- 
tle fever — a  little  grunt  at  expiration,  some 
cough,  does  not  nurse,  bowels  not  loose  but  a 
little  tympanitic,  fretful  when  awake,  sleeps  at 
times,  rouses  up  with  a  little  tremor.     You  give 
the  usual  remedies  to  quiet  the  cough,  empty 
the  bowels,   allay  the    flatulency,   give  rest, 
bathe  the  body  twice  daily — poultices,  or  cloths 
in  some  stimulant,  to  abdomen  and  chest ;  then 
rack  your  brains  for  something  else  to  do  be- 
cause baby  is  no  better.     Your  heart  is  troubled 
because  it  is  the  only  child,  or  only  son,  and 
because  it  is  the  first  time  you  have  been  called 
in  by  the  family.    You  have  spent  hours  in  the 
diy  and  several  nights  watching  it  get  no  bet- 
ter.    Well,  it  dies.    A  thousand  times  you  ask 
yourself  as  you  go  your  rounds :     "  Was  there 
not  something  else  I  ought  to  have  donef 
Several  such  cases  within  a  month  or  two  and 
you  would  give  your  last  summer's  hat  to  ha^e 
a  quiet  talk  with  some  old  doctor  somewhere 
within  ten  or  twelve  miles — but  he  is  not  there, 
l^ow,  would  it  not  be  almost  as  a  light  from 
Heaven  if  you  could  find  just  such  a  case  de- 
tailed in  your  ioumal  and  a  successful,  though 
ample  treatment  laid  down?    I  rather  think 
so.    I've' been  there.    I  am  an  old  doctor  my- 
self—a country  one  too— don't  think  that  I 
have  yet  "  attained  into  perfection,"  and  fre- 
qaentiy  just  such  cases  come  under  my  care. 
Some  die,  some  get  well,  and  in  the  medical 
ioumals,   where  the  country  doctors  describe 
their  cases,  I  have  found  good  help  and  always 
just  in  time.     One  way  to  bring  our  cases  be- 
fore the  brethren  is  at  the  County  Medical  As- 
sociation ;  another  is  to  write  out  your  case  and 
send  it  to  your  journal.  The  World,  for  in- 
stance, and  ten  to  one,  brother   Waugh,   or 
some  other  of  his  kind,  will  give  you  the  wink. 
Or,  havmg  had  one  or  more  cases  (common 
<aiaes)  and  found  a  treatment  that  has  succeed- 
ed, write  it  out  carefully  and  send  it     Don't 
put  it  all  into  your  own  pipe  and  smoke  it     It 
IS  the  common  every  day  cases,  complicated  by 
idioBByncrasy  or  heredity,  that  we  want — not 


some  rare  incurable  case  which  is  seen,  perhaps, 
once  in  a  lifetime,  or  not  at  all  by  the  county 
doctor.  Give  us  the  easiest  and  simplest  modes 
of  treatm^it  by  the  common  medicines  found  in 
every  doctors  pill  bags,  as  very  few  of  us  can 
afioid  costly  alomizers,  inhalers  &c.  If  you 
have  tried  any  of  the  new  remedies,  give  your 
experience,  or  any  new  use  for  the  old  ones. 

To  practice  what  I  preach,  h^«  is  a  good 
treatment  (I  found  the  hint  in  The  World) 
for  most  broiiohial  troubles  as  well  as  in  pneu- 
monia complicated  with  bronchitis. 

Omnnlated  para  obloride  oC  oaldnm 60  giains. 

Dorer*!  powder ^ » 10     " 

Water „ ^ 4  oonoes. 

Shake  boitle  before  using. 
Doee,  }itol  teaspoonAill  eyery  one,  two,  or  ttiree  hours. 

It  will  please  you,  while  at  the  same  time 
your  patient  will  be  quieted  and  sleep  bettier. 
In  whooping  cough  also  it  seems  to  do  splen- 
didly. Here  is  a  plan  I  have  pursued,  for 
several  years,  in  making  my  own  Dover's 
powders : 

Pow'd  opinm »..20  grains. 

"    ipecac ^ « 100 

Bromide  of  Boda»....» ^ ^ 60      ** 

Mix.  B 1  to  5  grains,  according  to  requirements. 

The  bromide,  not  being  an  inert  salt,  adda  to 
the  efficacy  of  the  mixture. 

Here  is  a  splendid  nerve  sedative  and  dia- 
phoretic.    This  is  an  idea  of  my  own. 


Acetanllide.... 


.80  grains. 
5  J 


Bromide  of  soda. 

Rub  weU  together  in  a  mortar. 
S.   8  to  5  grains  every  one,  two,  or  three  hours. 

Try  it  when  you  are  tired  and  have  a  slight 
headache,  then  give  your  patients  the  ben^ts 
of  it.  Dr.  Ben.  H.  Bbodnax, 

Brodnax,  La. 


Replies  — Feoal  Impaction  as  a  Cause  of  Female 
Deran9emeiits,-~lliast«rbatlon    in   Young 
Chlldren.—Treatment  of  Endo- Me- 
tritis.—Obstetrioal   Practice. 

Editor  Medical  WorId:— Dr.  Cochran's 
case,  (page  219)  is  probably  one  of  fecal  impac- 
tion, (may  be  due  to  habitual  constipation  or 
not)  which  is  usually  associated  with  melan- 
cholia, the  degree  differing  in  different  individ- 
uals. I  would,  therefore,  advise  the  doctor  to 
pay  attention  to  the  bowels.  Don't  be  misled  by 
her  statements,  stating,  perhaps,  that  her  bowels 
move  every  day,  but  give  her  active  purgatives 
for  five  or  six  days,  changing  preparations  each 
successive  day.  You  might  be  able  to  make 
out  the  impaction  by  physical  examination. 

Prof.  Skene  used  to  speak  of  a  case  under 
his  observation,  a  lady  belonging  to  a  church 
and,  in  spite  of  her  strict  religious  pursuits,  no 
body  could  make  her  believe  that  she  would  be 
saved.  The  pastor  of  the  church,  thinking  there 
was  disturbance  of  mind,  had  her  thoroughly 


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THE  MKDICAI,  WORLD. 


examined  by  an  expert^  who  pretty  soon  found 
out  the  cause  of  her  trouble.  After  the  fourth 
dofie  of  Epsom  salts  was  taken  that  lady  was 
oonfidendy  saved.  There  may  possibly  be 
chronic  ovaritis,  with  a  tendency  to  hysteria,  but 
the  history  and  symptoms,  as  dysmenorrhea, 
dyspareunia,  pains  and  exhaustion  after  defeca- 
tion etc.,  make  the  diagnosis  plain. 

In  regard  to  Dr.  Story's  case  I  would  say 
that  there  is  hardly  any  medical  treatment  for 
those  little  masturbators.  When  once  they 
acquire  the  habit  they  keep  it  up  secrectly,  if 
watched,  until  they  get  married,  and  a  good 
many  of  them  continue  that  immoral  act  even 
after  that,  not  being  satisfied  by  their  husbands. 
Anything  may  be  tried  first,  but  you  will  hardly 
succeed  in  curing  that  by  simple  measures.  A 
radical  cure  can  only  be  accomplished  by  find- 
ing out  the  most  sensitive  spot,  cut  down  and 
remove  the  nerve. — Boston  Medical  Journal, 

*'  Case  for  DiagnG8is,"(P<^^  21^)  ^  corporeal 
and  cervical  endo- metritis. 

Treatment:  General  tonics  and  hygiene, 
especially  regulation  of  the  bowels,  bladder  and 
sexual  relations.  Eemove  the  cause.  Ergotine 
if  uterus  is  large.  Locally :  Dilate  fully  and 
give  intra- uterine  injections  (with  a  loog 
syflnge)  of  tincture  of  iodine,  solutions  of  iron, 
copper  eta 

I  submit  to  the  profession  a  formula  which, 
if  timely  used,  will  break  up  cplds  and  abort 
many  diseases.  I  have  found  it  to  be  ex- 
cellent 


Phenacetine. 
Balopben  aa.. 


...gr.  iin. 


Omu.  Bolph ..gr.  ii  iv  yi. 

KaL  OTomidl „.. gr.  z. 

Mix  and  make  odo  powder. 
Big.   Oae  tuoh  powder  every  four  or  flye  boon  for  flye 
orflxdoiea. 

[After  detailing  a  very  interesting  obstetiic 
case,  in  which,  after  the  complete  failure  of 
another  physician,  he  himself  succeeded  in 
bringing  the  case  tor  a  satisfactory  termination, 
the  doctor  gives  the  following  general  views :] 

I  always  think  how  many  children  are  made 
still  in  the  grasp  of  the  steel  bars  (the  forceps) 
by  unexperienced  hands.  How  many  poor 
women  go  from  doctor  to  doctor,  from  dispen- 
sary to  dispensary,  to  cure  their  chronic  uterine 
troubles  induced  by  unskilled  managers.  The 
poor  woman  does  not  know  what  is  the  cause  of 
the  death  of  the  child  or  who  is  the  cause  of  her 
sufferings.  All  she  knows  is  that  the  child  was 
bom  without  life—  the  doctor  is  not  supposed  to 
give  life  for  the  child ;  she  knows  she  has  pain, 
nervous,  gastric  and  other  constitutional  disturlv- 
ances,  lucorrhea  etc;  she  knows  that  she  is  per- 
fectly miserable,  the  misery  dating  t>ack  to  a 
oonfinement,  but  is  perfectly  ignorant  as  to  the 
cause.     I  could  bring  up  many  instances  for 


illustration,  but  I  think  it  would  be  wasting* 
time,  because  every  physician  has  more  or  \em 
knowledge  of  cases  of  that  kind. 

From  the  above  we  may  deduct  the  follow* 
ing: 

1.  Ascertain  the  date  of  labor  as  nearly  as 
possible  and  prevent  prematurity.  I  think  that 
in  a  great  majority  of  cases,  where  everything^ 
else  is  normal,  feeble  pains  and  prolonged  labor 
are  due  to  prematurity,  because  the  attachment 
of  the  ovum  is  not  loosened,  the  movemaits  of 
the  fetus  not  vigorous  enough,  the  contractile 
powers  not  developed. 

2.  Don't  frighten  people  with  your  foroepe  ^ 
they  are  rarely  needed.  These  are  good  instru- 
ments in  skillful  hands,  needed  under  rare  cir- 
cumstances. 

3.  Use  quinine  and  other  drugs  in  proper 
time  and  the  proper  dose.  They  are  abo  rarely 
needed.  If  used  when  not  indicated  they  only 
disturb  the  normal  powers. 

4.  Do  not  exhaust  the  patient  Use  your 
own  judgement 

5.  Moderate  expresaio  fetus,  if  needed,  i» 
beneficial. 

6.  The  necessity  of  studying  medicine  four 
or  five  years.  Three  years — five  or  six  months 
a  year — ^is  hardly  sufficient  to  master  even  that 
branch  of  practice,  obstetrics,  alone. 

7.  A  high  grade  of  preliminary  education 
is  absolutely  necessary  for  those  entering  npcm 
the  study  of  medicine.  This  will  allow  to  study 
medicine  only  the  developed,  bright,  thinking- 
minds  and  wUl  debar  idiots. 

8.  A  cabinet  minister  of  public  health  is  the 
thing  our  country  needs. 

Max  Fbiedlander,  M.D., 
126  Moore  St.,  Brooklyn  N.  Y. 

For  Canker  Sore  Mouth.— Introducing  Remediet 
Into  the  Bladder  by  Hydrostatic  Preuure. 

Editor  Medical  World: — Dr.  Kelly,  of 
Alba,  Michigan,  a^  for  a  remedy  for  canker 
sore  mouth.  The  following  prescription  if 
always  successful  in  my  hands. 

B.   Add  carbolic............................. ....gttx. 

GlyoerlDl 

Aqun  rcwn oaaoe  I. 

M.  Big.  Take  on«  teaapoonftil  into  the  moaiti  Uiree  or 
fi>Qr  times  a  day. 

Thia  ought  to  be  held  in  the  mouth  for  a  few 
minutes,  making  it  come  in  contact  with  all  the 
mucous  membraue. 

Some  of  the  deepest  cankers  may  have  to  be 
touched  lightly  with  argenti  niiras. 

In  cases  of  cystitis  and  proetaiitis  I  have  ceas- 
ed for  some  time  to  give  medinue  internally  or 
inject  into  the  bladder  through  a  catheter.  I 
now  use  a  strong,  hard  rubber  syringe  and  in- 
troduce the  medicine  by  h}drostatio  pressorej 


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In  this  way  you  do  not  irritate  the  prostatic 
'Qiethra,  as  when  a  catheter  is  passed  It  pre- 
vents, aIso»  the  introduction  of  air  and  disease 
igernMu 

By  filling  your  syringe  with  the  remedy,  (the 
basis  of  which  is  glycerine  in  certain  quantities) 
and  forcing  all  the  air  out,  you  can,  so  to  speak, 
by  steady  gentle  pfesBure  and  the  co-operation  of 
your  patient  in  contracting  and  relaxing  the  com- 
f>reBBor  urethra  muscle,  enables  him  to  drink  it 
right  into  the  bladder.  You  get  immediate  re- 
sults and  a  sure  cure  in  a  short  time,  and  thus 
save  taking  remedies  that  are  uncertain  at  best 
and  that  many  times  injure  the  stomach  and 
Iddneys.  • 

It  is  just  as  efficient  in  stricture  and  chronic 
urethritis  and,  in  fact,  is  a  revelation  in  the 
treatment  of  such  diseases. 

S.  C.  DuMM,  M.D., 

1499  N.  High  6t,  Columbue,  O. 
s 

Ergot  and  Quinine  in  Obstetric  Praotioe.—Deiivery 
of  Plaoenta.— Canker  Sore  IMouth.~Query. 

Editor  Medical  World: — When  reading 
many  of  the  very  interesting  articles  contained 
in  The  World,  I  often  feel  inclined  to  take  a 
part  in  the  discussion.  Perhaps  the  best  means 
of  obtaining  knowledge  would  be  to  ask  ques- 
tions and  express  no  views — allowing  others  to 
instruct 

However,  to  Dr.  Huntsman's  article  of 
"Hour  Glass  Contraction,"  page  160,  I  would 
say  that  I  was  taught  by  Lusk  that  such  results 
would  at  times  be  obtained  by  the  use  of  ergot 
and  that  we  would  better  rely  on  the  use  of  qui- 
nine, which,  in  ten  grain  dose,  causes  uterine  con- 
tractions, and  also  braces  up  the  system  for  the 
oocasi(Hi.  If  needed,  friction  over  the  flmdus 
of  the  womb  will  often  act  nicely,  and  can  be 
used  after  giving  the  medicine.  There  are 
some  cases — and  which  are  of  the  greatest  im- 
portance—in which  we  do  not  get  satisfactory 
results  after  giving  medicines.  They  are  not 
all  primiparse.  Some  slight  malposition  may 
exist — the  head  a  little  large,  or  the  pelvis 
slightly  contracted — but  most  usually  there  is 
uterine  inertia — ^whicL  cases  are  perhaps  the  only 
ones  needing  medidnes — but  not  the  only  ones 
so  treated.  It  is  a  very  common  thing  in  most 
communities  for  some  physicians  to  give  all 
cases  medidne,  whether  needed  or  not,  presum- 
ing that  they  ^ve  done  their  duty  by  giving 
the  patient  the  benefit  of  the  doubt,  in  their  mind, 
whether  medicine  was  needed — and  in  many 
iofltances  they  rush  the  case  to  save  tame— the 
drug  most  frequently  used  being  ergot  Some 
of  these  cases  we  would  better  give  a  dose  of 
Dover^s  powders,  which  will  give  the  patient  a 
Kit  fer  a  few  hours,  and  rdaz  the  resisting 


parti  ftfter  which  the  case  may  proceed  nicely. 
Should  dilatation  be  about  completed  or  you  can 
not  have  full  control  of  the  patient  but  must 
complete  the  labor,  then  have  patient  to  sit 
up— walk  if  she  chooses,  keep  the  feet  and  limbs 
warm  by  protecting  them.  Should  patient  com-" 
plain  and  take  to  ^e  bed  and  the  pains  again 
become  indifierent,  have  her  to  kneel  by  the 
bed-side  or  in  bed  until  the  head  advances  well 
on  the  perineum,  after  which  the  patient  can  lie 
down  without  further  trouble.  Some  patients 
almost  refuse  to  comply  with  anything  which 
disturbs  the  rest  they  obtain  by  not  having 
strong  pains.  I  then  tell  them,  it  may  be 
necessary  to  deliver  with  instruments — which 
removes  their  objections.  Gravity,  obtained  by 
the  position,  greatly  aids  to  engage  the  head  in 
the  inlet,  and  the  pains  are  made  stronger  by  a 
change  of  position.  When  called  te  a  case  and 
on  examination  find  but  little  dilatation, 
pains  poor,  patient's  ^  statement  would  indicate 
that  she  has  gone  her  full  time,  we  proceed  to 
help— or,  rather,  might  say,  force  the  case — 
through  a  tedious  labor — should  we  not  think 
the  fruit  was  not  quite  ripe  enough  to  pluck? 

Some  cases  do  not  take  quinine  well.  For 
this  reason  I  ha^e  given  ergot,  ten  minims  each 
hour  if  needed. 

If  dilatation  is  complete  I  give  a  large  dose. 
I  have  had  one  hour-glass  contraction,  a  part 
above  and  part  below  the  contraction — which 
yielded  readily  to  dilatation  with  the  fingers^ 
after  which  I  have  not  trusted  the  use  of  ergot 
so  much. 

I  was  taught  to  tie  the  cord  in  two  places  and 
^cut  between  and  wait  then  for  the  after-birth. 
In  doing  so  I  always  had  trouble  to  remove  it 
I  use  one  ligature,  cut,  and  allow  the  placenta 
to  drain  ofi.  It  shrinks  in  size  and  may  almost 
always  be  found  ready  to  enter  the  vagina.  I 
pass  the  index  finger  above  one  edge,  bring  it 
down,  press  over  the  womb  with  the  disengaged 
hand,  and  I  have  no  trouble. 

Some  say  gently  draw  on  the  cord,  which  is 
most  apt  to  bring  it  down  as  a  parachute — act- 
ing like  a  valve  to  a  force  pump,  that  may  favor 
inversion.  Do  not  think  you  weaken  the 
mother  by  loss  of  blood,  as  I  have  heard  ex- 
pressed, as  there  is  no  circulation  between  the 
mother  and  the  plac^ta  after  the  child  is 
removed. 

Should  we  give  ergot  after  the  birth  of  child 
or  after  the  after-birth  is  removed  ?  If  so  why 
and  how  ? 

To  Dr.  Eelley,  page  174 : — Aqueous  ext. 
hydrastis  I  find  to  give  good  results  for  canker 
sores.     Apply  frequently. 

I  have  a  case,  young  man,  age  20,  right  eye  as 
prominentasin  a  bad caseof  exophthalmic  goiter. 


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THE  MEDICAL  WORLD. 


Seldom  pams,  and  then  only  when  used  much. 
Left  eye  natural.  Pulse  80  ;  heart  seldom 
palpitates  and  then  under  excitement  only;  is 
easily  startled  or  frightened — ^a  little  nervous  ; 
has  suffered  some  pain  about  the  heart.  No 
enlargment  of  thyroid.  The  trouble  commenced 
some  two  or  three  years  ago.  What  is  it  ?  Give 
best  treatment  W.  H.  Clouse,  M.D,, 

Crestline,  O. 


About  That  Case. 


Editor  Medical  World  :— I  wish  to  notice 
Dr.  Waugh's  comments  (May  No.,  page  154), 
on  the  case  of  typhoid  fever  which  I  reported 
in  the  April  No.,  page  124.  I  have  been  wait- 
ing hoping  that  others  might  offer  something  in 
regard  to  it 

As  Dr.  Waugh,  in  reporting  a  cure  of  a  case 
of  typhoid  fever  complicated  with  rheumatism, 
does  not  say  anything  about  excessively  high 
temperature  nor  other  malignant  symptoms,  we 
do  not  know  as  to  the  parallelism  of  his  case  and 
mine. 

I  reported  my  case  as  one  of  unusual  malig- 
nancy and  not  to  particularly  call  att^tion  to 
therapeutic  measures ;  but  will  say  to  Dr. 
Waugh,  who  supposes  that  the  phenomena 
observed  in  my  case  was  due  to  the  lack  of 
sufficient  intestinal  antisepsis,  that  that  was  one 
of  the  main  lines  of  treatment  followed,  and  was 
pushed  to  the  extent  of  markedly  deodorizing 
the  feces.  Anti-rheumatic  treatment  was  also 
used. 

The  doctor's  suggestion  would  mean  that  the 
lack  of  antiseptic  treatment  would  account  in 
not  only  my  case  but  others,  for  the  hyperpy- 
rexia and  other  malignant  symptoms.  I  could 
hardly  agree  with  him  in  this,  for  the  majority 
of  cases  of  typhoid  fever  would  recover  and  be 
attended  by  no  unusual  symptoms  if  not  a  doee 
of  any  medicine  were  given,  and  the  tieatment 
consisted  of  nothing  but  good  nursing  and  bath- 
ing. If  this  be  true  in  the  majority  of  cases 
there  must  be  something  else  to  account  for 
anomalous  ones. 

In  the  case  I  reported  tympanites  would  have 
been  a  more  prominent  symptom  if  great  putre- 
factive changes  were  going  on  under  insufficient 
antisepsis  and  to  the  ex|ent  of  causmg  the  train 
of  symptoms  observed. 

If  Dr.  Waugh  or  some  one  else  had  suggested 
the  idea  of  septicemia,  secondarily,  from  the 
absorption  of  ulcerative  products,  as  the  cause  of 
the  chills  and  exoeseive  fever,  I  would  not  have 
controverted  the  point,  though  I  think  the  most 
plausible  hypothesis  to  be  that  the  fever  was 
metastatic  in  tendency  and  involved  the  men- 
inges. 


me 


The  next  highest  temperature  observed  by 
3,  108^  Fah.,  was  in  a  clear  case  of  oerabio- 
spinal  meningitis.  L.  B.  Allen,  M.D., 

Humboldt  N^b. 


Neuralgia: 
Editor  Medical  World: — The  fbllowiog 
combination  I  have  found  to  be  very  effident 
for  neuralgic  conditions  and,  so  far  as  I  know, 
is  original  with  myself,  having  hit  upon  it  after 
trying  almost  everything  else  in  an  obstinate 
case. 

R.    Cioton  Chloral ^«gr.  ill. 

Coealntf' gr  V 

"^s^tis:^.^ .'"'' : — .-g  ? 

M.  K%rNVi: -'•  ^ 

Big.   One  pill  as  required. 

Rolesville,  N.  C.        L.  B.  Young,  M.D., 


Chronio  Inflammation  of  the  Bladder. 

Editor  Medical  World  : — I  would  suggest 
to  Dr.  H.  W.  Cobb,  of  Perry,  Mich.,  that  he 
try  iodoform  in  chronic  inflammation  of  the 
bladder — I  mean,  of  course,  to  wash  out  the 
bladder  with  an  iodoform  solution.  I  believe 
that  if  the  Doctor  will  persist  in  this  treatment 
he  will  succeed  in  curing  his_patient 

Girdler,  Ky.  G.  K  Cecil,  M.D., 


Replies.— For  Suppuration  of  Stump    Under  aa 

Artiflcial  Eye.—Masturbatlon  in  Female 

Children.— Reotai  Pathology  AfTeot- 

ing  the  General  System. 

Editor  Medical  World: — In  answer  to 
Dr.  Chas.  Gilbeit,  page  218,  June,  I  would  say 
that  astringents,  as  a  rule,  will  not  correct  the 
muco- purulent  discharge.  The  peroxide  of  hy- 
drogen, as  a  cleansing  solution,  is  excellent,  and 
should  be  used  before  using  the  following : 

B.    Iodide  of  potash 

Bromine aa^ » ^.dram  i 

Water ad » ^..oonoes  fUJ 

Slff.     Stock  solution. 

Add  one  dram  of  Uils  lolaUon  to  dz  oanoet  of  dear,  wann. 
distilled  water,  and  tkoronghly  cleanse  the  cavity  aa  needed. 

This,  however,  would  not  avail  of  much  if  the 
lachrymo-nasal  duct  is  affected  with  a  chronic 
catarrhal  inflammation.  The  lachrymal  sac  is 
a  reservoir  of  the  fluid  secreted  by  the  conjunc- 
tiva, and  if  this  fluid  is  infe  ted  with  the  strep- 
tococcus pyogenes,  as  we  have  good  reason  to 
believe  in  this  case,  I  would  advise  you«  firstly, 
to  slit  the  canaliculus  and  pass  the  indicated 
probes,  cleanse  the  nasal  duct,  and  thus  restore 
the  normal  calibre  of  the  lachry mo-nasal  duct 
If  pus  is  present,  it  is  well  to  remember  that  a 
solution  of  1*1000  of  pyoktanin  is  a  verr  suc- 
cessful remedy  to  use  Then  follow  with  the 
compound  bromine  solution  mentioned  aboye, 


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of  proper  dilution,  and  you  will  certainly  care 
yonr  case. 

To  Dr.  Wm.  F.  Small,  page  219,  I  would 
say,  apply  locally  in  full  strength  the  blomine 
comp.  sol.  to  the  malignant  ulcer  of  mouth. 

To  Dr.  R  T.  Story,  page  219 :  It  is  well  to 
remember  that  the  clitoris  is  the  most  sensitive 
spot  in  the  growing  female  organism,  and  is  one 
of  the  frequent  causes  of  masturbation.  Care- 
fully examine  if  the  hood  of  the  clitoris  is  ad- 
herent ;  if  so,  free  it,  and  do  not  forget  that 
rectal  trouble  is  frequently  found  in  the  young 
—eyen  in  the  babe.  Doctor,  if  you  have  not 
already  read  Dr.  Robert  T.  Morris'  "  Is  evolu- 
tion trying  to  do  away  with  the  clitoris  ?  "  send 
for  it. 

Would  also  say  to  Dr.  J.  Forman  Pineo, 
page  218,  that  if  he  will  carefully  examine  the 
nervous  patient's  rectum,  and  correct  the  proba- 
ble rectal  pathology,  the  general  nervous  enemia 
and  laryngeal  manifestations  will  speedily  cor- 
rect themselves.  For  years  I  have  been  highly 
interested  and  instructed  in  the  clinical  experi- 
ence meetings  as  presented  to  us  monthly  in 
The  Medical  World,  and  may  give  further 
evidence  of  my  high  appreciation  of  yotrr  jour- 
nal and  its  management  in  the  future. 

Marion,  OhA.  Dr.  A.  Rhii, 


Dry  Couoh.— Diphtheria.— Sanmetto.—Qastritit.— 
Ciilorate  of  Potattium  in  Anemia. 

Editor  Medical  World  : — I  have  received 
more  than  the  value  of  your  subscription  price 
from  the  following  treatment  for  dry  cough, 
which  appeared  in  the  April  number : 

R.     8yr.  plds. ounces  iai 

8yr.  piun.  ylw oances  i 

mt,  aoid  hydnodic oancei  ii 

Tr.  t  apsicnm  .» » ounces  ss 

MooilJige'acada ounces  1 

M.    8ic.~TeMpoonful  4  times  daily. 

Every  number  also  contains  editorial  and 
original  articles  of  merit 

I  notice  an  article  in  your  last  issue  claiming 
extraordinary  results  in  the  treatment  of  diph- 
theria with  gunpowder.  I  have  to  remaric  that 
there  8e«^ms  to  l)e  as  many  different  treatments 
of  this  terrible  malady  as  there  are  varieties 
and  modifications  of  the  disease.  I  have  had 
considerable  experience  with  diphtheria,  and  I 
firmly  believe  that  caees  do  occur  in  which  all 
treatment  is  powerless.  I  have  seen  cases  so 
rapid  in  their  march  that  death  has  occurred 
within  the  first  twenty- four  hours.  I  have  seen 
a  case  under  the  best  modem  treatment  in 
which  the  membrane  persisted  in  remaining  in 
the  throat  for  twenty  eight  days,  followed  by 
parai(y8is  and  loss  of  vision,  ending  afterwards 
in  perfect  recovery,  and  I  have  seen  several 
patients,  under  the  same  judicious  tieatment, 


die  within  fourteen  days  of  the  onset.  I  have 
used  neither  charcoal  nor  saltpetre  in  the  dis- 
ease. For  constitutional  treatment,  I  pin  my 
faith  on  tincture  of  iron,  sulphurous  add,  chlor- 
ate of  potash,  poke  roct,  'urpentine,  quinine, 
brandy, car  bonate  of  ammonia  and  the  solution  of 
acetate  of  ammonia,  compatibly  combined  in  dif- 
ferent mixtures  according  to  indications ;  for 
local  treatment,  I  rely  on  potassium  bromide^ 
potassium  chlorate  and  tincture  of  iron,  and  on 
salicylic  acid,  borax  and  glycerine  gargles. 
Tincture  of  iodine  and  salicylic  acid  crystals 
are  good  applications  locally  to  the  membrane. 
Sprays  of  peroxide  of  hydrogen  are  excellent ; 
so,  also,  is  carbolic  acid  solution.  Balcer's 
yeast,  as  a  gargle,  has  done  me  good  service. 
The  atmosphere  of  the  room  should  be  moist 
and  antiseptic,  made  so  by  steam  from  lime 
water  and  the  evolution  of  chlorine  and  sul- 
phurous acid  gases.  But  with  all  these  and 
other  excellent  means,  too  numerous  to  mention^ 
intelligently  used,  we  must  be  prepared  to  lose 
cases. 

In  catarrhal  diseases  of  the  urinary  organs 
with  difficult  micturition,  no  matter  what  the 
cause,  I  have  had  excellent  results  from  the  me 
of  sanmetto  in  teaspoonful  doses  four  times 
daily,  alternated  with  a  teaspoonful  of  acetate 
of  ammonia  solution  in  plenty  of  water,  into 
which  ten  drops  of  tincture  of  iron  are  dropped 
just  before  taking. 

In    a  recent  case  of  inflammadon  of  the 

stomach  with  obstinate  vomiting,  I  succeeded 

in  turning  it  to  a  favorable  issue  by  applying  a 

large  fly  blister  over  the  stomach,  injecting  per 

rectum  eighty  drops  tincture  of  opium  in  starai 

water,  directing  the  patient  to  swallow  smaU 

pieces  of  ice  every  few  moments,  and  by  the 

administration  of  the  following  : 

B,     Add  hydrocjan,  CH  (P.  B.) ....dram  i 

Bismuth  suonlt » dnm  11 

Tr.oalnmbie o.  nc  si 

AquA  q.  s.  ad oam  e  Ir 

M.  Sig.—TeaspoonAil  every  4  hours,  well  shaken  before 
taken. 

In  your  May  number  Dr.  Grinnell  says,  "I 
believe  more  ii  jury  has  been  done  by  the  in- 
ternal use  of  chlorate  of  potash,  than  all  the 
good  it  has  ever  accomplished."  Now,  I  must 
add  my  opinion  from  a  long  experience.  In 
the  treatment  of  anemia  I  have  found,  that  a 
solution  of  five  grains  of  chlorate  of  potash  in 
plenty  of  water,  into  which  ten  drops  of  tincture 
of  iron  have  been  dropped,  and  taken  immedi- 
ately after  meak  has  done  me  more  service 
than  any  other  remedies  whatever.  The  pro- 
per use  of  this  drug  in  suitable  cases  is  com- 
mendable. 

I  notice  a  reported  cure  of  a  case  of  genuine 
phthisis,  as  a  result  of  treatment  with  oodliver 
oil,  iron,  beechwood  creosote,  and  atropine  pills^ 


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in  one  of  onr  Canadian  medical  joumala,  I  can 
endorse  the  treatment,  but  can  only  hope  as  yet 
that  it  may  be  successful  hereafter. 

The  use  of  sulphurous  acid  internally  is  more 
potent  than  sulphites. 

J.  G.  Atkinson,  M.D., 

St.  James,  N.  B.,  Canada. 

Replies.— The  Treatment  of  Bronohial  Diseases 
by  Dr.  Green.— Esophtgesl  Stricture. 

Editor  Medical  World  :  The  treatment 
of  which  Dr.  R  J.  ^Thompson,  Ky.,  June 
World  page  218  writes  making  inquiry,  was 
first  practiced  by  Dr.  Horace  Green,  of  N.  Y. 

It  oonsiBted  in  injecting  into  the  lungs  or 
bronchi,  (as  the  case  demanded)  through  a 
rubber  tube,  one  dram  of  a  solution  of  argent, 
nit.,  forty  grains  to  the  ounce  of  water.  I  have 
in  my  possession  the  article  written  by  Dr. 
Green  in  1855,  giving  illustrative  casea.  I 
wonder  why  a  treatment  which  promised  so 
much,  and  is  the  most  rational  of  any,  has  fal- 
len  into  disuse. 

The  doctor  claimed  that  it  was  absolutely 
safe,  although  such  men  as  Erichsen,  Trous- 
«eau,  Hall  and  others  claimed  that  it  was  im- 
posedble  to  pass  a  sponge  probang  wet  with  the 
caustic  solution,  beyond  the  vocal  cords.  How- 
ever, Dr.  Green  pulsed  it  many  times  without 
barm.  The  operation  was  performed  several 
times  in  the  presence  of  8ims,  Parker,  Bow- 
ditch,  Sayre  and  Minor.  The  doctor  will  find 
the  article  in  Trans,  of  State  Med.  Soc.,  of  N. 
Y;,  1855,  p.  244.  Also  in  BraithwaUe*8  R^ 
irospeet,  VoL  xxxii  p.  60. 
V  The  case  of  Dr.  Pineo,  Cheater,  Novia  Scotia, 
Oan.,  in  my  opinion  is  stricture  of  esophagus — 
but  whether  spasmodic  or  organic,  of  couIse^  I 
cannot  say  positively.  However,  I  would  pass 
a  bougie  occasionally,  feed  through  the  stomach 
tube,  apply  belladonna  ointment  to  the  neck, 
aad  give  anti-hypterical  treatment,  keep  bowels 
open,  give  asafetida,  valerian,  etc.,  etc.  If  or- 
ganic, or  from  pressure  on  esophagus  from  some 
growth  or  aneurism,  any  late  work  on  surgery 
will  inform  you  of  the  best  course  to  pursue. 
J.  T.  Barnbtt,  M.D.. 

Hardinsburg,  Ind. 


ful  success.  He  and  Dr.  Omochen — daiiog 
surgeon — were  the  very  life  of  the  Thirteenth 
Street  School 

Your  journal  is  my  choice  of  all  others. 

Milbum,  La.  F.  H.  Maddox,  M.D., 


Editor  Medical  World  : — Dr.  Thompson, 
(page  218)  wishes  to  know  something  of  Dr. 
Howard  Green,  who  was  professor  in  Thirteenth 
Street  Medical  College,  New  York.  In 
1855  I  saw  him  operate  before  a  committee  to 
prove  his  claim  to  entering  bronchial  tubes, 
which  was  doubted  by  the  profession ;  nor  did 
•he  convince  them,  for  a  lighted  taper  at  exter- 
nal end  of  tube  was  not  blown  out  when  tube 
^as  introduced.  Yet  he  seemed  to  have  wonder- 


Editor  Medical  World  : — Dr.  Pineo's  < 
of  difficult  swallowing,  detailed  on  page  217,  is 
undoubtedly  a  case  of  stricture  of  the  esophagus. 
The  positive  diagnosLs  and  treatment  is  tbe 
pissage  of  an  esophageal  bougie  by  a  specialist 
prepared  for  such  work. 

C.  R  Marlette,  M.D., 

Brandenburg,  Ky. 


A  Secret  Cure  for  Cancer. 

Editor  Medical  World  : — I  enclose  a  let- 
ter for  you  to  dispose  of  as  you  see  fit.  It  b 
being  advertised  very  heavily  in  California  by 
Dr.  Chamlee,  formerly  of  Lone  Oak,  Texas.  I 
am  personally  acquainted  with  one  man  who 
had  a  cancer  taken  ofi  him  several  years  ago  by 
this  method,  he  says.  Now  it  is  returning,  and 
he  wants  me  to  treat  him  in  the  near  future.  I 
wish  tfie  remedy  tried,  and  the  results,  pro  or 
con.,  published  in  The  Medical  World. 

I  send  this,  believing  that  evprything  that  is 
of  benefit  to  humanity  should  be  published. 

M.  D.  iL 

[We  give  below  an  exact  reproduction  of  the 
method  of  treatmer  t,  as  it  appears  on  an  old 
and  worn  copy  enclosed  with  the  doctor's  letter. 
In  the  first  formula,  galangal  and  sangoinaria 
are  doubtless  intended.  Practically  the  same 
treatment  has  previously  appeared  in  The 
World. — Ed.] 
B  for  Cancer. 

1st  Take  strong  hop  tea,  use  com  meal  and 
make  a  poultice,  and  apply  over  night,  whidi  is 
merely  to  cleanee  the  pisurt 

2d.  Make  a  plaster  as  follows : 

Ghdlenger  pulv 

Sanguinary  ''    red,     aa    .    i  ounce 
Chloride  zinc,  .     .     iii  diams  xl  grs. 

Pulverize  thoroughly,  add  water  to  make  a 
thick  paste,  spread  on  a  linen  cloth,  apply ;  let 
It  remain  24  hours,  remove,  and  apply  %  Z  on 
4  times,  according  to  size  and  nature^  of  cancer. 
You  must  be  governed  by  the  appearance  <rf 
cancer.  Now  the  cancer  is  killed,  and  will  drop 
out  from  4  to  6  or  8  days,  and  needs  no  asaisi- 
ance,  and  will  drop  out  itself. 

You  then  make  a  salve  as  follows: 
Mutton  suet, 
Beeswax, 
Eng.  Resin,  aa,  i  lb.  or  less  if  you  wish. 

Melt  them  together;  while  cooling  add  oQ 
spike.  1  ounce.    Spread  on  a  linen  clothe  vpflj 


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ererv  12  hoars,  cleansing  the  cancer  each  time 
with  castile  soap ;  oontbue  until  healed. 
Make  a  bitter*  as  follows : 
Bine  cohosh, 
Black     " 
Sarsaparilla, 
Burdock, 

Yellow  Dock,  aa,  2  oz. 
Put  the  ingredients  in  3  qts.  water ;  simmer 
down  to  1  qt,  strain  and  bottle.  Then  add 
leptandrin  and  gamboge  aa  L  (50)  grs.,  cassia 
i  oz.,  licorice  i  oz.  Dose,  tableepoonful  8  times 
a  day. 

Also  takd  some  purgative  to  keep  bowels  ac- 
tive. 

After  you  apply  plaster  there  will  be  an  un- 
easy, neavy,  nervous  feeling.  You  can  use 
some  anodyne  to  procure  rest. 

Large  baby. 

Editor  Medical  World: — Permit  me  to 
leport  the  following  '•ase  of  "heavy  weight" 

Mrs.  Harris  K  Mason,  age  Sd,  No.  85  lit- 
eiarj  St,  this  City,  whom  it  has  been  my 
pleasure  to  attend  since  marriage,  was  on  May 
12th,  ddivered  of  a  fine  boy,  weighing  18  lbs., 
being  her  seventh.  Mrs.  M.  weighs  but  100 
lbs.  at  her  best,  is  of  Scotch  parents,  herself  a 
native  of  Ganada.  Mr.  M.  is  a  native  of  this 
oify,  an  ordinary  sized  man. 

Qiild  and  moiher  at  this  date  well. 

C.  M.  Chalpaut,  M.D., 

414  Pearl  St,  Qeveland,  O. 

The  AttHude  of  Railroad  Authorities  Toward  the 
Medical  Profettlon. 

Editor  Medical  World  : — ^You  ask  for  in- 
fbnnation  in  regard  to  the  payment  of  physi- 
cians by  nulroad  companies  in  case  of  accidents. 
I  live  on  the  line  of  the  Boston  and  Maine 
Railroad,  and  have  been  called  in  cases  of  ac- 
cidents. Sometimes  I  have  been  paid  by  the 
party  injured  ;  at  other  times  by  the  road.  Tie 
last  cafe  of  accident  I  attended  was  in  the  night, 
and  though  the  passenger  was  at  fault,  yet  I 
sent  my  bill  to  the  railroad  authorities,  at  the 
suggestion  of  the  station  agent,  and  it  was  paid 
at  once,  without  question. 

Wakefield,  Mass.        D.  S.  Ck)LES,  M.D., 

The  Morphine  Disease. 

Second  Paper. 

Editor  Medical  World: — In  the  earlier 
stages  few  and  trifling  lesions  of  the  ner- 
vous system  have  been  found.  It  is  at  all 
times  d]£Soult  to  tell  what  is  due  to  the 
morphine  and  what  to  intercurrent  or  pre  exist- 
ent disease.  Hyperemia  of  the  brain,  lungs, 
liver,  kidneys  aud  bowels  have  been  described ; 
with  apoplexies,   ecchymoses,   etc.      Cerebral 


anemia  is  usually  present.  The  lymphatie 
glands  have  been  found  inflamed,  or  suppurat- 
ing; the  heart  muscle  pale  and  sclerosed 
(Lewinstein),  or  hypertrophied ;  twice  it  wa» 
fattv  (Hirschfeld).  The  cells  of  the  spina) 
cord  present  tissue  faction,  vacuolation  and 
granuLeur  degeneration. 

When  the  drug  has  b^^en  discontinued  the 
tissues  gradually  resume  their  normal  function  ^ 
rapidly  and  fully  if  the  habit  be  of  short  dura- 
tion, slowly  and  imperfectly  as  it  has  continued 
longer.  The  nerves  resume  their  functions  al** 
most  violently,  and  when  relieved  of  the  long- 
continued  b^umbing  influence  of  the  drug,, 
they  become  hypereethetic,  their  abnormal  sen- 
sitiveness causing  acute  distress.  The  same  re- 
action is  often  noted  in  relation  to  other  vital 
functions.  As  the  symptoms  of  dementia  super- 
vene, with  obliteration  of  the  moral  sense,  the 
chances  of  complete  recovery  are  lessened.. 
Patients  who  have  been  treated  by  the  Keeley 
people  are  especially  difficult  to  handle,  as  they 
seem  to  be  ofien  devoid  of  shame,  and  to  look 
on  themselves  as  irresponsible  freaks  of  the  most 
interesting  description.  Prolonged  restraint,  for 
at  least  a  year  after  the  cure,  is  frequently  re* 
quired  to  render  it  permanent  in  such  cases. 
But  even  if  the  case  be  far  advanced,  a  per- 
manent cure  may  be  obtained,  provided  the 
patient's  means  permit  him  a  period  of  rest,  or 
light  occupation,  and  a  sufficient  motive  exists 
to  keep  him  from  falling  back.  The  possessor 
of  a  wife  and  children  is  a  more  hopeful  caso 
than  the  bachelor,  especially  if  the  latter  be 
supported  by  a  mother,  and  not  traine  *  to  sup- 
port himself.  It  is  astonishbg  that  men  of 
brains,  of  talent,  or  even  genius,  to  frequently 
fSdl  under  the  morphine  thralldonu  In  the 
majority  of  cases,  some  true  chord  will  be  found 
to  vibrate  in  harmony  with  duty.  Depravity 
is  rarely  so  complete,  self-indulgent  imbedtity 
so  deeply  seated,  but  that  motives  may  be  found 
that  will  arouse  the  latent  spark  of  manhood 
and  induce  the  patient  to  make  an  effort  to 
break  his  chains,  if  properly  helped. 

The  efforts  at  cure  and  other  incidents  may 
delay  the  course  of  the  disease ;  but  apart  from 
these  its  duration  is  variable.  Some  run  quickly 
through  the  stages,  while  in  others  the  progress 
is  slow.  Death  is  often  due  to  intercurrent  dis- 
ease ;  the  opium  habitue  being  peculiarly  liable 
to  die  of  epidemics,  cholera,  typhoid,  etc.  Sur- 
gical operadoDS  result  badly  with  them,  and 
tuberculosis  is  especially  frequent  Death  is  fre- 
quently due  to  an  over-dose,  taken  from  chagrin 
or  with  suicidal  intent. 

A  frequent  cause  of  lelapee  into  the  habit  u 
the  recurrence  ot  that  imperative  sense  of  need, 
of  which  we  have  spoken.  During  the  first  year 


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THE  MEDICAL  WORLD. 


after  the  cure,  thia  may  appear  at  any  time, 
when  the  patient  suffers  from  any  cause  of  de- 
pre8si<>n.  The  larger  the  amount  consumed  and 
the  longer  the  habit  has  lasted,  the  more  likely 
is  the  patient  to  relapse.  ^Neuropathies  and 
those  who  handle  drugs  are  also  most  likely  to 
relapse.  The  prognosis  is  always  best  when  the 
cure  has  endured  a  year  or  more ;  worse  when 
there  have  been  relapses  previously,  and  bad 
with  old  men,  alcoholics  and  the  tuberculous. 
There  is  scarcely  a  hope  of  cure  if  the 
patient  continues  to  use  alcohol,  ether  or  naph- 
thol  as  intoxicants,  or  cocaine.  Even  when  a 
cure  has  been  effected  in  cases  far  advanced,  the 
patient  is  not  necessarily  free  from  danger. 
Some  remain  well  for  months,  and  are  then 
seized  with  palpitations,  syncopes,  anguishes, 
sadness  and  nervous  accidents ;  they  fail  into  a 
<»chexia  that  soon  proves  fatal  if  morphine  be 
not  given.  The  system  is  no  longer  able  to  do 
without  the  drug ;  which,  however,  must  be 
controlled  by  the  physician. 

SYBiPTOMS  OF  WITHDRAWAL. 

When  the  morphine  is  suddenly  opt  off,  then 
occur  certain  symptoms  to  which  Lewinstein 
has  given  the  name  of  abfetiuence  phenomena. 
First  of  these  is  that  described  as  the  sense  of 
need.  It  is  rather  due  to  the  fear  of  suffering 
than  the  wish  for  euphoria.  It  is  never  want- 
ing ;  showing  itself  more  and  more  tenacious, 
imperious,  irresistable, until  the  victim  throws 
off  all  pretense  and  boldly  affirms  the  impossi- 
bility of  enduring  life  without  morphine.  If 
deprived  of  morphine,  the  malaise  and  agita- 
tion increase,  the  patient  becomes  irritable, 
quarrelsome,  critical,  injures  his  suiroundings, 
breaks  objects  within  his  reach.  By  turns  he 
rages  and  begs  with  tears  for  an  injection. 
Later,  his  agitation  becomes  extreme ;  he  cannot 
be  kept  quiet,  but  deafens  his  neighbors  by  his 
groans  and  cries.  There  may  be  even  furious 
•delirium,  clonic  convulsions  or  ataxic  trem- 
blings. Hallucinations  of  sight  and  hearing 
may  occur.  Following  this  comes  a  stage  of 
depression ;  they  remain  gloomy,  taciturn, 
plunged  in  despair,  often  of  suicidal  character. 
Reflex  excitability  is  exalted;  as  shown  by 
yawning,  sneezing,  little  fits  of  coughing,  spasm 
or  trembling  of  the  legs.  The  pupik  are  often 
unequal  between  the  second  and  eighth  days ; 
the  dilatation  sometimes  alternating,  and  the 
retina  is  photophobic  Besides  these  we  have 
the  pain  phenomena— neuralgias,  migraine  op- 
pressions, palpitations,  pain  on  swallowing.  Two 
important  phenomena  now  present  are  the  im- 
pulses to  suicide  and  to  theft  or  murder. 

When  the  patient  wants  morphine  there  is  no 
crime  from  which  he  will  hesitate  to  procure  it 


If  the  drug  be  abruptly  stopped,  the  symp 
toms  last  three  or  four  days ;  but  if  the  method 
of  very  gradual  reduction  be  pursued,  they  last 
so  much  the  longer.  If  a  dd^  however  small, 
of  morphine  be  given,  the  abstinence  symptoms 
disappear  promptly ;  but  recur  in  time  corres- 
pondmg  to  the  dze  of  the  dose.  Choleraic 
diarrhea,  collapse,  with  great  vital  deprenon, 
somnolence,  coldness,  difficulty  of  speech,  con- 
vulsions or  tremors,  may  occur  repeatedly,  end- 
ing in  death  or  recovery.  If  the  latter  the 
symptoms  gradually  subside,  the  mind  resumes 
its  sway,  and  the  appetite  returns.  As  tlie 
patient  begins  to  put  on  tat,  the  sexual  organs 
resume  their  vigor,  often  in  an  abnormal  degree. 
Men  may  suffer  from  priapism  and  testicular 
neuralgia,  relieved  by  emissions,  and  women  may 
display  erotomania.  These  soon  subside ;  and 
in  from  two  to  six  weeks  the  patient  is  free  from 
all  unpleasant  sensations.  At  various  periods, 
however,  according  to  the  conditions  of  life,  the 
sense  of  need  may  recur.  The  critical  time  is 
the  seventh  month,  when  a  melancholic  period 
(»ften  occurs,  and  the  danger  of  relapse  is  great. 

If  a  year  has  elapsed  without  recurrence,  the 
prognosis  is  good,  but  the  drug  must  never  be 
tasted  again. 

TREATMENT. 

The  treatment  has  for  its  objects  the  discon- 
tinuance of  the  habit  and  the  prevention  of  its 
resumption.  Lewinstein  stops  the  drug  ab- 
ruptly, confines  his  patient  to  a  [mdded  room 
with  a  sufficient  force  of  nurses  to  prevent  self 
injury.  This  is  only  suited  to  those  who  have 
used  the  drug  a  short  time  and  in  small  doses, 
when  the  strength  is  not  seriously  impaired. 
The  suffering  is  extreme,  delirium  often  super- 
vening, with  acute  symptoms  of  withdrawal. 
But  foi  this  very  reason  the  chances  of  per- 
manent cure  are  better,  as  the  suffering  makes 
a  lasting  impression  on  the  patient,  who  thus 
realizes  the  prowess  of  the  deadly  enemy  from 
whose  hands  he  has  escaped.  The  greater  the 
suffering,  the  less  likely  is  the  sufferer  to  again 
put  himstlf  in  the  clutches  of  this  demon. 

The  second  method  may  be  termed  the 
amateur's ;  tb  at  of  imperceptible  reduction.  This 
is  objectionable  from  many  points.  When  the 
reduction  has  proceeded  to  a  certain  point  the 
suffering  begins  and  continues  until  it  has  been 
completed.  If  a  half-grain  be  necessary  to  re- 
lieve, this  dose  cannot  be  reduced  with  the 
patient's  consent;  and  no  more  suffering  will 
follow  the  total  discontinuance  than  if  the  dose 
be  reduced;  so  that  the  slow  reduction  only 
prolongs  the  agony.  In  advanced  cases,  how- 
ever, the  reduclion  can  only  be  made  in  this 
way  ;  and  if  the  strength  be  seriously  impauned 
it  is  necessary  to  reduce  the  dose  as  much  as 


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poflBible  and  then  wait  till  the  strength  has  been 
reetoied  bj  suitable  means  before  total  with- 
drawal is  effected. 

In  most  oases,  Erlenmeyer's  method  of  rapid 
reduction  is  best  The  dose  is  reduced  one-half 
each  day,  so  that  it  is  totally  withdrawn  in  from 
four  to  ten  days.  The  suffering  is  not  so  severe 
as  in  Lewiiratein's  cases,  and  may  be  graduated 
to  the  patient's  powers  of  endurance. 

The  substitution  methods  are  only  to  be  con- 
demned. Alcohol,  chloral,  codeine,  cocaine  and 
cannabis  are  alike  objectionable  in  themselves, 
and  they  leave  the  disease  uncured.  After  us- 
ing them  a  variable  time  the  patient  invariably 
returns  to  morphine.  While  any  of  these  drugs 
will  lessen  the  pain  of  abstmence,  they  give  no 
real  relief,  as  the  pains  recur  with  the  same  in- 
tensity when  the  effect  of  the  dose  wears  off. 
They  simply  postpone  the  inevitable  conflict, 
when  the  patient  must  assert  his  manhood,  meet 
and  conquer  his  enemy,  or  the  cure  will  be 
transient  and  illusory. 

Whatever  plan  be  adopted,  the  essential  part 
of  the  treatment  consists  in  obtaining  perfect  con 
trol  over  the  patient  Many  men  think  they 
want  to  be  cured,  but  they  don't.  Unless  they 
show  the  sincerity  of  their  desire  for  escape,  by 
leaving  their  homes  and  devoting  themselves 
exclusively  to  the  work  of  a  cure,  it  is  not  worth 
while  to  attempt  it  They  will  reduce  the  dose 
till  real  suffering  begins,  and  then  they  will  find 
some  excuse  for  discontinuing  treatment,  or 
else  they  will  lie  about  it  Besides  this,  the 
patient  should  pay  enough  for  treatment  to  make 
him  feel  that  he  ought  to  get  the  value  of  his 
money,  and  thu3  his  cooperation  is  secured. 

DIET. 

During  the  reduction  period  the  patient 
should  be  fed  well,  on  easily  digested  and  num 
tious  food.  During  the  period  of  suffering  but 
little  will  be  taken  and  I  rely  then  upon  the  raw 
white  of  egg  in  water,  junket,  hot  soup,  and 
es^ially  bovinine.  Most  of  my  cases  live  on 
bovinine,  a  teaspoonful  or  more  every  hour. 
During  this  time,  I  am  sure  that  it  not  only 
keeps  up  the  strength,  but  shortens  the  suffer- 
ing* I  give  all  of  it  the  patient  can  be  induced 
to  take,  and  if  the  stomach  rebels,  it  is  given  by 
the  rectum. 

REGIME. 

Until  the  crisis  is  past,  the  patient  is  encour- 
aged to  keep  to  his  bed  ;  only  rising  when  the 
nervousness  is  relieved  by  walking  about  the 
room,  or  to  take  a  bath.  Not  for  a  moment  is 
he  left  alone  ;  a  competent  nurse  being  in  the 
room  constantly,  and  the  doctor  within  call. 
(Concluded  in  August  World). 

W.  F.  Wauuh,  M.D., 

103  State  St.  Chicago. 


Qui^  De|>artment. 


Qoestkms  axe  Mllcited  for  thk  Otiluinn.  Communlcatioaia 
not  accompanied  hj  the  pxxiper  name  and  addxeaa  of  the 
wijer  (not  neccaiarily  for  publication),  wiU  not  be 
noticed. 

The  great  number  of  reqaeata  for  private  answen,  for  the 
information  and  benefit  of  the  writer,  makes  it  neoeaa- 
ary  ^oa  to  chaxge  a  fee  for  the  time  required.  Thk 
fee  win  be  nom  one  to  five  d(dlan.  aooorainff  to  thm 
amount  of  reaeaicfa  aM  writia«  lequked. 

Ufe  is  Full  of  Queries. 

Editor MiEBicAL  World:— A  woman,  age 
29  years,  married  eight  years,  two  children  and 
five  miscarriages ;  one  giri  6  years  old  and  one 
1  year  old,  both  children  healthy.  Woman  in 
comparatively  good  health,  excepting  double  in- 
guinal hernia.  Uterus  almost  in  normal  position 
— just  the  slightest  ante-flexed,  but  not  enough 
to  give  any  trouble — or  it  has  proved  so  any 
way.  Bowek  regular  and  normal.  I  attended 
her  with  her  last  child.  The  labor  was  slow 
but  natural.  She  got  up  very  easily  without 
any  trouble.  Here  comes  the  peculiarity.  She 
will  go  from  oae  to  six  days  and  not  pass  a  sin- 
gle drop  of  urine.  She  has  not  {Missed  any 
urine  at  all  excepting  as  it  is  drawn  off.  She 
will  draw  off  two  to  four  pints  at  the  end  of  two 
or  four  days.  She  says  she  has  no  pain  or 
trouble  any  more  at  the  end  of  four  days  than 
she  has  at  the  end  of  twenty-four  hours.  She  says 
she  only  feels  full  a  little.  I  let  urine  stay  in  the 
bladder  seven  days  once  just  to  see  the  effects  ; 
none  any  way  only  she  said  she  felt  full.  Not 
the  slightest  symptom  of  urine  poisoning ;  urine 
was  almost  normal  when  taken  off.  She  had 
some  trouble  when  carrying  the  child,  before 
she  gave  birth  to  her  last  child,  and  sent  for  a 
doctor,  and  he  came  and  never  examined  her, 
she  says,  but  thrust  in  placenta  forceps  and  took 
a  four  and  a  half  or  five  months  fetus  away. 
Her  bladder  has  been  this  way  ever  since.  She 
has  given  birth  to  one  child  since  that  at  which 
I  attended  her.  The  hernia  came  on  after  she  was 
cut  up,  as  she  states,  on  right  side,  and  the 
left  followed  soon  and  the  bladder  has  been 
growing  worse  all  the  time.  I  have  exhausted 
all  drugs  used  for  bladder  troubles  and  many 
others  without  any  benefit,  have  used  lithiates 
with  no  benefit ;  I  have  washed  out  the  bladder, 
have  used  sounds  and,  in  fact,  every  conceiva- 
ble method  I  ever  heard  of  and  yet  I  have 
urine  to  draw  off.  Urethra  normal.  Nothing 
strange  or  abnormal  only  double  hernia  and 
bladder  will  not  empty  itself  and  she  will 
not  become  intoxicated  from  continence  of 
urine.  She  states  that  she  feels  better 
when  hernia  is  out  on  the  right  side.  She 
can  keep  hernia  in  but  she  says  she  does  not 
feel  so  badly  when  it  is  out  She  does  not 
have  any  sweating  to  carry  off  urine  or  any 


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THB  MEDICAL  WORLD. 


unusual  cHscharge  through  the  bowel.  I  can  not 
aocount  ior  her  condition  unless  it  be  from  the 
treatment  of  the  doctor  who  took  the  child  from 
her  at  four  or  five  months  and  caused  paralysb 
of  the  bladder  and  double  hernia.  I  have  had 
Dr.  Brown  of  Ft  Worth,  Tex.,  to  see  the  lady 
with  me.  Dr.  W.  B.  Walker, 

Granbury,  Texas. 

Editor  Medical  World: — Will  some  of 
the  brotherhood  suggest  efficient  treatment  for 
an  obstinate  case  of  acne  or  gutta  rosacea? 

Patient  is  in  the  prime  of  life,  a  man  of  (so 
he  claims)  temperate  habits,  medium  weight  and 
figure,  of  rather  nervous  temperament  Family 
history  gives  no  clue  as  to  tlie  etiology  of  the 
trouble,  wMch  has  existed  for  several  years 
now,  and  affects  chiefly  the  no3e,  cheeks  and 
forehead.  I  have  tried  in  turn  all  remedies, 
old  and  modem,  which  are  recommended  for  this 
ailment,  viz:  vegetable  alteratives,  iodides, 
mercurials,  calcium  sulphide  and  arsenic — all 
with  liMe  benefit  only.  I  am  now  giving  as  a 
last  trial  ichthyol,  as  advocated  by  Unna  and 
others,  and  feel  almost  tempted  to  try  the  fric- 
tion power  of  a  grindstone  on  my  patient's 
blotched  face  at  the  risk  even  of  making  mat- 
ters worse. 

If  any  one  of  the  brethren  has  a  more  reli- 
able treatment  to  offer  I  would  be  very  thank- 
ful for  it,  as  my  patient  wants  to  get  rid  of  his 
''copper"  at  any  sacrifice. 

Such  blemishes  seem  to  be  painfully  frequent 
in  this  section,  and  a  few  otber  sufferers  wait 
only  for  the  final  result  in  the  above  mentioned 
case — to  undergo  treatment.  The  organ  of 
smell  in  one  of  these  cases — iridescent  from  the 
richest  purple  to  a  saturated  plum  color,  is  so 
hypertrophied  that  it  has  assumed  the  propor- 
tions of  a  fair-sized  cucumber — ^thus  rendering 
that  otherwise  so  useful  organ  a  genuine  burden 
to  its  unfortunate  owner.  Is  there  a  non-sur- 
gical cure  at  all  for  such  deformity  ?  Perhaps 
try  the  absorbing  effect  of  galvanism  ?  Breth- 
ren, let  us  hear  &om  you  through  the  medium 
of  our  excellent  standard  exchange.  The 
Medical  World.        A.  C.  Zi  gler,  M.D., 

Allegheny,  Pa. 

Editor  Medical  World:— The  following 
may  be  of  interest  to  the  many  readers  of  The 
World.  I  trust  that  some  who  read  this 
article  will  take  the  trouble  to  reply  in  the  next 
issue  and  give  us  their  views  on  the  cause  of 
the  trouble. 

Girl,  8  years  old,  giod  family  history,  no 
syphilitic  or  tuburcular  trace.  Weight  of 
mother  and  father  about  175  pounds  each, 
weight  of  girl  about  65  pounds;  has  one  brother 


and  sister,  both  healthy  and  strong.  Her 
mother  states  that  the  patient  was  very  small 
when  bom,  and  has  had  poor  health  all  her 
life.  When  she  was  18  months  old  her  mother 
first  noticed  a  small  red  spot  on  the  little  toe  ot 
the  right  foot,  which  steadily  grew  larger  and 
more  angry  looking,  and  in  the  course  of  12  or 
15  months  the  toe  came  off.  Then  the  second 
toe  passed  through  the  same  stages,  and  the 
third,  fourth  and  fifth.  I  examined  her  first 
on  May  14th,  and  found,  by  probing,  all  the 
bones  of  the  foot  necrosed  and  several  large 
openings  in  the  foot.  No  sensation  below  the 
ankle.  The  foot  was  offensive  to  both  smell  and 
sight  I  advised  immediate  amputation.  On 
Wednesday,  two  days  later,  an  amputation  was 
performed  at  the  lower  third  of  the  leg.  The 
tibia  was  found  diseased — the  marrow  had  a 
dirty  brownish  appearance  and  was  of  the  con- 
sistency of  creamy  pus — resulting,  as  I  thought, 
from  medullitis.  The  periosteum  on  the  pos- 
terior side  was  diseased  and  not  attached  to  bone. 
It  was  thought  best  to  remove  the  entire  tibia. 
So  I  performed  the  Stephen  Smith  amputation 
at  the  knee  joint  The  operation  was  suocees- 
ful,  good  union  secured. 

To  continue  with  this  case.  About  three 
years  ago  the  little  toe  of  the  left  foot,  passed 
through  the  same  stages  as  that  of  the  foot  am- 
putated, and  came  off.  Now  the  second  toe 
appears  to  be  almost  ready  to  come  off.  The 
remainder  of  the  foot  has  a  good,  healthy 
appearance.  There  is,  however,  but  little  sen- 
sation in  the  foot  below  the  ankle.  I  do  not 
think  any  of  the  bones  beyond  the  second  toe 
are  diseased.  I  have  advised  an  amputation  of 
a  portion  of  the  left  foot  and  will  doubtless  per- 
form  it  in  a  short  time.  I  call  this  a  case  of 
Raynaud's  disease  or  symmetrical  gangrene. 

I  would  be  very  glad,  indeed,  to  Lear  from 
others  on  this  case. 

G.  A.  McBride,  M.D  , 

Fort  Gibson,  I.  T. 

[This  seems  to  be  a  very  interesting  case  of  a 
slow  form  of  symmetrical  gangrene.  We.  should 
like  to  have  the  case  widely  discussed. — £d.] 

Editor  Medical  World  : — I  am  at  sea  in 
regard  to  a  case  now  on  my  hands,  that  of  an 
old  lady,  about  70  years  of  age.  Three  yean 
ago  a  painful  spot  came  on  top  of  the  left  iooi, 
about  half  an  inch  to  an  inch  back  of  the  meta- 
tarso-phalangeal  joint  of  the  littie  toe.  Burn- 
ing pain.  No  other  trouble  apparent,  under 
the  care  of  physician  in  neighboring  town,  who, 
according  to  her  account,  used  about  everything 
on  it.  No  help  until  she  tried  a  patent  appli- 
cation, when  pain  disappeared  for  about  a  year. 
A  year  ago  she  came  under  my  care  with  re- 


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newal  of  the  old  trouble.  Had  tried  the  same 
patent  application  without  relief  this  time.  I 
have  treated  her  more  or  leae  constantly  for  a 
year  without  cure.  Have  succeeded  in  making 
^e  sotnewhat  more  endurable  but  that  is  about 
idL  Pain  has  now  moved  to  the  proximal  end 
of  the  third  toe.  She  is  usually  well  every 
other  way,  but  this  pain  is  so  severe  that  her 
friends  think  the  wear  upon  her  will  be  the 
cause  of  her  not  distant  death.  Will  some  one 
reach  out  a  helping  hand  ? 
Tacoma,  Wash.  C.  S.  Teel,  M.D., 


Editor  Medical  World  : — I  would  like  to 
ask  the  opinion  of  The  World's  many  readers 
on  the  following  case :  I  was  called  May  23d, 
to  see  Mrs.  K,  aged  21,  married  and  mother  of 
two  children,  the  youngest  of  which  is  16 
months  old,  and  nursing.  I  found  her  with  the 
following  symptoDos: — ^very  much  debilitated, 
anemic,  complaining  of  aching  and  nervousness, 
hepatic  torpor,  indigestion,  bowels  constipated, 
weak  heart  with  rapid  pulsations,  a  little  pain 
over  sternal  region,  with  a  sense  of  weight  or 
depressed  feeling  with  -slight  dyspnea.  Ex- 
amination failed  to  elicit  any  abnormal  condi- 
tion of  the  lungs. 

Family  history  good,  and  patient  had  never 
been  confined  to  bed  entirely. 

Diagnosis: — Anemia,  with  the  heart  trouble 
as  functional  and  sympathetic 

Treaiment: — I  prescribed  hydrarg.  chlor. 
mite,  and  soda  bicarb,  aa  grs.  ii  which  moved 
the  bowels  nicely. 

Quinia  sulph,  gra  60.  Ft.  caps.  No.  6. 
6ig : — One  three  times  daily. 

And  for  the  heart  trouble.  I  gave  one  tab- 
let every  three  hours  containing  the  following : 

Nitro-glyoeiliie. 1-100  gr 

Tr.  dig... 2  m 

Tr.  itroyluuiUrafl 2  m 

Tr.  beUadoniUL. »...» ^.^ ^  m 

The  husband  reported  at  the  office  Saturday 
morning,  May  26,  and  said  she  was  some  better, 
when  I  prescribed,  iron,  quinine,  strychnine, 
and  magnesia  com  p.  (MerrelFs)  as  a  general 
tonic.     Sig. — Teaspoonful  three  times  a  day. 

At  ten  o'clo(^  p.  m.  of  same  day  I  was  called, 
Che  messenger  saying  she  was  worse. 

I  went  and  found  her  in  a  cyanotic  condition, 
and  extremitiee  cold,  and  the  surface  of  the 
body  bathed  in  a  clammy  sweat,  rapid  and 
weak  heart,  with  no  radial  pulse  and  marked 
dyspnea. 

I  at  once  gave  a  teaspoonful  of  arom.  spts. 
ammonia,  and  hypodermic  injection  of  atropia 
j^  gr.  and  sent  for  counsel  about  a  mile  dis- 
taat,  and  in  the  meantime  I  had  hot  applications 
with  fiietioB  used  on  surtace  and  extremities. 


But  she  never  rallie^l  an'd  died  in  about  twentv 
minutes  after  my  arrival. 

I  attributed  the  sudden  death  to  paralysis  of 
heart 

Now,  what  I  want  to  know  is,  was  my  diag- 
nosis and  treatment  correct  ?  I  have  been  prac- 
ticing only  a  year  and  any  suggestions  as  to 
diagnosis  and  treatment  will  be  thankfully  re- 
ceived. W.  H.  Smith,  M.D., 

Glezen,  Ind.  • 


Editor  Medical  World  : — ^I  am  puzzled 
with  a  very  difficult  case  and  appeal  to  the 
WoBLD  readers  for  aid.  A  lady  of  40  came 
to  me  about  eight  years  ago  suffering  from  a 
chnmic  pruritus  vulvae  in  the  most  aggravated 
form  seemingly  possible.  She  had  suffered  for 
three  years  and  could  not  get  help  from  over  a 
dozen  physicians  to  whom  she  applied. 

After  a  fortnight's  treatment  she'  was  pro- 
nounced cured,  and  so  continued  for  over  two 
years.  About  six  months  ago  she  came  again, 
saying  that  over  a  score  had  given  her  treat- 
ment without  relief,  although  all  immaginable 
treatments  had  been  resorted  to  without  one 
particle  of  relief  from  the  intoUerable  itchings^ 
day  and  night,  without  a  moments  ease. 

Having  resorted  to  everything  usually  tried 
for  such  cases,  I  this  time  most  signally  fail  to 
relieve  the  poor  creature  in  the  least  bit,  and 
come  to  the  Wobld  for  advice.  There  appears 
to  be  no  uterine  trouble  and  otherwise  the  lady 
is  in  good  health,  except  that  she  is  a  little  sub- 
ject to  neuralgic  troubles  at  times,  and  slightly 
rheumatic  and  an  occasional  tonsillitis. 

The  readers  of  The  World  all  enjoy  a  hard 
one  occassionally  ;  now  I  give  it  to  them.  What 
would  you  do,  dear  Doctors,  if  you  bad  this 
one?  A.  C.  Matchette,  M.D., 

Bourbon,  Ind. 


Editor  Medical  World  : — Will  some  of  the 
readers  give  me  aid  in  the  following  case: 
Mrs.  A  ,  age  23,  delicate,  has  been  married 
about  nine  months;  menstruates  regularly. 
She  suffers  with  periodical  nervous  attacks, 
generally  about  the  time  of  menstruation. 
When  these  attacks  come  on  she  feels  like  faint- 
ing and  says  if  she  did  not  lie  down  she  would 
fall.  When  she  tries  to  say  anything  about 
this  time  she  says  something  altogether  differ- 
ent from  what  she  wants  to  say.  When  these 
attacks  come  on  nothing  will  releive  her  but 
morphine.  They  last  for  an  hour  or  more  then 
she  has  an  intolerable  headache  for  several 
days.  I  have  given  her  tonics  and  have  about 
exhausted  all  tiie  sedatives  at  my  command. 
She  did  not  suffer  in  this  way  until  after 
marriage. 


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She  also  suffers  with  a  very  sore  tongue,  for 
which  I  have  used  chlorate  of  potaeh,  nitrate  of 
silver,  listeriue,  without  giving  any  relief. 
Help  from  any  of  your  r^ers  will  be  very 
kindly  appreciated. 

Geo.  C.  Brooks,  M.  D., 

Sunbury,  N.  C. 


Editor  Medical  World: — Will  some  good 
brother  reader  of  The  World  help  me  out  on 
my  case? 

Boy,  ten  years  old,  has  convulsions,  and  has 
had  them  since  eighteen  months  old ;  has  been 
to  various  places  for  treatment — to  St.  Louis 
and  to  fifty  different  doctors,  or  more.  He 
came  under  my  observation  about  two  months 
ago.  He  is  a  stout,  hearty  looking  boy ;  family 
history  gooid.  I  find,  on  examination,  nothing 
wrong  with  spine ;  head  in  good  condition  ^  no 
history  of  blows  or  anything  of  the  kind ;  has 
two  or  three  small  papillaB  in  the  rectum ;  has 
been  circumcised. 

When  he  has  convulsions  the  muscles  of  the 
left  side  and  limbs  contract,  while  those  on  the 
right  side  do  not  The  convulsions  don't  last 
more  than  ten  minutes ;  he  sometimes  vomits, 
and  that  relieves  him.  He  only  vomits  mucus. 
He  has  a  wonderful  appetite ;  eats  more  than  a 
man.  He  has  no  tenderness  over  the  stomach 
or  bowels,  no  headache,  or  any  pains  at  all,  and 
in  ten  minuses  after  having  a  convulsion  he 
gets  up  and  runs  around,  as  well  as  he  ever 
was. 

I  gave  him  treatment  for  worms,  and  he 
passed  over  one  hundred  of  (uearis  lumbrieoides, 
but  he  still  has  the  convulsions.  Sometimes  he 
will  go  three  weeks  without  having  any,  and 
then  he  will  have  five  or  six  every  day.  Will 
some  good  brother  reader  of  The  World  tell 
me  the  cause,  and  also  the  treatment  ? 

I  like  The  Medical  World,  and  would  not 
do  without  it  It  is  a  present  help  in  time  of 
trouble.  Dr.  S.  B.  Morris, 

Washington,  Kan. 


Editor  Medical  World  : — Will  you  please 
publish  formula  of  Dewee's  Carminative  and 
oblige.  I  think  it  is  composed  of  asafodtidsB  and 
carb.  magnesia.  John  G.  Holland, 

Holland,  Va. 

[As  found  in  the  standard  textbooks  on 
materia  medica,  it  is  as  follows : — Carbonate  of 
magnesia,  5  parts ;  Tincture  of  asafetida,  7 ; 
Tincture  of  opium,  1 ;  Sugar,  10 ;  Distilled 
water,  enough  to  make  100  parts.  Dose  one- 
half  to  four  teaspoonsful.—  Ed.] 

Editor  Medical  World  : — I  shall  be  very 
grateful   to  any  of  your  numerous  readers  for 


suggestions  as  to  treatment  of  the  following 
case : — A  hale,  hearty,  robust  lady,  single,  25 
years  of  age,  is  afflicted,  and  has  been  for  two 
years  and  more,  with  spasmodic  contraction  of 
the  middle  toe  of  the  left  foot,  accompadted  1^ 
severe  pain.  So  frequent  are  the  attacks  and 
so  annoybg,  that  much  of  the  time,  while  in- 
doors she  sits  with  her  shoe  off. 

Various  means  have  been  u^ed  to  relieve  and 
cure  the  affliction,  but  without  avail. 

A  few  antispasmodics  have  been  given  inter- 
nally.  Locally,  sprays  of  chloroform  and  ether 
have  been  used.  The  toe  has  been  encircled 
with  a  fillet  A  splint  has  been  applied  to  the 
flexor  surface — but  all  to  no  effect. 

Any  suggestions  will  be  thankfully  received. 
J.  D.  NlCODEBfUS,  M.D., 

Walkersville,  Md. 


Editor  Medical  World  : — Will  you  kindly 
ask  your  readers  if  there  is  any  idiosyncrasy 
for  the  coal  tar  derivatives?  I  was  called  May 
2d,  to  see  C.  H,  age  thirteen,  who  was  taken 
eight  hours  previously  with  a  severe  attack  of 
gastro-duodonitis.  I  found  him  vomiting  every 
few  minutes ;  stomach  swollen  and  very  tender  : 
temperature  103.2^.  I  immediately  gave  him 
four  grains  of  acetanelid  in  four  dnuns  of  sweet 
milk.  In  less  than  half  an  hour  he  was  cramp- 
ing severely,  hands  so  badly  drawn  they  could 
hardly  be  opened.  I  gave  one  sixth  grain  of 
morphine  hypodermictdly  and  chloroform  by 
inhalation  till  cramps  were  relieved. 

Grave  F.  E.  aconite  through  out  the  case  and 
had  no  more  such  results.  Was  it  the  ace- 
tanelid that  cramped  him  ? 

He  said  he  had  never  taken  a  dose  that  did 
not  cramp  him  more  or  less,  but  never  so  badly 
as  this  time.  Dr.  W.  H.  Smith, 

Alba,  Texas. 


Editor  Medical  World: — C.  G.,  male, 
age  50,  good  family  and  personal  history,  was 
attacked  four  years  ago  with  acute  rheumadsm 
of  left  ankle  lasting  one  week ;  recovered  ;  had 
a  second  attack  eight  or  ten  months  after  the 
first,  lasting  three  or  four  days ;  recovered  with 
the  exception  of  a  weak,  tired  feeling  in  the  It  ft 
leg.  His  expression  is,  '*it  (the  lefk  leg)  has  a 
dead,  tired,  tingling  pin-sticldng  sensation,  like 
creeping  paralysis." 

This  stite  of  affairs  has  be^i  going  on  ever 
since,  gradually  growing  worse,  until,  at  present 
both  legs,  hips  thighs  and  body  up  to  the  waist 
are  affected.  He  has  but  little  use  of  left  leg, 
which  is  partly  wasted  away ;  no  trouble  above 
waist  Qeneral  health,  except  as  above  stated, 
good.     Any  light  as  to  cause  and  treatm^it. 


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either  by  private  letter  or  dirough  The  World, 
will  be  gratefully  received. 

J.  F.  McMatb,  M.D., 
Andersonville,  Ga. 


Editor  Medical  World: — I  would  like 
very  much  to  get  a  few  suggestioDS  from  mem- 
bers of  The  World  family  on  the  treatment  of 
a  certain  diseased  condition,  which  is  not  given 
sufficient  notice  in  man^  of  our  text-books  on 
Practice  of  Medicine,  The  disease  to  which  I 
refer  is  chronic  nasal  catarrh. 

The  treatment  of  acute  nasal  catarrh  is  a 
simple  thing,  and  I  have  never  failed  to  efiect 
a  cure  in  a  G^ort  time ;  but  with  chronic  catarrh 
it  is  different  In  some  cases  we  know  that  the 
catarrh  is  only  a  symptom  of  some  constitutional 
disease,  such  as  scrofula,  syphilis,  etc.  In  such 
cases  the  only  rational  treatment  is  to  treat  the 
constitutional  disease.  But  I  believe  there  is  a 
lar^e  class  of  patients  in  whom  no  such  consti- 
tutional trouble  exists.  It  is  for  the  benefit  of 
th'is  latter  class  that  I  ask  assistance.  I  hope 
to  get  many  valuable  suggestions  from  members 
of  The  World  family,  and  especially  from  Dr. 
Waugh. 

The  World  is  an  invaluable  aid  to  the  busy 
practitioner.  G.  W.  Jobe,  M.D., 

Eroe,  Ark. 

Editor  Medical  World: — Will  some  of 
your  readers  be  kind  enough  to  give  me  infor- 
mation on  the  following  cases  ?  I  am  young 
both  in  years  and  experience,  and  so  I  appeal 
to  older  heads. 

Case  1.  Mrs.  M.,  35  years  old,  mother  of  six 
childr^i,  has  attacks  of  icterus  from  time  to 
time,  which  generally  last  from  a  week  to  ten 
days  regardless  of  treatment,  though  her  symp- 
toms are  somewhat  ameliorated  by  calomel, 
which  she  takes  of  her  own  accord.  With  these 
attacks  she  has  colicky  pains  over  the  liver  and 
oflen  complains  of  a  lump  just  over  the  location 
of  the  gall  bladder.  I  am  inclined  to  attribute 
her  symptoms  to  gall  stones,  which  from  time 
to  time  obstruct  the  gall  duct  Now,  if  such  be 
the  case,  will  chloroform  in  5!  doses  every  4 
hours  dissolve  the  stone  ?  Or  if  not,  what  will  ? 

Case  2.  The  above  lady  has  a  son  about  12 
years  old,  who  has  no  real  sickness,  but  is  al< 
ways  puny,  his  skin  presents  an  icteritious 
appearance,  appearing  almost  the  color  of  a 
mulatto.  He  has  been  in  that  condition  for 
several  years.  Has  had  intermittent  fever  and 
I  have  given  him  quinine,  iron,  arsenic  and 
strychnine  with  the  hope  of  breaking  the  fever 
and  building  up  his  system,  as  he  was  anemic. 

His  fever  is  broken  and  general  health  much 
improved,  but  his  skin  remains  yellow.     Can 


some  older  head  give  me  the  cause  of  his  yellow 
skin  and  the  best  treatment  for  him  ? 

Case  3.  Mrs.  S.,  age  50,  had  menopause  five 
years  ago,  suffers  at  times  with  piles  but  com- 
plains of  hot  flushes  which  only  remain  on  her 
for  about  five  minutes  and  leave  her  in  a  per- 
spiration. The  least  exposure  or  dietitio  error 
is  sure  to  bring  on  an  attack.  She  has  been 
given  quinine,  supposmg  it  to  be  malarial,  but 
the  trouble  coDtiDues.     Give  treatment 

Case  4.  Miss  H.,  single,  but  the  mother  of 
several  children,  has  a  sore  on  her  hand  which 
is  caused  from  milking  cows  and  is  rebellious  to 
all  treatm^it  so  long  as  milking  is  continued, 
but  gets  well  as  soon  as  she  stops,  to  reappear  as 
soon  as  milking  is  resumed. 

She  has  had  it  at  intervals  for  the  past  three 
years.  What  is  it  and  what  shall  I  do  for  it  ? 
I  have  prohibited  milking,  but  sbe  cannot  well 
obey.  W.  Walter  Tison,  M.D., 

Sneads,  Fla. 


Editor  Medical  Worm)  : — In  reply  to  my 
request  as  to  the  best  method  of  testing  alcohol, 
a  gentleman  from  one  of  the  Southern  States 
sent  me  direct  by  letter  a  method  through  the 
process  of  burning  the  alcohol.  I  lo?t  his  let- 
ler.  Will  this  gentleman  or  someone  else  send 
the  test  through  The  World  or  by  letter  or 
some  other  method.      G.  M.  Morton,  M«D., 

Toronto,  South  Dakota. 


Editor  Medical  World: — Will  some  one 
of  The  World  family  please  tell  me  what 
will  remove  soot  from  an  old  scar?  The  wound 
has  been  healed  several  mouths,  but  the  disfig- 
urement caused  by  the  use  of  the  sooj;  still  re- 
mains. W.  B.  PULLEN, 

Chirenoy  Texas. 


Editor  Medical  World: — Wish  to  have 
suggestions  upon  following  questions : 

1.  What  will  remove  the  stain  of  brass  upon 
the  skin  ? 

2.  What  is  the  best  treatment  for  corns  ? 

3.  What  is  best  way  to  get  rid  of  warts — 
these  little  seed  warts  that  sprout  up  on  hand 
and  especially  upon  to  the  palmar  surface  ? 

4.  Best  method  of  removing  a  wen  upon  the 
head  just  above  the  ear,  of  several  years  growth, 
about  size  of  hen  egg  ? 

Stroud's,  Ga.  J.  G.  Colwell,  M.D., 


Editor  Medical  World: — I  received  the  book, 
'The  Physician  as  a  BiisineiS  Man,"  all  O.  K.  I  find 
it  invalu  thle  to  a  jouu^  physician  starting?  out  in  life. 
What  we  need  is  a  '^buninestf  physician,"  and  your  lit- 
tle volnme  points  the  way  clearly.  It  only  remains 
for  OS  to  ** Apply  as  direcied  " 

Mora,  Minn.  Dr.  J.  Abthub  Lewis. 


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THE  MEDICAL  WORU), 


Current   Medical   Thought. 

PottMlum  Parmanganata  in  Morphia  Poisoning. 

[We  quote  the  following  interestiDg  corres- 
pondence from  the  Univ.  Med,  Mag.  The 
claims  of  Dr.  Moor  seem  to  have  been  estab- 
lished beyond  any  doubt  — £d.] 

Extract  from  SderUifie  American  of  February 
3,  1894.  "Doctor  Wm.  Moor,  New  York 
"City,  experimented  upon  himself,  before  twelve 
other  physicians,  by  swallowing  three  grains  of 
morphine,  followed  immediately  by  the  drink- 
ing of  four  grains  of  potassium  permanganate 
dissolved  in  four  ounces  of  water.  The  physi- 
cians had  Dr.  Moor  under  close  surveillance 
for  five  hours  after  the  experiment,  but  no  ill 
results  were  made  manifest  Dr.  Moor's  dis- 
covery if,  that  the  permanganate  will  select  a 
soluble  salt  of  morphine  from  the  albumen 
fpeptone,  and  other  contents  of  the  stomach,  with 
^astonishing  rapidity."  A  short  time  after  read- 
ring  the  above,  I  saw  in  the  Press  a  paragraph 
•h^ed  Pittsburg,  which  stated,  "that  a  man 
thad  been  taken  to  a  Hospital  in  a  moribund 
(State,  having  drunk — some  two  or  three  hours 
previously^ three  ounces  of  laudanum.  The 
(physicians  finally,  as  a  last  resort,  employed 
the  hypodermic  use  of  potassium  permanganate, 
resulting  in  the  saving  of  the  man's  life." 
Having  naturally  inferied,  from  the  account  in 
<the  iSd^HAc  American^  that  the  antidotal  prop- 
•erty  of  the  permanganate  was  a  chemical  not  a 
•physiological  one,  I  was  rather  incredulous  re- 
garding the  newspaper  account,  and,  therefore, 
-wrote  the  superintendent  of  the  hospital  in 
Pittsburg,  receiving  in  reply  the  following, 
which  is  the  gbt  of  two  letters  received  from 
Dr.  E.  B.  Grigg,  the  house  physician. 

"March  20,  1894. 
♦*  Dear  Doctor  :  The  clipping  you  sent  is 
perfectly  correct  The  patient's  respirations 
were  Jour  per  minute,  pulse  not  extremely 
weak,  face  cyanosed,  and  every  reflex  absent ; 
pupils,  of  course,  extremely  small  and  inactive. 
In  short,  the  man  was  dead.  In  four  hours  he 
was  perfectly  conscious,  complaining  only  of 
sleepiness.  The  permanganate  was  injected 
hypodermically,  and  worked  beautifully;  the 
principal  and  primary  effect  seemed  to  be  an 
increase  in  depth  and  number  of  respirations. 
His  pupils  were  contracted  and  inactive  for 
nearly  twenty^four  hours  after  he  regained  con- 
sciousness. From  above  history  and  descrip- 
tion you  will  see  that  the  permanganate  is  a 
physiological  antidote.  The  permanganate  so- 
lution used  was  very  hurriedly  made,  so  that 
the  exact  strength  of  the  solution  is  not  known, 
but  I  estimated  it  to  be  about  one-half  of  a  sat- 


urated solution.  Each  injection  was  ^too  drae&ma 
of  this  solution.  The  second  injection  was 
given  about  forty  minutes  after  the  first  The 
the  third  and  fourth  were  given  one-half  hour 
apart,  and  the  third  (me-half  hour  after  the 
second.  The  last  three  were  at  fifteen  minute 
intervals ;  seven  injections  in  alL" 

I  sincerely  hope  the  foregoing  is  not  all  we 
are  to  hear  (^  the  action  of  the  new  antidote. 

Altoona,  Pa.  Robert  P.  Finley. 


Tlia  Radioal  Oure  of  Hydrooela. 

By  M.  F.  Gavin,  M.D.  {BosUm  Medical  cmd 
SurgicalJoumaly  March  1,  1894.) 

This  author  considers  that  no  simple,  uncom- 
plicated case  of  hydrocele  ought  to  be  treated 
other  than  by  injection.  The  use  of  tincture  of 
iodine,  the  simple  as  well  as  the  compound,  ia 
too  #ften  followed  by  failure  to  urge  its  use, 
which  is  often  attended  by  a  scene, — ^patients 
often  fainting  and  suffering  from  griping  paina, 
retraction  of  the  testicle,  nausea,  and  even 
vomiting ;  unpleasant  things  to  have  happen  in 
one's  office.  For  about  six  years  he  has  treated 
all  suitable  cases  of  hydrocele  by  injecting  half 
an  ounce  of  a  solution  composed  of  equal  parts 
of  carbolic  acid,  alcohol,  and  glycerin ;  a  small 
bulb  syringe  "answers  very  well.  A  little  care 
is  necessarry  in  the  use  of  the  solution.  Pro- 
tect the  skin  surrounding  the  canula  with  a  lit- 
tle gauze  or  absorbent  cotton,  so  as  to  avoid  the 
burning  sensation  so  easily  produced  on  the 
tender  skin  covering  the  scrotum ;  allow  the 
fluid  to  remain.  The  injection  is  practicallj 
painless,  and  no  unpleasant  effects  follow  its 
use.  Patients  are  allowed  to  attend  to  their 
ordinary  business,  and  in  from  two  to  four  weeks 
the  acute  hydrocele  disappears. —  Univ.  Med, 
Mag. 

Emargenoy  Splints. 

The  railway  surgeon  can  make  good  use  of 
his  worn-out  trousers  Huring  these  hard  timea  if 
he  will  go  to  the  pains  to  have  them  washed  and 
sterilized,  and  then  use  the  following  prepara- 
tion, which  should  be  painted  with  a  brush  over 
the  one  side  (of  course  always  put  the  beat  side 
out) :  Alcohol,  1  i  pints ;  gum  shellac,  1  pound; 
borax,  1  drachm. 

Place  the  vessel  containing  this  in  a  kettle  of 
hot  water  and  let  it  remain  until  thoroughly 
dissolved,  then  apply  with  a  paint  brush  to  the 
one  side  of  any  woolen  goods.  Place  in  appo- 
sition the  two  wet  or  painted  sides  and  dry  the 
solution  into  the  goods  by  a  hot  fire.  Addi- 
tional layers  of  goods  can  be  used  if  dedred, 
but  for  the  ordinary  case  two  plies  of  woolen 
goods  or  of  half  woolen  and  cotton  is  sufiSioient. 

The  drying    process  can  be  assisted  very 


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greatly  by  laying  the  goods  on  a  table  aftei^ 
haying  plaoed  the  two  painted  sides  together, 
leaving  the  outside  dry  and  running  over  that 
with  a  hot  iron.  Aftidr  you  have  done  this 
print  the  one  side  with  the  above  preparati(m 
and  get  any  ordinary  light  "  fleeced  goods," 
which  can  be  procured  at  almost  any  dry  goods 
store,  paint  the  plain  side  of  the  fleesed  goods 
and  glue  that  on  to  the  painted  side  of  the 
woolen  goods  already  prepared.  This  can  be 
soon  completed  by  running  a  hot  iron  over,  the 
same  as  before.  Now  you  have  a  woolen  board, 
BO  to  speak,  of  two  ply  of  woolen  or  cotton  and 
woolen  goods  and  a  ply  of  fleeced  goods,  which 
is  ready  to  hang  up  in  your  office  tor  use. 

When  you  have  a  fracture  of  any  kind  need- 
ing a  splint  all  you  have  to  do  is  to  take  the 
size  of  the  limb  and  the  shape  of  the  parts  to  be 
covered  with  the  splint,  and  by  running  a  hot 
iron  over  this  splint  it  is  immediately  softened 
and  can  be  cut  tind  applied  to  any  part  of  the 
body  very  accurately  and  with  the  fleeced  sida 
in.  It  makes  a  very  comfortable,  durable  and 
practical  splint,  whkh  only  needs  to  be  held  in 
place  by  a  roller  bandage  and  in  a  few  minutes 
dries  and  holds  the  parts  in  complete  apposition, 
without  weight  or  becoming  irritated  to  the 
parts  and,  above  all,  is  cheap,  easily  made, 
readily  applied  and  can  always  be  had  at  hand 
ready  for  any  case  of  emergency. — Railway  Age. 

AfitHoxio  Function  of  the  Liver. 

Those  acquainted  with  the  views  propounded 
by  Professor  Bouchard  will  be  conversant  with 
his  ideas  concerning  the  poison-destroying  prop- 
erties of  the  liver ;  he  and  his  followers  attach 
greet  importance  to  the  power  of  the  liver-cells 
to  nullify  the  effects  of  the  toziness  manufac- 
tured in  the  intestines.  The  correctness  of  this 
is  apparently  corroborated  by  Schiff,  Heger, 
Roger,  and  others,  who  found  that  alkaloids  in- 
jected into  the  branches  of  the  portal  vein  were 
much  less  toxic  than  when  introduced  into  the 
general  venous  circulation.  M.  Pavlow,  by 
means  of  a  ligature  placed  on  the  portal  vein, 
found  the  blcKxi  was  compelled  to  deviate  from 
the  liver  and  pass  directly  into  the  general  cir- 
culation, when  poisonous  symptoms  appeared — 
fever  and  nephritis  with  albuminuria.  That 
this  nephritis  is  not  due  to  hypertension  of  the 
blood  in  the  renal  vessels  was  evidenced  by  the 
fact  that  no  such  kidney  trouble  is  caused  by 
ligature  of  the  inferior  vena  cava,  although 
this  manoeuvre  is  productive  of  a  greater  ten- 
sion in  the  renal  vessels  than  the  operation  in 
question.  A  wound  artificia  ly  produced  in  an 
animal  whose  portal  vein  has  been  tied  heals 
very  slowly,  whereas  a  similar  wound  in  an  an- 
imal where  the  inferior  vena  cava  has    been 


ligated  cicatrizes  without  difficulty.  The  con- 
clusion is  that,  if  the  blood  is  prevented  from^ 
passing  through  the  liver,  toxsemia  occurs,  due 
to  the  &ct  that  the  liver  no  longer  plays  a  pro- 
tective role  against  toxines,  which  are  being 
continually  febricated  in  the  intestinal  canal. — 
The  Laneei  (London). 

Bloodvessai-Pain. 
Many  pains  that  are  otherwise  unexplainable 
must  be  attributed  to  changes  in  the  walls  of 
bloodvessels.  While  seni^ble  nerve  fibres  have 
not  been  demonstrated  in  the  tissues  of  blood- 
vessels, Thoma  has  found  Pacini's  corpuscles  in 
tbe  adventitiva  of  the  larger  vessels.  In  cases 
where  after  a  continued  headache  apoplexy 
takes  place  and  in  which  upon  autopsy  a  throm- 
bus is  found  in  a  dilated  artery  the  pm  cannot 
be  explained  by  the  local  anemia  caused  by  the 
obstruction,  as  the  brain  sub tance  is  insensible ; 
nor  can  the  pain  be  explained  by  a  pressure 
upon  the  membranes,  in  consequence  of  a  dis- 
turbed circulation,  since  the  circle  of  Willis 
furnishes  an  abundant  collateral  circulation  and 
outlet  for  any  locally  increased  blood  supply. 
The  pain  must  therefore  be  looked  foi:  in  the 
bloodvessels.  These  pains  according  to  Noth- 
nagel,  serve  to  differentiate  between  hemorrhage 
and  thrombotic  softening.  Severe  headaches 
without  any  signs  of  intense  arterial  congelation 
bemg  a  sign  of  thrombotic  softening  in  conse- 
quence of  a  diseased  artery.  Severe  pain  also 
takes  place  in  embolism  where  the  embolus  be- 
comes organized  and  grows  together  with  the 
wall  of  the  bloodvesseL  Vague  pains  in  the 
back  and  belly,  which  are  often  diagnosed  as 
rheumatism  or  neuralgia  may  be  due  to  arter- 
ioscleosis  of  the  aorta  or  iliac  arteries.  The 
fixed  pain  of  aneurisms  long  before  these  can 
be  diagnosed  by  physical  signs  are  not  due  to 
pressure  upon  surrounding  nerves  but  must  be 
attributed  to  the  bloodvessel  itself  and  therefore 
serves  as  a  sign  for  tbe  diagnosis  of  aneurism. 
Great  stress  is  to  be  laid  upon  fixed  pain  by  the 
side  of  the  sternum  in  the  early  diagnosis  of 
aneurism  of  the  thoracic  aorta. — Med.  Review. 


Hiooougli  and  Hereditary  Syphilis. 

According  to  Carine  (Intemation,  Klin-Ruvr 
dsehauy  Union  Medieale)  hiccough  in  the  new- 
bom  is  to  be  regarded  as  a  symptom  of  heredi- 
tary syphilis.  It  is  of  rather  common  occur- 
rence, and  id  one  of  the  earliest  signs  of  the 
disease,  coming  on  during  the  first  few  hours 
or  days  after  birth,  sometimes  before  the  coryza. 
It  lasts  two  or  three  weeks.  The  author's  views 
are  supported  by  numerous  cases  and  by  the 
effect  of  anti-syphilitic  treatment  on  the  hic- 
cough. — Cliniqae. 


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'    THE  MEDICAL  WORLD. 


Treatment  of  Rheumatitm* 

At  nigbt,  before  retiriog,  I  order  a  hot  mas- 
tard  foot  bath  and  the  following  prescription : 

R.    Pulv.  Dot « gr.  xv. 

Hyd.  ohlor.  mlt «.gr.  x. 

M.  «t  ft.  capsol.  No.  tj. 

8.   Take  both  before  retiring. 

I  alfHiys  direct  these  capsules  to  be  taken 
with  a  solution  of  bicarbonate  of  soda  ^,  to 
water  5vj. 

Go  at  once  to  bed  and  atay  there.  In  the 
morning,  if  there  is  no  action  on  the  bowels, 
give  a  bottle  of  solution  of  citrate  magnesia 
freshly  prepared.      I  then  order  the  following : 

R.     PdMB.  iodid -.  O*.  8S. 

Vinioolcb.  ral...„ "]         .. 

FL  ext.  sarss  ....« „ ^ „...  }■    ^  « 

Tinct  oiaohoB  oomp J    "^'J* 

Mix. 

S    DePtertspoooAil  In  half  a  glan  of  water  one  boor  after 
eaobmeal. 

Sometimes  this  dose  must  be  varied  on  ac- 
count of  idiosyncrasj — this  the  physician  must 
decide  in  each  case. 

This  treatment  usually  gives  relief  and  is 
founded  upon  a  true  and  solid  pathology. — Dr. 
Thomas  O.  Snmmers,  of  Waukeshau,  Wis.,  in 
J(mr.  Amer,  Med.  Asso 


The  Vertigo  of  Drugs. 


Some  drugs  in  common  use  have  the  property 
of  producing  vertigo  when  employed  in  usual  or 
long-continued  doses.  Belladonna,  salicylate 
of  ^a,  nitrate  of  silver  and  cocculus  indicus  are 
all  capable  of  inducing  revolving  sensation  of 
vertigo  like  Meniere's  disease,  with  a  peculiar 
reeling  gait,  and  sometimes  a  falling  to  the  left 
or  righl  side,  or  twirling  around  in  a  circle. 

Conium,  lobelia,  physostigma,  gelsemium  and 
camphor,  in  similar  d  )ses,  will  cause  vertigo, 
but  without  these  strange  vagaries  of  motion. 
Tobacco,  tea,  coffee  and  absinthe,  used  to  excess, 
frequently  induce  it,  through  their  influence  on 
the  nervous  system.  And  it  follows  such  trivial 
causes  as  prolonged  sneezing  or  lusty  **  blowing*' 
of  the  nose,  or  may  be  due  to  gastric  disturb- 
ance or  disordered  vision. 

But  drug-vertigo  is  significant,  and  should  be 
carefully  watched,  as  some  persons  are  more 
susceptible  to  the  action  of  these  remedies  than 
others,  and  it  may  be  a  premonitory  symptom  of 
possible  poisoning. 

Louis  Lewis,  M.D.,  in  Times  and  Register. 


Treatment  of  Alooholitm. 

McConnel  (Quarterly  Jour,  of  Inebriety)  re- 
ports 25  cases  treated  by  nitrate  of  strychnia, 
given  subcutaneously  in  doses  of  a  thirtieth  to 
a  gixth  of  a  grain,  twice  daily  for  ten  days,  then 
once  daily  for  ten  days,    the  highest  dose  being 


reached  about  the  third  or  fourth  day,  and  oon* 
tinned  to  the  close  of  the  treatment  The 
border-line  of  toleration  was  reached  in  most 
cases  with  a  dose  of  two-fifteenths  of  a  grain. 
Internally,  cinchona,  peroxide  of  hydrogen*  and 
capsicum  were*frequently  prescribed  in  comUn- 
ation.  When  bromide  of  sodium  failed  to  pro- 
cure sleep,  paraldehyde  always  sueceeded.  In 
the  latter  cases,  strychnine  in  doses  of  one-twen- 
tieth of  a  grain,  with  elixir  of  pboepkatea  and 
calisaya,  was  ordered  to  be  taken  <»oe  or  twice 
daily  for  four  or  five  weeks  aft»r  oeasiiig  the  in- 
jections. 

From  the  results  obtained  in  these  25  oases, 
we  can  learn  that,  simultaneously  with  the  use 
of  strychnine,  the  crave  for  alcohol  in  inebriates 
diminishes,  and  in  a  few  days  is  completely 
gone,  and  through  the  withdrawal  of  the  poison- 
ous beverages  and  the  tonic  effects  of  the  strydi- 
nine  there  is  a  more  or  less  rapid  restoration  to 
sound  physical  health,  and  of  the  mratal  pow- 
ers ;  but  as  most  of  those  treated  have  relapsed 
within  from  one  to  eleven  months,  the  inhibit- 
ing power  of  the  remedy  is  not  permanent 

While  we  have  in  strychnine  a  true  antago- 
nist to  the  action  of  alcohol,  and  one  that  ^1 
counteract  its  effects,  the  inebriate  still  requires 
aid  which  can  scarcely  be  expected  of  drugs ; 
he  needs  the  mental  and  will  power  to  over- 
come his  acquired  or  inherited  tendency  to  re- 
sort to  narcotics.  This  must  come  from  treat* 
ment  which  seeks  first  to  restore  all  the  abnor- 
mal conditions  of  the  patient,  whether  due  to 
alcohol  or  otherwise ;  then  strict  abstinenoe 
must  be  maintained,  the  patient  beiDg  aided  bj 
moral  suasion,  the  diversion  of  continual  em- 
ployment, and  the  education  of  the  mental  and 
moral  faculties  to  a  high  status,  even  the  influ- 
ence of  hypnotic  suggestion  may  be  applied  in 
suitable  cases,  as  has  been  done  recently  frith  a 
fair  measure  of  success.  And  where  these 
means  fail,  institutions  where  voluntary  or 
forced  detention  can  be  secured,  and  where  all 
the  present  known  means  can  be  most  suoeeas- 
fuUy  applied,  mu8t  be  the  only  hope  of  restor- 
ing the  unfortunate  subjects  of  narcomania. — 
Phiku  Polyelinie. 


The  Cold  Bath  in  Asthenic  Diseases. 

Baruch  (Therap.  Qaa.)  urges  the  value  of 
this  measure,  and  thus  descril^  its  effect.  A 
patient  suffering  from  an  infectious  disease,  lies 
prostrate,  with  thready  pulse,  shallow  breathing, 
dull  eye,  picking  at  the  bed  clothes,  subsultus, 
involuntary  defecation.  All  these  remind  oa 
that  we  have  the  very  climax  of  asthenia. 
Seat  such  a  patient  in  a  shallow  warm  bath, 
and  pour  with  some  force  one  or  two  basins  at 


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75^  F.  or  lees,  over  his  head  and  shoulders ; 
rub  him  gentiy ;  repeat  if  indicated. 

The  result  will  aatonish  those  who  have  not 
tried  it  There  is  a  gasp  for  breath,  the  dull 
eye  resumes  its  luster,  the  facial  cyanosis  yields 
to  a  better  hue,  the  pulse  becomes  slower  and 
lees  compressible.  The  wheels  of  life  are  again 
«etin  motion,  not  as  in  the  case  of  syncope,  to 
remain  so  ;  but  to  again  be  over- balanced  by 
the  toxic  blood  which  supplies  the  nerve  cen- 
tres. Again  and  again  this  afiusion  must  be 
repeated.  Fear  not  the  so  called  shock,  for 
this  is  ju(t  what  you  want  to  evoke  ;  it  is,  when 
jadiciously  administered,  followed  by  reaction, 
and  reaction  is  the  great  stimulus,  greater  than 
all  medicinal  agents  or  alcoholic  stimulants. — 
Simon  Baruch,  M.D.,  in  Therapeutic  GmiUe, 


Chest  Paint. 

These  may  be  due  to— 

1.  Intercostal  neuralgia ;  tenderness  at  points 
only. 

For  neuralgia  strap  the  chest  and  give  ar- 
senic, with  an  occasional  mercurial  purge.  Qui- 
nine acts  best  after  mercury. 

2.  Rheumatism  of  the  fascia,  the  whole  leg- 
ion  being  tender.  Chest  rheumatism  is  con- 
nected with  beer  drinking.  The  salicylates  are 
useless ;  alkalies  cf  doubtful  utility.  The  best 
remedy  is  water,  drank  in  enormous  quantities. 

3.  Neuritis ;  circumscribed  linear  tenderness. 

4.  Acute  pleurisy;  chill,  fever,  friction 
sound. 

5.  Dry  pleurisy ;  very  common,  relieved  so 
sarely  by  adhesive  btrape  that  this  belief  con- 
firms the  diagnosis. 

6.  Neuroma. 

7.  Aneurism  ;  may  not  cause  pain,  even  if 
large. 

8.  Cancer. 

9.  Ataxia. 

10.  Spinal  disease. 

11.  Bronchitic  pain  ;  calls  for  strapping  and 
ofHum. 

12.  Myalgia;  relieved  by  straps. 

13.  Mitral  disease  ;  rarely  painful. 

14.  Aortic  disease  ;  generally  painful. 

15.  Dyspepsia ;  diffusible,  radiating  pains. 

16.  Diabetes  mellitus,  in  later  stages  ;  pain  at 
the  centre  of  sternum.     A  bad  omen. 

17.  2^oeter ;  pain  may   precede  eruption   for 
days. 

18.  Angina  pectoris. 

19.  A  pseud  J  angina,  occuring  in  women  ;  not 
relieved  by  nitrites,  but  instantly  by  chloroform. 

20.  Phthisis. 

21.  Syphilis. 

22.  Gout.     H.  M.  Browriy  in  Cin,  Med.  Jour. 


\  Oalottlus  and  Syphilis. 

Syphilis  is  very  prevalent  in  China,  and 
many  cases  in  all  stages  of  the  disease  are 
treated  in  the  Medical  Missionary  Society's 
Hospital,  but  it  is  very  rare  to  meet  with  cal- 
culus in  a  syphilitic  patien^  So  few  have  been 
the  cases  that  the  question  has  arisen  whether 
or  not  the  two  diseases  were  antagonistic.  Cal- 
culus is  not  uncommon  in  men  who  have  had 
gonorrhoea,  since  it  is  often  lodged  in  the  ure- 
thra behind  stricture,  and  the  contraction  of  the 
canal  is  sometimes  an  obstacle  to  litholapaxy. 

It  may  be  an  interesting  question  in  pathol- 
ogy to  investigate  the  influence  of  the  syphilitic 
poison  on  the  formation  of  the  accretion  of  uric 
acid  and  its  compounds ;  and  this  study  may 
lead  to  far  reaching  results  on  the  subject  of 
prophylaxis,  which  is  now  receiving  so  much 
attention. — Phila.  Polyclinic 

Ipeoao  as  a  Hemottatio. 

From  India  comes  a  report  that  ipecac  in  dose 
of  tw(  nty  grains,  taken  as  a  bolus  before  food,and 
if  practicable  early  in  the  morning,  is  superior 
to  ail  other  haemostatics.  It  is  es|  ecially  available 
in  hemorrhage  from  bleeding  surfaces,  epistaxis, 
hsemoptjsis,  and  the  various  uterine  fluxes.  If 
the  recumbent  position  is  enforced,  it  is  claimed 
no  remedy  is  necessary  to  avert  emesis. — Med, 
Age. 

Elimination  and  Antiseptio  Treatment  of  Typhoid 

Dr.  W.  B.  Thistle,  in  The  Medical  Reeard, 
gives  his  method  of  treating  this  disease  as  that 
of  free  purgation  with  any  good  purgative — 
compound  cathartic  pills,  calomel,  Ealines,  cas- 
cara,  etc.  The  symptoms  begin  to  abate  aa 
soon  as  free  purgation  is  established — four  to 
six  daily  movements.  Salol  is  aldo  given,  and 
large  draughts  of  w«ter.  Hissucce&s  is  remark- 
able, as  he  reports  forty  cases  treated  ^lithout 
accident  or  death,  and  gives  as  the  average  time 
for  the  return  to  normal  temperature  as  about 
eleven  days.  We  quote  the  following  from  Lis 
article  as  an  excellent  description  of  the  process 
of  typhoid  intoxication  : 

It  is  now  well  established  that  typhoid  fever 
is  the  condition  which  follows  infection  of  the 
organism  by  a  specific  form  of  bacillus.  What 
concerns  us  more  particularly  is  the  mauner  in 
which  the  bacillus  brings  about  the  changes 
which  we  attribute  to  it,  for  it  is  only  from  a 
knowledge  of  that  kind  that  we  can  work  out 
a  successful  treatment.  The  bacillus  entering 
the  body  would,  under  ordinary  circumstances, 
be  carried  quickly  through  the  stomach  and 
upper  bowel  until  its  onward  course  becomes 
somewhat  retarded  by  the  ileo-cfecal  valve.     In 


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this  situation  the  intestinal  contents  are  perhaps 
most  alkaline.  This  region,  is  therefore  most 
favorable  to  bacterial  growth.  Multiplication 
occurs  with  extreme  rapidity,  so  that  the  intes- 
tinal contents  in  a  few  days  teem  with  countless 
numbers  of  fungL  They  are,  however,  by  no 
means  confined  to  'the  intestine,  but  are  con- 
veyed by  the  absorbents  into  the  follicles  in  the 
intestinal  wall,  and  through  the  radicals  of  the 
portal  veins  to  the  liver,  and  so  on  through  the 
system  generally.  They  may  be  found  in  the 
Eolid  viscera,  tissues,  and  fluids  throughout  the 
entire  body.  That  the  main  culture  is,  how- 
ever, in  the  intestine  is  borne  out  by  the  fact 
that  immense  numbers  are  in  the  evacuations, 
and  that  infection  is  universally  attributed  to 
unsterilized  fecal  matter.  Keeping  pace  exactly 
with  this  process  in  the  bacillus,  is  the  produc- 
tion and  accumulation  of  a  chemical  substance — 
a  byproduct,  which  is  a  necessary  element  in 
the  vital  activity  of  the  bacillus.  By  separat- 
ing this  substance  from  cultures,  and  experi- 
menting with  it,  many  of  its  properties  have 
been  determined  by  Brieger,  Novy,  Sims- Wood- 
head,  and  others.  It  was  found  to  produce 
local  as  well  as  what  may  be  called  constitu- 
tional effects.  Sims-Woodhead  likens  it,  acting 
locally,  to  a  '<  caustic."  Its  first  and  mildest 
efiect  is  to  stimulate  the  cells  of  the  part,  caus- 
ing them  to  become  swollen,  and  to  increase  in 
their  rate  of  multiplication.  If,  however,  the 
toxine  is  allowed  to  remain  long  in  contact  with 
the  cells,  or  if  it  is  in  sufficiently  concentrated 
form,  instead  of  irritation  and  increased  activity 
the  cells  lose  their  vitality  and  necrosis  takes 
place.  As  examples  of  its  constitutional  efiect 
we  may  instance  fever,  delirium,  tremor,  leth- 
argy, or  its  mydriatic  action  on  the  pupil.  If 
a  large  dose  be  given  to  an  animal,  it  speedily 
dies  narcotized ;  if  a  somewhat  smaller  dose  be 
given,  and  repeated  for  a  time,  the  animal 
gradually  merges  into  coma,  and  shortly  dies. 
The  toxine,  is,  in  fact,  the  weapon  of  the  bacil- 
lus»  without  which  it  would  be  a  harmless  par- 
ticle of  vegetable  protopUsm. 

The  symptoms  generally  are  determined  by 
the  amount  of  poison  in  the  body,  and,  in  the 
case  of  difierent  individuals,  by  a  varying  de- 
gree of  susceptibility,  or  a  varying  degree  of 
virulence  in  the  poison  itself.  The  local  dis- 
turbance is  determined  by  the  quantity  of  the 
poison  in  contact  with  the  tissues,  to  its  degree 
of  concentration,  and  to  the  length  of  time  it 
remains  in  contact  It  is  by  noting  these  facts 
regarding  the  toxine  that  one  gets  the  key  to 
the  situation.  Look,  for  example,  at  the  case 
of  the  intestinal  follicles;  why  is  it  that  the 
tissues  here  suffer  (o  such  an  extreme  degree? 
Surely  not  from  any  selective  action  of  the  bac- 


teria, but  rather  from  the  fact  that  the  follicles 
are  in  close  proximity  to  the  main  oalture,  and 
are  surrounded  by  lymph  sinuses  into  which 
empty  the  lacteal  ducts  of  the  surrounding  villi. 
Each  follicle  is,  in  fact,  the  reservoir,  to  which  is 
conveyed  both  poison  and  bacteria  absorbed  Atmi 
the  intestine.  The  bacteria  and  poison  cariied  to 
other  parts  of  the  body  produce  in  a  minor  de- 
gree the  same  results.  Molecular  death  is 
much  increased  wherever  this  poison  is  present, 
but  as  a  rule  ulceration  takes  place  only  in  the 
intestinal  nodes.  The  reason  seems  clear  ;  the 
bacilli  invading  the  follicle  are  at  first  predsely 
in  the  same  position  as  a  similar  colony  in  like 
tissue  in  any  other  part  of  the  body,  and  after 
having  given  rise  to  a  certain  degree  of  disturb- 
ance, would,  as  in  other  situations,  be  overcome 
by  the  tissues,  seldom  giving  rise  to  necrosis  en 
masse*  But  the  anatomical  conditions  being 
different,  the  Ijrmph  tissue  in  the  intestinal  foll- 
icles wages  unequal  war,  since  reinforcement 
both  in  the  way  of  fresh  bacilli  and  of  pois(m 
absorbed  from  the  intestine  is  constantly  arriv- 
ing, carried  by  the  lacteals  of  the  surrounding 
vilU,  until,  eventually,  the  poison  becomes  so 
concentrated  that  all  resistance  is  overcome, 
and  the  follicle  undergoes  necrosis.  The  slow 
percolation  of  finid  through  the  follicles  aids  in 
their  destruction,  as  it  favors  concentraticm  and 
prolongs  the  period  of  contact 

As  a  corollary  to  this  it  appears  that  ulcera- 
tion of  Peyer's  patches  is  by  no  means  an  essen- 
tial or  necessary  result  of  typhoid  infection. 
For,  if  the  base  of  supplies  should  be  cut  off, 
the  bacteria  already  in  the  follicles  might  rea- 
sonably be  expected  to  produce  the  same  /re* 
suits,  and  disappear  in  the  same  manner  as  a 
like  number  of  bacilli  located  in  similar  tissue 
in  any  other  part  of  the  body. 

There  are  many  ways  to  serve  one's  country 
other  than  fighting  in  the  field.  For  example. 
Dr.  D.  H.  Oliver,  of  Indianapolis,  Ind.,  did  not 
make  a  bill  against  a  soldier  or  his  family  dur- 
ing the  war,  and  those  owing  him  anything  who 
wished  to  enlist,  were  invited  to  call  at  his 
office  and  get  a  receipt  for  the  same  witheut 

pay-         

Important  Point  In  Cataraot  Operationt. 

Dr.  L.  Webiter  Fox,  the  eminent  ophthalmic 
surgeon,  1304  Wajnut  street,  Philadelphia, 
read  before  the  recent  meeting  of  the  Pennsyl- 
vania State  Medical  Society,  a  paper  advocat- 
ing capsulotomy  at  the  close  of  an  operation  for 
the  removal  of  cataract.  We  quote  the  follow- 
ing  from  this  interesting  paper : 

"  The  opaque  lens  cataract  with  its  capsule, 
obstructs  the  vision,  causing  blindness.     .     . 


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The  most  diBheartening  ^Actor  in  a  cataract 
(^ration  is  that,  sooDer  or  later^  the  posterior 
capsule  itself  thickens,  and  again  dimness  of 
yision  follows ;  the  lessening  of  the  sight  is  not 
so  great  as  it  was  before  the  removal  of  the  lens, 
bat  still  the  patient  is  debarred  the  comfort  of 
reading,  writing,  or  attending  to  business  mat- 
ters in  which  it  is  necessary  to  have  perfect 
vision.  It  is.  to  prevent  the  latter  change  that 
I  advocate  the  splitting  or  parting  of  the  pos- 
terior caps  ale  at  the  time  of  the  primary  Oper- 
ation." 

The  Doctor  then  describes  minutely  the 
technique  of  this  delicate  operation,  which  is  of 
more  special  interest  to  the  operating  specialist 
What  is  of  special  interest  to  the  general  prac- 
titioner is  to  know  the  importance  of  this  detail 
in  the  operation  itself. 

Qonorrhea. 

A  new  specific  for  gonorrhea  is  a  1  per  cent, 
solution  of  creasote  in  decoction  of  Hamamelis 
combined  with  boric  acid.  It  is  claimed  that 
this  will  destroy  the  gonococci  in  two  hours. — 
Pacific  Medical  Journal, 


Abortive  Treatment  of  Gonorrhea  by  Perman- 
ganate of  Potash. 

Large  injections  ot  permanganate  of  potash 
methodically  used  is  the  best  method  of  treatment 
yet  introduced.  Its  advantages  are,  being  abso- 
lutely painless  in  cases  of  anterioi  urethritis 
and  scarcely  painful  in  cases  of  inflammation  of 
the  whole  tract ;  it  can  be  commenced  or  left 
off  without  inconvenience ;  it  has  no  detrimental 
action  on  the  mucus  membrane,  but  suppresses 
every  trace  of  discharge  from  the  first  lavage, 
and  is  successful  in  11  times  out  of  14 — about 

The  size  of  the  injection,  and  its  frequency 
and  strength,  must  be  adapted  to  individual 
cases.  With  reference  to  their  reaction,  gener- 
ally strengths  of  1  to  4000  or  1  to  2000,  or 
even  1  to  1000  are  tolerated. — Revue  de 
Therap,  Med.  Chir.,  Times  and  Reg. 

Venereal  Warts. 

Apply  at  the  base  of  each  tumor  a  10  per 
cent  solution  of  cocaine,  then,  with  a  sharp  cur- 
ette, scrape  off  the  vegetations.  Check  the 
slight  bleeding  by  pressure  with  a  pad  of  gauze 
or  lint,  then  dust  freely  with  boracic  acid. 
Jno.  M.  Foster,  M.D.,  in  Int.  Jour  burg. 


Treatment  of  Tuberouious  Bones  and  Joints. 

We  quote  the  follovring  from  Dr.  Eagleson's 
(Seattle,  Wash.)  report  on  Surgery,  Washing- 
ton State  Medical  Society,  reported  in  the  Med. 
SenHneL 


Dr.  N.  Senn,  in  his  work  on  <'  Tuberculosis 
of  Bones  and  Joints,"  published  a  few  months 
ago,  says  emphatically  that  'Hhe  successful 
treatment  in  some  cases  of  bone  and  joint  tuber- 
culosis, by  parenchymatous  and  intra-articular 
injections,  is  one  of  the  most  important  achieve- 
ments in  modem  surgery*"  The  splendid  re- 
sults obtained  by  this  method,  in  his  hands,  in 
the  treatment  of  this  very  common  and  obstin- 
ate disease,  should  induce  every  surgecm  to  give 
it  thoughtful  consideration.  His  method  is  to 
carefully  aspirate  the  tubercular  joint  or  abscess 
cavity,  and  then  thoroughly  irrigate  it  with  a 
3  per  cent  solution  of  boracie  add,  until  the 
solution  returns  perfectly  clear.  He  then  in- 
jects through  the  canula  into  the  cavity  from 
one  half  an  ounce  to  two  ounces  of  10  per  cent 
emulsion  of  iodoform  in  glycerine.  He  takes 
great  care  to  have  the  trocar  'and  syringe 
thoroughly  sterilized  before  using  them.  He 
usually  finds  beneficial  symptoms  after  the  sec- 
ond injection,  which  should  be  made  in  from 
one  to  two  weeks.  The  symptoms  are  a  decline 
in  the  temperature,  lessening  of  pain  and  the 
I  amount  of  pus  in  the  cavity. 

Dr.  Senn  claims  that  he  has  never  seen  a 
case  of  iodoform  poisoning  result  from  the  injec- 
tions when  glycerine  was  used  for  the  emulsion. 

I  have  recently  had  a  case  of  very  marked 
intoxication  after  the  injection  of  an  emulsion 
containing  37  i  grains  into  a  large  psoas  abscess 
cavity.  I  reported  this  case  to  Doctor  Senn 
and  he  replied  that  "such  an  accident  was  very 
rare."  He  objects  to  the  use  of  the  ethere&l 
solution  for  injections  on  account  of  the  pain 
attending  its  use,  and  the  much  greater  liability 
to  constitutional  poisoning,  and  also  the  danger 
of  sloughing  from  the  great  pressure  caused 
from  the  rapid  vaporization  of  the  ether  at  the 
body  temperature.  ( 

Next  to  iodoform  he  considers  balsam  of  peru 
of  the  greatest  benefit  in  ii^ections. 

The  Infinity  of  Soientiflo  Retearoh. 

In  his  address  on  "  The  Leaven  of  Science," 
at  the  opening  of  the  Wistar  Institute  of  Anat- 
omy and  Biology,  Philadelphia,  Prof.  Wm. 
Osier,  of  Baltimore,  gave  utterance  to  the  fol- 
lowing passage : 

"Turning  from  the  men  to  the  subject  in  * 
which  they  worked,  from  the  past  to  the  pres- 
ent, let  us  take  a  hasty  glance  at  some  of  the 
developments  of  human  anatomy  and  biology. 
Truth  has  been  well  called  the  daughter  of 
Time,  and  even  in  anatomy,  which  is  a  science 
in  a  state  of  fact,  the  point  of  view  changes 
with  successive  generations.  The  following 
story,  told  by  Sir  Robert  Christian,  of  Barclay, 
one  of  the  leading  anatomists  of  the  early  part 


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THB  MBDICAL  WORLD. 


of  this  century,  illustrates  the  old  attitude  of 
miod  still  met  with  among  ''  bread  and  butter  ** 
teach^^ofthe  subject  Barclay  spoke  to  his 
class  as  follows :  <' Gentlemen,  while  carrying 
on  your  work  in  the  dissecting  room,  beware  of 
making  anatomical  discoveries ;  and  above  aU 
beware  of  rushing  with  them  into  print  Our 
precursors  have  left  us  little  to  discover.  You 
may,  perhaps,  fall  in  with  a  supernumerary 
muscle  or  tendon,  a  slight  deviation  or  extra 
branchlet  of  an  artery,  or,  perhaps,  a  minute 
stray  twig  of  a  nerve — that  will  be  all.  But 
beware !  Publish  the  fact,  and  ten  chances  to 
one  you  will  have  it  shown  that  you  have  been 
forestalled  long  ago.  Anatomy  may  be  likened 
to  a  harvest  field.  First  come  the  reapers, 
who,  entering  upon  untrodden  ground,  cut 
down  great  store  of  com  from  all  eides  of  them. 
These  are  the  early  anatomists  of  modem 
,  Europe,  such  as  Vesalius,  Fallopius,  Malpighi 
and  Harvey.  Then  come  the  gleaners,  who 
gather  up  ears  enough  from  the  bare  ridges  to 
make  a  lew  loaves  of  bread.  Such  were  the 
anatomists  of  last  century — Valsalva,  Cotun- 
nius,  Haller,  Winslow,  Vicq  d'Azyr,  Camper, 
Hunter,  and  the  two  Monroa.  Last  of  all 
come  the  geese,  who  still  contrive  to  pick  up  a 
few  grains  scattered  here  and  there  among  the 
stubble,  and  waddle  home  in  the  evening,  poor 
things,  cackling  with  joy  because  of  their  suc- 
cess. G^itlemen,  we  are  the  geese."  Yes, 
geese  they  were,  gleaning  amid  the  stubble  of 
a  restricted  field,  when  the  broad  acres  of  biol- 
ogy were  open  before  them.  Those  were  the 
days  when  anatomy  meant  a  knowledge  of  the 
human  frame  alone ;  and  yet  the  way  had  been 
opened  to  the  larger  view  by  the  work  of  John 
Hunter,  whose  comprehensive  mind  grasped  as 
proper  subjects  of  study  for  the  anatomist  all 
the  manifestations  ^f  life  in  order  and  disorder. 


The  Contarvativa  Valua  of  Inflammation.— Phil- 
osophy of  Peritonitis. 

Treves,  in  the  Lettsomian  lectures  on  peri- 
tonitis, reported  in  the  British  MedicalJmimal, 
and  abstracted  in  the  Univ.  Med.  Mag.^  gives 
expression  to  the  following  views : 

The  inflammatory  process  is  an  absolute  ne- 
cessity in  the  majority  of  surgical  cases,  because 
*  under  its  action  the  cells  of  the  body  rise  in 
their  millions  as^ainst  the  invasion  of  micro- 
organisms. It  is  by  the  inflammatory  process 
that  the  poison  is  destroyed,  and  the  growth  of 
the  organisms  arrested.  In  cases  of  tuberculo- 
sis of  the  luDgs  it  is  generally  assumed  that  a 
destructive  inflammation  is  the  chief  cause  of 
death.  It  is  not  the  inflammation  which  is  at 
fault,  but  this  process  attempts  to  arrest  the 
further  progress  of  the  bacillus. 


Inflammation  is  distinctly  not  a  malignant 
energy,  worbipg  only  for  evil ;  it  is  a  procesa 
with  a  purpose,  and  that  a  beneficial  one. 

The  BelaHon  of  Peritonitis  to  the  Inflamma- 
tory Process. — In  a  large  proportion  of  exam- 
ples of  fatal  peritonitis,  the  leading  symptoms 
are  those  of  poisoning,  and  not  of  inflammation, 
and  death  is  due  rather  to  toxemia  than  to  in  - 
flammation  of  the  serous  membrane. 

When  the  patient  dies  and  the  abdomoi  is 
opened,  the  amount  of  inflammation  discovered 
is  out  of  all  proportion  to  the  phenomena  which 
preceded  death.  In  one  case  there  may  be 
merely  some  injection  of  the  peritoneum,  with 
loss  of  its  polished  surface.  In  another  there 
may  be  an  ounce  or  so  of  thin  greenish  pus 
around  the  cecum,  and  not  the  kind  of  formida- 
ble effusion  which  would  be  expected  in  a  case 
of  death  from  inflammation. 

In  some  of  the  most  rapid  cases  of  death  after 
a  lesion,  which  is  known  to  t>e  capable  of  caus- 
ing peritonitis,  no  inflammatory  changes  are 
found  within  the  abdomen.  * 

It  is  noteworthy  that  the  cases  in  which  sup- 
puration is  most  pronounced  are  among  the 
most  &vorable  examples  of  peritonitis,  and  that, 
on  the  other  hand,  the  acute  and  most  unfavor- 
able cases  are  found  in  those  which  show  the 
least  inflammatory  changes. 

Of  100  cases  of  peritonitis  collected  from  the 
record  of  the  London  Hospital,  70  died;  if 
there  be  excluded  from  these  13  cases,  in  wlidch 
the  cause  of  peritonitis  was  either  not  discovered 
or  was  due  to  cancer  or  tuberculosis,  there  re- 
main 57  fatal  cases.  In  15  of  these  the  exuda- 
tion was  found  to  be  pumlent ;  in  11  it  was 
described  as  sero-purulent ;  in  the  remaining  31 
examples  there  was  no  suggestion  of  pus. 

In  not  a  few  instances  of  puerperal  peritoni- 
tis, the  cases,  if  regarded  pathologically,  are 
merely  examples  of  septicemia  in  the  ordinary 
sense. 

The  surgical  treatment  of  the  acute  diffuse 
inflammatory  peritonitis  as  a  purely  inflamma- 
tory affection  has  not  been  very  successful. 
Tlus  treatment  consists  in  incision  and  evacua- 
tion of  the  fluid.  It  answers  admirably  in  sup 
purative  inflammation  of  the  pleura,  and  in 
cases  of  localized  pumlent  peritonitis,  as  met 
with  in  the  pelvis  and  around  the  cecum,  and  in 
the  tuberculous  variety,  but  in  the  general  form 
of  peritonitis  is  comparatively  useless.  The 
mortality  attending  the  operation  of  strangulated 
hemia,  except  in  connection  with  umbilical  her- 
nia, does  not  appear  to  have  been  greatly  im- 
proved by  the  introduction  of  antisepsis  in  sur- 
gery 

The  Peculiarities  of  the  Peritoneum, — Both 
pleurse  may  be  very  much  inflamed,  and  evm 


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go  on  to  BoppuratioD,  and  stall  not  be  so  severe 
as  a  like  inflammation  of  the  peritoneum.  It 
will  therefore  be  said  that  the  gravity  of  the 
two  cases  depends  not  upon  a  damage  to  the 
serous  membranes,  but  upon  a  resulting  dis- 
turbance of  function  in  the  viscera  they  cover. 
From  this  point  of  view  peritonitis  may  be  more 
aptly  compared  with  meningitis. 

A  patient  may  have  all  the  functional  dis- 
turbances dependent  upon  peritonitis  without 
having  peritonitis,  and  yet  live.  Again,  septic 
matter  may  find  its  way  into  the  pleura,  serious 
symptoms  may  follow,  yet  they  are  by  no  means 
fatal,  and  certiunly  not  to  be  compared  in  grav- 
ity and  deadliness  with  those  which  characterize 
introduction  of  septic  matter  into  the  peritoneal 
cavity. 

The  surface  of  the  peritoneum  is  very  con- 
«iderable,  probably  as  great  as  that  represented 
by  the  entire  ihtegument  of  the  body. 

The  membrane  possesses  remarkable  powers 
of  absorption,  as  shown  by  the  manner  in  which 
milk,  blood,  and  peptones  are  taken  up.  It  is 
said  to  be  capable  of  absorbing  an  amount  equal 
to  from  3  to  8  per  cent  of  the  body  weight 

The  peritoneum  offers  a  limited  resistance  to 
septic  organisms  and  their  products.  The  re- 
sistance varies  within  wide  limits. 

No  tiseue  in  the  body  provides  more  favor- 
able conditions  of  healing  than  does  the  perito- 
neum. 

The  peritoneum  does  not  show  the  same  de- 
gree of  vulnerability  in  all  parts,  nor  are  all 
portions  of  it  alike  in  the  manner  in  which  cer- 
tain lesions  are  responded  to.  The  part  which 
is  apparently  most  sensitive  to  infection,  and 
which  is  most  proae  to  rapidly  spreading  and 
diffuse  inffamm&tion,  is  that  which  covers  the 
small  intestine. 

The  parietal  peritoneum  has  certainly  not  so 
high  a  degree  of  susceptibility,  and  is  not  apt 
to  assume  the  diffuse  and  low  forms  of  inflam- 
mation. 

Localized  peritonitis  is  met  with  in  those  re- 
gions which  are  more  or  less  unoccupied  by  the 
coils  of  the  small  bowels — namely,  in  the  sub- 
phrenic district,  in  the  region  of  the  cecum,  and 
especially  in  the  outer  side  of  that  region,  and, 
lastly,  in  the  pelvis. 

It  is  remarkable  what  extensive  progress  a 
peritoneal  inflammation  may  make  in  the  region 
of  the  liver  or  within  the  pelvis  without  inducing 
very  alarming  symptoms. 

Mikulicz  speaks  of  the  transverse  colon  as  if 
it  were  a  barrier  to  prevent  the  spread  of  peri- 
tonitis downward,  and  suggests  that  the  compa- 
ratively simple  character  of  pelvic  peritonitis 
inay  be  due  to  the  dependent  position  of  the 
pelvic  basin. 


The  peritoneum  appears  possessed  of  great 
sensitiveness,  a  matter  of  moment  in  the  pro- 
duction of  shock.  Other  things  being  equal, 
an  operation  carried  out  ^/rithin  the  abdomen  of 
a  person  who  has  had  chronic  peritonitis,  or  who 
has  exhibited  repeated  subacute  attacks,  and 
whose  peritoneum  presents  adhesions,  is  likely 
to  be  attended  with  better  results  than  when  the 
peritoneum  has  been  found  wholly  undisturbed. 


Eariy  Treatment  of  Caroinoma  Uteri. 
Dr.  Howard  A.  Kelly  says:  The  end  in 
view  is  twofold — first,  by  treating  cervices  liable 
to  become  cancerous,  and  thus  prevent  the  for- 
mation of  this  neoplasm ;  and  secondly,  to  de- 
tect cancer  of  the  cervix  at  a  sufficiently  early 
date  to  successfully  eradicate  the  disease. 

1.  It  is  the  duty  of  the  obstetrician  to  see 
each  patient  at  his  office  from  two  to  three 
months  after  her  confinement,  and  there  to  ex- 
amine and  make  a  careful  record  of  the  condi- 
tion of  the  pelvic  structures,  stating  accurately 
what  lesions  have  been  produced  by  the  confine- 
ment 

2.  Cervical  lacerations  should  be  carefully 
described,  noting  the  position  and  the  depth  of 
the  tear  and  the  appearance  of  the  lipe.  Lacer- 
ations require  no  treatment  when  the  lips  are 
thin,  uninfiltrated,  and  lie  together.  Thick,  in- 
filtrated, and  everted  lips  associated  with  cer- 
vical catarrh  call  for  depletory  treatment  fol- 
lowed by  repair  of  the  laceration. 

3.  Every  woman  who  has  passed  thirty- five 
years  of  age  and  has  borne  a  child  should  have 
this  examination  made  without  delay  by  a  com- 
petent physician,  and  if  the  cervical  lips  do  not 
appear  perfectly  sound  she  should  be  kept  un- 
der observation  and  examined  at  intervals  of 
from  six  to  eight  months. 

4.  Every  woman  over  thirty-five  with  cervi- 
cal tear  should  be  examined  at  least  once  a 
year  for  ten  years,  or  longer,  if  the  appearance 
of  the  lecerated  area  is  not  perfectly  hcMolthy. 

5.  These  rules  apply  with  special  force  to 
patients  whose  &aiily  history  shows  a  marked 
inclination  to  cancerous  diseases. 

If  these  rules  are  conscientiously  observed 
there  is  not  a  shadow  of  doubt  but  that  thous- 
ands of  lives  would  be  saved  yearly  in  this 
country  alone  by  timely  interference  with  a 
disease  so  markedly  local  and  accessible  in  its 
origin. — Arch,  of  Gyn. 

Diagnosis  of  Canoer  of  Uterus. 

The  American  Oymzeologieal  Journal  gives  a 
number  of  pointers  regarding  the  early  diagnosis 
of  carcinoma  uteri  as  follows :  The  classical 
symptoms  of  cancer  of  the  uterus  are  hemor- 
rhage,  offensive  discharge  and  pain.     When 


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these  are  all  present  the  disease  has  usaally 
spread  beyond  the  uteras. 

A  sign  of  great  value  in  early  diagnosis  of 
cancer  of  the  cervix  is  hemorrhage  follow- 
ing sexual  intercourse.  Whenever  this  occurs 
the  case  should  be  thoroughly  investigated. 

When  women  have  ceased  to  menstruate,  and 
again  have  a  metrostaxis,  the  case  should  be 
carefully  studied. 

Leucorrhoea  is  common  in  the  early  stage  of 
cancer. 

Pain  is  present  in  almost  all  cancers  late  in 
their  course.     It  is  seldom  an  early  symptom. 

Epithelioma  may  or  may  not  be  difficult  of 
diagnosis  at  au  early  stage.  When  a  definite 
area  in  the  cervix  is  hard,  infiltrated  and  con- 
stitutes a  distinct  mass  or  tumor  in  the  cervix,  it 
is  probably  cancer  and  should  be  examined 
microscopically.  When  the  mass  begins  to 
ulcerate  the  diagnosis  is  plain.  Cancer  of  the 
body  of  the  uterus  is  almost  always  the  malig- 
nant adenoma. — Med.  Progress. 


Freoklet  and  Wartt. 


At  the  last  meeting  of  the  American  Derma- 
tological  Association,  Doctor  Morrison,  of  Balti- 
more, recommended  for  the  removal  of  freckles 
a  solution  of  seven  grains  corrosive  sublimate  in 
six  ounces  distilled  water,  to  which  are  added 
four  and  five  drachms  respectively  of  tincture 
of  camphor  and  rose  water  ;  three  or  four  thick- 
nesses of  linen,  cut  to  cover  Ihe  seat  of  freckles, 
are  moistened  with  the  foregoing  solution  and 
placed  upon  the  fsice  at  night  until  they  are 
dry,  whatever  remains  on  the  skin  is  left  till 
morning  and  then  washed  off.  Dr.  Morrison 
declares  that  after  a  few  nightly  applications 
the  face  will  be  red,  and  the  epidermis  peels  off 
in  fine  scales,  when  any  soothing  ointment  may 
be  employed. 

For  the  removal  of  warts  he  prescribes  five 
grains  of  corrosive  sublimate  and  a  drachm  of 
salicylic  acid  in  one  ounce  collodion — he  often 
increases  the  amount  of  mercuric  chloride  to 
thirty  grains,  if  the  milder  application  does  not 
answer.  If  applied  every  day,  the  upper  crust 
being  removed  before  each  succeeding  applica- 
tion, four  days  will  usually  soften  the  growth  to 
such  a  degree  that  gentle  traction  removes  the 
wart 

In  this  connection  it  might  be  added  that 
Doctor  Sympson,  in  the  Quarterly  Medical  Jour- 
nal, warmly  recommends  that  any  treatment  of 
freckles  and  warts  should  be  accompanieed  by 
the  internal  administration  of  small  doses  of 
arsenic.  He  declares  that  the  desired  result  is 
thus  more  speedily  brought  forward. 

Our  own  experience  is  that  any  mild  solution 
of  corrosive  sublimate  penciled  daily  and  faith- 


fully upon  freckles  will  usually  remove  them  ; 
but  we  can  see  no  object  in  substituting  a  solu- 
tion of  bichloride  in  collodion  for  glacial  acetic 
add,  or  the  even  more  potent  acid  chromic,  for 
removal  of  warts. — Med.  Age. 


Items  firom  the  Chioago  "  Medioal  Times." 

The  knee  chest  position  for  the  restoration  of 
an  arm  or  cord  in  tedious  labors  now  so  com- 
monly used,  was  suggested  less  than  ten  years 
ago. 

The  persistent  use  of  phosphorized  cod  liver 
oil  will  in  some  cases  restore  gray  hair  to  its 
original  color  and  will  prevent  it  from  tumisg 
gray. 

Baudy  claims  that  neurasthenia  is  due  to  de- 
ficient supply  of  lymph  from  lymph  stasis.  Ad 
increase  of  leucocytes  retard  osmosis  thus  re- 
tarding neutrition. 

The  oldest  anatomical  specimen  in  existence 
is  a  skeleton  in  the  University  of  Basle,  pre- 
pared by  Vesalius,  in  1543. 

There  are  300  cases  of  small-pox  in  Chicago^ 
and  New  York  and  other  eastern  cities  are 
suffering  to  a  similar  extent 

It  is  known  that  the  milk  of  the  sow  is  the 
richest  of  all  lacteal  secretions.  It  contains  al- 
most 50  per  cent,  more  of  the  butter,  sugar 
and  cheesy  matter  than  cows  milk. 

A  writer  poured  the  bi-sulphide  of  carbon  on 
cotton  in  an  open-mouthed  bottle  and  held  it 
against  tbe  forehead  of  several  patients  with 
nervous  headache,  relieving  every  case. 

It  is  reported  that  in  DiAchjQniana  for  cen- 
turies preventive  inoculation  has  been  performed 
for  immunity  from  the  poison  of  snake  bite. 
The  gland  from  the  snake  dried  and  pulverized 
is  used. 

The  irrigation  of  fistulse  in  ano  with  turpen- 
tine in  full  strength  has  cured  a  number  of  cases. 

More  than  5,000  people  are  reported  to  have 
died  from  typhoid  fever  in  Chicago  within  five 
years. 

Oautet  of  Sexual  Debility. 

Dr.  F.  R.  Sturgis,  in  Gaillardls  Med.  Monthly, 
gives  the  following  summary  of  his  views : 

1.  That  the  cases  of  sexual  debility  which 
are  marked  by  imperfect  erections  and  by  pre- 
mature emissions,  are  usually,  if  not  entirely, 
due  to  hyperesthesia  of  some  portion  of  the  ure- 
thra. 

2.  That  masturbation  has  very  little,  if  any- 
thing, to  do  with  it,  beyond  the  fact  that  if  in- 
dulged in  to  excess  it  may  induce  a  tendency 


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towards  this  hypereBthetic  condition,  but  this  is 
is  more  marked  in  masturbators  than  it -is  in 
those  perqpns  who  indulge  to  excess  in  the  vene- 
real act 

3.  That  organic  stricture  has  little,  if  any- 
thing, to  do  with  it ;  but  that,  associated  with 
this  hjperesdietic  condition,  there  is  an  irritable 
<x>ndition  of  the  canal  which  produces  spasmodic 
contractions  of  the  urethra  upon  attempts  to  pass 
instruments,  oftentimes  during  the  first  act  of 
micturition  and  at  the  time  of  connection. 

4.  That  varicocele  plays  no  unimportant  part 
in  these  cases. 

5.  That  neuralgia  of  the  testis,  if  a  cause  of 
this  disease,  induces  it  merely  as  a  secondary 
consequence  to  the  pain  which  is  one  of  the  dis- 
tinguishing features  of  this  disease. 

6.  That  tuberculosis,  syphilis  and  gonorrhoea 
may  also  play  their  part,  and  should  all  be 
reckoned  with  in  summing  up  the  causes  which 
may  induce  this  peculiar  and  depressing  condi- 
tion of  affkirs. 


Phlmotit. 
A  practical  hint  with  regard  Jb>  the  treatment 
of  phimosis,  never  known  to  fail:  Use  thin 
strips  of  gentian-root  as  wedges,  inserting  some 
six  or  eight  between  the  glans  and  prepuce. 
The  gentian  probably  acts  in  a  twofold  manner 
— as  an  expanding  wedge,  deriving  its  moisture 
from  the  secretion,  and  also,  perhaps,  doing  good 
as  an  astringent — East,  Me<L  Record. 

To  Abort  Qonorrhcea. 
Wash  out  anterior  urethra  for  four  days  with 
1  to  4000  permanganate  of  potassium. — Jamik, 
Med,  Record, 


Earaoha. 
If  without  indications  for  operative  treatment, 
drop  into  the  ear  several  times  daily  a  little  of 
the  following :  Menthol  and  camphor,  of  each 
twenty  grains,  in  one  ounce  of  albolene. — Med. 
Record.  

Immunity  Against  Diteata. 

The  study  of  infectious  diseases,  their  specific 
origin  from  the  toxines  of  micro-organisms,  and 
the  possibility  of  rendering  the  human  system 
immune  against  certain  diseases  by  the  intro- 
duction into  the  blood  of  those  susceptible  of 
certain  antitoxines,  has  opened  a  wide  field  for 
study  and  experiment  Recognizing  the  fact 
that  toxines  are  destroyed  by  heat  at  a  much 
lower  temperature  than  antitoxines,  Bonaduce 
has  made  the  following  experiments  (Foster  in 
N.W.  Lancet): 

**  Blood  was  drawn  from  three  children  bom 
with  all  the  characteristics  of  hereditary  syphi- 


lis. After  standbg  on  ice  for  a  day,  thirty-five 
c.  c.  of  serum  were  obtained,  to  which  100  c.  c. 
of  sterilized  water  was  added;  the  mixture 
heated  for  ten  minutes  at  100^  C.,  and  filtered. 
A  patient  was  selected  with  a  characteristic 
chancre  and  enlarged  inguinal  glands,  and  was 
given  twelve  injections  during  twenty-four  days, 
of  about  twelve  minims  each,  of  the  prepared 
serum.  The  injections  were  made  with  all  suit- 
able precautions  into  the  subcutaneous  cellular 
tissue.  The  chancre  and  the  adenopathy  com- 
pletely disappeared;  there  were  no  further 
symptoms,  and  eight  months  Uter  the  patient 
remained  well,  and  showed  aWblutely  no  signs 
of  syphilis.  Further  experiments  are  now  in 
progress." — Memphis  Med.  Monthly. 


Oooaina  in  Small-Pox. 
Dr.  Samayoa,  after  usbg  this  alkaloid  in 
several  cases  of  small  pox,  states  his  results  as 
foUows : 

1.  Cocaine,  given  continuously  from  the  be- 
ginning, can  completely  abort  the  disease. 

2.  If  given  after  the  eruption  has  appeared, 
it  will  transform  confluent  or  hemorrhagic  forms 
into  the  discrete. 

3.  Sometimes,  when  the  cocaine  is  given  from 
the  beginning  of  the  disease,  the  eruption  as- 
sumes a  corneal  aspect,  and  the  pestules  collapse 
before  the  usual  time. 

4.  Cocaine  prevents  suppuration,  hence  there 
is  no  secondary  fever,  and  no  pitting. 

5.  To  obtain  these  results  it  is  necessary  to 
give  cocaine  as  soon  as  the  initial  symptoms 
appeaii  and  must  be  continued  without  inter- 
ruption. 

The  best  preparation  is  the  hydrochlorate, 
and  should  be  continued  five  or  six  days,  or 
even  nine  if  necessary.  —N,  Y.  Therap.  Review. 


Pilocarpine  Inoompatibia  With  Calomel. 

It  has  frequently  been  observed  that  mixtures 
of  pilocarpine  salts  and  calomel  turn  black 
when  moistened  with  wa(er.  According  to  A. 
Schneider  (Chem.  ZeiL)  this  discoloration  is 
produced  by  the  formation  of  a  double  tedt  of 
the  alkaloid  with  mercuric  chloride,  metallic 
mercury  being  separated.  When  the  mixture 
is  treated  with  water  the  double  salt  passes  into 
the  filtrate,  and  is  precipitated  by  potassium 
iodide,  which  salt  does  not  ordinarily  throw 
down  pilocarpine  salts. — Druggists*  Circular. 


Simple  Cure  for  Delirium  Tremens. 

Burson  reports  that  he  has  treated  a  number 
of  cases  of  delirium  tremens  which  had  failed  to 
be  helped  by  hypnotics,  with  great  success  by 
means  of  liberal  draughts  of  hot  water,  a  cupful 


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every  half  hoar  or  hour,  according  to  the  ur- 
gency of  the  case.  He  believes  it  is  the  meet 
rapid  eliminator  of  the  alcohol  from  the  system. 
— DruggisUf  Circular, 

Formulas  for  Injecting  Hemorrhoids. 
There  are  many  formulas  for  employment  in 
injection.  Those  which  have  given  me  most 
satisfactory  results  are  : — carbolic  acid  in  gly- 
cerine and  water  of  a  strength  of  12,  15,  33, 
50,  95  per  cent 

R.  Fid.  ext  ergot. 

SoL  acid  carbolic,  95  per  cent aa  drams  J 

A  solution  g€  carbslic  acid  in  sperm  oil,  1  to 

2  or  1  to  4. 

B.  Tannic  add «. *, ...1  part 

Carbolic  acid — 2  parts 

Alcohol « 4  parte 

Glycerine  opt ^ ^ 8  parts 

Mix. 

This  solution  used  in  the  Brinkerhoff  treat- 
ment, I  am  informed,  has  the  following  for- 
mula: 

B.  Oarbolicaeid. onnceij 

Olive  oil onuces  v 

Chloride  or  sine « gr.  vilj 

Mix. 

The  Hoyt  formula,  so  I  have  been  told  by 
one  of  the  parties  who  was  cured  by  Hoyt,  is, 
carbolic  acid  and  glycerine,  equal  parts,  diluted 
with  six  times  its  volume  of  water,  a  few  drops 
being  used.  Hoyt  claims  there  is  not  a  hsemor- 
rhoidal  case  possible  but  what  can  be  obliterated 
by  this  means :  that  he  has  used  it  for  fifteen 
years  in  about  five  thousand  cases,  and  he  does 
not  believe  a  more  simple  or  satisfactory  means 
of  cure  could  be  devised. — Llewellyn  Eliot,  M. 
D.,  Washington,  D.  C,  in  Vcu  Med  Monthly, 

Explosive  and  Inflammable  Compounds. 

Whenever  substances  rich  in  oxygen,  or  easily 
deoxidized,  are  ordered  to  be  mixed  with  other 
ingredients,  the  dispenser  should  always  care- 
fully consider  the  order  of  mixing.  Such  sub- 
stances should  never  be  rubbed  with  easily  oxi- 
dizable  bodies. 

Substances  which  easily  part  with  their  oxy- 
gen are  picric  acid,  and  chlorate?,  iodates, 
bichromates,  permanganates,  nitrates,  and  pic- 
rate  of  potash,  nitrate  and  oxide  of  silver, 
chlorate  of  calcum,  etc.  Such  substances  should 
first  be  rubbed  to  a  powder  in  a  mortar,  then 
mixed  with  the  safe  ingredients,  and  lightly 
mixed  with  the  easily  oxidizable  substances  by 
means  of  a  wooden  rod.  Of  the  latter  may  be 
named  charcoal,  organic  powders,  iodine,  sul- 
phur, sulphides,  ethereal  oils,  and  ammonia 
salts. 

Oxide  of  silver  if  to  be  combined  with  any 
organic  substance,  should  first  be  dampened 
with  water ;  if  creoiote  is  ordered  with  oxide  of 
silver  in  a  pill,  it  will  explode.     Pills  contain- 


ing oxide  of  silver  are  liable  to  inflame  if  th^ 
become  warm.  They  have  been  known  to  take 
fire  in  the  pocket,  causing  severe  bums. — Indi- 
ana PharmaeisL 


The  Smallest  on  Record. 
A  baby  was  recently  bom  in  a  small  Con- 
necticut town,  which,  if  reports  be  true,  rivals 
anything  of  the  kind  yet  reported  from  Chicago : 
"  The  parents  are  Swedes.  The  father  is  em- 
ployed by  a  farmer  cutting  the  timber,  and 
weighs  about  190  pounds.  The  mother  is  a 
stout,  healthy  woman,  weighing,  perhape,  160 
pounds.  The  child  is  a  male,  as  perfectly 
formed  as  a  babe  can  be,  and  on  its  birth 
weighed  only  eight  ounces.  Its  face  is  about 
the  size  of  a  horse-chestnut  A  ring  worn  on 
the  little  finger  of  its  mother  was  easily  slipped 
over  his  foot  nearly  up  to  the  knee.  It  is  the 
opinion  of  the  attending  physician  that  the  child 
will  live.  The  child  is  so  small  that  three  of 
its  like  could  play  hide  and  seek  in  a  cigar 
box." — Medical  Fortnightly. 


Medical  Examining  Boards  ss  Viewed  by  the  lit- 
telligent  Laity.    . 

We  quote  the  following  from  the  Philadd' 
phia  Record  : 

"  Out  of  the  forty-four  States  in  the  Union 
there  are  only  sixteen  in  which  a  medical  diplo- 
ma of  itself  is  no  license  to  practice,  and  in 
which  a  State  examination  is  required  before 
legal  permission  to  practice  may  be  obtained. 
These  sixteen  States  are  Alabama,  Arkansas, 
Florida,  Maryland,  Minnesota,  Mississippi,  New 
Jersey,  New  York,  North  Carolina,  North  Da- 
kota, Pennsylvania,  South  Dakota,  Texas, 
Utah,  Virginia  and  Washington.  The  ease 
with  which  bogus  diplomas  may  be  obtained  in 
this  and  other  countries,  and  the  alarming 
prevalence  and  persistency  of  quackery,  should 
awaken  the  L^islatures  of  all  the  derelict 
Commonwealths  to  the  necessity  for  State  super- 
vision. Life  ought  not  to  be  put  in  jeopardy 
through  the  ignorance  of  practitioners  who  are 
paid  to  cure,  but  who  o^n  blindly  assist  io 
swelling  the  death-rate. 


Ingrowing  Toe-Nail. 
Veeder  has  made  use  of  a  method  for  treating 
this  ailment  during  the  past  ten  years,  which 
answers  very  well.  It  consists  simply  in  cat- 
ting a  piece  of  ordinary  felt  plaster,  sold  for  use 
in  cases  of  corns  or  bunions,  so  as  to  be  the 
exact  size  and  shape  of  the  nail  about  which  the 
ulceration  is  located.  The  bit  of  plaster  thus 
shaped  and  fitted  to  the  nail  is  to  be  firmly  at- 
tached thereto,  so  as  to  press  aside  the  overlap- 
ping granulations  from  off  the  naiL     By  bold- 


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ing  it  in  this  poeitioQ  a  minute  or  two,  until  it 
•dries  and  adheres  firmly  to  the  nail,  it  becomes 
strongly  fastened,  and  will  stand  considerable 
rough  usage,  but  as  an  additional  security,  a 
strip  of  isiaglasB  plaster  is  wrapped  three  or  four 
times  around  the  toe  and  plaster.  If  properly 
applied,  the  relief  is  said  to  be  immediate,  and 
the  cure  is  complete  as  soon  as  the  thinned  and 
jsgg&i  edge  of  the  nail  underlying  the  granu- 
lation  has  grown  out  to  its  normal  size. — Drug- 
^isUf  (Xreular, 


Ichthyol  for  Piles. 

Ichthyol  is  said  to  make  a  good  application 
for  itohmg  piles.  It  should  be  mixed  witb  pe- 
irolatam  in  the  proportion  of  one  dram  to  the 
«anoe,  and  applied  as  oiten  as  desired. — Drug- 
fwtf  drcvJar. 

Infliienoe  of  Alcohol,  Qlyeorin  and  Oil  on  DIsIn* 
footants. 

Koch  demonstrated  experimentally,  in  1881, 
that  carbolic  add,  dissolved  in  alcohol  or  oil, 
parts  with  almost  all  its  disinfecting  power. 
Shortly  alter,  by  means  of  careful  experiments, 
Wolffugel  confirmed  the  assertions  of  Koch 
wiUi  respect  to  solutions  of  -carbolic  add  in  oiL 
Lenti  (Joum.  de  Pharm.)  has  continued  these 
reeearchiBS,  including  corrdrive  sublimate,  and 
using  various  vehides.  His  conclusions  are  as 
fellows : 

1.  Absolute  alcohol  in  the  abs^ce  of  water 
«(mipletely  annihilates  the  baeteriddal  power  of 
sublii^ate  and  carbolic  acid  over  the  spores  of 
malignant  carbuncles.  This  poww  is  re-mani- 
fested only  when  the  proportion  of  water  added 
to  the  alcohol  is  2  per  cent  ki  1  to  1000  solu- 
tion of  sublimate,  and  70  per  cent,  in  solutions 
of  carbolic  add.  Ftirther,  the  duration  of  the 
action  must  not  be  less  than  twenty-four  hours 
for  sublimate,  or  less  than  forty-dght  hours  for 
carbolic  add. 

2.  The  snme  is  true  of  glycerin,  which  in- 
hibits die  action  of  sublimate  solutions  (2  to 
iOOO)  when  the  proportion  of  water  iriliich  they 
contain  is  less  than  40  per  cent  As  for  car- 
bolic add,  here  the  inhibitory  action  of  the  gly- 
cerin is  still  more  marked,  for  with  solutions 
containing  10  per  cent  of  carbolic  add,  com- 
plete destruction  of  the  spores  takes  place  only 
when  the  proportion  of  water  is  80  per  oent  and 
more. 

8.  Oarbolie  add  and  lysol  dissolved  in  olive 
^il  lose  mtirely  thdr  disinfecting  power.  These 
results  are  of  great  value  in  thdr  bearing  on 
the  jwacfioe  of  hygiene  and  prophylaxis,  from  a 
iargical  point  of  yiew. — Druf/gisUf  CireuUr. 


Treatment  of  Alop 

Ferraton  some  time  ag( 
Lyons  Societe  des'Sdeno 
Med.,  No.  15,  1893,)  a  so 
treated  for  parasitic  alopeu 


<N 


lodion  and  who  was  completely  cured  in  three 
months.  The  method  consists  in  applying  the 
substance  to  the  patches  after  the  hair  has  been 
cut  very  close.  After  three  or  four  applica- 
tions, made  at  intervals  of  four  or  five  days, 
it  is  observed  that  when  the  collodion  is 
stripped  off,  some  lanugo  hairs  are  brought 
away  with  it  The  patient  need  be  seen  only 
once  in  four  or  five  days.  According  to  the 
author  the  collodion  imprisons  the  parante  and 
prevents  the  contamination  of  neighboring 
parts  and  the  transmisrion  of  the  disease  to 
other  persons.  It  excludes  the  air,  and  pos- 
dbly  the  iodine  acts  as  a  paradtidde  and  as  a 
stimulant  of  the  scalp.  Moreover,  the  collodion 
acts  as  an  epilatory. — BriL  Med.  Jovr. 


Therapeutlo  Briefli. 


— In  the  Berliner  kHnUehe  Woehemehrift 
(dted  in  the  CeniralhlaU  fur  KlinUche  Medi- 
cin)  Dr.  P.  Furbinger  treats  of  the  peanut  as 
an  article  of  food  rich  in  albumin,  of  which  it 
contains  forty-seven  per  cent.,  together  with 
nineteen  per  cent  of  fat  and  non-nitrogenous 
extractive  matters.  He  recommends  the  use 
of  roasted  peanuts  in  the  form  of  soup  or  mush. 
On  account  of  thdr  cheapness,  peanuts  are 
recommended  as  a  popular  article  of  food,  es- 
pecially in  poorhouses  and  the  like  ;  moreover, 
they  are  recommended  as  an  article  of  food  for 
the  corpulent,  for  diabetes,  and  for  the  subjects 
of  kidney  disease,  in  the  last  mentioned  of  which 
foods  rich  in  animal  albumin  are  to  be  avoided. 

— A  mixture  of  chloroform  (ten  parts)  ether 
(fifteen  parts)  and  menthol  (one  part,^  used  as 
a  spray,  is  recommended  as  an  excellent  and 
prompt  means  for  obtaining  Local  Anes- 
thesia, lasting  for  about  five  minutes. — Boitan 
Med.  and  Surg.  Jour. 


Wayne's  DIuretio  Elixir. 

I  used  it  ten  years,  but  found  the  price  too 
high.  I  now  manufacture  it  myself  for  half 
the  price,  and  find  it  identical,  producing  the 
same  results.  I  have  put  it  up  for  dxteen 
years,  and  know  it  to  be  a  good  diuretic. 

Take  of: 

R.  Potast.  acetate 3  ounces 

FLezt  bucha ».  .............  «....s  ounces 

PL  ert.  Juniper 1)^  ounces 

Simple  nrrap  luflloienttoiDske l  pint 

Mix.   One  desMrtipoonfkil  three  or  four  times  d^ly. 

— Dr.  Crider,  in  a  previous  number  of  this 
journal. 


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266 


THB  MBDICAL  WORLD. 


A  UmAiI  8alv«. 

The  prescription  given  below  is  from  Dr.  H. 
Kylberg.  It  was  obtained  from  him  during 
his  travels  in  Sweden  by  an  influential  friend^ 
upon  condition  that  he  should  not  open  it  till  he 
had  left  the  country.  The  properties  ascribed 
are  to  extract  pus,  if  any  be  present,  and  to 
heal  any  wound  by  promoting  healthy  granula- 
tions. The  doctor  states  Uiat  in  the  cases 
in  which  he  has  used  it,  it  has  acted  like 
magic: 

R.    Lapii  calamlnaiiB  prop. 
Venice  mrpentloe 
Yellow  wax 

6oat*«  tallow aa oanee  il 

Cotton  Med  oil ounce  1. 

Boil  up  la*t  four  parte  in  clay  pot,  then  add  the  caliminarto 
and  itir  until  hardening. 

—  Cal.  Medical  Journal, 

[Lapis  calaminaris,  or  calamine,  is,  properly 
speaking,  acetate  of  zina  The  old  calamine 
(carbonate  of  zinc)  is  now  called  smithsonite. 
The  prepared  calamine  is  finely  pulverized  by 
a  special  process,  described  in  the  U.  8.  D. — 
Ed.] 


Formulas. 


— ^Tbe  heart  cannot  be  weakened  under 
chloroform  except  by  interference  with  the 
breathing.  It  is  useless  and  dangerous  to  take 
the  pulse  as  a  guide.  Watch  the  respiration. 
Safety  is  insured  only  by  regular  natural 
breathing. — Lawrie,  in  Med.  Record. 


— ^Lotion  for  pruritus  vulvae  {Pradiiioner): 

a.  H7df«»ii  perolUorid gsain  J 

Alumlmi. ...» RMin  xjl 

Pair  amyli.......... ..»..  diam  J« 

Aquie  menibs  pip.  q.  s.  ad. ounce ^ 

M.   0t  flat  lotto. 

8I|.   Apply  estemaUy  to  the  aflbotcd  parte. 

— Dr.  Ckrasso  Michele,  Director  of  the 
Military  Hospital  at  Genoa,  has  used  since 
1888,  in  the  treatment  of  pulmonary  tuberiul- 
oeis  constant  inhalations  of  oil  of  peppirmint. 
(BosUm  Med.  and  Surg.  Jour.,  Jan.  11,  1894.) 
He  combines  the  inhalation  with  the  in  emal 
administration  of  an  alcoholic  solution  of  creo- 
sote, glvceiine  and  chloroform,  to  which  is 
added  oleum  menths  piperitso,  1:100.  His  re- 
sults a^e  rqmtad  as  remarkable.  Not  only 
were  incipient  cases  cured,  but  at'vanced  cases 
also,  some  thirty-nine  in  all,  with  cavity-f  jrma- 
tion  and  abundant  bacilli  in  the  sputum.  All 
the  cases  treated  were  of  pulmonary  diseases 
only,  without  tubercular  affection  elsewhere. 

— Epihelioma  of  superficial  variety  may  be 
treated  with  alternate  applications  of  ten  per 
cent  methyl-l  lue  and  twi  nty  per  cent  chromic 
add. — Darier,  in  Med.  Beeard. 


Correotlon. 

In  the  formula  for  <<Fetid  Diarrhea  in 
Children,''  page  224,  June  World,  the  quan- 
tities are  wrong.  The  sulpho-carbolate  of  zinc 
should  be  grains,  instead  of  drams,  and  the 
subnitrate  of  bismuth  should  be  drams  instead 
of  ounces. 


FOR   DIPHTHERIA. 

Editor  Medical  World: — ^I  have  found 
the  fjlbwing  jield  excellent  results  in  diph- 
theria: 

R.  Papoid dnMMi 

Hidng  bichlor ...4cra  1-6 

Tr.  fmL  chlor » .dramf  il 

Glyoerinlorijnipi ..»q.B.  ounoetia 

M.  a  Applf  to  to  .ills  and  £uiees  with  mop  (nbbiiir 
the  membraiie  off  if  poiiible  and  appljrlnff  direct  to  dtoemtl 
■nrfkoe).  For  Nares,  ose  glyoerole,  papoul  and  bichloi.  hj- 
draff.  In  tame  proportion,  per  atomiier,  qatn.  lolph.  aod 
toniot  at  Indloated. 

For  pernicious  type  of  anemia  with  malarial 
origin  I  have  found  nothing  superior  or  equal 
to  Uq.  sod.  arsenL  E  A.  Schutz,M.D.r 

1502  N.  Bond  Street,  Baltimore,  Md. 


TREATMENT  OF  PLEITRI0Y  : 

R.    Ouaiacol  pare .....dram  j 

TinciorB  of  iodine t......dBaai  f^ 

Paint  the  w  bole  of  this  lionid  each  evening  on  the  affected 
dde.  ThetemperatareqaicUy  fhlls,  an  abundant  peispln- 
tion  takes  plaoe»  and  the  effUiion  becomee  toon  ateorbed. 


DIARRHEA  INCIDENT  UPON  TEETHING  : 
.ftt  xU 

rK 


M. 


Addl  lufphnrtd  dil 

Morphince  sulph , 

8p('.irtnUaliM 

Syr  stngib... »..»......................aa  ouaeet  m 

Aqua ...q.  s.  ad.   oanoei  i^ 

Sig.— diam  J.  every  three  hooa. 


IRRITABLE  HEART. 

R.    Chloralamfd „ diam  1? 

Tinct  belladonDte.. ..diamlj 

Elixir  ilmpUo. q  a  ad.    dramiv 

M.    Rig  —  easpo  nAil  three  Umm  daily,  between  mmiB 
and  at  bedtime. 


AN  ANTI- EPILEPTIC  MIXTURE. 

Prof.  Brown-84quard  (La  Revue  MUioaU, 
March  18,  1894)  praises  the  following  formula 
in  epilepsy : 


....AO 


Bmmtde  potuh,  )  ..  * 
IodtdAp>tath.     /  •• - 

(/n  XXX). 
Bromileaui  nonia 2.0 

(gfi  XXX) 
Bicarb  pot  nh „ 8.50 

(gr«^  xxxTlO). 
Inftvlon  oolumbo^..... ....1S0.O 

(ouno  I  vj). 
Three  tabte»poooftibi  a  dav,  of  which  twa  are  to  be  taken 
in  the  CTening  townr  Js  bed  time. 

(This  is  the  prescription  which  the  gieat 
Napoleon  the  First  formerly  empby^.— 
Pritchard.) — Lancet  Clinic 


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THE  MBDICAX  WORLD. 


2H7 


TO  PREVENT   PITTING  IN  SMALL- POX. 

CorroflTe  lablimate 
Opiiim  extract..., 


'  I  of ateh  1  gme.  [15gn.] 


Aleobol  ».5  sme  \\H  fl.  drs.] 

Olfoerln 60  gme  [l}i  fl.  01.I 

Paint  frequently  on  the  Caoe  and  neck,  so  as  to  keep  the 
parti  eonitantly  mokt 

(Tbeltehing  of  the  akin  will  dlMppear.  and  the  i>iiatnlea 
Qsnally  abort.  It  is  claimed,  on  or  about  the  fifth  day.) 

—A.  M.  8.  Bulletin. 


LEUCOCYTHKiaA. 


R.   Add.  aisenicoB .. 
Fierri.  redact 

Solnise  Bolphat.. 
zt  gentian 

M.  F.  i»lhiLMu.40. 
Sig.    Two  puis  three 


«r.j 

..aa  drams  J 
'""'A'  ■• 


a  day. 


—^Review, 


MORNING  SICKNESS. 

R.  Cecil  oxalate  •***— - ^.........gr.  zzIt 

Bismnth.  soboit drams  J 

Pepatn gr.  xfl 

M.  P.  paly.    DlTideindos.No.  12. 

filg.    One  powder  three  times  a  day  before  meals. 


'lb. 


APOPLEXY. 

R.  Ether,  sulf onncesfR 

camphor  i^ulv.........^..... diamsj 

Mt 

filg.    Por  bnbcutaneoos  iDjectlon. 


ALOPECIA. 

R.   Eztr.  Jaborandl  fluid .:....  fl  oances  j 

Tlnct  cantharid ^ ...fl  drams  Q 

Bay  ram fl  onnoes  It 

M. 

8ig.    Rnh  In  the  scalp  twice  a  week. 

R.  Bala. Perny fl  dramsii 

01.  ridDi ., fl  ounoea  1    • 

Alcohol , fl  ounces  IIJ 

TiBCt.  canth fltmnote  ss 

M. 

81g.    Rub  well  into  roots  of  hair  night  and  morning. 

STRANGURY. 

R.  Decoct  nyae  nrsi »1...  fl  ounces  t 

PotaasU  acetas ounces  ss 

Tinot,  opU « ....drama  i 

Syr.  adlJAe. w ounces  J 

M. 

81g.   Teaspooftfbl  three  ttmes  a  day . 


HEREDITARY  SYPHILIS. 

This  formuU  will  be  found  exeelldntin  here* 
ditary  STphilis.  The  particular  feature  6f  ele-' 
gaDoe  about  it  bebg  the  syrup  of  hydriodic 
add  whicby  by  double  deoompodtion,  forms 
with  the  bichloride  of  Biercury,  the  biniodide,' 
with  exeem  of  iodine.  The  stomach  will  toler- 
ate tMs  perfectly  and  it  is  more  pleasant  to  the 
taste  thni  the  old  potaseium  ufoiide  and  mer- 
cury c<mibinatioii,  while  quite  as  active : 

K.    Syr.  Add  Hydrlodlc  (Hottelley'i)...ouncea  iiss 

Hydrarg.  Wohlorid gr.  i 

Vlnnm  aericum... ..........^..ounces  iss 

Adoa.....^.. .....ounces  il 

M.  Dlssotre  the  meicury  in  the  water  and  add  the  solution 
I0  the  syrup.  Let  stand  foi  ten  minutes,  stirring  frequently, 
then  add  tne  wine. 

SIgna.— Teaipoonftal  three  times  dally  in  a  wlneglassful  of 
water. 


Eucalyptol  (Sander  &  Sons)  in  all  eruptive 
diseases,  as  measles,  scarlatina,  small-poJ:,  etc. 

R.     Eucalyptol  (Sander  A  Sons) ounces  ss 

Add  carbolict grs.  y 

Lanoline ounces  ij 

M.    Sig.— Applj  oyer  eruptiye  surikoe. 

The  aboye  will  increase  the  acUyity  of  the  skin  and  be- 
sides proye  an  excellent  antiseptic 


H. 


HYDROCEPHALUS. 

Potass,  iodide... ....drams  ss 

Aq.  dcstlU « « fl  ounces 

Syrup,  menth  pip....... fl  oimoes 

Tlnci  digital scroples 


:1 


Sig.*  .Half  a  tablespoonftaLl  three  times  a  day. 


*'CHEIJ9£A   pensioner"    RHEUMATIC   MIXTURE. 

R.  Ouaiao  resin  puly .«^. 1  ounce 

Rhubarb,  puly «^ .2  drachms 

Cream  of  tartar...^ 1  drachm 

Sulphur  eublimed ..I  drachm 

Sutmeg,  puly.» » ..2  oonoea 
bney  or  glycerin.. ..16  ounces 

Mix  the  powders  thoroughly  and  rub  wttn  the  honey  to  a 
uniform  paste.    Dose;  two  lablespsonibls  night  and  morning. 

— The  Formulary. 

LALLSMAND's  GOUT  MIXTURE. 

R.  Ext  colchlcnm  acetic  B.  P 80 grs 

Sxt.  opium  aqueous...^...... ..80  grs 

Potass,  iodide 1  ounce 

Potan.  acetate ^ounoe 

DiKtilled  water ..6  onnoes 

White  wine 1  ounce 

Rub  the  extracts  with  tbe  water  unul  dissolyed.  add  the 
salts  and  then  the  wine.    Dose:  20  diope  8  limes  a  day. 

—lb. 


Wit  and  Wisdom, 

THE  BIGGEST  CASE  OH  BBCOBD. 

Haye  70a  heard  of  the  recent  diabetic  attack  iu 
(ingress?  The  whole  Senate  passed  sugar  on  June 
5th,  and  the  House  is  expected  to  do  so  soon. 

•Mbllin's  Food  was  used  ezclusiyelj  at  the  Day 
Narsery,  World's  Fair,  Chicago. 

Fob  elegant  products  of  the  German  scientifio 
laboratories,  address  W.  H.  Schieffelin  &  Co.,  New 
York. 

Send  for. reports  in  regard  to  Phjtoline  and  Pineo- 
line  to  Walker  Phannaoal  Co.,  St  Lonis,  Mo. 

A  Grim  yiflw  of  It. 

The  death  of  an  ossified  man  in  Tennessee  is  reported. 
He  died  hard. — Chicago  Tribune,  This  is  as  bad  as  the 
man  who  f»wallow«d  a  thermometer  and  died  by  de- 
grees ;  it  sqggests  also  the  .9ase  of  the  oonsnmpiiye 
undertaker  who  di(d  of  a  ooffin.—ife^ifica/  Bsoord, 
Thtse  remind  us  of  the  man  who  choked  while  eating 
an  apple  and  died  of  ^ppleplezy. — National  MedUoal 
Revitw,  It  was  in  a  St  Louis  hotel  that  a  Pike  coontj 
farmer  blew  out  the  gas  and  dieil  from  gastritis. — 
Meyer  Brolkers  Druggie — Not  any  worse  than  the  man 
struck  bj  an  engine ;  yerdict,  died  fr«Mn  locomotor 
attacksia. — MotUiiat  Pham.  Jour.  Htill  worse  the 
ca^e  of  that  pie-eating  dyfifieptio  of  Tiflis,  <dr  he  died 
of  piesemia,  superinduced  by  typhlitis. —  Wtstem  Drug- 
gist, 

Before  thiw  dif^mal  contest  is  finished  we  mttj  expect 
some  rf  marks  about  the  ca!*e  iif  the  defunct  side  show 
glass-eater  whoHe  clearest  symptom  was  a  pane  in  the 
stomach,  although  his  lights  w^^re  found  to  be  not 
badly  out  of  order.  '*  Ymi  sir,  fact,  nir ''  And  then 
they  will  all  solemnly  proceed  to  take  a  smile. 


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268 


THE  MBDICAi  WORLD. 


FoK  cat  rates  in  iiiBtraiiients  and  cases,  address  L 
Phillips,  Atlanta,  Ga. 

AN  EXFLOBIVB  MIXTURE. 

A  mixture  of  barium  hyposnlphate  and  potassium 
chlorate  detonates  upon  the  slightest  shock,  ^  the  ex- 
plosion beitig  very  |>owerful  if  there  be  any  huidrance 
to  the  free  escape  of  the  gases  generated. 

Syrup  of  sodium  hypophosphite  with  sodium  chlor- 
ate are  as  dangerous  as  nitroglycerine. 

A  8TOBT  is  going  th^  rounds  to  the  effect  that  a  married 
lady  had  a  birthday  anniversary  a  short  time  ago,  upon 
which  her  husband  presented  her  with  a  pretty^  piano 
lamp.  He  was  much  flattered  when  she  told  nim  she 
intended  to  give  it  his  name,  until  he  asked  her  rea- 
son for  such  a  prooeedine.  *'  Well,"  said  she,  ''you 
Imow,  dear,  it  nas  a  good  deal  of  brass  about  it.  it  is 
handsonie  to  look  at,  it  is  not  remarkably  brilliant, 
requires  a  good  deal  of  attention,  is  sometimes  un- 
st^y  on  its  legs,  liable  to  explode  when  half  full, 
flares  up  occasionally,  is  always  out  at  bedtime,  and  is 
bound  to  smoke.*' 

Have  you  seen  the  new  aluminum  instruments  ? 
Have  you  heard  of  them  7  If  not,  write  immediately 
to  Wm.  H.  Armstrong  A  Co.,  Indianapolis,  Ind.,  for 
information,  circulars  and  illottrAtions,  and  mention 
this  paper.  Surgery  should  have  the  advantages  of 
this  wonderfhl  metu,  and  the  above  mentioned  firm 
offers  the  i 


The  man  who  is  in  proverbs  versed 

Can  often,  often  save  his  jaw 
By  cutting  off  all  dry  debate 
With  an  old  and  rusty  saw. 
Ik  just  appreciation  of  the  therapeutical  virtues  of 
SanmeitOf  I  have  to  state  that  in  several  cases  of  pro*' 
tatitis.  atony  of  the  urinary  bladder,  loss  of  semen  and 
sexual  capacity,  I  have  tried  the  preparation,  and  ia 
every  instance  my  patients  have  derived  some  benefit 
from  its  use.    I  shall  continue  to  commend  Strntnett^' 
to  my  patients  in  the  like  afflictions,  with  perfect  con- 
fidence.      Louis  Baueb,  M.D.,  M.  R.  C  8.,  £ng^ 
Prof,  of  Surgery,  etc,  St.  Louis  College  of  Phyai^ 

cians  and  Surgeons,  St.  Louis,  Mo. 
*'FoB  tabes-mesenterie,  sickness  in  gestattoay 
cholera  infkntum,  ^etc,  Influvin  has  been  pronoonoed 
almost  a  specific.  Samples  irill  be  sent  by  W.  J3L 
Warner  &  Co..  Philadelphia,  to  any  physician  request- 
ing the  same  for  use." 


DIURSnO  AOnON  or  0A8GABA  ftAGBADA. 

Mr.  Milnes  Hev  (Homsey  Lane,  N.^  writes  to  the 
BritMh  Medical  taunud:  ''Some  little  time  ago  I 
notioed.mfter  taking  some  cascara  sagrada  incrwed 
frequency  of  micturition.  I  oould  then  find  no  cause 
for  this.  Shortly  after  I  again  took  this  drug,  and 
again  noticed  the  same  effect.  As  I  could  find  no 
reference  to  its  action  as  a  diuretic,  I  began  to  watch 
its  actions  on  anjr  of  my  patients  who  migbt  be  taking 
it.  and  in  the  migority  or  cases  I  found  it  to  act  an  a 
diuretic,  a  few  only  not  noticing  any  difference.    In 

one  case,  a  Mr.  D.  H ,  the  efl^M^  was  marked,  as 

the  patient  himself  complained  of  the  number  of  times 
a  day  he  was  obliged  to  urinate.  I  analyzed  his 
urine,  and  found  it  to  be  quite  healthy.  On  stopping 
^e  cascara  be  ceased  to  be  troubled.  One  or  my 
medical  brethren  told  me  that  he  had  also  noticed 
this  same  effect  of  this  drug  upon  himself.  The  cas- 
cara sagradik  that  I  use,  ana  have  always  used,  is  the 
liquid  extract  of  Parke,  Davis  A  Co.  I  should  be  in- 
terested to  hear  if  this  diuretic  action  has  been 
observed  by  others." 

FOB  SUPERFLUOUS  RAIB8. 

Equal  parts  of  yellow  sulphate  of  arsenic  and  quick- 
lime, maae  into  a  Mste  with  hot  water,  is  said,  by  Dr. 
B.  Morrison  of  Baltimore,  to  remove  superfluous 
hairs.  The  paste  is  applied  to  the  parts  and  allowed 
to  dry.  This  removes  the  hair  in  from  ten  to  twenty 
days,  and  sometimes  permanently. — Ik. 

A  lotion  of  alcohol,  three  ounces,  salicylic  acid, 
one  drachm,  will  cause  a  prompt  disappearance  of 
pimples  and  comedones. 

AKTI-MALABIAL. 

B.  Syr.  add  bydxlodlc,  (Hostelley'i) oc  111 

liq.  pocaau  anenlt ^ f  dr.i] 

Tinct  capsloam f  dr.  iy 

M.    Big.    TeMpoonftil  three  times  dally,  In  water. 

The  above  is  a  good  alterative  tonic  and  seldom 
fails  to  prevent  recurring  attacks  of  malaria. 


OXMS  OF  THOUOHT. 

Besponsibility  educates.— Wendell  Phillips. 

To  a  mule's  ears  a  mule's  voice  is  always  music. 

If  thou  desire  to  be  wise,  be  so  wise  as  to  hold  ihj 
tongue. — Lavater. 

Much  bending  breaks  the  bow;  much  unbendiiig^ 
the  mind. — Bacon. 

Good  manners  and  good  morals  are  sworn  friends 
and  fast  allies.— Bartol.  . 

Living  without  a  plan  is  as  foolish  as  going  to  sea. 
without  a  compass  in  the  ship. 

The  father  who  is  not  willing  to  be  bothered  by  hi» 
boy's  questions,  will  not  be  likely  to  be  bothered  by 
his  confidences  after  a  while. 

Fob  samples  of  Uterine  Wafers,  send  to  Micajafa  A 
Co.,  Warren,  Pa. 

DTBMENOBBHBA. 

a  F.  Baker,  M.D.,  Decatur,  Mich.,  says :  *<  I  have 
prescribed  Aletris  Cordial  in  two  cases  with  very  fav- 
orable results.  The  first  a  casec  of  suppressed  meosea 
of  short  duration.  Her  age  was  about  fifteen  yeer«. 
Had  been  regular  for  over  a  year;  missed  her  cata- 
menia  for  the  first  time,  and  sufllbred  from  headache 
and  general  malaise.  The  Aletris  Cordial  in  teaspoon- 
ftil  doses  three  times  a  day,  set  her  all  right  in  a  (vw 
days.  The  second  was  a  case  of  dysmenorrhea.  Age 
of  patient  about  twenty-eight  or  thirty  years.  Had 
always  suffered  extremely  at  her  menstrual  pMriods, 
unless  under  the  influence  of  some  narcotic^  and  almost 
always  was  obliged  to  take  her  bed  for  two  or  three 
days  at  each  period.  She  used  a  half  pound  boUle  <^ 
the  Aletris  Cordial,  in  teaspoonful  dow  three  times  a 
day,  with  perfect  relief  from  pain  while  under  the  in- 
fluence of  the  Cordial,  or  to  use  her  own  words,  she 
would  not  have  known  b^  her  fedings  that  ^e  waa 
unwell,  and  did  not  feel  different  in  any  respect  than 
when  in  her  usual  health." 

The  dangerous  communion  cup  meets  increasing- 
opposition.  Doctors  should  agitate  Uie  su^ect,  like 
Dr.  A.  J.  Longfellow  of  the  M.  E.  Church  in  Fostoria, 
Ohio,  who  moved  the  following  resolution:  "Re^ 
solved,  That  the  church  purchase  four  hundred  little 
wine  glasses  and  each  oommunicant  receive  the  wine 
out  of  a  glass  that  no  other  person  has  used,  and  the 
bread  passed  on  baskets  or  plates,  and  tiiat  it  be  not 
handled  or  Iwoken  by^  the  preacher."  This  is  a  good 
second  movement  against  the  still  more  dangerous  in- 
cident of  alcohol  ii^  the  communion  cup. 

I  AH  pleased  with  the  results  obtained  from  the  use 
of  Freligh's  Tsblets  and  Tonic  A.  T.  Speer,  M.D., 
Newark,  O. 

Passifloba  Inoabnata  (passion  flower)  ia  a  weli 
{Oontinvtd  on  ntati  Uctf,) 


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7^  kmcmU^f^  t^t  ft  f^^n  can  use  is  the  only  real  knowledge;  the  only  know- 
ledge that  has  life  and  growth  in  it  and  converts  itic^f  into  Radical  power.      The 

rut  hangs  like  dust  about  the  drain,  or  dries  like  raindrops  off  the  stones.-^l?KOxnm, 


.The  Medical  World. 

.    FUBUSHBD  MOXTTHLT,  by  C  P.  TaYJjOVL^  H.  D. 


C  F.  Tayi^r,  M.  D., 
J.  J.  Tayw)il,  M.  D., 


?  Editors. 


Mlilplliiti  to  any  part  of  tlie  United  States  and  Canada, 
OWB  DOLLAB.  per  year.  To  Engrland  and  the  British 
Colonies,  Prva  Shilunos  per  year.  Poeta^^e  free. 
Siagrle  copies,  Tbn  Cbitts.  These  rates  must  be  paid 
imvoHably  in  advance, 

Vc  cannot  always  supply  bcu^  numbers.  Should  a  num- 
ber foil  to  reach  a  subscriber,  we  will  supply  another, 
if  notified  before  the  end  of  the  montli. 

Hy  BO  money  to  agents  for  this  journal  unless  publisher's 
racdpit  is  given. 


ALL  Communications  to 
THE   MEDICAL  WORLD," 
15SO  Chestnut  Street, 

PHILADKLPHIA.  PA. 


Vol  XIL 


August,  1894. 


Na  8. 


Some  Thoughts  Upon  Self- Poisoning. 

One  of  the  most  important  prindples  to  be 
kept  in  mind  by  the  physician  in  treating  his 
patients  is  to  estimate  the  extent  to  which  dis- 
eases and  their  Complications  are  due  to  the 
absorption  of  poison  arising  within  the  body  of 
the  patient  This  subject  forms  a  very  inter- 
esting and  a  most  profitable  subject  for  study. 
These  poisons  tax  the  system  to  accomplish 
their  eliminationy  and  often  cause  the  principal 
phenomena  of  the  disease.  How  to  prevent  their 
further  formation,  to  promote  the  speedy  elimin- 
ation of  those  that  are  generated  and  to  neu- 
tralise within  the  system  those  that  cannot  be 
eliminated,  should  be  the  constant  inquiry  and 
aim  of  the  physician  in  each  individual  case. 

Considering  the  alimentary  canal,  we  are 
well  aware  of  the  disturbances  caused  by 
n^lected  constipation  and   the  consequent  ab- 


sorption of  poisonous  products.  But  not  aU 
realize  the  far  graver  danger  from  the  absorp- 
tion of  toxines,  from  an  inflamed  or  ulcerated 
colon,  or  from  the  stomach  duodenum  and  oiher 
portions  of  the  tract  in  a  state  of  acute  or 
chronic  catarrh,  or  of  ulceration,  as  in  typhoid 
fever  and  gastric  or  duodenal  ulcer.  In  any 
unhealthy' condition  the  tract  should  be  kept 
clean  and  pure,  by  enemas  of  sterlized  water, 
hot  or  cool,  by  the  administration  of  salines  and 
antiseptics  or  by  other  means  specially  suitable 
to  the  case.  A  catarrhal  mouth  and  throat 
should  be  frequently  cleansed  and  put  in  a  con- 
dition to  heal  as  quickly  as  possible,  and  car- 
ious teeth  should  be  closely  looked  after.  The 
nasal  mucous  membrane  is  often  a  source  of 
mild  systemic  infection.  The  antiseptic  toilet 
or  treatment  of  the  nose  should  not  be  forgotten. 
Diseased  conditions  of  the  kidneys  and  bladder 
are  fruitful  sources  of  grave  infection  and  the 
problem  of  free  elimination  must  be  constantly 
m  the  mind  of  the  medical  attendant  until  the 
cause  can  be  corrected. 

The  catarrhal  condition  of  the  female  genital 
tract  is  also  a  frequent  source  of  poisoning, 
causing  many  functional  disturbances,  as  head- 
ache,  malaise,  back  ache,  etc.  This  is  especially 
likely  to  be  the  case  towards  the  close  of  the 
menstrual  period.  Antiseptic  irrigation  here  is 
very  useful,  but  we  have  found  packing  the 
vagina  with  boracic  acid  singularly  benefidal. 
Toxic  principles  arising  from  imperfect  action 
of  the  liver  are  not  so  definitely  understood  as 
they  should  be.  These  continuJetUy  tax  the  in- 
genuity of  the  physician  to  promote  their  perfect 
elimination  until  the  condition  giving  rise  to 
their  formation  can  be  corrected. 

Besides  the  direct  antiseptic  flushing,  irri- 
gating and  cleansing  of  surfaces  that  can  be 
reached  in  that  manner,  the  physiological  or- 
gans of  elimination  should  be  kept  in  a  state  of 

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THE  MEDICAL  WORLD. 


perfect  activity— -the  skin,  the  bowels,  kidneys 
and  lungs.  In  the  state  of  primitive  nature, 
the  skin  is  a  perfect  elimini^ting  organ.  In  the 
civilized  state,  however,  we  envelope  it  closely 
with  clothing,  and  thu6  interfere  with  the 
proper  performance  of  its  function.  This  must 
be  counteracted  by  bathing  or  dry  rubbing  and 
by  frequent  air  baths  and  occasional  vapor 
baths.  It  is  well  recognized  that  a  Turkish 
bath  will  take  the  place  of  several  hours  extra 
sleep  in  resting  and  refreshing  one  who  is  very 
tired  from  protracted  exertion:  This  simply 
means  that  it  aids  the  system  in  more  rapidly 
eliminating  the  extra  physiological  toxines  aris- 
ing from  excessive  muscular  action.  The  soles 
of  the  feet  present  an  eliminatmg  surface  which 
is  effective  far  out  of  proportion  to  its  area. 
However,  they  must  be  kept  in  perfect  condition 
— always  clean  and  dry.  In  mild  weather  going 
bare-footed  awhile  each  day  is  beneficial,  and  in 
winter,  toasting  them  before  a  hot  fire  a  half 
hour  in  the  evening  will  be  of  great  service. 

So  far  as  possible,  then,  the  physician  should 
constantly  look  to  the  elimination  of  all  toxic 
products  and  by  suitable  treatment  prevent 
their  further  formation.  This  may  seem  like  a 
homely  article,  but  its  object  is  to  bring  together 
and  systematize  ideas  that  generally  exist  in  the 
mind  of  the  physician  only  as  isolated  facts,  and 
also  to  point  out  and  emphasize  a  most  impor- 
tant factor  in  the  preservation  of  health,  and  the 
treatment'of  disease.  Far  from  being  exhaust- 
ive, it  is  merely  suggestive,  presenting  only  the 
simplest  principles  of  one  of  the  most  profound 
problems  in  pathology,  which  involves  fully  one 
half  of  the  entire  treatment  of  disease.  Each 
practitioner  must  work  out  the  problem  to  the 
achievement  of  practical  results  mainly  himself, 
by  years  of  daily  study,  observation  and  inves- 
tigation. 

Dr.  George  B.  Gray,  of  Grace  Hospital,  To- 
ronto,  Canada,  writes  us  that  he  cannot  speak 
too  highly  of  Dr.  W.  B.  Thistle's  treatment  of 
typhoid  fever,  as  found  in  July  World,  pages 
257  and  258.  He  has  witnessed  its  brilliant 
results  in  the  General  Hospital  in  Toronto,  and 
has  successfully  used  it  in  private  practice.  He 
thinks  that  this  treatment  will  require  a  new 
history  of  the  disease  to  be  written,  so  completely 
does  it  change  every  feature  of  it 

It  is  stated  in  the  lay  press  of  Southern  Cali- 
fornia that  the  jicama  root,  of  that  locality,  is  a 
cure  for  typhus  fever  and  for  smallpox. 


Qri^inal  QommuRioations. 

Short  aiticleB  on  the  treatmeiit  of  diaeaaet,  and  ocpoieiMC 
with  new  remedtos,  are  soUdted  from  the  profeaoion  fix 
this  department;  alao  difficult  caaes  for  diaffnoeit  aad 
treatment. 

▲itides  accepted  must  be  contrlbated  to  thia  journal  omh. 
The  editors  are  not  reaponalhle  for  viewa  cxprcaicd  69 
contiibutOTB. 

Oop7  must  be  received  on  or  before  the  tw^fth  of  Um 
month  for  publication  in  the  next  month.  Umiaed 
Mannacript  cannot  he  returned. 

Cniainfy  it  it  txeeOeni  diadpKntfrr  an  atiihor  to  feel  that  kt 
must  say  aU  ke  has  to  sav  in  the  fewest  possible  words,  m 
his  reader  is  sure  to  skip  them;  and  in  the  plain€st  possihl* 
words,  or  kis  reader  will  certainly  misunderstand  them. 
GenemUy,  also,  a  downright  f^ may  he  told  in  a  pUia 
way:  and  we  want  downright  Jaets  at  ptrestmi  more  them 
'%S>thing  «2if  .— Ruaxzir. 


READ.     REFLEOT.    OOMPARE.     REOORD. 

Repliet. 

Editor  Medical  World  : — I  am  reminded 
that  I  omitted  to  give  the  prescription  for  alco- 
holism in  my  last  letter  (page  231).  It  is  that 
given  in  a  World  of  recent  date,  I  think,  bj 
Dr.  Chapman,  as  the  Keeley  "  dope ;"  except- 
ing  that  for  the  chloride  of  gold  and  sodium,  I 
substituted  bichloride  of  mercury. 

[For  the  benefit  of  those  who  may  not  have 

the  April,  1893,  World,  we  reproduce  the 

formula  here : 

B.    Aari  et  lodli  chloridi....^ — gr.  zii 

Btr7Chnl]mnitratii..........».« ............gr.j 

AtToplnsB  iulph ^ ^.  H 

Ainmonli  mnrlat ..gf*  ▼] 

Aloin «.« ». ....gr] 

Hjdraatin. »^»^.»-^gt.  ^ 

O&oeiini ^ «..f.  oi.  J 

Flo.  Qxt.  dnohoDffi  oomp*. — »£  oa.  lU 

Fld.extk  eiythiox.  coca ...Xoa.) 

Aquffi  dew « f.  o*.y 

M.&   One  dram  at  7, 9, 11  a.  m.;  and  at  1»  3. 5. 7»  9  pn. 

—Ed.] 

I  am  glad  to  see  vaccination  discussed.  Much 
harm  has  been  done  this  most  useful  procedaie 
by  extravagant  claims  as  to  its  hannlesBiiea 
and  efficiency — claims  not  borne  out  by  experi- 
ence. VacdDation  may  transmit  syphilis, 
tuberculosis,  infectious  fevers,  varioella  or  im- 
petigo contagiosa ;  it  may  arouse  a  dispositioD 
to  eczema,  scrofula  or  struma ;  it  may  be  fol- 
lowed by  tetanus,  erysipelas,  adenitis,  abeoes, 
pneumonia,  ophthalmia,  or  other  diseAses.  V 
done  scientifically,  antiseptioally,  with  pure  and 
fresh  virus,  on  a  proper  case,  by  an  ezperieii<^ 
vaccinator,  it  is  remarkably  free  from  these  inju- 
rious sequences.  And  here  is  where  I  object  to 
the  practice  of  putting  this  work  in  the  hinds 
of  all  sorts  and  conditions  of  men — students, 
policemen,  druggists,  etc.  The  Lord  is  good  to 
Chicago,  or  the  results  of  such  methods  woold 
be  disastrous  to  the  people,  and  vacdnttioQ 
would  receive  unmerited  obloquy.     The  truth 


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THE  MEDICAX  WORLD. 


271 


as  to  the  protective  power  is  that  it  varies  with 
different  individuals  and  with  the  virus  em- 
ployed. Some  persons  are  forever  protected  by 
a  single  vaccination.  Others  require  revacci- 
nation,  even  yearly.  We  are  not  all  built 
alike,  though  on  the  same  general  plan.  The 
only  way  to  find  out  if  the  old  vaccination  is 
stUl  in  force  is  to  try  a  new  one. 

Dr.  Clouse's  patient  with  one  promment  eye- 
ball (page  244),  probably  is  developing  a 
tomor  that  pushes  the  eye  forward. 

I  quite  agree  with  Dr.  Allen  as  to  the  re- 
covery of  a  majority  of  typhoid  cases  under 
the  bath  treatment,  or  with  no  treatment  at  all ; 
but  nowadays  we  are  not  satisfied  unless  all  re- 
cover. Rheumatism  is  a  rare  complication  of 
typhoid  fever,  and  the  occurrence  of  the  two  at 
once  is  probably  accidental.  In  my  case  the 
temperature  ran  very  high,  the  cerebral  symp- 
toms were  marked,  but  the  man  recovered  with 
oat  permanent  injury,  except  a  total  loss  of 
memory  as  regarded  the  payment  of  my  bill. 
In  typhoid  we  may  have  the  symptoms  resulting 
from  the  work  of  several  different  microbes,  and 
this,  I  believe,  best  accounts  for  the  varieties 
and  anomalous  cases. 

Dr.  Walker's  case  (page  249)  has  a  very 
large  bladder,  paralyzed.  She  should  tal^e 
strychnine  and  duboisine,  or  cantharidine ;  use 
galvanism  to  the  bladder,  applied  by  an  intra- 
vesioal  electrode,  and  never  let  the  bladder  go 
over  eight  hours  without  emptying.  The  most 
likely  cause  of  the  paralysis  is  over-distension. 

For  acne  rosacea  (page  250)  try  puncturing 
with  an  acne  lancet,  arseniate  of  strychnine  in 
fall  doeee  internally,  chromic  acid  solution 
locally,  as  strong  as  the  skin  will  bear  without 
irritation,  and  see  if  there  is  not  a  urethral  in- 
flammation to  be  cured.  Forbid  all  malt 
liqaors. 

Dr.  McBride's  case  is  probable  Raynaud's 
disease,  ii  not  one  of  ergotism.  It  is  a  case  for 
"iron,  wine,'  quinine  and  codliver  oil,"  rich 
food  and  sea  air.  The  second  foot  will  have  to 
come  off  at  the  ankle,  anyway. 

The  possibilities  in  Dr.  Teel's  case  (page 
250)  range  from  corns  to  senile  gangrene.  Be- 
fore deciding  on  the  latter,  let  a  chiropodist 
look  the  foot  over.  These  gentlemen  find  corns 
on  the  sole  of  the  foot,  .under  the  nails,  and  in 
many  uneitpected  locations. 

Dr.  Smith's  patient  (page  251)  died  of  heart- 
clot,  due  to  some  sudden  strain  on  an  organ 
weakened  by  prolonged  nursing  and  consequent 
anemia.  Why  will  women  persist  in  nursing 
cluldren  so  long,  when  statistics  show  that  preg- 
nancy  is  more  likely  to 'occur  during  lactation 
than  at  other  times?  The  best  treatment  of 
rack  a  case  is  to  wean  the  baby,  give  a  rich 


diet  and  tonics,  especially  iron,  lime  and  cod- 
liver  oil.  Still  I  do  not  want  to  be  understood 
as  criticising  Dr.  Smith,  who  was  right  in  his 
diagnosis  (heart-clot  and  heart  paralysis  are 
two  names  for  one  condition)  and  treatment, 
everything  he  mentions  being  useful. 

Dr.  Matchette  must  not  overlook  the  tonsillar 
and  rheumatic  attacks  in  his  pruritic  patient, 
but  should  take  that  as  an  indication  and  give 
sodium  salicylate  internally.  Locally,  apply 
an  ointment  of  trikresol  and  salicylic  add,  a 
dram  of  each  to  the  ounce  of  simple  cerate.  If 
trikresol  be  not  attainable,  use  carbolic  acid  or 
creosote.  Do  not  overlook  the  slightest  endom- 
etritis, as  this  often  keeper  up  the  disease. 

I  would  be  willing  to  assert,  without  seeing 
her,  that  Dr.  Brooks'  case,  (page  251)  has  en- 
dometritis. A  course  of  local  treatment,  with 
iron,  quinine  and  cod-liver  oil  internally,  and 
anti-nervine  at  the  'paroxysms,  ought  to  cure 
her. 

Dr.  Morris  (page  252)  should  not  let  his 
epileptic  boy  eat  as  much  as  a  man.  It  is  a 
common  trick  of  epileptics,  and  a  fruitful,  ex- 
citing cause  of  convuleions.  I  would  give  boy 
mueuna  pruriens  (cowhage),  as  this  is  about  the 
only  thing  that  absolutely  clears  out  worms. 
Then  give  the  bromides,  as  suggested  in  my 
little  manual,  and  keep  the  disease  under  con- 
trol until  the  boy  outgrows  it 

Dr.  Nicodemus  (page  252)  has  a  case  of 
paroxysmal  contraction  of  one  toe.  Give  sum- 
bul  or  valerian  internally,  in  full  doses ;  let  her 
have  a  bottle  of  bromic  ether  or  some  pearls  of 
amyl  nitrite  to  inhale  when  the  spasm  occurs ; 
and  if  these  do  not  cure,  cut  the  flexor  tendon. 
I  take  it  for  granted  that  the  doctor  has  exam- 
ined the  foot  and  found  no  troublesome  com, 
callosity  or  ingrowing  nail  to  cause  the  trouble. 

As  Dr.  Smith's  case  had  gastro  duodenitiF,  I 
do  not  see  why  the  cramps  should  be  attributed 
to  the  acetanilid  given  him.  If  the  drug  had 
previously  been  followed  by  cramps  with  him, 
in  other  affections,  it  is  an  idiosyncracy. 

Dr.  McMath's  case  (page  252)  is  one  of  as- 
cending paralysis,  due  to  a  lesion  of  the  spinal 
cord,  beginning  in  the  posterior  columns.  It  is 
possible  that  the  first  rheumatic  attack  was 
really  a  neuritis,  and  myelitis  followed.  The 
treatment  of  such  a  case  consists  of  electricity, 
massage,  mercury,  counter  irritation  to  the  spine 
and  nutrition. 

Chronic  nasal  catarrh  is  a  condition  that  re- 
quires chronic  treatment  Wash  out  the  nos- 
trils well  by  spraying  with  Dobell's  solution ; 
then  apply  compound  albolene  spray  with  an 
atomizer.  Do  this  three  times  a  day,  for 
months,  varying  the  applications  to  secure  bet- 
ter results.    • 


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272 


THE  MBDICAX  WORI,D. 


Dr.  Tison's  first  case  may  have  gall-stones  or 
malaria.  Chloroform  will  not  dissolve  stones 
in  the  biliary  passages.  If  anything  will,  it  is 
the  succinate  of  soda,  five  grains,  thrice  daily, 
for  a  year.  In  the  second  case,  the  jaundice  is 
the  evidence  of  permanent  obstruction  of  a 
bile-duct,  or  it  is  malarial.    Give  a  full  dose  of 

[>ilocarpine  and  it  will  relieve  the  skin  of  its 
oad  of  bile.  Besides  this.  I  would  advise  the 
doctor  to  continue  his  excellent  tonic  treatment 
If  not  relieved,  the  boy  must  remove  to  another 
climate.  The  third  case  would  be  benefited  by 
macrotin.  The  fourth  case  has  a  sore  that  I 
would  suspect  to  be  syphilitic,  from  the  history. 
It  would  be  well  to  give  her  mercury,  and  treat 
her  hands  and  the  cows  teats  with  antiseptic 
lotions.  Thorough  washing  with  chlorinated 
«oda  solution  should  do  good,  with  compound 
tincture  of  benzoin  applied  to  all  sores  on  the 
teats  or  hands.  This  should  be  repeated  before 
«ach  milking  until  the  sores  are  healed. 

Dr.  PuUen  may  remove  soot  from  a  tear  by 
<;utting  it  out ;  not  by  any  other  way,  as  carbon 
is  insoluble. 

In  Dr.  Col  well's  cases:  1.  I  do  not  know. 
2.  To  remove  corns,  cut  them  out  carefully, 
without  bleeding  the  patient,  then  cover  with  a 
comfelt  and  amicated  plaster,  and  have  the 
shoe  overhauled  by  an  intelligent  shoemaker,  if 
you  can  find  one.  3.  Warts  may  be  touched 
^very  day  by  a  drop  of  pure  formalin,  or  by  a 
saturated  solution  of  chromic  acid.  4.  Doctor, 
cut  the  wen  open  and  pull  it  out  of  its  socket, 
removing  every  particle. 

William  F.  Waugh,  M.D., 

103  State  St,  Chicago. 

[The  following  letter  will  also  be  of  interest. 
—Ed.] 

Prof.  W.  F.  Waugh,  M.D.,  103  State 
Street,  Chicago,  111. 

Dear  Sir: — You  are  perfectly  right  when 
you  write  to  me  that  in  cases  of  neurasthenia  I 
should  examine  the  neck  of  the  bladder  and 
the  kidneys.  Both  of  them  are  at  fault  in  the 
case  in  which  I  asked  your  advice. 

I  have  a  case  of  epilepsy  of  three  years 
standing,  produced,  according  to  my  judgment, 
by  reflex  irritation  from  the  neck  of  the  blad- 
der, and  I  will  induce  the  patient,  who  has 
been  treated  on  both  sides  of  the  Atlantic,  to 
see  you  and  be  treated  by  you  with  electricity. 
Yours,  J.  A.  MuENiCH,  M.D., 

Madison,  Wis. 

Editor  Medical  World:— I  like  the  new  summer 
dress  of  The  World  better  than  any  in  which  it  has 
yet  appeared— and  inside  it  is  a  marvel  of  interest, 
vahie  and  excellence.         H.  A.  Robinson,  D.D.8. 

Fozcroft,  Maine. 


Tropa-Cooaine  in  Painless  Extrtction  of  Taetii. 
Editor  Medical  World: — Tropa-cocaine,  or 
benzoyl-pseudo-tropeine,  as  it  is  sdentifiollly 
termed,  is  an  alkaloid,  first  taken  from  the 
leaves  of  the  Javanese  Coca  plant  by  Grieael,  of 
Berlin,  through  suggestions  from  Liebennann, 
who  subsequently  prepared  the  same  subetanoe 
synthetically.  We  owe  the  credit  of  its  devel- 
opement  as  a  practical  and  useful  therapeutic 
agent,  however,  to  an  American  physician.  Dr. 
A.  P.  Chadboume,  of  New  York  city.  My  in- 
vestigations of  its  usefulness  have  been  confined 
to  the  art  of  painless  extraction  of  teeth.  Tropa- 
cocaine  is  of  a  somewhat  similar  nature  to 
cocaine,  excepting  that  it  is  almost  free  from  the 
toxic  and  other  deleterious  effects  of  that  other- 
wise wonderful  drug.  It  is  preeminently  a 
local  anesthetic,  and  as  such,  it  possesses  advan- 
tages over  cocaine  that  make  it  incomparable. 
These  advantages  may  be  even  greater  than  at 
present  demonstrated.  They  consist  in  greater 
power ;  quicker  action  ;  freedom  from  systemic 
disturbances  to  a  great  extent;  is  not  depressing 
to  the  cardiac  motor  ganglia ;  does  not  produce 
ischemia  nor  hyperemia ;  is  a  moderate  antisep- 
tic, rendering  subcutaneous  injections  free  from 
danger  of  sloughing  or  abcesses  ;  retains  its  ac- 
tivity for  months  in  solution,  and  is  free  from 
the  danger  of  cocainism,  because  of  its  very 
slight  systemic  effects. 

The  principal  drawback  to  its  use  lies  in  its 
present  great  expense,  which  is  unnecessary,  ai 
it  is  not  difficult  to  obtain,  nor  expensive  in 
manipulation.  It  is  best  used  in  four  per  cent 
solution,  using  a  weak  solution  of  pure  sodium 
chloride  as  a  menstruum.  Its  permanency  In 
solution  is  probably  due  to  lack  of  fungoid  de- 
generation, as  a  result  of  a  natural  antiseptic 
quality  which  cocaine  does  not  possess.  In  the 
painless  extraction  of  teeth  I  have  been  charmed 
by  its  use.  The  many  concurrent  and  subse- 
quent ill  effects  of  cocaine  have  driven  it  almost 
completely  from  the  hands  of  concientioas  physi- 
cians and  dentists.  Tropa-cooaine  now  is  offmd 
as  a  more  worthy  and  reliable  substitute.  Bj 
its  use  we  may  avure  the  possessor  of  unwanted 
teeth  that  extraction  of  offending  molars  maj 
be  compared  to  clipping  of  the  fingex  nails— 
nothing  more.  We  may  coolly  secure  a  firm 
base  hold  of  a  decayed  crown  and  successfully 
remove  what  would  otherwise  more  than  likelj 
be  broken,  bungled,  and  botched.  We  maj 
even  crush  through  the  edge  of  the  alveolar 
process,  grasp  an  ugly  root,  and  smile  as  it 
quickly  and  without  pain  emerges  in  to  the  light 
of  day.  My  experience  has  taught  me  that  de- 
tails must  not  be  neglected,  however,  in  its  use, 
if  we  would  have  the  best  results.  The  gums 
near  the  teeth  to  be  extracted  should  be  fint 


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wet  with  the  solution,  and  after  a  delay  of  about 
one  minute,  two  minims  should  be  injected  with 
a  hypodermic  syringe,  in  two  places  about  one 
half  inch  apart,  and  not  less  than  one  foiirth 
inch  from  the  margin  of  the  gums,  both  inside 
and  outside  of  the  teeth,  making  four  injections 
of  two  minims  each.  This  amount  i^  sufficient 
for  the  extraction  of  from  one  to  six  teeth  in 
in  that  vicinity.  The  effect  of  the  drug  will 
continue  about  twenty  minutes.  Minims  should 
be  guaged  by  the  small  thumb  screw  on  the 
piston  of  the  syringe.  The  injections  should  be 
deep,  and  in  the  direction  of  the  roots. 

A.  D.  Hard,  M.D., 
317  South  St,  La  Fayette,  Ind. 

Dislocated  and  Fraotured  Humerus. 

Editor  Medical  World: — I  was  called 
January  14th,  1894,  to  see  Miss  Eva  K.,  age 
12.  8he  had  had  a  fall  twelve  hours  before 
and  the  family,  supposing  she  had  just  bruised 
aod  sprained  her  shoulder,  had  been  applying 
linimenls,  thinking  it  would  be  all  right,  but  it 
gjrew  worse. 

I  found  it  very  much  swollen  and  painful 
She  could  not  bear  for  it  to  be  touched  or  man- 
ipulated. 

I  placed  her  under  complete  anesthesia.  On 
examination  found  the  head  of  the  humerus  in 
the  axillary  region,  also  complete  fracture  of 
upper  third  of  the  humerus. 

I  reduced  the  dislocated  head  by  using  my 
thumbs  as  a  fulcrum,  placing  my  left  hand  over 
the  acromian  process  and  grasping  the  lower 
part  of  the  upper  third  of  the  humerus  with  my 
right  hand  an^  using  this  as  a  leverage,  with  my 
assistant  holding  the  lower  part  of  the  arm  in 
litae  with  the  upper.  In  this  way.  the  head  was 
very  easily  reduced  in  the  way  it  came  out  I 
then  made  a  fulcrum  out  of  absorbent  cotton, 
and  one  assistant  held  this  in  place,  while  the 
other  made  traction  on  the  arm  from  the  wrist. 
I  placed  some  layers  of  abeorbent  cotton  along 
the  full  length  of  the  humerus  and  the  upper 
part  of  the  forearm.  I  then  applied  very  thick 
paste-board  dampened  with  hot  water  so  as  be 
pliant,  anterior  and  posterior,  so  as  to  cover  or 
encaae  tte  arm,  and  the  upper  half  of  the  fore- 
arm. I  then  bandaged  it  smoothly.  I  brought 
the  arm  at  a  right  angle  with  the  body  and  ban- 
daged it  there.  I  brought  the  elbow  well  up 
with  it  and  made  the  shoulder  look  like  it  was 
one  and  a  half  or  two  inches  higher.  By  this 
mode  I  got  union  by  first  intention  of  the  shaft, 
and  the  head  remained  m  its  proper  place.  She 
(Udn't  suffer  any  pain  to  speak  of  during  her 
convalescence,  excepting  when  I  commenced  to 
manipulate  her  arm  so  she  would  have  proper 
use  of  it 


I  am  happy  to  say  that  to-day  she  has  the 
same  use  of  it  that  she  has  with  the  other. 
Rhea  MiU.,  Tex.     J.  W.  France,  M.D.^ 


Whiskey  in  Systtmlc  Poisoning. 

Editor  Medical  World  : — Dr.  Kohler,  in 
The  World  for  March,  on  page  84,  in  criticis- 
ing Dr.  Parkinson's  treatment  of  diphtheria^ 
gives  a  plan  of  treatment  of  his  own  andrecom- 
mends  the  free  use  of  whiskey,  without 'stating 
at  what  stage,  or  condition,  or  why  he  would 
give  it,  only  use  it  **freely"  "given  in  large 
doses  without  fear  of  intoxication,  as  the  virul- 
ence of  the  disease  counteracts  the  effects  of  the 
remedy" 

The  doctor  undoubtedly  has  gotten  hold  of 
an  important  fact,  well  understood  and  compre- 
hended by  many  of  the  experienced  practitioners  ; 
but  without  further  explanation  his  suggestions- 
are  very  misleading  to  the  inexperienced,  for 
the  reason  that  the  "free  use  of  whiskey"  is 
certainly  not  adapted  to  all  cases,  or  in  all  stages 
of  the  disease,  and  may  do  much  harm  if  em- 
ployed indiscriminately,  but  that  there  are  casea 
and  conditions  in  which  we  can  accomplish  with 
whiskey  what  we  cannot  with  any  other  remedy,, 
can  scarcely  be  questioned ;  but  it  is  important 
that  we  clearly  understand  those  conditions,  anci 
the  object  for  which  we  are  giving  it 

I  think  it  will  be  admitted  without  debate 
that,  aside  from  laryngeal  croup,  the  chief  dan- 
ger in  diptheria  is  the  paralysing  and  depress- 
ing  effect  of  the  poison  in  the  blood,  a  condition 
by  no  means  peculiar  to  diphtheria,  but  is  ob- 
served in  the  poison  of  dissecting  wounds,  some 
forms  of  erysipelas,  gangrene,  etc.,  etc. 

Its  profound  impression  upon  the  nervous 
system  is  unmistakable,  and  when  anv  case,  be 
it  diphtheria  or  whatever  the  cause  of  the  toxic 
or  animal  poison,  has  reached  this  stage, 
whiskey  will  not  intoxicate,  but  its  effect  is 
salutary,  and  it  should  be  given  freely. 

Whiskey  being  an  anti-f«  rment,  and  at  the 
same  time  anesthetic,  its  action  is  twofold  when 
administered  in  this  condition.  It  at  least 
retards,  if  it  does  not  arrest,  the  process  by 
which  this  toxic  material  is  formed,  and  at  the 
same  time  so  obtunds  the  nervous  sensibility  as 
to  render  the  nervous  system  more  tolerant  of 
the  poison,  thus  holding  matters  in  abeyance 
until  the  eliminating  organs  will  have  had  time 
to  get  rid  of  the  offending  material. 

Also,  there  is  probably  no  other  known 
remedy  with  which  we  can  so  completely  satu- 
rate every  tissue  of  the  body,  and  which  we  cai» 
bring  in  contact  with  every  atom  of  the  poison^ 
without  injury. 

But  valuable  as  this  remedy  is  in  certain  coor 


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THE  MEDICAL  WORLD. 


ditioDS,  it  should  never  be  used,  without  having 
clearly  in  mind  the  object  to  be  accomplished.  ' 

Imperfectly  as  we  understand  what  we  call 
toxic,  septic,  or  animal  poison,  whiskey  seems 
to  act  alike  ii^  all  cases  of  rapid  development,  that 
is,  it  does  not  intoxicate,  it  retards  the  process, 
and  renders  the  nervous  system  more  tolerant  to 
the  toxic  influence!  This  is  equally  true  of 
venomous  poisons  as  well  a3  those  under  discus- 
sion. J.  C.  Spohn,  M.D., 

Fort  Scott,  Kan. 


The  Lowest  Death  Rate  Yet  Reported. 

Editor  Medical  World  : — Your  letter  of 
the  22d  is  at  hand  and  contents  noted.  I  am 
glad  of  the  opportunity  of  contributing  the  fol- 
lowing : 

The  human  family  is  composed  of  two  classes 
— ^those  who  are  afflicted  with  disease,  and  those 
who  are  not.  The  former  are  ever  searching 
for  remedial  agents  and  health  resorts,  that 
they  may  be  restored  to  health.  And  all  are 
anxious  to  prolong  their  live?  to  the  extreme 
limit  The  germ  theory  of  disease  which  has 
claimed  the  attention  of  the  best  medical  minds 
in  the  world,  has  at  last,  under  the  searching 
light  of  the  microscope,  passed  irom  theory  to 
established  fact,  and  the  medical  mind  is  now 
turned  to  combatting  the  conditions  by  which 
disease  is  produced.  The  germs  or  microbes 
exist  in  the  water  we  drink  and  in  the  air  we 
breathe,  and  through  these  two  sources  they 
find  an  entrance  into  the  human  sjstem  and 
contaminate  tha  blood. 

There  was  a  time  in  the  history  of  this  State 
when  the  mention  of  its  name  was  suggestive  of 
ague,  bilious  fever,  neuralgias,  sallow  complex- 
ion, enlarged  spleens  and  diseased  livers.  But, 
thanks  to  the  intelligence,  energy  and  industry 
of  our  people,  the  low  lands  and  swamps  have 
been  drained  and  brought  into  a  high  state  of 
cultivation,  and,  as  a  result,  the  germ-producing 
cause  of  disease  is  gone,  and  malarial  disease 
in  this  poition  of  Indiana  is  a  thing  of  the 
past 

Now,  as  to  this  locality :  I  have  practiced 
medicine  and  surgery  here  since  1867.  When 
I  came,  the  Wabash  and  Erie  Canal  was  here, 
but  navigation  on  it  was  almost  abandoned.  Its 
surface  was  covered  with  a  vegetable  growth, 
its  banks  produced  luxuriantly  the  largest  spe- 
cimens of  weeds  of  almost  every  variety,  and 
adjacent  to  and  near  the  city  in  ere  low  tracts  of 
land  covered  with  vegetable  matter  ;  the  streets 
were  not  improved ;  no  gutters  carried  off  the 
accumulated  filth ;  no  system  of  water  works  ; 
and,  in  addition  to  all  this,  the  prairie  lands 
east  and  southeast  of  the  city  abounded  in  ponds 


and  low  places,  where  large  quantities  of  vege- 
tation grew,  fell  down  and  decayed.  The  con- 
sequence was  that  all  the  conditions  were  favor- 
able to  the  development  of  malarial  diseases. 
For  the  first  ten  years  after  I  came,  that  is, 
from  1867  to  1877,  about  one  fourth  of  the 
population  of  the  city  and  surroundinfi^  country 
were  prostrated  with  ague,  bilious  fever,  and, 
in  short,  with  all  the  diseases  produced  by  ma- 
larial poison. 

What  has  occurred  since?  The  canal  has 
been  abandoned  and  drained,  and  in  many 
places  it»  former  bed  is  under  a  state  of  good 
cultivation  ;  and  under  the  direction  of  a  vrise 
and  intelligent  city  government  our  streets  have 
been  graded,  graveled  and  guttered,  and  the 
sidewalks  are  composed  of  concrete.  The  water 
supply  is  now  obtidned  from  flowing  springs 
within  the  corporate  limits  of  the  city.  The 
water  is  pure,  cold  and  healthfuL  In  addition 
to  this,  there  are  two  flowing  artesian  wells  on 
the  city  plat,  one  of  which  contains  the  valuably 
mineral,  lithium.  y-^^ 

I  have  been  secretary  of  the  city  Board  of 
Health  for  the  past  two  years,  and,  under  the 
State  law  r^ulating  such  matters,  all  deaths 
and  contagious  diseases  were  reported  to  me. 
There  was  in  that  time  but  one  epidemic  of  scar- 
let fever  and  diphtheria.  The  city  and  town- 
ship together  have  a  population  of  upwards  of 
4,000  people.  In  1892  the  death  rate  per 
thousand  was  a  fraction  less  thin  five ;  in  1893 
just  five;  up  to  this  date,  June  29,  1894,  eight 
deaths  are  reported. 

During  the  past  ten  years  no  case  of  malarial 
fever  has  occurred  in  my  practice,  and  irom 
what  I  learn  from  the  other  physicians  here,  my 
experience  has  been  theirs. 

The  city  is  situated  on  the  east  bank  of  the 
Wabash  river  ;  the  soil  is  sandy,  and  the  ground 
rises  gradually  from  the  river  to  a  height  of 
over  100  feet 

Situated  in  Warren  County,  four  miles  from 
this  city,  is  the  *'  Indiana  Mineral  Springs,'* 
famous  for  its  Magnet  Mineral  Mud  Baths  and 
Lithia  Water  which  cannot  be  surpassed  for  the 
relief  of  all  functional  diseases.  Other  springs  of 
value  have  recently  been  discovered  in  the  im- 
mediate vicinity,  and  all  indications  point  to  this 
locality  as  a  great  health  resort  in  the  near  future. 

The  climate  for  the  greater  part  of  the  year 
is  delightful,  the  surrounding  country  is  rich, 
productive  and  picturesque,  and  the  landscape, 
as  viewed  from  the  elevation  east  of  the  city,  is 
unsurpassed  in  beauty. 

I  have  avoided  any  statement  that  exagger- 
ates in  the  least  the  healthfulness  of  this  locality. 
If  there  is  any  place  that  can  truthfully  be  called 
a  health  resort,  it  is  this.     No  locality  in  Cali- 


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fbmia,  New  or  Old  Mexico,  caa  furnish  a 
smaller  annual  death  rate  per  thousand,  so  far 
as  I  know.  J.  T.  Rice, 

Attica,  Fountain  Co.,  Ind. 


The  Injection  Treatment  of  Hernia. 

Editor  Medical  World  : — There  is  a  very 
profitable  branch  of  minor  surgery  that  has  been 
almost  entirely  lost  to  the  medical  profession, 
viz. :  the  non- surgical  treatment  of  reducible 
hernia. 

Carefully  prepared  estimates  show  tbat  nearly 
if  not  quite  one-tenth  of  the  entire  population — 
old  and  young,  male  and  female — sufier  from 
some  form  of  rupture. 

Physicians  have  allowed  nearly  all  of  this 
valuable  clinical  material  to  go  directly  to  the 
trues  makers,  because  they  could  do  no  more 
than  the  truss  maker — simply  fit  a  truss. 

These  cases  may  now  be  reclaimed  to  the  pro- 
fession by  adopting  the  non- surgical  deep  hypo- 
dermic method  of  treatment  This  method  of 
operating  was,  it  seems,  first  experimented  with 
bj  the  elder  Fancoast  in  1836.  He  us€$d  the 
tincture  of  iodine,  and  the  reaction  was  so  great 
that  the  practice  was  condemned.  Later  on, 
Heaton,  of  Boston,  reported  numerous  cures, 
but  his  injections  also  set  up  violent  infiamma- 
tion,  the  patients  being  confined  to  their  beds  for 
some  time.  .  Then,  too,  the  fluid  used,  not  being 
aseptic,  the  results  in  many  cases  were  serious, 
and  the  profession  once  more  condemned  the 
procedure. 

Latterly  the  method  has  been  again  revived, 
but  along  strictly  scientific  lines,  and  is  now  re- 
ceiving the  attention  of,  and  being  adopted  by, 
advanced  surgeons  all  over  the  country. 

In  many  cases  of  hernia  in  children  that  have 
been  brought  to  me  for  treatment,  I  found  that 
the  parents. had  been  told  by  the  attending  phy- 
sician to  pay  no  attention  to  the  rupture — that 
the  child  would  outgrow  it  This  is  a  great 
mistake.  The  earlier  a  rupture  is  properly 
treated  after  its  discovery,  the  better,  whether 
in  young  or  old.  The  first  thing  to  be  done  is 
to  reduce  the  hernia,  and  then  to  apply  a  well- 
fitting  truss  of  some  kind — one  that  will  hold 
the  hernia  in  place.  In  some  very  young  chil- 
droi  I  use  a  home  made  truss.  This  is  made  of 
canton  flannel,  of  three  or  four  thicknesses,  two 
and  one  half  inches  wide,  well  quilted,  and  long 
enough  to  go  around  the  body  and  lap  well. 
Upon  one  edge,  where  it  will  fit  over  the  seat  of 
the  rupture,  a  wellstufled  pad  of  cotton  should 
be  stitched,  so  placed  as  to  make  firm  pressure 
when  applied.  Fasten  the  belt  in  place  by 
means  of  safety  pins.  Have  a  perineal  strap 
of  the  same  material,  to  hold  the  band  down. 
if  properlv  made  and  put  on,  this  bandage  will 


be  all  that  will  be  needed  in  the  way  of  treat- 
ment at  first  Have  several  of  them,  so  they 
may  be  kept  clean. 

In  some  large  scrotal  hernias,  in  adults,  I 
have  found  it  better  to  use  at  first  a  so  called 
scrotal  truss,  with  a  soft  pad  and  a  perineal 
band.  Afier  a  few  injections  have  been  ^nade,. 
and  the  hernia  is  more  easily  retained,  a  differ- 
ent truss  should  be  used,  as  firm  and  even  pres- 
sure must  be  brought  to  bear  upon  the  canal 
and  over  the  inner  ring,  to  keep  the  parts  well 
coaptated  until  firm  adhesion  takes  place. 

The  technique  of  treatment  is  as  follows: 
Place  the  patient  on  the  table,  replace  the  pro- 
trusion, if  out,  and  wash  the  parts  with  some 
antiseptic  solution.  I  nearly  always  use  lysol,. 
and  find  it  very  effective.  Next  locate  the  ex- 
ternal ring  by  invaginating  the  scrotum  with 
the  index  finger,  and  inject  into  the  skin,  imme- 
diately over  it,  a  few  minims  of  a  five  per  cent, 
solution  of  cocaine.  It  may  be  well,  in  some 
cases,  to  add  to  each  cocaine  injection  one  drop 
of  a  one  per  cent  solution  of  nitro-glyoeiine,  to 
prevent  any  possible  unpleasant  reaction  from 
the  cocaine,  but  I  have  not  yet  found  this  neces- 
sary. If  a  very  small  needle  is  used  for  the 
fluid  the  cocaine  may  be  omitted. 

Having  allowed  two  or  three  minute )  for  the 
cocaine  to  take  effect,  proceed  to  inject  the  her- 
nial fluid.  There  are  several  minor  details  iD 
this  procedure  that  roust  be  observed.  See  that 
you  have  sufficient  fluid  in  the  syringe,  and  that 
the  air  is  excluded.  Free  the  tip  of  the  needle 
of  the  drop  of  fluid  naturally  gathering  there, 
oil  it,  and,  havirg  punctured  the  skin  at  the 
seat  of  the  cocaine  injection,  carry  the  needle 
through  the  outer  ring,  dipping  it  down  and  into 
the  canal,  and  follow  this  up  to  the  inner  ring, 
carefully  avoiding  the  cord,  and  guiding  the 
needle  at  first  by  means  of  the  finger  pushed  up 
to  the  outer  ring. 

Having  reached  the  internal  ring,  or  as  nearly 
as  possible,  slowly  inject  from  three  to  five,  or 
even  more,  minims  of  the  fluid,  as  may  be 
deemed  best,  and  withdrawthe  syringe.  Some- 
times I  ins3rt  the  needle  a  little  belo  y  the  loca- 
tion of  the  inner  ring  in  an  oblique  direction^ 
passing  it  in  until,  from  experience,  I  judge  it 
to  have  reached  the  proper  point,  and  then 
make  the  inje<;tion.  A  little  practice  will  soon 
enable  any  one  to  operate  successfully.  Gently 
massage  the  seat  of  injection  with  the  fingers> 
so  as  to  evenly  distribute  the  fluid  in  the  tissues^ 
Repeat  the  operation  every  five  to  seven  days, 
according  to  the  reaction.  There  will  be  more 
or  less  of  a  burning  or  smarting  sensation,  last- 
ing for  two  to  five  minutes,  when  it  will  pass 
off. 

The  truss  must  be  adjusted  before  the  patient 


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THE  MEDICAL  WORLD. 


^ta  up,  and  he  must  be  instructed  to  take  it  oft 
only  after  laying  down  at  night,  and  to  replace 
it  before  arising  in  the  morning.  There  will 
be  some  soreness  of  the  region  following  the  in- 
jection, lasting  for  a  day  or  two.  This  must  be 
explained  to  the  patient,  that  he  may  expect  it 
A  healthy  adhesive  inflammation  must  be  set 
"tip,  or  the  rupture  will  not  be  cured.  From  six 
to  twelve  injections  are  generally  required  to 
effect  a  cure.  The  older  the  subject  the  longer 
the  time  required. 

The  fee  for  the  treatment  of  hernia  is  graded 
to  the  ability  to  pay,  and  to  the  degree,  as  well 
ss  the  nature  of  the  case.  A  double  rupture 
will  require  double  work.  In  such  cases  I  gen- 
^  ^erally  alternate  the  treatment  on  the  two  sides, 
flo  as  to  not  subject  the  patient  to  too  much  dis- 
comfort. The  charge  for  fitting  a  truss  should 
be  not  less  than  ten  dollars,  except  to  poor  pa- 
tients, to  be  paid  at  once.  For  the  subsequent 
treatment,  from  twenty-five  to  one  hundred  dol- 
lars or  more,  according  to  circumskinces,  msy 
he  charged,  one-half  to  be  in  advance,  and  the 
4)alance  when  a  cure  is  effected,  or  as  may  be 
agreed.  It  is  always  better  to  get  seme  advance 
f>ayment  The  patient  is  far  more  likely  to  fol- 
low up  the  treatment  and  pay  the  balance  than 
of  such  payment  is  not  made. 

In  all  my  cases  I  have  not  had  a  single  dan- 
gerous symptom,  or  one  bordering  on  that  line. 
The  patient  loses  no  time  from  work  or  business, 
except  the  fifteen  to  twenty  minutes  required  in 
the  office  once  a  week,  and  in  a  comparatively 
flhort  time  walks  out  a  well  man. 

The  only  point  to  be  emphasized  is,  that  just 
•enough  infiammatioti  must  be  kept  up  for  a  suf- 
ficient length  of  time  to  effectually  seal  up  the  ' 
canals.  A  little  experience  will  soon  determine 
this.  Commence  with  a  minimum  dose  and  in- 
crease to  the  tolerant  point,  and  keep  it  there.  * 
The  truss  must  be  worn  for  some  time  after  the 
^tient  is  pronounced  well,  to  afford  protection 
to  the  parts  until  the  adhesions  are  quite  firm. 

Of  course,  in  operating  by  the  injection  meth- 
od, only  a  thoroughly  tested,  safe  and  reliable 
'fluid  should  be  used.  Furthermore,  the  doctor 
should  know  just  what  he  is  using,  and  thus  be 
free  from  the  feeling  of  prescribing  or  using  a 
^secret  preparation. 

Wm.  H.  Walling,  M.D., 

1606  Green  street,  Phila. 


ViM  it  the  EfTdot  of  Quinine  ?— Cholera  Infantum.— 
Forceps. 

Editor  Medical  World  : — Last  summer  I 
Attended  G.  B.,  age  19,  weight  127  pounds, 
height  5  feet  7  inches.  He  had  pneumonia  at 
the  age  of  11,  being  under  treatment  at  that 
time  for  six  months.     Father  died  of  phthisis 


tuberculosis,  idso  one  uncle.  When  called,  I 
found  a*well-developed  malaria,  tongue  heavily 
coated,  pulse  98,  temperature  99},  enlargement 
of  liver  and  spleen,  slight  tympanites,  bowels 
constipated.  Gave  calomel  and  podophyllin  in 
broken  doses  every  hour,  until  bowels  moved. 
Then  two  grains  of  quinine  every  two  hours, 
until  symptoms  of  cinchonism  made  their  ap- 
pearance ;  afterward  two  grains  of  quinine  four 
times  a  day,  also  calomel  and  podophyllin  suffi- 
cient to  keep  bowels  in  condition. 

Af\;er  four  days  the  pyrexia  ceased,  and  he 
improved  fast.  The  quinine  ordered  only  twice 
a  day.  On  the  tenth  day,  contrary  to  my  ad- 
vice, he  attended  a  wedding,  drank  C9ld  beer, 
and  took  part  in  a  batn  dance.  Four  days  after- 
wards I  was  called  in  baste,  and  learned  from 
his  mother  that  he  had  two  passages  of  pare 
blood,  also  bad  cough,  expectoration,  tmged 
heavily  with  blood  ;  not  much  pain,  only  while 
coughing;  pulse  80,  and  hardly  perceptible; 
skin  clammy  and  cold. 

Gave  fl.  extr.  ergot,  turpentine,  aromatic 
snlphuric  acid,  and  tinct  opii.,  aa  gtt.  v.  in 
mucilage  accacise,  every  half  hour,  applied  hot 
Whisky,  with  aromatics,  to  chest,  abdomen  and 
legs.  No  more  bloody  stools  after  four  doses. 
Then  I  put  him  oii  anodyne  pine  expectorant 
and  syrup  hydriodic  add,  a  teaspoonful  alter- 
nately every  two  hours,  and  t  ^r.  of  calomel 
three  times  per  day.  Five  months  continuedf 
treatment  made  him  well  and  strong.  Was  it 
quinine? 

As  the  time  for  cholera  infantum  'is  here 
again,  let  me  give  you  my  treatment :  Tinct. 
opii  camph.,  listerioe,  elixir  lactopeptine, 
glycerine,  equal  parts.  Give  small  doses  at 
first  Lemonade — sour,  not  sweet — and  when 
occiput  is  hot  lay  the  little  sufferer  on  cold  com- 
presses ;  he  will  be  thankful  for  it  Aromatic 
whisky  or  mustard  plaster  on  abdomen,  also  on 
legs. 

This  reminds  me  of  a  very  able  article  from 
the  pen  of  Professor  Larabee,  in  the  Cholera 
Infantum,  No.  4,  1892.  He  calls  the  mustard 
plaster  an  old  chestnut  I  was  sorry  to  see  the 
baby  thrown  out  with  the  bath.  That  chestnut 
is  easy  to  crack.  Professor,  you  surely  do  not 
deny  that  capillary  action  in  cholera  infantum 
Ib  a  fundamental  neceesity;  and  how  can  we 
obtain  it  more  quickly?  It  is  a  well-known 
fact  that  a  mustard  plaster  on  the  abdomen  and 
epigastrium  often  is  sufficient  to  quiet  gastric 
disturbances,  opening  tbe  road  for  other  reme- 
dies. When  discharges  are  very  fetid,  flushing 
of  the  colon  with  3  to  5  per  cent  solution  of 
creolin,  or,  better,  listerine,  10  to  20  per  cent 
solution.  Diet,  exclusively  predigestod  food, 
until  all  gastric  disturbance  has  disappeared. 


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277 


The  qaeetion  when  to  use  the  forceps  seems 
*8till  to  trouble  some  minds.  When  the  head 
-stops  advancingy  and  pains  are  insufficient,  then 
is  the  time.  No  conscientious  physician  will  al- 
low his  patient  to  drag  along,  sitting  there  to 
^wait  exhausted  nature's  efiorts.  I  admit  that 
forceps  are  used  more  now  than  twenty-five 
years  ago ;  and  why  ?  Because  we  know  the 
necessity.  In  old  medical  works  we  read: 
"  Never  use  forceps  on  a  primipara."  Simple 
(theory,  without  the  least  practipal  foundation. 
•The  forceps  in  the  hands  of  a  skillful  accouch- 
•€ur  are  a  safe  method  of  delivery.  With  a 
"Sawyer's"  forceps,  which  every  obstetrician 
ought  to  have,  you  have  the  labor  under  per- 
fect control,  and  the  worst  rigid  perineum  is 
^afe ;  you  cannot  do  so  without 

In  a  twenty-seven  years'. large  obstetrical 
practice  I  came  to  that  conclusion.  Apply  your 
jbrceps  after  the  rotation  of  head;  use  •trac- 
tion only  when  pains  are  present;  when  the  occi- 
put reaches  the  perineum  only  allow  it  to  ad- 
-vance  far  enough  to  stretch  the  perineum,  and 
when  danger  seems  apparent,  hold  it  in  check. 

Use  hot  fomentations  during  the  intervals  of 
{)ain.  Do  I  use  ergot?  -  No.  In  75  per  cent, 
of  labors  we  find,  when  called  in  time,  the  pa- 
tient suffering  from  false  pains,  and  I  always 
^ve  tinct  opiL  and  flu.  extr.  gelsemium,  20  to 
.  30  drops,  which  brings  on  natural  pains  in  a 
short  time.  If  the  os  remuns  rigid  after  first 
doee,  repeat  in  an  hour.  Give  it  until  it  has  the 
^desired  effect  Medicines  whose  actions  are 
known  to  a  certainty  must  be  given  according 
io  effect,  and  not  according  to  text-books.  After 
the  child  is  bom  keep  your  hands  on  the  uterus, 
and  when  you  feel  it  contracted,  the  placenta 
•can  easUy  be  brought  out  by  gentle  traction  on 
the  cord  and  squeezeing  of  the  uterus  externally. 
In  abortions,  empty  the  uterus  and  see  it  con- 
tracted before  you  leave  your  patient.  A  physi- 
dan  not  doing  so  is  guilty  of  criminal  negligence, 
in  my  eyes.  Dr.  John  Zenneb, 

Colwich,  Kan. 


Aoetaniiid.— Hernia- 


Editor  Medical  World: — In  the  June 
number  of  The  World,  page  200,  Dr.  D. 
Boswell  writes  under  the  caption  "Is  Acetanilid 
So  Dangerous?"  and  makes  some  strong  points 
•against  the  ofc-repeated  statements  that  acetani- 
lid sometimes  produces  great  depression  of  the 
heart  and  circulation,  accompanied  by  cyanosis. 
A  majority  of  the  physicians  with  whom  I  have 
4alked  upon  this  subject  are  afraid  ot  the  de- 
pressant addon  of  the  drug  and  use  it  with  cau- 
tion. My  experience  with  it  has  shown  several 
instances  of  partial  collapse  after  its  adminis- 


tration in  only  moderate  doses.  >But  the  most 
serious  results  I  have  seen  follow  its  use  were 
manifested  in  its  action  upon  the  kidneys.  In 
every  case  where  it  has  been  given  in  repeated 
doses  the  urine  became  dark-colored  and  dimin- 
ished in  quantity  more  than  we  would  expect  it 
to  do  simply  from  the  amount  of  perspiration 
produced  by  the  drug^ 

In  cases  of  continued  fever,  where  acetanilid 
has  been  employed  daily  for  two  or  three  weeks, 
I  have  seen  strangury  occur  repeatedly.  This 
strangury  does  not  differ  in  symptoms  from 
that  produced  by  cantharides,  but  it  does,  not 
yield  to  camphor.  In  consultation  once  I  saw 
two  young  ladies,  sisters,  both  of  whom  had 
taken  acetanilid  regularly  for  more  than  four 
weeks  during  continued  fever,  and  who  had  the 
most  obstinate  cases  of  strangury  I  have  seen. 
In  a  married  lady,  aged  twenty-five,  previously 
healthy,  who  had  a  continued  fever,  m  the  firet 
week,  the  physician  gave  8  grain  doses  of  ace- 
tanilid every  hour  until  three  doses  were  taken 
— that  is  twenty-four  grains  in  two  hours  Com- 
plete suppression  of  the  urine  immediately 
supervened  and  the  secretion  was  never  re- 
established. The  patient  died  within  forty-eight 
hours.  We  could  find  no  cause  for  the  sup- 
pression except  the  acetanilid.  Let  us  hear  if 
others  have  not  had  a  similar  experience. 

Of  late  we  have  heard  much  of  the  treatment 
of  hernia  by  the  injection  process.  I  have 
gone  to  some  trouble  to  look  the  matter  up,  and 
have  arrived  at  the  conclusion  that  this  treat- 
ment of  hernia  is  much  superior  to  the  knife  in 
every  way.  I  find  that  hundreds  of  cases  have 
been  successfully  treated  in  this  manner.  Of 
more  than  thirty  such  persons  examined  by 
myself  not  one  shows  any  signs  of  hernia.  Some 
of  these  were  treated  five  years  since.  This 
would  look  as  if  it  were  a  permanent  cure.  I 
have  employed  the  injection  treatment  in  several 
cases  with  entire  success.  With  a  definite 
knowledge  of  the  anatomy  of  the  parts,  a  correct 
comprehension  of  the  conditions  present  and  a 
proper  needle  to  work  with,  no  physician  need 
fear  to  undertake  the  operation  by  injection.  It 
is  simple,  is  quickly  done,  is  almost  painless 
and,  therefore,  requires  no  anesthetic.  I  can 
not  find  where  any  bad  results  have  ever  fol- 
lowed the  employment  of  this  treatment  Cer- 
tam  it  is  that  a  number  of  advertisers  in  this 
country  are  doing  an  immense  business  in  this 
line  and  are  curing  their  patients,  I  cannot 
understand  why  the  rank  and  file  of  the  pro- 
fession are  so  slow  to  take  up  a  line  of  treatment 
which  promises  so  much,  particularly  when  it  is 
computed  that  there  are  four  ,millions  of  rup- 
tured people  in  the  land. 

Covington,  Ky.     W.  R.  Gillespie,  M.D., 


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THE  MEDICAL  WORLD. 


The  MeriU  of  Aoetanilid. 

Editor  Medical  World  : — In  Juoe  number, 
page  200,  Dr.  Boswell,  of  Imperial,  Neb.,  gives 
US  an  interesting  article  on  acetanilid.  I  con- 
eluded  to  come  to  his  assistance,  and  give  my 
experience  with  one  of  the  most  important  pre- 
parations of  the  coal  tar  (or  phenol)  series.  I 
am  of  the  same  opinion,  and  often  ask  why  our 
brothers  in  the  medical  profession,  could  con- 
demn so  valuable  a  preparation.  The  dangers 
produced  by  it,  that  appeared  so  often  in  these 
columns,  seems  to  be  almost  without  foundation. 

It  appears  to  me  that  the  great  secret  lies  in 
the  inexpensiveness  of  the  drug ;  if  it  would  cost 
fifty,  seventy-five  ceutsor  one  dollar  in  ounce,  our 
brothers  would  prescribe  it  more  readily.  Take 
some  of  the  other  expensive  preparations  under 
the  same  head ;  you  will  find  that  they  have  the 
same  section  and,  if  tested  properly,  are  not  as 
good  as  acetanilid. 

Several  years  ago,  while  in  Berlin,  Germany, 
X  had  occasion  to  buy  some  phenacetine,  one  of 
the  phenol  series.  What  did  I  pay  for  it? 
Eighteen  cents.  If  I  want  to  buy  it  in  my  own 
country  I  am  obliged  to  pay  seventy-five  cents 
to  one  dollar  an  ounce.  Germany  gives  pro 
tection  to  her  physicians  while  the  United  States 
does  not 

One  year  ago,  when  in  Washington,  D.  C, 
at  the  medical  congress,  twenty- five  representa- 
tives from  New  York  came  down  representing 
as  many  foreign  manufacturers,  telling  us  peo- 
ple how  to  fix  certain  drugs  and  allowing  them 
exclusive  right  and  patents.  That  is  why  we 
are  obliged  to  pay  enormous  sums  for  foreign 
drugs. 

Brothers,  what  we  want.is  better  medical  leg- 
islation in  the  United  States. 

I  give  acetanilid  the  credit  of  my  success  in 
starting  out  in  the  medical  profession.  Seven 
years  ago  a  family  was  stricken  with  scarlet 
fever.  The  mother  died  at  the  end  of  five  days. 
The  father  took  the  disease  a  few  days  later. 
When  I  was  called  in  I  found  a  temperature  of 
about  104^.  I  at  once  prescribed  acetanilid.  In 
two  hours  the  fever  came  down  to  102^  and 
staid  there.  A  day  afterward?  the  only  child, 
four  months  old,  also  took  the  disease,  with  a 
temperature  of  103}^.  I  gave  it  the  same 
medicine,  with  the  most  happy  results,  and  both 
got  well.  After  these  good  results,  I  am  using 
it  in  all  fevers.  Not  only  is  acetanilid  valuable 
in  fevers,  but  as  an  anodyne  it  is  most  valuable, 
having  no  disagreeable  efiect  on  the  stomach. 

In  nervous  headache,  rheumatism,  etc.,  it  is 
especially  valuable.  I  give  it  in  small  doses 
frequently  repeated.  I  have  now  been  using 
this  drug  for  a  little  over  seven  years,  and  never 
was  disappointed  nor  had  bad  results  from  its 


u)e.  Brothers,  I  urge  upon  you*  to  give 
tanilid  a  fair  trial.  You  will  not  only  suatain 
your  reputation  but  at  the  same  time  you  will 
save  money.  •    Dr.  A.  G.  Kbum, 

Lebanon,  Pa. 


Antipyretis.— Repliet. 

Editor  Medical  World  : — While  pertising 
the  interesting  pages  of  The  Worlo  I  was 
somewhat  amused  at  the  wide  difference  of  the 
opinions  of  Drs.  Borham  and  BoswelU — page 
200,  June  World — concerning  the  antipjredcsL 
I  think  Dr  Borham  goes  to  an  extreme  wheo 
he  says  in  speaking  of  the  coal-tar  derivatives; 
"I  have  found  them  in  sufficient  doses  to  be  dan- 
gerous and  in  smaller  doses  inoperative,  and  in 
the  diseases  of  children  almost  useless."  Dr. 
Boswell  says^  **l  have  prescribed  and  dispensed 
pounds  and  pounds  of  it  and  have  failed  to  ever 
see  any  of  the  fearful  efieots  we  are  told  it  pro- 
duces." ^ 

Now,  I  am  not  writing  to  critiaize,  bot  I 
think  if  Dr.  Boswell  will  try  some  of  the  new 
antipyretics  to  hold  the  fever  within  proper 
limits,  throughout  a  severe  case  of  typhoid  fever, 
he  will  notice^43ome  of  those  "fearful  effects.*' 
I  wish  simply  to  say  that  I  use  both  kinds  of 
antipyretics — coal-tar  derivitives,  and  aconite 
with  veratrum  viride.  When  I  am  called, to 
see  a  patient  and  he  has  a  fever  of  103,  4  or  5*^ 
and  a  splitting  headache,  I  could  not  give  my 
patient  anything  better  than  ten  grains  of  ace- 
tanilid, moistened  with  aromatic  spirits  of  am- 
monia. 

I  use  aconite,  veratrum  viride  and  cold  baths, 
one  or  all,  where  the  action  of  an  antipyretic 
is  to  be  maintained  for  several  dajs  or  weeks. 
In  other  cases  I  employ  the  new  antipyreticsL 
Isn't  that  a  good  plan,  Brothers? 

I  would  like  to  ask  Dr.  W.  G.  Abbott, — ^page 
208,  June  World,  case  third — ^if  be  made  a 
perfect  aqueous  solution  of  acoaitine  and  calomel! 

Dr.  Sam'l.  W.  Roberts,  page  19S,  gives  an 
account  of  a  case  of  malignant  diphtheria,  in  a 
very  healthy  and  clean  place  in  which  **qo 
measure  of  isolation  or  disinfection  were  taken  ^ 
and  this  was  the  first  and  only  case  that  ever 
occurred  in  that  neighborhood."  There  being 
several  children  in  the  family,  and  assuming  that 
.Dr.  Roberts  will  not  deny  that  the  diseaaa  is 
an  infectious  one,  the  question  comes  to  mv 
mind :     Was  it  a  case  of  diphtheria  f 

Doctor,  what  theory  do  you  offer  to  acooont 
for  the  phenomena  of  diphtheria  ? 

If  it  isn't  a  "bug,"  what  i§  it? 

Dr.  I.  W.  Cohen  (page  212),  remember  The 
Medical  World  is  growing  as  well  as  its  list 
of  subscribers.  Probably  Dr.  Mebring«  like  my- 
self hasn't  got  The  World  for  1890,  which 


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279 


gives  a  process  for  removiDg  carcinoma  without 
the  knife — I  wasnH  a  doctor  then  and  maybe 
Dr.  Mehring  wasn't  Think  what  a  big  thmg 
The  World  is.  E.  E.  Thomas,  M.D„ 

Horn  Hill,  Texas. 


Alkaloidaf  Medication. 

Editor  Medical  World: — [  note  with 
pleasure  the  manifestly  increasing  interest  in 
medication  with  the  activt^  principles,  as  evi- 
denced by  the  more  frequent  mention  of  the 
same  in  your  pages.  Dr.  Buckley  always  has 
something  good  to  say  and  his  article  in  your 
June  issue  on  Children's  Ailmeiits  dederves 
more  than  passing  notice. 

Dr.  G.  M.  Smith  details  what  appears  to  be 
his  first  experience  with  alkaloidal  granules, 
but  we  would  infer  from  his  success  that  it 
would  not  be  his  last  We  are  sure  the  doctor 
will  take  our  suggestion  kindly,  not  to  give  the 
granules  in  a  spoon  with  a  little  water  as  he 
did,  unless  there  is  some  spec  al  indication  call- 
ing for  the  method.  As  a  rule,  except  when 
omipletely  dissolved,  they  should  always  be 
placed  dry  on  the  tongue  and  washed  down 
with  pure  cold  water  or  some  other  bland  drink. 
By  so  doing  almost  all  taste  is  effectually  cov- 
ered, and  thid  is  not  one  of  the  lesser  advan- 
tages of  the  alkaloidal  method.  We  are  pleased 
to  note  Dr.  Smith's  success  with  zinc  sulpho- 
carbolate  in  typhoid  fever.  To  all  who  are  not, 
like  the  doctor,  well  posted  on  the  great  useful- 
ness of  this  salt,  we  will  say  that  one  of  the  best 
artidefl  we  have  seen  is  given  in  the  June  Alkor 
Undid  Clinic  by  Dr.  Shaller,  of  Cincinnati. 
(The  writer  of  this,  being  the  editor  of  the 
Clinicy  will  furnish  all  the  sample  copies  that 
may  be  desired. )  This  is  one  of  the  best  rem- 
edies for  the  various  and  troublesoma  derange- 
ments of  alimentary  decomposition  and  is  a 
timely  topic  at  this  season  of  the  year. 

W.  C.  Abbott,  M.D., 

2666  Commercial  Street,  Chicago,  111. 


of  our  fellow- men  is  one  of  the  inherent  rights 
of  humanity  "  reserved  to  the  people*"  and  with 
which  governments  have  no  moral  right  to  in- 
terfere. A  Cabinet  health  officer,  exerting  his 
energy^  in  a  proper  direction,  could  no  doubt 
accomplish  great  ^ood.  On  the  other  hand, 
V  such  officer,  if  injudicious,' might  inflict  on  the 
profession  and  the  country  lasting  injury. 

Such  officers  might  be  chosen  as  other  Cabinet 
officers  are— not  so  much  on  account  of  their 
fitness  for  the  place  as  for  their  political  influ- 
ence. Almost  every  day  we  see  in  the  conduct 
of  our  government,  both  State  and  National, 
men  of  honest  worth  and  moral  stamina  pushed 
aside  to  make  room  for  the  political  trickster, 
who  is  both  able  and  willing  to  sell  the  people's 
best  interests  for  political  or  individual  advan- 
tage. This  wickedness  is  already  apparent  in 
seme  medical  examining  boards.  None  will 
deny  that  the  health  officers  in  many,  if  not  all 
the  States,  are  doctors  that  have  a  'Apolitical 
pull/'  or  have  gained  their  prominence  by  a 
constant  stream  of  ''interviews"  in  the  secular 
press.  I  know  of  one  instance  where  one  of 
these  officers,  in  public  print,  assured  the  public 
that  a  certain  disease  prevalent  in  his  city  was 
not  scarlet  fever,  but  scarlatma. 

The  ablest  jurists  of  this  country Jiave  always 
held  the  right  of  expatriation  as  inviolable, 
either  by  the  State  or  National  governments. 
Our  government  has  never  deemed  it  judicious 
to  erect  legal  barriers  against'  those  citizens  who 
wish  to  remov^  from  one  State  to  another.  In 
fact,  the  Supreme  Court  of  the  United  States 
has,  time  and  again,  declared  that  no  State  has 
any  legal  right  to  enact  such  laws. 

There  is  more  than  one  side  to  the  question 
of  medical  censorship  by  political  methods,.and^ 
as  a  full  and  free  discussion  cannot  injure  the 
right,  I  would  like  to  see  the  pros  and  cons  set 
forth  in  The  Medical  World,  the  June  num- 
ber of  which  is  superlatively  good. 

St  John,  Wash.      Dr.  J.  W.  Lockhart, 


The  Important  Question  of  the  Regula  ion  of  the 
Praotice  of  Medicine. 

Editor  Medical  World: — Dr.  Line's  arti- 
cle in  the  June  number  suggests  a  query :  If 
the  States  have  a  constitutional  right  to  enact 
laws  regulating  the  practice  of  medicine,  as  they 
now  do,  by  what  authority  can  Congress  deprive 
them  of  that  right? 

If  reeulating  the  practice  of  medicine  by  the 
States  does  not  come  within  what  is  known  as 
tt»e  "  police  powers  of  the  State ; "  if  it  is  not 
one  of  the  rights  "  reserved  to  the  States  respect- 
ively," is  not  such  reglation  a  usurpation  of 
Federal  authority?  I  am  inclined  to  the  belief 
that  the  right  to  relieve  the  physical  sufferings 


8ome  Medical  Fallacies. 

Editor  Medical  World  : — When  one  reads 
of  the  incantations  of  the  medicine  man  of  the 
Indians,  of  the  witchcraft  of  oHen  times,  or  of 
the  decoctions  of  snake  skins,  spider  legs  and 
rats'  eyes,  of  the  Chinese  doctor,  one  is  tpt  to 
think  with  pity  of  the  infatuated  dupes  who  are 
taken  in  by  them. 

And  yet  how  much  better  or  wiser  are  the 
educated,  cultured  minds  of  to  day  !  I  propose 
to  look  for  a  few  moments  at  a  few  of  the  theo 
ries  which  we  are  asked  to  swallow  as  facts,  and 
which,  in  the  writer's  opinion,  should  be  sifted 
by  the  meshes  of  common  sense. 

I  know  we  are  told  that  what  is  foolishness 


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to  day  is  science  to-morrow.  We  are  told  that 
Harvey  and  Jenner  wiere  ridiculed  in  their  day ; 
but  we  are  not  ridiculing  these  wild  theories  of 
to-day.  Are  we  not  swallovdng  them  with  open 
mouths,  not  even  trying  them  hy  the  standard  of 
common  sense,  but  taking  it.  for  granted  that  by 
some  inexplicable,  unguessable  theory,  known 
laws  may  be  overthrown,  and,  in  fact,  expect- 
ing results  as  foolish  as  the  alchemist  of  old  ? 

It  is  not  neceesary  to  more  than  incidentally 
refer  to  the  foolish  vagaries  of  the  Christian 
scientists.  But  when  we  find  leading  lights  of 
the  homeopathic  school,  educated  men,  rushing 
in  to  print  with  the  account  of  having  cured  (?)  a 
case  of  tinea  sycosis  with  one  dose  of  the  two 
hundredth  dilution  of  sulphur,  or  of  having 
cured  a  case  of  sweating  feet  with  smelling  a 
few  times  of  the  two  hundredth  dilution  of  sugar 
of  lead,  or  collecting  pus  from  a  case  of  itch  on 
a  negro,  for  the  purpose  of  "  proving "  it,  it 
leads  us  lo  say,  "What  are  we  coming  to?" 
Now  to  the  main  issue — the  point  I  am  driv- 
ing at 

We  are  asked  by  men  "away  up"  in  the 
medical  profession  to  believe : 

Ist.  Extract  of  lambs'  testicles  will  make  a 
iban  young  again. 

2d.  Extract  of  bullock's  heart  will  cure  or- 
ganic heart  disease. 

3d.  Extract  of  sheep'is  brain  will  cure  epi- 
lepsy and  other  nervous  troubles. 

4th.  Extract  of  spinal  cord  will  cure  numer- 
ous diseases. 

5th.  The  application  of  a  d^  of  metal,  such 
as  iron,  copper,  gold,  will  cure  hemiplegia — 
sometimes ! 

6th.  Extract  of  kidney  will  cure  Bright's  dis- 
ease. 

I  will  take  up  these  absurd  propositions  by 
number,  and  will  premise  by  saying,  I  do  not 
condemn  all  of  the  so-called  animal  extracts,  for 
there  is  as  much  difference  between  giving  thy- 
roid extract  for  myxedema,  and  heart  extract  or 
cardine  for  heart  lesions,  as  there  would  be  be- 
tween giving  pepsin  for  digestive  troubles  and 
boiled  feathers  for  alopecia. 

Proposition  1st  They  say  it  doesv  good  in 
some  instances.  So  do  bread  pills.  What  con- 
dition must  a  man's  brain  be  in  for  him  to  in- 
vent the  experiment,  in  the  first  place  ?  I  should 
as  soon  expect  to  hear  of  lamb  penis  stew. 

2d.  As  soon  expect  "sheep's  trotters"  to  cure 
onychia,  or  bird  claws  to  cure  a  felon.  The  heart 
is  composed  of  animal  tissue  (muscular),  and 
has  a  mechanical  duty  to  perform,  and  why 
should  extract  of  hearc  affect  it  any  more  than 
extract  of  diaphragm  ? 

3d.  I  wonder  what  effect  extract  of  calves' 
brain  would  have  on  the  inventor.     In  the  old- 


fashioned  disease  of  rachitis  is  it  not  more  ra- 
tional to  give  the  chemical  constituents  of  bone, 
as  the  hypophosphites,  etc.,  than  it  would  be  to 
give  extract  of  bones  ? 

4th.     Is  there  not  danger  here  of  starting 
our  original  tails  to  grow  again  ?    If  not,  let  as 
^Wke  it  obligatory  on  our  senators,  etc.,  to  take 
daily  doses,  to  give  them  back-bone. 

5th.  "  Cases  of  writers'  cramp,  and  of  chorea, 
among  spasmodic  affections,  and  neuralgia,  have 
been  suddenly  cured  by  the  use  of  the  esthesio- 
genic  metal "  (Bartholow's  Materia  Medica,  6th 
ed.) ;  but  the  writer  adds,  p.  313,  "  but  failures 
are  greatly  more  frequent  than  the  sucoesses." 

I  have  the  greatest  respect  for  our  noble  Bar- 
tholow,  and  do  not  believe  he  would  use  thifr 
treatment  for  neuralgia,  etc.  But  let  us  never 
more  talk  of  homeopathic  vagaries,  while  our 
standard  authors  refer  to  such  "  stuff  "  except 
in  condemnation. 

The  above  was  prompted  by  reading  an  ex- 
cellent editorial  in  the  Lancet. 

One  more  fallacy,  and  I  will  close  this  already 
lengthy  article.  I  refer  to  the  theory  as  to  the 
use  and  origin  of  the  appendix  vermiformis. 

Flint's  Physiology  sensibly  says :  **  Tlie  use 
of  the  appendix  is  unknown."  Gray's  Anato- 
my more  positively  says  it  is  "  the  rudiment  of 
the  lengthened  cecum  found  in  all  mammalia, 
except  some  of  the  higher  apes  and  Che  wom- 
bat," but  says  nothing  of  its  use.  Others  go- 
farther,  and  say  it  is  the  remains  of  what  we 
had  formerly,  before  we  descended  from  apes. 
That  is  on  a  par  with  saying  the  hair  on  our 
heads  is  the  remains  or  rudiments  of  the  hair 
which  still  covers  our  forefathers,  the  apes. 

I  like  better  to  say,  "  And  God  inade  the 
beast  of  the  earth  after  his  kind,**  etc;  "8a 
God  created  man  in  his  own^mage,"  etc 

Now,  don't  think  I  want  to  get  into  a  theo* 
logical  argument  I  give  this  as  one  reason 
why  I  believe  the  appendix  is  an  organ,  with  & 
mission  to  fulfil;  and  that  sometime  some  man 
will  find  why  God  put  it  there,  as  they  have 
found  the  use  of  the  thyroid  gland. 

To  those  who  advocate  amputation  of  eveiy 
appendix  I  would  say,  with  a  recent  writer, '  It 
is  a  wonder  some  one  don't  discover  that  socfa 
men's  heads  are  the  useless  rudiments  of  a  onoe- 
needed  organ  in  our  forefathers,  the  apes." 

The  World  is  just  the  journal  to  let  light 
on  these  questions. 

Vemonia,  Ore         C.  H.  Newth,  M.D., 


Editor  Medical  World: — I  like  jour  joarnAl,. 
because  it  helps  me  in  every  waj — helps  me  in  mj 
own  cases,  and  gives  me  the  chance  to  help  some  other 
fellow  who  ne^s  it — and  who  is  it  that  does  not 
appreciate  a  good  thing,  with  or  without  sogar  ? 

Brodnaz,  La.  Ben  H.  Brodnax,  M.D. 


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281 


Diarrhea  in  Cliiidren.  ^ 

Editor  Medical  Wobld: — ^The  profession 
owes  Dr»  J.  J.  Taylor  lastiDg  praise  for  his  most 
-excellent  article  on  page  233,  June,  1892, 
WoRLD^his  formula  for  diarrhea.  We  sug- 
gest that  you  publish  it  every  summer  during 
Ths  World's  life.  I  feel  safe  in  saying  that 
in  my  hands  it  has  saved  dozens  of  lives.  We 
have  an  unusually  large  number  of  cases  of 
diarrhea  this  year,  and  all  respond  to  this  treat- 
inent     Long  .live-  Dr.  Taylor  I 

Woodstock,  Va.  W.  S.  Cline. 

[The  formula  is  as  follows : 

R.   Sab-nitimte  of  biimilth. drams  Iv 

PulTeilxed  nat-megs. 

Prepared  ohaU,  of  each drams  ij 

Solpho-carbolate  of  sine grains  xlj 

Sympof  idnger....... ounces  iij 

M.    UseshakelaSeL 

8.     One  ieaspoonftil  after  each  pasMge. 

This  makes  a  thick  mixture,  which  is  not  un- 
pleasant to  take.  If  syrup  be  not  desired,  use 
tincture  of  ginger  with  water  or  mucilage  of 
.acada  The  ^icylate  or  the  sub-gallate  of 
bismuth  is  a  good  substitute  for  the  sub-nitrate. 

As  we  have  so  often  stated  in  regard  to  med- 
ical knowledge,  we  did  not  originate  this  form- 
ula entirely.  Like  all  other  valuable  inform- 
ation, it  has  grown,  each  one  improving  it  accor- 
ding to  his  experience.  Dr.  Cline's  example 
should  be  more  generally  followed — ^that  of  re- 
porting successful  or  unsuccessful  experience 
with  methods  of  treatment  that  have  been  pub- 
lished. Sometime  we  should  like  to  publish  a 
-epedal  number  composed  entirely  of  confirma- 
tory experiences  with  facts  that  have  appeared 
in  The  World.  It  would  make  a  most  useful 
and  valuable  number. — J.  J.  T.] 


An  Obitetrio  Experience. 

Editor  Medical  World  : — I  have  a  case  of 
obstetrics  to  report  that  may  be  of  interest  to  the 
many  readers  of  The  World.  January  24th, 
was  called  at  4  p.  m.  to  see  Mrs.  8.,  age  36,  and 
the  mother  of  four  children.  I  found  the 
patient  suffering  from  la  grippe,  with  a  terrific 
cough  and  vomiting,  with  uterine  hemorrhage, 
aeven  months  and  a  half  gone  in  pregnancy. 
The  08  uteri  dilated  to  about  the  size  of  a  ten 
cent  piece.  I  gave  medicine  to  check  the  hem- 
orrhage. 

January  25th,  was  called  again — hemorrhage 
again.     I  gave  as  a  checking  powder : 

B.    Plnmbl  aoetaUi. gr.  xU 

pptt.  polT ^ gr.  vl 

Ipecac  pulT gr.  vl 

DfTlde  into  twelve  powden. 

fiig.   One.erery  hair  hour  tUl  hemorrhage  Btope. 

It  did  the  work.  I  was  called  again  on  the 
27th;  still  uterine  hemorrhage.  I  prescribed 
the  above  formula  with  good  results. 


On  the  10th  of  February,  I  was  called  again. . 
Still  found  uterine  hemorrhage.  On  the  9th 
of  March,  I  was  called  again  and  tound  patient 
in  labor.  Upon  examination  I  found  the  os 
dilated  and  a  spongey  substance  within.  I 
notified  the  husband  that  we  had  a  case  of 
placenta  previa ;  I  gave  ergot.  The  next  day 
at  two  o'clock  she  was  delivered  of  a  2i  lbs. 
child.  The  placenta  was  split  One-half  was 
lapped  over  the  child's  face ;  the  other  half  was 
attached  to  the  uterine  walls.  It  looked  smooth, 
as  if  it  had  been  split  with  a  knife.  She  made 
a  good  recovery,  and  the  child  is  doing  well. 

Ozark,  Ark.  J.  R  Dunn,  M.D., 


Respiratory  Inflammations  Treated  by  tlie  Fumes 
of  Aoetio  Acid  or  Red  Wine  Vinegar. 

Editor  Medical  World  :— I  have  read  in 
the  May  number  of  The  World  a  letter  from 
Mr.  £.  J.  Marsters,  mentioning  the  use  of 
fumes  of  acetic  add  in  consumption,  bronchitis 
and  other  respiratory  infiammations.  I  have 
been  using  tins  medication  since  1889  and  I 
have  always  obtained  very  good  results.  The 
remedy  was  suggested  to  me,  first  by  an  **old 
woman."     It  consisted  in : 

*'  To  boil  a  handful  of  hops  in  about  one  pint 
of  water ;  when  hot  and  steaming,  add  to  the 
miLsh  one  or  two  tablespoonfuls  of  strong  vine- 
gar, instruct  the  patient  to  place  his  face  over 
the  steaming  vessel,  covering  his  head  with  a 
laree  towel  or  table-cloth,  and  let  him  inhale 
ana  breathe  the  steam  freely." 

About  the  time  mentioned  above,  I  had  a 
patient,  a  woman,  in  the  last  stage  of  consump- 
tion, with  hectic  fever,  hemoptysis,  colliquative 
sweats  and  diarrhea,  and  my  only  successful 
way  to  relieve  her  was  by  atomizations  of  crea- 
sote  in  glycerine  by  means  of  a  Codman  & 
Shurtleff's  steam  atomizer. 

She  became  disgusted  with  the  creasote  ato- 
mizations and  I  knew  that  I  would  be  com- 
pelled to  let  her  die  without  any  more  relief  on 
this  account,  when  I  noticed  in  the  January 
number  of  The  Medical  World  (1889)  an 
article  on  '^acetic  acid  as  a  disinfectant"  I 
thought  then  I  would  try  to  use  it  in  place  of 
creasote,  but  as  my  poor  patient  was  tired  of 
atomizations,  I  determined  to  improve  (?)  the 
manner  of  administering  the  old  woman's  remedy. 
My  patient  grew  decidedly  better,  she  exper- 
ienced remarkable  relief  and  I  am  satisfied  I 
prolonged  her  life  and  made  her  considerably 
easier;  she  died,  anyhow,  about  two  months 
after. 

I  have  used  the  treatment  frequently  since, 
and  I  have  always  been  very  much  pleased 
with  it,  and  to  the  satisfaction  of  my  patients. 
This  is  my  way  of  operating ;  I  put  in  a  glass  re- 


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tort  about  eight  fld.  ounces  of  good,  strong,  red 
wine  vinegar.  The  retort  is  connected  by  a 
glass  tube  with  a  double  neck  bottle  (this  bot- 
tle is  a  part  of  a  Bergeon's  apparatus  I  had 
bought  about  about  two  years  before!)  filled 
one-half  or  three-quarters  with  a  fresh  hot  mush 
— not  too  thick— of  hops  and  strongly  acidulated 
water.  The  tube  coming  from  the  retort  nearly 
touches  the  bottom  of  the  bottle  and  I  insert  in 


several  weeks  with  Dr.  Green  to  study  his 
special  treatment  and  perfect  himself  in  the 
technique  of  the  operation.  After  returning 
home  he  opened  an  office  and  treated  several 
patients  by  this  method.  I  remember  of  hear- 
ing of  several  cures  that  he  made  and  others 
benefitted  by  the  treatment  Dr.  Miller  died  a 
few  J  ears  after  this.  I  do  not  think  this  treat- 
ment   became    popular  with  the  New   York 


^c- 


the  other  neck  of  the  bottle  a  bended  lube  pass- 
ing through  the  cork  about  one  inch  into  the 
bottle;  my  apparatus  is  then  ready.  In  placing 
an  alcohol  lamp  under  the  bottom  of  the  retort, 
the  fumes  of  the  vinegar  are  generated ;  they 
pass  through  the  hot  hop  mush  and  are  breathed, 
as  warm  as  possible,  by  the  patient.  Hops, 
may  be  probably  omitted  or  replaced  by  other 
aromatic  or  sedative. 

This  treatment  always  affords  great  relief  in 
sore  throat,  tonsillitis,  coughs,  asthma,  dyspnea, 
hemoptysis,  etc.,  etc. 

I  have  also  employed  successfully,  in  cases  of 
la  grippe,  the  simple  method  suggested  by  the 
old  woman. 

Red  vrine  vinegar  is  by  far  the  best  to  be 
employed,  probably  on  account  of  the  astring- 
ency  of  the  tannin.     Dr.  H.  P.  Montborne, 

Spokane,  Wash. 


doctors  and  very  little  was  said  of  it,  outside 
the  newspapers  and  laity. 

Salisbury,  Mo.       C.  A.  Jennings,  M.D., 


Dr.  Green's  Treatment  of  Bronchial  Affections. 

Editor  Medical  World: — In  answer  to 
Dr.  J.  R.  Thompson,  of  Woodburn,  Ky.,  I 
will  say  that  I  was  living  in  Virginia  in  the 
year  1856,  before  graduation  in  medicine.  At 
that  time  Dr.  Howard  Green,  of  New  York 
City,  had  acquired  quite  a  reputation  in  the 
treatment  of  chronic  bronchitis  and  incipient 
tuberculosis  by  the  injection  of  a  solution  of 
nitrate  of  silver  (strength  not  known)  through 
a  rubber  tube  into  the  larynx  or,  as  some  said, 
into  the  bronchial  tubes.  I  remember  that  a 
practising  physician  of  our  county.  Dr.  Thomas 
H.  Miller,  went  on  to  New  York  and  remained 


Periodic  Headacbet. 

Editor  Medical  World: — Some  time  since, 
I  called  attention  to  an  article  published  in  The 
World,  in  regard  to  Haig's  uric  acid  theory  of 
periodic  headaches,  trusting  that  the  attention  of 
physicians  might  be  called  to  this  subject  and 
more  light  gleaned  to  guide  us  in  the  future. 

In  tins  paper  I  shall  only  attempt  giving  a 
few  of  the  symptoms  attending  these  headadiea 
and  an  outline  of  the  treatment  which  I  have 
pursued,  with,  at  least,  a  fair  degree  of  success ; 
some  of  my  patients  having  been  relieved  per- 
manently, others  for  many  months  and  some  of 
them  for  years,  to  become  sufferers  again  on  a 
return  to  an  unwholesome  diet,  as  a  too  free  use 
of  nitrogenous  food,  or  the  use  of  wines,  and 
malt  or  other  spiritous  liquors. 

While  I  do  not  believe  all  cases  of  periodic 
headaches  result  from  a  lithemic  condition,  yet, 
in  my  opinion,  this  is  largely  the  case. 

On  inquiry  we  find  that,  previous  to  an  attack, 
the  urine  is  clear,  more  copious  and  of  lighter 
specific  qravity  than  normal,  but  during,  and 
immediately  after  an  attack,  it  becomes  darker, 
is  of  lighter  specific  gravity  and  deposits,  on 
standing,  a  brown  or  reddish  sediment,  leaving 
a  stain  on  the  bottom  of  the  vessel  that  is  diffi* 
cult  of  removal.  It  is  also  abnormally  acid* 
The  patient  is  irritable,  despondent  and  com- 
plains of  lassitude  and  weariness.     The  tongue 


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is  coated,  akin  sallow  and  bowels  constipated. 
There  are  eructations  of  gas,  with  other  evid- 
ences of  faulty  digestion.  The  heart's  action  is 
irregular  and  irritable.  Patient  complains  of 
rheumatic  pains  in  the  pectoral,  intercostal  and 
cervical  muscles,  also  in  the  occtpito-frontalis 
and  the  joints.  In  my  opinion  these  attacks 
oftt  n  take  the  place  of  a  headache.  I  have  had 
two  such  cases  within  the  last  few  months,  that 
have  suffered,  one  from  a  rheumatic  attack  of 
the  shoulder  joint,  and  the  other  of  the  hip,  the 
latter  winding  up  with  a  headache  of  several 
hours  duration. 
Treatment ;  during  the  paroxysm,  if  light ; 

R,     Pbenacettne - vn  5 

Bromide  of  potauium gn.  10 

To  be  given  at  a  dose  and  repeated  every  hour 
until  relief  is  obtained,  or  three  or  four  doses 
have  been  taken.  If  the  attack  be  severe,  the 
extremities  will  be  cold,  when  a  hot  foot  bath, 
with  plenty  of  mustard,  continued  for  twenty 
five  or  thirty  minutes,  the  bath  being  kept  hot 
by  the  frequent  additions  of  hot  water,  will  be 
found  useful.  If  the  hands  be  immersed  in  Lot 
water,  at  the  same  time,  the  effect  will  be 
heightened.  If  the  coal  tar  preparations  are 
given,  special  attention  must  be  paid  to  the 
heart's  action,  as  many  patients  will  not  tolerate 
them,  and  a  dangerous  cyanosis  may  be  brought 
on.  Phenacetine,  in  my  opinion,  is  the  least 
depressing.  Next  to  this,  I  prefer  the  acetanilid. 
If  the  patient  is  restless,  the  pupils  contracted 
and  the  pain  pretty  general  over  the  head,  ten 
drops  of  the  tincture  of  gelseminm  (green)  with 
twenty  or  thirty  drops  specific  passi  flora,  every 
hour,  but  with  only  half  the  quantity  of  gelse- 
minm after  the  first  dose,  will  often  give  prompt 
relief.  If  there  be  nausea  or  vomiting,  wash 
oat  the  stomach  with  water  as  hot  as  can  well 
be  taken,  adding,  if  necessary,  a  few  drops  of  fl. 
ext  ipecac.  Should  the  above  treatment  prove  in- 
effideni,  as  it  sometimes  will,  especially  if  not 
begun  early,  it  only  remains  for  us  to  give  relief 
by  a  hypodermic  injection  of  morphine. 

The  treatment  between  paroxysms  will  be 
largely,  but  not  exclusively,  dietetic.  There  is 
invariably  faulty  digestion,  but  no  rigid  coune 
of  diet  can  be  adhered  to  in  all  cases.  Tempera- 
ment, habits  and  surrounding  conditions  must 
be  taken  into  consideration.  Foods  that  are 
easily  digested  and  assimilated,  consisting  largely 
of  non-nitrogenous  substances,  must  be.  chosen. 
Toast  with  milk,  Graham  mush,  eaten  with 
en  am  and  a  little  pure  white  sugar — ^though 
little  saccharine  matter  should  be  allowed — with 
such  vegetables  as  are  found  to  agree,  and  as 
digesdon  improves,  small  quantities  of  fish  and 
soft  boiled  or  poached  egg  may  be  taken. 
Every  thing  eaten  should  be  properly  cooked, 


and  no  fried  food  of  any  kind^  should  be  taken 
into  the  stomach.  Avoid  all  sweet  meats,  pas- 
tries, pies,  gravies,  pork,  desserts,  malt  liquor^, 
sweet  wines,— usually  all  alcoholic  stimulants. 

A  warm  sponge  bath,  containing  chloride  of 
soda  should  be  taken  every  day  or  every  second 
day,  followed  by  a  thorough  rubbing,  with  a 
moderately  coarse  towel.  If  convenient,  the 
shower  or  tub  bath  may  be  substituted  for  the 
above,  with  advantage.  Systematic  massage  is 
most  excellent 

Medicine  s :  If  the  tongue  is  coated  and  bowels 
con^ipated,  i  begin  treatment  by  giving  ^vq  ^ . 
grains  of  triturated  calomel  (one  to  five),  and  * 
one  grain  of  triturated  podophyllin  (one  to  five),  ^ 
every  three  hours  until  bowels  move  or  three 
doses  of  the  mixture  are  taken,  following  the 
last  powder,  in  two  or  three  hours,  with  a  small 
dose  of  effervescing  sulpL  of  magnesia,  provided 
there  is  not  free  action  from  the  bowels.  To 
regulate  the  bowels  and  excite  the  liver  to 
healthy  action,  give  one  granule  (i  grain)  of 
podophyllin,  with  two  granules  (^2  gr^^i^)  of 
aloin,  at  bed  time,  to  be  followed  on  rising, 
next  morning  with  a  heaping  teaspoonful  of 
eff.  sulph  magnesia,  in  i  to  i  glass  of  cold  water. 
This  may  be  administered  daily  until  the  bowels 
become  regular,  then  gradually  omitted,  giving 
every  second  or  third  day  or  less  frequently 
until  no  longer  required,  using  in  the  meantime 
such  dietary  as  will  conduce  to  a  regular  condi- 
tion of  the  bowels. 

Remedies  which  improve  digestion  and  give 
tone  to  tie  digestive  organs  will  be  foun  ^  use- 
ful, as  gentian,  wahoo,  wafer  ash,  or  nux 
vomica,  before  meals,  followed  by  an  after  meal 
dose  of  some  reliable  preparation  of  pepsin.  If 
the  pepsin  be  given  in  maltine,  plain,  better  re- 
sults may  be  secured.  A  favorite  remeiy  with 
me  is  the  pepsin  and  wafer  aeh,  in  which  gly- 
cerine is  used  as  the  vehicle.  Three  granules 
(^  grain)  of  quasseine  with  one  or  two  granules 
(tIt  &^^)  of  arseniate  of  strychnine,  is  also  a 
favorite  prescripiion. 

These  remedies  should  be  given  before  meals. 
If  acids  are  indicated  I  prescribe  the  hydro- 
chloric. I  have  not  tried  the  nitro- muriatic 
acid  in  these  cases.  I  have  eometimes  found 
Howe's  acid  solution  of  iron  to  act  remarkably 
well,  improving  digestion  and  toning  up  the 
system  generally.  Alternated  with  Fowler's 
solution  of  arsenic,  each  to  be  given  in  four 
drop  doses,  the  latter  before  meals  and  the  for- 
mer between  meals  and  at  bedtime,  will  often 
give  the  best  results. 

But  we  must  clear  out  the  abnormal  quantity 
of  uric  acid.  Acetate  of  potash,  salicylate  of  soda, 
and  the  preparations  of  lithia  ar^  among  our 
best  remedies.     The  acetate  of  potash  is  apt  to 


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THB  MEDICAL  WORLD. 


disagree  with  the  stomach.  A  three  grain  tab- 
let of  dtrate  of  lithia  (prepared  hy  W.  R. 
Warher  &  Co.)  is  Dot  unpleasant  and  with  me 
has  proven  quite  efficient.  I  order  one  tablet 
four  or  five  times  a  day  dissolved  in  a  glais  of 
water,  to  be  taken  while  effervescing. 

The  length  of  mj  paper  admonishes  me  that 
I  am  calling  for  more  than  mj  share  of  space 
in  one  of  the  best  medical  journals  published. 

In  conclusion  let  me  urge  the  necessity  of 
securing  normal  digestion  and  proper  assimila- 
tion of  food.  W.  B.  Squire,  M.D., 
\^    Worthington,  Ind. 


The  Morphine  Habit 

(Conduded  from  July  World.) 

Editor  Medical  World: — ^At  the  begin- 
ning of  treatment  every  patient  is  placed  on  the 
uie  of  an  alkaline  water,  containing  potassium 
bromide,  carbonate  and  acetate,  the  proportions 
varying  with  the  case.  The  urine  is  kept  slight- 
ly alkfdine,  the  kidneys  active,  and  the  nerves 
sedated,  by  the  three  salts  named.  The  bowels 
are  cleared  out  by  cathartics,  and  the  result  of 
this  is  sometimes  surprising  to  the  patient,  as 
well  as  to  his  attendants. 

These  preliminaries  being .  attended  to,  the 
physician's  duty  is  to  watch  the  reduction,  and 
note  whether  the  symptoms  are  due  only  to  it  or 
to  underlying  disease  uncovered  by  the  removal 
of  the  morplmie.  All  emergencies  arising  must 
be  treated  without  opium,  tUs  drug  being  blot- 
ted out  of  the  patient's  materia  medica  for  all 
time  to  come.  Weakness  of  the  heart  demands 
the  liberal  use  of  sparteine ;  neuralgia  requires 
heat  and  the  anti-nervine  powders  (acetanilide, 
ammonium  bromide  and  sodium  salicylate). 
Nausea  or  diarrhea  are  best  treated  by  the  ox- 
ides of  zinc  and  silver,  biembth  and  oxalate  of 
cerium.  Aching  of  the  bones  and  muscles,  par- 
ticularly of  the  knees,  is  greatly  relieved  by  the 
salicylates,  and  by  hot  or  cold  water.  Faradism 
and  the  galvanic  current  are  also  of  value  in 
some  cases,  to  relieve  the  pains  until  the  proba- 
tionary period  is  past  To  reduce  the  severity 
of  withdrawal  symptoms  the  hot  bath  is  of  the 
utmost  value.  The  hotter  the  water,  the  greater 
is  the  relief.  The  patient  may  spend  hours  in 
the  tub  if  he  so  desires,  and  return  to  it  when- 
ever he  pleases.  Hypodermics  of  water,  hot  or 
cold,  or  of  chloroform  water,  as  near  the  seats 
of  pain  as  possible,  often  give  relief,  but  should 
only  be  used  with  the  patient's  knowledge,  as 
deceit,  once  detected,  ruins  the  physician's  influ- 
ence. Excessive  doses  of  bromides  cause  a  very 
offensive  breath  and  injure  the  digestion.  Hy- 
drobromic  add  ftometimes  answers  a  good  pur- 
pose, in  doees  up  to  half  an  ounce.     For  insom- 


nia, some  do  well  on  trional,  while  others  sleep- 
better  on  sulfonaL  The  large  doses  sometimes- 
fail  when  moderate  ones  succeed. 

The  secret  of  success  is  sedation.  The  nerves^ 
released  from  the  paralyzing  effects  of  morphine, 
react  sometimes  with  violence.  Hyperesthesia 
is  the  rule,. and  little  bumps  give  rise  to  com- 
plaints of  paiif,  that  are  not  altogether  imagin- 
ary or  asBumeld  for  a  purpose.  The  speoal 
senses  are  acutely  sensitive.  I  have  given  an- 
timony, aconite,  veratrum  and  apomorpluDe 
with  advantage.  The  latter  is  a  specific  for 
removing  the  desire  for  tobacco.  But  the  drog^ 
that  best  replaces  morphine  is  eeerine,  or  phy- 
sostigmine  salicylate.  This  contracts  the  pupO, 
acts  as  a  sedative,  but  is  a  tonic  to  the  muscular 
fibers  of  the  intestinal  canal,  and  to  the  heart 
It  was  for  these  reasons  that  I  first  administered 
it  to  a  morphine  case,  and  unexpectedly  lound 
that  it  produces  the  sense  of  comfort,  euphoria, 
fully  eqvMly  or  even  superior,  to  thai  of  mor- 
phine. 

This  alkaloid  is  derived  from  the  physostigma 
venenosumi  the  ordeal  bean  of  Calabar.  Fhj- 
sostigmine  depresses  the  motor  functions  of  the 
spinal  cord,  in  large  doses  depressing  the  nootor 
nerve- ends  also,  and  even  the  sensory.  It  stim*- 
ulates  involuntary  muscular  fiber,  increasingp 
the  peristaltic  action  of  the  bowels,  and  raising 
the  arterial  tension,  while  slowing  the  pulse.  It 
contracts  the  pupil  and  decreases  intra-ocular 
tension.  When  the  morphine  had  been  redaced 
in  one  of  my  cases  to  i  gr.  per  day,  the  symp- 
toms presented  were :  Abnormal  irritability  o£ 
the  brain  and  cord,  hyperesthesia,  motor  rest* 
lessness,  weakness  of  the  pulse,  giving  the  seo- 
sation  of  half-filled  arteries,  mobUe  pupils,  tend- 
ing to  dilate ;  lack  of  tone  to  the  stomach  and 
bowels,  and  the  bladder  as  welL  This  condition 
seemed  to  indicate  the  use  of  physostigmine,  and 
I  gave  jj^  grain  hypodermically.  Not  only 
did  it  relievethe  condition  present,  but  it  pro- 
duced euphoria ;  the  patient  insisting  that  I  had 
given  him  morphine  in  a  larger  dose  than  tt 
the  preceding  injection.  This  result  has  fol- 
lowed every  dose  of  the  drug  I  have  since  given* 
The  relief  is  complete  for  the  time  being.  It 
does  not  last  as  long  as  that  of  morphine.  I  am 
not  able  as  yet  to  say  how  often  it  should  be 
given,  or  to  what  extent  the  dose  may  be  in* 
creased,  because  in  every  case  thus  far  treated 
by  me  the  patient  has  been  able  in  a  few  daya 
to  throw  off  the  habit,  and  do  without  either 
morphine  or  the  substitute.  '  And  I  am  firmlj 
convinced  that  nothing  will  enable  a  man  to 
adhere  to  his  resolution,  and  make  the  cure 
permanent,  like  the  ennobling  consdousness  that 
he  has  fought  his  battle  and  won  it  "  Reoit 
the  devil  and  he  will  flee  from  you."     Set  year 


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foot  on  his  neck  and  his  power  over  you  is  bro- 
ken. Henceforth  the  demon  may  come  as  a 
siren  to  seduce  jou,  but  never  as  a  relentlefs 
Arrant  to  master  you  by  force. 

From  the  time  the  victory  is  won  I  employ 
every  effort  to  confirm  in  my  patients  the  moral 
force.  The  pride  of  manhood  in  its  strength  is 
aroosed  by  gymnastic  exercises,  feats  of  strength 
and  field  sports,  whenever  possible.  The  moral 
force  is  strengthened  by  urging  the  man  to  face 
unpleasant  things.  Morphmomaniacs  are  luxu- 
ry-loving weaklings,  phydcal  cowards,  moral 
shirks.  I  will  make  them  plunge  into  a  tub  of 
ice-cold  water,  and  when  they  learn  to  do  this, 
and  to  enjoy  the  shock,  as  they  do  in  a  few 
days,  I  feel  sure  of  the  cure.  A  man  cannot 
help  respecting  himself  better  when  he  marches 
into  the  cold  tub  resolutely,  when  he  has  never 
before  in  his  life  done  sudh  a  thing.  The  first 
letter  received  when  my  patients  return  io  their 
homes  is  pretty  sure  to  tell  of  the  tank  being 
put  up. 

When  the  morphine  has  been  wholly  with- 
held for  twenty- four  to  thirty  hours,  in  those 
deeply  sunk  under  its  influence,  the  suffering 
may  be  severe.  I  then  give  one  dose  of  mor- 
phine, i  to  i  grain;  the  patient  has  a  good 
sleep,  and  awakes  free.  In  milder  cases  this 
sleep  comes  without  morphine ;  but  in  all,  when 
the  marked  abstinence  symptoms  have  endured 
for  forty- eight  hours,  the  crisis  is  past  and  the 
battle  won.  A  return  of  the  symptoms  is  then 
only  likely  after  exposure  to  cold  or  wet,  or  to 
work ;  the  likelihood  to  such  return  decreasing 
rapidly. 

The  after  treatment  consists  in  such  measures 
as  are  required  by  each  case.  Every  underly- 
ing disease  is  studied  and  treated  on  the  best 
systems.  Nerve  degeneration  and  the  neurotic 
ccmdition  require  massage,  electricity,  systematic 
feeding,  inunctions  of  oils,  carefully  graduated 
exercises,  and  the  use  of  the  drugs  we  have 
learned  to  classify  as  nerve  foods — phosphorus, 
arsenic,  quinine,  iron  and  strychnine.  Fellows' 
syrup  and  hydroleine  are  preparations  I  am 
never  without,  and  give  to  every  case  during 
convalescence.  Neuralgics  always  take  the  fol- 
lowing : 

B.   PhosphoiL gr.  Ji 

Add  anexilofi^ gr.J 

Btnrchnlns  solpb gr.  m— 1 

QidDin  folplL^ dram  i 

vel 

Ferrl  carb.  tacoh diam  J 

H.    et  In  pil.  na  zz  diy. 
&     1  three  Umes  dail]r. 

This  is  repeated  in  one  or  two  weeks  without 
the  phosphorus. 

For  the  paroxysms  they  take : 

R.  AcetanlUd.... 

Sodli  laUof  lat.  (Schering's) 

AjDmonli  bromld. aa diam  i 

M.  niT.  in  ohart.  no.  zlj. 

8.    1  eTez7  hour  or  two  for  pain. 


There  is  not  much  need  of  appetizers ;  during 
the  four  weeks'  reconstruction  they  have  a  rav- 
enous appetite,  and  get  fat  Pepsin  and  malt 
extract  are  employed  at  first,  with  hydrochloric 
acid,  until  the  digestive  power  catches  up  witb. 
the  demand. 

I  have  said  that  unless  a  man  wants  to  be 
cured  there  is  little  use  in  making  the  attempt. 
Sometimes  a  patient  comes  at  the  solicitation  of 
relatives — a  broken-hearted  mother,  perhaps. 
He  goes  through  the  course,  is  completely  re- 
lieved of  his  habit,  put  in  excellent  physical 
condition,  and  immediately  goes  back  to  the 
morphine;  not  because  he  has  any  reason,  or 
even  excuse,  but  because  his  moral  nature  is 
completely  depraved  by  the  habit.  He  is  ne 
longer  compos  mentis,  and  the  only  hope  is  in  i^ 
prolonged  confinement  in  an  insane  asylum. 
By  years  of  abstinence,  with  suitable  recon- 
structive treatment,  the  d^eneration  of  nerve 
tissue  may  be  stayed,  and  a  fair  recovery  made^ 
enabling  him  to  resume  his  place  in  society. 
Without  this  he  is  doomed.  He  is  as  surely  in* 
sane  as  any  maniac 

There  are  numerous  devises  by  which  the 
suffering  can  be  reduced,  so  that  I  have  repeat- 
edly been  told  by  my  patients  that  they  had  not 
experienced  anything  meriting  the  name  of  pain. 
The  greatest  suffering  is  due  to  the  apprehension* 
of  death,  and  this  requires  the  quiet  assurance 
of  the  trusted  physician.  As  treated  at  a  sana- 
torium, the  severer  "withdrawal  symptoms  are 
over  in  twenty- four  houis;  and  when  a  patient 
has  been  that  long  without  the  drug  he  is  past 
the  crisis,  and  commences  to  pluck  up  courage. 
It  is  the  rule  then  for  him  to  urge  that  he  be 
given  no  more  morphine— that  he  will  take  ne- 
more,  let  the  consequences  be  what  they  may  ; 
and  this  is  perfectly  sincere.  From  this  time 
on  the  feeling  of  rejuvenation,  as  the  currents* 
of  life  begin  to  flow  once  more  in  their  old  chan- 
nels, imparts  a  delightful  sense  of  returning 
vigor,  of  freedom,  youthful  buoyancy,  resem- 
bling the  sensatioDS  of  one  released  from  lon^ 
imprisonment  In  the  whole  range  of  medical 
practice  I  have  found  nothing  so  fascinating  a» 
this  releasing  of  the  body  from  bondage,  rescu- 
ing the  soul  from  perdition. 

In  placing  before  the  profession  my  new  rem- 
edy I  do  so  with  profound  misgivings.  I  dread 
lest  it  may  be  seized  upon  as  the  agent  of  a  new- 
drug  habit.  I  know  it  will  be  used  to  accom- 
plish that  impossible  task — curing  a  doctor  ot 
morphinism  while  he  is  attending  to  his  prac- 
tice. It  will  be  employed  also  improperly^ 
while  the  patient  is  still  taking  morphine,  or 
without  the  use  of  the  system  to  which  it  is  only 
an  accessory.  And  from  these  causes  its  use- 
will  be  disappointing  to  many.     But  to  those 


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D\rho  will  use  it  in  the  manner  I  have  indicated, 
I  truBt  that  eserine  (phjsostigmine  salicylate) 
will  prove  a  valuable  addition  to  the  therapeu- 
tics of  morphinomania. 

William  F.  Waugh,  M.D., 
103  State  St,  Chicago. 

Pointless  Pointers, 

Editor  Medical  World: — In  the  July 
World  Dr.  A.  C.  Matchette  asked  help  in  a 
•case  of  pruritus  vulvae. 

I  suggested  in  a  letter  that  he  use  salicylate 
of  sodium,  grs.  viij  every  two  hours,  six  doses 
each  day  for  two  days,  and  then  grs.  iv  every 
two  hours  the  succeeding  two  days 

I  just  received  a  letter  from  Dr.  M.,  in  which 
he  says :  "  Your  B  is  a  dandy,  indeed,  and 
works  like  a  charm,  if  only  permanent." 

Of  course,  pruritus  is  a  neurosis,  and  the 
probable  cause  of  it  is  uric  add.  His  patient, 
he  said,  was  subject  to  attacks  of  neuralgia  and 
rheumatis]^. 

Recently  I  had  a  case  of  urticaria  or  "  bold 
hives."  I  used  all  the  usual  remedies,  and 
eome  unusual  ones,  and  my  patient  still  returned 
with  the  same  s  ory — "only  temporary  relief." 

There  was  an  element  of  periodicity  in  the 
disease,  as  she  was  worse  each  evening  about 
fi^e  o'clock.  I  prescribed  cinchonidia  sulpL, 
which  gave  her  some  relief.  That  caused  me  to 
f  think  it  a  neurosis,  and  I  gave  her  the  salicyl- 
ate of  Eodium,  as  above,  and  she  was  relieved  at 
once. 

I  think  I  can  cure  a  case  of  acute  articular 
rheumatism  as  readily  with  salicylate  of  sodium 
as  I  can  an  intermittent  fever  with  quinine.  I 
prescribe  Squibb's  preparation. 

In  Vol.  L,  fourth  series  of  the  International 
Clinics,  there  is  a  lecture  on  the  treatment  of 
rheumatism,  by  A.  Earnest  Sansom,  M.D.  His 
treatment  is  xx  gr.  doses  of  the  salicylate  every 
flix  hours  until  six  doaes  are  taken.  He  says 
that  in  some  cases  the  remedy  aSects  the  heart 
unfavorably.  I  would  expect  that  when  such 
large  doses  are  exhibited.  It  will  more  fre- 
<iuently  affect  the  stomach,  and  a  suspension  of 
the  treatment  is  neoessary,  and  valuable  time 
will  be  lost  I  had  used  the  salicylate  for  years, 
but  empirically.  I  gave  it  because  others  said 
it  was  "  good  for  rheumatism." 

Nearly  two  years  ago  Prof.  R  H.  Babcock, 
of  Chicago,  asked  me  if  I  had  read  Alexander 
Haig  on  "  Uric  Acid." 

I  said  "  No,"  and  he  remarked,  "  It  is  a  good 
thing ;  get  it  and  read  it"  I  did  so,  and  now 
I  can  "give  a  reason  for  the  hope  that  is  with- 
in me." 

I  would  advise  every  reader  of  The  World 
who  has  not  read  it  to  purchase  it,  and  read  it 


over  and  over  again.  To  me  it  is  more  inter- 
esting than  "  Ships  that  Pass  in  the  Night."  and 
far  more  useful  to  the  physician.  You  will  not 
need  any  novels  to  interest  you  these  hot  days 
until  you  have  read  that  book  twice,  at  least 
You  can  get  it  for  $2.40,  net 

Recently  I  have  been  using  sulpho-earbolate 
of  zinc  for  fermentative  diarrhea  (and  nearly 
all  diarrheas  are  from  that  cause),  with  good 
results.  I  saw  it  recommended  in  cases  of  ty- 
phoid fever,  and  concluded  that,  if  good  in  the 
diarrhea  of  typhoid  fever,  it  would  be  good  for 
the  "Army  Quick  Step,"  from  which  I  have 
been  a  sufierer  since  1862. 

The  diarrhea  unfitted  me  for  active  work  du- 
ring the  hot  season,  and  last  year  I  thought  it 
was  going  to  "  muster  me  out,"  but  thanks  to 
sulpha  carbolate  of  zinc,  grs.  iv  after  each  meal, 
I  am  "about  as  good  as  new."  I  use  Metric 
Granule  Q)/s  1  gr.  tablets,  because  they  are 
convenient  Now,  the  time  of  summer  complaint 
is  at  hand.  Remember,  it  is  always  ferm^nia- 
live.  Causation:  heaJt,  overfeeding,  improper 
feeding. 

I  first  give  small  doses'  of  Rochelle  salt  in  the 
water  the  patients  drink ;  then — 

R.   Nux  Yomloa  tr gtt  x  (Lloyd's) 

AocJnlte  tr „ grtx       •• 

Syrujx. diamsi 

H.    Slg  — Drops  20,  eyeiy  boar  unUl  better. 

Stop  feeding,  as  far  as  possible ;  give  water 
in  small  quantities  frequently;  feed  malted 
milk  or  diluted  sweet  cream,  one  part  to  ten  of 
warm  water,  sweetened  with  sugar  of  milk  or 
coarse  granulated  sugar,  as  it  is  the  purest  form 
of  sugar. 

In  cases  of  cholera  infantum  add  to  this  2  gr. 
doses  of  subgallate  of  bismuth  every  two  hours. 
The  latter  is  Eold  under  the  name  of  "  derma- 
tol"  most  generally.  It  is  a  most  excellent 
antiferment  It  is  more  pleasant  to  the  taste 
than  the  zinc. 

Professor  Waugh  is  an  interesting  writer,  but 
I  cannot  get  the  results  from  metric  granules 
that  he  claims. 

I  bought  an  outfit,  but  I  went  back  to  Lloyd's 
specific  tinctures  because  I  understood  them 
best,  and  got  the  desired  results. 

I.  B.  Washburn,  M.D., 

Rensselaer,  Ind. 

[In  regard  to  the  above  we  will  state  that  we 
have  found  Schering's  salicylic  acid  and  salicyl- 
ate of  sodium  to  be  especially  pure. — Ed.] 

Editor  Medical  World  :— The  Medical  Wobld 
binders  to  hand  aad  volumes  bound.  Thaoki.  Be- 
sides making  a  handsome  addition  to  the  librarjt 
they  make  it  so  convenient  when  referring  to  the 
journals,  I  would  not  be  without  them  now  for  many 
times  their  cost.  W.  J.  OooPXB,  M.D., 

Crockett,  Miss. 


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2SJ' 


Corn*.—  Wen*.— Warto.—  Gall  Stonea.—  Prurltua 
Vulvn.— Aone  Rosacea. 

Editor  Medical  World  : — For  corns  there 
is  Dothing  better  than  the  following : 

R.   Salicylic  acid gn  xxx 

Ext.  cannabis  indlca. gr  x 

Collodion^ «« f  aramsiT 

Paint  on  com  night  and  morning  for  six  days; 
at  the  end  of  this  time  soak  fett  in  hot  water, 
and  remove  com  with  thumb  nail  or  dull  knife. 
Keep  tightly  corked.  If  it  should  become 
solid  add  a  few  drops  of  sulph.  ether. 

For  the  wen,  there  is  no  easier  method  of  re- 
moval than  to  make  an  incision  and  lift  it  out 
You  can  do  this  without  pain,  by  injecting  co- 
caine under  the  skin  in  several  points  over  the 
tumor. 

The  warts  can  be  removed  by  applying  a  sat- 
urated alcoholic  solution  of  salycilic  acid. 

For  removing  soot  from  an  old  scar — well,  I 
never  bad  but  one  such  case,  and  I  removed  it 
by  blistering.  There  may  be  better  methods. 
The  com  mixture  in  this  a^rticle,  less  the  can- 
nabis, I  think,  will  remove  it  if  applied  long 
enough. 

W.  Walter  Tison,  M.D.:  Give  your  patient 
sodium  phosphate  for  months.  Your  diagnosis 
is  certainly  correct,  and  the  above  remedy  is,  in 
my  opinion,  the  b^  I  have  tried  all.  Give 
anodyne  when  pain  commences,  also  half  pint 
olive  oil. 

I  would  give  her  son  sod.  phosph.  also. 

Dr.  A.  C.  Matchette,  Bourbon,  Ind.:  Try 
one  of  the  following  for  pruritis  vulvae : 

1.  Sol.  of  ac.  boracic,  20  gr.  to  the  1  ounce 
of  water. 

2.  Cocaine,  10  gr.  to  1  ounce  of  lanoline. 

3.  10  to  30  m.  oil  peppermint  to  the  1  ounce 
of  lanoline. 

4.  Comp.  tr.  benzoin,  1  dram  to  the  1  ounce 
of  lanoline. 

Dr.  2^igler,  Allegheny,  Pa.:  Try  one  of  the 
following  for  your  case : 

1.  Aa  salicylic,  dissolved  in  ooUodion. 

2.  Alcoholic  sol.  of  ac.  salicylic. 
3- 

B.   Mneilage  tragacanUi.:. f  dnuns  in 

Tr.  camplL. » dranu] 

.    SolplL  preclp orameiQ 

Glyiserine. » dranu  ij 

M.    8lg.— Apply  8  timea  dally. 

Failing  with  this,  use  the  knife,  slit  the  ca- 
pillaries in  their  length,  or  use  electrolysis ;  run 
the  needle  along  the  calibre  of  the  vessles. 

Hardinsburg,  Ind.    J.  T.  Barnett,  M.D., 


To  Remove  Soot  from  Soars,  Stains  from  the  Skin, 

and  Warts  and  Wens.— For  Sore  Tongue. 

For  Gall  Stones, 

Editor  Medical  World: — In  answer  to 
W.  B.  Pullen,  of  Texas  :  To  remove  soot  from 
a  scar,  I  recommend  the  electric  needle,  using 
six  cells,  with  solution  of  peroxide  of  hydrogen, 
or  acetic  acid,  diluted  one  half . 

In  answer  to  J.  G.  Col  well,  M.D.,  for  stains 
on  the  skin,  I  suggest  peroxide  of  hydrogen, 
full  strength. 

To  remove  warts,  electric  needles,  •  touch 
with  acetic  acid.  To  remove  a  wen,  use  elec- 
tric needle ;  apply  antiseptics  dissolved  in  olive 
oil ;  apply  to  the  neck  of  the  tumor,  then  tie  a 
silk  or  lined  thread  around  it,  and  in  a  few  days 
it  will  drop  oft. 

In  answer  to  (Jeorge  C.  Brooks,  M.D.,  for 
sore  tongue,  I  recommend  permanganate  of  pot- 
ash or  peroxide  of  hydrogen ;  use  as  a  gargle. 

In  answer  to  Dr.  W.  Walter  Tison's  inquiry 
I  would  say  that  olive  oil  is  the  only  remedy 
that  will  dissolve  gall  stones.  A  wineglassful 
night  and  morning  before  meals,  until  a  pint  is 
taken.  T.  Henry  Whiting,  M.D., 

McVicker's  Theatre,  Chicago,  111. 


For  Itching  Piles. 

Editor  Medical  World: — The  following 
formula  has  given  me  gratifying  results  in  itch- 
ing piles. 

R.     Add!  tannic!  drams  ss 

Pulv.  oamphorse , tcruplefl  1 

Pnlv.  aiumini grs.  x     , 

PulV..Opll gT8.  ill-v 

Addi  carboUd m.  v-x 

Vaseline ounces! 

M.  et  Ft  uoguentmn. 

Big.— Apply  nig  It  and  morning. 

With  the  above  I  prescribe  sulphur  inter- 
nally. 

T.  W.  Stuart  Albin,  M.D., 
Cheboygan   Mich. 


Nasal  Catarrh. 

Editor  Medical  World  : — In  reply  to  Dr. 
Smith,  of  Filley,  Neb.,  who  wishes  a  good 
treatment  for  nasal  catarrh,  that  does  not  re- 
quire an  expensive  apparatus,  I  would  suggest 
that  he  get  for  his  patient  an  albolene  atomizer^ 
costing  about  $1.00  and  have  him  use  the  fol- 
lowing as  a  spray  two  or  three  times  a  day. 

R.    Menthol « grs.  v 

Camphor gm.  v 

Sacaiyptol  (Sanden> gtts.  t 

01.  ganlthena. - gtts.  v 

M.    Albolene ....ounces  J 

If  there  exists,  as  is  very  common  in  these 
casee,  a  lowered  condition  of  the  general  sys- 
tem, it  is  very  important  that  constitutional 
treatment  should  go  hand  in  hand  with  the  local 


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measures  if  we  would  secure  the  best  Results. 
For  this  purpose  the  following  may  be  used. 

JEL     Syr.  hypophoe.  oo.  (Fellows) ^..ounces  iU 

Syr. hydnodlo aoid  (Hostelly's) ounces) 

Liq.  pot.  aisenltlB ...dmmi] 

91.    Big.— Tetspoonful  three  times  a  day  after  meals. 

While  we  realize  that  there  are  various  forms 
of  rhinitis,  as  the  atrophic  and  the  the  hyper- 
trophic, that  require  modifications  in  the  treat- 
ment to  suit  each  particular  case,  the  above  will 
be  found  to  give  good  results  in  nearly  all  forms 
of  this  troublesome  affection  and,  if  continued 
for  a  reasonable  time,  will  not  only  relieve  but 
«ure  'the  greater  part  of  the  cases  we  meet  un- 
<ier  forty  years  of  age. 

Tell  "Inquirendo"  to  give  his  patient  who  is 
troubled  with  incontinence  of  urine  while  cough- 
ing or  sneezing,  the  following : 

R.    Tr.  noz.  Tom. 

Tr.  belladon aa oanoes  ss 

M.  Sig.— 16  drops  8  times  a  day.  Add  one  drop  to  the 
4o6e  each  day  untu  relieved. 

Prospect,  Pa.         J.  B.  Thompson,  M.D., 

Pneumonia, 

Editor  MsDiiCAL  World: — A  delicate  fe- 
male child,  eighteen  months  old,  attacked  with 
acute  double  pneumonia  involving  a  large  half 
of  the  breathing  area  in  both  lungs,  was  thus 
treated  with  ease  and  success  in  three  weeks 
time: 

Two  muslin  bags  filled  with  hops  were  fre- 
quently applied  hot  to  back  and  front  of  the 
chest  walls.  These  were  made  large  enough  to 
act  as  complete  jacket  poultices  and  were 
heated  by  immersing  them  in  hot- water  as  often 
as  they  cooled.  I^ter,  these  bags  were  re- 
placed by  a  roll  of  absorbent  cotton  over  the 
well  oiled  chest,  (hot  cottonseed  oil  being  used.) 

To  relieve  dyspnea  and  cough,  malto  yerbene, 
one  teaspoonful  three  times  a  day. 

To  relieve  high  pulse  and  temperature,  tinct. 
digitalis,  three  drops  twice  a  day. 

To  support  strength,  bovinine  in  milk  freely. 
Cool  water  often  for  thirst  Fruit  and  gradual 
diet,  care  also  was  taken  to  shift  the  sleeping 

dtion,  to  aid  in  combating  congestion  of  the 


ungs. 

The  condition  three  weeks  ago  was  almost 
hopeless.  To-day  she  is  about  well,  enjoys  life 
and  means  to  get  her  share  of  it 

John  Dixwell,  M.D., 

52  W.  Cedar  Street,  Boston,  Mass. 


Jaborandi  and  Quinkne  to  Facilitate  Labor. 

Editor  Medical  World: — J.  A.  Hunts- 
man, M.D..  on  page  161,  asks,  ''What  can  we 
use  with  any  certainty  to  increase  and  maintain 
strong  pains  and  hasten  labor  instead  of  ergot?" 

Use    fluid    extract  of  jaborandi,  fifteen  to 


twenty  drops  every  twenty  minutes,  until  pains 
arise  or  emesis  takes  place.  Then  follow  with 
a  full  dose  of  quinine  and  usually  you  will  be 
rewarded  by  a  speedy  termination  of  labor.  I 
used  ergot  K)r  the  first  fifteen  years  of  my  prac- 
tice, but  owing  to  the  peculiar  effect  it  has  in 
some  persons  upon  the  circular  and  transverse 
fibres  of  the  uterus  1  abandoned  its  use.  Then 
for  the  next  six  years  I  shifted  from  one  drog 
to  another,  using  in  that  time  of  most  all  that 
are  reputed  to  contain  oxytocic  properties,  but 
for  the  last  twelve  years  I  have  adhered  closely 
to  jaborandi  and  quinine  and  find  that  they  sel- 
dom fail  to  give  satisfaction.  To  me  The 
Medical  World  is  indispensable. 
Colusa,  Cal.       S.  B.  Littlepaoe,  M.D., 


Vaccine  Internally  Against  Small  Pox. 
Editor  Medical  World  : — In  reference  to 
the  article  '  Small  Pox. — Solution  of  Valine, 
etc,^*  in  the  June  number  of  this  journal,  page 
192,  it  can  be  proved  that  the  priority  does  not 
belong  to  Dr.  R.  Landell,  who  made  internal 
use  of  vaccine  in  1837,  but  to  others ;  viz : 

1.  In  1833,  Bentzendorff  published  a  case  of 
small  pox,  treated  with  vaccine,  in  Allgemeine 
Homeop.  Zeitung,  2.149. 

2.  In  1834,  Gross  published  two  cases  in 
Allg.  J?.  Ztg.,  4  47. 

3.  In  1835,  Bethmann  reported  a  case  in 
Allg.  H,  Ztg.,  6.177. 

4.  In  1834,  Synbius  published  several  cases 
treated  with  variolin,  in  Arthio  fxter  die  Homeop. 
Heilkund,  14,2.104. 

5.  In  1836,  Attomyr  published  a  case  in 
Allg.  H.  Ztg.fiJd, 

6.  In  1836,  Schmid  reported  three  cases  in 
Allg.  H.  Ztg.,  6.306. 

7.  In  1836.  Tietze  reported  two  cases  in  Pnt- 
iische  Beitraege  im  Gebiete  der  HameopaihiCt 
2.60. 

In  all  cases,  vaccine  and  variolin,  whose 
effects  were  alike,  changed  the  disease  verj 
quickly  into  a  milder  form  of  much  shorter 
duration.  F.  6.  CEhme,  M.D., 

Roseburg,  Oregon. 

For  Acne. 
Editor  Medical  World  : — Dr.  A.  C.  Zie- 
gler,  Allegheny,  Pa.,  asks  for  treatment  ot 
'*  acne  or  gutta  rosacea.'*  I  suggest  either  of 
the  following  remedies  as  a  wash  to  the  affected 
parts,  and  report  the  result  to  the  brotherhood 
of  The  Medical  World  : 

E.  Amygdal.  dulc ..» ouncei  i 

*'         amar ^..oonoesai 

Ft.  emuU.  cum.  aq.  oeras.   nigr. 

adde.. oonoeax 

Mere  ohlor.  oorr .gn.  tI 

Tr.  bensol ...drains  ri 

Saeci.  olt.  reo.  expreM ....ounoM  m 


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run  medicai.  would. 


289 


Or: 

R.  Flor.  lolpb drams  1 

Aqo*  Mturn onncea  1 

Or: 

R.  Cuinr.  lolph ^ «.. gr.  vlli 

Aqua  dlBtill ounoeslv 

Tine,  benzol drams  il 

Xake  Lillian,  Minn.     A.  Niblson,  M.D., 


Treatment  for  Diphtheria. 

Editor  Medical  World  : — I  was  favorably 
impressed  with  Dr.  Tillotson's  article  upon  the 
treatment  of  diphtheria  (with  gunpowder)  in 
the  June  World.  I  soon  had  opportunities  to 
test  his  treatment,  and  found  it  satisfactory  in 
relleying  the  diphtheritic  symptoms.  The  pa- 
tients idfterward  had  some  urinary  difficul- 
ties, however,  and  one  complained  of  the  gargle 
having  an  unpleasant  effect  upon  his  teeth.  It 
appeared  expedient  to  modify  the  treatment, 
4Uid  the  following  prescription  was  prepared : 

R,  Best  wUIow  charcoal gialns  xx 

Solphnr drams  xvi 

Water « „ ^ „ drams  Iv 

Syrup  simpL..^.. ^...........drams  xll 

The  charcoal  and  sulphur  to  be  weU  shaken  with  the 
^water,  and  the  syrup  added.  ' '  Shaxe. ' '  Big.  One  teaspoon- 
ital  every  hour  for  an  adult  until  symptoms  unprove,  then  In- 
crease the  interrals  between  doses. 

As  a  gargle  the  tablets  prepared  by  the 
Philadelphia  Granule  Co.,  known  as  the  Com- 
pound Thymoline  Tablets,  one  tablet  to  eight 
ounces  of  water,  make  a  preparation  which 
seems  to  act  well.  My  patients  are  given  the 
charcoal  and  sulphur  mixture  and  directed  to 
gargle  with  a  teaspoonful  of  the  comp.  thymol- 
ine sol.  before  each  dose.  Young  children  can 
have  the  throat  mopped  or  sprayed.  Several 
very  threatening  cases  have  been  speedily  cured 
by  this  treatment,  and  the  results  so  far  seem  to 
justify  its  being  offered  for  publication. 

John  J.  Ligqet,  M.D., 

Ladiesburg,  Md. 

Qui;  D®l>aptinent. 


QncstioBS  an  Mtteited  for  this  Ccdtnnn.  Communlcationa 
not  accompanied  by  the  proper  name  and  addxvss  of  the 
wijer  (not  neccMarUy  for  publication),  wiU  not  be 
nocloed. 

The  great  number  of  requests  ftr  private  answers,  for  the 
information  and  benefit  of  the  writer,  makes  it  necesa- 

fee  win  be  from  one  to  five  dollars,  acoMdinf  to  tha 
amount  of  research  ami  writing  reqSred.    ^^ 

Has  any  one  had  experience  with  any  really 
valuable  treatment  for  genuine  hydrophobia? 
Also,  what  is  the  slightest  wound  you  have  ever 
known  to  be  followed  by  the  development  of 
the  genuine  disease?    Address  the  editor. 


Germany)  the  principal  ingredient  of  the  hair 
dye  published  in  July  1893  World. 

Editor  Medical  World  : — I  write  to  request 
some  of  tbfe  numerous  readers  of  your  most  val- 
uable journal  to  kindly  favor  me  with  advice 
in  my  own  case.  I  apa  fifty  six  years  old.  I 
kave  been  an  active  practitioner  of  medicine 
thirty-three  years.  I  have  had  occasional  at- 
tacks of  amaurosis  for  nearly  forty  years.  I 
now  suffer  from  giddiness,  tinnitus  aurium,  con- 
fusion— kind  of  a  dazed  feeling  at  times.  I  am 
still  in  active  practice.  Sleep  fairly  well,  good 
appetite.  Had  my  heart  examined  recently  by 
a  most  excellent  physician,  who  assured  me 
that  there  was  nothing  abnormal  there.  Urine 
shows  no  trace  of  albumen ;  no  specific  taint  ; 
moderate  user  of  tobacco ;  never  drank  whisky 
but  moderately.  Your  kind  attention  to  the 
above  request  will  be  most  gratefully  appre- 
ciated. F.  R.  Gregory,  M.D., 

Stovall,  N.  C.       , 


We  regret  that  we  are  unable  to  inform   our 
readers  where  they  may  obtain   (this  side  of 


The  True  Pathology  and  Classifloation  Wanted. 

Editor  Medical  World  : — I  want  to  pre- 
sent to  the  World  family  the  history  of  a  fever 
we  have  been  having  to  deal  with  more  or  less 
for  the  last  ten  years  in  this  section^  for  the 
purpose  of  settling  the  diagnosis.  It  has  gone 
under  so  many  names  that  it  is  confusing.  It 
is  called  by  one,  slow  fever ;  by  another,  ma- 
larial fever ;  by  another,  typhomalarial  fever ; 
by  another,  typhoid  fever,  and  by  another,  gas- 
tric fever.  It  commences  with  a  few  days  of 
tired  feeling  and  headache,  followed  with  a 
slight  fever  in  the  eveniag  for  a  few  days. 
Then  it  will  become  a  remitting  fever,  with  the 
remission  in  the  morning,  and  continue  from 
three  to  six  weeks  in  spite  of  all  treatment,  and 
the  rule  is  to  get  well.  The  temperature  ranges 
from  101°  to  104°  or  105°,  and  gradually  de- 
clines to  normal.  Bowels  generally  costive  and 
sometimes  very  loose.  There  ia  in  nearly  every 
case  more  or  less  tympanites.  A  few  cases 
have  red  splotches  over  the  bowels.  A  few 
have  hemorrhage  from  the  bowels.  They  all 
have  a  gurgling  sensation  on  pressure  over  the 
right  iliac  region.  About  one  half  have  epis- 
taxis.  ,  The  tongue  at  first  has  a  whitish  coat, 
then  becomes  very  dry  and  brown  in  centre, 
with  red  edges ;  then  cleans  off  very  red  and 
sleek,  and  remains  so  for  the  rest  of  the  time. 
Most  of  the  cases  have  more  or  less  delirium 
and  some  subsultus  tendinum.  No  locality  is 
exempt;  sometimes  we  will  have  only  one  case 
in  a  family,  and  I  have  seen  nine  in  a  family  of 
ten.  I  have  usually  been  inclined  to  the  diag- 
nosis of  typhoid  fever,  and  directed  my  treat- 


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ment  accordingly,  whicH  in  the  main  haa  been 
antiseptic,  sulpho-carbolate  of  zinc  being  pre- 
ferred, with  opium  to  quiet  the  nervpus  system 
and  control  the  bowels ;  turpentine  when  indi- 
cated; also,  hydrochloric  acid,  alcohol  and 
digitalis  in  some  cases.  Fluid  diet  rigidly  ad- 
hered to  from  b^inning. 

HQlsboio,  Tenn.  C.  M.  H.  Farrar, 

• 

Editor  Medical  World  : — I  will  be  very 
thankful  if  some  one  with  special  experience 
will  give  us  the  best  treatment  and  DDanage- 
ment  of  marasmus,  infantile  catarrh  of  the  bow- 
ells,  etc.  This  subject  is  briefly  treated  in 
text  books,  and  the  medical  journals  give  but 
little  attention  to  it  I  am  sure  it  is  very  com- 
mon, and  requires  the  best  resources  of  the 
physiciah.  Dr.  M.  R  Peters, 

Boiling  Springs,  Pa. 

Dr.  Smith,  of  Star  P.  O.,  Wis.,  has  a  case 
in  which  the  glans  penis  has  atrophied  so  that 
it  is  about  one-half  the  proportional  size  when 
that  organ  is  in  a  state  of  erection,  and  becomes 
flexed  upwards,  so  that  proper  intercourse  is 
interfered  with.  He  wishes  suggestions  from 
others  who  may  have  had  similar  cases. 

Editor  Medical  World  : — Can  any  of  your 
German  readers  tell  me  what  <<Red  Butter"  is 
and  what  it  is  used  for  in  Germany  ?  I  have 
been  told  that  oneor  two  doses  would  cure  "piles." 

Filley,  Neb.  S.  J.  Smith,  M.D., 

Editor  Medical  World  : — Will  you  please 
insert  a  query  for  the  treatment  of  "eUimoi- 
ditis"  in  The  World? 

The  case  is  of  eight  months  standing,  con- 
tinual muco-purulent  discharge  from  bone. 
Treatment  has  been  of  little  avail  with  me. 

Trenton,  N.  J.  Dr.  I.  B.  Loos. 

Editor  Medical  World: — A  neighbor's 
little  boy  yesterday  swallowed  a  cent.  Is  there 
anything  to  be  done  in  such  a  case  ?  I  have 
had  several  such  cases  in  my  life;  they  did  well 
without  interference. 

It,  the  cent,  is  composed  I  think,  mostly  of 
copper,  and  is  about  seventy-six  grains  in 
weight 

I  should  like  to  hear  from  you  if  you  think 
there  is  any  treatment  indicated,  also  the  out- 
look for  the  boy.     John  M.  Bingay,  M.D., 

Tueket,  Nova  Scotia,  Canada. 

[Feed  the  patient  with  coarse  v^etable  food, 
in  order  that  a  large  amount  of  dry  waste  be 
produced.  When  by  that  means  he  becomes 
constipated,  move  the  bowels  by  the  use  of  gly- 
cerine injections  or  suppositories  or  by  small  in- 
jections of  water,  but  not  by  cathartics.     The 


coin  should  be  observed  to  pass  not  later  than 
the  third  or  fourth  day.  No  trouble  is  likely 
to  occur  on  account  of  the  accident. — Eo.] 

[This  advice  being  also  sent  the  Doctor  per- 
sonally, he  wrote  back  that  the  coin  passed  in 
just  fifty  hours  after  being  swallowed,  and  that 
the  boy  was  all  right — Ed.] 

Editor  Medical  World: — I  wish  to  re- 
port the  following  case  in  your  journal, 
trusting  that  by  so  doing  I  may  receive  some 
suggestions  as  to  treatment  by  the  numerous 
readers  of  The  World.  Mr.  M.,  aged  thirty- 
four,  married,  came  to  me  for  treatment  after 
having  been  in  the  hands  of  several  physicians 
without  any  apparent  relief.  On  questioning 
him,  he  states  that  he  first  began  to  feel  8i(£ 
nearly  two  years  ago.  He  says  that  he  went  to 
Nebraska  in  the  Fall  of  '92  to  deliver  some 
sheep  and  that  whilst  there,  he  went  out  hunt- 
ing and  a  severe  snow  storm  overtook  him. 
He  was  determined  to  get  to  town  that  after- 
noon, so  he  started  back.  When  he  got  to  the 
house  he  was,  to  use  his  own  words,  ringing  w^ 
the  usual  results  following,  a  severe  bronchitis. 
Two  months  afterward  he  felt  considerable  pain 
in  the  lumbar  region.  He  went  to  a  physician 
Bnd  was  told  that  nothing  serious  was  the  matter 
with  him.  Gradually  he  kept  on  getting  worse; 
finally  edema  of  the  ankles,  scrotum  and  under 
the  eyelids  set  in,  which  successively  disappeared 
and  returned.  The  morning  I  examined  him  I 
found  him  extremely  anemic  and  weak.  Some 
edema  of  the  ankles  and  under  the  eyes — the 
typical  Bright's  eye ;  dyspnea  marked ;  temp^ti- 
ture  normal ;  had  recurrent  attacks  of  diarrhea 
at  times  and  constipation  at  others  (which  I  at- 
tributed in  part  to  diet  and  treatment).  The 
examination  of  the  urine  showed  it  to  contain 
albumen  one  per  cent,  pale,  almost  the  color  of 
water.  Specific  gravity  1.013 ;  some  fittty,  and 
aho  granular  tube  casts.  Neuralgic  pains  on 
the  legs,  but  principally  on  the  left  arm  and 
shoulder.  Pains  coming  with  regularity  at  bed 
time  and  increasing  in  severity  as  morning  ap- 
proaches. Uremic  symptoms  occur  once  in  a 
while.     My  diagnosis  is  chronic  Bright* s  disease. 

As  to  treatment  I  am  giving  him  Basham's 
mixture,  tablespooaful  three  times  a  day,  also 
the  chloride  of  gold  and  sodium,  grain  one- 
twentieth  three  times  a  day  and  a  general  tonic 
treatment,  meeting  emergencies  as  they  arise. 
The  edema  has  entirely  disappeared ;  debility 
and  pains  persist  For  the  pains  I  have  tried 
nearly  everything,  morphine  at  times,  without 
any  apparent  success.  Hot  water  bags  lessen 
the  pains,  but  only  for  a  short  interval.  I  am 
afraid  to  use  morphine  any  more  excepting 
when  uremic  convulsions  set  in.     Will  some 


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291 


of  the  readers  of  The  World  suggest  some- 
thing to  lessen  or  eradicate  the  neuralgic  pains 
if  possible  ?  Any  further  suggestions  as  to  gen- 
eral treatment  will  be  graciously  and  gratefully 
receiyed.  M.  F.  Desmarais,  M.D.» 

Lbs  Vegas,  N.  M. 

Editor  Medical  World: — Will  some  of 
your  numerous  readers  give  me  a  treatment  for 
tan  and  freckles — one  that  will  do  the  work  ? 
I  have  used  pot  carb.  sodii  chloridi,  liq.  potas* 
sae,  plumbi  acetas,  acid  hydrocyanic^  diL,  hydrag. 
chlor.  cor.,  zinc  oxide,  zinc  carbonate,  acid  hy- 
drochloric, muriate  of  ammonia,  etc.,  all  exter- 
nally. All  have  failed.  I  should  like  to  hear 
from  some  of  the  knowing  ones.  I  have  been 
in  the  business  forty-two  years,  but  this  case 
heads  me.  B.  I.  A.  Cull,  M.D., 

Camilla,  Mitchell  Co.,  6a. 

Editor  Medical  World: — I  have  a  case 
on  hand  for  which  I  would  like  to  have  advice 
in  regard  to  treatment. 

MiB.  Z ,  aged  above  60,  mother  of  four 

children,  husband  dead  some  years.  Six  years 
ago  had  diabetes  mellitus,  with  abscess  of  one 
toe  on  left  foot  Under  proper  diet  and  reme- 
dies recovered.  Two  years  after  had  a  second 
attack,  with  abscess  on  two  toes  of  same  foot, 
from  which  she  also  recovered,  and  had  good 
health  until  last  February,  when  she  had  a  third 
attack,  with  abscesses  on  the  under  surface  of 
the  right  foot  This  is  the  worst  attack.  She 
has  had  some  hAlf  dozen  abscesses  formed  on  the 
bottom  of  the  foot,  which  have  coalesced  into  an 
open  nicer,  three  inches  long  one  inch  wide, 
and  a  half  inch  deep. 

I  put  her  on  the  anti-diabetic  diet,  as  laid 
down  by  the  best  writers,  and  gave  her  arsenic, 
opium,  codeine,  solol,  bromide  of  ammonia, 
quinine,  etc.  Under  the  treatment  all  traces  of 
sogar  in  the  urine  disappeared.  Am  now  giv- 
bg  her  Baaham's  Mixture  and  bromide  of  am- 
monium. She  was  doing  nicely ;  had  no  pain 
in  the  foot,  until  two  weeks  ago  the  foot  began 
to  pain  her  at  night,  and  is  at  times  very  pain- 
ful, requiring  anodynes^  for  which  codeine,  in 
half  gr.  doses,  does  best  She  has  now  sugar  in 
the  urine,  alUiough  abstaining  from  all  forbid- 
den diet  The  ulcer  shows  no  tendency  to 
heaL 

I  would  like  to  have  advice  as  to  treatment 
I  am  very  anxious  to  cure  her. 
Jefferson,  Md.  J.  J.  Culler,  M.D., 

Editor  Mf  DicAL  World  : — Can  any  of  your 
.readers-  furnish  us  through  The  World  or 
otherwise,  the  formula  of  Dr.  Schuyler's  anti- 
leptic?         Dr8.  Perrine  &  Loughridge, 

El  Dorado,  Ark. 


Current   Medical   Thought. 

Pruritus  Vulvn. 

The  persistent  tickling,  itching,  and  burning 
of  pruritus  viilvse  points  not  only  to  simple 
hyperemic  irritation,  but  to  a  more  marked  in- 
volvement of  the  skin-covering  and  its  terminal 
nerve-bulb  filament  Webster,  on  the  basis  of 
microscopic  examination  of  excieed  portions  of 
skin  a£fected  with  pruritus,  describes  a  subacute 
inflanmiation  of  the  papillary  bodies  and  ad- 
vanced fibrosis  of  the  nerve-endings,  especially 
marked  in  the  region  of  the  clitoris  and  the  upper 
portion  of  the  smaller  labia.  These  obeervationB 
strongly  suggest  that  the  disease  is  in  reality  an 
inflammatory  neurosis  of  the  vulvar  coriunu 

The  severe  forms  are  always  associated  with 
local  lesion.  Even  though  this  is  not  percepti- 
ble to  the  casual  examination,  microscopic  re- 
search will  i:eveal  thickening  and  infiltration. 

The  pruritus  is  usually  caused  by  a  local  dis* 
ease  of  the  vulva.  This  r^on  is  swarming  in 
germs.  It  is  claimed  that  in  diabetic  pruritus 
the  leptothrix  and  allied  organisms  occasion  the 
deep  skin  inflammation,  but  others  of  the  my  coses, 
such  as  that  due  to  the  oidium  albicans,  are  often 
attended  with  itching. 

Webster  classifies  the  cases  of  pruritus  as  fol- 
lows: 1.  Endogenous  cases.  Under  this  head- 
ing are  included  those  in  which  the  blood  is 
altered,  as  from  icterus,  chronic  nephritis,  dia- 
betes mellitus,  the  waste  products  circulating  in 
the  blood  acting  upon  the  terminal  nerve-fila- 
ments and  occasioning  itching.  Under  the  same 
heading  would  be  included  the  pruritus  due  to 
medicines,  such  ^lb  morphine,  iodoform,  alcohol, 
eta  Under  the  endogenous  cases  would  also  Im 
classified  pruritus  caused  by  varices  or  conges- 
tion of  the  pudendal  veins  of  the  hemorrhoidals 
or  of  the  pampiniform  plexus,  such  as  may  come 
from  a  weak  heart,  pregnancy,  hemorrhoids,  or 
displacement  or  overgrowths  of  the  womb.  More- 
over, certain  well-known  skin  diseases  may 
occasion  vulvar  itching.  Thus,  erythema,  herpes, 
urticaria,  and  certain  forms  of  eczema  may,  after 
an  acute  attack,  leave  permanent  alterations  of 
the  papillary  bodies,  which  react  upon  the  nerve- 
endings.  Finally,  fermentation  in  the  intestinal 
tract  may  give  rise  to  products  which,  absorbed 
into  the  blood  may  act  upon  the  nerve-endings. 
The  frequent  occurrence  of  constipation  in  women 
makes  this  a  causative  factor  of  no  little  import- 
ance. 

Under  the  exogenous  cases  are  classed  those 
due  to  alteration  or  increased  secretions  of  the 
vulvar  glands,  hyperidrosis,  seborrhea,  polyuria 
with  either  altered  or  normal  urine,  diseased 
secretion  from  the  vulva,  vagina,  and  uterus. 

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catarrh  and  suppurative  secretions  from  the  rec- 
tum, especially  discharges  from  inflamed  piles. 
These  secretions  are  irritative  partly  from  their 
direct  chemical  action,  partly  nrom  their  decom- 
position, irritant  products  being  formed  which 
act  directly  upon  the  macerated  epithelium, 
causing  erythema,  intertrigo,  eczema,  and  in 
certain  cases  pruriginous  vulvitis.  Causes  of  a 
parasitic  nature  are  also  frequently  operative  in 
causing  pruritus.  Thus,  the  pediculi,  the  as- 
carides,  the  oxyuris  vermicularis,  leptothrix, 
oidium  albicans,  micrococcus  ursense,  gonococcus, 
nmegma  bacillus,  the  ordinary  putrefactive  bac- 
teria, and  the  streptococci  and  staphylococci  are 
said  to  be,  if  not  the  primary  and  predisposing, 
at  least  the  secondary  exciting  causes  of  itching. 

Of  mechanical  causes,  masturbation  will  per- 
haps take  the  first  rank ;  persistent  washing  and 
fricti(Hi,  especially  when  applied  by  means  of 
sponges,  which  are  always  uncl«  an,  encourages 
infection.  The  symptoms  are  aggravated  by  the 
scratching  and  rubbing  occasioned  by  the  symp- 
tom. Thermic  influences  are  also  operative; 
thus,  there  is  a  winter  'and  summer  pruritus. 

Usually  careful  examination  as  to  etiology 
indicates  the  most  prombing  method  of  cure. 
Thus,  where  the  disease  is  due  to  parasites,  lack 
of  cleanliness,  to  drugs  to  decomposing  dis- 
charges, to  venous  congestion,  etc.,  Uie  efficient 
treatment  is  obviously  removal  of  the  cause  of 
the  diseased  local  conditions.  In  those  cases 
dependent  upon  visceral  alteration,  the  local 
treatment  must  be  subordmate  to  attention  to 
the  general  condition.  Thus,  the  appropriate 
regimen  must  be  indicated  in  each  instance  in 
accordance  with  whether  the  patient  be  diabetic, 
jaundiced,  subject  to  Bright's  disease  or  suffer- 
ing from  venous  congestion  incident  to  heart 
weakness.  The  gouty  or  rheumatic  diathesis 
must  be  properly  treated. 

Antiseptics  as  local  applications  are  most  use- 
ful. These  are  generally  combined  with  astrin- 
gents and  with  local  anesthetics. 

Among  the  favorite  methods  of  treatment  are 
prolonged  hot  baths,  followed  by  hot  douches. 
These  douches  should  be  antiseptic  and  anes- 
thetic ;  thus,  solutions  of  carbolic  acid  as  hot  as 
can  be  borne  are  of  special  service.  It  is  note- 
worthy that  the  area  afiected  by  puritus  can 
stand  a  much  stronger  solution  than  can  be  used 
upon  a  healthy  surface ;  thus,  irrigations  of  1 
to  40  or  1  to  20  may  be  made.  Bichloride  is 
also  serviceable,  but  the  anesthetic  effect  of  the 
carbolic  acid  is  lacking  in  this  drug.  A  favorite 
prescription  of  D.  Hayes  Agnew,  recommended 
as  almost  a  specific  in  pruritus  ani,  is : 

R.    Bulphate  of  zinc,    , 

Alum,  of  each,  equaf  parts. 

To  be  mixed  and  heated  until  the  water  of  crys- 


talization  is  driven  off.  A  drachm  of  this  ia 
added  to  an  ounce  of  water  and  is  applied  locally. 
At  times  the  carbolic  lotion  proves  too  irritatiDg ; 
then  a  simple  astringent  may  be  employed,  such 
as  fluid  extract  of  hydrasds,  1  dram  to  1  pint,. 
or  hamamelis  fifty  per  cent.,  or  even  full  strengh. 
After  prolonged  douching,  either  with  hot  eola- 
tions of  hydrastis  or  hamamelis,  the  parts  may 
be  bathed  with  a  preeciption  made  up  of — 

R.    Menthol gr.  1 

Coooalne « gr.  zzxTi 

Alcohol....... 

Water,  of  each oonoei  f 

Or  an  ointment  may  be  applied  made  up  of. — 

B.     Menthol ,. dram  i 

Simple  cerate otincet  11 

OU  of  sweet  almonds. ......ounce  i 

Carbolic  add ^ dram  1 

PolT.  £inc  oxide „ drams  11 

Or, 

R.     Menthol draml 

Carbolic  add. dram  i 

Lanolin — ounces  11 

Pnl7.  zfnc  oxide ...dram  ii 

Unguent,  sine  oxide ounce! 

Or  a  strong  lotion  of  carbolic  acid  may  be  dabbed 
on,  according  to  the  following  formula : 

R.     Carbolic  add drams  ii 

Glycerin « 

Water,  of  each drams  ix 

Painting  the  vulva  with  glycerin  mixed  ?rith 
a  ten-per-cent  solution  of  chloroform  and  gly- 
cerin, with  a  ten-per-cent  solution  of  carbolic 
add  and  glycerin  and  alcohol,  or  a  solution  of 
nitrate  of  silver  of  similar  strength  is  sometimes 
serviceable. 

Madden  recommends  oleate  of  chloral  painted 
over  the  parts.  This  is  a  compound  formed  of 
equal  parts  of  camphor,  chloral,  and  oleic  add. 
Where  the  disease  is  due  to  irritating  uterine 
or  vaginal  discharges,  he  recommends  the  intro- 
duction of  a  tampon  of  cotton-wool  loaded  with 
equal  parts  of  finely  powdered  alum  and  sugar,, 
and  carried  within  the  vulvar  orifice.  He  holds 
that  in  his  dispensary  practice  black-wash  b 
regarded  as  a  most  generally  useful  as  well  a» 
a  very  cheap,  available  application  in  such 
cases. 

Goodell  recommends  a  strong  emulsion  of 
iodoform  and  glycerin  (ten  to  twenty  per 
cent). 

Skene  commends  vaginal  douches  of  acetate 
of  lead,  and  dusts  subnitrate  of  bismuth  on  the 
labile  to  prevent  friction.  This  he  holds  ia 
especially  serviceable  in  diabetic  cases.  In  the 
cases  in  which  the  etiology  was  obscure,  he 
states  that  the  remedies  which  have  given  him 
the  best  results  are  bichloride  of  mercury  in 
emukion  of  bitter  almonds,  one  grain  to  the 
ounce,  applied  to  the  parts  afiected  twice  a  day; 
a  powder  composed  of  one  grain  of  morphine 
to  two  grains  of  chalk,  applied  night  and  mom^ 


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ing ;  equal  parts  of  tincture  of  opium,  iodine, 
and  aconite,  and  eight  per  cent,  of  carbolic 
add,  applied  once  a  day ;  and  ethereal  solution 
of  iodoform,  applied  hy  means  of  an  atomizer. 
In  some  cases  application  of  equal  ^  parts  of 
carbolic  acid  and  tincture  of  iodine  relieved 
permanently.  This  was  used  in  one  case  by 
means  of  an  atomizer,  the  spray  being  driven 
under  high  air- pressure.  An  acute  inflamma- 
tion followed,  but  after  the  patient  recovered 
from  this  the  pruritus  did  not  return.  In  cer- 
tain cases,  in  spite  of  every  local  and  general 
treatment^  disease  persists  and  renders  life 
almost  unendurable.  Under  such  circumstances 
there  remains  surgical  intervention. 

Garrard  reported  the  first  case  of  surgical 
mtervention.  The  clitoris  was  the  part  affected  ; 
its  removal  was  followed  by  cure. 

Schroeder  carefully  loodized  the  points  of 
itching,  and  then  removed  them  by  section  in 
five  cases.  In  one  of  these  cases  the  disease 
was  complicated  by  carcinoma.  In  another,  in 
addition  to  excision  of  the  diseased  vulvar 
surface,  a  ring  of  skin  was  taken  from  around 
the  anus.  In  the  three  remaining  cases  the 
disease  was  purely  pruritus  vulvse.  In  the  first, 
a  small  area  was  removed  from  the  right  labium 
majus ;  in  the  second,  the  right  labium  majus 
was  excised,  and  following  this  several  lesser 
operations  were  performed;  in  the  third,  in  which 
both  the  clitoris  and  lower  lips  were  involved, 
the  operation  was  more  extensive.  The  women 
all  recovered.  The  operator  stated  that  inter- 
vention should  only  be  attempted  when  the 
itchmg  was  localized,  and  cautions  against 
attempting  to*  cure  a  widely  diffused  pruritis  by 
the  knife. 

Kustner  also  reports  three  successful  cases. 

Martin  reports  four,  and  a  number  of  other 
operators  state  that  the  results  were  successful. 

Sanger  ( CeniralblaU  fur  Oynakologie,  No.  7, 
1894)  contributes  the  full  notes  of  two  cases, 
both  entirely  successful. 

He  closes  his  thesis  with  the  following  state- 
ment: 

The  partial  or  total  extirpation  of  the  vulva 
is  an  entirely  legitimate  operation  in  cases  of 
chronic  pruriginous  vulvitis  not  curable  by 
other  means.  In  younger  persons  the  surgeon 
should  be  content  with  partial  operation.  In 
aged  persons,  when,  the  disease  is  widely  ex- 
tended, the  whole  vulva,  including  the  glans 
clitoris,  should  be  entirely  extirpated  and  the 
wound  closed  by  plastic  operation. — Therapeutic 
Oazette. 

Editor  Medical  World  : — I  have  been  an  nninter- 
lunted  Biibecriber  to  The  Wobld  ever  since  the  first 
number  was  published,  and  cannot  now  do  without  it. 

Sharon,  Ga.  A.  C.  Davdson, 


'    A  Food  for  Infants. 

Eivlart,  after  much  experimentation,  has 
evolved  the  following  method  for  making  a  food 
containing  about  one  third  of  the  solid  contents 
in  the  form  of  maltose : 

Materials :  Wheat  flour  or  barley  meal,  ten 
ounces  (two  tablespoonfuls  heaped  as  high  as 
possible);  water|  fifk;ysix  ounces  (three  pints 
and  a  half);  extract  of  malt,  half  a  teaspoonful 
or  small  teaspoonful. 

Process:  With  a  scant  quart  of  the  water 
make  the  flour  into  gruel,  boiling  ten  minutes 
in  a  double  boiler.  Take  out  the  inner  vessel 
and  add  the  rest  of  the  water  cold,  the  malt 
extract  being  added  to  the  last  few  ounces.  Ijet 
it  stand  fifteen  minutes.  Put  back  the  inner 
vessel  and  allow  to  boil  fifteen  minutes.  Strain 
through  a  coffee-strainer  of  wire  gauze. 

This  food  has  been  largely  uscnI  in  the  babies' 
ward  of  the  Post-graduate  Hospital  of  New 
York  by  Dr.  Chapin,  who,  in  the  same  journal, 
gives  his  results.  The  food  was  largely  used 
as  a  diluent  for  milk,  and  was  found  much  su- 
perior to  sitaaple  barley-waler  or  any  other  dilu- 
ent used. — N.  Y,  Med,  Jour. 


Treatment  of  Pruritis  AnI. 


Dr.  A.  Berger  states  that  the  following 
method  immediately  relieves  the  itching  and 
causes  a  rapid  disappearance  of  the  eczema  of 
the  perineum  and  scrotum,  which  frequently 
exists  in  these  cases :  A  cotton  pledget,  about 
two  or  three  centimetres  (I  to  H  inch)  in 
length  and  steeped  in  a  two  per  cent  solution 
of  hypochlorate  of  lime,  is  introduced  into  the 
anus.  This  pledget  is  allowed  to  remain  until 
there  is  a  slightly  smarting  sensation,  when  it  is  ^ 
immediately  withdrawn  and  the  anal  region 
washed  with  the  same  solution. — InL  Jour. 
Surg. 

Quaiaool  in  Diabetes  and  the  Poiyuria  of  Diabetes. 

Dr.  T.  Qemens  (  Wien  Med.  Presse,  No.  6, 
1894)  praises  the  action  of  guaiacolinthe  treat- 
ment of  diabetes,  and  the  associated  polyuria. 
The  dose  of  the  (pure)  drug  was  3  to  6  to  10 
drops  three  times  a  day  in  a  tablespoonful  of 
milk,  or  if  tolerated,  in  an  egg-cupful  of  cod- 
liver  oil.  In  order  to  control  its  influence  he 
did  not  order  any  special  diet,  and  examined 
the  urine  passed  after  dinner  on  several  consecu- 
tive days.  After  the  patient  had  taken  the 
drug  for  eight  days,  his  urine,  which  usually 
contained  from  1.86  to  2  9  per  cent  of  sugar 
in  the  afternoon,  showed  a  very  considerable  re- 
duction; in  some  cases  the  sugar  was  only  pres- 
ent in  a  very  slight  quantity,  in  a  few  entirely 

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lacking.  After  it  liad  been  taken  from  two  to 
four  weeks,  here  and  there  a  few  sweet  foods 
containing  sugar  could  be  allowed  without  in- 
fluencing the  amount  of  sugar  in  the  urine.  A 
still  more  striking  action  was  observed  in  the 
polyuria  of  diabetes.  In  some  cases  in  eight 
days  the  quantity  of  urine  was  reduced  by  half. 
This  Was  controlled  by  discontinuing  and  reduc- 
ing the  dose  of  the  drug.  In  all  cases  the 
general  condition  was  improved  while  the 
remedy  was  well  borne. — Me<L  and  Surg, 
Reporter, 


Compound  Comminuted  Fracture  of  Frontal  Bone 
and  Left  Orbital  Plate,  with  Evulsion  of 
*  Eyeball— Recovery. 

John  Cullen,  aged  29  years,  employed  at  a 
lumber  mill,  fell  headforemost  from  a  height  of 
thirteen  feet  His  forehead  struck  against  a 
nut  which  screwed  down  an  iron  bolt  in  the 
fixed  machinery  of  the  mill.  The  nut  was  a 
square  one,  measuring  one  inch  each  way,  and 
the  bolt  projected  about  half  an  inch  from  the 
nut  I  saw  the  man  wjthin  an  hour  of  the 
accident  He  had  a  compound  comminuted 
fracture  of  the  frontal  bone,  with  perforation 
and  splintering  of  the  left  orbital  plate.  The 
external  wound  was  nearly  two  inches  long,  ex- 
t^iding  through  the  supra- orbital  notch,  and 
dividing  that  firtery  and  nerve.  The  eyeball 
was  torn  from  its  attachments  and  protruded 
from  the  socket,  the  evulsion  being  almost  com- 
plete; the  optic  nerve  stretched  and  exposed  to 
the  extent  of  two  inches  and  partially  torn 
across.  He  had  lost  a  good  deal  of  blood,  but 
was  conscious  and  sensible.  He  was  removed 
to  &  suitable  place,  to  secure  due  care  and 
nursing,  and  shortly  afterwards  I  proceeded  to 
treat  the  case  as  follows: 

The  wound  and  the  cavity  of  the  orbit  were 
saturated  with  carbolized  oil  (1  in  20)  by 
means  of  a  syringe,  after  which  several  spicula 
of  bone,  incapable  of  coaptation,  were  removed, 
six  small  fragments  being  taken  away.  The 
iDJury  to  the  eyeball  and  optic  nerve  being  too 
severe  to  warrant  the  hope  of  restoration,  I  re- 
moved the  eye— care  being  taken  to  get  as  good 
a  ''stump"  as  possible.  The  wound  was  sutured 
with  carbolized  gut,  and  drainage  provided  for. 
After  dustmg  the  surface  with  iodoform,  a  thick 
compress  of  aseptic  gauze  was  applied.  Care 
was  taken  to  effectually  close  the  other  eye,  so 
as  to  secure  the  most  perfect  rest,  and  I  may  say 
here  that  this  precaution  was  absolutely  adhered 
to  for  ten  days.  I  then  gave  him  a  hypodermic 
injection  of  morphia  and  cocaine  (}  grain  each). 
During  the  first  twelve  hours  after  the  accident 
his  temperature  rose  to  102^,  and  this  pyrexia 


was  accompanied  with  a  little  delirium  and 
restlessness;  by  the  third  day  however,  this  had 
quite  disappeared  and  his  temperature  was 
practically  normal.  It  was  carefully  noted 
twice  daily  for  ten  days,  during  which  it  never 
rose  above  99^.  The  wound  healed  in  a  very 
remarkable  manner.  By  the  fifteenth  day 
there  was  a  firm  and  satisfactory  cicatrix,  and 
since  then  a  deposition  of  new  bone  has  been 
steadily  progessing.  He  recovered  without  an 
untoward  symptom.  Three  months  after  the 
accident  he  was  fitted  with  a  glass  eye,  and 
shortly  after  he  resumed  work. 

The  case  is  interesting  from  several  points. 
Such  a  fracture  is  extremely  rare.  In  an  ex- 
tensive surgical  experience  of  a  quarter  of  a 
century  I  have  not  seen  such  another,  nor  have 
I  read  of  one.  The  proximity  to  the  base  of 
the  brain,and  the  probability  of  injury  to  the 
ethmoid  bone  and  olfactory  nerve  involved  the 
risk  of  cerebral  mischief  which  fortunately,  did 
not  occur.  Too  much  stress  cannot  be  laid,  in 
such  cases  of  injury  to  the  optic  nerve,  on  the 
absolute  exclusion  of  light  from  the  other  eye, 
so  as  to  secure  functional  rest  At  present, 
twelve  months  after  the  accident,  the  remaining 
eye  is  sound  and  the  sense  of  smell  unaffected. 

Alfred  M.  Watson,  M.  D.  Edin.;  M  RC.8. 
Eng.     Duncan,   Vancouver  Island,   B.C.; 
OrUario  Med.  ToarnaL 


m 


The  Treatment  of  Lead  Poisoning  with  Monotul- 
phlte  of  Sodium. 

M.  Perou  states  that  the  administration  of  40 
centigrammes  a  day  of  monosulphite  of  sodium 
gives  rapid  relief  in  lead  colic.  He  states  that 
the  elimination  of  the  metal  is  much  hastened 
by  this  treatment,  and  that  the  sulphite  is  an 
efficient  prophylactic  agent  The  employment 
of  the  drug  is,  he  &ays,  devoyi  of  danger. 


Treatment  of  Certain  Forms  of  Aone  Rosaoaa. 

Petiini  (La  Roumanie  Med,.  1893,  No.  3), 
after  ineffectual  employment  of  all  possible  (?) 
procedures,  finally  adopted  the  following,  with 
best  results,  in  the  case  of  two  young  persons. 
Pustules  were  emptied  by  Vidal's  scarification 
method.  Three  days  after  each  other  s\\  affect- 
ed places  were  painted  with 

Flexible  oollodion M  parts. 

IcythyoL X 2  parts. 

RoBOiicn 1  part. 

Five  or  six  days  after  the  first  painting  the 
redness  begins  to  disappear  and  the  acne  pap- 
ules to  decline.  Recovery  occurs  usually  after 
two  or  three  repetitions  of  treatment — M  fur 
Prak  Derm.y  XVIII.,  No,  10.— Atlanta  Med. 
and  Surg.  Jour. 


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296 


Disinfecting  tlie  Inlestinal  Tract. 

Quite  recently  Dr.  Ernst  Freund  (New  York 
Medical  Record)  has  succeeded  in  completely 
sterilizing  the  contents  of  the  intestine  by  the 
administration  of  peppermint- oil,  which  is  pre- 
ferably exhibited  in  the  form  of  the  following 
capsules:  menthol,  gr.  1);  oil  of  sweet 
almonds,  %  4-$;  from  6  to  8  capsules  in  the 
twenty- four  hours.  The  dose  of  menthol  ad- 
ministered never  exceeded  fifteen  minims  in  the 
cases  in  which  this  method  of  treatment  was 
tried  by  Dr.  Singer,  and  the  author  has  never 
observed  any  unpleasant  symptoms  to  follow  the 
use  of  this  remedy.  The  administration  of 
purgatives  with  the  same  end  in  view  did  not 
prove  so  satisfactory. 


Acetaniiid  as  a  Dressing  for  Wounds. 

Under  this  title  Dr.  F.  W.  Harrell,  of  Gil- 
man,  Washington,  surgeon  in  charge  of  the 
Seattle  Coal  and  Iron  Company's  mines,  reports 
the  use  of  powdered  acetaniiid  as  a  dressing  for 
the  various  injuries,  bums,  scalds,  contused 
and  lacerated  wounds,  into  which  dirt  of  vari- 
ous kinds  has  been  ground,  occurring  among 
the  employes.  In  an  effort  to  find  some  agent 
which  would  prevent  the  suppuration  which  so 
freqn^itly  accompanies  these  csases,  he  was  led 
to  try  acetaniiid,  beeause  of  its  non-hygroscopic 
properties,  and  reasoning  that  as  a  coal  tar  pro- 
duct it  was  inimical  to  the  development  of 
germs. 

Unusual  success  is  claimed  for  it  in  the  large 
number  of  cases  in  which  it  has  been  tried. — 
Colvmbus  Med,  Jour, 


Epsom  Salts  for  Diarrhea  in  Children. 

In  the  Summer  diarrhea  of  children  Dr. 
Stuart  Patterson  {Pittsburgh  Medical  Review, 
August  19)  employs  magnesium  sulphate.  In 
the  cases  mentioned  by  him  the  ages  ranged 
from  one  to  six  years.  The  dose  and  mode  of 
administration  of  the  remedy  were  as  follows : 
The  mother  was  directed  to  give  to  a  child  a 
year  old  an  even  teaspoonful  of  sulphate  of 
magnesium,  sufficiently  moistened  to  swallow, 
as  soon  as  she  arrived  at  home,  the  process  to 
be  repeated  in  the  morning,  and  the  child  to  be 
brought  back  to  me  at  3  P.  M.  on  that  day, 
that  being  the  hour  of  my  service  at  the  dis- 
pensary. This  procedure  was  repeated  daily 
at  the  same  hours  till  the  discharges  became 
yellow.  For  the  older  children  the  dose  ranged 
firom  a  heaping  teaspoonful  to  a  heaping  table- 
spoonfuL  The  afler-treatment  consisted  of 
general  tonics  and  prophylactic  precautions. 
The  former  were  selected  according  to  the  ne- 


cessities of  each  case.  Those  most  frequently 
used  were  syrup  of  iodide  of  iron,  cod-liver  oil, 
compound  syrup  of  hypopho^phites,  strychnine, 
quinine,  pyrophosphate  of  iron,  etc. — College 
and  Clinical  Record. 


A  Nut  for  the  Anti.Vaccinationists. 

Of  1201  persons  acting  as  nurses  and  physi^ 
cians  to  the  hospital  ships  of  Great  Britain 
where  small-pox  patients  were  confined,  only 
six  took  the  disease  during  the  years  from  1884 
to  1892,  and  all  recovered.  All  had  been 
vaccmated. — N.  Y,  Med.  Times. 


Vomitihg  of  Pregnancy.   , 

R.  Fluid  extract  of  valerian o*.  j. 

Fowlei'fl  solution min.  xvj. 

Bicarbonate  of  sodium dram  J. 

M.  8.    One  teaspoonftQ  every  two  or  three  hours. 

— Dr.  Berry  in  Memphis  Med.  Monthly. 


— ^An  idea  of  the  social  status  of  the  medical 
profession  in  England  may  be  gleaned  from  the 
fact  that  the  Duke  of  Westminster,  a  large 
proprietor  of  houses  in  a  fashionable  quarter  of 
London,  refuses  to  lease  any  of  these  to  physi- 
cians, surgeons  or  dentists,  lest  prospective  fash- 
ionable tenants  be  frightened  away. 

[And  yet  some  physicians,  ignoring  the  fact 
that  they  belong  to  the  class  known  as  wage- 
workers,  mistakenly  take  the  part  of  capital  and 
aristocratic  'Vested  rights"  in  the  great  contest 
that  has  been  in  progress  during  the  past  few 
years  for  greater  industrial  freedom.  As  sure 
as  the  contest  continues,  it  will  reach  the  n\ed- 
ical  profession  some  day — in  fact,  has  already 
reached  it  in  many  localities. — Ed.] 


— ^The  plan  of  using  electricity  to  produce  a 
cheap  disinfectant  irom  ordinary  water,  tried 
in  this  city  last  summer,  is  being  tried  with 
great  success  at  Havre  and  L'Orient,  France, 
according  to  La  Lumiere  Eleetrique,  The  sea 
water,  afiter  being  electrolyzed,  is  conducted 
through  lead  pipes  to  the  various  houses,  where 
it  can  be  drawn  upon  at  will.  The  destruction 
of  germs  is  absolute,  while  the  fertilizing  prop- 
erties of  the  sewage  are  unimpaired.  The  cost 
is  about  forty  cents  a  year  for  each  member  of 
the  population. 


Progrettive  IMan. 


The  hope  of  the  race  is  now,  as  heretofore, 
in  the  student  who  is  ever  on  the  alert  and 
questions  the  position  of  state,  of  church  and 
of  philosophy,  as  to  their  individual  worth ;  if 
either  makes  for  an  enlarged  personal  freedom 

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THB  MEDICAL  WORLD. 


it  shall  be  fostered ;  but  if  either  shall  be  found 
to  retard  pergonal  advancement,  it,  through 
neglect,  shall  be  permitted  to  enter  upon  the 
period  of  senile  atrophy. 

The  earth — man's  home — ^is  for  the  enlight- 
ened. Only  they  who  are  loyal  to  this  spirit 
are  destined  to  survive.  They  alone  have  in 
them  the  functional  activities  of  organic  life. 

From  "Mind  a  Product  of  Brain  Energy,'* 
by  Charles  J.  Lewis,  M.D.,  Chicago,  in  Jour. 
Amer.  Med.  Association. 


Cla88-Room  Notes. 

[From  the  College  and  Clinicai  Record.] 
^  Amyl  Nitrite  often  gives  relief  in  cases  of 
dysmenorrhea  accompanied  with  uterine  spasms. 
Coniine,  if  applied  locally  in  the  form  of  a 
poultice,  Prof.  Hare  says,  will  relieve  the  pain 
in  cases  of  Cancer. 

The  Slowing  of  the  False  in  a  woman  after 
labor,  Prof.  Parvin  eays,  is  to  be  regarded  as  a 
favorable  sign. 

The  best  way  to  treat  Abscesses  of  the  Liver, 
Prof.  Keen  says,  is  by  abdominal  section  and 
jiot  by  aspiration. 

Dr.  Wolff  advises  the  use  of  calomel  during 
the  early  stages  of  Pneumonia  on  account  of  its 
effect  on  the  exudate. 

In  no  other  disease  than  Pneumonia^  Prof. 
Wilson  says,  is  the  chill  at  the  onset  of  the  dis- 
ease so  constant  and  severe. 

A  case  of  Encephahid  Cancer.  Prof.  Keen 
says,  rarely  extends  over  a  period  of  eighteen 
months  before  it  causes  the  death  of  the  patient 
Prof.  Keen  says  PapillomatOy  or  warty-tu- 
mors, very  often,  during  the  cancerous  age  of 
life,  d^enerate  into  epitheliomatous  growths. 

If  the  Secretion  of  Milk  be  too  abundant. 
Prof.  Parvin  says,  a  lessening  of  the  amount  of 
liquid  taken  will  often  reduce  the  amount  of 
milk. 

Prof.  Brinton  says  the  adhesive  straps  in  a 
case  of  Fracture  of  the  Ribs  should  be  applied 
to  the  chest  during  the  time  of  expiration. 

Prof.  Parvin  says  that  he  has  cured  an  obsti- 
nate case  of  Eclampsia  by  the  internal  adminis- 
tration of  antimonii  et  potassii  tartras. 

Bromides  combined  with  opium.  Prof.  Hare 
says,  will  often  prevent  the  nauseating  effects 
which  Opium  has  on  many  persons. 

Quinine,  Prof.  Hare  says,  does  not  produce 
abortions ;  it  only  acts  on  the  uterus  after  that 
organ  has  begun  contracting  under  the  force  of 
the  labor  pains. 

In  all  cases  of  Pneumonia  in  which  the  dis- 
ease extends  to  the  periphery  of  the  lungs  we 


have  a  pleurisy  also,  developing  a  condition  then 
known  as  pleuro-pneumonia. 

Cases  of  Diabetes  Insipidus  aud  also  cases  of 
Nervous  Polyuria,  Prof.  Hare  says,  will  often 
be  greatly  benefited  by  the  administration  (d 
gallic  acid  combined  with  opium. 

In  cases  of  Alcoholism  in  which  nervous  irri- 
tability is  such  as  to  require  chloral  as  a  seda- 
tive. Prof.  Hare  says  strychnine  should  always 
be  combined  with  the  chloral. 

Aft«r  Obstruction  at  the  IHo-cecal  Valve,  ac- 
cording to  Prof.  Keen,  the  sigmoid  ffexure  of 
the  colon  will  be  the  next  most  common  place 
for  obstruction  to  take  place. 

Dr.  Parvin  says  Albuminuria  in  the  primi- 
gravida  occurs  generally  at  the  end  of  the 
seventh  or  beginning  of  the  eighth  month,  while 
in  the  multigravida  it  occurs  generallv  at  the 
beginning  of  the  ninth  month. 

Prof  Keen  says  when  there  are  chills  and 
sweats,  accompanied  by  high  fever  and  other 
signs  of  the  presence  of  pus  in  the  economy,  if 
no  cause  can  be  found  the  liver  should  be  care- 
fully examined  for  the  presence  of  an  Abscess. 

In  cases  otEcchymosis  of  the  Eyelid,  or  Black 
Eye,  Prof.  Hare  says,  in  order  to  prevent  much 
discoloration  or  exudation,  a  curd  may  be  ap- 
plied, made  by  adding  some  alum  to  the  white 
of  an  Qgg  or  milk  until  a  curd  is  formed. 

Prof.  Parvin  says  a  Thrombosis  of  the  vulva, 
which  is  due  to  varicose  veins,  should  not  be 
opened  until  at  least  three  days  after  labor  has 
taken  place,  on  account  of  the  great  danger  of 
a  hemorrhage  taking  place,  which  may  prove 
fatal. 

When  we  have  a  Fracture  of  the  Larynx  afr 
social  ed  with  bleeding  and  emphysema,  Pro£ 
Brinton  says  tracheotomy  must  always  be  per- 
formed ;  for  according  to  statistics,  all  cases  of 
recovery  that  have  occurred  have  had  such 
operation  performed. 

Prof.  Wilson  does  not  think  that  caustic  ap- 
plications should  be  applied  to  the  membrane 
iu  Diphtheria,  nor  does  he  think  that  the  mem- 
brane should  be  detached  by  the  aid  of  instru- 
ments. He  prefers  the  application  of  a  miM 
antiseptic  spray. 

In  Injury  to  the  Head,  Prof.  Keen  says  a 
valuable  means  of  differential  diagnosis  is,  that 
if  a  linear  fracture  has  occurred,  the  blood 
which  marks  a  fissured  fracture  cannot  be  wash- 
ed away,  while  blood  which  has  coagulated  in 
an  unbroken  suture  can  be. 

If  after  the  delivery  of  a  child  the  Afler 
Pains  continue  for  some  hours  and  occur  in 
quick  succession,  Prof.  Parvin  says  that  it  ii 


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Bometimes  an  indication  of  uretro-peritonitis,  and 
the  temperature  of  the  patient  should  always  in 
such  cases  be  carefully  watched. 

The  use  of  purgatives  during  an  attack  of 
Puerperal  InfecHofiy  Prof.  Parvin  thinks,  is  sel- 
dom advisable  excepting  in  the  beginning  of  a 
peritoneal  inflammation,  when  it  will  be  benefi- 
cial to  have  a  fi*ee  and  copious  evacuation  c^  the 
bowels  by  the  use  of  salines. 

For  the  relief  of  Pain  in  the  Stomach  due  to 
a  gaatric  catarrh,  Prof.  Hare  advisee  the  follow- 
ing:— 

B.  Add.  hydrocvanlc.  dUut f  dr.  j-IJ 

Ext  oannabto  indlcee  fl.. f  dr.  l] 

Ext.  hyoscyami, .\ f  oz.  ra 

Spirit  chloroformi,  q.s.  ad, f  oz.  iij. 

Siff.— Teaspoonfta  every  three  hours  until  the  pain  is  re- 
Uered.  . 

Prof.  Hare  says  that  there  is  no  drug  in  medi- 
cine that  will  give  as  much  relief  as  the  Spirits 
of  Chloroform^  in  the  dose  of  from  twenty  to 
thirty  drops,  to  a  patient  suffering  from  abdomi- 
nal pain ;  and  it  possesses  also  the  advantage 
over  opium  that  it  does  not  constipate. 

Shoeky  as  a  rule.  Prof.  Keen  says,  is  more 
marked  in  the  male  than  in  the  female.  It  is 
also  les3  marked  in  those  cases  in  which  an  oper- 
ation is  performed  on  those  who  have  been  ill 
for  some  time,  than  in  those  who  are  operated 
on  because  of  a  sudden  or  recent  accident 

Prof.  Keen  says  gallstomes  occur  three  times 
as  often  in  women  as  in  men. 

Syphilis,  Prof.  Brinton  says,  predisposes  to 
the  non-union  of  fractured  bones. 

Prol  Parvin  says  a  woman  suffering  from 
uterine  hemorrhage  bears  opium  better  than 
under  almost  any  other  condition. 

Prof.  Parvin  thinks  that  the  lochii^l  discharge 
is  less  in  women  who  nurse  their  children  than 
in  those  who  do  not 

Digitalis,  Prof.  Hare  says,  should  not  be  ad- 
ministered in  the  presence  of  high  fever,  as  it 
does  not  act  when  such  fever  exists. 

Prof.  Wilson  says  that  diphtheria  is  a  dis- 
ease of  all  climates  and  seasons,  but  that  civili- 
zation predisposes  to  its  occurrence. 

Grave  cases  of  jaundice  occuring  in  recently 
bom  children.  Prof.  Parvin  regards  as  a  sign 
that  septic  infection  has  taken  place. 

Vomiting  which  is  present  at  the  onset  of  an  ' 
attack  of  scarlet  fever,  Prof.  Wilson  says,  will 
geDerally  subside  of  its  own  accord. 

Decreased  arterial  tension  and  increased  ven- 
ous pressure  both  cauee  dropsy,  and  in  both 
conditions  Prof,  Hare  says  digitalis  is  indicated. 


Arsenic,  Prof.  Hare  says,  has  been  found  to 
be  useful  in  stopping  the  vomiting  occuring  in 
those  suffering  from  cancer  of  the  stomach. 

Prof.  Keen  is  of  the  opinion  that  there  is 
scarcely  any  benign  tumor  that  may  not  under- 
go degeneration  and  become  malignant  in  char- 
acter. / 

In  administering  the  bitartrate  of  potassium 
as  a  purgative.  Prof.  Hare  says  that  the  com- 
pound jalap  powder  should  always  be  combined 
with  it 

Malignant  tumors  of  the  breast.  Prof.  Keen 
says,  seldom  appear  before  the  age  of  thirty- 
five,  excepting  sarcoma,  which  may  appear  at 
any  age.  ^ 

Prof.  Hare  says  it  is  well  always,  to  combine 
with  chloral  hydrate  a  bromide,  as  the  chloral 
increases  reflex  irritability,  which  the  bromide 
will  prevent. 

If  during  the  administration  of  chloroform 
the  pupils  suddenly  become  dilated.  Prof.  Hare 
says  there  is  great  danger  of  sudden  death  tak- 
ing place. 

Vaccination,  Prof.  Wilson  says,  should  be 
performed  in  three  places,  since  the  greater  the 
amount  of  pox  produced,  the  greater  is  the  im- 
munity that  follows. 

Cases  of  diabetes  occuring  in  gouty  persons, 
Prof.  Hare  says,  has  been  found  to  be  greatly 
benefited  by  the  administration  of  arsenic  com* 
bined  with  lithia. 

Prof.  Hare  says  that  it  is  much  better  to  re- 
duce the  temperature  in  cases  of  fe^er  by  the 
aid  of  cold  baths  or  sponging,  than  by  the  em- 
ployment of  antipyretic  drugs. 

Enlarged  glands,  in  cases  of  carcinoma  should 
always  be  removed,  Prof.  Keen  says,  at  the 
time  when  the  tumor  itself  is  removed,  if  they  be 
accessible  in  any  manner  possible. 

As  a  rule.  Prof.  Keen  says,  chronic  obstruc- 
tion of  the  bowel  is  generally  at  or  below  the 
ileocecal  valve,  while  an  acute  obstruction  is 
generally  at  or  above  the  ileoceecal Valve. 

Prof.  Brinton  says  the  non  union  of  a  frac- 
tured bone  is  often  due  to  the  fact  that  on  ac- 
count of  the  low  vitality  of  the  patient,  the 
callus,  after  having  formed,  is  absorbed  again. 

Hemorrhage  occuring  in  a  patient  two  or 
three  weeks  after  the  delivery  of  a  child  has 
occurred,  is  very  frequently  caused,  Prof. 
Montgomery  thinks,  by  retroversion  of  the 
uterus. 


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Alcohol  should  be  adminiBtered  to  patients 
suffering  from  diphtheria,  and  as  a  rule  it  will 
be  found  that  they  are  able  to  take  large 
amounts  without  manifesting  any  bad  symp- 
toms. 

In  all  cases  in  which  a  spontaneous  fracture 
of  a  bone  occurs,  without  undue  force  having 
been  applied  to  it,  Proi  Keen  says,  malignant 
disease  of  the  bone  should  always  be  sus- 
pected. 

Dr.  Da  Costa  says  that  plugs  of  gauze  soaked 
in  a  strong  solution  of  antipyrine  will  be  found 
very  efficient  in  stopping  hemorrhage  from  the 
nose,  the  antipyrine  acting  as  a  good  styptic. 

Prof.  Parvin  says  eclampsia,  oocuring  in  a 
pregnant  wonmn  before  labor,  is  fatal  in  about 
fifty  per  cent  of  the  cases,  while  if  it  occurs 
after  labor  it  h  fatal  only  in  about  eight  per 
cent  of  the  cases. 

Diacrhoea  due  to  proctitis.  Prof.  Hare  says, 

will  often  be  cured  by  injections  of  the  chlorate 

V  of  potassium  in  the  strength  of  tweaty  grains  to 

the    ounce;    one  ounce   to   be  injected   at  a 

time. 

All  cases  of  ulcers  which  will  not  yield  to 
treatment.  Prof.  Keen  says,  should  be  suspected 
of  being  malignant  in  character,  excepting 
when  the  ulcer  be  on  the  leg  and  is  due  to  a 
varicose  condition  of  the  veins. 

In  making  a  digital  examination  in  a  case  of 
face  presentation,  great  care  must  be  exercised 
by  the  obstetrician ;  it  must  be  made  very 
gently,  so  that  no  injury  be  inflicted  to  the  face, 
especially  to  the  eyes. 

Prof.  Parvin  thinks  that  a  woman  who  after 
delivery  has  a  pulse  above  100  per  minute,  is 
in  danger  of  having  a  uterine  hemorrhage,  and 
the  obstetrician  should  not  leave  her  until  the 
pulse  has  decreased  in  number. 

Prof.  Wilson  says  the  following  spray  will  be 
found  useful  in  diphtheria : 

R.   Caftolnse gr.  xx    • 

Sodll  bicarb gr.  ▼ 

Aquseq  B.Ad f  ounoelj 

M.  Sig.    Apply  locally  aa  a  spray  to  the  membrane. 

Prof.  Wihon  does  not  favor  the  use  of  the 
chlorate  of  potassium  in  cases  of  diphtheria,  not 
only  on  account  of  it  not  influencing  the  disease 
favorably,  but  more  on  account  of  the  injurious 
effect  which  it  exercises  on  the  kidneys. 

Prof.  Keen  thinks  that  the  majority  of  the 
cases  of  appendictis  need  no  surgical  interfer- 
ence.    The  reason  that  eo  many  cases  prove 


fatal  which  have  been  operated  on,  is  due  to  the 
fact  that  surgical  interference  has  been  done 
too  late. 

In  true  angina  pectoris.  Prof.  Hare  says 
the  heart  feels  as  if  it  were  contracted  ;  while  in 
pseudo-angina  pectoris  the  heart  gives  a  sensa- 
tion to  the  patient  as  if  it  were  in  an  expanded 
condition,  too  large  for  the  cavity  in  which  it  is 
contained. 

The  higher  up  a  volvulus  of  the  bowel  has 
taken  place,  the  less  will  be  the  amount  of  urine 
voided.  Prof.  Keen  gays.  It  is  due  to  the  fact 
that  the  higher  up  the  volvulus  occurs,  the  les 
will  be  the  amount  of  absorption  that  will  take 
place  from  the  bowel,      ^ 

Prof.  Hare  says  in  very  obstinate  chronic  or 
subacute  rheumatism,  which  will  not  yield  to 
the  ordinary  treatment,  cimicifuga  will  some- 
times do  good,  especially  in  cases  in  which  the 
rheumatism  is  situated  in  the  muscles  rather 
than  in  the  joints  themselves. 

The  following  local  application.  Prof.  Hare 
says,  will  be  found  serviceable  in  cases  of  bron- 
chitis, occuring  in  infantSi  associated  with  some 
nervousness :  oil  of  amber  one  part,  and  olive 
oil  three  parts.  This  is  to  be  applied  to  the 
back  and  front  of  the  chest 

For  the  nervous  symptoms  occurring  in  child- 
ren suffering  from  cholera  infantum.  Dr.  Ash- 
ton  says  hypodermic  injections  of  morphia  sul- 
phate, gr.  a^ft  ■|io>  ^^^  atropine  sulphate, 
gr.  g  I  ff-fl  I  A,  will  be  found  useful,  but  their 
effect  must  be  carefully  watched. 


Some  Notes  on  African  Fever  with  Catet. 

[As  many  of  our  readers  are  particularly  in- 
terested in  the  study  of  malarial  diseases,  we 
offer  the  fbllowing  instructive  account  from  the 
pen  of  a  traveler,  Dr.  Clowe,  in  Albany  Medical 
Annals  :'\ 

During  two  years  spent  on  the  west  coast  of 
Africa  it  has  been  my  fortune  to  meet  with 
malarial  poisoning  in  all  its  forms  and  in  vary- 
ing degrees  of  malignancy. 

No  white  person  can  spend  any  length  of 
time  there  without  being  attacked  with  fever. 
On  the  care  he  takes  of  himself,  more  than  his 
constitutional  vigor,  depends,  I  think,  his  life. 
Certainly  this  has  all  to  do  with  the  frequency 
and  severity  of  the  attacks  Immediately  upon 
landing,  and  sometimes  before,  the  system  seems 
to  imbibe  the  poison  which,  however,  may  (but 
does  not  always)  lie  dormant  until  some  little 
thing  calls  it  forth.  There  are  several  things 
which,  singly  or  combined,  may  serve  to  bring 


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299 


on  a  chill  and  its  subsequent  consequenoes.  Any 
over-exertion  in  the  sun  is  very  likely  to  be  fol- 
lowed by  an  attack.  Exposure  to  wet  or  cold, 
especially  the  cold  air  of  the  early  morning 
seems  to  speedily  induce  an  attack.  Constipa- 
tion favors  the  de^ebpment  of  the  poison. 
Mental  excitement  of  any  k  nd  or  alcoholic  ex- 
cesses soon  result  in  ti  ouble. 

The  natives  of  Angola  suffer  very  generally 
from  fever  but  almost  always  of  a  mild  type. 
Those,  however,  coming  down  from  the  high- 
lands to  the  coast  often  suffer  severely.  It  is 
rarely  fatal  among  the  blacks.  The  whites  at 
the  coast,  who  are  almost  all  Portuguese,  lead 
generally  dissipated  lives ;  striving  to  overcome 
the  dreary  monotony  of  a  trader's  life  by  all 
sorts  of  excesses.  In  some  of  the  hot  seasons  the 
mortality  is  frightful  among  them.  Sometimes 
one-third  of  the  whites  die  in  a  single  season.  The 
majority  of  the  fatal  cases  seem  to  be  of  a  cere- 
bral type.  The  treatment  adopted  by  the 
Portugese  is  largely  calomel  with  emetics. 
Quinine  is  used,  but  somewhat  sparingly.  The 
average  duration  of  fatal  cases  is  very  short, 
from  four  to  ten  hours  telling  the  story.  A  man 
may  be  well  in  the  ^lorning  and  buried  at  night, 
very  little  ceremony  being  used.  Up  country, 
however,  the  results  are  different.  Fatal  cases 
are  not  so  common.  The  fewness  of  the  cases  I 
have  to  present  from  up  country,  is  due  to  the 
favorable  climate  and  altitude.  In  all  Bihe  and 
Bailundu  where  I  was  stationed,  there  were  only 
eighteen  deaths  among  whites  during  the  two 
years  I  was  there,  and,  as  I  said  above,  cases 
of  a  malignant  type  are  vastly  less  freqaent 
there  than  along  the  sea. 

All  whites  suffered  from  chills  and  occasional 
intermittent  attacks,  but  it  was  the  exception  to 
see  a  severe  case.  Those  who  took  best  care  of 
themselves  were  least  troubled.  Grenerally  upon 
the  appeaiance  of  the  premonitory  symptoms 
(which  grow  to  be  well  known)  a  dose  or  two  of 
quinine,  in  size  suited  to  the  individual,  would 
be  sufficient  to  wavd  it  off.  This,  however,  must 
be  accompanied  by  absolute  rest.  The  natives 
generally,  use  no  treatment,  except  to  lie  down 
in  the  sun  until  the  sweating  stage  appears.  In 
my  dispensary  work  among  them,  I  used  largely 
a  mixture,  each  dram  of  which  contained  the 
following :  Cinchonid.  sulph.  gr.  x,  Tr.  Aeon, 
rad.,  m  v.;  Tr.  Menth.  Pip.,  git,  xx.;  To  be  re- 
peated if  necessary.  One  dose,  however,  was  all 
that  was  usually  needed.  For  the  whites,  when 
trouble  had  actually  begun,  Warburgs  Tr.  in 
doses  of  two  to  four  drams  seemed  best  for  gen- 
eral use  and  was  followed  by  uniformly  good 
results  in  the  milder  cases.  Arsenic,  I  tried  fre- 
quently and  thoroughly,  among  blacks  and 
whites,  but  observed  no  benefit  as  far  as  pre- 


venting attacks  was  concerned.  As  a  tonic  it 
was  useful.  The  followini^  incomplete  report 
of  cases  are  taken  from  no'ee  made  at  the  time, 
when  under  a  pressure  of  work,  and  when  I 
myself  was  often  far  from  feeling  at  my  best 
They  may,  however,  prove  of  some  interest 

Case  L 

Senhor  Madeiras,  a  Portuguese  trader,  about 
24  years  of  age,  leading  a  dissipated  life,  was 
taken  with  a  chill  and  fever,  and,  not  growing 
better,  I  was  sent  for,  some  eighteen  miles,  to 
see  him.  Upon  reaching  the  place,  twelve 
hours  afler  the  first  chill,  found  him  presenting 
the  following  conditions:  Temp.  106.5°  F.  ; 
pulse  120  and  thready ;  exceedingly  restless 
and  nervous ;  headache ;  deeply  jaundiced ;  was 
vomiting  constantly  ;  pain  in  loins  and  limbs. 
Was  shown  me  about  four  ounces  of  what  ap- 
peared to  be  pure  blood,  parsed  from  his  blad- 
der eight  hours  ago.  No  secretion  since.  He 
would  answer  c6rrectly  all  questions  put  to  him, 
but  if  not  spoken  to  for  a  few  minutes  would 
become  delirious.  Administered  Warburg's 
tincture,  i  oz.,  to  be  repeated  in  three  hours. 
Also  pot  chlo.  gr.  xx.,  to  be  repeated  hourly 
for  a  time.  Ordered  a  sinapism  oyer  region  of 
kidneys,  and  quin.  bisulph.  to  be  given  next 
morning,  if  he  was  alive.  Saw  him  again  the 
ifecond  day  from  that  time.  Temp.  99°  F. ; 
skin  moist  and  cool ;  profuse  secretion  from 
kidneys  ;  bowels  regular  ;  no  pain  ;  slept  well; 
had  taken  a  little  nourishment ;  is  still  some- 
what jaundiced.  Administered  hydrag.  chlor. 
mit  gr.  X.,  and  ordered  a  daily  dose  of  quin. 
bisulph.  gr.  xx.  at  bedtime.  He  progressed 
steadily  from  that  time,  and  was  out  in  a  week. 

Case  II. 

Senhor  F.  A.,  sergeant  in  Portuguese  army, 
stationed  in  Bihe.  Was  sent  with  about  fifty 
black  soldiers  to  quell  a  threatened  uprising  of 
the  natives  about  eighteen  miles  from  the  fort 
Started  at  eight  o'clock  p.  m.,  and  marched  the 
distance  through  a  pour  of  rain.  Very  muddy 
and  hard  walking.  He  had  no  sleep  that  night 
or  next,  until  he  again  reached  the  fort  Dur- 
ing night  of  exposure  had  a  chill,  as  also  the 
following  night  I  saw  him  three  days  after 
first.chili.  Found  him  wildly  delirious.  Temp. 
105+F.  per  rectum;  pulse  110  ;  bowels  mov- 
ing frequently,  and  vomiting  often ;  mouth 
thickly  covered  with  black  sordes.  Not  rational 
at  any  time.  The  only  treatment  given  had 
been  to  fire  the  calves  of  both  legs  for  a  space 
the  size  of  the  palm  of  one's  hand.  This  had 
been  kept  discharging  by  frequent  irritation. 
It  was  found  impossible  to  give  him  any  medi- 
cine by  mouth,  as  four  men  could  not  control 


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him.  Hyperdennics  of  quinbe  had  no  seeming 
effect  He  sank  rapidly  and  died  the  same 
night 

Case  III. 

Mrs.  S.,  American.  Had  been  eight  years 
in  the  country,  three  years  of  which  had  been 
spent  at  the  coast  Had  had  freqnent  attacks 
of  fever,  varying  in  severity.  Had  a  miscar- 
riage at  six  weeks,  brought  on  by  a  fall.  Re- 
covered from  it,  but  was  still  weak,  when  one 
week  after  leaving  her  bed  she  overexerted  her- 
self and  was  attacked.  Had  a  very  severe  chill 
at  9  p.  m.,  which  was  controlled  by  hypodermic 
of  quin.  bisulph.,  gr.  x.,  morph.  sulph.  gr.  i, 
with  hot  applications.  Very  soon  began  to  vomit 
large  quantities  of  bile.  This  was  stopped  by 
hypodermics  of  morph.  and  atrop.  Was  ena- 
bled to  take  two  drams  of  Warburg's  tina,  and 
keep  it  down.  Slept  fairly  well  balance  of  night, 
until  6  a.  m.,  when  she  awoke  vomiting  and 
purging.  Now  nothing  availed  to  check  the 
vomiting.  Morph.  sulph.,  cerium  oxalate,  co- 
caine hyd.  chlor.,  ipecac,  carbolic  acid,  tr. 
iodine,  etc.,  etc.,  were  tried  in  succession.  At 
9  a.  m.  began  to  be  delirious.  Secretion  of 
urine,  scanty.  At  1  p.  m.  none  in  bladder,  n«r 
was  any  pa^ed  again.  Great  pain  over  kidneys, 
not  relieved  by  hot  applications  or  stimulation. 
Two  hypodermics  of  morph.  sulph.,  i  grain, 
checked  vomiting  for  one  hour  from  6  p.  m.^but 
it  came  on  again.  She  passed  soon  into  a  coma- 
tose  condition  and  died  at  10  p.  m.,  only  twenty- 
five  hours  from  initial  chill.  No  autopsy.  For 
seven  hours  before  death  was  deeply  jaundiced. 

Case  IV. 

Mr.  C,  American.  Had  suffered  from  fre- 
quent attacks  of  fever,  generally  slight,  lasting 
a  day  or  two  and  relieved  by  quinine  or  War- 
burg's tine,  in  good  sized  doses.  After  severe 
exertion  in  sun  at  midday,  experienced  sudden 
lassitude,  which  kept  up  until  a  chill  supervened 
at  6  p.  m.  This  was  relieved  by  usual  reme- 
dies, but  was  followed  by  another  in  the  after- 
noon of  next  day  On  third  day  took  quin.  bi- 
sulph., gr.  xlviii,  in  two  doses — one  at  12  m., 
the  other  at  3  p.  m.  Had,  however,  a  slight 
chill  again,  and  temp,  rose  to  104.5^  F.  Began 
to  be  jaundiced.  Next  day  took  Warburg's  tr., 
two  drams  every  other  hour,  and  a  double  dose 
at  3  p.  m.  By  this  time  was  very  yellow  in- 
deed; had  complete  anorexia,  splitting  head- 
ache, pain  in  back,  urine  very  scanty  and  highly 
color^ ;  no  diarthea ;  evening  temp.  106.4^  F. 
No  sleep.  Next  morning  no  better.  I  resolved 
to  try  an  emetic ;  administered  gr.  1,  aat  et 
pot  tart  As  soon  as  emesis  took  place  experi- 
enced  great  relief.      A  profuse  perspiration 


came  on,  and  headache  relieved.  At  noon  quin. 
bisulph.,  gr.  xx;  temp  at  4  p.  m.  101®  F. 
Took  nourishment.  Next  morning  repeated 
the  emetic,  with  further  benefit ;  jaundice  re- 
duced; temp,  normal.  Made  a  complete  re- 
covery in  about  one  week. 

These  cases  well  illustrate  the  worst  type  of 
malarial  poisoning. 

No  one  there  is  safe  from  its  effects.  One 
day  it  may  appear  in  its  mildest  form,  but  the 
next  may  usher  in  a  grave  attack,  or  one  from 
which  the  victim  may  not  recover. 


Formulas. 


FOR  THE  NIGHT  SWEATS  OF  PUMONARY 
TUBERCULOSIS. 

R.     QnlnisB  lolpbat 

ZlDCi  BUlpbat aa  gr.  11 

Kxt.  hyoscyaml gr.  J 

Kxt.  nuds  vomica gr.  Vc 

M.   Ft.pU.J.  "^ 

Big.— Take  at  bed  time. 

Dr.  Ewart,  La  Semaine  MH. 


EPISTAXIS. 

The  method  of  Dr.  Rougier  is  to  i>aint  the 
spot  from  which  the  haemorrhage  seems  to  come 
with: 

B.     Collodion ounces  iij 

Acid,  carbolic 
Add.  benzoic 
Add.  tannic aagr.  Ixzr.  M 

This  preparation  coagulates  albumen  instaD- 
taneously,  and  its  use  is  not  painful.  Th^ 
author  also  employs  it  after  removal  of  adenoid 
tumours,  tonsillotomy,  etc. — La  Med,  Mod. — 
Ontario  Med,  Jour, 


TO     PREVENT     SEPTIC      INFECTION      THROUGH 
ABRASIONS. 

B.     Ichthyol 4.0  (diam  j) 

Flexible  «x>llodlon 80.0  (ounces  J) 

M.   &— Apply  with  camel's  hair  brush  once  or  twice 
daily. 

BILIOUS  COLia 

R.     Splr.  chlorof. .2.4  (dram  Si) 

FL  ezt  dioscorea  Tisc .......»..0.4  (gn.  t\) 

Bpir.  yini.  rect 4  0  (arsmj) 

Glyoerine  and  water qu.  s.  ad^...30.0  (ounces  j) 

4co  (dram  J)  eyety  half  or  one  to  six  hours,  according  tt> 
indication. 


REMEDY  FOR  ACNE  : 

B.     Sulphate  of  zinc )    r^r^^unnm^ 

Sulphurated  potash /    ofeach20gii. 

Rosewater 1  fluid  ounce 

Precipitated  sulphur ......80 grains 

Apply  three  times  a  day. 

HICCOUGH : 

B.     Bismuth,  subnitr. gr.  xij 

Zlnci  oxidl, 
Zlnci  yalenanat, 

Pulv.  calumbse dram  j 

PulT.opli .gr.  isii 

Spirit  anisi q.  a. 

M.   Big*— TeaspoonfUl  in  a  glass  of  sweetened  water. 


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FOR  CHRONIC  CYSTITIS  : 

R.     UqooTiB  Potassse ^ m  xxx 

Inftisi  UYse  Uni 

InAul  Bacba ^..aa  ounce  j 

Mtooe  et  fl  at  mistnra.  This  makes  lour  tablespoonftils— 
one  doic. 
Thto  dote  four  times  dftly. 


FOR  DIABETES. 


R,    Nitrite  of  pilocarpine gr.  iil 

Dilute  alcohol ^ dram  i 

DistiUed  water. ^ ounces  ss 

4  or  5  drops  of  this  mixture  may  be  placed  upon  the  tongue 
two  or  three  times  a  day. 


NON-BITTER  QUININE. 

Quinine  sulph gr.  xy 

Add.  sulph  dil .M.  XV 

8pr.  menth.  pip ...^drams  ijss 

Sol.  saocharm.  saturat drams  v 

AqusB  de8t......„. ounces  vj 

— Medical  News, 


MALARIAL    TONIC. 

The  following  was  used  in  St  Louis  Female 
Hospital : 

R.  Ferri  sulph dram  J 

Addi  nitrici  (C.  F.) dram  J 

Misoe  et  aade 

Aqus  omnamomi , ounces  iij 

Qulninse  sulph. .drams  iss 

Misoe  etadde 

Potaan  dtralis drams  IJ 

AqusB  oiunamoml ounces  iiJ 

M.   Sig.   Teispoonftil  in  a  little  water  three  times  a  day, 
given  after  meals. 

The  above  formula  to  be  mixed  just  as  wi;it- 

ten,  ur  a  aediment  will  form.     Do  not  use  the 

dried  sulphate  of  iron,  but  the  pan  coperas. 

— St  Louis  Courier  of  MedidTie* 


FOR  IRRITABLE  COUGH. 

R.    Addl  hydrocyanid  dlluti. f  dram  iss 

Morphinse  aoetatis gr.  iss 

Mndlaginis  acadsB ounces  J 

Sympi  pruni  virginianse f  ounces  iv 

Aquam ad.  ounces  vj 

Biisoe  at  flat  mistura. 

A  teaspoonftQ  to  be  sipped  every^four  or  six  hours. 

Praetitioner, 


APPLICATION   FOR  CHRONIC  ULCER. 

R.  Add  chromic gr.  xxx 

Add.  tannic gr.  xx 

Morph.  sulph gr.  v 

Chloral,  hyorat ^ dram  vJ 

Aquffi ^ « *.....o3 

M.  Bur.  Apply  Arequentlv,  during  the  day.  with  a  camel 
hair  pencil;  in  the  interim  keep  the  ulcer  covered  lightly 
with  a  cloth  or  bandage. 

—Ibid. 


GLYCOSURIA. 


Choleriform  Diarrhea  in  Cliildren. 

Dr.  Bndthwaite  (La  Semaijie  Medicalsy  No. 
ItAf  1894)  has  had  good  results  in  choleriform 
diarrhoea  in  children  with  the  following : 

R.  Salicylate  Soda. 

Snphate  lron.........aa 0 1 60  (gia.  ix). 

Neutral  pure  glycerine 10     0  (dram  Qss). 

Water 40 1  0  (ounces  Jss). 

A  teaspoonfta  fbur  times  a  day. 

— Med,  and  Surg.  Reporter. 


Dr.  L.  D.  Kasterbine  regards  the  following 
as  an  excellent  prescription  : 

R,  AddilaeUd, 

Aquse  destillatse ....aa ounce  j 

j         M.  et  nat  mistura. 

Big.   Teaspoonml  in  water,  before  meals. 

— Louisville  Med.  Monthly. 


VOMITING   OF   PREGNANCY. 

R.  Fid.  ext.  valerian ounce  i 

Fowler's  soL  arsenic ....minims  xvj 

Sod.  bicarb dram] 

M.   Sig.    TeaspoonAil  every  two  or  three  hours. 

— Dr.  Julian  Berry,  Mace,  Ind.,  in  Memph. 
Med.  Jour. 


MIGRAINE. 

R.     Butyl-Chloral  hydrate .^.  xx 

TlDCt  gelsemium m  xxx 

Tinct  cannabis  Ind mxv 

Glycerin ounces  ss 

Water, « q.  s.  ad.  ounces  llj 

M.    Sig.— A  thirA  part  to  be  taiEen  at  once.   The  dose  to  be 
repeated  m  half  an  hour. 

— Practitioner. 


LUBRICANT    FOR    URETHRAL    SOUNDS, 
CATHETEHS,    ETC. 

<jru yon  uses : 

R.  Powd.  soap JM)  00  (drams  15) 

Glycerine 26.00  (drams  7) 

Water 25  00  (drams  7) 

Sublimate 0  02  (K  grain) 

This  is  antiseptic,  without  irritant  action  on 
the  canal,  and  being  much  more  slippery  than 
the  ordinary  oils  or  fats,  it  renders  the  intro- 
duction of  the  instruments  easier. 

-  Times  and  Register. 


ANTI-MALARIAL. 

The  following  has  given  unusual  satisfaction  in 
malarial  conditions ;  seldom  failing  to  prevent 
recuring  attacks : 

R.    Syr.  add  hydriodic  (Hostelley's) ounces  iij 

Lig.  Potassii  Arsenit drams  ij 

Qmnina  sulph dram  j 

Tbict  capsicum drams  iv 

M.    Sig.— TeaspoonfUl  three  times  a  day. 

CATARRH  OF  GALL- DUCTS. 

R.     8odU  Phosphat ounces  J 

Bicarbonate  of  soda ounces  ss 

Extr.  taraxaci  fl fl.  ounces  i 

Aq.  menth.  pip - ounces  II 

Syr.  cort  aurant fl.  ounces] 

M.    Sig.— Teaspoonfbl  three  times  a  day. 

Med.  Rev. 


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THE  MEDICAL  WORLD. 


CHRONIC  RHINITIS  AND  PHARYNGITIS. 

Dr.  H.  M.  Dunlop,  Sanitarium  at  Battle 
Creek,  Mich.,  claims  to  have  obtained  splendid 
results  from  the  application  of  the  following : 

R.     OL  dimamoD gtte.  xx 

Buoalyvtol  (Sander  &  Sods) drains  lii 

01.  gaoltheriss gtts  zxx 

Menthol  crysial grs.  zx 

Lfq.  albollne ounces  iij 

M,    Sig.-  Use  with  atomizer. 

— Baderiologieal  World  &  Modeme  Medizine, 


ANTIDIABETIC  POWDER. 

The  formula  of  Dr.  Monin  is  : — 

R.  'Bicarbonate  of  sodium ounces  ij 

Benzoate  of  sodium drams  x 

Salicylate  of  sodium drams  y 

Carbonate  of  lithium ~ ounves  ss 

M.    Sig.— Teaspoonitil  at  each  meal. 

— Rev.  Med.  Phar. 


St.  Louit  Female  Hospital  Formula. 

By  R.  M.  KiRLBY,  M.D.,  Superintendent. 
From  St.  LouU  Med.  Cour, 

RHEUMATIC  NEURALGIA. 

B.     Potta8«8e  bicarb  (82  0) ounces  j 

Sodsebi3arb ounces  ij 

M.  ft  chart  No.  i. 

SIg.— Take  a  teaspoonful  in  glass  of  cold  wster  eyery  4 
hours  untU  aU  pain  is  relieyed.  Then  an  occasional  dose  for 
■eyenddays. 

REMEDY  FOR  CHILLS,  IN  LIEU  OF  QUININE. 

B.     Liquor  potass®  arsenitis, 

Tincturs  lodlnii,  aa ; ounces  ss 

(16  626CC.) 
M.    Sig.— Dose  for  an  adult— 10  drops  in  water  or  milk 
three  times  a  day. 

LOCAL  APPLICATION  FOR  TREATMENT  OF   HER- 
NIA IN  CONNECTTION  WITH  TRUSS. 

R.     Axt.  beUddonnsB,  fluid ^ drams  ij 

Tinct.  opii drams  iss 

Glycerinl„ i^unceei 

Af'id  tannic drams] 

Tlnot  cantharides ....ounces  b< 

Aquse. 7. Oj 

M.  Slg.— Apply  thoroughly  and  irequentiy  oyer  region  of 
hernia,  wearing  tnus  constantly. 

MALARIAL  TONia 

R.     Ferri  sulph drums  j 

Addi  niirici(C.  P) drams  J 

Mifceetadd: 

AquK  cinnamoni ounces  i^j 

Quininse  sulph drams  iss 

Misoeetadd: 

Potasses  diratis drams  i1 

Aqus  dnnamoni.. otfnces  iij 

M.  Big.— Teaspoonful  in  a  little  water  three  tlmtt  a  day, 
giyen  after  meals. 

[The  above  formula  to  be  mixed  just  as  writ- 
ten, or  a  sediment  will  form.  Do  not  use  the 
dried  sulphate  of  iron,  but  the  pan  coperas.] 

TONIC  TO  BE  USED  IN   CONNECTION    WITH   PRE- 
CEDING  FORMULA. 

R.    Liquor  potassffi  arsenitis » dram^  yll 

Tinct.  nuxyom drams  } 

M.  Sig.— Take  from  7  to  10  drops  three  a  day,  half  an  hcur 
after  meals,  in  a  little  water. 


FOR  REMOVAL  OF  CORNS  FROM  THE  FEET  WITHi 

OUT  PAIN. 

R.     Acid  Falieyllo „ «t.  xx 

Cannabis  indica,  fluid dram»  i 

Collodion » ..drams  UJ 

M.  Big.- Apply  thoroughly«sriih  camel's  hair  pencil  ovef 
the  com,  morning  and  night,  for  four  or  fiye  days.  TheoKwIi: 
the  com  in  as  hot  water  as  can  be  borne  until  com  becosd' 
soft— then  remove  it  with  foroeps  or  point  of  knife  Usde. 

TREATMENT  OF   GOITRE,  WHEN    IMPOSSIBLE  Ilf\ 

USE  KNIFE. 

R.     ErgoUne gr.  xt 

Glycerine „ drams  n 

Chloroform drams  ns 

AqusB  dis ,  q.  4.  ad .....drams  \% 

M.  Sig.— Inject  into  btdy  of  tumor  wlih  hypodenoit 
syringe,  half  drachm  of  mixture  eyery  6  or  7  dayt. 

APPLICATION  FOR  CHRONIC  ULCER. 

R.     Acid  chromic « — gr.  xxx 

Add  tannic « gr.xx 

Morph.  sulph ^ gr.y 

Chloral  hydrat dtamvt 

Aquse. -.0  j 

M.  Slg.— Apply  fluently  during  the  day,  wi  h  a  euiei^ 
hair  pencU- in  the  interim  keep  the  ulcer  ooyeted  11^> 
with  a  cloth  or  bandage. 


— In  sciatica  and  other  neuralgias  : 

E.  T<nct  aconiti,  i 

TincK.  colch.  seminis, 
Tinct,  belladonnae 

Tinct.  actesB  racemoen,  aa  partes  squales. 
Sig.  Six  drops  every  six  hours. 

— Metcalf.     I 
— In  toothache,  (Jour,  de  Pharmaeie :) 

R.   Dry  alcoholic  extract  opium... ! 

CJamphor aa. 0.80 

Balsam  Pera 

Mastic - aa. 1.0 

Chloroform 100 

Introduced  into  the  cavity  it  calms  the  paio 
at  once. 


TO    HARDEN    THE    SKIN    OF    BED  RIDDEN   PA- 
TIENTS IN  ORDER  TO  PREVENT  BED80RB9. 

The  parts  first  to  be  washed  with  an  antisep- 
tic solution  twice  daily,  dry  and  apply  the  fol- 
lowing powder : 


R. 


M. 


R. 


Puly.  camphor 200  (dram  v) 

Amyl.  puly — »..J20.0  (ounces  iiiss} 

Cretse  gallic 6u.O  (ounces  Ij) 

Alum  ustum „..4.0  (diaiD]) 

Add  Boradc 80  0  (ounces!) 

Puly.oxid.  zinc 80.0  (ounces]) 

Acid  carbolic 2.0  (dram  m) 

Oil  of  gaullheria 2.0  (dram«) 


SHILOHS   CONSUMPTION   CURE. 


Muriate  of  Morphine S  gn 

Muriatic  add z  minuDS 

Fluid  Extract  henbane 2  orams 

Fluid  extract  ginger 3  drams 

Fluid extr  ct wllaoherry 8 drams 

Diluted  Alcohol „ 8  draiM 

Chloroform l  drsm 

Essence  peppermint 80  minimi 

Syrup  of  tar Sounrcs 

Simple  eyrup  to  makt* 8  ounces 

Mix. 

-76. 


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SEVEN  SEALS,    OK  GOLDEN  WONDER. 

R.   Sther « 4  pArts 

Cliloioibrm .....6  partii 

Camphor ....A  parti 

Oil  of  peppermint » parts 

Tinot.  of  Oapdcom ^ 85  parts 

Alcohol  (90  per  cent) 60  parts 

These  proportions  are  approximate.  This  preparation  is 
rsoommended  for  cholera  morbus,  rheumatism,  warts,  corns 
and  all  diseases. 

?  —lb. 


LYDIA   PINKHAM'S  COMPOUND. 

R.  Cramp  Bark , 1  pound 

Partridge  berry  Tine. I  pound 

Poplar  Dark Vi  pound 

Unicom  root }c  pound 

Casrta .«... ^  pound 

Beth  root.» 6  ounces 

Sugar .« „ 6  pounds 

Alcohol >^  gallon 

Water  q.  s. 
To  two  and  one-half  gallons  of  an  infbsion  prepared 
flroxn  the  drugs  in  about  No.  40  powder,  and  filtered,  add  the 
sicar ;  agitate  until  dissolyed,  then  add  the  alcohoL 

—lb. 


Reviews. 


Ak  ILLU8TBATED  DICTIONARY  OP  MSDICINE,  BlOL- 

COY  ANB  Allisd  801BNCB&  67  George  M. 
Ooaki,  A.M.,  M.D.  Boyal  octovo,  1688  pages. 
8heep  or  half  morocco.  $10.00  net;  half  Russia, 
$12.00.  P.  BUkiston,  Sod  &  Co.,  1012  Walnut 
street,  Philadelphia, 

We  take  real  pleasure  in  introducing  to  our  readers 
this  magnificent  volume— one  that  our  profession  can 
well  be  proud  of.  The  science  of  medicine,  extending, 
as  it  does,  into  the  domain  of  all  the  natural  sciences 
as  collateral  branches,  possesses  a  very  extensive  no- 
Boeaclature.  Dr.  Qould's  Dictionary  is  the  first  one  to 
give  it  full  justice.  Aided  by  a  competent  corps  of 
a'Bistants,  it  has  been  the  aim  of  the  author  to  give  not 
only  the  old  and  accepted  words  in  medical  literature, 
hut  also  all  the  new  words  recently  developed  in  the 
growth  of  the  science.  Thus  we  find  a  vast  number  of 
words  thst  appear  in  no  other  dictionary. 

The  illustrations  are  profuse,  and  very  fine  and 
clear.  There  is  a  lan^e  number  of  useful  tables  (110 
in  all),  as  tho^e  of  the  nerves,  the  muscles,  bacteria, 
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the  information  plainly  before  the  eye,  making  it 
retdily  obtainable.  This  gives  the  book  an  encyclo- 
pedic character  that  makes  it  doubly  valuable. 

The  spelling,  pronunciation,  derivation  and  defini- 
tion of  medical  terms  are  given  as  fully  and  clearly  as 
possible.  In  spelling,  the  advanced  principles  are 
adopted  to  a  most  gratifying  extent  This,  with  the 
other  features,  entitles  the  work  to  be  regarded  as 
strictly  up  to  modern  ideas  and  requirements.  Evenr 
physician  and  surgeon  will  want  to  have  a  copy  of  this 
lodispensable  and  matchless  work. 

IiSTEEifATiONAi,  Clinigs.      Fourth  Series,  Vol.  I. 
Published  by  J.  B.  Lippincott  Co.,  Philada. 
This  is  a  quarterly,  composed  of  the  best  clinical 
lectures  from  eminent  men  in  the  profession  through- 
out the  world.    The  series  has  become  very  popular. 

CLmiCAL  ^LA.in7AL  FOB  THB  StUDY  OF  DISEASES  OF 

THE  Throat.  By  James  Walker  Downie,  M.B., 
of  Glasgow,  Scotland.  268  pages,  illustrated* 
cloth,  $2.50.  Macmillan  &  Co.,  66  Fifth  Avenue, 
New  York.  Sold  by  John  Wanamaker,  Phila- 
delphia. 


This  is  a  handy  and  thorough  manual  for  those  in 
general  practice  who  have  a  considerable  amount  of 
practice  in  this  specialty. 

Essentials  of  Diseases  of  the  Ete,  Nose  and 
Throat.  Part  I— The  Eye,  by  Edward  Jackson, 
A.M.,  M.D.  Part  II— The  Nose  and  Throat, by 
E.  Baldwin  Gleason,  S.B.,  M.D. 

Essentials  of  Nervous  Diseases  and  Insanity. 
By  John  C.  Shaw,  M.D, 

Essentials  of  Pharmacy.  By  Prof.  L  R  Sayre, 
Ph.G.,  of  the  University  of  Kansas. 

The  above  three  volumes,  price  $1.00  each,  are  the 
second  editions  of  the  popular  Question  Compends, 

Sublished  bv  W.  B.  Saunders,  925  Walnut  St.,  Phila- 
elphia.  For  a  hasty  review  or  for  a  primary  prepa- 
ration for  a  more  thorough  study  of  a  subject,  they 
have  a  legitimate  place  in  scientific  literature.  These 
particular  volumes  are  by  authors  of  eminent  ability. 

Treatment  of  Typhoid  Fiver.  By  D.  D.  Stewart^ 
M.D.  ^ of  JefiTerson  Medical  College,  Philadelphia. 
Paper,  25  cents.  George  S.  Davis,  Detroit,  Mich. 
Dr.  Stewart  is  an  undoubted  authority  in  matters 
pertaining  to  the  practice  of  medicine.  The  work  is 
divided  into  four  chapters:  Prophylaxis;  Manage- 
ment of  a  Case ;  Specific  and  Antiseptic  Treatment ; 
Treatment  of  Special  Symptoms  and  Complications. 
In  the  antiseptic  treatment  the  author  favors  beta- 
naphthol.  He  also  discusses  other  antiseptic  agents, 
but  does  not  recognize  Uie  merits  of  sulpho  carbolate 
of  zinc,  the  most  useful  and  least  harmful  of  them  all. 
He  very  justly  devotes  twenty  pages  to  the  treatment 
by  baths— the  very  best  single  treatment  for  the  dis- 
ease ^et  discovered.  The  treatment  by  bacillus  cul- 
tures is  also  mentioned  and  explained. 

The  Nurse's  Dichionary  of  Medical  Terms  and 
Nursing  Treatment.  By  Houner  Morten, 
aoth,  139  pages,  pocket  size^  $1.00.  W.  B.  Saun- 
ders, 925  Walnut  street,  Philadelphia. 

A  book  which  every  progressive  nurse  must  have. 

The  Eclectic  Practice  in  Diseases  of  (^hildrin. 
By  John  M.  Scudder,  M.D.    436  pages.    Sheep, 
$5.00.    John  M.  Scudder's  Sons,  Cincinnati,  O. 
For  sale  also  by  J.  B.  Lippincott  Co.,  Philada. 
As  this  is  the  seventh  edition  of  this  work,  its  value 
seems  to  be  recognized  by  the  profession.    We  admire, 
especially,  the  classification  of  the  various  subdi  visions 
of  the  subject.    The  treatment  of  diseases  is  'based 
up  >n  the  practice  of  the  eclectic  school,  which  is  not 
far  different  from  that  of  successful  nonsectrrian  phy- 
sicians e7eqr where.    No  one  can   study  this  book 
without  receiving  benefit  from  iL 

TuscoLUM,  a  Latin  Greek  periodical,  by  the  Sodetas 
Ru^biana,  at  Rugby  Aoulemy,  1415  Locust  street, 
Philadelphia. 
Specimen  copies  of  a  little  magazine  of  the  above 
title  have  reached  us,  which  may  be  of  interest  to  most 
of  our  readers.  The  object  of  the  publication  is,  in- 
deed, a  great  one,  for  it  aims  at  revolutionizing  class- 
icsal  teaching  bv  setting  up  the  principle  that  a  lan- 
guage must  be  known  before  one  undertakes  to  read  a 
book  in  it,  while  our  coUeges,  as  we  all  know  too  well, 
try  to  make  students  read  Latin  and  Greek  authors 
before  they  know  the  language.  The  manner  in 
which  Tuaculutn  carries  out  its  principles  is  truly  in- 
genious, yet  very  simple.  Latin  and  Greek  sentences 
are  formed  from  the  start,  with  the  help  of  points, 
lines  and  geometrical  figures,  which  lead  up  to  various 


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THE  MBDICAI.  WORLD. 


"1 


objects,  and  upon  the  gained  vocabulary  conversational 
facility  is  gained.  It  has  found  its  way  already  into 
several  schools,  one  even  in  China,  and  many  private 
parties  are  pursuing  the  course,  both  in  this  city  and 
m  the  country,  Rince  the  authors  profess  to  give 
instruction  by  mail.  Beginners  and  those  whose 
Latin  may  be  **nasty,"  will  do  well  to  try  this  new 
method.  Price,  single  copies,  10  cents;  11.00  per 
annum. 

Anglo- Israel.     By  Rev.  Thomas  Rosling  Howlett, 
B.  A.,  A.  M.     Price,  11.00.     Published  by  the 
author,  16  South  Front  street,  Philadelphia. 
This  is  the  third  edition  of  this  most  interesting 
stu^y  of  the  Jewish  problem,  with  the  addition  of  a  sup- 
plement of  nearly  one  hundred  pages  and  map.    In  it 
the  author  demonstrates  the  identitjr  of  the  ''Ten  lost 
tribes  of  Israel,'^  with  the  all-conquering  Anglo-Saxon 
race  of  Europe  and  later,  of  America.     It  is  a  work 
which  any  student  of  Biblical  history  or  of  Anthro- 
pology cannot  afford  to  miss.    , 

The  Wobk  of  Justine  Sieoemundin,  the  Mid- 
wife. 
The  Libotations  of  the  Use  of  the  Pessaby. 

Two  very  interesting  pamphlets  (repniits),  by  Hun- 
ter Bobb,  M.D.,  Associate  in  Gynecology,  Johns  Hop- 
kins University,  Baltimore,  Md. 

NoN  NocKRE.    By  A.  Jaoobi,  M.D.,  New  York. 

A  very  interesting  and  valuable  address,  reprinted 
from  the  Sew  York  med.  Record, 

Studies  and  Methods  in  Suprapubic  Hysterec- 
tomy. 

Abdominal  Suboery  and  Its  Evolution  and  In- 
volution. 

Vawnal  Extirpation  of  the  Uterus. 

A  Few  Points  op  Interest  to  the  Family  Phy- 
sician. 
The  above  are  four  very  interesting  and  valuable 

reprints  by  Prof.  Joseph  Eastman,   M.D.,   LL.  B., 

Indianapolis,  Ind. 

Hygienic  vs.  Drug  Treatment  op  Typhoid 
Fever.  By  Charles  E.  Page,  M.D.,  Boston, 
Mass. 

A  pamphlet  reprint  that  would  be  of  interest  to  all 
practicing  physicians. 

Olive  Oil  as  a  Remedy  in  the  Treatment  of 
Gastric  Ulcer.  By.  E.  J.  Senn,  M.D.,  of 
Rush  Medical  College,  Chicago,  IlL  A  valuable 
reprint. 

Etiology  of  Pelvic  Diseases  in  Women  and 
Their  Prophylaxis.  By  H.  O.  Werder,  M.D., 
Pittsburg,  Pa.  A  reprint  of  interest  to  ever- 
practitioner. 

Mensuration  in  the  Physical  Diagnosis  of  Pul- 
monary Phthisis.  By  George  A .  Evans,  M .  D., 
909  Bedford  avenue,  Brooklyn.  A  reprint  con- 
taining information  of  great  value. 

Erectile  Tissues— Their  Physiology,  Pathology 

AND  Treatment. 
Some  Interesting  Reflex  Neuroses. 
Liquor  Sedans,  Saw  Palmetto,  Damulna,  Pichi, 

Etc. 

The  above  are  three  interesting  reprints,  by  John 
J.  Caldwell,  M.D.,  1110  North  Fulton  avenue,  Balti- 
more, Md. 


Columbian  Collection  of  Essays  on  Swedish 
Gymnastics.  By  Baron  Nils  Posse,  B.  8c, M- 
G.,  23  Irvington  street,  Boston,  Mass. 

Have  you  read  Mr.  Bellamy's  famous  book,  '*  Look- 
ing Backward  ?  **  It  has  caused  the  rise  of  '*  Nation* 
alism,"  and  much  good  literature  on  this  subject  from 
the  pens  of  Mr.  Bellamy  aud  others  has  appeared 
since  the  publication  of  the  above-pamed  book.  Are 
you  interested  in  the  subject  ?  If  so,  write  to  Mr.  B. 
Franklin  Hunter,  Eleventh  and  Pme  streets,  Phila- 
delphia, for  free  literature.  Mr.  Hunter  onselfishlj 
devotes  time,  energy  and  money,  to  what  he  believes 
to  be  the  greatest  educationall  need  of  the  times. 

The  Esoteric  Bbautty  and  Utility  of  the  Micro- 
scope. By  Ephraim  Cutter,  A.M.,  L.L.D.,  M^ 
D.,  121  Broadway,  N.  Y.    Price,  40  cents. 

Differential  Diagnosis  of  Nephritis.  This  is  a 
handy  and  useful  chart,  by  Emmet  L.  Smith,  M. 
D.,  525  Forty-third  street,  Chicago,  111. 

Railway  Surgeon.  Published  every  other  Taesdaj. 
$5.00  per  year.     Monadnock  Block,  Chicaga 

This  is  the  official  jotimal  of  the  National  Associa- 
tion of  Railway  Surgeons,  with  Dr.  R.  Harvey  Ree4 
as  editor. 

The  Medical  Epitomist.  Quarterly.  Price,  M 
cents  per  year.  72  South  Illinois  street,  Indima- 
polis,Tnd, 

The  Strike  at  Shane's.  A  Sequel  to  ''Black 
Beauty."  Gold-Mine  Series  No.  2.  A  Prize 
Story  of  Indiana:  Price  only  10  cents.  George 
T.  Angell,  19  Milk  street,  Boston,  Mass. 

This  story  deals  especially  with  the  subject  of  cm- 
el  tv  to  animals,  and  is  worth  more  than  its  weight  in 
gold.  Every  person  in  the  United  States  should 
read  it. 

"Nil  Desperandum."  Price,  10  cents.  Published 
by  the  American  Humane  Education  Society,  11> 
Milk  street,  Boston,  Mass. 

The  Physician's  Wife.  By  Mrs.  Ellen  M.  Flr»- 
baugh,  of  Robinson,  111.  Clothe  186  pages,  illus- 
trated, 11.25.  The  F.  A.  Davis  Co.,  Philadelphia. 

This  is  a  breezv  little  work,  giving  a  very  enter- 
taining view  of  the  life  of  a  physician's  wife,  as  ob- 
served, particulariy,  in  the  medium-sized  towns  m  the 
great  west  The  author  has  an  especialljr  pie  asin^ 
and  winning  style,  equally  effective  in  irresistible 
humor,  in  poetical  fancies  or  in  touching  pathos.  The 
womanly  good  sense  scattered  through  the  book  is 
also  to  be  noted  and  appreciated.  We  all  know  that 
physicians  have  the  very  best  wives  in  the  world,  and 
this  book  in  regard  to  them  will  please  and  entertain,, 
but  not  instruct  In  fact,  it  was  not  written  for  in- 
struction. 

Healthful  Womanhood  and  Childhood.  By 
Henry  Bizby  Hemenway,  A.M.,  M.D.,  of  Roab 
Medical  College,  Chic^o,  111.  Publbhed  by  V. 
T.  Hemenway  <&  Co.,  Evanston,  111.  Cloth,  290 
pages,  with  illustrations  in  a  separate  pamphlet 

This  is  a  book  of  plain  talks  to  non-profeasioiial 
readers  relative  to  healthy  aod  diseased  conditiooa 
peculiar  to  women,  and  concerning  the  care  of  yonn^ 
children.  The  author  is  best  known  to  the  professioii 
as  having  published  in  the  Journal  of  ikt  Ameriotm 


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THE  MEDICAL  WORLD. 


305 


Medical  Attsociation  the  most  sensible  and  practical 
article  regarding  the  relation  of  homeopathy  to  the 
regular  profession  that  has  ever  yet  been  produced. 
In  the  work  now  before  us  he  is  addcesting,  not  his 
brother  physicianB,  but  the  laity,  and  especially 
women.  The  language  is  plain  and  direct,  and  the 
information  is  of  a  sensible  and  useful  character.  It 
would  be  an  especially  useful  book  for  married  women 
to  reftd,  and  for  those  ab->ut  to  be  married.  A  careful 
reading  of  it  would  also  prepare  a  mother  for  the 
duty  or  giving  plain  instruction  to  her  young  daugh- 
ter upon  the  mystery  of  her  sexual  nature. 

The  Photographic  Timec  for  April  6th,  contains  sn 
interesting  account  of  an  interview  with  Edison,  and 
a  dncription  of  his  latest  invention — the  Einetoscope. 
The  artide  is  illustrated  by  some  photographic  repro- 
ductions of  pictures  taken  by  the  instrument.  There 
is  also  an  account  of  the  life  and  work  of  Mr.  H.  P. 
Bobin«on,  the  renowned  artist  photographer,  with 
some  samples  of  his  latest  and  finest  productions  re- 
cently exhibited  at  the  London  Photographic  Salon. 
The  rest  of  the  magazine  is  made  up  of  matter  inter- 
esting to  every  photographer,  amateur  or  professional. 

The  St.  L^uis  Clinigriie  has  passed  into  the  hands  of 
Dr.  Emory  Lanphear,  Professor  of  Surgeir  in  the 
College  of  Phvsicians  and  Surgeons.  Dr.  Lanphear 
will  conduct  the  journal  in  the  interests  of  the  school, 
and  of  the  medioid  profession  of  the  West. 

Wit  and  Wisdom. 

Thz  International  Medical  Congress,  at  Rome, 
awarded  a  gold  medal  to  the  Schering  Chemical  Co. 

For  the  remedies  used  in  Dr.  Waugh's  Treatment 
of  Morphinism,  see  the  adv.  of  the  Phildelphia  Gran- 
ule Co.j  No.  10  South  18th  street,  Philadelphia,  Pa. 
in  this  issue. 

We  have  received  a  communication  from  a  com- 
mittee representing  the  candidates  from  the  twelve 
medioid  colleges  whose  graduates  came  before  the 
State  MedicU  Board  of  Pennsylvania  for  examination 
recently,  tendering  their  sincere  thanks  for  the  cour- 
teous reception  extended  and  the  fair  treatment  shown 
to  them  bj  the  examiners. 

Mellin's  Food  received  the  highest  awards  at  the 
World's  Fair. 

If  you  will  pay  express  charges,  a  free  sample  of 
Maltine  will  be  sent  you.  Address  the  Maltine  M'f 'g 
Vyo.,  168  Duane  street,  New  York,  N.  Y.  You  men- 
tion the  Medical  World,  of  courbe. 

When  you  want  to  give  gold,  arsenic  and  mercury, 
prescribe  the  "Mercauro,''  maoe  by  E.  M.  Johnson 
Co.,  41  Piatt  street,  New  York. 

THE  LEGAL  AlO)  MEDICAL  PROFESSION& 

A  writer  in  the  November  number  of  the  Forum 
says  some  veiy  sharp  things  of  the  United  States 
Senate,  especially  as  studied  in  the  light  of  history. 
The  author  has  this  to  say  about  the  profession  of 
medicine: 

"We  nut  politics  on  a  lower  level  than  our  fathers 
put  it.  With  them  it  was  easily  the  noblest  of  pro- 
fessions, now  it  is  neglected.  The  law  has  suffered  in 
the  same  way,  perhaps,  but  not  to  the  same  degree. 
The  profession  of  meuicine,  on  the  contrary,  has  risen 
higher  in  our  esteem." — Food, 


PREVENTION  OP  BOIL?. 

Dr.  Koensbach  (Munch.  Med.  Wochenachr.)  in  order 
to  prevent  the  development  pf  crops  of  boils,  in  the 
back  of  tbe  neck  and  nose,  especially  advises  persist- 
ently rubbing  the  region  attacked  with  some  fatty 
substance,  as  cold  cream,  lanoline,  unsalted  butter  or 
lard.  Lanoline,  above  all,  is  to  be  preferred.  The 
development  of  boils  is  due  to  dryness  of  the  skin, 
and  by  inunction  of  a  fatty  substance  the  dryness  is 
removed  and  the  penetration  of  micro-organisms  pre- 
vented.— Ex. 

FOR  CHOLERA  INFANTI7M. 

B.  Llsterine. 

Glycerine  (c.  p.)  - 

8>r.  SioapL 

Aquse  clDnamon »....aa. dram  i. 

M.    Sig  f-Teaspoonltil  every  one,  two  or  three  houn. 

ThirtT'Two  pa^  devoted  to  the  management  of 
Summer  Complaints  of  Infants  and  Children,  may  be 
had  upon  application  to  the  manufacturers  o^  Lister- 
INE — ^Lambsrt  Pharmacal  Co.,  St.  Louis. 

NORMAL  LIQUID   CANNABIS   INDICA  IN   UNPLEASANT 
DREAMS. 


Dr.  R.  T.^  Edes,  in  the  Boston  Medical  and  Surg 
JowmaJly  especially  necommends  Cannabin  Indica  for 
the  relief  of  unpleasant  dreams,  transforming  them 
into  those  of  a  more  agreeable  character. 

"  The  dru^  should  not  be  given  in  so-called  '  full 
doses,'  that  is,  not  sufficiently  Jarp;e  to  produce  effects 
obvious  to  anyone  but  the  patient,  an4  he  hardly 
should  be  sure  of  it  For  example,  if  en>eriments 
have  shown  that  ten  drops  of  the  preparation  to  be 
used  gives  rise,  in  the  average  person,  to  some  excite- 
ment, rapid/  talking,  laughter,  double  consciousness, 
etc.,  let  the  dose  for  the  purpose  we  are  considering 
be,  say,  six  or  seven.  I  have  found  that  a  very  con- 
venient plan  of  administration,  admitting  of  varying 
the  dosage,  is  an  alcoholic  extract,  which  may  then 
be  dropped  in  the  desired  quantity  upon  a  spoonful 
of  granulated  sugar. 

'*  1  have  frequently  had  occasion  to  prescribe  Cana- 
6u  Indica,  and  have  found  Parke,  Davb  &  Co.'s  Nor- 
mal Liquid  always  efficient  in  doses  of  ten  to  forty 
mimims.  It  would  undoubtedly  give  satisfaction  in , 
cases  like  the  above  mentioned,  where  the  dreams  are 
known  to  be  habitual  and  not  due  to  the  '  traditional 
mince  pie  *  or  disordered  digestion." 

CARBOLIC  ACID  ANTIDOTE. 

In  moments  of  emergency  the  druggist  is  often 
called  upon  to  act  in  the  role  of  a  physician,  and  the 
very  common  mode  of  shuffling  off  this  mortal  coil 
by  the  carbolic  acid  route  suggests  that  an  antidote  is 
always  at  hand  in  everv  drug  store.  A  strong  solution 
of  sulphate  of  soda  (Glauber's  salt)  is  very  prompt  in 
its  action.  Should  tne  patient  be  unable  to  swallow,  a 
stomach  tube  may  be  easily  improvised  ^ith  a  yard 
or  so  of  rubber  gas  tubing  and  a  funnel  through  which 
the  antidote  should  be  acuninistered. — New  Idea. 

If  tou  want  first-class  uterine  supporters,  send  to 
the  Hastings  Truss  Co.,  224  S.  9th  street,  Phila.,  Pa. 

WEU3HFIELD,  O.,  Jan.  18, 1894. 
Willis  H.  Davis,  Keokuk,  Iowa :— I  am  entirely 
pleased  with  my  case.  I  like  it  full  better  than  I  do 
the  costly  Leader,  as  it  is  more  compact  and  neater  in 
appearance,  and  at  the  same  time  it  holds  in  ounces 
the  same. — H.  M.  Fenton,  M.D. 

For  "  Seno,''  a  new  digestive  agent,  send  to  the 
Sultan  Drug  Co.,  St.  Louis,  Mo. 

For  sample  of  M'cajah's  Uterine  Wafers  address 
Micajah  &  Co.,  Warren,  Pa. 


Digitized  by 


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306 


THB  MEDICAL  WORLD, 


For  free  box  of  Dyspepsia  Tablets,  address,  The  P. 
J.  Noyes  M'f 'g  Co.,  Lancaster,  N.  H. 

We  hayk  been  entirely  satisfied  with  goods  bought 
of  the  Western  Leather  M'f  *g  Co.,  125  to  137  Bees 
street,  Chicago.    Send  to  them  for  medicine  cases. 

Db.  p.  Berardinone  has  had  fayorable  results  in 
the  treatment  of  pulmonary  tuberculosis  by  the  sub- 
cutaneous injection  of  Aristol,  a  compound  of  thymol 
and  iodine,  introduced  by  W.  H.  Schieffelin  &  Co., 
New  Tork. 

For  generous  sample  of  Pancreo-Bismuth  and  Pep- 
sin, address  Geo.  C.  Frye,  Chemist,  Portland,  Maine. 

Convulsions  may  frequently  be  cut  short,  like 
magic,  by  teaspoonful  doses  of  Celerina  repeated  at 
short  interyals.  The  nausea  as  an  after-effect  of 
chloroform  or  ether  narcosis  may  g^erally  be  con- 
trolled in  the  same  manner. 

Wb  are  entirely  pleased  with  the  abdominal  sup- 

S)rters  and  elastic  eoods  supplied  by  G.  W.  Flayell  & 
ro.,  1006  Spring  Garden  street,  Philadelphia,  Pa. 

For  cut  rates  in  instruments,  address'  I.  Phillips, 
Atlanta,  Ga. 

Brooklyn,  Ind.,  March  25,  1898, 
I  haye  used  Freligh's  Tablets,  and  can  cheerfully 
recommend  them  as  worthy  of  trial  by  the  profession, 
as  I  haye  been  usine  them  for  the  past  three  months 
with  good  results.    I  can  say  I  am  well  pleased. 

C.  M.  Ijndley,  M.D., 
Class  of  1860. 

DIURETIG  AND  RHEUMATia 

R.  Lithium  salicylate. ....2  drams. 

Liq.  tong.  saL ....8  on. 

Olyceiine. loz. 

Aqua  mentha  pip. 2  ozs. 

H.   Big.— Two  teaspoonlUla  eyery  two  hours. 

Antikamnla.  *'The  importance  attached  to  this 
drug,  I  think,  is  due  to  its  anodyne  and  analgesic 
power,  and  the  celerity  with  which  it  acts.  As  an  an- 
tipyretic in  feyers,  it  acts  more  slowly  than  antipyrine, 
but  it  is  not  attended  with  depression  of  the  cardiac 
system  and  cyanosis.  Wheneyer  a  sedatiye  and  an 
ansdgesic  together  is  indicated,  this  remedy  meets 
the  demand.  In  aeyere  headaches  it  is  the  remedy 
par  exeeUeneeJ*—N.  C.  Med.  Jour, 

Dr.  Orazio  Satariano,  Barrafranca.  Italy,  says : 
"Although  opposed  to  the  use  of  pharmaceutical 
specialties,  I  was  struck  with  the  formula  of  Bromidia 
(Battle),  and  knowing  the  action  of  its  ingredients 
could  not  bring  myself  to  belieye  in  its  possessing 

freater  therapeutic  power  than  its  component  parts, 
loweyer,  I  determined  to  try  it  in  a  seyere  case  of 
mammary  neuralgia,  which  had  proyed  refractory  to 
an  infinitude  of  other  remedies.  The  result  was  bril- 
liant, and  far  beyond  my  expectations." 

The  man  who  went  out  to  milk  and  sat  down  on  a 
boulder  in  the  middle  of  the  pasture  and  waited  for 
the  cow  to  back  up  to  him,  was  the  eldest  brother  of 
the  man  who  kept  store  and  did  not  adyertise,  because 
he  reasoned  that  the  purchasing  public  would  back  up 
to  his  place  when  it  wanted  something. — The  Sioux 
OUy  (Iowa)  Tribune, 

The  following  is  from  a  physician  in  Barcelona, 
Spun: 

**  The  results  which  I  haye  obtained  in  my  dispen- 
sary for  sick  children,  together  with  my  priyate  cases, 
haye  been  extremely  satisfactory.     In  fact,  I  haye 


of 
treated   yarious   cases         dys|)epsia,  in    which  the 
patients,  fully  prostrated  and  without  power  to  digest 
their  food,  haye,  thanks  to  the  use  of  Inglayin,  been 
rapidly  cured. 

"In  the  case  of  'apepsia^  or  loss  of  appetite,  in 
children,  accompanied  with  diarrhoea,  I  haye  obtained 
good  results  from  the  use  of  Ingluyin,  which  thera- 
peutic agent  is  extracted  by  the  house  of  Warner  & 
Co.  from  the  stomach  of  the  chicken. 

'*  I  haye  also  found  Ingluyin  useful  in  the  organic 
complaints  of  the  stomach,  and  in  the  indomitable 
yomiting  and  painful  dyspepsia  to  which  women  are 
subject  during  pregnancy.  I  haye  employed  the 
agent,  moreoyer,  in  the  conyalesoent  state  of  many 
patients,  when  I  haye  not  only  noted  the  alteration  of 
the  gastric  secretions,  but  the  extreme  instability  of 
the  stomach." 

W.  H.  HosTELLEY  &  Co.,  Gentlemen  : — I  gave  the 
Syrup  of  Hydriodic  Acid  to  a  young  man  with  chronic 
gleet  The  fellow  seems  wonderfully  relieyed.  Says 
he  feels  like  another  man.  I  cheerfully  commend  it 
to  all  needing  an  iodine  alteratiye.  Will  continue 
to  use  it  Dr.  James  A.  Berrtman, 

,    Darlington,  Ind. 

For  a  genuine  Peroxide  of  Hydrogen — ^prescribe 
Marchand's. 

NuTROLAcns  is  an  efficient  tonic  to  the  secretion 
of  milk.  Large,  liberal  sample  (one  dollar's  worth) 
free,  if  you  pay  expref's  charges.  Nutrolactis  Co., 
93  Warren  Street,  New  York. 

A  MATTER  of  the  utmost  importance  in  thebuaincfli 
and  professional  success  of  the  physician  is  the  use  of 
suitahle  and  appropriate  printed  matter— enyelopes, 
letter  heads,  bill  heads,  professional  and  social  ctuedB, 
and  special  forms  of  prescription  blanks.  (See  yalu- 
ablerormsin  "The  Physician  as  a  business  Man"). 
For  all  these  articles  and,  in  fact,  for  all  kinds  of 
printing  suitable  to  a  physioian*s  needs,  send  to  Wil* 
liam  Koehl.  Erie,  Pa.  A  firm  that  makes  a  specialty 
of  this  kind  of  work  poasesses  manifest  adyantagea. 

For  concentrated  tincture  of  t^assiflora  Incaraata, 
send  to  John  B.  Daniel,  Wholesale  Druggist,  84  Wall 
street,  Atlanta,  Ga. 

DuRiNO  hot  weather,  Horseford's  Acid  Phosphate 
makes  a  refreshing  tonic  drink.    Sample  free,  if  yoa 
>ay  express  charges.      Bumford  Chemical  Works, 
''royidence^  R.  I. 

A  PROPER  food  for  infants  is  Horlick's  Malted 
Milk.     Sample  free.    Malted  Milk  Co.,  Baeine,  Wis. 

Auntie :  "Does you  know,  doctor,  dat  if  you'se  not 
doin'  Sam's  liyer  no  good,  you'se  makin'  a  Christian 
out'n  him?*' 

Doctor  (mystified) :  '*  What  makes  you  think  so, 
auntie  7  ** 

Auntie  :  "  Cause,  ebery  time  he  takes  a  dose  ol 
your  medicine,  he  says,  *0  Lord.* " — Sunny  S9uik, 

For  improyed  batteries,  send  to  Mcintosh  Battery 
and  Optical  Co.,  141  to  143  Wabash  aye ,  Chicago. 


1^ 


The  Cliarles  N.  Oittenton  Co.,  115  Fulton  b^««.. 
New  York,  introduce  Colden's  Liquid  Beef  Tonic  ana 
Syapnia,  the  purified  opiunL 

During  this  season  you  will  want  to  use  Chionia 
for  biliousness  and  aUied  disorders.  For  sample, 
address  Peacock  Chemical  Co.,  St.  Louis. 

For  hollow  suppositories,  or  for  fine  fflyoerine  sup- 
positories, address  Hall  &  Buckel,  Wholsesale  Drt^^ 
gists,  218  Greenwich  street.  New  i  ork. 


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Uax  Synip  of  Figs  for  a  laxatiye. 

Fob  treatment  of  the  Morphine  Hahit  send  to  B. 
Keith  &  Co.,  75  William  street,  New  York. 

Sbbvaht—'' Please,  mam,  Mrs.  Nexdoor  wants 
jon  to  lend  her  some  reading  matter  suitable  for  a 
sick  person.'*  ,    ^ 

MiBTBEaB—"  Certainly.  Give  her  those  medical 
almanacs."— -Yw  York  t^eekly, 

Thx  jealousy  of  physicians  is  remarkable.  No 
sooner  does  one  of  them  discover  a  disease  than  half 
a  dozen  more  concentrate  all  their  energies  upon  its 
snppression.  — PucL 

XJSB  the  most  excellent  Baby  Powder,  made  hj 
Br.  Jnllos  Fehr,  Ancient  Pharmacist,  Hoboken,  N.  J. 

Fine  cUnical  thermometers  are  made  by  H.  Wein- 
hagen,  22  and  24  North  William  street,  New  York. 

Fob  fine  grannies,  address  The  Abbott  Alkaloidal 
Co.,  Ravenswood,  P.  O.,  Chicago,  111. 

As  a  superior  surncal  dressing,  use  Unguentine, 
made  by  the  Norwich  Pharmacal  Co.,  Norwidi,  N.  Y. 

Fob  tablets  conyenient  for  dispensing,  address  H. 
E.  Mulford  Co.,  2132  Market  street,  Philadelphia, 
Pa. 

Wb  haye  used  with  satisfaction,  the  Pile  Ointment 
made  by  Fred.  W.  Stewart,  Oswego,  N.  Y. 

*'  Pboplb  don't  die  over  here  yery  often,  do  they  ?  " 
inquired  the  smart  New  Yorker. 

^No,  only  once,"  replied  the  Philadelphian,  and 
there  was  an  intense  silence. 


BBIGHT  POINTS  FBOM  THE  OD  QUABTEBLY. 

[For  a  sample  copy  address  Od  Chemical  Co.,  New 
York.] 

ExoBBsrvE  yemiting  may  be  controlled  by  giying 
one-half  to  one  drop  of  oil  of  doyes  in  a  little  water. 

Bloom  has  giyen  atropine  successfully  in  thirty 
cases  of  uterine  hemorrhage.  He  gaye  gr.  1-100 
eyeiy  three  or  four  hours. 

Fob  threatened  bed  sores  the  skin  should  be  rubbed 
with  alcohol,  in  order  to  restore  the  circulation,  and 
then  ndlic  acid  applied,  which  will  constringe  the 
dilated  blood  yessela. 

Salictuo  acid  and  its  salts  are  among  the  most 
efiectual  agents  in  the  treatment  of  pleurisy  with 
^Hosion.  * 

The  extensiye  use  of  iodoform  in  the  treatment  of 
old  people  is  not  adyisable,  as  it  is  yery  liable  to  pro- 
duce deurium. 

In  APFLYiHa  iodine  to  inflamed  buboes,  furuncles 
etc,  do  not  P*int  the  swelling  itself,  but  apply  it 
around  the  inflamed  area. 

In  sevebb  cases  of  chorea,  arsenic  and  the  hot 
pack  will  be  found  to  act  almost  as  a  specific. 

Calomel  may,  in  the  stomach,  if  an  excess  of  hy- 
drochloric acid  IS  present,  be  conyerted  into  corrosiye 
■oblimate.  Hence  it  is  best  to  combine  the  calomel 
with  sodium  bicarbonate. 

The  louff  continued  use  of  alkalies  has  a  tendency 
to  destroy  Uie  blood  and  irritate  the  kidneys. 

A  Fbenoh  author  claims  that  boric  acid  adminis- 
tned  in  fiye  grain  doses  three  times  a  day  will  abort 
boik 


CiTBio  Acid  is  said  to  be  a  prompt  remedy  to  stop 
nose  bleeding.    A  solution  injected  into  the  nostrils. 

Chlobide  of  oalcium,  in  doses  of  four  grains,  is 
yaluable  in  the  treatment  of  pneumonia. 

Sulphate  of  magnesia  is  a  good  chemical  antidote 
for  carbolic  acid  poisoning. 

MuBiATE  of  Ammonittm  in  full  doses  will  oyer- 
come  the  immediate  effects  of  drunkenness. 

Dropsy  of  the  feet  alone  means  heart,  dropsy  of 
the  belly  alone  means  liyer,  and  dropsy  of  all  the  body 
means  kidneys. 

Whebe  you  are  in  doubt  as  to  the  diagnosis,  exam- 
ine the  urine. 

Pbof.  Bbinton  says  blood  in  the  urine  is  generally 
from  the  kidneys,  but  if  it  clots  or  is  bright  red  in 
color,  then  it  is  not  from  the  kidneys,  but  may  be 
either  due  to  a  diseased  condition  of  the  bladder  or  of 
the  prostate  gland,  or  to  a  stricture  or  to  a  urethritis. 

Inyolution  of  the  sexual  organs  after  confinement 
takes  place  more  rapidly  and  satisfactorily  if  the  mother 
nurses  her  child. 

PiCBOTOXiNE,  1-40  gr.* at  bedtime,  controls  the 
night  sweats  of  consumptiyes. 

Twenty  nains  of  camphoric  acid,  giyen  at  night, 
controls  nignt  sweats. 

Cocaine  preyents  suppuration  in  small*pox.  Dr. 
Saymayoa,  of  Oautemala^  says :  hence  there  is  no 
secondary  feyer,  and  no  pitting. 

Salicylate  of  Bismuth.— Salicylate  of  Bismuth 
has  been  found  useful  in  infantile  diarrhoea. 

Convulsions  in  children  are  sometimes  cut  short 
by  turning  the  patient  on  the  left  side. 

Gall  stones  occur  three  times  as  often  in  women 
as  in  men. — Keen. 

Dbuos  that  increase  the  arterial  tension  will  also 
increase  the  flow  of  the  milk. 

Use  neither  sound  nor  catheter  where  the  bladder 
is  inflamed. 


FALSE  MODESTY,  A  CBIME. 

Dr.  Hattie  T.  Griswold,  who  is  far  from  bdng  a 
pessimist  or  a  sensational  writer,  inyeighs  bitterly 
against  the  false  delicacy  which  is  ashamed  to  speak  oC 
the  mystery  of  life  in  as  proper  manner  to  a  child,  and 
prompts  teachers  and  parents  to  let  their  boys  and 
girls  learn  by  a  terrible  experience,  perhaps  and  often, 
too  late,  what  they  were  too  modest  to  warn  them 
against.  In  eyery  community  there  are  debased  women 
who  seek  to  hire  our  boys  to  destruction,  and  male 
friends  who  delight  in  demoralising  and  ruining  our 
girls,  and  ^et  we  let  our  childreo  go  out  into  a  world 
teeming  with  oyerwhelming  temptations  without  so 
much  as  a  word  of  warning  as  to  the  awful  consequences 
of  sexual  yice.  The  eternal  demand  in  nature  for 
puritj,  and  the  lasting  disease,  sufierinff  and  disgrace 
that  ineyitabljr  punish  impurity,  cannot  oe  too  eany  or 
too  strongly  impressed  on  eyery  child.  Whoever, 
therefore,  shirks  the  duty  of  im[>arting  to  those  under 
their  care  the  power  of  discrimination  between  good 
and  eyil«  delibmUdy  sins  against  Qod  and  man,  bemuse 
they  wilfully  cause  bodies  to  be  ruined  and  souls  to  be 
lost,  through  ignorance  of  what  they  shotdd  haye 
taught  them  to  ayoid. — Indian  Med,  Beeord, 


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THB  MEDICAI,  WORLD. 


Some  Reaeont  for  Beooming  a  Phytloian. 
By  H.  p.  Crabbe,  Washington,  D.  C. 

DoeUrr  Greathear^s  Beaaona, 

1.  Becaose  I  see  in  the  life  of  a  doctor  the  best  op- 
portonity  to  serve  God  and  m;^  fellow  mea. 

2.  Because  I  believe  a  physician  can  find  opportun- 
ities to  cheer  the  hearts  of  the  unhappy  not  given  to 
other  men. 

3.  Because,  as  a  doctor,  I  can  go  among  the  p'^or, 
carrying  help  and  comfort. 

4.  Because  to  relieve  suffering  will  be  my  daily  duty. 

5.  Because  to  give  health  is  to  give  more  than 
money. 

6.  Because  I  know  that,  "  inasmuch  as  ye  have  done 
it  unto  one  of  the  least  of  these  my  brethren,  ye  have 
donA  it  unto  me  " 

7.  Because  I  would  lend  my  life  to  the  Lord  by  giv- 
ing it  to  the  poor. 

Djctor  NarrownUnd!%  Reasons. 

1.  Because  it  is  easier  to  become  a  great  physician 
than  a  great  lawyer.  Sick  people  are  more  easily 
fooled  than  well  people. 

2.  Because  women  are  more  easily  influenced  than 
men,  and  a  physician  deals  more  with  women  than 
with  men. 

3.  Because  a  doctor  can  ingratiate  himself  into  the 
hearts  of  women,  and  through  them  influence  their 
husbands.  * 

4.  Because  I  would  like  to  be  a  professional  man, 
and  I  think  the  life  of  a  minister  of  the  Gospel 
requires  to  much  self  sacrifice,  and  the  life  of  a  lawyer 
too  much  real  work. 

5.  Because  it  Is  easier  for  a  doctor  to  conceal  his 
ignorance  than  for  men  in  other  professions. 

6.  Because  a  doctor  has  fine  opportunities  to  make 
love  to  the  ladies. 

7.  Because  I  would  like  to  know  enough  of  medicine, 
and  the  physical  man,  to  be  able  to  take  excellent  care 
of  my^  own  dear  self. — lUus,  Me<L  Jour, 


**  TBIKBSSQIi  FOB  INHALATION." 

The  following  is  from  a  communication  to  the  Z/cm- 
teL  by  Dr.  Robert  Lee,  of  West  Kensington,  England: 
*'  The  interesting  observations  of  Professor  Charteris 
on  Trikresol,  eommunicated  through  the  Lancet^  must 
have  attracted  the  attention  of  many  of  its  readers , 
and  the  important  fact  that  Trikresol  is  free  from  the 
poisonous  qualities  of  carbolic  acid  must  have  sug- 
gested its  great  superiority  in  medical  and  sui^ieal 
practice.  I  have  tried  a  specimen  of  8chering's  Trik- 
resol, in  order  to  ascertain  whether  it  could  be  used 
for  inhalation,  as  the  poisonous  properties  of  carbolic 
acid  have,  for  that  purpose,  made  it  somewhat  objec- 
tionable. My  object  was  to  determine  whether  Trikre- 
sol, when  mixed  with  water  in  definite  proportion, 
would,  like  carbolic  acid  when  treated  similarly,  yield 
a  vapor,  on  boiling,  of  definite  and  constant  strength — 
a  peculiarity  which  attaches,  as  I  pointed  out  f^ome 
years  ago,  to  carbolic  acid,  and  which  makes  it  supe 
rior  to  all  other  antiseptics  for  inhalation.  I  find  that 
Trikresol  follows  the  same  law,  as  might  have  been 
expected,  as  carbolic  acid,  and  that  a  mixture  of  one 
dram  of  Trikresol  to  one  pint  of  water  gives  ofl^,  when 
boiled  continuously,  a  vapor  of  the  same  strength  as 
the  mixture.  This  is  rather  strong  for  children,  and 
a  weaker  solution  may  be  used.  To  what  important 
uses  this  property  of  Trikresol  can  be  applied  in  the 
treatment  of  many  maladies  by  inhalatioa,  I  hardly 
neid  point  out.^' 


HOW  TO  TELL  THB  SPEED  OF  THE  TBAIN. 

Superintendent  Alvey,  of  the  Baltimore  A  Ohio 
road,  lives  out  at  Takoma,  and  the  coterie  of  com- 
muters in  the  smoking  car  always  save  a  seat  for  him 
in  the  morning,  no  matter  how  big  the  cr  jwd  may  be. 
Coming  in  to  church  recently,  some  one  asked  him 
how  fast  the  train  was  running.  ^  He  pulled  out  his 
watch,  and,  after  quickly  glancine  at  it,  peered  in- 
tently out  of  the  window.  In  a  little  while  he  re- 
marked, quietljr : 

"This  train  is  going  between  thirty-one  and  thirty- 
two  miles  an  hour. ' 

There  was  a  chorus  of  queries  as  to  how  he  had 
determined  it,  because  his  manner  left  no  doubt  in 
the  mind  of  any  one  that  he  was  entirely  serioas. 

"  It  is  very  easy  to  find  out  the  speed  when  yon  are 
traveling  on  a  double  tracked  road,"  he  replied.  "  If 
yon  are  curious  about  it  hereafter,  just  look  at  the  in- 
side of  the  outer  rail  on  the  opposite  track  for  a  mm- 
ute  or  two  until  you  find  that  vou  can  distinguish 
where  one  rail  joins  another.  Then  count  the  joints, 
and  as  many  rails  as  you  pass  in  twenty  one  seconds  is 
the  number  of  miles  your  train  is  traveling  an  hour 
Try  it  yourselves  and  figure  it  out  and  jou  will  find 
out  I'm  right." —  Washington  Post* 


NATUBE  VBBSUB  PHYSIC. 


Editor  Medical  Wobld  :— 

If  we  look  back,  two  scores  or  more. 
Bleeding  then  was  to  the  f9re 
We  wonder,  in  the  present  age. 
Why  such  practice  was  the  rage ; 
We  wonder  if  the  human  kind 
Were  stronger  then  than  now  we  find. 
Mercury,  too,  then  ruled  th6  day. 
And  had,  indeed,  a  mighty  sw^y. 
It  was  the  power  to  cure  all  ills. 
In  plaster,  powder,  and  in  pills. 
Some  even  now  life's  blood  will  t^ke. 
Lauding  its  praise — as  not  a  fake. 
Mercury,  too,  doth  hold  a  power 
With  many,  to  this  very  hour. 

Now  antiseptics  are  the  go, 

Anale^ics  daily  grow, 

And  dosemetrics  granules,  seem 

To  try  to  be  the  leading  team. 

In  fact,  the  M.  D.'s  of  this  age 

Are  puzzled  how  their  minds  to  gauge. 

One  reads  the  journals  of  this  day 
And  notes  what  numerous  wri(«n»say. 
The  more  he  reads — 'tis  plain  to  see — 
Ue  and  the  writers  can't  agree. 
If  we  would  study  nature  more, 
Leave  physic  to  the  hind — not  fore — 
Give  rest  to  stomach,  body,  mind. 
With  little  phprsic,  we  will  find 
That  nature  will  the  healing  do, 
And  give  to  blood  its  healthy  hue. 

Science  to  phvsic  is  out  of  name. 
Nature  is  a  kindly  dame. 
Hygiene,  with  diet — less  the  meat— 
Would  many  an  undertaker  cheat ; 
Pure  blood  will  banish  all  disease, 
The  lesser  minerals — if  you  please- 
Lead  is  a  poison,  slow  but  sure. 
And  copper,  nature  won't  endure. 

The  less  of  beer,  and  wine  and  whiskef, 
Will  make,  indeed,  the  nerves  less  frisky ; 
Heart  failures  will  the  fewer  be, 
(OmtiRued  on  next  leaf.) 


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Tkg  kmomMge  that  a  man  can  use  is  the  onlyreal  knowUdgt;  the  anlyknouh- 

f  stones.'-^BROUDM^ 


M£4  iXat  has  life  and  growth  in  it  and  converts  itulf  into  practical  power, 
rtsi  hangs  lihe  dust  about  the  Srain,  or  dries  like  raindrops  off  the  stone 


IThe  Medical  World. 


MONTHLT,  bj  C  F.  TATX.01L,  M.  D. 


C  F.  TaTZiOR,  M.  D., 
J.J.  Taym>r,M.D., 


?Editoks. 


I  to  anj  part  of  th«  United  States  and  Canada, 
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Cotariea,  Pxvb  8Hn:.LxifOS  per  year.  Postage  free. 
•iagle  oopiea»  Tax  Cnrrs.  These  rates  must  be  paid 
immmHabfyim  advance. 

Wmcmmok  always  supply  back  nnrntters.    Should  a  num- 
ber fidl  to  reach  a  subscriber,  we  will  supply  another, 
j      if  notified  before  the  end  of  the  month. 

H9  BO  flMmcy  to  agents  for  this  journal  unless  publisher's 

I 
Mammmm  azx  CoxicnincATioif a  to 

"THE  IMEDICAL  WORLD," 
1520  Chestnut  Street, 

FHILADBLPHIA.  PA. 

Vd.  Xn.        September,  1894.         Na  9. 

Hpdi*ophobis,  or  Rsbies. 

An  acoideiit  having  recently  occurred  to  a 
Httle  daughter  of  the  writer,  giving  rise  to  very 
much  anxiety,  and  attended  with  serious  dan- 
ger, he  feds  impelled  to  present  the  following 
infdMrmation  in  regard  to  this  most  terrible  dis- 
ease. The  subject  is  one  of  such  importance 
that  he  hopes  that  this  information,  in  some  form, 
may  be  published  in  every  county  paper  in  the 
United  States,  for  the  farther  instruction  of  the 
laity,  who  seem  to  have  some  very  erroneous 
views  regarding  it 

There  i$  a  genuine  disease,  known  as  rabies 
er  hydrophobia.  It  is  as  distinct  from  mental 
influflDce  as  locomotor  ataxia  or  any  other  re- 
cognised disease.  It  is  a  disease  affecting  espe- 
eially  the  central  nervous  system,  the  brain  and 
spinal  cord.  It  is  an  infectious  disease,  always 
arising  from  inoculation  of  animals  or  man  suf- 
fering from  the  disease.     This  bdng  true,  intel- 


ligent and  determined  efforts,  extending  over 
the  entire  country,  would  result  in  its  final  total 
extirpaticm.  For  this  purpose,  all  unnecessary 
dogs  or  cats  should  be  humanely  put  to  death* 
AU  stray  dogs  or  cats,  having  no  responsible 
ownership^  should  also  be  put  to  deatii.  All 
necessary  ones  should  be  properly  tagged,  for 
ready  identification  when  necessary,  and  muzzled 
when  required  for  safety.  A  high  dog-tax  b 
one  of  the  most  beneficent  forms  of  taxation  ever 
proposed.  It  relieves  the  community  to  that 
extent  from  the  necessity  of  other  forms  of  taxa- 
tion, and  helps  to  eliminate  surplus  dogs.  The 
owner  will  willingly  pay  the  tax  on  those  ani- 
mals that  are  really  useful,  while  those  that  are 
not  worth  the  tax  ought  to  be  put  out  of  the 
way. 

The  first  symptom  of  the  disease  in  a  dog  or 
other  animal  is  a  tendency  to  roam.  Hence 
every  stray  dog  is  a  suspicious  character,  and 
should  be  looked  after.  If  he  has  not  bitten 
any  animal  or  person,  and  no  owner  be  found 
for  him,  he  should  be  killed.  However,  if  he 
has  bitten  any  person  or  animal,  he  should  not 
on  any  a4seount  be  killed,  even  although  he  is 
supposed  to  be  mad.  By  thus  killing  him  you 
remove  the  only  certain  means  of  diagnosis  yon 
have  as  to  whether  he  was  rabid  or  not,  and, 
consequently,  the  only  element  of  prognosis  you 
have  as  to  the  likelihood  of  those  bitten  by  him 
to  develop  the  disease.  The  importance  of  this 
cannot  be  overestimated.  Be  not  too  quick  with 
the  gun  or  dub.  Capture  the  dog  and  diain  or 
pen  him  up.  If  he  has  rabies  he  will  soon  dis- 
tinctiy  show  it,  and  will  be  dead  within  tea 
days.  This  will  end  the  uncertainty,  and  all 
the  animals  bitten  by  him  should  be  killed,  and 
the  penNXis  bitten  should  be  at  once  put  under 
the  specific  treatment  K  he  proves  not  to  be 
rabid,  a  great  anxiety  is  relieved,  and  the  wounds 
may  be  regarded  as  ordinary  lacerated  and  punc- 
tured wounds. 

Two  pdnts  must  especially  be  borne  in  mind : 


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A  rabid  dog  seldom  fears  water,  and  he  never 
has  fits.  A  rabid  man  cannot  drink  because  of 
m  severe  spasm  of  the  throat,  and  after  a  few 
painful  attempts  he  acquires  a  fear  or  dread  of 
water.  A  rabid  animal,  on  the  other  hand,  sel- 
dom has  these  laryngeal  spasms,  and  he  loves 
water,  as  it  helps  to  cool  his  intense  thirst  As 
to  the  fits,  dogs  have  many  nervous  disorders 
characterized  by  them,  but  they  do  not  occur  in 
rabies.  They  have  occasional  slight  convulsive 
Iremors,  which  cannot  be  called  ''fits,"  as  ordi- 
narily understood.  A  little  courage,  coolness 
and  presence  of  mind  wUl  go  a  long  way  towards 
helping  to  determine  any  doubtful  case. 

The  other  welMmown  symptoms  of  madness 
will  be  observed:  The  animal  shows  a  change 
of  disposition,  a  tendency  to  eat  strange  things ; 
tearing  up  clothing  and  wood ;  there  is  the  pecu- 
liar hoarse  **  rabid  "  bark  or  howl,  with  extreme 
restlessness  and  irritability.  Very  soon  after 
this  follows  the  period  of  mania,  when  he  wUl 
rush  with  the  fury  of  a  demon  at  any  animal  or 
man  he  meets,  with  occasional  momentary  peri- 
ods of  abstraction,  glaring  into  vacancy,  then 
suddenly  becoming  furious  again,  even  tearing 
at  parts  of  his  own  body,  a  sticky  saliva  drip- 
ping irom  his  moutL  This  is  followed  shortly 
by  the  stage  of  paralysis,  observed  first  in  the 
hind  legs  and  the  lower  jaw.  This  gradually 
progresses  until  it  ends  in  death.  The  entire 
period,  from  the  first  signs  of  taking  the  disease, 
is  usually  about  eight  days,  although  it  may  be 
ft  much  shorter  time,  the  stage  of  paralysis  com* 
ing  on  almost  at  once. 

The  poison  may  be  conveyed  by  a  lacerated 
bite,  by  a  simple  punctured  bite,  by  forcible 
licking  with  the  hard,  rasping  tongue,  or  by  the 
saliva  coming  into  direct  contact  with  any  raw 
surface  of  the  skin  or  mucous  membrane  of  the 
mouth,  that  would  be  sufficient  to  allow  a  vacd- 
nation  to  take. 

The  period  of  incubation  in  dogs  may  be  as  short 
as  fifteen  days,  or  as  long  as  two  hundred  and 
forty  days,  but  is  usually  from  thirty  to  fifty 
days.  During  this  entire  period  the  animal  may 
eommunieate  the  disease  by  iis  saliva.  This  is  a 
▼ery  important  fact,  that  is  not  very  generally 
known.  In  man  the  period  of  incubation  is 
usually  from  six  to  eight  weeks,  but  it  may 


(rarely)  be  as  short  as  twenty  days,  or  as  long  wm 
one,  or  even  two  years.  The  period  is  likeljr  to 
be  shorter  in  eases  bitten  about  the  face  and 
neck,  and  in  children. 

The  wound  should  be  treated  by  abstracting 
the  poison,  and  by  cauterization.  If  on  a  limb, 
a  ligature  should  be  applied  above  the  wound. 
The  wound,  if  not  too  extensive,  should  be  cat 
out  The  abstraction  of  the  poison  should  be 
by  thorough  cuppmg,  or  by  sucking  it  out  with 
the  mouth  (preferably  by  the  patient  himself), 
rinsing  the  mouth  each  time  wi(h  a  strong  solu- 
tion of  carbolic  acid,  or  with  strong  vinegar*  al* 
oohol  or  other  antiseptic  fluid.  The  cauteriza- 
tion should  be  by  nitrate  of  silver,  by  caostic 
potash  or  coda,  or  by  a  hot  iron. 

When  the  animal  by  which  a  person  has  beoi 
bitten  is  demonstrated  to  be  actually  rabid,  the 
specific  treatment  elaborated  by  Pasteur  should 
be  entered  upon  at  once.^  The  delay  should  be 
as  short  as  possible,  but  never  more  thaa  ten 
days. 

This  treatment  consists  of  a  series  of  injections 
of  a  preparation  of  ral)ic  virus,  beginning  with 
a  weak  preparation  and  using  a  stronger  and 
stronger  one  each  day,  until,  at  last,  pure  rabic 
virus  is  used.  This  treatment  requires  fifteen 
days.  It  is  very  successful,  the  percentage 
of  mortality  being  about  nil  when  the  treat- 
ment is  resorted  to  without  delay. 

*The  Pasteur  treatment  is  administered  in  this 
country  at  the  Pasteur  Institute,  97th  street  and  Stk 
arenue,  New  York  City. 


Some  Proposed  Remedies  for  Rabios. 

Dr.  Goss,  of  Marietta,  Ga.,  confirms  the 
claims  of  Dr.  Meyer,  of  QHpee  CSty,  Neb.,  that 
echinacea  augustifoHa,  tuStot  found  in  sandv, 
rocky  regions  of  the  we^^d  southwest,  will,  it 
administered  in  the  forar  of  a  tincture,  prevent 
the  development  of  hydrophobia  in  one  inocu- 
lated with  it  The  accurate  directions  for  its 
administration  are  not  given. 

Other  remedies  recommended  for  this  disoaee, 
to  be  administered  early  during  the  incubative 
period,  are  datura  stramonium,  inula  heleni%tm 
(elecampane),  xanthium  spiiumim,  pilocarpine, 
eta  The  usual  directions  are,  to  administer  the 
drug  in  hot  solution,  until  a  course  of  mild  dia- 


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phoresifl  is  produced,  lasiiDg  two  or  three  days. 
The  patient  is  then  cousidered  immune  from  the 
disease.  As  there  is  considerable  testimony  sus- 
taining the  claim  for  each  of  these  remedies,  it 
is  quite  possible  that  the  dieums  may  be  true, 
and  that  this  slow- acting  poison  may  prove  to  be 
one  quite  easily  eliminated  from  the  system  du- 
ring the  period  of  its  incubation. 

When  once  the  disease  has  reached  the  nerve 
centres,  however,  and  its  symptoms  b^in  to  be 
manifest,  there  has,  thus  far,  be«jn  no  cure  dis- 
covered for  it 

As  this  disease  is  very  rare,  it  requires  the 
testimony  of  many  accurate  observers  to  estab- 
lish any  reliable  facts  concerning  it  For  that 
reason  we  should  be  especially  pleased  if  our 
readers  would  communicate  to  us,  briefly,  any 
personal  experiences  they  may  have  had  with  it 


Agents  Recently  Mentioned  for  Surgical  Dressings. 

The  ideal  surgical  dressing  must  be  an  efficient 
germicide,  non  toxic  to  the  individual  and  to 
the  local  tissues,  non-irritating,  and  as  conven- 
ient for  application  as  possible*  The  agent 
which  most  fully  combines  the  essential  first 
three  of  these  requirements  with  as  gnat  a 
degree  as  possible  of  the  last  one,  will  finally  be 
adopted  as  the  favorite  dressing  by  the  pro- 
firasion. 

In  the  Railway  Surgeon^  Dr.  Brumbaugh,  of 
Huntingdon,  Pa.,  gives  his  successful  experience 
with  the  use  of  pure  unrectified  rye  whiskey  as  a 
moist  dressing. 

"The  application  of  pure  rye  whiskey  as  a 
dressing  for  injuries  wheil  the  tissues  have  been 
crushed  or  lacerated,  has  been  a  favorite  with 
me  for  over  fifteen  years,  and  the  results  have 
been  so  satisfactory  that  I  have  adopted  it  as  a 
dressing  for  all  operations,  when  its  use  is  at  all 
practicable.  I  have  found  that  parts  so  con- 
tused or  lacerated  that  they  would  otherwise 
slough  away,  r^ain  their  tone  and  assume  the 
functions  of  healthy  tissue  under  its  use.  In 
injuries  such  as  are  met  in  lailroad  work,  all 
the  parts  involved,  muscles,  fascia  and  tendons 
are  stretched,  torn  triturated  or  contused  from 
the  point  of  injury  to  the  next  joint  or  division 
of  limb  above,  and  the  application  of  the  moist 
dressing,  and  that  kept  so  by  whiskey,  sug- 
^ed  itself  as  one  eminently  proper  and  prom- 
ising good  results  My  experience  with  a  large 
number  of  serious  cases  in  which  I  applied  tOs 


dressing  has  been  very  satisfactory.  In  no  in- 
stance, whtn  the  application  has  been  made 
faithfully,  has  there  been  a  drop  of  suppuration 
or  a  particle  of  irritation  or  swelling  or  any 
sloughing,  and  no  oflensive  odors  whatever.'' 

He  cites  cases  of  the  worst  forms  of  injuriesy 
and  of  stumps  after  amputation,  most  success- 
fully treated  with  rye  whiskey  dressing.  He 
keeps  the  part  moist  with  whiskey  for  fourteen 
days  then  substitutes  a  dry  dressing.  He  also 
warns  againet  too  frequent  dressings,  as  the  less 
the  part  is  exposed  to  the  air,  the  better. 

At  a  recent  meeting  of  the  Philadelphia 
Academy  of  Surgery,  Dr.  O.  H.  AUis,  recom- 
mended the  appli  ation  of  full  strength  carbolic 
acid  in  all  varieties  of  burns,  and  also  urged 
this  use  of  the  drug  in  deep  sinuses  of  all  kinds. 
He  also  uses  a  strong  solution  of  the  same  drug 
as  a  lotion  for  recent  wounds. 

In  certain  phases  of  surgery,  sulphur  has 
been  used  with  great  success.  '  This  is  particu- 
larly emphasized  in  diseases  of  bones  and  joints^ 
especially  of  tuberculous  character,  by  W. 
Arbuthnot  Lane,  F.R  C  S.,  in  the  Medical 
Week  He  removes  the  diseased  bone  and 
synovial  membrane  and  rubs  in  sterilized  sul- 
phur.    He  summarizes  the  pointa  as  follows  : 

1.  It  appears  to  exert  no  deleterious  influ- 
ence upon  the  individual's  health. 

2.  It  gives  rise  to  products  which  are  pow- 
erfully caustic  in  their  action,  and  must  conse- 
quently be  used  in  small  quantities,  and  with 
discretion. 

3.  It  destroys  all  organisms,  whether  free  in 
a  cavity  or  growing  in  the  surrounding  tiseues. 

4.  It  acts  much  more  powerfully  upon  re- 
cently incised  structures  than  upon  granulating 
surfaces. 

5.  Its  action  is  rendered  more  uniform  and 
genera],  and  less  violent,  by  mixing  it  with 
glycerine. 

6.  If  it  be  necessary  to  use  a  considerable 
quantity  of  the  drug  it  must  be  removed  within 
a  few  days.  Irrigation  with  dilute  perchloride 
of  mercury  lotion  has  proved  very  useful  in  the 
removal  of  small  sloughs,  etc.,  after  the  sul- 
phur has  been  evacuated  and  the  structures 
scraped. 

And  now  the  various  coal-tar  antipyretics, 
especially  acatanilid,  have  been  given  a  new  and 
most  important  use.  They  are  found  to  be  very 
efficient  antiseptic  and  fioothing  powders  for 
dressings  in  general  surgical  work. 


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THB  MBDICAL  WORLD. 


Monumente. 

ProporidoDs  are  frequently  made  to  the  pub- 
lic to  subscribe  for  a  monument  to  some  eminent 
member  of  the  medical  profession.  Members 
of  the  profession  are  also  asked  to  contribute  to 
the  monument  fund  of  some  eminent  public 
man.  On  that  account  we  wish  to  suggest  that 
the  true  monument  is  not  a  useless,  expensive 
shaft  or  pile  of  masonrj,  but  the  foundation  of 
a  school  of  learning,  a  library  or  other  public 
institution  for  the  advancement  of  science,  the 
uplifting  of  the  race  or  the  amelioration  of  suf- 
fering, or  the  endowment  of  a  department, 
chair  of  research  in  certain  branches,  a  scholar- 
ship, ward  or  bed  in  some  already  existing  in- 
stitution. This  kind  of  a  monument  is  con- 
stantly alive,  warm  and  reproductive. 

Private  monuments  may  well,  also,  be 
adapted  to  the  same  principle.  Instead  of  an 
expensive  stone,  there  may  be  a  very  modest 
one  to  your  loved  one,  saying,  if  you  wish,  '<For 
her  enduring  monument  see  the  public  park  for 
children,''  or  other  benificent  institution.  The 
father  of  a  little  boy  who  was  fond  of  animals 
could  not  more  beautifully  perpetuate  his  mem- 
ory than  by  erecting  a  small  fountain  and 
drinking  trough  where  most  needed,  with  the 
inscription  of  his  name  and  the  sentence,  **  He 
loved  animals." 

Even  very  small  sums  could  be  beautifully 
used  in  many  ways,  as,  for  example,  in  a  per- 
petual subscription  to  some  library  or  institu- 
tion for  a  paper  or  magazine,  devoted  to  some 
noble  purpose,  as  the  promotion  of  kindness  to 
animals,  or  a  year's  subscription  to  such  a  peri- 
odical to  •each  one  of  the  circle  of  relatives  or 
^ends.  Afamy  a  noble  and  progressive  cause 
could  be  very  rapidly  advanced  by  constantly 
putting  this  principle  into  practice.  How  much 
better  for  humanity  this  would  be  than  a 
memorial  window  that  shuts  out  the  pure  light 
of  heaven  from  the  worshipers. 

The  planting  of  «sef  ul  fruit,  nut  or  shade 
trees  where  badly  aeeded  to  redeem  some  waste 
place  or  refresh  the  wayfarer,  would  be  an  in- 
expensive way  of  providing  a  living  monument 
to  a  departed  loved  one.  The  habit  of  pre- 
eerving  every  fruit  seed  and  carrying  it  until  a 
euitaUe  spot  is  found  for  plantii^;  it— even 


by  the  wayside — ^would  soon  give  us  all  the 
fruit  that  could  possibly  be  needed. 

This  is  only  suggestive  as  to  the  infinite  ways 
that  may  be  found  for  making  beneficent  mono- 
ments,  whose  power  for  good  would  be  con- 
stantly growing  and  widening.  Having  the 
principle  in  mind,  each  loving  heart  can  best 
work  it  out  for  individual  cases,  according  to 
circumstances  and  personal  taste.  The  ques- 
tion, **  In  what  way  can  we  most  appropriately 
invest  this  money  to  perpetuate  and  consecrate 
the  memory  of  our  loved  one  to  the  benefit  of 
mankind?"  will  not  long  remain  without  an 
answer.  For  struggling  humanity's  sake  let 
the  display  of  wealth  and  the  ostentation  of  this 
world  stop  at  the  cemetery  gate.  Within  thoae 
sacred  precincts  let  all  be  on  a  common  plane. 
Let  the  appropriate  cultivation  of  flowers  show 
the  love  and  replace  the  towering  monument 


Dr.  William  Moor  suggests  that,  in  case  of 
paisoning  either  by  the  alkaloid  or  the  tincture 
of  opium,  some  diluted  sulphuric  add  or  vine- 
gar be  given  with  the  antidote,  to  convert  insol- 
uble fliorphine  into  a  more  soluble  salt,  while 
using  the  permanganate  ofpotassium  as  a  spedfie 
antidote. 

For  Typho-Mslarial  Fever. 

In  an  article  in  the  Alkalaidal  CUnic,  Dr.  R. 
H.  Salmon  of  Seagoville,  Tex.,  states  that  he 
gave  as  follows : 

For  the  fever,  acooitine,  veratrine;  for  in- 
testinal antisepsis,  copper  arsenite,  sulpha  car- 
bolate  of  zinc ;  for  the  sluggish  bowels,  calomel* 
podophyllin ;  as  tonic,  strychnin  arseniate,  qui- 
nine. 


Treatment  of  Oanoert  with  Methyl  Blue. 

Prof.  V.  Mosetig  Moorhof  showed  a  patient 
sufiering  from  villous  cancer  of  the  gall-blad- 
der, treated  with  pyoktanin  internally  and  lo- 
cally. He  introduced  into  the  examination 
wound  every  two  days  a  pencil  of  methyl-blue^ 
and  gave  0.60  gramme  (9}  grains)  in  pills. 
This  treatment,  begun  March  6,  was  followed 
by  complete  cure. — La  Semaine  MSdieale^  Ifay 
12,  1894.— Dnw.  Med.  Jwr. 


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Qriginal  Qommuiiioations. 


Short  artidai  on  the  treatment  of  dSaeaaea,  and  czperieno' 
with  new  remedies,  are  solicited  from  the  profinsion  fo. 
this  department ;  alao  difficult  cases  for  diagnosis  anf* 
treatment. 

Artldes  accepted  most  be  oontrltmted  to  this  joomal  omh 
The  editors  are  not  responsible  for  views  expressed  of 
oontributora. 

Oop7  mu8t.be  received  on  or  before  the  twelfth  of  th* 
month  for  publication  in  the  next  month.  Unuser 
Manuscript  cannot  be  returned. 

Cfrtainfy  it  is  dxctOeni  iUc^Knefyr  an  anihor  to  feel  thai  h* 
must  say  all  he  has  to  say  in  uu  fewest  possibU  words,  &■ 
kis  reader  is  sure  to  ski/ them;  and  in  tke  plainest  possibl 
words^  or  kis  reader  will  certainly  misunderstand  them 
Generally,  also,  a  downright  fad  may  be  told  in  a  plai*^ 
way:  and  we  want  downright /ads  at  present  more  that 
%9^hing  «2w.— RuaxzH 


READ.     REFLECT.    COMPARE.     RECORD. 

Alooholitm.— Replies  — Commente. 

Editor  Medical  World:— The  number  of 
letters  that  oome  to  me,  asking  for  further  in- 
formation concerning  the  treatment  of  alcohol- 
ism,  shows  that  I  was  not  explicit  enough  in  mj 
last  letter,  and  that  a  good  many  are  interested 
in  the  subject.  In  Dr.  Chapman's  formula,  as 
given  in  August  World,  I  substitute  }  grain 
of  oorrosiYe  sublimate  for  the  12  grains  of  dou- 
ble chloride  of  gold.  That  gives  ^  grain  of  the 
sublimate  every  two  hours,  or  \  grain  per  day 
— enough,  surely.  But  when  you  give  \  grain 
of  the  gold  salt  at  each  dose,  or  2  grains  per 
diem,  1  think  it  is  pretty  heavy  dosing.  Dr. 
Chapman's  solution  for  hypodermic  use  must  be 
also  criticized.  Permanganate  of  potassium 
does  not  color  the  strychnine  solution,  but  pre* 
cipitates  it  Since  strychnine  is  present  in  the 
''  dope,"  in  doses  of  gr.  -^  eight  times  daily, 
there  does  not  seem  to  be  any  good  reason  for 
its  presence  also  in  the  solution.  At  any  rate, 
I  have  had  better  results  from  cafieine-  the  al 
kalmd,  not  the  citrate— dissolved  in  distilled 
water  by  the  addition  of  sodium  salicylate.  Of 
this  I  give  from  1  to  6  grains  hypodermically, 
four  times  daily.  If  the  patient's  means  permit 
the  use  of  mandragorine,  I  employ  it  also  hypo- 
dermically,  instead  of  atropine,  when  the  dose 
of  that  alkaloid  in  the  "  dope  "  is  insufficient. 
Decidedly,  mandragorine  excels  atropine — the 
former  being  less  unpleasant  and  more  efficient 
If  in  a  few  days  the  patient  does  not  begin  to 
weaktti  on  his  sppetite  for  alcohol,  I  add  apo- 
morphine  to  his  liquor,  or  give  it  in  the  '*shot," 
giving  about  ^  grain  at  each  dose,  gradually 
increasing  to  ^  grain  if  necessary.  When  the 
desire  for  liquor  is  dead,  I  employ  physostigmine 
instead  of  atropine,  and  brucine  instead  of 
strychnine,  giving  the  latter  in  doses  of  -^  gr. 
every  two  hours,  increasing  if  necessary  to  gr. 


^,  or  even  gr.  ^—trying  to  get  the  tonic  effect 
on  the  pulse,  and  keep  it  Now  comes  an  im- 
portant part  of  the  treatment : 

R.   PoUs.  acetat. ^ drams  It 

Potaa.  biomid » grains  xl 

PoUs.  Dltrat. — grains  XT 

Poia»  carb « «, grains  xx 

H.  a— Dissolve  in  one  to  two  quatti  of  nlAln  soda  (car^ 
bonio  acid  water),  and  Kft  ihe  patient  drink  this  qoantity 
ereryday. 

The  quantity  of  water  depends  on  his  capa- 
city, but  the  free  flushing  of  the  emunctories  is 
of  great  value.  The  diet  should  be  non-stimu- 
lating,  with  plenty  of  fruit  juices,  v^etable 
acids  and  milk,  but  no  rich  foods  or  condiments. 
The  one  thing  that  will  interfere  more  than  any 
other  with  success  is  absinthe. 

I  feel  strongly  like  taking  issue  with  Dr. 
Spohn  (page  273)  on  the  use  of  alcohol  in  diph- 
theria. As  I  look  back  at  my  years  of  practice 
since  I  thoroughly  comprehended  the  importance 
of  antiseptic  treatment  in  this  disease,  I  fail  to 
recall  a  case  in  which  alcohol  did  not  do  more 
harm  than  good.  Recently  I  have  not  given  it 
to  any  case  of  diphtheria  proper.  In  laryngeal 
diphtheria  or  membranous  croup,  alcohol  may 
act  as  a  sedative,  restraining  the  tendency  to 
such  ex>  rtion  as  will  bring  on  paroxysms  of 
strangling,  but  I  prefer  opium.  However,  the 
necessity  for  operation  comes  so  soon,  and  is  so 
urgent,  that  the  space  for  sedatives  is  but 
slight 

Of  what  use  is  alcohol  in  medicine  ?  As  a 
heart  tonic  we  have  a  better,  in  digitalin ;  as  a 
lung  tonic  we  have  a  vastly  better  in  strychnine; 
as  a  food,  we  have  a  dozen  better.  Nitrate  of 
amyl  acts  quicker,  atropine  warms  one  up  better, 
capsicum  is  a  better  remedy  for  collapse.  What 
use  is  there  for  alcohol  in  which  we  cannot  do 
better  ?  To  tide  over  a  dangerous  time,  I  would 
prefer  to  take  my  chances  with  iron,  quinine, 
strychnine,  concentrated  food  and  attention  to 
hygiene. 

A  word  in  regard  to  the  use  of  dosimetric 
granules:  Dr.  Washburn  (page  286)  had  been 
accustomed  to  using  Lloyd's  specific  tinctures. 
He  knew  them,  and  could  apportion  the  doses 
to  each  particular  case  with  the  nicety  a  man 
gets  who  dispenses  his  own  drugs.  When  he 
began  to  use  the  granules,  he  had  to  learn  his 
doses  all  over — how  much  alkaloid  equalled 
any  dose  of  the  tincture,  etc.  His  first  trials 
did  not  strike  the  nail  directly  on  the  head,  and 
he  went  back  to  the  drugs  he  knew  and  could 
use  most  skillfully.  This  difficulty  is  experi- 
enced by  every  one  in  beginning  the  use  of  a 
new  line  of  preparations.  By  a  vast  deal  of 
experimenting,  some  failures  and  disappoint- 
ments, we  gradually  learn  to  know  our  granules 
as  we  did  the  tinctures ;  and  we  can  then  appre- 
ciate the  improvement.     It  is  troublesome  at 


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first,  but  worth  the  trouble.  But  I  would  be 
sorry  that  anyone  would  believe  I  confine  my 
practice  wholly  to  granules,  and  I  do  not  hesi- 
tate to  use  whatever  preparation  will  give  me 
the  best  results.  One  difficulty  is,  that  many 
of  the  granules  are  too  small  in  dose  to  be  of 
any  use,  unless  one  gives  a  handful. 

I  have  never  seen  a  genuine  case  of  hydro- 
phobia, nor  have  I  seen  any  one  who  had. 
Those  who  are  in  a  position  to  know  best  of 
such  matters,  such  as  Prof.  Zuill,  U.  P.  Vet 
College,  strongly  doubt  the  existence  of  such  a 
disease  in  man.  Meningitis,  septicemia,  tetanus, 
uremia  and  other  afi^ectiona,  have  been  treated 
as  hydrophobia.  Had  I  a  case,  however,  where 
a  diagnosis  could  be  fairly  made,  I  would  give 
jaborandi  in  full  doses,  or  muscarine. 

Dr.  Gregory  (page  289)  may  attribute  his 
cerebral  symptoms  to  uricemia,  disease  of  the 
ear,  eye  or  nose.  Each  of  thf  se  is  capable  of 
producing  giddiness,  tinnitus  and  confusion ;  or 
these  symptoms  may  be  due  to  indigestion,  con- 
stipation, malaria,  anemia,  plethora,  or  too 
free  use  of  cofiee.  From  the  history,  I 
would  expect  to  locate  the  trouble  in  the  eyes, 
and  would  first  have  them  examined  by  a  com- 
petent oculist 

Dr.  Farrar  (page  289)  describes  a  form  of 
fever  that  has  given  trouble  to  diagnosticians  in 
many  parts  of  the  country.  There  are  three 
elements  possible,  and  I  believe  most  cases  come 
under  one  of  them:  1st  Typhoid  fever.  2d, 
Malarial  fever.  .  3d.  A  gastro-intestinal  ca- 
tarrhal fever,  due,  I  believe,  to  a  specific  as  yet 
unknown  germ.  I  have  seen  a  number  of  the 
latter,  which  I  am  sure  were  neither  typhoid 
nor  malarial ;  the  whole  aspect  of  the  cases  was 
unlike  either.  There  was  depression,  verging 
to  the  typhoid  state,  with  coated  tongue,  with  a 
dry,  brown  stripe  down  the  center,  but  not  the 
"  small  red-tipped,  pointed  tongue  "  of  typhoid  ; 
nor  were  there  rose  spots,  ''  taches  bleuatres"  or 
pea-soup  stools.  Gurgling  at  the  right  iliac 
fossa  is  BO  generally  found  in  abdominal  dis- 
eases, that  it  is  not  characteristic  of  typhoid 
fever.  The  ft  ver  course  is  not  the  typical  one 
of  the  latter  di&ease,  varying  weekly,  though 
the  temperature  is  higher  in  the  afternoon.  The 
force  of  the  disease  is  felt  in  the  stomach,  and 
the  epigastrium  may  be  hot  and  bulging  while 
diarrhea  is  not  present  unless  cathartics  are 
given,  when  all  symptoms  are  aggravated. 
Nothing  did  my  cases  as  much  good  as  sulpho- 
carbolate  of  zinc,  in  doses  of  gr.  v.,  every  two 
hours,  with  20  gr.  quinine  suppositories,  and 
rectal  feeding.  I  believe  the  diagnosis  of  these 
three  conditions  can  only  be  certainly  made  by 
a  microscopic  examination  of  the  stools  and 
blood,  showing  the  presence  or  absence  of  the 


typhoid  bacillus,  Laveran's,  or  perhaps  a  new 
micro-organism.  Otherwise  we  cannot  be  sure 
but  that  we  have  a  variety  of  one  or  the  other 
of  these  diseases. 

Marasmus  is  a  pretty  comprehensive  term,  as 
we  find  included  under  it  ca^es  of  tuberculoos, 
rickets,  indigestion,  malassimilation  and  catarrh. 
Of  these,  rickets  is  that  most  likely  to  be  over- 
looked in  the  early  stages.  There  is  the  rickety 
type— flat  head,  large  cranium,  small  face, 
teeth  delayed  and  crowded  into  a  small  jaw,  late 
closure  of  fontanelles,  and  late  walking;  nervous- 
ness, fretting,  irritative  diarrhea,  the  food  giv- 
ing distress  till  it  is  voided  undigested ;  wasting, 
fever,  and  later,  inability  to  hold  the  head 
erect  The  treatment  consists  in  the  use  of  cal- 
cium lactophosphate,  gr.  v.-xv.,  daily,  malt  ex- 
tract and  the  diges  ive  principles  combined,  at 
each  feeding,  and  a  diet  of  raw  white  of  egg,  beef, 
and  strictly  predigested  milk.  Sometimes  milk 
in  any  form  disagrees,  and  must  be  suspended 
for  a  time.  Cream  may  be  substituted,  if  good 
and  pure.  Rub  the  body  from  head  to  foot 
daily  with  hot  cod  liver  oU.  Of  the  malt  ex- 
tracts, the  best  I  have  ever  used  in  this  form  of 
marasmus  was  a  granulated  extract,  made  by 
Wiley  &  Wallace,  of  Philadelphia.  I  usually 
give  sour  fruit  juice  also,  either  lemon,  orange, 
grape  or  shaddock,  as  experience  shows  to  be 
most  acceptable  to  the  child.  Of  the  pepsins,  I 
have  used  papain,  laciopeptine,  Wyc^'s  pep- 
tonic piUs,  and  Carnrick's  pepteoizyme,  and  do 
not  like  to  express  a  preference,  having  found 
all  serviceable  in  some  cases.  Pure  water, 
woolen  underclothing,  and  proper  hygiene  of 
the  house  and  surroundings,  are  absolutely  es- 
sential to  success  in  treating  any  form  of  ma- 
rasmus. 

For  "  ethmoiditis,"  I  would  recommend  thor- 
ough washing  out  the  diseased  cavities  with 
peroxide  of  hydrogen  solution,  then  spraybg 
with  fluid  petrolatum.  It  may  be  necessary  to 
trephine  the  frontal  sinuses  to  secure  proper  an- 
tisepsis and  drainage. 

Dr.  Desmarais  (page  290)  will  Have  a  mor- 
phine case  on  his  hands  soon.  If  there  is  still 
albuminuria,  give  potassium  acetate  untU  the 
symptom  has  disappeared.  For  the  neuralgic 
pains  in  the  arm,  nitro  glycerine  to  relieve,  and 
strychnine  arseniate  (full  doses)  to  cure,  ss 
this  arm-pain  points  to  the  heart  All  the 
eliminants  must  be  kept  in  good  working 
order. 

For  tan  and  freckles,  use  an  ointment  of 
camphor,  chlorofornii  glycerine  and  lanoiine, 
applied  every  night  It  will  remove  tan,  and 
perhaps  the  freckles. 

Dr.  Culler  (page  291)  should  try  the  lactate 
of  strontium  for  his  case  of  diabetes.    It  has 


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given  me  better  results  than  any  other  remedy, 
excepting  possibly  the  jambul. 

If  I  can  get  the  time  before  The  World 
goes  to  press,  I  will  send  some  cases  of  morphino- 
mania,  to  complete  the  series  of  papers  I  have 
been  writing.  If  not,  Ihey  will  he  ready  for  the 
next  number. 

I  have  just  been  notified  of  my  election  as 
Professor  of  Physiology  in  the  College  of  Phy- 
sicians and  Surgeons  of  this  city.  The  course 
opens  on  September  4th,  so  that  I  will  have  to 
commence  at  once  on  my  lectures,  i  have 
always  had  a  wish  to  deliver  a  course  on  physi- 
ology, feeling  that  there  is  more  in  the  physio- 
logical treatment  of  disease  than  is  generally 
thought  This  will  not  conflict  with  my  course 
at  the  Poet  Graduate  College,  where  I  now  give 
clinical  lectures  three  times  a  week.  There  is 
some  talk  of  a  summer  medical  college  here, 
which  may  materialize  in  the  coming  spring. 
William  F.  Waugh,  M.D., 

103  State  St,  Chicago. 

[Dr.  Waugh  writes  us  that  his  numerous  en- 
gagements are  keeping  him  so  busy  that  he  is 
finally  compelled  to  make  some  discrimination 
in  the  perfect  avalanche  of  letters  that  he  re- 
ceives, asking  advice  in  difficult  caees.  Some 
send  fees,  and  others  do  not.  In  justice  to  him- 
self and  to  those  who  pay,  he  is  now  compelled 
to  charge  a  iee  for  all  consultations  by  letter, 
which  will,  however,  be  made  so  small  as  to 
work  no  hardship  on  any  one.  The  fee  to 
World  subeciibers  will  be  $1.00 ;  to  all  others 
$2.00.  For  cases  requiring  microscopic  or 
chemical  examination  of  urine,  sputa,  tumors, 
etc.,  there  will  be  an  additional  fee  of  $5.00. 
The  doctor  is,  of  course,  free  to  charge  his  pa- 
tient what  he  pleases.  This  will  enable  Prof. 
Waugh  to  continue  these  letter  consultations, 
which  he  would  otherwise  be  compelled  to  give 
up,  on  account  of  the  increasing  pressure  on  his 
time. — Ed.] 


A  Prompt  and  Cheap  Remedy  for  Anemia. 

Editor  Medical  World: — As  every  phy- 
sician knows,  there  is  a  large  number  of  poorly- 
nourished  children,  who  are  so  pale  that,  like 
one  of  Victor  Hugo's  street  gamins,  the  skin  is 
''white  with  a  lymphatic  whiteness."  A  mere 
glance  at  one  of  them  causes  the  doctor's  mind 
to  revert  to  the  blessings  of  the  iron  age,  and  it 
18  to  call  more  especial  attention  to  one  of  the 
most  common,  and  at  tke  same  time  one  of  the 
most  neglected,  prepaiations  of  this  metal  that 
prompts  me  to  indite  these  lines. 

The  preparation  to  which  I  refer  is  the  massa 
ferri  caibonatis,  or  Valet's  mass.  It  is  cheap, 
aad  easily  made  into  pills  by  adding  to  it  a  cer- 


tain amount  of  c'nchonidia  sulphate  or  powdered 
gentian  root.  I  uae  these  to  give  the  mass  the 
proper  consiatence,  and  for  the  additional  reason 
that  either  will  add  to  the  tonic  properties  of  the 
prescription. 

When  one  of  these  short  winded,  pufiy  look- 
ing cases  is  presented,  I  put  him  on  pills  con- 
taining about  3  grains  of  the  mass,  three  times 
a  day,  to  be  taken  immediately  after  meals.  It 
is  surprising  to  see  how  rapid  is  their  improve- 
ment. 

But  there  are  numbers  of  cases  of  anemia 
that  will  not  improve  until  they  get  a  cardiac 
tonic.  The  heart  is  weak  and  irritable,  and 
nutrition  cannot  improve,  for  obvious  reasons. 
A  case  I  remember  some  years  ago :  A  girl,  14 
years  old,  had  been  treated  by  several  physi- 
cians, and  they  all  prescribed  iron,  but  with  no 
improvement  At  tbe  time  I  was  called  to  see 
her  she  had  been  given  up  to  die.  I  found  that 
she  was  a  subject  of  mitral  insufficiency,  and  as 
soon  as  I  added  digitalis  and  nux  vomica  to  the 
iron  she  improved  at  once,  and  was  completely 
recovered  in  a  few  months,  married  the  next 
year,  and  is  now  the  mother  of  several  chil- 
dren. 

Other  cases  improve  rapidly  under  the  iron 
preparations,  but  they  cannot  be  cured.  There 
seems  to  be  a  constitutional  tendency  to  degene- 
ration of  the  red  blood  corpuscles,  and  they  re- 
lapse as  soon  as  the  iron  is  withdrawn.  The 
iron  preparations  should  be  alternated  with  each 
other,  and  at  times  arsenic  or  mercury  added  to 
the  treatment.  Keep  them  growing,  and  keep 
up  the  health  to  the  highest  standiud  possible, 
until  they  ''outgrow"  the  disease. 

Homer,  Ga.         V.  D.  Logkhart,  M.D., 


The  Cold  Bath  in  Malignant  Scarlet  Fever. 

Editor  Medical  World: — On  July  31st 
I  was  called  eight  miles  distant  to  see  a  strong 
girl  of  ten  years  with  scarlet  fever.  Tempera- 
ture 104*;  other  symptoms  of  moderate  severity. 
Had  been  sick  two  days.  I  prescribed  tr.  aco- 
nite rad.,  pot  chlo.  and  listerine,  internally,  and 
listerine  as  mouth  wash,  and  externally  mild 
carbolized  vaseline,  to  lessen  the  irritation  of  the 
skin. 

August  1st — Temperature  105^  Excessive 
delirium  and  restlessness,  and  dusky-red  skin, 
with  sluggish  capillary  circulation,  diarrheie 
stools,  and  profound  impression  of  the  nervous 
SjTStem.  The  appearances  were  that  she  would 
not  live  more  than  thirty-six  or  forty-eight 
hours. 

Hopmg  to  prolong  her  life  until  the  poison 
should  be  eliminated  in  part,  a  cold  bath.  Brand 
method,  every  half  hoar,  was  ordered.     Alco- 


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holic  stimulantB  were  /r  eely  used,  and  brisk  rub- 
bing of  the  entire  surface  on  removal  from  the 
water. 

Improvement  was  noticed  from  the  first  bath. 

August  2d. — Temperature  103°.  All  symp 
toms  improved. 

August  3d  — Temperature  100*^.  Disease 
assuming  a  mild  character. 

August  4th. — Temperature  99°.  Symptoms 
aU  of  mildest  character.  Functions  all  good. 
Eruption  incomplete,  but  of  good  character. 
Discharged  the  patient,  conditionally. 

It  seems  proper  in  this  case  to  attribute  the 
extremely  rapid  improvement,  and  the  change 
in  the  character  of  the  dUease  from  one  of  ma- 
lignancy to  one  of  mildness  to  the  efficacy  of  the 
cold  bath.  If  this  be  true,  need  we  lose  so  many 
of  those  malignant  cases  ? 

Please  let  us  hear  from  those  who  have  had 
experience  with  this  method  of  treatment. 

J.  C.  McAllister,  M.D., 

Driftwood,  Pa. 


The  Use  of  Creolln  in  the  Treatment  of  Diphtheria. 

Editor  Medical  World  :— Having  had 
considerable  experience  in  treating  diphtheria, 
and  not  being  satisBed  with  the  results  obtained, 
about  one  year  ago  I  decided  to  try  a  new  anti- 
septic locally  to  the  affected  parts,  an  antieeptic 
which  I  am  very  partial  to,  especially  in  obstet- 
rical work,  viz.:  creolin. 

Believing,  as  I  do,  that  diphtheria  is  prima- 
rily a  local  disease,  and  that  the  systemic  symp- 
toms are  not  due  to  the  absorption  of  the  germs 
of  the  disease  into  the  general  circulation,  but 
that  the  ptomaine  of  the  germ  produces  its  deadly 
effects,  local  antisepsis  comes  into  great  promi- 
nence in  my  method  of  treatment. 

Of  course,  few,  if  any,  would  deny  that  the 
disease  would  entirely  disappear  if  perfect  sani- 
tation and  hygienic  conditions  could  prevail. 

I  believe  that  internal  medication  is  only  of 
use  in  eo  far  as  it  stimulates  the  patient  and 
poanteracts  the  damage  produced  by  the  ab- 
sorbed ptomaine. 

Some  of  the  reasons  which  lead  me  to  believe 
that  creolin  has  superior  virtues  in  the  treatment 
of  this  disease  are  as  follows : 

Formerly,  when  using  bichloride,  H^O*, 
iron,  etc ,  locally,  and  strychnine,  iron,  stimu- 
lants, etc.,  inteinally,  as  indicated,  my  average 
death-rate  was  over  twenty  per  cent,  notwith- 
standing every  care  was  taken  by  having  good 
nursing  and  surroundings  for  the  patient  In 
the  general  run  of  cases  where  creolin  has  been 
employed  by  me,  it  has  been  used  in  a  one  per 
cent  solution  with  water.  In  some  instances 
this  will  be  found  to  be  too  strong,  and  will  irri- 


tate the  parts.     In  such  cases  a  milder  solution 
must  be  used. 

My  results  from  this  treatment  have  been 
excellent.  Out  of  about  twenty  cases  treated, 
no  deaths  have  resulted,  and  I  can  say  that  no 
cases  have  been  included  in  this  list  that  were 
doubtful  in  character.  All  have  been  true 
cases  of  diphtheria,  and  of  the  usual  type  of 
severity;  and  at  the  same  time,  during  the  paat 
year,  I  find  upon  investigation  that  the  death- 
rate  in  our  city  from  this  disease  has  been  abont 
the  same  as  in  former  years.  Certainly  I  could 
not  have  escaped  the  severe  cases  altogether, 
and  it  naturally  follows  that  there  was  some 
virtue  in  the  treatmeot  employed  in  my  cases. 

Now,  since  all  the  other  treatment  was  used 
as  in  former  years  exoep  ing  the  antiseptic,  ap- 
plied loyally,  I  am  led  to  believe  that  the  auo- 
cess  I  have  obtained  has  been  due  to  the  use  of 
creolin. 

It  has  been  applied  in  different  ways,  to  meet 
the  various  indications  of  the  cases.  Where 
the  patient  could  gargle,  I  have  used  it  in  tlua 
form.  Then,  again,  it  may  be  used  by  meaos 
of  a  spray,  or  applied  on  a  swab.  In  every 
case  great  care  should  be  exercised.  In  aU 
cases  where  creolin  has  been  used  it  will  be 
noticed  that  the  affected  parts  are  kept  in  a  very 
cleanly  condition;  that  is,  if  care  has  been  used. 
But  if  force  is  used  when  applying  the  solution, 
the  membrane  may  be  entirely  detached,  and 
this  does  no  good,  because  it  will  soon  return, 
but  it  may  do  great  harm,  because  it  leaves  a 
raw  surface,  through  which  fatal  absorption  can 
take  place. 

Again,  if  the  solution  is  applied  with  care, 
and  often —say  every  hour—one  will  obserrre 
that  the  spreading  of  the  membrane  is  limited, 
and  that  it  soon  begins  to  lessen  in  size,  like  a 
piece  of  ice  in  the  sun,  and  finally  disappe&n 
without  leaving  any  raw  surface 

In  fact,  when  the  membrane  has  entirely  dis- 
appeared, the  parts  will  usually  be  found  healed. 

In  all  cases,  whether  or  not  the  nares  show 
signs  of  infection,  they  should  be  carefully 
cleaned  by  means  of  the  spray  several  times 
each  day. 

Of  course,  I  do  not  believe  that  creolin  is  an 
infallible  remedy  in  this  disease,  but  since  it  is 
a  non-toxic  antiseptic,  it  is  safe  to  use  freely; 
and  since  it  has  given  me  such  good  results,  I 
am  led  to  believe  that  there  is  more  virtue  in  it 
than  has  been  previously  supposed,  and  that  it 
is  worthy  of  an  extensive  trial  in  the  treatment 
of  diphtheria. 

O.  W.  Braymer,  A.M  ,  M.D.,  Ph.D., 

Camden,  N.  J. 

Physician  to  the  Camdea  Home  for  Frif^ndleas  Chil- 
dren, Surgeon  to  the  Camden  City  Dispensary,  cte. 


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Theory  and  Treatment  of  Diphtheria. 

Editor  Medical  World  : — The  question,  is 
diphtheria  a  constitutional  disease  from  the  be- 
ginning,  or  not,  seems  to  trouble  the  profession 
as  much  as  ever.  Having  had  considerable  ex- 
perience in  diphtheria,  allow  me  to  contribute 
my  mite. 

I  believe,  from  experience,  that  diphtheria  is 
first  local,  and  changes  into  constitutional  very 
qmcklj.     To  relate  cases : 

A^ugust  10th,  1892.— F.  W.,  a  boy  14  years 
old,  fell  from  a  wagon,  was  kicked  in  the  bead 
by  the  horse,  and  sustained  four  severe  contu- 
sions, three  of  them  open.  I  dressed  them.  For 
forty-eight  hoars  all  went  smoothly ;  then  the 
stitches  of  one  wound  were  cutting  their  way 
out  I  removed  them,  and  found  the  wound 
covered  with  a  dirty  gray  exudate  and  an  aene- 
ous truption  around  the  margin.  Treated  with 
H^O^  Ftrong  solution  for  forty  eight  hours. 
Wound  looking  clean ;  all  other  wounds  healing 
by  first  intention.  In  forty- eight  hours  after 
the  wound  had  acted  badly,  patient  complained 
about  sore  throat,  and  I  found  a  full  fledged 
diphtheria  of  the  throat.  Treatment  by  per- 
oxide spray,  and  tr.  iron,  twenty  drops  every 
two  hours,  cleaned  up  matters  in  four  days.  I 
traced  the  cause  of  the  disease  to  diphtheria 
germs,  retained  for  two  years  in  the  soil.  There 
had  been  five  cases  in  the  house  in  front  of 
which  the  accident  happened. 

2.  While  tearing  out  old  rotten  cellar  boards 
in  a  house  where  diphtheria  had  been  rampant 
five  years  ago,  C.  B.,  male,  30  years  old,  com 
plained  about  malaise,  slight  stifiness  in  the  sn- 
gles  of  the  mouth,  and  a  slight  sore  throat  In 
tw«ity-four  hours  diphtheria  developed,  but  was 
mild,  and  resulted  in  recovery  in  three  days 
uider  local  treatment  by  peroxide  of  hydrogen 
and  iron. 

Another,  who  helped  to  do  the  work,  was 
taken  sick  forty  eight  hours  afterwards,  ne- 
glected to  call  a  physician  for  three  days,  and 
had  one  of  the  severest  cases  of  diphtheria. 

My  treatment  is  not  original.  I  use  peroxide 
of  hydrogen  (13  vol.)  spray,  full  strength,  every 
two  hours  for  forty-eight  hours;  then  reduce 
strength  of  the  solution  one  half  and  use  for 
twenty  four  hours  After  that  I  stop  it,  as  I 
find  a  new  membrane  developing  when  used  too 
long.  Then  I  substitute  petmang.  of  potash, 
gr.  4  to  the  ounce,  in  spray.  I  clear  out  the 
bowels  with  calomel  and  soda,  and  depend  en- 
tirely  on  tincture  of  iron  (I  always  use  a  tinc- 
ture at  least  a  year  old,  as  larger  doses  can  be 
given  and  retained).  I  also  employ  poultices 
to  the  neck,  steam  inhalatioas  with  cinnamon 
and  carbolic  acid ;  fluid  diet.  Use  stimulants 
if  heart-sounds  are  weak  and  watch  carefully. 


Spray  out  nostrils  every  fo\ir  hours  with  1  to  4 
peroxide  or  permanganate.  Sulphate  of  copper 
sol.  added  to  the  poultice  seems  to  reduce  the 
swelling.     Do  not  give  chlorate  of  potash. 

P.    H.    VON   ZlEROLSHOFEN,  M.D., 

Croghan,  N.  Y. 

Traumatic  Tetanus. 

Editor  Medical  World  :— On  May  25th, 
1894, 1  was  called  to  see  Isaac  Johnson's  boy,  age 
13.  At  that  time  L  found  him  suffering  and  in 
great  agony.  His  jaws  were  so  tightly  locked 
that  I  could  not  introduce  the  lip  of  my  little 
finger  between  his  teeth.  I  was  unable  to 
question  him,  for  as  I  did  it  would  throw  him 
into  a  tetanic  spasm  and  cause  him  to  assume 
an  opisthotonus  position. 

From  ocular  symptoms  I  at  once  suspected 
tetanus  and  immediately  sought  to  determine 
the  cause.  An  examination  of  the  foot  revealed 
a  small  punctured  wound,  situated  in  the  sole  of 
the  left  foot,  about  an  inch  below  the  junction 
of  the  great  and  first  toes. 

On  questioning  other  members  of  the  family, 
I  elicited  the  f  ict  that  a  fe^  days  previous,  the 
boy  had  called  his  mother's  attention  to  the 
wound,  which  he  said  was  caused  by  having 
stepped  on  a  nail,  and  which  at  •the  time  appeared 
trivial,  so  that  no  further  thought  was  given  it 
until  alarming  symptoms  suddenly  developed. 
My  suspicion  being  confirmed  as  to  the  diagnosis, 
I  first  injected  hypodermically  i  grain  of 
morph.  suiph.  and  then  made  a  crucisil  incision 
through  the  puncture,  evacuating  a  thimbleful 
of  pus  with  about  twice  that  quanity  of  a  mix 
ture  of  blood  and  pus.  I  then  prescribed  a  pre- 
paration containing  morphia  sulphate,  bromide 
of  potash  and  chloral  hydrate,  to  be  given  every 
two  hours,  with  instructions  not  to  waken  the  pa- 
tient, and  directed  the  nurse  to  paint  the  entire 
foot  twice  a  day,  and  the  sole  of  the  foot  to  the 
edge  of  the  incision  every  3  hours,  with  iodine. 
Poultices  of  flaxseed  and  blatta  orientalis  being 
applied  continouslj. 

The  spasms  continued  during  the  four  days 
following  my  first  visit,  although  not  so  violently. 
The  entire  muscular  system  remained  very  rigid 
and  there  was  complete  inaction  of  the  bowels. 
For  the  muscular  rigidity  the  patient  was  fric- 
tioned  with  a  liniment  composed  chiefly  of  chlo- 
rofjrm,  spts.  camphor  and  aqua  ammonia  and 
an  ointment  of  sulphate  ef  quinine,  with  lanolin 
as  the  base  For  the  bowels  a  saturated  solu- 
tion oi  sulphate  of  magnesia  wa^  given  per  orem, 
aided  by  enemata.  Liquid  nourishment  and 
very  little  of  that  is  what  sustained  the  patient. 

At  my  second  visit.  May  25th,  on  re-examin- 
ing the  foot  I  noticed  the  appearance  of  a  bluish 
spot,  about  two  inches  below  the  point  of  my 


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first  incision.  DraWing  my  lancet  through  this 
spot  there  was  a  slight  discharge  of  matter  and, 
on  probing,  I  soon  found  that  the  two  openings 
communicated.  I  thereupon  introduced  a  groov^ 
director  and  made  a  free  and  deep  incision  con- 
necting the  two  openings.  The  result  was,  to 
my  surprise,  the  discharge  of  a  splinter  an  inch 
and  a  half  in  length.  A  continuation  of  the 
treatment  outlined  above  was  advised  and  fol- 
lowed. 

The  patient  at  this  writing  is  up  and  about, 
having  called  to  see  me  at  my  office.  His  ap- 
pearance does  not  show  signs  of  the  sieze  passed 
through.  Dr.  Louis  E.  Meyer, 

Thibodaux,  La. 

Cases  in  Praotioe.— Phantom  Tumor.— Chancre  in 

an  Infant,— Viburnum  in  Obstetrios.— Gel- 

seminum  for  Neuralgia.— Treatment 

for  Diarrhea.— Chloride  of  Cal- 

oium  for  Pneumonia. 

Editor  Medical  World  : — On  June  3d,  I 
was  hurriedly  called  to  attend  Mrs.  H.,  aged 
40,  in  her  eighth  confinement  The  messenger, 
her  husband,  stated  that '' the  midwife  in  charge 
was  unable  to  manage  the  case."  The  distance 
being  over  eight  miles  from  my  office,  1  made 
l^ll  haste  and  reached  the  lady  in  less  than  an 
iiour.  I  made  the  usual  examination  but  could 
find  no  presentation,  nor  was  the  os  dilated.  I 
then  b^an  a  careful  examination  of  the  abdo- 
men, but  could  find  no  child.  I  diagnosed  *'  phan- 
tom tumor,"  and  informed  the  anxious  friends 
that  it  was  a  case  of  deception.  Now,  this  lady 
had  given  birth  to  numerous  children  and  the 
husband  for  the  past  three  weeks  had  discon- 
tinued the  erection  of  a  new  home  awaiting  the 
happy  event,  and,  I  may  add,  is  still  waiting. 

On  July  16th,  Harry  N.,  aged  two  years, 
was  brought  to  my  office  by  his  mother,  for  the 
purpose  of  ascertaining  the  cause  of  a  sore  on 
his  penis.  After  examination  I  found  a  true 
chancre  on  the  *' corona  glandis."  Syphilitic 
treatment  was  given  and  the  usual  cure  re- 
sulted. 

Onpaie  329  of  the  April  World  is  an 
article  on  "Viburnum  Prunifolium,"  by  Dr. 
Hilton.  On  the  merits  of  the  Doctor's  articles 
I  prepared  a  quantity  of  the  medicine  as  di- 
rected. My  first  opportunity  came  on  a  lady 
of  refinement,  who  had  been  running  a  lawn 
mower.  She  was  seven  months  pregnant  I 
gave  teaspoonful  doses  every  four  hours,  accom- 
pan  el  by  oodine,  ^  of  a  grain  every  three 
hours.     The  treatment  was  satisfactory. 

I  was  called  on  the  29th  of  June  to  attend 
Mrs.  K.,  in  her  seventh  oonBnement  Now, 
here  was  a  chance  for  the  viburnum.  This  lady 
is  known  to  always  have  a  very  tedious  labor, 
requiring  from  twenty-four  to  forty-eight  hours 


and  often  forceps  to  terminate  the  labor.  As  I 
confined  her  on  the  two  previous  occasions  for- 
ceps were  necessary  and  were  used.  I  entered 
her  home,  at  3  p.  m.,  gave  her  one  teaspoonful  of 
viburnum  repeated  every  two  hours,  accompan- 
ied with  hypodermics  of  morphine  and  atro|Nne. 
(There  was  slight  dilatation  upon  my  first  exam- 
ination )  At  seven  o'clock  I  packed  my  case, 
the  lady  having  given  birth  to  a  9i  pound  boy, 
and  the  confinement  was  so  easy  that  all  were 
surprised,  as  well  as  the  doctor.  Try  it,  my 
brethren,  you  will  be  pleased. 

On  June  26th  I  prescribed  for  Mr.  P.,  who 
was  troubled  with  facial  neuralgia,  giving  him 
thirty  drops  of  fl.  ext  gelseminum  in  an  ounce 
of  water,  teaspoonful  every  four  hours.  It 
worked  nicely.  He,  thinking  to  prescribe 
for  himself  at  a  later  day  and  thus  save  a 
small  office  fee,  went  to  the  nearest  drug  store 
and  there  purchased  sixty  drops  of  fl  ext.,  tak- 
ing the  same  at  one  dose.  It  is  needless  to  say 
that  the  Doctor's  fee  was  incurred  and  Mr.  P.» 
is  much  wiser  to  day. 

In  the  August  World,  page  281,  you  wiU 
find  Dr.  Taylor's  "  Treatment  of  Diarrhea  in 
Childrwi."  I  have  for  the  past  two  years  re- 
lied on  this  remedy,  and  I  can  say  I  have  been 
called  to  cases  that  have  been  given  up  by 
other  physicians,  and  with  this  treatment  have 
caused  a  cure  and  often  saved  life. 

In  The  World  for  July,  page  241,  will  be 
found  an  article  by  Dr.  Ben  H.  Brodnax.  re- 
lating to  chloride  of  calcium.  Well,  on  July 
l3th,  I  had  an  opportunity  to  try  this  drug  on 
a  child  thirteen  months  old. 

The  child  was  '*  fretful,  a  little  grunt  at  ex- 
piration, some  cough,  bowels  not  loose,  but  a 
little  tympanitic,  slept  some."  I  tried  several 
drugs  without  relief,  child  was  growing  worse. 
I  gave  the  calcium  a  trial.  After  two  doses 
the  father  of  the  child  came  to  my  office  and 
reported  the  child  as  doing  so  well  I  need  not 
call  again.  I  fear  I  have  already  takea  too 
much  space  in  the  good  old  World. 

Roger's  City,  Mich.      R  Erskike,  M.D., 

[A  very  practical  letter.  Doctor,  could  yon 
find  out  how  that  child  caught  syphilis  ? — Ed  ] 

£leotro  Vapor  Baths, 
Editor  Medical  World  : — To  the  average 
mortal  the  idea  of  a  bath  is  at  once  assooiated 
with  soap  and  water,  and  with  a  large  number 
the  soap  is  omitted  and  only  the  water  thought 
of.  Some  people  never  take  a  bath  except  in 
hot  weather  when  they  go  into  the  water  swim* 
ming,  and  then  only  take  a  bath  incidentally 
with  amusement,  and  if  they  did  not  stay  in  the 
water  long  enough  to  thoroughly  macerate  the 
skin,  would  not  then  be  clean. 


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319 


Mark  Twain  tells  us  about  a  man  who  so 
thoroughly  abhorred  water,  because  his  brother 
was  drowned  in  it  when  a  boy,  that  be  never 
drank  anything  but  whiskey.  But  people  of 
average  intelligence  with  proper  ideas  of  clean- 
lineflB,  usually  make  good  use  of  water  applied 
to  the  body  externally,  for  hygienic,  and  cosmetic 
reasons.  As  we  know,  the  body  is  largely  com- 
posed of  water,  and  it  is  highly  essential  to  life 
and  health  internally  and  externally.  As  has 
been  said,  water,  the  universal  solvent,  is  the 
**  blood  of  the  eaith,"  and  when  we  have  a  long 
drouth  it  is  a  self  evident  fact  that  neither 
animal  nor  vegetable  life  would  continue  without 
water. 

Water,  as  a  therapeutic  agent,  has  a  variety 
of  indications  and  effects,  but  our  attention  will 
be  directed  only  to  the  use  of  water  as  a  hygienic 
and  therapeutic  agent  when  utilized  in  the  form 
of  vapor  as  a  batfcu 

Vapor  baths  are  not  a  thing  of  to  day,  but 
are  of  great  antiquity,  as  we  have  accounts  of 
the  use  of  the  vapor  bath  during  the  12th 
century,  so  that  none  of  our  modem  physicians 
can  claim  the  honor  of  invention.  It  is  even 
now  and  has  for  ages  been  employed  among 
semi-dvilized  and  barbarous  nations.  Whether 
applied  by  the  savage  in  his  hut  by  pouring 
water  over  heated  stones,  or  dropping  hot  stones 
into  the  water  until  it  boils  and  throws  off  the 
vapors,  or  applied  in  an  elegant  marble  tiled 
saloon,  by  an  experienced  masseur,  the  object 
aimed  at  and  achieved  is  essentially  the  same. 

We  excrete  refuse  matter  in  four  ways  viz : — 
by  the  kidneys,  bowels,  lungs  and  the  skin,  and 
the  proportionate  area  of  excretory  surface  is 
Ibe  inverse  of  the  order  named. 

It  is  estimated  that  thet^re  are  seven  million 
pores  in  the  human  skin,  each  one  of  which  has 
Us  especial  function  to  perform.  Interfere  with 
that  function  to  any  great  extent,  by  covering 
the  pores  with  an  imperoious  covering  and  how 
quickly  death  ensues. 

So  we  see  how  essential  it  is  that  the  skin 
perform  it's  whole  share  of  the  work. 

The  skin  not  only  has  an  excretory  function, 
but  it  acts  as  a  safe  guard  against  heat  or  cold. 

Stop  the  evaporation  of  the  insensible  pers- 
piratioi:  and  the  body  temperature  rapidly  rises ; 
bcrease  it  and  it  rapidly  falls. 

As  ordinarily  applied,  a  soap  and  water  bath 
does  not  cleanse  the  skin,  for  be  it  applied  ever 
so  frequently  and  thoroughly,  the  skin  will  be 
seen  under  a  magnifying  gla«  to  be  dotted  all 
over  with  thousands  of  little  dark  points,  showing 
where  the  mouths  of  the  pores  and  ducts  are 
plugged  with  dirt. 

Perspiration  keeps  the  pores  open  by  pushing 
out  these  minute  plugs  and  depositing  them  upon 


the  surface,  thence  to  be  rubbed  off,  and  the 
vapor  bath  is  the  ideal  excitant  to  this  process. 

By  an  artificial  elevation  of  external  tem- 
perature, exoemosis  is  aided  and  the  moist  heat 
is  better  than  the  dry  heat,  in  that  it  soaks  the 
surface  and  loosens  the  dried  and  dead  epithelial 
scales  and  plugs,  making  the  vis  a  tergo  required 
be  less  than  it  otherwise  would.  When  a  person 
sweats  as  one  does  f  ither  as  a  result  of  physical 
exercise,  work  or  hot  weather,  this  process  goes  on, 
but  in  this  instance,  the  excreted  effete  matter 
and  dirt  is  allowed  to  dry  on  the  surface  and 
the  pores  are  still  either  covered  or  plugged  up. 
Therefore  something  else  is  required,  following 
the  exoemosis;  that  is.  friction,  applied  to  the  skin, 
to  entirely  remove  the  matter  from  the  skin, 
and  leave  it  clean. 

There  are  a  variety  of  baths  known  by  dif- 
ferent names,  and  differing  only  in  minor  details, 
as  the  object  sought  in  all  is  essentially  the 
same. 

The  Turkish  bath  i)  a  sweat  produced  by 
immersion  in  a  dry  bot  air.  The  Russian  bath 
is  produced  by  means  of  a  moist  hot  vapor  or 
steam  according  to  the  degree  of  heat  The 
Turko  Russian  is  a  combination  of  both,  as  its 
name  signifies. 

The  aromatic,  perfumed,  medicated,  and  sul- 
phur, mercurial,  salt,  alcohol,  and  vinegar  bath, 
is  either  of  the  before  named,  with  the  air  or 
vapor  charo^ed  with  the  agents  indicated. 

The  aromatics  commonly  used  are  the  essen- 
tail  oils  of  aromatic  herbs  or  trees,  as  cedar, 
turpentine,  pine,  needle,  anise,  sassafras  and 
a  numbei  of  others.  The  oriental  bath  is  a 
Turko  Russian  aromatic  bath,  so  named  from  the 
custom  of  the  orientals  anointing  the  body  with 
spices  and  perfumes  after  the  bath,  and  is,  in  my 
experience,  the  most  pleasant,  satisfactory  and 
preferable. 

These  baths,  as  given  in  the  larger  commercial 
bath  houses,  have  many  objections,  a  few  of  which 
will  be  discussed.  These  places  consist  essen- 
tially of  four  departments,  viz  the  warm  room 
the  hot  room,  the  steam  room  and  the  cold  room. 
In  the  hot  and  the  steam  rooms  the  temperature 
is  very  high,  too  high  f  r  comfort  or  health. 

A  person  entering  the  hot  room  has  a  sense 
of  suffocation,  which  is  often  highly  painful  and 
injurious.  In  these  rooms  the  atmosphere  is 
superheated  and  must  necessarily  be  deficient 
in  oxygen  and  loaded  with  carbonic  acid  gas 
and  nitrogen,  and  when  a  number  have  been  in 
the  same  small  room  it  is  charged  with  the 
emanations  from  their  sweating  bodies,  the 
exhalations  from  their  lungs,  bacteria  and 
microbes  of  consumption  and  skin  diseases  of  all 
descriptions,  and  to  the  mind  of  all  physicians 
must  certainly  be  an  unsafe  place  in  which  to 


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breathe.  Then,  after  the  high  temperature  room 
the  person  is  at  once  subjected  to  a  sudden  rev- 
ersal of  temperature,  in  going  suddenly  to  the 
cold  shower, or  the  plunge,  and  it  must  certainly 
be  a  strong  constitution,  and  a  well  balanced 
ner^rous  organization  to  withstand  the  shock. 

Even  with  the  strongest  and  best,  there  is  a 
sense  of  weakness  and  debility  that  follows  that 
requires  hours  of  rest  to  dispel.  This  is  nature's 
protest  against  such  barbarity.  The  barbarous 
nations  rush  from  their  hot  sweat  holes,  and 
jump  into  a  cold  s  ream  or  roll  in  the  snow,  but 
that  is  because  they  know  no  better,  and  with 
many  the  remedy  is  worse  than  the  dieeace,  as  it 
is  often  fatal.  Yet  I  have  heard  some  of  our 
intelligent  physicians  praiee  this  form  of  bath, 
and  generally  recommend  it 

The  therapeutic  c%binet  bath  has  been  devised, 
in  order  to  utilize  the  good  points  and  avoid  the 
evil  results  of  the  vapor  bath,  and  as  now  used, 
is  a  safe,  pleasant,  healthful  and  beneficial 
means  of  combating  disease. 

It  consists  of  a  cabinet,  or  box,  which  sur- 
rounds the  body,  leaving  the  head  outside,  thus 
preventing  the  heating  of  the  head,  eyes,  nose 
and  lungs,  and  allowing  the  patient  to  breath 
pure  cool  air  and  converse  freely.  Sulphur 
and  mercurial  vapor  could  not  safely  be  applied 
to  the  body  any  other  way. 

In  this  way  each  patient  gets  his  bath  alone, 
he  is  gradually  heated  and  gradually  cooled, 
thus  doing  away  with  the  sudden  extreme  change 
of  temperature,  and  subsequent  shock  to  the 
nervous  system,  and  ihe  great  physical  depres- 
sion. The  patient  sweats  more  freely  at  a  lower 
temperature,  and  there  is  less  danger  of  taking 
cold  afterward.  The  electro  vapor  bath  is  any 
or  all  of  these  baths,  combined  with  general  or 
local  applications  of  the  different  forms  of 
electricity.  As  the  bath  cabinets  are  now  ar- 
ranged, the  currents  can  be  applied  over  any 
part  of  the  body,  and  the  moist  skin  makes  a 
good  conductor,  and  the  cataphoric  action  of  the 
current  aid^  the  absorption  of  the  medicament 
contained  in  the  vapor,  and  at  the  same  time 
exerts  its  own  sedative,  stimulating,  or  anodyne 
effects. 

The  after  treatment  consists  of  massage,  dry- 
ing, rubbing,  cooling,  spraying  with  alcohol,  etc., 
and  when  through,  the  patient  is  cooler  than 
when  he  entered,  the  skin  is  soft  and  velvety, 
and  clean,  and  the  patient  says  he  is  rested  and 
refreshed  and  better  able  to  do  work  both  phys- 
ical and  mental,  and  can  at  once  go  about  his 
budness  without  risk.  This  form  of  therapy  is 
applicable  to  many  affections,  such  as  rheumatism, 
that  bug- bear  of  medicine,  both  articular  and 
muscular,  lumbago,  sciatica,  neuralgia,  neuras- 
thenia, colds,  bronchitis,  many  foims  of  female 


diseases,  impotence,  paralysis,  and  a  host  of  skin 
diseases,  especially  common  acne  and  hivee.  As 
a  simple  h)'gienic  measure,  the  electro- vapor  cab- 
inet bath  is  invaluable  as  a  cleansing  and  pro- 
phylactic agent 

The  writer  has  had  one  of  these  aparatusee  in 
practical  daily  operaticm  for  a  year,  and  can 
speak  from  an  experience  that  is  entirelj 
satisfactory.  Neither  the  profession  nor  the 
laity  are  alive  to  the  importance  and  the  benefits 
to  be  derived  from  this  form  of  medicine,  bat 
both  are  rapidly  awakening  to  the  fact  that  there 
is  something  in  it,  and  are  taking  to  it  with 
goods  rt  suits.  Like  any  other  therapeutic  agent, 
the  vapor  bath  can  be  abused,  and  must  be 
given  with  judgement  and  sense,  and  when  so 
given  will  not  be  a  disappoint  men  t  The  day  will 
come  when  it  will  be  recognized  and  generally 
approved  by  all. 

Homer  C.  Bennett  M  D., 

No.  5-7  Collins  Block,  Lima,  0. 

A  Unique  M  thod  of  Removing  the  Urine  fk*om  an 
Over  Distended  Bladder. 

Editor  Medical  World:— Some  three 
months  ago,  a  Koord  was  brought  to  the  hos- 
pital, who  for  a  month  or  more  had  been  suf 
fering  from  retention  of  urine.  The  only  way 
he  had  been  able  to  get  any  relief  was  by  one 
standing  his  full  weight  upon  the  bladder.  In 
that  way  they  were  able  to  force  out  a  quantity 
two  or  three  times  a  day,  but  never  able  to 
fully  empty  it  Is  this  a  modern  or  im  ancient 
method  ?  I  have  not  found  it  mentioned  in  the 
books.  He  is  a  large,  strong,  well  built  Koord, 
sixty  years  of  age,  had  never  seen  a  sick  day, 
nor  had  any  of  the  venereal  diseases ;  had  never 
done  any  hard  work  further  than  to  rob  and 
steal.  The  retention  came  on  suddenly  without 
any  known  cause.  When  he  was  first  brought 
in  the  bladder  was  very  greatly  distended  ;  he 
was  unable  to  walk,  and  with  difficulty  could 
ride.  I  passed  a  No.  12  steel  catheter  with 
ease,  drew  off  about  four  quarts  of  water,  the 
color  rather  high,  but  with  no  abnormal  odor. 
He  remained  in  the  hospital  for  a  week  or  so, 
having  his  urine  drawn  off  twice  a  day,  in  the 
meantime  using  treatment  to  try  and  tone  up  the 
organ  so  as  to  have  it  resume  its  normal  duties. 

He  was  taught,  in  the  meantime,  to  use  the 
catheter  himself,  as  I  was  about  to  leave  for  a 
time.  It  is  now  three  months  since  I  first  saw 
him,  and  a  faithful  use  of  sanmetto  and  many 
other  cure  alls  (!)  highly  recommended  for  sudi 
troubles,  have  failed  to  accomplish  anything; 
he  still  has  to  use  the  catheter.  Now,  what  is 
the  trouble?  A  paralyzed  organ  from  solong 
neglect  which  does  not  recover  its  contradlity  ? 
I  had  some  faith  in  sanmetto,  but  it  failed  here. 


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The  mau  haa  another  peculiarity,  a  double  tes- 
ticle on  the  left  side ;  he  takes  a  good  deal  of 
pride  in  it  D.  M.  B.  Thom,  M.D., 

Mardin,  Turkey  in- Asia. 


A  Monttrosity.— Dilating  the  Cervix  for  Dysmen- 
orrhea.—Plea  for  Acetanilid. 

Editor  Medical  World  : — I  send  you  two 
photographs  of  two  views  of  a  child,  delivered 
one  year  ago,  which  confinement  I  attended. 
The  woman  was  in  the  best  of  health  during  her 
pregnancy  excepting  an  abece«  upon  either  la- 
bium majorum,  each  of  which  I  lauced  at  differ- 
ent times  and  both  of  which  discharged  a  large 
quantity  of  offensive  pus. 

The  mother  was  a  primipara  a«t.  20  ;  the 
father  60  There  was  a  very  large  amount 
liquor  amniL  The  case  was  a  breech- presenta 
tion.  I  believe  this  child  can  lay  claim 
more  deformities  than  any  other  of  which  I 
have  ever  heard.  If  any  reader  of  The  World 
has  had  a  case  of  any  worse  deformities  I  would 
be  fr  lad  to  hear  from  him. 

You  will  observe,  first,  that  it  has  a  meningo 
oele — protrusion  of  the  meninges  of  the  brain, 
caused  by  an  accumulation  of  fluid  within  the 
cranium.  I  found  the  brain  substance  protrud- 
ing (encephocele)  with  the  meninges  from  the 
occipital  region  of  the  skulL  The  occipital 
bones  had  expanded  and  were  much  thinner,  a) 


the  sex.  I  therefore  pronounced  it  a  hermaph- 
prodite. 

As  seen  from  the  phonos.,  talipes  varus  was 
a  very  prominent  deformity.  The  child  was  at 
least  of  eight  mouths  development,  weighed  eight 
pounds,  still  born.  The  delivery  was  easy.  The 
mother  made  a  good  recovery. 

If  Dr.  Brooks,  of  Sunbury  N.  C  ,  will  dilate 
the  cervix  two  or  three  times,  a  week  or  two 


Qe 

"I 


ia  usually  the  case,  I  believe.     The  saggital  su 
ture  was  intact  to  the  frontal  bone,  but  from 
the  frontal  bone  to  the  inferior  maxillary  there 
was  no  union  of  the  parts. 

There  was  only  the  slightest  sign  of  a  nose  upon 
either  side  of  the  division.  There  were  no  eye 
balls.  The  jaws  were  unnaturally  large,  resem- 
bling thof  e  of  a  ho^.  There  was  no  evidence 
of  a  left  arm  but  the  right  was  perfectly  devel- 
oped. The  major  part  of  the  small  intestines 
were  protruding,  most  of  the  etomach,  part  of 
the  liver  could  be  seen,  all  covered  by  a  thin 
membrane.     1  was  unable  to  distinguish  as  to 


before  each  menstruation,  I  think   his  patient 
will  get  better. 

Dr.  Garey's  experience  with  acetanilid  coin- 
cides exactly  with  mine.  I  have  used  the 
remedy  for  several  years  with  the  best  of  results. 
It  is  like  many  other  remedies,  must  be  given  in 
reasonable  doses.  I  seldom  give  over  five  to 
six  grains  at  a  time.  Owing  to  the  condition  of 
Dr.  W.  H.  Smith's  patient  I  believe  the  milk 
given  with  the  acetanilid  produced  the  cramps 
he  mentioned. 

Zeb  Vance  Sherrill,  M.D., 

Bland,  Va. 


Permanganate  of  Potassium  for  Hornet's  Sting. 

Editor  Medical  World  : — I  pent  a  man, 
with  others,  into  a  field  to  atsist  in  cutting  a 
certain  piece  of  grass.  This  man  came  in  c  m- 
tact  with  a  nest  of  hornets,  one  of  which  stung 
him  over  the  right  eye  In  about  fifteen  min- 
utes the  man  came  to  the  stable  with  a  fellow 
helper  to  grind  their  scythes,  when  he  said  he 
had  been  thus  stung,  and  that  his  eye  pained 
him  badly.  My  attention  being  called  to  it,  I 
^aw  that  the  parts  were  quite  badly  swollen.  I 
immediately  dissolved  ttiree  grains  of  perman- 
ganate of  potassium  in  half  an  ounce  of  water 
and  applied  it  to  the  part  swollen,  and  in  five 
minutes  the  pain  ceased  and  in  six  hours  the 
swelling  was  gone.        A.  W.  Hobbs,  M.D., 

Freedom,  N.  H. 


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THB  MEDICAL  WORLD. 


/  A  Oat e  of  Obt tetrlos. 

Editor  Medical  World  : — In  March  last  I 
was  hurriedly  called  from  my  home,  at  a  dis- 
tance of  twelve  miles,  to  see  a  girl  about  sixteen 
years  of  age,  stated  by  the  messenger  who  came 
after  me  to  be  dying  in  child  birth,  and  suffer- 
ing with  the  most  fearful  puerperal  convulsions. 
He  stated  that  she  had  been  taken  in  labor  on 
Thursday,  and  this  was  now  Sunday.  Hastily 
mounting  my  horse,  I  was  soon  at  the  patient's 
bedside.  I  found  her  utterly  unconscious,  and 
suffering  from  fearful  puerperal  convulsions, 
her  tongue  protruding  from  her  mouth  and 
fearfully  cut,  swollen  and  bleeding  profusely, 
the  patient  apparently  in  the  very  agonies  of 
death,  throwing  herself  from  side  to  side  of  the 
bed  with  maniacal  fury,  utterly  unable  to  swal- 
low, and  her  parents  and  neighbors  standing 
around,  looking  on  in  speechless  terror.  What 
scenes  a  doctor  is  sometimes  called  upon  to  wit- 
ness, that  to  his  dying  day  are  indelibly  photo- 
graphed on  his  memory  I 

On  examination  I  found  the  os  rigid  and  un- 
dilatable.  She  had  made  no  progress,  and  from 
the  very  nature  of  the  uterine  action  she  could 
not  The  waters  had  made  their  escape  two 
days  betore.  Something  had  to  be  done,  and 
that  quickly.  I  administered  a  hypodermic  of 
morphine  and  atropine.  This  seemed  for  the 
time  being  to  have  a  quieting  effect.  During 
the  interval  I  administered  a  full  tablespoonful 
of  tincture  of  lobelia,  my  purpose  being  to  relax 
the  system  and  relieve  the  rigidity  of  the  os. 
Waiting  about  an  hour,  I  gave  her  another  full 
tablespoonful  of  the  tincture,  causing  her  in  a 
short  time  to  vomit  freely.  I  then  again  made 
an  examination,  and  found  the  os  not  quite  so 
rigid  and  slightly  dilatable;  no  bearing-down 
pains  amounting  to  anything.  I  then  gave 
tincture  of  ergot  in  full  ("oses,  but  without  any 
apparent  effect,  the  convulsions  setting  in  again 
with  redoubled  vigor.  Again,  by  the  use  of 
hypodermics  I  gained  fur  the  patient  a  slight 
season  of  quietude,  and,  after  waiting  awhile,  I 
again  examined,  and  found  a  footling  presenta- 
tion, with  the  arm  above  the  child's  head.  I 
succeeded  in  bringing  down  the  arm,  but  found 
another  complication  —the  umbilical  cord  being 
fast  tied  around  the  neck.  At  this  critical  pe- 
riod the  patient  again  went  off  into  the  most 
fearful  convulsions,  through  which  I  greatly 
feared  she  would  never  survive.  I  then  stated 
to  the  parents  and  friends  that  I  must  and 
should  deliver  her  at  all  hazards.  I  then  had 
her  placed  on  her  father's  knees,  he  holding  her 
firmly  around  the  waist,  while  two  other  assist- 
ants held  her  arms  above  her  head,  and  two 
more  held  her  feet  apart  I  then  knelt  between 
her  knees,  and  after  thoroughly  anointing  the 


parts,  ae  also  my  hands,  with  vaseline,  ]  gentler 
but  firmly  grasped  the  feet  of  the  child,  ualiig' 
gentle  traction,  delivering  her  in  about  fifteor 
minutes,  having  in  the  meantime  to  unfasten  the 
umbilical  cord  from  around  the  child's  neck  be- 
fore I  could  possibly  deliver  the  child,  a  male;^ 
weighing  about  eleven  pounds,  dead,  of  coune, 
and  had  been  so  some  days. 

After  the  delivery  of  the  placenta,  hemorr- 
hage set  in,  the  blood  coming  in  great  gush^. 
I  had  to  act  quickly  to  save  my  patient's  life. 
Inserting  my  hand  into  the  uterus,  1  grasped 
the  fundus  externally.  After  giving  two  spoon- 
fuls of  ergot  contraction  took  place,  and  the 
hemorrhage  ceased.  I  have  no  doubt  that  had 
the  flooding  continued  a  few  seconds  longer  £ 
should  have  lost  my  patient.  She  however, 
made  a  ra^iid  recovery.  Of  course,  I  have  not 
given  this  case  with  all  its  details  and  minutase^ 
but  enough  for  a  slight  conception  of  the  case. 

Florence,  Tex.      W.  K.  Grayson,  M.D., 


Vomiting  of  Pregnancy. 


Editor  Medical  World  : — A  great  deal  haa 
been  written  on  this  subject,  but  unfortunately 
the  mystery  of  its  causation  is  far  from  being 
solved.  The  old  theory  of  a  sjrmpathetic  re- 
lation between  the  stomach  and  uterus  seems 
very  plausible  in  some  cases  in  which  the  effect 
is  manifest  by  nausea  and  vomitiug  during  the 
period  of  evolution  or  when  there  is  a  displace 
meat  of  the  body  or  irritation  of  the  os.  Though 
we  may  give  this  theory  a  prominent  recognitioiiy 
yet  it  is  very  inadequate  when  it  comes  to  the 
question  of  why  the  nausea  and  vomiting  are 
manifest  only  in  the  morning  or  in  the  evening, 
as  some  cases  may  be,  and  then  only  during 
certain  periods  of  gestation. 

Let  us  reason  a  little.  The  appetite  is  largely 
under  the  influence  of  the  sympathetic  nervooB 
system,  if  not  entirely  so  ;  and  anything  which 
interferes  with  the  nutrition  or  functions  of 
that  system  causes  a  marked  change  in  the  de- 
sire one  has  for  food.  Fright  disgust  chagrin, 
or  bad  news  will  have  an  almost  instantaneous 
effect  on  the  appetite.  It  is  even  so  in  some 
cases  of  nausea  and  vomiting.  Now  wb^  a 
woman  conceives  she  has  evidently  to  furnish 
all  the  material  for  the  growth  and  develop 
ment  of  her  fetus,  even  the  oxygen  needed  in 
the  process.  The  brain  of  the  fetus  is  very 
much  larger  in  proportion  to  its  weight  than  is 
that  of  an  adult ;  so  is  its  osseous  system ;  and 
now,  since  we  know  that  the  phosphate  of  lime 
is  largely  used  in  forming  both  ne  ^e  and  bone, 
we  can  readily  see  what  the  mother  has  bees 
furnishing.  If  the  mother  eats  the  same  kiod 
of  food  after  conception  as  she  did  before  and 


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faniisbes  her  fetus  with  phosphate  of  lime  in 
abundance,  we  are  forced  to  believe  that  the 
mother  will  suffer  with  the  troubles  caused  by  a 
deficieucy  of  the  lime.  Now  what  are  those 
troubles?  First,  I  might  say,  is  starvation  of 
the  bony  system,  as  is  manifest  in  decay  of  the 
teeth,  which  is  so  common  with  all  pregnant 
women.  Second,  starvation  of  the  nervous 
system,  as  is  manifest  by  neuralgia,  headache, 
psychic  changes,  anorexia,  boulimia,  etc.  The 
trophic  or  sympathetic  nerves,  being  deficient  in 
their  supply  of  the  phosphate  of  lime,  would 
naturally  take  on  weakness  and  irritability, 
such  as  bring  about  the  above  disorders. 

In  my  hands  the  above  is  not  altogether 
theoretical.  Last  August  my  wife  gave  birth 
to  a  child  which  soon  died  of  spina  bifida.  The 
case  was  reported  in  The  Medical  World  of 
September  or  October,  1893.  At  this  writing 
she  is  about  four  months  advanced  in  her 
second  pregnancy.  When  I  first  learned  her 
condition,  two  or  three  months  ago,  I  began 
giving  her  syr.  calcii  lactophos.  to  secure  against 
another  deformity,  if  possible.  The  acid  lacto 
phosphate  soon  caused  irritability  of  the  bladder, 
and  it  therefore  was  abandoned.  Soon  follow- 
ing that  the  irritability  ceased,  but  nausea  and 
vomiting  returned  in  its  stead.  I  again  tried 
the  lime,  but  used  the  phosphate  in  lieu  of  the 
lactophosphate,  so  as  to  avoid  the  acid ;  again 
the  vomiting  ceased.  When  the  vomiting  first 
ceased  under  the  lactophosphate  I  did  not  recog- 
nize the  cure,  but  when  it  returned  without  the 
lime  my  wife  knew  it  and  called  my  attention 
to  it.  I  don't  know  whether  this  remedy  will 
prove  successful  in  all  cases  or  not,  but  I  do  know 
that  it  is  satisfactory  <*  at  our  house.''  I  would 
like  for  the  profession  to  try  the  lime  and  see  if 
it  is  "  any  good." 

If  this  theory  is  true  it  may  be  that  sickness 
in  the  morning  is  caused  by  twelve  hours  with- 
out food  and  hungry  nerves.  The  phosphate  of 
lime  ingested  at  supper  may  be  exhausted  be- 
fore morning.  Sometimes  eating  something  be- 
fore attempting  to  rise  so  btrengthens  the  nerves 
that  nausea  does  not  appear. 

How  about  the  evening  sickness  ?  Perhaps 
the  twelve  hours  of  laboi*  so  exbaupted  the 
nerves  that  they  become  deranged,  though  food 
be  taken  at  regular  intervals.  Why  does  vom- 
iting 0  cur  only  during  the  first  three  or  four 
months?  Because  this  is  the  period  of  form- 
ation and  development  of  the  fetus,  and  at  the 
four  or  fifth  month  the  relation  between  the 
brain  and  skeleton  and  the  rest  of  the  child  is 
having  a  better  symmetry  than  before,  and  then 
the  child  has  nothing  to  do  but  grow  and  kick 
around  as  it  pleases.  Why  is  it  that  in  gome 
cases  nausea  and  vomiting  come  on  during  the 


last  month  of  pregnancy?  Simply  because 
nature  is  making  the  last  and  finishing  effort  to 
prepare  the  child  for  an  independent  life,  so  it 
makes  an  extra  demand  for  phosphate  of  lime 
on  the  mother's  economy. 

The  above  reasons  are  highly  theoretical  and 
may  be  subject  to  criticism.  One  thing,  how- 
ever, I  do  know,  and  that  is  this :  I  gave 
phosphate  of  lime,  and  nausea  and  vomiting 
ceased.  You  must  believe  that  much  anyhow, 
and  then  if  you  don't  like  my  theory  you  can 
build  one  of  your  own. 

J.  J.  Waller,  M.D., 

Oliver  Sprina^  TeniL 

Editor  Medical  World  : — In  July  World, 
page  243,  Dr.  Clouse  says:  "There  is  no  cir- 
culation between  the  mother  and  placenta  after 
the  child  is  removed." 

Is  there  any  circulation  between  the  mother 
and  placenta  before  the  child  is  removed  ?  Cer- 
tainly not 

I  know  a  physician  of  thirty  years'  practice, 
who  sa}s  he  does  not  tie  the  cord  until  the  pla- 
centa is  separated,  the  indication  of  which,  he 
says,  is  cessation  of  pulsation  in  the  cord — hav- 
ing the  erroneous  and  very  common  idea  that 
the  pulsation  is  from  the  mother's  heart  instead 
of  that  of  the  child.  D.  Rose,  M.D., 

1064  Millard  ave.,  Chicago,  111. 

Ciinical  Memoranda. 

Editor  Medical  World  :—  For  itching  piles 
I  have  long  used  the  following : 

B.   Powd.  camphor „ i  soniple 

•*       opium 5  t^nAws 

Ctlomel I  scruple 

Carbolic  add 6  grains 

Simple  cerate q« to  make  >^  ounce 

Mix  and  apply  nlgnt  and  morning. 

For  pruritus  ani,  caused  by  eczema,  also  for 
scrotal  eczema,  I  have  used  a  1  to  1000  solution 
of  corrosive  sub.,  applied  by  means  of  the  posi- 
tive pole  of  the  galvanic  battery.  The  current  in- 
tensity may  be  from  five  to  ten  milliamperes. 
This  method  of  treatment  is  the  moat  effective 
of  anything  I  have  ever  used  for  tinea  circinat- 
us,  ringworm,  and  all  forms  of  parasitic  infec- 
tion. It  will  kill  the  acarus  scabiei  also,  but 
for  this  trouble  I  prefer  a  bath  with  the  follow- 
ing lotion :  Take  four  ounces  each  of  sulphur 
and  quicklime;  slake  the  lime,  place  the  two  in 
a  gallon  of  water  and  boil  for  a  half  hour,  or 
until  you  get  about  a  pint  of  solution.  Let  it 
settle,  pour  off,  and  use  freely  over  the  whole 
surface  of  the  body  for  half  an  hour.  Wash  off 
with  a  neutral  soap,  and,  with  a  complete  change 
of  clothing,  the  patient  is  well.  Tincture  of 
benzoin  comp.,  painted  directly  on  the  parts,  is 
also  most  excellent  for  pruritus  vulvse  and  ani. 


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THE  MEDICAL  WORLD. 


For  vagiDismus,  hyperesthesia  of  the  labia 
and  vagina,  an  application  of  a  five  per  cent 
solution  of  cocaine,  by  means  of  the  galvanic 
cathode,  gives  the  quickest  relief  Use  a  carbon 
electrode,  covered  with  absorbent  cotton,  with  a 
current  intensity  of  ten  ma.  During  the  inter- 
vals of  treatment,  which  should  be  given  every 
other  day,  let  the  patient  use  a  douche  made 
with  the  comp.  thymoline  tablet ;  also  appropri- 
ate constitutional  treatment. 

General  pruritus,  or  hyperesthesia,  from 
whatever  cause,  in  addition  to  internal  medica- 
tion, is  generally  very  much,  if  not  entirely, 
relieved  by  applying  the  positive  pole  of  the 
faradie  battery  to  the  skin,  using  the  hand  of 
the  operator  as  an  electrode,  holding  the  con- 
necting electrode  in  the  free  hand.  The  nega- 
tive pole  may  be  placed  upon  the  pat-ent  at  any 
convenient  point  Go  over  the  whole  surface 
with  as  strong  a  current  as  can  he  borne  by  the 
operator.  He  will  feel  it  in  his  hands  and 
wrists,  while  to  the  patient  it  will  scarcely  be 
perceptible. 

I  find  that  in  many  of  these  cases  aconitine 
aids  very  much,  as  it  is  a  nerve  sedative  o^  pro- 
nounced character.  Dissolve  five  granules  of 
amorphous  aconitine,  gr.  -^^  each,  in  half  a  tum- 
bler of  water,  and  give  a  teaspoonful  every  half 
hour.  This  will  frequently  produce  sleep  in 
nervous  patients  when  all  other  hypnotics 
fail. 

I  notice  that  Dr.  Washburn,  August  World, 
says  that,  not  getting  good  lesults  from  metric 
granules,  he  went  back  to  specific  tinctures. 
My  experience  is  almost  eotirely  in  favor  of  the 
granules.  (I  use  those  made  by  the  Philadel- 
phia Granule  Company).  Perhaps  the  doctor 
did  not  push  the  remedies  far  enough.  In  giv- 
ing such  small  doses,  they  must  be  frequently 
repeated.  I  have  given  strychnine  arseniate, 
gr.  y^,  one  every  fifteen  minutes  for  an  hour, 
Uien  every  half  hour  for  another  hour,  then 
every  hour  or  two,  with  most  excellent  efiect 
So  with  the  other  granules;  the  light  doses, 
rapidly  instilled,  do  not  ghock  the  system,  but 
seem  to  so  assist  nature  that  good  results  follow 
in  nearly  every  instance.     Try  again,  Doctor. 

For  hydrocele  and  varicocele  I  use  the  same 
fluid  with  which  I  inject  for  hernia.  One  dose 
generally  effects  a  cure. 

Wm.  H.  Wallikg,  M.D., 

1606  Green  street,  Philadelphia. 


Editor  Medical  World  :— I  am  Batisfied  there  has 
been  more  than  one  life  8aved  as  a  result  of  my  read- 
ing The  Medical  World.  1  do  not  wish  to  miss  a 
single  number.  T.  W.  Warner,  M.D., 

Parker,  Kan. 


A  Radical  Treatment  of  Hydrocele. 

Editor  Medical  World:— In  the  July 
number  of  The  Medical  World  I  see  a  form 
of  treatment  for  the  radical  cure  of  hy  rooele, 
by  M  F.  Gavin,  M.  D.,  of  Boston,  in  which  he 
uses  a  combination  of  acid  carbolic,  alcohol  and 
glycerin,  giving  that  mixture  preference  over 
the  tincture  of  iodine,  which  is  in  general  uae 
by  physicians. 

Below  1  give  a  plan  of  treatment  which  I 
have  been  using  for  the  past  twenty  years,  and 
with  but  one  certain  result,  and  that  the  posi- 
tive, radical  cure  of  the  existing  hydrocele, 
and  that  without  the  patient's  having  a 
"  scene." 

The  great  and  serious  objection  to  the  injec- 
tion of  any  irritating  fluid  into  the  cavity  of  the 
scrotum,  the  object  of  which  is  to  produce  a  aof- 
ficient  amount  of  inflammatory  adhesion  to  pre- 
vent the  recurrence  of  the  serous  accumulation 
of  the  scrotum,  is  that  once  the  fluid  is  injected 
it  is  beyond  the  physician's  control,  and  the  in- 
flammation may  assume  a  dangerous  c<Hidi- 
tion. 

My  method  is  as  follows :  AflU^r  being  certain 
that  the  testicle  is  not  in  the  way,  push  in  the 
trocar  and  withdraw  all  the  serum  through  the 
canula,  then  reinsert  the  trocar  and  push  through 
the  other  wall  of  the  scrotum ;  then  withdra^r 
the  trocar  and  push  through  the  canula  a  fnece 
of  tape  or  fillet  of  muslin,  about  half  an  inch  in 
width  and  six  or  eight  inches  in  length ;  with- 
draw the  canula  and  secure  the  seton  in  situ  by 
tying  the  ends  together ;  then  place  the  patient 
in  bed,  and  support  the  scrotum  by  placing  a 
folded  napkin  beneath ;  then  keep  moistened  by 
laying  on  a  square  of  surgeon's  lint,  mfHStened 
by  a  solution  of  liq.  plumbi  mb.  oceL,  with  tinct 
opii  and  aq.  pura  qs. 

Change  the  position  of  the  seton  once  eveiy 
twelve  hours,  or  oftener  if  neceasaiy.  When 
the  amount  of  inflammation  is  considered  suffi 
cient,  withdraw  the  fillet  and  direct  your  pati^t 
to  wear  a  suspensory  bandage  for  a  month  or 
two. 

During  the  past  ten  years  I  have  operated  on 
quite  a  number  of  person^  and  some  of  them 
were  men  of  advanced  age,  from  over  fifty  to 
sixty  four,  and  all  made  complete  and  satisfac 
tory  recoveries. 

I  am  positive  that  any  medical  brother  who 
will  try  the  above  method  will  never  go  back 
to  the  use  of  irritating  injections. 

In  my  method  you  *'  hold  the  lines ; "  in  the 
other  you  do  not,  and  the  team  U  beyond  coo* 
trol,  and  you  may  have  a  disastrous  run- 
away. H.  B  Denison,  M.D., 

Stockton,  Cal. 


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The  Secretary  of  Health  and  the  National  Certifi- 
cate. 

Editor  Medical  World  : — Replying  to  the 
maoj  ioquiries  in  regard  to  my  article  in  the 
June  World,  I  wieh  to  say  that  the  only  way 
to  succeed  in  accomplishing  the  purpose  set 
forth  in  that  article,  is  for  the  medical  profes- 
sion (all  schools )  to  work  together.  There  is  no 
physician  but  who  has  some  influence  with  the 
representative  in  Congress  from  his  district,  and 
if  every  phyncian  will  talk  Secretary  of  Health, 
etc  ,  to  them,  and  give  them  our  reasons  for 
making  the  request,  we  will  finally  succeed. 
Not  only  talk  it  to  the  members  of  Ck)ngre8S, 
bat  educate  the  laity  that  it  is  as  important  to 
them,  and,  in  fact,  more  so  than  to  the  medical 
profession,  that  their  families  are  being  waited 
upon  by  competent  physicians. 

There  is  only  one  way  to  make  a  law  to  com- 
pel the  difierent  States  to  recognize  a  certificate 
from  the  Secretary  of  Health,  and  that  is  by  an 
amendment  to  the  constitution  of  the  United 
States,  which  must  be  approved  by  at  least  two- 
thirds  of  the  Statea  I  think,  however,  that  if 
the  Congress  of  the  United  States  would  pass  a 
law  making  a  new  cabinet  officer  in  the  Secre- 
tary of  Health,  and  give  him  the  power  pointed 
out  in  my  June  article,  and  requiring  all  who 
hereafter  desire  to  enter  the  medical  service  of 
the  United  States  to  be  the  holder  of  one  of 
these  certificates,  that  it  would  be  but  a  short 
time  until  the  different  States  would  pass  laws 
making  a  license  from  the  Secretary  of  Health 
the  only  requirement  to  practice  medicine  there- 
in. This  would  compel  all  schools  to  submit 
their  graduates  to  an  examination  before  they 
were  given  diplomas.  There  might  be  a  few 
selfish  States  that  would  hang  back  for  awhile, 
who  would  be  compelled  to  finally  yield  to  the 
higher  power.  All  reasonable  persons,  whether 
physicians  or  not,  must  see  the  disadvantage  the 
present  system  of  State  examinations  is  to  the 
medical  profession.  Unless  a  physician  desires 
to  stay  in  the  same  State  all  his  life  he  cannot 
take  up  a  special  study  of  any  branch  of  medi- 
cine and  devote  his  time  to  that ,  but  must  keep 
up  to  the  times  on  all  branches,  in  order  that 
he  may  be  able  to  pass  these  examinations,  to 
say  nothing  of  the  time  he  is  compelled  to  wait 
before  he  can  begin.  You  cannot  make  a  phy- 
sician out  of  ever  boy,  no  matter  how  much 
education  you  give  him.  Neither  can  you 
make  a  surgeon  or  an  obstetrician  out  of  every 
one  who  graduates  in  medicine.  Perhaps  it 
may  be  the  one  who  has  the  lowest  per  cenL  in 
his  class  that  will  turn  out  to  be  a  great  sur- 
geon. I  know  chemists  who  were  bright  when 
Uiey  graduated,  but  who  could  not  pass  any 
State   examination   now.     So   I   say,  give  the 


young  student  a  chance  to  earn  a  title  that  will 
be  of  sufficient  importance  that  it  will  be  hon- 
ored anywhere  in  the  United  States. 

I  hofie  the  profession  will  work  in  harmony 
upon  this  subject,  and  if  they  do,  some  time  we 
will  have  a  law  that  we  wil  I  be  proud  of. 

Doniphan,  Neb.  T.  H.  Line,  M.D  , 


A  Need  of  a  Secretary  of  Public  Health. 

Editor  Medical  World: — Public  interest 
is  a  private  duty.  Public  prosperity  depends 
on  individual  prosperity,  and  individual  pros- 
perity will  shortly  wane  in  the  absence  of  health. 
Upon  no  class  is  the  duty  more  singly  devolved 
than  upon  the  physician,  to  proclaim  the  neces- 
sities regarding  the  health  of  a  nation's  people. 

The  laity,  who  bear  the  brunt  of  the  bane, 
are  unaware  of  the  existing  evils  until  some  epi- 
demic or  endemic  disease  steals  upon  them  and 
makes  its  ravages,  to  the  detriment  of  human 
life. 

"  To  prepare  for  war  in  time  of  peace,"  to 
prevent  as  well  as  cure  disease,  is  why  the  de- 
mand is  made  to  officers  in  high  places  and  our 
sovereign  govt  mment  to  install  at  the  head  of 
our  government  a  Secretary  of  Health,  who 
shall  have  rights  and  privil^es  on  a  parity  with 
other  government  officers. 

It  is  important  to  represent  and  bring  tO;bear 
potent  means  by  which  the  commonwealth  may 
be  educated  and  evade  disease.  ^  h 

Without  statistics  and  access  to  current  liter- 
ature, the  public  will  remain  ignorant  of  the 
prevailing  maladies  to  which  they  are  exposed, 
and  need  only  the  departure  from  sanitation  to 
rage  on  the  human  family  like  fire  on  prairie 
grass. 

With  a  Secretary  of  Health,  with  rights  and 
power  to  control  quarantines  naval  hospitals, 
epidemics,  etc.,  it  would  not  only  give  to  the 
medical  world  the  information  and  best  mode  of 
treating  disease,  but  place  literature  in  the 
hands  of  the  public,  and  provide  a  medium  by 
which  they  could  be  reached  and  enlightened. 

Our  public  schools  are  often  a  source  of  pes- 
tilence. 

How  often  do  we  see  the  child,  as  it  reaches 
the  period  of  puberty,  lose  the  vigor  and  spirit 
of  its  age  from  overwork  of  the  growing  brain, 
bad  hygiene  and  ill  lighted  rooms?  Yet  the 
parents,  blinded  by  the  praise  from  the  teacher, 
and  the  rapidity  with  which  the  child  is  pushed 
through  book  after  book,  overlook  the  ravages 
on  the  constitution  and  the  irreparable  injury 
done  to  the  mind. 

It  is  an  observable  fact,  that  the  opthalmolo- 
gist  in  this  day  has  an  alarmingly  increasing 
number  of  patients,  a  large  percentage  of  which 
are  from  the  walls  uf  some  institution  of  learn- 


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THE  MEDICAL  WORLD. 


ing.  80  often  do  we  see  habits  formed  in  school 
which  become  a  second  nature  as  age  develops 
into  maturity.  ^ 

It  is  appalling  to  note  the  number  that  date 
the  first  cigarette  or  the  first  chew  to  their 
school-days.  The  habits  of  school  days  have 
given  rise  to  hundreds  of  quack  nostrums  and 
patent  medicines,  with  their  literature,  to  delude 
the  guilty  and  shame  faced  youth,  and  thus,  in 
their  fear,  find  themselves  minus  anywhere  from 
<5  to  $30. 

Why  should  we  keep  a  standing  army  to  pro- 
tect our  citizens  from  the  invading  foreign  ene 
my,  and  let  the  seed  of  habit  and  disease  be 
sown,  which  will  grow  and  ripen  into  suffering 
and  death  of  humanity  ? 

Vaccination  is  a  recognized  preventative  of 
small  pox  by  the  scientific  world,  yet  we  have 
no  national  regulation,  either  as  to  our  vaccine 
virus  farms  nor  the  universal  employment  of  the 
preventative. 

We  often  hear  of  the  injurious  effects  of  im 
pure  virus,  or  the  non- protection  from  the  same 
cause,  without  the  power  to  enforce  or  the  right 
at  law  to  punish  the  perpetrator  of  the  fraud. 
Endemic  and  epidemic  foci  are  often  left  unmo- 
lested in  our  midst,  which,  if  under  the  rule  of 
the  government,  could  be  attacked  and  eradi- 
cated, 

A  more  uniform  law  governing  the  medical 
practice  should  be  established  throughout  the 
United  States. 

In  the  first  place,  we  should  have  a  State 
Examining  Board,  with  sub- boards  in  each 
county,  composed  of  the  best  physicians  of  the 
county,  as  many  States  now  have — ^these  to  ex- 
ist and  be  under  uniform  rule,  vested  with  power 
both  to  determine  the  capability  of  candidates 
for  the  practice  of  medicine,  and  the  supervision 
of  the  sanitary  condition  of  all  public  buildings 
and  the  instruction  of  the  general  public  as  to 
the  same. 

With  a  Secretary  of  Health,  and  State  and 
County  Boards,  composed  of  competent  physi- 
cians, the  public  would  be  placed  in  touch  with 
the  central  health  government,  and  confirmed 
by  the  combined  skill  of  the  whole  profession  of 
the  United  States,  it  would  afford  a  central  point 
at  which  public  records,  histories  and  statistics, 
could  be  stored. 

These  could  be  despatched  to  the  most  remote 
and  rural  districts  on  the  signal  of  the  outburst 
of  an  epidemic,  always  in  time  to  prevent  spread 
and  destruction. 

Then,  and  not  until  then,  will  we  see  the 
power  of  disease  reduced  to  a  minimum.  Our 
people  could  then  turn  their  thoughts  from 
evils  and   lust  to  those  ennobling  ones  that 


can  only  be  wrought  by  education  of  the 
masses. 

To  enact  this  in  the  halls  of  Congress  would 
immortalize  that  body,  as  well  as  mark  the  dawn 
of  an  age  of  health,  harmony,  and  all  that  this 
implies. 

Our  nati)n's  happiness  depends  upon  it 

Let  our  national  law-makers  leave  for  awhile 
the  millionaire,  the  railroad,  the  tariff,  the  trusts, 
and  the  manufactory,  and  come  with  us  to  the 
bedside  of  the  sick,  bereaved  and  desolate,  un- 
able to  care  for  their  own  needs,  much  less  to 
reward  their  physicians. 

Let  them  look  on  the  raging  epidemic  that  is 
cutting  down  the  babe  and  the  youth,  the  hope 
of  our  country,  and  then  consider  if  our  demands 
are  not  plausible. 

Brother  physicians,  lend  your  aid  to  this 
great  cause. 

Menlo,  Ga.  T.  S.  Ragland,  M.D., 


Use  and  Abuse  of  Mustard  at  a  Counter-lrritaiii 

Editor  Medical  World  : — I  noticed  an  ar- 
ticle in  the  current  number  of  the  World,  in 
which  the  writer  speaks  of  the  great  value  of 
mustard  as  a  stimlant  of  the  capillaries  in  chol- 
era infantum.  Now,  I  am  convinced  of  the  fact 
that,  for  a  counter  irritant,  we  have  nothing  as 
convenient  as  mustard,  and  I  should  not  like  to 
be  without  it  in  cases  of  pleurisy  and  some  other 
internal  inflammations. 

But  when  the  nerves  of  sensation  in  the  skin 
are  paralyzed,  and  the  contraction  of  the  capil- 
laries has  forced  all  of  the  blood  out  into  the 
arteries,  whether  this  paralysis  is  caused  by  the 
shock  of  an  injury,  or  the  collapse  of  a  choleraic 
discharge,  the  paroxysm  of  dysmenorrhea!  hys- 
teria, the  analgesia  of  paraldehyde  poisoning,  or 
the  coma  of  puerperal  convulsions,  what  is  the 
use  of  any  rubi^cient  ?  How  can  you  stimu- 
late the  circulation  excepting  by  applying  some 
thing  to  the  central  nervous  system  ?  And  afUr 
thai  has  been  successfully  applied  there  is  no 
occasion  for  the  external  irritation.  I  have  se^ 
cases  of  dysmenorrhea!  spasms,  where  mustard 
and  capsicum  were  rubbed  on  and  into  the  sUn, 
until  the  hands  of  the  manipulators  were  blis- 
tered, and  the  skin  of  the  patient  was  not  even 
warmed,  uniil  after  a  dofe  of  morphine  had  re- 
stored the  nervous  equilibrium,  and  we  wanted 
our  patient  to  rest;  then  the  skin  became  red, 
and  even  blistered  in  places,  and  that  some 
twenty-four  hours  after  the  occasion  had  passed. 
I  have  been  called  to  see  a  person  in  puer- 
peral convulsions,  and  found  her  with  mustard 
on  the  calves  of  the  1^8,  but  no  effect  until  after 
a  vein  had  been  tapped  and  a  quantity  of  blood 


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had  been  taken.  I  could  mention  so  many  cases 
that  have  occurred  where  the  mustard  has  been 
oaed  where  it  was  worse  than  useless,  that  per- 
haps I  do  not  use  it  as  much  as  I  might,  with 
benefit 

In  the  cases  of  infants  I  am  always  cautious, 
as  it  is  a  very  severe  remedy.  When  it  does 
work  it  is  too  much  like  fire  to  be  used  indis- 
criminately. I  have  known  of  a  very  young 
child  being  hurried  out  of  existence  by  the  too 
extensive  application  of  mustard. 

Bridgeton,  R.  L        H.  J.  Bruce,  M.D., 


Correotioii.~Swallowing  Foreign  Bodies.— Cocaine 
for  Gastric  irritability. 

Editor  Medical  World  : — In  my  commu- 
nication in  the  August  World  there  is  a  typo- 
graphical error.  In  my  prescription  for  dia- 
rhea  it  should  read  two  ounces  of  syrup  instead 
of  two  drams. 

Dr.  Bingay's  case  was  not  as  serious  as  he 
supposed. 

I  accidentally  learned  a  good  lesson  about 
two  years  ago,  that  I  have  been  able  to  make 
good  use  of  since  in  one  case. 

A  boy  four  years  old  accidentally  swallowed 
the  head  of  a  picture-frame  nail.  It  was  about 
three  fourths  of  an  inch  in  diameter.  That  eve- 
ning he  slipped  to  some  cheese  in  the  pantry, 
and  ate  all  he  wanted.  The  second  day  the 
nail-head  passed,  entirely  encased  with  cheese. 

1  prescribed  cheese  for  a  child  that  swallowed 
a  small  breast-pin,  and  it  was  also  passed  in  due 
time,  covered  with  cheese.  Pieces  of  money, 
such  as  nickels,  dimes  and  pennies,  are  not  dan- 
gerous, even  if  retained,  unless  they  should  ob- 
struct the  bowel,  which  is  not  very  probable. 
Give  cheese  and  a  cathartic. 

To  prevent  boils,  give  two  one-grain  tablets 
of  sulphide  of  calcium  every  two  hours.  It  is 
the  beet  remedy  to  prevent  new  crops  of  them  I 
have  tried. 

The  pernicious  vomiting  of  pregnancy  I  have 
been  able  to  control  in  two  cases  with  cocaine. 
I  gave  four  granules  fifteen  minutes  before  eat- 
ing, to  enable  them  to  retain  food,  and  I  gave 
it  every  three  or  four  hours  to  quiet  the  stom- 
ach.    I  used  the  metric  granules. 

I  had  a  good  result  with  it  in  a  case  of  gas 
tritis,    with  vomiting   whenever    the    smallest 
quantity  of  food  was  taken.     The  best  indica 
tion  for  it  is,  the  patient  vomits  immediately 
after  taking  food  or  water. 

I.  B.  Washburn,  M.D., 

Rensselaer,  Ind. 


Common  Remedies. 

Editor  Medical  World  : — I  have  noticed 
with  pleasure,  from  time  to  time,  the  introduc- 
tion or  recommends  tioQ  of  household  or  common 
remedies  for  certain  diseases,  etc.  I  am  one  of 
thoee  who  appreciate  this. 

I  myself  introduced  and  recommended  the 
following  in  1884,  in  the  town  of  Igo,  Cal.,  viz.: 
Acetic  add,  lime  water,  common  salt  solution, 
turpentine,  vinegar,  etc  ,  per  atomizer. 

When  I  settled  in  the  town  of  Igo,  Shasta 
County,  California,  in  1884,  I  introduced  the 
above  remedies. 

The  first  patient  who  used  the  first  atomizer 
was  a  Mrs.  Lizzie  Dunham,  wife  of  Warren 
Dunham,  proprietor  of  the  Igo  Hotel,  of  that 
place.  Mrs.  Dunham  suffered  with  ulceration 
of  the  left  lung,  etc  I  recommended  to  her  the 
use  of  an  atomizer,  into  which  she  put  half  a 
pint  of  acetic  add  and  half  a  pint  of  water,  the 
steam  of  which  she  inhaled.  I  prescribed  lime 
water,  common  salt  solution,  turpentine,  vine- 
gar, etc,  all  per  atomizer,  since  1884,  through- 
out the  Igo  district  The  people  are  using  these 
remedies  still. 

You  will  now  aak  me  whether  I  cured  any 
of  those  caws.     My  answer  is,  "No." 

You  will  also  ask  me  whether  any  of  my 
cases  were  benefitted  by  this  treatment  My 
answer  is,  "  Yes" — every  one  of  them,  more  or 
less.  Dr.  H.  Schafer, 

San  Diego,  Cal. 


Tell  your  neighbor  practidoDer,  if  he- is  not  already 
asabfcriber,  to  send  (1  now  for  1895,  and  receive 
World  for  the  remainder  of  this  year/ree. 


Malignant  Pustule. 

Editor  Medical  World:— Dr.  W.  C. 
Hontz's  fatal  case,  reported  in  July  Medical 
World,  was  undoubtedly  malignant  pustule  of 
a  severe  type. 

About  fifteen  years  ago  I  treated  a  young 
man,  who  supposed  he  had  a  splinter  on  the 
back  of  his  hand,  with  a  small,  dark-bluish 
point  He  picked  it  with  a  needle,  when  only 
a  drop  or  two  of  dark  blood  oozed  out  The 
hand  commenced  to  swell  rapidly,  and  pain  of  a 
throbbing  character  wae  experienced.  The  at- 
tending physician  had  poulticed  the  hand  and 
painted  the  whole  arm  twice  a  day  with  tincture 
of  iodine,  and  had  given  Dover's  powders  in- 
ternally. The  case  became  worse  and  worse. 
The  doctor  wae  discharged  and  I  took  the  case, 
changing  the  diagnosis  from  erysipelas  to  ma- 
lignant pustule  The  ugly-looking  and  tumified 
sore  was  dusted  with  morphine  freely,  and  then 
powdered  permanganate  of  potash  applied,  and 
kept  undisturbed  for  two  days  by  strips  of  rub- 
ber adhesive  plaster.  After  its  removal  the 
burned  surface  was  douched  with  carbolized  hot 
water.     The  enormously  swelled  arm  was  ban- 


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daged  from  the  tip  of  the  fingers  up  to  the  shoul- 
der, and  kept  wet  i¥ith  the  folio mng : 

R.   Goulard'B  extract  (•lol.  plumbi  aoetatis)  ...1  pint 

Cooked  water  (cooled) 2  plats 

Tr  opiam ounoesii 

Internally  he  received  the  following,  viz. : 

B.   Murliit.  tine  iron ^ drama  ▼! 

Mariai  (fqaiolQe. gr  (<*)  IW) 

Glycerine drimazvUi 

M     Si^  — Teaapoonfnl  in  tialf  kI&w  of  wjiter  e^ery  three 
hours  tilt  five  do^es  ave  taken,  then  every  f  «ur  (4)  hours. 

In  three  days  this  youog  man  was  O.  K., 
with  the  exception  that  the  mixture  upset  his 
stomach,  which  soon  regaii  ed  its  former  func- 
tion after  three  weeks'  strict  diet 

The  above  mixture  possesses  powerfiil  germi- 
cidal properties,  and  nothing  eq^uals  it  in  such 
cases.  In  puerperal  septicemia,  in  connection 
with  uterine  injections,  it  has  no  equal,  as  far 
as  my  experience  goes. 

Ten  years  ago  a  farmer,  aged  fifty  years, 
who,  when  in  his  raging  delirium,  was  given  up 
on  account  of  blood-poisoning,  resulting  from  a 
small  pustule  on  one  of  his  fingers,  made  equally 
as  good  recovery.  J.  Pirn  at,  M.D., 

Evansville,  Ind. 


It  Aoetanilid  So  Dangerous? 

Editor  Medical  World  : — In  noticing  Dr. 
W.  R  Gillespie's  comments  (page  2'J7),  on  my 
remarks  on  the  use  of  acetanilid,  I  wish  to  say 
that  I  have  used  it  ever  since  it  was  first  put  on 
the  market  and  I  have  to  see  the  first  case  of 
Btranguary  or  collapse  from  its  use  in  my  hands. 
It  might  be  should  I  give  twenty  four  grains  in 
two  hours,  that  it  would  produce  unpleasant 
effects,  but  I  have  never  found  it  neces- 
sary to  prescribe  any  such  doses,  7i  grains 
every  three  hours  in  cases  of  hyperpyrexia  be- 
ing the  maximum  dose  I  ever  prescribe  ;  Feldcm 
go  above  &ye  grains  for  an  adult  I  will  con- 
fess 1  have  never  experimented  to  see  just  how 
much  a  patient  could  stand  of  it  before  it 
knocked  him  out,  although  I  have  given  it  con- 
tinuously for  weeks  in  cases  of  continued  fever. 
I  also  have  had  cases  of  total  suppression  of 
urine  where  na  acetanilid  had  been  given  and 
before  it  was  ever  heard  of,  and  until  further 
evidence  is  produced  will  have  grave  doubt^s  of 
its  causing  it  in  Dr.  G.'s  case. 

I  was  called  in  consulta  iou  with  Dr.  H  ,  of 
Lamar,  Neb.  He  had  been  using  acouite  and 
veratrum  for  ten  days,  at  the  end  of  which  time 
the  fever  was  105i  F.  with  active  delirium  and 
typhoid  symptoms.  I  proposed  acetanilid  to  re- 
duce fever,  but  Dr.  H.  was  one  of  those  who 
believed  in  the  direful  effects  of  this  drug, 
especially  in  children.  This  being  a  child  ten 
years  old,  I  agreed  to  assume  all  responsibility 


and  exonerate  the  doctor  if  it  killed  the  child, 
and  under  the  circumstances  gave  the  child 
nearly  double  what  I  would  ordinarily.  The 
first  dose  did  more  in  two  hours  than  his  aooni'e 
and  veratrum  had  done  in  ten  days — reduced  the 
fever  from  105  i  to  99,  and  he  had  no  collapse 
or  strangury  either.  As  bold  a  champion  of 
acetflcnilid  as  I  am,  I  have  never  prescribed  it 
in  the  dose  mentioned  on  page  278, — ten  grains. 

All  I  ask  my  brother  practitioners  is  to  give 
acetanilid  a  fair  trial  in  doses  suited  to  each 
patient,  and  not  ten  grain  doses,  either.  How 
many  excellent  remedies  have  we  when  given 
in  proper  doses,  that  are  dangerous  when  given 
in  massive  doses?  A  remedy  that  has  such 
power  over  the  temperature  of  the  body  we 
would  naturally  expect  to  give  unpleasant 
effects  if  given  in  such  outrageous  doses.  I  still 
maintain  that  there  is  no  drug  that  will  as 
promptly  remove  excessive  body  heat,  and  notb« 
ing  is  its  superior  except  the  cold  bath. 

Imperial,  Neb.  D.  Boswell,  M.D., 


For  Gall  Stones,  with  Jaundice. 

Editor  Medical  World:— If  Dr.  Tison, 
(July  number,  page  253),  will  try  in  his  two 
cases  of  icterus,  chlorate  of  soda  and  olive  oil, 
he  will  be  pleased  with  the  results. 

For  the  lady,  a  No.  1  capsule  full  of  the 
chlorate  of  soda,  three  times  a  day  after  meals, 
and  ftur  ounces  of  olive  oil  when  the  first 
symptom  of  pain  begins,  and  if  this  does  not 
operate  in  six  hours,  give  four  ounces  more  If 
the  stomach  is  irritable  give  a  hypodermic  of 
one  quarter  grain  morphine  to  hold  the  ml 
down. 

Give  the  boy  a  No.  1  capsule  of  the  chlorate 
of  soda  after  meals  and  two  ounces  of  olive  oil 
twice  a  week. 

Continue  the  soda  in  each  case,  if  it  does 
good,  for  three  or  four  m  mths. 

Case  3.  For  the  hot  flushes,  give  dilute  sul- 
phuric acid,  twenty  drops  three  times  a  day,  in 
a  wine  glass  of  water. 

Jno,  H.  Ferguson,  M.D., 

Mine  La  Mot'e,  Mo. 


For  Pruritus  Vulva 

Editor  Medical  World  : — [  have  been  in- 
terested in  the  articles  on  pruritus  vulvae.  I 
use  a  wash  locally  of: 


R.   Veratnim  Tlride, 

AInobol. 

Aqji* aa .. 

Big.    t7i>e  thr«»e  tim  adiuly. 


Use  this  in  connection  with  the  salicylate  of 
sodium  as  directed  by  Dr.  A.  C.  Matchette  and 
you  seldom  fail.       James  D.  Quinn,  M.D., 

No.  1036  Ann  street,  Newport,  Ky. 


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THE  MEDICAL  WORLD. 


329 


Tooaooo  Lotion  for  Pruritus  Vulva. 

Editor  Medical  World  :— If  Dr.  A.  C. 
Machette  will  order  a  stfong  decoction  of  plug 
tobacco  to  bathe  the  vulva  with,  he  will  poei- 
tivelj  cure  his  pruritus  vulvae. 

August  A,  Klein,  M.D., 

2  Rutland  St,  Boston,  Mass 


Simple  Treatment  for  Intestinal  Catarrh  in  Chil- 
dren. 

Eiitor  Medical  World: — For  the  benefit  of 
Dr.  M.  R.  Peters  (pa^e  290)  and  others  that 
may  be  concerned,  I  would  say  that  I  have  had 
gratifying  success  with  a  simple  treatment  for 
infantile  catarrh  of  the  bowels. 

1.  Clean  out  the  iutegtinal  tract  with  a  good 
dose  of  castor  oil,  including  one  drop  of  turpen- 
tine. 

2.  Make  a  four  ounce  solution  of  one  tablet 
(gr.  Y^)  arsenite  of  copper,  and  one  tablet  of 
chlorodyne,  such  as  made  by  Mulford  &  Co.  or 
Parke,  Davis  &  Co. ;  sweete  i  with  sugar  or  fla- 
vored syrup  (preserves  syrup  as  can  be  found 
in  nearly  every  household,  is  good)  and  of  this 
give  one  teaspoonful  every  hour  the  first  day, 
every  two  hours  the  second  day,  and  every  three 
hours  the  third  day,  if  necessary.  I  hardly 
ever  use  more  than  half  of  such  four  ounce  so- 
lution in  one  case,  and  scarcely  ever  have  oc3a- 
lion  to  supplement  anything  else.  I  always 
instruct  to  keep  the  child  as  comfortable  as  pos- 
sible, guard  the  diet  and  never  wake  it  to  give 
the  medicina 

I  admire  The  World  for  its  eminently  prac- 
tical character,  and  from  that  standpoint  I  offer 
this  mite.  A.  S.  Todd,  M.D., 

Elberton,  Oa. 


Tests  for  Alcohol. 


Editor  Medical  World:— In  regard  to 
Dr.  Q.  M  Morton's  inquiry  for  a  test  for  alco- 
hol, I  must  say  his  question  is  a  vague  one. 
Alcohol  is  tested  mainly  for  water,  methyl  al- 
cohol orgitoic  bases,  fusel  oil  (amylic  alcohol ), 
aldehyd  or  f  arfurol,  any  one  of  which  may  ex- 
ist as  an  impurity  or  adulterant  in  ethylic  al- 
cohol. 

From  his  letter  I  imagine  he  wants  a  test  for 
water  in  alcohol  There  are  many  methods  of 
detecting  water  and  determining  the  percentage, 
some  of  the  simplest  of  which  1  give.  1.  Al- 
cohol contaiuing  more  than  25  per  cent  of  water 
will  not  bum  in  a  lamp.  2  Add  small  amount 
of  finely  powdered,  fused  potass,  carb. ;  shike; 
if  2  per  cent  water  is  present  the  carbonate 
be?omee  damp;  if  more,  it  dissolves.  3.  An 
hydrous  cupric  sulphate  (white)  becomes  blue 


when  added  to  alcohol  containing  water.  4. 
Add  a  drop  of  alcohol  containing  3  per  cent  of 
water  to  ten  or  twelve  drops  of  benzol;  the 
liquid  remaios  clear ;  if  from  3  to  7  per  cent 
water  is  present  cloudiness  appears ;  if  over  7, 
the  drops  separate.  J.  M.  Bell  M.D., 
Prof.  Chem.  Central  Med.  College, 
St  Joseph,  Mo. 


Editor  Medical  World: — The  test  which 
I  desired  to  obtain  for  alcoholic  liquors  was  to 
detect  adulterations  and  fraud.  I  am  satisfied 
that  some  druggists  are  using  artificial  cheap 
and  poor  liquors  in  prescriptions.  Wines 
should  be  the  fermented  juice  of  grapes. 
Brandy  is  obtained  bv  distillation  of  fer- 
mented grapes.  Whiskey  by  distillation  of 
fermented  grain,  usually  com,  wheat  and  rye. 
Rum  from  fermented  molasses,  etc.  How  are 
physicians  to  know  that  druggists  are  dispensing 
pure  liquors  in  prescriptions  ? 

Fraudulent  port  wines  are  made  of  old  hard 
cider,  alcohol,  cinnamon,  cloves,  alum  and 
water.  Sherry  wine,  of  old  cider,  alcohol, 
water,  coloring  and  flavoring.  Brandy,  of  alco- 
hol, water,  acetic  ether,  caramel  q.  s.  to  color. 
Whiskey,  of  alcohol,  essence  of  bourbon,  prune 
juice,  caramel  q.  s.  to  color 

There  are  many  other  formulas  which  are 
used  in  preparing  artificial  liquors.  I  am  of 
the  opinion  that  many  druggists  are  not  dis- 
pensing the  beet  liquors  in  prescriptions,  and  that 
the  medical  profession  is  being  deceived,  and  that 
patients  are  being  defrauded,  and  that  possibly, 
in  many  acute  cases,  valuable  lives  may  be  lost 
on  account  of  fraud  and  deception  on  the  part 
of  some  druggists.  Many  druggists  are  not 
selling  better  grades  than  saloons  and  many  are 
no  more  couscientious  than  saloon  keepers  in 
r^ards  to  the  quality  of  liquors  they  dispense 
in  doctors'  prescriptions  I  am  anxious  to  find 
a  cure  for  this  evil.      G.  M.  Morton,  MD„ 

Toronto,  S.  Dak. 


[A  writer  in  the  Druggists  Circular,  under 
the  title,  "Drug  A lulterations  in  New  York 
State,"  gives  the  following  under  the  sub-head- 
ing of 

Liquors. 

It  is  probable  that  our  liquor  supplies  are 
tampered  with  as  much  or  more  than  anv  other 
class  of  goods  carried  by  pharmacists.  Of  five 
samples  each  of  brandy  and  whisky,  as  supplied 
to  the  metropolitan  retail  trade,  only  two  of  one 
and  one  of  the  other  could  be  deemed  good. 
Two  of  each  contained  less  than  40  per  cent,  of 
alcohol  by  volume,  and  three  of  the  brandy  and 


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four  of  the  whisky  were  colored  with  caramel 
and  flavored  with  eesential  oils.  Every  drug- 
gist should  test  his  stock  of  such  goods  and  re- 
port to  his  jobber.  The  State  liquor  law  has 
practically  made  it  impossible  for  a  druggist  to 
sell  enough  in  ten  years  to  pay  his  license  for  a 
single  year.  There  are  no  drug  stores  known 
to  this  committee  where  doctors  pseacribe  enough 
liquor  to  pay  anything  like  $20  per  year.  If, 
then,  any  is  kept  in  stock,  it  should  be  of  the 
best  quality.  Any  pharmacist  can  apply  one 
or  two  rough  tests  that  will  answer  his  require- 
ments. When  half  an  ounce  of  liquor  is  shaken 
up  with  two  drams  of  concentrated  ether,  on 
settling  it  should  show  a  line  of  demarkation  at 
the  same  height  as  when  the  same  test  is  applied 
to  a  sample  of  dilute  alcohol,  that  he  knows  to 
contain  50  per  cent  by  volume  of  absolute  al- 
cohol. On  evaporating  a  weighed  quantity 
over  a  water  bath,  the  dried  residue  should  not 
weigh  more  than  ^^  of  the  total  weight,  and 
should  not  taste  or  smell  of  caramel,  and  should 
not  taste  unusually  sweet  or  have  a  spicy  flavor.] 


That  Mysterious  Skin  Disease  on  the  Hand.— As  to 
Feeding  Young  Babies. 

Editor  Medical  World  : — ^Many  thanks  to 
some  of  your  readers  for  replies  to  my  queries, 
by  private  letter  a3  well  as  through  your  jour- 
nal. 

For  gall  stones  every  one  recommends  olive 
oil.  I  have  been  successful  with  that  remedy 
once,  but  having  used  other  drugs  at  the  same 
time,  I  was  not  sure.  Dr.  Waugh  eays  chloro- 
form will  not  dissolve  gall  stones.  I  agree  with 
him.  My  idea  was  taken  from  "  Flint's  Prac- 
tice of  Medicine,"  page  134. 

My  case  of  sore  hand  is  of  some  interest.  Dr. 
Waugh  is  wrong  when  he  suspects  syphilis ;  but 
he  only  suspects.  This  case  is  one  of  a  disease 
that  is  never  spoken  of  in  text  books,  and  so 
was  overlooked  by  me  for  the  time,  but  I  have 
it  at  last  It  is  a  Southern  disease,  so  far  as  I 
can  learn,  and  is  known  as  ground  itch,  dew 
•poison,  etc.  All  children  who  run  barefooted 
in  the  morning  dew  have  it  It  was  carried  to 
the  woman's  hands  from  the  cow's  teats.  It  is 
caused  by  a  m'croecopic  insect,  I  am  sure,  as 
any  germicide  will  cure  it,  and  nothing  but  a 
germicide  will. 

On  January  9th,  1894,  I  was  called  to  see  a 
lady  with  pneumonitis,  but  found  her  moribund  ; 
and,  she  having  a  baby  six  weeks  old,  I  warned 
the  family  to  give  the  little  one  to  a  near  rela- 
tive, who  had  a  babe  about  the  same  age. 
Greatly  to  my  surprise,  the  grandmother  said 
she  could,  and  would,  raise  it  by  feeding,  and 
gave  the  little  one  a  potato  in  my  presence.     I 


told  her  she  would  kill  it,  but  ehe  said  she  had 
raised  more  children  than  I  had,  or  ever  will ; 
said  she  would  give  it  com  bread  and  meat  and 
other  articles,  that  I  am  sure  would  have  killed 
me,  much  less  .the  babe.  To  make  matters 
short,  she  had  her  way,  and  last  week  she  showed 
me  the  baby — as  fine  and  hearty  a  child  ae  I 
ever  laid  eyes  on.  She  continued  to  feed  it,  she 
said,  and  had  a  good  laugh  at  me,  because  I 
had  said  it  would  die  if  she  fed  it.  "Why," 
said  she,  '^  you  could  not  kill  it  if  you  fed  it  on 
litwood  knots."  I  said  that  I  had  no  doubt  but 
that  it  could  stand  it 

I  find  that  many  mothers  raise  their  babies 
from  the  very  cradle  by  hand,  and  many  do 
not  have  cows'  milk  for  it,  either ;  and  if  yon 
tell  them  about  food  hurting  it  they  only  laugh 
at  you. 

While  I  always  make  mothers  give  nothing 
but  milk  to  babies  until  the  first  tooth  appears, 
and  deem  it  brutality  to  feed  an  infant  on  such 
indigestible  stuff,  still  I  would  like  to  know 
how  a  baby  can  live  on  such  food  at  an  age 
when  the  stomach  is  intended  to  digest  only 
milk.  Is  the  stomach  of  an  infant  sufficiently 
developed  to  digest  food  that  a  man  can  hardly 
digest?  While  I  do  not  believe  it  is.  still  this 
baby  has  survived  and  gotten  fat  on  it ;  and  I 
can  recall  at  least  a  half-d(  zen  more  babes  in 
this  section  that  have  had  the  same  treatment. 

I  would  be  pleased  to  see  the  subject  discussed 
in  your  journal. 

Knowing  these  facts,  can  one  be  surprised,  in 
visiting  a  cemetery,  to  find  two  small  graves  to 
one  large  one  ?  and  is  it  justice  to  place  the 
average  life  of  man  at  the  medium  figure  of  all 
deaths,  and  let  infantile  mortality  be  taken  into 
account?  Why,  many  babes  are  murdered 
with  food.  W.  Walter  Tison,  M.D., 

Snead's,  Fla. 


Metallic  Body  Swallowed. 

Editor  Medical  World  : — In  The  Medi- 
cal World  of  August,  page  290,  Dr.  John 
M.  Bingay,  of  Tusket,  Nova  Scotia,  Oanada» 
asks  a  question  concerning  a  cent  which  trav- 
eled down  the  throat  of  one  of  his  little 
patients. 

On  July  2d,  a  child  of  about  eighteen  months, 
swallowed  a  cent  The  parents  sought  aid  from 
the  family  physician,  and  he  advised  a  physic 
and  gave  some  medicine  internally.  The  fami- 
ly became  dissatisfied  with  the  treatment,  owing 
to  the  fact  that  the  child  was  unable  to  swallow, 
except  liquids.  They  sent  for  me  on  July  7th. 
I  saw  the  case  and  succeeded  in  forcing  the 
cent  (which  had  lodged  in  the  esophagus)  into 
the  stomach.     I  then  ordered  maahed  potatoes 


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and  food  of  suclra  nature  that  would  produce 
a  solid  movement  of  the  bowels,  so  as  to  cause 
the  eent  to  become  coated  and  prevent  irritation 
during  its  trip. 

The  child  did  well  until  July  21st,  when  the 
cent  passed,  even  without  the  parents  knowing 
it  unti]  they  found  it  in  the  napkin. 

Uncle  Sam's  money  is  good,  and  usually 
passes.  Perhaps  Canadian  money  is  just  as 
good*  J.  S.  Beamensderfer,  M.D., 

Manheim,  Pa. 


Inhalations  of  Acetic  Add  in  Respiratory  AfTec- 
tiont.—Ltxative  and  Antiseptic  Treatment  of 
Typlioid  Fever  and  Septic  Intes- 
tinal Diseases. 

Editor  Medical  World: — ^About  three 
weeks  ago  I  was  called  to  see  a  woman,  Mrs.  B., 
50  years  of  age,  whom  I  found  in  a  very  ema- 
ciated condition  and  with  the  worst  case  of 
asthma  I  have  ever  seen ;  she  was  exhausted 
and  laboring  for  breath.  She  gave  a  history 
of  night  sweats,  family  tuberculosis,  pain  in  the 
larynx,  etc. 

On  examination,  I  was  not  able  to  detect  any 
signs  of  tuberculosis,  but  signs  of  asthma.  I 
gave  her  the  following  prescription : 

B.   Ammon  ohlor dimmsU 

Tr.  beUadoDse dram  i 

Ext.  gxindUsB  Tobufltn fl  ounce  i 

Aqu» »^ ounce  i 

Tr.  gentian,  oomp » q.  s.  ounces  iy 

M.    Stg.   Dram  i  eyery  foor  hours. 

At  the  same  time  I  ordered  acetic  acid  in- 
halations three  or  four  times  a  day.  A  few 
days  later  I  was  called  again  to  relieve  her  of 
an  attack  of  pleurisy  from  a  cold.     She  was 

Grfectly  satisfied  with  the  first  medicine  I  gave 
r.  It  relieved  the  asthma  like  magic, 
cured  the  trouble  in  the  larynx,  stopped  the 
night  sweats  and  gave  her  appetite.  She  told 
me  no  doctor  before  could  ever  relieve  her  and 
she  don't  remember  the  time  when  she  had  any 
desire  for  food.  This  time  I  gave  her  salicy- 
late of  soda.  I  always  give  that  in  the  first 
stage  of  pleurisy,  if  there  is  the  slightest  iheu- 
matic  history,  with  gratifying  results.  I  also 
gave  some  digitalis,  her  heart  being  weak  and 
the  stitch  disappeared  before  24  hours. 

A  week  ago  I  was  called  again,  she  this  time 
complaining  only  of  weakness.  She  did  not 
take  any  medicine  for  two  weeks,  put  aside  the 
inhalations,  because  she  said  it  seemed  to  upset 
her  stomach. 

On  physical  examination  I  found  a  typical 
case  of  phthisis,  the  left  apex  being  afiected. 
A  very  weak  heart  with  old  murmurs.  She 
was  as  thin  as  anybody  could  imagine,  so  weak 
that  she  could  not  lift  her  hands  and  the  facial 
expression   was  that  of  approaching  death.     I 


myself  thought  that  her  hours  of  life  were 
very  few  indeed. 

I  gave  her  mils  containing  iron,  quinine  and 
digitalis,  also  ordered  the  inhalations  to  be  Cv>n- 
tinued  and  to  day  I  was  told  that  she  feels  bet- 
ter, and  in  fact,  feels  quite  well. 

I  don't  think  she  is  going  to  be  cured,  be- 
cause, even  if  the  destructive  process  of  the 
tubercular  germs  could  possibly  be  stopped,  she 
will  die  of  heart  failure,  but  I  believe  that  if  I 
had  given  her  the  remedies  indicated  in  such 
disease,  such  remedies  as  cod  liver  oil  and 
creosote,  which  were  given  to  her  by  other 
physicians  with  no  apparent  result,  she  would 
have  been  dead  now  from  exhaustion. 

Now,  I  don't  know  which  of  the  two  acted 
better,  the  internal  medication  which  I  pre- 
scribed for  her  or  the  acetic  acid  inhalation. 
The  patient  thinks  that  the  medicine  prescribed 
acted  like  magic  but  don't  deny  the  good 
effect  of  acetic  acid  inhalation. 

I  certainly  think  that  my  treatment  was 
rational,  because,  by  giving  her  dintalis, 
quinine  and  iron,  I  put  the  heart,  blood  and 
stomach  into  shape,  thereby  enforcing  the  re- 
sisting forces  to  disease;  but  I  also  think, 
though  not  yet  convinced  of  its  specific  action, 
that  acetic  add  inhalations  had  a  good  share 
in  it. 

Acetic  add,  I  think,  may  prove  a  good 
remedy  in  respiratory  afiections.  It  is  a  very 
old  remedy  and  perhaps  one  of  the  oldest  in 
medical  history.  My  grandmother  used  it  as  a 
house-hold  remedy. 

I  was  delighted  to  read  Dr.  W.  B.  Thistle's 
treatment  of  typhoid  fever  in  the  July  number. 
I  carried  that  plan  of  treatment  in  my  mind  a 
number  of  months  before  it  appeared  in  your 
valuable  journal,  which  brings  so  many  good 
tidings  for  humanity,  and  I  thought,  **  I'll  carry 
that  treatment  out  as  soon  as  I  shall  have  the 
first  chance  to  do  it."  It  is  a  good  plan  if 
treatment  By  the  use  of  cathartics,  the  septic 
material  present  in  the  alimentary  tract  is  swept 
out  and  by  the  use  of  antiseptics,  its  formation  is 
prevented. 

I  adopted  a  similar  manner  of  treatment  for 
diarrhea  and  cholera  infantum  and  other  gas- 
tro-inte^tinal  troubles  of  children,  giving  them 
ol.  ricini.  ^-^i,  three  or  four  times  a  day,  fol- 
lowing each  passage  by  the  proper  dose  of  salol 
or  sulpho  carbolate  of  zinc. 

By  this  means  not  only  were  all  my  cases 
cured  in  a  comparatively  short  time,  in  this 
dty  where  so  many  children  succumb  to  that 
disease  every  day,  but  also  the  nature  of  the 
disease  changed  it  took  on  a  much  milder  form. 
I  based  this  method  of  treatment  upon  the 
words  of  an  eminent  authority  who  impressed  it 


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upon  my  mind.  '^  Learn  to  follow  nature's 
foit-etepa  and  help  her  where  she  is  incom- 
petent, etc" — MeCorkle. 

If  nature  starts  a  diarrhea  it  is  a  conservative 
pro  *ess  to  get  rid  of  an  irritant  particle  of  food 
or  poiaon  introduced  from  without.  One  dose 
of  castor  <  il  or  any  other  cathartic  do^s  as  much 
work  as  five  or  six  efforts  on  the  part  of  nature, 
and.  now  by  admiuistering  cathartics  where 
there  is  a  couservative  diarrhea  we  lessen  the 
seventy  of  exhaustion  which  follows  such  a 
diarrhea.  By  lessening  the  number  of  nature's 
efforts,  the  poison  is  gotten  rid  of  more  quickly 
and  we  prevent  absorption.  Of  course,  stimu- 
lants, fresh  air  and  regulation  of  diet  should  not 
be  forgotten.  Everybody  knows  the  good  effects 
produced  by  intestinal  antiseptics. 

Brethren,  this  is  not  a  new  mode  of  treat- 
ment Look  up  medical  history,  buy  old  books 
and  writings  of  practice  of  medicine,  the  same 
as  I  do,  and  you  will  find  that  it  was  used  be 
fore.  **  There  is  nothing  new  under  the  sun." 
Max  Friedlander,  M.D., 

5  Sumner  Ave.,  Brooklyn,  N.  Y. 


For  Aone  Rotaoea.— Canadian  Doctor's  Opinion. 

Editor  Medical  World  : — In  leply  to  Dr. 
A.  C.  Zi^ler,  of  Alleghany,  Pa.,  I  would  place 
before  him  the  following  treatment  for  acne  lo- 
sacta: 

B.    Uq.  Aiventcalif dramflln 

Tr.  nucU  ▼om drains  ill 

Tr.  ferrl  mur dramt  v 

Tr.  geiit  CO oi  nets  ill 

P'it.  aceiaiih dramas  i 

Aqusead ouncefl  Till 

M  SiR.  Drams  ii,  t.  L  d.  p  c.  in  aqua.  Wa«b  mouth 
after  each  dose. 

Et. 

R.    Zincozidl  drams  11  scrupIeBli 

Hydrant,  bichlor gr.  iv 

Vasellm  ad ouncet>  11 

M.    Big.    Apply  1. 1.  d  for  first  week. 

Et. 

R.    Ac.  hydrocyan.  dil gtt  16 

Bismuth  suonlt dmmslss 

Zinc  oxldi drams  1 

VasellQ»-,a<i ounces  il 

M.  Big.  Apply  night  and  morning  for  second  and  third 
week. 

Delaski  Marr,  M.D., 
Ridgetown,  Ont.,  Canada. 


The  ''  Red  Butter,"  of  Russia. 

Editor  Medical  World  : — In  reply  to  the 
question  of  Dr.  S.  J.  Smith,  Fiiley,  Neb., 
(World,  page  290),  I  beg  to  inform  him  that 
in  Russia,  and  it  seems  to  me  in  Germany 
as  well,  under  the  name  of  *'  Red  Butter,"  the 
people  are  asking  for  **  ung.  hg.  oxidi  rubri." 

Whether  one  or  two  doeei  of  it  would  cure 


piles,  I  leave  it  to  the  judgment  of  the  Doc- 
tor. M.  L.  LOEVENSON,  M.D., 
189  Maxwell  street,  Chicago,  111. 


Editor  Medical  World  : — Boracic  add, 
glyceriue  and  ammonia  can  be  united,  making 
what  1  think  is  the  boro  glyceiide  of  ammonium. 
It  makes  a  useful  cleaning  antiseptic,  valuable 
in  bites  and  stings  of  imects,  and  when  diluted, 
to  clean  instruments,  as  a  wash  for  rhus  poison- 
ing, etc 

I  hope  the  boys  and  girls  in  the  big  World 
family  will  try  it  and  som*"  phartnacist  will 
make  it  W.  S.  Newlon,  M.D., 

Oswego,  Kans. 


Personal  Reminiscence  of  Dr.  Green. 

Editor  Medical  World: — I  notice  that  J. 
R  Thompson,  M.D.,  of  Woodbum,  Ky.^  would 
like  to  know  who  Dr.  Green,  a  specialist  m  lung 
diseases,  was  I  matriculated  as  a  practidoner 
of  three  years'  practice  in  the  New  York  Medi- 
cal College  in  the  winter  of  1855  and  1856, 
loca  ed  on  Thirte<  nth  street.  East  Broadway. 

Horace  Green,  M.D.,  L.L.D.,  was  president 
of  that  CO  lege  at  that  time.  He  informed  me 
that  be  formerly  resided  in  Vermont.  He  had 
an  office  at  No.  12  Waverly  Place,  New  York 
City,  where  he  treated  diseases  of  the  throat 
ai  d  Jungs  as  a  specialist  He  claimed  to  insert 
a  rubber  tube  down  the  bronchial  tubes,  and 
also  into  cavities  in  the  lungs^  aud  inject  nitrate 
of  silver,  from  5  to  60  grs.  to  the  ounce  of  water. 
He  claimed  he  had  cured  many  cases  of  dis- 
eases of  the  air  passages  by  this  treatment 
Sone  half  dozen  of  us  attended  his  clinics  twice 
a  week,  at  his  office,  12  Waverly  Place.  We 
saw  him  operate  many  times.  We  were  of  the 
opinion  that  he  did  not  succeed  every  time — 
that  occasionally  the  tube  entered  the  esophagus. 
Nevertheless,  he  was  quite  successful  in  treating 
mauy  cast  s  of  throat  and  lung  diseases.  He 
prescribed  cod  liver  oil  and  tonics.  He  relied 
on  nitrate  of  silver  for  a  local  application,  and 
his  treatment  for  the  throat  gave  good  results. 
His  office  was  thronged  with  patients. 

Dr.  Horace  Green  has  been  dead  many 
years.  A.  R.  Cummings,  M.D., 

Claremont,  N.  H. 


Correction. 

Editor  Medical  World  : — In  article  "Peri- 
odic Headaches,"  page  282,  August  WoBUH 
sixth  line  from  the  bottom,  read  '  higher  spe- 
cific gravity,"  instead  of  "  lighter,"  etc. 

Worthington,  Ind.     W.  B.  Squire,  M.D., 


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Qui<;  (Department. 

O««»tiona  ftre  solicited  for  this  Column.  Commanicationt 
oot  accompanied  bj  the  proper  name  and  address  of  the 
writer  (not  neoestaiily  for  publication),  will  not  be 
noticed. 

rue  ifreat  niunber  of  requests  for  private  answers,  for  the 
information  and  benefit  of  the  writer^  makes  it  neces*- 
J^  f^!."?  to  charge  a  foe  for  the  time  required.  Thk 
fee  will  be  from  one  to  five  dollars.  aooOTdlnf  to  tw 
amount  of  research  and  wiithur  required 

What  was  the  Cauae  of  Death  ? 

Editor  Medical  World  : — Mrs,  C.  J.,  age 
37,  ^idow,  youQgest  chUd  age  11,  light  build, 
suffered  six  months  with  wha  she  described  as 
indigestion.  At  the  beginning  of  illness  she 
had  been  whitewashing  ceilings,  and  ever  since 
faal  felt  as  if  her  head  wanted  to  fall  backwards. 
No  treatment  until  a  month  ago.  When  seen 
was  emaciated.  All  organs  apparently  normal 
except  stomach.  Was  vomiting  everything. 
Had  more  or  lees  vomiting  for  weeks,  nnii 
gested  food,  stringy  mucus  and  sometimes  bile. 
Temperature  normal.  Pulse  80  to  90.  Tongue 
bluish  and  but  little  coated.  Pain  in  back  of 
neck  extending  to  occiput  Was  treated  for  a 
catarrhal  condition  of  stomach.  In  less  than  three 
weeks  there  was  marked  improvement  Then  she 
became  apparently  hysterical.  In  a  day  or  two 
she  thought  she  was  offending  certain  persons.  In 
another  day  she  had  done  some  things  that  ehe 
thought  people  would  misunderstand  and  think 
her  dishonest  In  another  day  she  was  mentally 
deranged ;  wanted  to  poison  herself;  thought  her 
soul  was  lost.  Eyes  and  facial  expression  in- 
dicated melancholia.  Pulse  120.  .Head  at 
times  would  fall  back  and  if  not  watched  she 
would  fall  on  the  floor.  Much  difliculty  in 
swallowing.  Not  much  difficulty  in  sp  aking, 
but  she  spoke  seldom.  Was  very  excited  at 
times.  These  stages  in  mental  symptoms  all 
occurred  in  less  than  a  week.  On  the  second 
day  preceding  death,  she  was  given  a  dram  and 
a  half  of  aqueous  extract  of  opium  (H  grains 
morphia  to  the  ounce).  This  quieted  her.  On 
the  day  previous  to  her  death  she  was  given  at 
3,  6,  9,  and  12  p.  m.,  the  following  doee : 

R.     Wxt  0lrfl..i».m»;»**m»..i.4 ntAUB  8 

Sxt  cannabis  Ind, fl  minims  li 

Di^tsUn ~ grain  I  lOO 

Hyurag.  submur grain! 

No  drowdncss  until  after  midnight  Fell  to 
sleep  at  1  a.  m.  Sleep  not  quiet  At  4  a.  m. 
the  breathing  changed  to  that  in  which  there 
was  4,  5  or  6  long  full  breaths,  then  a  pause 
for  over  a  minute,  then  a  repetitijn.  It  was 
never  stertorous.  Eye  reflex  gone,  but  the 
winking  of  the  eyes  continued  at  times  until 
death.  Pupil  not  much  contracted.  When  a 
finger  was  passed  into  her  mouth  to  clear  out 
mucus,  she  at  times  would  bite  it     Extremities 


warm  uniil  death.  Pulse  110  to  80  up  to  time 
of  death,  shortly  before  which  it  became  weak 
and  intermittent  She  died  at  2  a.  m.,  ten  hours 
after  this  condition  set  in.  Was  given  hypo- 
dermically  during  the  first  four  hours  of  time, 
five  grains  of  permanganate  of  potash.  During 
the  last  four  hours,  three  sixteenths  grain  of 
strychnine.  Kept  up  pretty  steady  artificial 
breathing.  Used  ammonia  Drew  of!  about 
twelve  ounces  of  norcnal  urina  Could  the 
case  be  one  of  acute  bulbar  paralysis  ?  If  sim- 
ple opium  poisoning,  then  here  is  a  case  where 
the  permanganate  of  potash  was  of  no  use,  and 
it  was  not  a  bad  case  of  narcosis,  if  dosage 
counts  for  anything.  R  T. 


How  Does  He  Live  7 


Editor  Medical  World:— I  have  recently 
made  a  partial  acquaintance  with  a  case  of  such 
extraordinary  features,  at  least,  to  myseK,  that 
I  wish  to  place  it  before  the  readers  of  your 
journal. 

The  reason  I  have  not  reported  it  before  now 
is :  I  have  resided  in  this  vicinity  only  a  few 
months,  and  the  case,  from  its  almost  incredible 
chronicity,  had  ceased  to  excite  an  interest  suffi- 
cient  to  be  a  topic  of  general  conversation ;  con- 
sequently 1  did  not  know  it  till  a  lew  weeks 
ago. 

On  the  23d  of  July,  1894  I  saw  the  case, 
and  found  it  as  follows :  On  the  forehead,  near 
the  scalp,  two  ulcers,  covered  by  a  scab  each,  of 
exuded  matter,  I  think  very  nearly  or  quite  one 
inch  high ;  near  the  outer  canthus  ot  left  eye  an 
enormous  depression  or  hole ;  alveolar  of  left 
submaxillary  broken  up.  His  right  arm  is 
flexed  on  the  humerus,  right  hand  extended  or 
thrown  back  on  forearm ;  first  phalanges  drawn 
backward  at  right  angles ;  the  remaining  pha- 
langes drawn  inward ;  both  hands  are  in  the 
same  condition.  In  his  lefc  arm,  in  the  neigh- 
borhood of  where  Colles'  fracture  occurs,  is  a 
solution  of  continuity,  or  a  separation  of  radius 
and  ulna.  The  cuticle  and  tissue,  if  any,  besides 
the  skin,  is  deeply  constricted.  In  order  to  be 
sure  about  this,  I  took  hold  of  the  hand.  It 
admitted  enarthrodial  movement  Lower  ex- 
tremities are  covered  with  scaly  scabs,  which 
almost  defy  description. 

The  most  wonderful  part  of  this  brief  sketch 
is  that  this  person,  George  W.  Johnson,  is  thir- 
ty-one years  old,  and  has  been  afilicted,  more  or 
less,  during  twenty-nine  years  of  his  life,  and 
during  the  sixteen  years  past  has  been  a  literal 
helpless  burden  on  his  parents  and  family. 

His  position,  which  is  intermediate  between 
the  supine  and  right  lateral,  has  been  continu- 
ously maintained,  day  and  night,  during  the 


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last  nine  years !  The  above  is  his  own  state- 
ment, fully  confirmed  by  his  parents  and  others, 
whose  veracity  is  unquestioned,  so  far  as  known 
to  me. 

His  intellect  is  good.  He  is  surprisingly 
cheerful,  and  entered  into  conversation.  I  did 
not  examioe  him  as  fully  as  I  wished,  on  ac- 
count of  the  very  offensive  fetor  about  his  per- 
son. I  inquired  for  consumption,  scrofula  and 
cancer  in  his  ancestors,  with  negative  informa- 
tion with  one  exception.  The  mother  stated 
that  when  he  was  a  babe  she  had  cancer  of  one 
breast,  and  had  to  take  it  from  him.  He  is 
8^1  alive  L.  A.  Smith, 

Omba,  Mo. 


Editor  Medical  World  : — Can  any  of  the 
many  readers  of  this  valuable  aid  give  sugges- 
tions in  the  following  case  of  epileptic  fits  ? 

The  patient,  a  man  aged  forty- nine,  married, 
with  a  family.  He  had  a  severe  spell  of  acute 
rheumatism,  after  which  he  never  ceased  to 
complain  of  bright  specks  floating  before  his 
eyes.  In  the  fall  afterwards  he  received  a  very 
hsA  cut  with  an  axe  across  the  ankle  bone.  The 
scar  is  large  and  ugly,  and  in  one  place  grown 
down  to  the  bone.  It  is  always  tender,  so  that 
it  hurts  to  keep  that  side  of  the  foot  down  on  the 
bed.  He  has  tried  many  doctors,  and  also  pat- 
ent medicines.  The  spells  stay  off  while  he 
takes  the  medicine,  and  return  as  soon  as  he 
stops.  He  has  them  very  severe  about  every 
nine  days,  when  not  taking  medidne.  Some 
eight  months  after  the  cut  he  commenced  hav- 
ing the  convulsions,  now  three  years  this  Sep> 
tember.  Some  think  the  cut  the  cause  of  the 
trouble,  others  not  He  is  thin  in  flesh,  weak, 
and  of  a  nervous  temperament 

Now,  kind  readers,  any  information  on  the 
subject  will  be  thankfully  received  by  a  constant 
reader  of  the  World.  K  M.  N. 


Is  There  Death  in  the  Cup. 

£ditor  Medical  World  : — There  is  a  move- 
ment in  f  ome  of  our  churches  to  substitute  in- 
dividual cups  at  the  communion  service,  in  place 
of  the  large  cups  from  which  scores  partake  in 
common. 

The  change  is  stated  to  be  desirable  for  sani- 
tary reasons. 

I  write  to  ask  The  World  readers  togive  their 
views  upon  the  question  ;  also  to  report  any 
authentic  cases  of  disease  directly  tracable  to 
the  communion  cup  as  now  used.  If  there  is 
death  in  the  cup,  because  so  many  partake  of  it 
at  the  same  service,  we  should  devise  other 
methods  of  distributing  the  wine  at  the  Lord's 
supper.  Wm.  H.  Walling,  M.D., 

1606  Green  St.,  Phila  ,  Pa. 


Editor  Medical  World. — A  doctor,  in 
making  a  prescription  for  rheumatism,  told  the 
patient  to  be  sure  and  return  and  report  if  the 
remedies  were  successful  in  curing  the  case,  as 
he,  the  doctor,  was  a  terrible  rheumatic  sufferer, 
and  had  no  relief  from  anything  of  all  he  had 
taken. 

Now,  I  am  about  like  that  old  doctor.  I 
have  the  most  obstinate  cafe  of  rheumatism, 
from  head  to  toe,  with  depositis  about  all  joints, 
gradually  growing  worse  and  worse,  and  never  * 
better.  Aches  and  pains,  pains  and  aches,  from 
year  in  to  year  out,  with  not  a  particle  of  relief 
from  over  one  hundred  different  prescriptions, 
each  year  for  the  paat  five  or  six  years.  I  doubt 
if  any  anti  rheumatic  has  been  left  untried,  and 
without  relief. 

Who  of  the  brotherhood  has  a  shot  in  his 
locker  that  he  can  advise  for  this  case  ? 

Brighton,  Ind.       Mary  D.  Shaw,  M.D., 


Editor  Medical  World  : — Will  some  of  the 
World's  readers  please  give  me  some  aid  in 
my  case  -  in  fact,  several  cases  of  about  the 
same  nature. 

I  waa  called  July  ^Oth  to  see  Miss  G.,  aged 
27,  and  with  the  following  symptoms  :  Frequent 
urination  (every  hour),  burning  pain  on  urina- 
tion and  for  some  moments  after,  and  some 
tenesmus.  Micturates  much  more  frequently 
when  on  her  feet  and  moving  around  than  when 
quiet  No  backache  or  any  general  pains,  and 
general  health  good.  The  symptoms  develop 
suddenly.*  She  had  a  fall  about  ten  years  ago, 
and  had  hematuria  at  that  time.  The  urine  is 
dark  in  color,  heavy  sediment  on  standing,  and 
acid  in  reaction.  No  albumen  or  sugar.  I 
pronounced  it  acute  cystitis,  and  gave 

R.  PotanU  dtratis drams  ylli 

Addi  benxoici drams  il 

.  InAis.  bnohu qs  a(t. oances  yi 

Slg.— Drams  il  every  three  hours. 

Grave  the  above  until  the  urine  became  alka- 
line in  reaction  and  normal  color,  and  no  more 
burning,  but  the  frequency  is  about  the  same. 

Now,  readers,  what  I  want  to  know  is :  Is 
my  diagnosis  correct,  and  what  is  the  best  thing 
to  do  to  reduce  the  frequency  ?  I  am  a  new 
man  in  the  field,  and  desire  aid. 

B.  A.  BoBB,  M.D., 

Mitchell,  South  Dakota. 


Editor  Medical  Word  :— One  of  my  ther- 
mometers has  lost  the  selfregistering  quality. 
How  can  I  restore  it?  As  other  physicians 
may  have  met  with  the  same  accident,  please 
insert  in  your  interesting  journal. 

Roseburg,  Oregon.        Dr.  F.  G.  Oehme, 


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Editor  Medical  World  : — Will  you  or  some 
of  the  brotherhood  give  diagnosis  and  treatment 
for  a  lady,  Mrs.  C,  whom  I  was  called  to  see 
May  27th,  and  found  with  the  following  symp- 
toms: 

Determination  to  head,  temperature  103^ ; 
hands,  forearm,  feet  and  legs  cramping ;  severe 
pain  in  head,  back  and  left  side,  just  under  the 
10th  to  12th  ribs.  The8e  symptoms  lasted  about 
two  hours,  when  they  subsided,  to  retunL  about 
twelve  hours  later,  lasting  this  time  about  six 
or  (ight  hours.  The  symptoms  passing  ofi,  she 
appeared  to  be  perfectly  easy  and  in  good  health, 
excepting  considerable  soreness  of  spinal  column 
(from  occiput  to  sacrum). 

I  was  called  back  on  the  28th,  to  find  her 
with  the  same  symptoms,  then  daily  for  a  week. 

During  those  exacerbations  she  prays  and 
talks  very  intelligently,  but  after  the  attack,  or 
subsidence  of  the  above  symptoms,  she  does  not 
remember  anything  she  said 

She  has  been  affected  with  those  paroxysms 
ever  since  the  27th  of  May.  They  do  not  occur 
regularly.  Sometimes  it  will  be  two  or  three 
days,  and  she  has  passed  five  or  six  days  with- 
out anything  more  than  slight  pain  in  the  head 
and  left  side,  sometimes  in  the  region  of  the  sto- 
mach. Appetite  very  good ;  stomach  and  bow- 
els in  good  condition.  The  pain  and  soreness 
of  the  spinal  column  has  not  been  a  regular  at- 
tendant 

She  had  leucorrhea,  with  slight  pain  in  the 
lower  part  of  the  bowels.  I  treated  her  success- 
fully for  these  symptoms.  This  was  during  the 
first  two  weeks  of  her  illness.  I  have  had 
counsel  early  in  the  case,  but  without  marked 
benefit 

This  lady  is  twenty- five  years  old  ;  been 
married  five  years ;  has  two  children  ;  had  con- 
vulsions during  her  first  confinement,  and  was 
comatose  for  several  hours  after  delivery.  Her 
second  confinement  was  normal.  First  child  a 
male,  second  Amale.  Their  ages  are,  respect- 
ively, four  years  and  one  year. 

There  has  been  some  variation  in  appearance 
of  menses,  it  not  appearing  at  regular  intervals. 

As  to  her  family  history  her  grandmother 
on  her  mother's  side  died  with  consumption ; 
her  father  and  mother  are  healthy  and  of  good 
make. 

I  hope  this  will  receive  your  undivided  at- 
tention, as  this  is  the  first  case  I  have  ever  re- 
ported and  as  I  am  very  young  in  the  practice. 

Dr.  W.  F. 


worse  at  night  than  in  daytime.  In  winter, 
even,  he  does  not  dare  to  keep  warm,  else  the 
itching  will  set  in.  This  has  troubled  him  for 
about  four  years.  He  has  doctored  with  ^ve 
doctors,  and  is  now  under  my  care.  I  can  re- 
lieve it,  but  it  soon  returns.  I  would  be  pleased 
to  know  the  cause  and  treatment  for  this  trou- 
ble. Eli, 
Tipton,  Iowa. 


Editor  Medical  World  : — Will  you  please 
ask  your  many  readers  if  any  of  them  know  the 
agent  or  medicine  used  by  chiropodists  that  they 
apply  to  hard  corns  and  callosities,  that  causes 
them  to  soften  in  a  few  minutes,  and  can  then 
be  lifted  or  dissected  out  at  once  without  much 
pain? 

I  would  also  like  to  hear  from  any  one, 
through  the  columns  of  your  valuable  journal, 
their  opinion  and  results  from  the  use  of  bis- 
muth subgalla^e  in  eases  of  fermentative  dys- 
pepsia, as  well  as  in  chronic  diarrhea.  I  have 
used  it  recently  with  good  results  ;  its  action 
seemed  prompt  and  efficient  The  only  author- 
ity I  have  ever  read  on  its  use  was  from  Prof. 
Austin  Flint,  who  speaks  very  highly  of  it.  I 
would  be  pleased  to  hear  from  any  who  have 
tried  it  J.  W.  Smith,  M.D, 

Plymouth,  Ind. 


Editor  MiDicAL  World: — A  man  of  forty 
years  has  a  troublesome  complaint  A  narrow 
strip,  extending  from  the  anus  two  inches  back 
to  the  left,  itches  fearfully  when  he  is  warm. 


Editor  Medical  World  : — I  would  like  the 
opinion  of  the  World  family  on  the  case  of  a 
woman,  ag^d  forty-two  years,  height  5  feet  8 
inches,  weight  185  pounds,  who  has  given  birth 
to  three  children  and  had  one  miscarriage.  Has 
no  uterine,  rectal  or  bowel  trouble ;  appetite, 
pulse,  respiration,  and  all  the  reflexes  except 
the  plantar,  are  normal.  Plantar  reflex  absent. 
Strong  neurotic  and  tuberculous  family  history. 
Five  years  ago  she  was  taken  with  a  sharp  pain 
over  the  atlas,  at  the  base  of  the  i^kuU,  accom- 
panying each  paroxysm  of  coughing.  Two 
years  afterward  she  had  pneumonia,  and  on 
getting  better,  the  pain  returned,  and  has  since 
become  more  frequent,  until  it  is  now  nearly 
constant.  She  describes  it  as  beginning  at  the 
back  of  her  head,  and  working  up  along  the 
sides  to  the  frontal  suture,  when  it  feels  like  a 
tight  band  around  her  head,  and  as  if  her  brain 
was  gorged  with  blood.  For  a  year  or  more 
she  has  been,  at  times,  unable  to  swallow  liquids, 
having  to  make  several  trials,  and  even  then  a 
portion  will  return  through  the  nose,  though 
there  is  no  difficulty  in  swallowing  solids  at  any 
time.  Now,  brethren,  what  have  I  got,  and 
what  shall  I  do  with  it? 

Blaine,  Wash'n.         W.  A.  King,  M.D., 


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Editor  Medical  World  : — Will  some  of  the 
World  family  give  us  the  technique,  explain- 
mg  fully  how  to  use  solar  cautery?  The 
World  is  very  practical  and  welcome,  but  has 
not  explained  this  subject. 

Batavia,  N  Y.         D.  B.  Horton,  M.D., 


Editor  Medical  World: — I  wish  to  leport 
the  following  case  in  your  journal,  trusting  that 
by  so  doing  I  may  receive  some  suggestions  as 
to  treatment  by  the  numerous  readers  of  The 
World. 

Miss  C,  age  18,  has  an  osteoma  of  the  up- 
per third  oi  the  sternum,  involving  the  width 
of  that  bone  and  three  inches  of  its  length;  caa 
readily  be  detected  by  the  eye.  This  growth 
she  discovered  eight  months  ago  and  it  has  been 
growing  slowly  but  steadily  ever  since.  She 
was  placed  under  my  care  six  weeks  ago.  I 
then  put  her  on  iodide  of  potash  three  times 
daily,  painted  the  locality  with  tincture  of  io- 
dine, and  applied  a  pressure  bandage  over  the 
tumor. 

Three  weeks  ago  I  again  examined  her,  and 
found  the  tumor  growing  laterally — that  is,  in- 
volving the  adjacent  ribs  to  a  slight  extent  I 
then  onlered  the  bandage  removed,  and  contin- 
ued with  the  iodide  and  iodine.  One  week  ago 
she  came  to  me,  complaining  of  a  dry,  hacking 
cough,  and  pain  on  pressure  over  the  tumor.  I 
am  now  almost  satisGed  that  it  is  growing  inter- 
nally. Can  any  one  suggest  anything  in  treat- 
ment besides  the  knife  ? 

Neither  her  father  nor  mother  gives  any  his- 
tory of  any  constitutional  trouble  .  Any  sug- 
gestioQ  as  to  treatment  will  be  graciously  and 
gratefully  received.  I.  R  Siess,  M.D., 

Alexandria,  La. 


Editor  Medical  World  :— I  would  like  to 
ask  your  many  readers  for  an  old  formula.  It 
is  a  cure  for  corns.  I  remember  fifteen  or 
twenty  years  ago  of  an  old  doctor  going  about 
with  a  brown  coloi^  salve  which  he  would 
apply  with  the  point  of  a  knife,  and  in  two  or 
three  minutes  would  take  out  the  com  with  no 
blood  or  pain.  Does  anyone  know  the  formula 
or  any  other  that  will  remove  a  com? 

E.  a  Blythe,  M.D., 

Engleman,  Collins  Co.,  Texas. 


Editor  Medical  World  :— I  would  like  to 
know  what  is  the  best  thiug  to  do  to  remove 
gunpowder  stains  from  the  face. 

Clinton,  N.  J  J.  M  Frace,  M.D., 

[As  this  subject  was  thoroughly  discussed  in 
The  World  in  past  years,  we  should  like  to 
suggest  that  any  surgeon  who  made  use  of  me- 
thods at  that  time  brought  out,  report  to  Dr. 


Frace  at  once  the  best  results  of  their  experi- 
ence.—Ep.] 

The  doctor  who  asks  for  precise  treatment  for 
alcoholism  and  the  morphine  habit  should  read 
these  pages  closely,  where,  from  time  to  time, 
there  have  appeared  and  will  hereafter  appear, 
the  latest  information  on  the  subject. 


For  "Odontunder,"  consult  back  files  of  The 
Medical  World. 


Current    Medical    Thought. 

A  Buinesss  Proposition. 

The  medical  profession  is  among  the  first  to 
suffer  in  a  financial  crisis.  The  doctor  bill  is 
the  last  to  be  paid.  The  doctor  almost  necessa- 
rily does  a  trust  or  book  business.  His  aocounts 
run  from  a  few  days  to  etemity.  From  the 
time  he  enters  a  medical  college  until  he  reoeives 
the  degree  of  MD.,  his  time  and  energy  are 
given  to  leaming  the  human  body  in  health  and 
disease.  He  spends  no  time  in  leaming  finan- 
cial methods,  and  who  is  good  or  who  is  bad. 
When  he  sees  a  diseased  condition  in  the  human 
body,  in  sunt  or  sinner,  he  names  it  The  re- 
lief of  suffering  is  his  shibboleth.  Tn  case  of 
injury  he  does  not  stop  to  inquire,  *'  Is  ttus  a 
saint  or  a  sinner?  a  philanthropist  or  an  assas- 
sin ?  "  but  <<  Here  is  suffering,  and  I  will  relieve 
it."  He  labors  and  watches  and  serves  until 
he  is  truly  a  servant  He  feels  that  it  is  his 
duty  to  do  so.  It  is  a  part  of  his  life  He  be- 
comes so  engrossed  in  his  work  that  if  he  does 
n  )t  forget  self  he  has  a  hesitancy  in  asking  for 
a  recompense — for  pay  for  his  work.  A  number 
of  physicians  have  told  me  it  is  the  hardest  task 
of  all  to  ask  their  patients  for  their  fees,  and 
especially  when  they  knew  the  financial  condi- 
tion of  the  patient  This  subject  U  forced  upon 
us  at  the  present  time  The  finances  of  the 
people  are  in  a  deplorable  condition,  and  who 
suffers  more  on  this  account  than  the  doctor? 
There  is  plenty  of  money,  but  not  in  general 
circulation.  We  admit  that  doctors  are  not 
known  generally  as  financiers.  This  is  not  be- 
cause of  their  lack  of  ability,  but  because  their 
energy  has  been  expended  in  other  dirccticms^ 
and  they  have  permitted  others  to  do  the  finan- 
cial work  of  the  world.  What  has  been  the 
result?  These  financiers  have  done  the  work, 
and  to  their  own  interest.  We  would  have 
done  the  same,  but  where  we  are  at  fault  is  in 
blindly  and  implicitly  submitting,  and  support- 
ing measures  advocated  by  these  financiers  widi* 
out  inquiring  into  and  examining  them  for  oar- 
selves.     We  do  not  take  any  man's  ipsi  dixit  in 


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questions  in  oar  profession,  and  why  this  blind 
belief  in  these  finandal  questions,  which  are  of 
as  much  yital  importance  to  us  as  to  the  finan- 
cier or  statesman  ?  There  is  something  wrong 
in  the  financial  world  for  profe^sioDal  and  labor- 
ing men  generally.  There  is  plenty  of  money « 
but  it  is  held  by  comparatively  few  persons.  It 
is  true  that  all  of  us  have  been  at  fault  in  a 
measure.  We  have  not  kept  within  our  means 
in  many  instances.  Various  courses  have  con- 
tributed to  the  present  money  stringency.  But 
it  seems  to  an  outsider  that  there  is  a  basic  fault. 
Jost  what  this  is,  is  not  clear  to  our  mind,  but 
it  has  assumed  the  question  form,  as  toPows, 
viz.:  Why  was  silver  demonetized  in  the  United 
States?  Who  asked  for  its  demonetization? 
What  was  the  effect  of  its  demonetization  on  the 
debtor  class  of  the  country?  What  was  the 
effect  on  the  creditor  ?  Did  it  not  change  the 
money  volume  of  the  country?  In  what  way, 
and  what  was  the  effect  upon  the  financial  world  ? 
Will  some  financial  medical  editor  or  doctor 
give  us  some  light  on  this  subject  ? — Editorial 
in  Kansas  Medical  JoumaL 

[No  one  asked  for  the  demonetization  of  sil- 
ver excepting  those  interested  in  gold  and  goM* 
bearing  obligations.  Its  effect  was  to  greatly 
enhance  the  value  of  their  possessions  and  in- 
come, to  the  loss  of  all  professional  and  produ- 
cing classes.  The  congressmen  who  voted  for 
it  were  of  only  two  classes — wolves  and  geese. 
The  few  who  stood  Dut  against  it  and  the  o'her 
acts  of  so-called  **  credit-strengthening  "  legisla- 
fion,  by  which  the  people  have  been  impover- 
ished, battled  nobly  but  vainly. 

But  now  that  silver  is  demonetized,  it  seems 
to  us  better  not  to  go  back  over  that  track  again, 
but  to  go  forward  in  the  direct  path  towards 
scientific  money;  let  us  demonetize  gold  also. 
Let  the  metals  all  stand  equally  before  the  law 
as  merchandise,  standing  upon  their  intrinsic 
value.  Those  who  need  metals  for  international 
exchange  could  then  get  them  for  tbat  purpose 
as  easily  as  now. 

Then  let  the  government  establish  the  true 
money  of  civilization.  Let  us  issue  (without 
Uie  intervention  of  private  banks)  a  paper  cur- 
rency, sufiScient  in  volume  for  the  busmess  of 
this  country,  made  legal  tender  for  all  obliga- 
tions in  all  sums,  and  redeemable,  nut  by  a 
promise  to  pay  metals,  but  by  being  received  by 
the  government  for  all  obligations  of  whatever 
kind  due  it  Of  course,  it  mutt  have  no  cxeep^ 
Hon  clause 

The  advantages  of  this  kind  of  money  are : 

1.  Greater  convenience  of  handling. 

2.  Cheaper  to  transport  from  place  to  place. 

3.  Greater  stability  of  value. 


4.  No  loss  suffered  by  wearing,  as  is  the  case 
with  metallic  coins 

5.  Elasticity  of  volume,  so  that  monetary 
stringency  is  not  likely  to  occur.  The  business 
of  the  country  can  go  on  without  interruption 
from  such  a  cause,  and  scientific  and  profes- 
sional men  can  pursue  their  studies  and  practice 
without  fear  of  such  undesirable  disturbance. 

When  we  have  a  reliable  governmental  (not 
private  or  corporation)  system  of  finance  the  in- 
dustries of  this  country  will  spring  up  as  if  by 
magic;  on  the  farms  and  in  every  village  town 
and  city,  all  honest  people  can  engage  in  pro- 
ductive work,  and  our  country  will  be  prosper- 
ous as  never  before  Is  not  the  doctor  interested 
in  this,  both  for  himself  and  bis  family  ? 

Let  the  ciiculating  medium  of  the  country 
pass  direcily  from  the  heart  to  the  general  sys- 
tem, and  let  us  eradicate  the  various  aneurisms 
and  abscesses  (the  banks,  etc.)  which  now  afiHict 
the  body  politic,  and  through  which  the  circu- 
lating medium  is  compelled  to  pass. — Ed.] 

Methods  of  Medical  Study. 

Each  individual  who  learns  to  study,  devel- 
ops a  method  peculiar  to  his  perroaality,  his 
condition  and  his  aims.  One  of  the  most  im- 
portant objects  of  a  general  training  is  to  enable 
the  individual  to  ascertain  the  best  methods,  as 
well  as  objects,  of  study.  In  this  respect  the 
me' hods  of  others  are  instructive. 

Dr.  Herman  Knapp  says  that  the  following 
was  Helmholtz*s  method :  When  he  got  a  pam- 
phlet he  examined  the  tiile,  the  introduction, 
and  so  much  of  the  first  pages  as  was  necessary 
to  see  what  the  author  was  aiming  at.  Then 
he  laid  the  pamphlet  aside,  and  worked  out  the 
problem  stated  by  the  author  in  his  own  way. 
When  he  ha  i  found  the  solution  he  compared 
it  with  the  pamphlet,  to  sea  if  it  corresp  mded  or 
not  If  it  did  not.  he  went  over  the  pamphlet 
to  see  whether  he  or  the  writer  was  correct. 

It  is  evident  that  this  habit  of  study  developed 
original  thinking  Books  and  pamphlets  were 
simi  ly  of  use  to  Helmholtz  as  furnishing  prob- 
lems upon  which  he  trained  his  own  powers. 
Indeed,  we  are  certain  that  the  adoption  of  this 
habit  would  render  more  poweiful,  acute  and 
accurate,  the  thinking  of  any  person.  If  it 
were  applied  to  medical  journal  articles,  we 
fear  that  often  nothing  would  be  found  in  the 
introiuction. 

Another  habit  of  study,  practiced  by  most  to 
a  greater  or  less  degree,  is  by  an  analysis  of 
writers.  For  our  purpose,  writers  of  medical 
books  and  papers  may  be  divided  into  three 
classes.  The  first  class  never  say  anything  of 
value  that  has  not  been  said  far  b^er  hundreds 
of  times  before;  the  student  makes  a  list  of 


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these,  and  passes  without  notice  every  book  or 
article  written  by  a  name  on  this  list  There  is 
a  second  class,  that  sometimes  say  a  good  thing, 
and  occasionally  make  a  correct  observation. 
If  the  student  hsa  plenty  of  time  to  gather  out 
the  wheat  from  the  abundant  chafi.  he  may  read 
the  book)  and  papers  of  those  on  this  list,  but  if 
his  time  is  limited  he  would  better  avoid  them. 
The  third  class  includes  those  who  never  speak 
or  write  anything  unless  they  have  something 
to  say,  and  who  take  such  pains  to  prepare  it 
that  the  reader  easily  collects  the  instruction. 

A  vast  amount  of  valuable  time  is  wasted  in 
the  endeavor  to  properly  classify  those  who  write 
and  speak.  Once  classified,  they  are  readily 
disposed  of.  Medical  writers,  we  suspect,  forget 
to  take  into  consideration  the  class  into  which 
their  readers  are  likely  to  put  them. 

It  is  the  world's  misfortune  that  so  many 
books,  practically  worse  than  worthless,  come 
into  existence  yearly.  A  little  care  by  each 
student  in  the  direction  indicated  will  materially 
assist  him  in  'separating  the  wheat  from  the 
chaff." — Am.  Lancet, 


Surgical  Hints. 

By  George  W.  Oriffitht,  fif.  D.,  lu'LouitviUe  Med.  Monthly. 

Use  black  pins  in  surgical  dressings;  they 
will  not  rust  and  can  be  more  readily  seen. 

Unroll  martin  or  rubber  bandages  and  let 
them  hang  at  full  length ;  by  doing  this  fre- 
quently they  will  last  much  longer. 

Do  not  make  the  mistake  of  having  plaster 
of  Paris  bandages  longer  than  three  yards. 

An  addition  of  a  few  drops  of  oil  wintergreen 
will  entirely  destroy  the  unpleasant  odor  arising 
irom  vaseline  or  cosmoline  dressings. 

Discard  the  cone ;  administer  chloroform  on 
napkin  or  mask.  The  danger  is  almost  re- 
duced to  nil  The  cone  necessarily  prevents  the 
admixture  of  atmospheric  air. 

Excelsior  butter  cloth  will  be  found  to  be  the 
most  satisfactory  material  for  bindages  for  gen- 
eral use. 

Plain  bandages  over  a  plaster  of  Paris  appa- 
ratus is  far  better  than  the  be- daub  of  plaster 
used  by  some  surgeons  as  a  finish  or  outside 
dressing. 

Vin^ar  with  equal  parts  of  water  will  act  as 
well,  if  not  better  than  tincture  arnica  when  the 
latter  is  indicated. 

The  hypodermic  syringe  is  a  good  and  useful 
instrument — to  leave  at  home.  It  is  resorted  to 
too  frequently  where  other  means  might  be 
adopted.  The  opium  habit  follows  its  use  more 
readily  than  any  other  manner  of  administra- 
tion of  this  drug. 


The  careful  surgeon  will  use  an  apron  during 
office  service.  The  smell  of  iodoform  and  the 
ornamentation  of  <<  blood  spots  "  will  thereby  be 
prevented  to  a  great  extent 

Plaster  of  Paris,  liniments  and  carbolic  add 
harden  and  roughen  the  hands  of  the  surgeon. 
An  application  on  going  to  bed  of  ointment 
composed  of  melted  tallow,  beeswax  and  sweet 
oil  to  the  hands,  will  soften  them  in  one  night 

A  pair  of  blunt  scissors  carried  in  the  pocket 
will  be  found  a  useful  and  indispensible  com- 
panion for  the  surgeon. 


Atropine  to  Stop  Hemorrhaget. 

In  an  article  in  the  Charlotte  Med.  Jour.^  Dr. 
J.  W.  Byers,  writes  as  follows : 

The  great  value  of  atropine  in  the  varioua 
forms  of  shock  is  generally  recognized,  while  its 
hemostatic  properties  in  all  forms  of  hemorrhage 
are  not  so  well  known.  Atropine,  by  its  power 
to  stimulate  both  the  primary  and  secondary 
vaso-motor  centres  and  at  the  same  time  excite 
the  cardio-innervatiug  centre,  tends  to  increase 
the  power  and  efficiency  of  the  hearths  action. 
By  its  power  to  stimulate  the  innervating  im- 
pulses distributed  to  the  muscular  coats  of  the 
arteries  and  heart,  the  volumetric  capacity  of 
the  arterial  system  is  expanded,  and  thus  blood 
is  taken  from  the  distended  veins  and  the  loesia 
arrested.  This  change  in  the  position  of  the 
bulk  of  the  blood  brings  about  lessened  pressure 
in  the  veins,  and  a  clot  forms,  the  vessel  doses, 
and  the  hemorrhage  ceases.  As  a  hemostatic 
in  all  kinds  of  hemorrhage  when  the  bleediog 
is  of  a  passive  nature  it  is  almost  a  specific  In 
epistaxis  it  is  invaluable,  if  not  a  spedfic  in 
doses  of  y^  to  ^  grain  given  hypodermatic- 
ally  as  often  as  every  twenty  minutes  until  the 
blood  is  completely  stayed.  Dmitrieff  reports 
the  successful  management  of  two  cases  of  met- 
rorrhagia by  atropine 

In  one  case  hemorrhage  persbted  despite  the 
employment  of  the  usual  remedies,  indudmg 
the  tampon,  but  ceased  after  the  injection  of  ^ 
grain  of  atropine.  Tbe  second  case  was  that  of  an 
anemic  woman,  who  became  syncopal  and  cold 
from  loss  of  blood.  The  first  injection  was 
followed  by  improvement  and  the  third  by  ces- 
sation of  the  bleeding. 

Atropine  in  hemorrhage  has  proven  in  mj 
hands  to  be  the  best  possible  remedy.  It  is  free 
from  danger,  acts  immediately,  and  can  be  used 
conveniently  from  the  fact  that  most  hypodermic 
cases  contain  the  remedy.  A  trial  will  convince 
one  of  its  great  value. 

[We  suggest  that  in  the  form  of  granules 
atropine  can  be  always  convenient — Ed.] 


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Comparison  of  Professional  Fe«s. 

The  Paiifie  Medical  Journal,  in  the  course  of 
an  able  editprial,  says  the  following : 

Why  a  lawyer  should  be  paid  500  per  cent 
more  than  a  doctor  for  doing  500  times  as  little 
work,  we  suppose  is  entirely  owing  to  the  fact 
that  the  lawyer  is  that  much  more  capable  of 
taking  care  of  his  own  interests.  Exactly  why  ' 
the  secular  press  of  this  country  should  take  the 
same  view  of  the  case  is  a  mystery.  A  case  in 
point  The  daily  papers  at  the  present  time 
are  congratulating  ex- President  Harrison  upon 
receiving  a  fee  of  $25,000  for  four  hours  work  in 
court ;  had  a  medical  man  of  equal  or  more 
abUity  than  Mr.  Harrison  charged  a  many 
times  millionaire  $5,000  for  a  month's  constant 
attention,  the  whole  press  would  be  charging 
him  with  robbery  ~a  man  to  be  avoided  when 
you  are  sick,  etc.  Another  case  in  point  Judge 
Levy,  of  this  city,  has  just  allowed  a  firm  of  at- 
torneys a  fee  of  $80,000  for  looking  after  the  rou- 
tine business  of  an  estate  for  a  few  months,  and 
yet  this  very  same  judge  refused  to  allow  a  fee  of 
$30,000  wUch  a  mtdical  man  had  presented 
for  many  month's  attendance  on  a  millionaire 
and  his  family.  The  actual  work  was  probably 
100  times  more  than  that  performed  by  the  at- 
torney who  received  $80,000 ;  while  the  re- 
sponsibility was  probably  500  times  more,  yet 
his  Honor,  Judge  Levy,  saw  fit  to  cut  the  doc- 
tor's fee  down  to  $  10,000.     And  why  ? 

[The  pages  of  The  Medical  World  are 
open  to  Judge  Levy,  of  California,  or  any 
reputable  judge  or  attorney,  to  explain  if  pos- 
sible, why  these  discriminations  should  be 
made. — &).] 


The  Dosage  of  Alkaloids  and  Other  Active 
Principles. 

8o  many  questions  come  to  us  as  to  what  is  the 
required  dose  of  each  of  the  alkaloids,  etc.,  that 
we  wish  to  make  as  full  a  statement  as  possible 
of  the  principles  upon  which  these  drugs  are 
properly  administered.  The  idea  of  a  standard 
adult  doee,  to  secure  a  full  effect,  is  not  a  logi- 
cal one,  as  what  is  a  light  dose  for  one  patient 
would  be  a  full  dose  for  another  one.  The 
scientific  method  is  to  give  the  minimum  dose, 
nsually  that  contained  in  one  granule  or  other 
similar  preparation,  and  repeat  it  at  short  inter- 
vals until  the  desired  effect  is  observed,  then 
lengthen  the  intervals  to  maintain  that  effect 
Thos  no  more  medicine  is  given  than  is  needed 
and  the  patient  does  not  get  an  overwhelming 
effect  at  any  time.  However,  many  do  not  wish 
to  give  the  repeated  small  doses,  but  wish  to  give 
wluit  may  be  taken  as  a  standard  full  dose,  re- 
peating at  longer  intervals  or  when  its  effects 


have  begun  to  declina  For  their  benefit  we 
give  below  what  have  been  generally  accepted 
as  the  standard  adult  dose  of  many  of  the  alka- 
loids, corresponding  to  an  average  dose  of  the 
crude  drug. 

Aconitine,  grain  y^^, 

Atropine,  grain  ^, 

Brucine,  grain  ^, 

Strychnine,  grain  :^, 

Codeine,  grain  i, 

Morphine,  grain  i  to  i. 

Colchicine,  grain  -j-^^, 

Daturine,  grain  y^^, 

Duboisine,  grain  y^, 

Emetine,  as  expectorant,  grain  y^ ;  as 
emetic,  grain  i. 

Gelseminine  grain  ^, 

Hyofccine  hydrobrpmate,  grain  y^, 

Hyoscyamine,  grain  yj^, 

Physostigmine,  grain  y^. 

Pilocarpine,  grain  i, 

Quasseine,  grain  i, 

Sanguinarine,  grain  -j^, 

Sparteine,  grain  i, 

Veratrine,  grain  •^. 

These  active  principles  may  be  given  in 
solution,  using  due  mathamatical  precision  as  to 
the  amount  of  the  drug  contained  in  eaoh  drop 
or  teaspoonful  of  the  solution ;  but  we  have 
found  it  far  more  convenient,  accurate  and 
economical  to  administer  them  in  earefuUy  pre- 
pared granules  or  other  similar  preparations, 
giving  the  number  required  by  multiplication 
to  make  the  desired  amount  of  the  drug. 


The  Course  of  BuMets 


Some  people  seem  to  think  that  a  small 
b.ullet  at  very  high  speed  will  pierce  the  tissues 
of  the  body  without  doing  much  general 
damaga  This,  however,  is  erroneous.  The 
bullet  hurries  forward  with  it  particles  of  the 
substance  through  which  it  is  passing  and  thus 
practically  becomes  a  larger  projectile.  If  a 
bullet  be  fired  through  a  book,  it  cuts  out  disks 
of  increasing  diameter  as  it  traverses  the  pages. 
Hence,  too,  it  is  plain  that  the  greater  the  sec- 
tional area  the  greater  the  damage.  As  to  the 
heating  of  the  bullet,  it  has  certainly  been  much 
exaggerated,  and  its  effects,  if  indeed  it  has  any, 
may  be  safely  n^lected.  The  physical  consti- 
tution of  a  body  has  a  most  important  bearing 
upon  a  bullet  entering  it  Why  does  a  bullet 
of  certain  size  and  travelling  at  a  certain  rate 
simply  perforate  some  substances,  such  as  wood 
or  iron,  while  in  others,  such  as  clay,  brain,  eta, 
it  exercises  a  bursting  and  disruptive  action? 
The  answer  is  quite  simple:  the  destructive  effects 
vary  directly  as  the  viscosity  of  the  body.  This 
was  established  by  remarkable  researches  on  the 


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THB  MEDICAL  WORLD. 


effects  of  bullets  on  soft  tissues  made  by  Huguier 
after  he  had  observed,  the  results  of  the  wounds 
inflicted  in  the  fighting  in  Paris  in  1848.  He 
suggested,  from  observations  made  on  ceitain 
dead  organs,  such  as  Tung,  ihat  ihe  reason  of 
the  great  lateral  disturbance  was  that  the  tissues 
contained  water  in  large  quaniij,  and  that  the 
energy  of  the  moving  projectile  being  imparted 
to  the  particles  of  water  caused  the  dispersion  of 
these  in  a  hydrodynamic  fashion.  This  sug- 
gestion was  shown  to  be  correct  by  Kocher  in 
1874—1876.  If  a  shot  be  fiied  through  two 
tin  canisters  of  equal  size,  the  one  full  of  dry 
lint  and  the  other  of  wet,  it  will  simply  perforate 
the  former,  but  cauee  the  latter  to  burst  explo- 
sively. In  the  same  way  shots  fired  into 
dough  have  more  or  less  disruptive  effect  accor- 
ding to  the  percentage  of  water  in  the  dough; 
and  in  general  the  more  fluid  the  substance  the 
greater  the  destruction.  !Now,  in  life  the  brain 
is  a  more  or  le§s  fluid  body,  though  in  a  state  of 
rigor  mortis  it  is  practically  a  (olid  owing  to 
coagulation  of  the  blood  and  protoplasm. 
Hence,  a  shot  fired  into  the  skull  must  have  a 
disruptive  effect  and  tend  to  burst  it — From 
a  paper  read  by  Prof.  Victor  Horsley  before  the 
Koyal  Institution. 


Two  New  Uses  for  Bichloride  of  Mercury. 

We  notice  the  following  two  interesting  items 
in  the  Medical  Summary : 

How  to  Arrest  a  Boll,  Carbuncle  or  Malignant 
Pustule. 

•  Dr.  P.  C.  Barker  writes  that  he  has  used  the 
following  procedure  for  several  years,  with  un- 
varying success.  Take  a  large  hypodermic 
syringe,  holding,  say,  half  an  ounce,  fitted  with 
a  small  needle.  Fill  it  with  a  1  to  500  solution 
of  mercuric  chloride,  insert  the  needle  into  one 
of  the  peripheral  openings,  in  case  it  is  a  car- 
buncle, and  wash  out  the  little  cavity.  Then 
dir€ct  the  needle  to  war  Is  and  into  the  surround- 
ing induration  and  force  a  little  of  the  solution 
into  it  Treat  every  opening  and  its  correspond- 
ing peripheral  circumference  in  the  same  man- 
ner, carefully  washing  out  the  necrosed  connect- 
ive and  other  tissues  that  h&ve  become  separated. 
Repeat  this  daily  with  the  solution,  gradually 
reduced  to  one-half  the  original  strength,  until 
all  induration  has  disappeared  and  granulations 
have  begun  to  appear.  It'  the  first  injection  be 
thoroughly  performed  the  spread  of  the  carbun- 
cle will  be  arrested  at  once,  and  there  will  be 
no  more  pain.  Washing  out  the  little  cavities 
is  painless,  but  the  injection  into  the  indurated 
tissues  is  not  free  from  pain.  The  same  treat 
ment  is  applicable  to  the  little  furuncles  that 


invade  the  meatus  auditorius  extemua,  and  the 
inner  surface  of  the  alae  nasi. 

To  Abort  Syphilis.    » 

Bichloride  of  mercury  (10  grains  to  ounces  j), 
painted  on  a  chancre  as  soon  as  it  appears,  kills 
all  specific  germp,  and  there  will  be  no  systemic 
manifestation.  Then  you  only  have  a  local 
sore  to  heal. 

Lotion  of  Retorcin  for  Seborrhea  of  the  Scalp. 

Dr.  Kate  W.  Baldwin,  in  the  Philadelphia 
Polyclinic^  recognizing  the  inconvenience  and 
inefficiency  of  ointments  in  the  treatment  of  dis- 
eased conditions  of  the  scalp,  relates  her  excel- 
lent success  in  treating  seborrhea  with  lotions  of 
resorcin.  Many  of  her  cases  were  of  the  very 
worst  kind,  yet  success  followed  the  treatment 
The  following  is  an  extract  from  her  article : 

'*  The  fifty  cases  have  been  taken  from  pri- 
vate and  dispensary  practice,  ranging  from 
seven  to  sixty- seven  years  of  age,  from  all 
classes  and  conditions  of  society.  The  diseased 
conditions  covering  simple  seborrhea,  with  pru- 
ritis  and  falling  of  the  hair,  also  the  mo^t  ag- 
gravated cases  of  seborrheic  eczema,  with  Uiick, 
oily  crusts  literally  covering  the  scalp,  and  in 
several  cases  extending  to  the  forehead  and  into 
the  eyebrows. 

*' Resorcin  stimulates  the  glands  and  hair 
follicles,  and  markedly  increases  the  growth  of 
hair.  It  is  also  an  odorless,  powerful  antisep- 
tic, germicide  and  exfoliative,  readily  soluble 
in  water  or  any  strength  of  alcohol,  and  so  seems 
particularly  adapted  to  this  class  of  cases,  and 
has  been  used  in  each  and  all  of  the  fifty  cases, 
to  the  exclusion  of  all  other  medicamenta,  ex- 
cept as  adjuvants  or  excipients.  It  may  be 
used  in  a  simple  aqueous  or  alcoholic  solution. 
My  standard  formula  is  : 

a.   Rewroini w drams  H 

Glycerine f  anas  lij 

Alcohol  absoluti. 

Aqua  Roea.  ........aa f  ounces  Ij 

"  This  was  varied  to  suit  the  particular  case, 
never  having  increased  the  amount  of  resorcin. 
In  a  few  cases,  where  the  suri^M)e  was  very  dry, 
I  have  added  ten  to  fifteen  drops  of  olive  oil  to 
the  four- ounce  mixture,  but  it  should  be 
thoroughly  emulsified,  otherwise  it  is  better  left 
out 

''According  to  the  case,  the  lotion  should  he 
used  once,  twice,  or  three  times  a  week.  In 
very  bad  cases,  every  day  for  a  week,  and  then 
les3  frequently.  It  should  be  applied  directly 
to  the  scalp,  and  not  to  the  hair.  This  may  be 
accomplished  by  parting  the  hair,  section  after 
section,  and  using  the  solution  on  a  tiny  bit  of 
absorbent  cotton,  the  smaller  the  better.  It 
should  be  thoroughly  rubbed  into  the  scalp  un* 


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til  every  bit  of  the  diseased  portion  is  covered, 
this  followed  by  a  brisk,  dry  shampoo,  continued 
for  from  two  to  ten  minutes. 

"  In  two  or  three  days  nearly  all  of  the  accu- 
molated  necrosed  epithelium  will  be  loosened, 
so  that  it  may  be  removed  with  the  fine  portion 
of  an  ordinary  dressing  comb  and  brush  (it  is 
better  not  to  use  the  regulation  fine  tooth  comb). 
In  any  ordinary  case  this  treatment,  thoroughly 
carried  out  for  from  two  to  four  weeks,  will  put 
the  scalp  in  a  good  condition. 

'*  In  cases  where  there  is  much  crusting,  par- 
ticularly the  thick,  oily  crusta,  the  treatment 
should  commence  with  a  thorough  shampoo 
with  sapo  viridis,  adding  just  enough  water  to 
make  a  lather,  followed  by  sufiicient  clear  water 
to  free  the  hair  frem  all  suda.  Whed  dry,  ap- 
ply the  resorcin.'' 


Nfw  Treatment  of  Sea-Sickness. 

Dr.  W.  N.  Skinner,  who  has  had  much  ex- 
perience as  a  surgeon  on  transatlantic  steamers, 
says  (K  Y.  Med.  Journal,  Dec.  9,  16.  23  and 
30,  1893,)  that  after  having  studied  the  symp- 
toms of  naupathia  in  their  completeness,  he  is 
convinced  that  they  are  due,  above  all,  to  the 
lowering  of  the  blood  pressure,  and  that  this 
lowering  depends  upon  a  paresis  of  the  centers 
of  innervation  of  the  heart  and  arteries.  To 
counteract  this  he  uses  a  solution  of  atropine  and 
strychnine  hypodermically.  The  following  is 
the  formula  which  he  most  frequently  em- 
ploys: 

B.   A  tropin,  solph ^ a02  mmme  (gr.  840) 

Stryi  hQin.  Bulph 0  04  gramme  gr  8^} 

Aq.  menth.  pip 40  grammes  (os.  IJ  t») 

Fkaol 

One  gramme  (15  minims)  of  this  solution 
contains  half  a  milligramme  (gr.  1-134)  of  atro- 
pine and  one  milligramme  (gr.  1-67)  of  strych- 
nine, which  he  considers  the  adult  dose.  If  in 
the  space  of  two  hours  after  the  first  injection 
the  patient  be  not  cured,  he  gives  a  second,  and 
possibly  a  third  two  hours  later.  It  is  not  pru- 
dent to  exceed  this  amount  per  day.  The  e£fects 
are  often  surprising.  In  the  majority  of  cases 
the  vomiting  ceases  at  once,  and  soon  afterwards 
no  more  nausea,  cephalalgia  or  distress  is  felt 


Isopathy  In  Africa. 
By  W.  Thorton  Parker,  M.D. 

Doctor  Tbirk,  in  the  year  1846,  published 
in  the  Medical  Weekly,  of  Vienna,  a  very  inter- 
eetiog  account  of  the  so  called  ''poison  physi- 
cians "  among  the  Caffirs  and  Hottentots  at  the 
Gape  of  Good  Hope,  Africa. 

These  medicine  men  claim  to  cure  ca  es  of  poi- 


soning which  have  resulted  from  snake-bites,  or 
from  the  wounds  of  poisoned  arrows.  To  enable 
him  to  properly  prepare  himself  as  a  qualified 
poison  physician,  the  following  procedure  is 
adapted  :  He  secretes  under  the  article  of  fur, 
which  constitutes  his  only  clothing,  a  poisonous 
scorpion,  to  whose  stings  he  freely  exposes  him- 
self. After  the  reaction  resulting  from  the 
first  sting  is  accomplished,  another  sting  is 
accepted,  and  when  tJie  effect  of  this  is  over,  a 
third  and  a  fourth,  and  so  on  until  the  body 
becomes  perfectly  insensible  to  the  stings  of  a 
single  scorpion  ;  then  he  exposes  himself  to  the 
stings  of  two  in  the  same  manner  then  three, 
and  more  scorpions,  until  at  last  the  bodysefms 
utterly  unaffected  by  such  poison.  Advancing 
further  in  his  preparation,  the  poieon  doctor 
hardens  his  body  in  like  manner  against  the 
bites  of  a  peculiar  webless  spider  which  lives  in 
holes,  then  in  like  manner  against  the  bites  of 
the  crown  serpent  And  lastly,  to  complete 
the  charm  or  invulnerability  against  poison,  he 
submits  to  the  ))ites  of  the  puff-adder. 

All  these  preliminaries  having  been  faith- 
fully cartied  out^  the  poison  doctor  is  ready  to 
begin  the  ezerciae  of  his  art  From  time  to 
time,  however,  he  must  renew  the  strength  ot 
his  healing  properties  and  sustain  his  reputalion 
as  a  poison  doctor  by  re- exposing  himself  to 
these  bites. 

The  treatment  of  patients  placed  imder  his 
professional  care  is  effected  in  the  following 
manner :  A  piece  of  fur  cape  of  the  poison 
doctor,  which  has  been  soaked  with  the  medical 
man's  sweat,  is  then  put  into  some  water  which 
the  patient  is  directed  to  drink.  In  cases  where 
the  poisoning  took  place  some  consider^ible  time 
before  applying  to  the  doctor,  some  very  offen- 
sive doses  are  swallowed  by  the  patient 

The  poisoning  of  arrows  is  effected  with  the 
secretion  from  the  wa  er  of  the  spider  mentioned 
above  with  the  ven  )m  of  the  crown  snake  and 
the  puff  adder  mixed  with  gall. 

These  cases  are  interesting  as  illustrations  of 
a  savage  instinct  which  recognizes  the  power  of 
animal  extracts  as  means,  not  only  of  inducing 
serious  injury,  but  as  methods  to  prepare  the 
body  to  resist  these  same  noxious  influences. 
In  England  we  had  Jenner's  method  in  vaccin- 
ation ;  in  Berlin,  the  tuberculin  of  Koch ;  in 
Paris,  the  hydrophobin  of  Pasteur.  The  sub- 
cutaneous injections  of  BrowuS^quard  are  in 
the  same  line  of  thought  and  experimi  nt  It  is 
the  evolution  of  preventive  medicine  originat- 
ing in  the  mind  of  the  untutored  savage,  ani 
passing  onward  and  upward,  until  the  very 
highest  bacteriological  skill  confirms  its  theories 
for  the  protection  and  health  of  mankind. — 
Druggists'  Circular. 


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Treatment  of  Pyorrht a  AlveolarU. 

Under  the  name  of  Rigg's  disease  this  affec- 
tion of  the  teeth  and  gums  is  known  as  one  of 
the  most  obstinate  in  yielding  to  treatment  In 
a  recent  number  of  the  Philadelphia  Polyclinic^ 
Dr.  Joseph  Head  describes  his  method  of  con- 
trolling this  disease.  He  advises  first  the  re- 
moval of  all  tartar  from  the  roots  of  the  teeih 
by  carefully  scraping  from  the  bottom  of  the 
pocket  to  the  neck.  He  then  applies  aromatic 
sulphuric  acid  to  dissolve  any  calcareous  pieces 
that  may  be  left,  and  to  stimulate  the  parts  to 
healthy  action.  He  then  orders  the  following 
wash: 

R.  Add  benzoic «..drami  1 

TlDCt  encalvptus fl  drunsUJ 

SpiTlt.  viu.  rect fl  onncesiy 

OL  menUi.  pip : fl  dranuiFB 

M.  One  teaspoonAil  in  half  a  glan  of  water  held  in  the 
month,  morning  and  evening,  for  uro  Aill  minutes. 

For  systemic  treatment  he  prescribes  lithium 
carbonate  in  five  grain  doses  three  times  a  day  ; 
or  sodium  salicylate  in  proper  doses.  However, 
he  says  that  far  more  valuable  than  drugs  for 
general  treatment  is  plenty  of  exercise  in  the 
open  air,  and  restriction  of  diet  Meat  should 
be  used  sparingly ;  all  alcoholic  beverages 
should  be  prohibited  ;  and,  as  a  rule,  the  quan- 
tity of  food  should  be  diminished.  Dr.  Head 
says  that  he  has  known  patients  who  have  long 
resisted  local  treatment,  derive  speedy  relief 
when  they  follow  the  diet  he  prescribes,  which 
is  as  follows : 

All  malt  or  alcoholic  beverages  are  to  be 
prohibited.  Meat  to  be  used  sparingly.  In 
fact,  rather  than  tell  the  p%tient  what  to  avoid 
it  is  much  better  to  write  for  him  which  foods 
he  can  take,  such  as  eggs  soft  boiled,  tripe, 
oysters  raw,  roasted,  broiled  or  stewed,  always 
rejecting  the  eyes.  Young  lamb  three  times  a 
week,  fresh  fish—especially  white  fish,  perch, 
flounders.  White  meats  of  fowl,  game  birds, 
eta  An  occasional  meat  broth,  or  clear  soup 
carefully  made,  not  rich  and  without  vegetables. 

All  fats  to  be  avoided.  Vegetables  :  maca- 
roni, spinach,  tomatoes  stewed.  Peas,  fresh  and 
young.  Beans:  lima,  French  and  string, 
young  and  fresh.  Squash  and  carrots,  young. 
Oyster  plant  or  salsify,  stewed  celery.  Egg- 
plant baked.  Watercress,  head  cabbage,  sauer- 
kraut, Brussels  sprouts,  cauliflower,  lettuce, 
com  salad.  Dry  and  milk  toast,  pulled  bread, 
Zweibach  (toasted  rusk),  steamed  crackers. 
Wheat  bread  rather  stale,  preferably  the  crust 
Rolls,  Graham  bread.  Oatmeal  mush  or  por- 
ridge. Cracked  wheat  Weak  tea  with  slice 
of  lemon  instead  of  milk.  Very  little  sugar. 
Coffee  without  milk. — Food, 

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year  free. 


The  Drinking  Treatment  of  Typhoid. 

Some  years  ago  M.  Debove  recommended 
the  use  of  large  amounts  of  water  internally  in 
typhoid  fever.  "  1  make  my  patients  drink," 
he  said  ;  and  this  was  his  chief  special  treat- 
ment. The  object  was  to  dilute  the  fluids  of 
the  system  and  wash  out  the  toxines  in  the 
blood  and  intestinal  canal.  M.  lichteim 
adopted  this  treatment  and  reports  nine  success- 
ful cases.  Recently  M.  MaUlart,  of  Geneva, 
has  made  an  elaborate  study  of  this  mode  of 
treatment,  reporting  fourteen  cases  in  detail,  of 
which  one  died.  {Rtvue  de  Mideeiney  Novem" 
her,  1893,  and  March,  1894.)  Maillart  thinks 
that  the  water-drinking  method  should  be 
*<  erected  into  a  special  method  of  treatment." 
In  order  to  secure  the  proper  results  the  patient 
must  drink  ^Ye  or  six  litres  (quarts)  of  water  a 
day.  There  is  no  contra* indication  for  the  use 
of  water  in  this  way,  for  it  does  not  weak^  the 
heart,  but  has  rather  the  contrary  effect.  The 
results  obtained  are  a  progressive  lowering  of 
the  fever,  a  disappearance  of  dryness  ef 
the  mouth,  a  marked  sedation  of  all  the 
nervous  symptoms,  and  an  improvement  in 
the  action  of  the  heart  and  kidneya  There  is 
an  abundant  diuresis  and  an  unusual  increase 
in  the  perspiration.  Urea  is  carried  off  in  large 
amounts.  The  treatment  does  not  shorten  the 
course  of  the  disease,  but  simply  makes  it  easier 
and  less  fatal.  Patients,  we  are  told,  take 
kindly  to  this  method.  The  typhoid  patient 
takes  usually  six  to  eight  glasses  of  milk  daily, 
and  if  to  this  are  added  ten  to  twelve  glasses  of 
waver,  the  diluent  effect  should  be  very  great 
—Ed.  Med.  Rec, 

A  mixture  of  chloroform  (ten  parte)  ether 
(fifteen  parts)  and  menthol  (one  part,)  used  as 
a  spray,  is  recommended  as  an  excellent  and 
prompt  means  for  obtaining  local  anesthesia, 
lasting  for  about  five  minutes. — Boston  Med. 
and  Surg.  Jour. 

Chlorinated  Lime  in  Pruritus  Ani. 

Jameison  (Edinburgh  MedicalJoumaly  Jxmey 
1894)  states  that  Berger  has  had  excellent  re- 
sults from  the  use  of  liquor  calcis  chloratse  (B. 
P.)  in  pruritus  anu  A  piece  of  abeorhoit 
cotton  is  saturated  in  the  solution,  and  inserted 
into  the  anus  for  the  distance  of  an  inch.  This 
is  left  in  situ  till  a  slight  burning  is  experienced. 
The  cotton  is  removed  and  the  anal  region 
washed  with  the  solution.  The  parts  are  left 
undried.  Pruritus  is  said  to  vanish  at  onoe. 
On  its  reappearance  the  procedure  must  be  re- 
peated. Any  eczema  which  may  happen  to  be 
present  will  rapidly  disappear. — Intemaiumal 
Med.  Mag. 


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To  Use  Granules  Hypodermioally. 

1.  Boil  a  little  water  in  a  spoon  over  a  flame; 
this  sterilizes  it 

2.  Take  up  a  syringeful  to  wash  out  and 
sterilize  the  syringe. 

3.  Dissolve  the  required  amount  of  granule? 
in  a  sufficient  amount  of  the  water  remaining 
in  the  spoon  to  equal  the  amount  required  for 
injection,  boiling  while  dissolving. 

L.  Take  up  solution  in  syringe  and  when 
cool  enough  inject — Dr.  W.  H.  Walling. 


— For  rosacea,  Petrinio  in  Med.  Record  : 

R.  lehUirol 2  parts 

Reioroiii 1  pirt 

OoUo  JlL  flexil 30  parts 

— In  cancer  of  the  uterus  total  extirpation  is 
destined  to  be  the  operation  whether  the  dis- 
ease is  cervical  or  corporeal,  and  if  done  in  time 
will  permanently  cure  a  certain  portion  of  cases. 
If  any  tissuea  adjacent  to  the  uterus  are  already 
involved,  it  should  not  be  attempted. — Lewis 
m  Med,  Record, 

— Acetate  of  aluminium  is,  next  to  carbolic 
and  salicylic  acid,  the  disinfectant  which  pre- 
vents, for  the  longest  time,  the  development  of 
micrococci  and  produces  no  irritation. — Frai- 
pont 

— Locally  for  joint  rheumatism  : 

R.  Add.  aaUoTlic drams  Jss 

Alcohol,  aosolat f  ounoesl 

del  ridnl « f  ounces  ij 

Apply  by  compress  covered  with  imperme- 
able tissue. — Ruel. 

— Chloride  of  gold  and  sodium  in  pills  or 
granules,  given  in  doses  from  two  milli- 
grammes to  three  centigrammes  improved  the 
general  condition  of  paralytics  in  the  first  and 
second  periods. — Boubila. 

— The  majority  of  so-called  recoveries  from 
appendicitis  treated  medically  are  not  recover- 
ies in  the  full  sense  of  the  word,  but  simply  a 
respite  which  enables  one  to  settle  worldly  af- . 
&irs  and  take  out  a  life-insurance  policy  in 
anticipation  of  a  fatal  termination. — Sanborn. 


Quettione  Asked  by  the  Board  of  Medical  Exam- 
inert  of  Virginia. 

[Oar  readers  will  take  an  interest  in  perusing:  this,  a 
fairly  representatiye  list  of  qaestions.  The  Southern 
J<mrnal  of  Homeopaiky^  in  pablishinff  the  list  says : 
"  W^e  publ  sh  these  questions  for  the  purpose  of  ez- 
hikriting  the  fact  that  the  terror  of  the  examining 
board,  even  the  sinffle  board,  is  largelj  in  the  imagin- 
ation. The  properly  educated  graduate  need  have  no 
fears,  but  the  ignorant  may  justly  tremble.''] 


ANATOMY. 

1.  (a)    Give  anatomy  of  ooracoid  process. 
(6)     Describe  upper  extremity  of  ulna. 

2.  Give  attachments,  vascular  and  nervous  supply 
of  biceps,  rectus  femoris,  and  steiuo-cieido- mastoid. 

3.  Give  the  anatomy  of  4th  ventricle. 

4.  Describe  the  male  urethra. 

6.    Give  the  relations  of  the  caecum. 
6.    Give  superficial  origin,  course,  foramen  of  exit 
and  distribution  of  12th  or  hypoglossal  nerve. 

PHYSIOIiOGY. 

1.  Define  the  term  food,  ^ve  general  classification 
of  same  and  mention  the  prmcipal  inorganic  ingred 
ients  of  food. 

2.  Give  composition  of  human  milk  and  state  what 
acid  is  found  when  it  sours. 

3.  Describe  the  capillary  blood  vessels  and  give 
the  physical  condition  which  influences  the  movement 
of  the  blood  through  the  same. 

4.  Give  origin  and  distribution  of  the  10th  pair  of 
cranial  nerves  and  their  physiological  function  in  eon- 
nection  with  the  formation  of  the  voice. 

6.  Give  properties,  physical  and  diemical,  and 
also  the  function  of  saliva,  gastric,  pancreatic  and  in- 
testinal juice,  and  bile. 

6.  Describe  the  tongue  and  mention  the  conditions 
necessary  (o  the  performance  of  the  gustatory  function. 

CHEMISTTY. 

1.  Define  atomic  weight,  molecular  weight,  com- 
bustion and  isomorphism. 

2.  Give  history  of  chlorine,  its  chief  uses  and 
chemical  properties. 

3.  Mention  two  oriiranic  and  inorganic  bases.  Give 
chemical  formulae  of  the  two  latter  and  state  chief 
chemical  and  physical  nroperties  which  as  bases  dis- 
tinguish them  from  ados. 

4.  Define  the  following  and  give  example  of  each, 
(a)  an  alcohol,  (6)  a  simple  ether,  {c)  a  hydro-carbon, 
\d)  a  carbo  hydrate. 

6.  Describe  mag.  sulph.  State  how  prepared. 
Give  chemical  properties  and  tests  for  mar.  salts. 

6.  Give  source  of  potassium  its  physical  and  chem- 
ical properties,  and  name  the  principal  salts  of  this 
metal  which  are  used  in  medicine. 

JUBI8PBUDENCE. 

1.  Give  the  legal  importance  and  evidence  necen- 
sanr  to  establish  the  identity  of  the  living  and  dead 
body. 

2.  Define  a  wound  legally ;  classify  and  give  prin- 
cipal characteristics  of  wounds  inflicted  on  the  living 
and  dead  body. 

HTOIEKE. 

1.  State  the  variou*  methods  of  cooking  food  and 
.  that  most  conducive  to  health  and  reasons  for  same. 

2.  Name  the  principal  occupations  or  trades  pre- 
judical  to  the  heidth  of  the  operative  and  what  diseases 
they  produce. 

8.  Give  the  general  divisions  of  the  baths,  the 
temperature  of  each  and  their  hygienic  uses. 

4.  Name  the  diseases  that  may  be  transmitted  by 
the  excreta;  as  alvine  discharges,  vomica,  or  sputa, 
and  how  prevented. 

SURGERY. 

1 .  Give  symptoms,  diagnosis,  and  methods  of  treat- 
ment of  stricture  of  the  urethra. 

2.  Give  causes,  symptoms  and  treatment  of  intes- 
tinal obstruction. 

3.  Give  definition,  pathology,  diagnosis  and  treat- 
ment of  aneurism. 


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4.  Give  varieties  of  luxations  of  the  shonlder-joint. 

5.  What  are  the  signs  of  fracture  of  the  surgical 
neck  of  the  femur. 

6.  Give  definition  and  treatment  of  a  retro  pharyn- 
geal ab6ce^6. 

OBSTBTBJCS,  &C 

1.  Give  the  diferential  diagnosis  of  pregnancy. 

2.  Name  the  prettentations  of  the  fceius  usually 
found  in  natural  labors,  and  aUo  those  requiring  ma- 
nipulative interference  for  their  correction. 

3.  Give  the  diagnr  sis,  prognosis  and  treatment  of 
concealed  or  accidental  hemorrhage  and  the  conditions 
existing  in  unavoidable  hemorrhage. 

4.  What  are  the  chief  causes  i.f  sudden  death  dur- 
ing or  immediately  following  labor. 

6.  What  are  the  most  approved  measures  for  the 
restoration  of  the  new-bom  in  cases  of  asphyscia  or 
suspended  aroination 

6.  Describe  the  Sims  and  knee-chest  positions,  and 
state  their  respective  object. 

FRAcncB. 

1.  Describe  the  differential  diagnosis  between 
croupous  and  catarrhal  pneumonia. 

2.  Give  the  treatment  proper  for  capillary  bron- 
chitis of  infancy  and  childhood. 

3.  Describe  the  differential  diagnosis  between  the 
eruptive  symptoms  of  variola  or  fcmall  pox,  and  vari- 
cella or  chicken  pox. 

4.  Describe  the  physical  diagnosis  of  acute  pleu- 
ritis,  both  in  the  dry  or  moist,  or  effusive  stage. 

5.  Name  some  of  the  chief  causes  of  infantile  con- 
vulsions and  explain  their  mode  of  action. 

6.  Name  some  of  the  chief  causes  of  acute  nephritis 
and  describe  its  proper  methods  of  treatment. 

MATERIA  MEDICA. — (hOMCEOPATHIC  ) 

1.  Give  the  indications  for  aconite  in  sthenic  fever. 

2.  Differentiate  between  aconite  and  belladonna  in 
scarlet  fever. 

3.  How  is  opium  prepared  and  nhat  are  the  thera- 
peutic indications  for  its  use  in  sunstroke  ? 

4.  Give  the  uterine  indications  for  ^epia. 

5.  Give  three  leading  remedies  in  treatment  of 
pneumonia  with  their  characteristic  ii'dications. 

6.  What  is  a  poisonous  dOf>e  of  morphia  and  give 
treatment  of  morphine  poistning. 

7.  Give  the  mind  symptoms  of  arsenic 

8.  Give  the  difference  between  decimal  and^cen- 
tessimal  triturations. 

MATERIA  MTDICA. — (OLD  SCHOOL.) 

1.  Name  methods  by  which  medicine  may  be  intro- 
duced into  the  circulation  and  the  conditions  when 
each  is  to  be  preferred. 

2.  What  are  anaesthetics?  Contra-indications  for 
their  use.  Treatment  of  dangerous  symptoms.  Modes 
of  death  from  ai  festhetics. 

3.  To  what  class  of  remedies  do  the  following  be- 
lonir;  give  most  efficient  preparation  with  do^e  of 
each?  Arsenic,  iodine,  zinc,  hyoscyamus,  chloral, 
aspidium  felix-mas. 

4.  What  are  oxytocics?  Mention  three,  with 
mode  of  action  and  dose. 

5.  Name  the  principal  digestive  agents ;  explain 
their  physiolog  cal  action  and  dose. 

6.  Explain  the  action  of  saline  cathartics  Name 
the  principal  ones  in  use,  with  dose. 

7.  What  medicines  are  employed  as  gastric  seda- 
tives, and  explain  their  mode  of  action. 

8.  Write  a  prescription  containing  at  least  four 
ingredients,  stating  for  what  conditions  it  might  be 
used.    (Do  not  abbreviate.) 


Formulas. 


ASTHMA. 

R.  Tlrct  bellad diam8i>« 

Tfnct  lobelia -. drams  il 

Syr.  zlnziberlB ounces  Jl 

Syr.  add  hydrkdic  (Hottellej's) 

q.  B.  ad.........ouDce8  v} 

M.    SIg.— Teaspoonfnl  thiee  or  firar  tlmts  a  day. 

A  little  sweet  spirits  of  Ditre  should  be  given 
to  stimulate  the  urinary  secretioDS  which  are 
usually  scanty  before  the  attack.  The  nitre 
should  not  be  given  for  at  least  an  hour  aiter 
the  other  medicine. 

This  treatment  has  been  thoroughly  tried 
and  seldom  fails  to  shorten  the  parosiem  and 
give  relief.  It  should  be  continued  for  some 
weeks  and  then  followed  by  a  good  tonic  iind 
general  reconstructive. 


RHEUMATISM. 

B.  Tlnct  eiiniciftigs onnoesij 

Vinl.  oolch.  sem onno(8iJ« 

Syr.  add  hydrlodic  (Uoite  ley's) oancesT 

M.   Big.— Teaspoonfal  in  water  four  (4)  times  daily. 


AN   ANTI-EPILEPTIC   MIXTURE. 

Prof.  Brown-S^uard  (La  Rhme  Medieak^ 
March  18,  1894))  praises  the  following  form- 
ula in  epilepsy : 

*•  F<r:t£Sr.'J - Qn*^)».. 

Bromide  ammonia (grs.  zzz)  2.0 

Bicarh.  potasn (jen.  zxzTflJ)  2  50 

Infli^ion  Colombo (ounces  vj)  lau  o 

Three  tableftpoooAils  a  day,  of  <«bich  two  are  to  be  taken 
in  the  eveBlng  towards  btd-time. 

(This  is  the  prescription  which  the  great 
Napoleon  the  First  formerly  employed.— iVit- 
chard. ) — Lancet-  Clinic. 

[We  have  used  the  above  prescription  in  an 
epileptic  on  whom  the  disease  was  rapidly 
growing,  with  the  best  of  results.  Two  years 
was  given  as  the  time  it  should  be  continutd, 
but  the  patient,  tiring  of  it,  discontinued  its 
use,  and  in  less  than  a  month  the  symptoms 
reappeared.  It  was  again  resumed,  resulting  in 
an  apparently  complete  cure. — Ed.] — Toledo 
Med.  Compend. 


FOR  PRURITIB  OF  THE  VULVA. 

B.   Potassium  bromide ....diam  I 

Luoolin dram  1 

Caloirel drams  5 

Olive  oil ....ounces  2 

Local  appU«  ation. 

—Deut.  Med.  Woeh, 


FOR  ECZEMA  OF  THE  VULVA. 

B.  Tincture  oninm. 8  0  (drsms  if) 

Sodium  bicarbonate S.0  (dimmp  U) 

Potassium  bicarbonate... ». 4  0  (diams  1) 

Glycerin ..„ 60  (drams  ]s) 

Water .20tf.O  (ouncM  ^) 

Local  application. 

—Lu9ch. 


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OUmtXST  FOB  BBDS0BE8. 

E.  Fero  tMilMm... »..^.^».......^ dimnn  2 

Beml  oliitnieiit.....^ ^ ^.dimnn  12 

BMla  olntmeiit.^ ^....«-«...^^.oiUMmi  i 

DiiMtloDi:  Apply  daily. 

CHOLERA   INFAyrUM* 
a,  BimBthtiobnlteM, 

LMtOp60tlll6| 

OamfKbie, 

XD0iayplol<8ud«r  A  8<m*i) m. di»ai  J 

TlBOt  opli  campbonU»»......^^.....^.dimint  il 

fliT.  rtmpHflli. — »^ ».^..q.  t.  ad.  oanoM  IJ 

M.  aig.— Ono-balf  to  ona  teas  •oonAil  ereiy  two  to  ftiiir 
hooii,  aoQordiiig  ta  age  and  mgenoy. 

CATARBHAL  IGTEBU8. 

Dr.  BoaliBndla  (l^itahd,  Na  6,  1894) 
reoommends  in  catarrhal  ictenu  the  following 
formula : 

B.  Powdered  earenma  root.^ (diame  y))  25.0 

Powdeied  ginger  root..^-.^ (diams)^  5.0 

Sofident  ftff  tmrty  powden.   Twotliie«timeeaday. 

— Priichard. — Laneet  Clinic 

A  NEW  TREATMENT  OF  TAPE-WOBM. 

Dr.  Drcmke  (Bevxta  de  Bibliographie  MULi- 
cahf  Na  7,  1894),  in  the  treatment  of  tape- 
worm,  aasooiateB  the  three  most  powerful  tenia- 
foges,  thus  hoping  to  obtain  a  more  active  thera- 
peutic influence.     His  formula  is : 

R.  Honey  .....r.^ ............^.(diama  y)  2ao 

Koii«o  flowtiis...^..^ ...(diamsT)  20iO 

Divide  this  into  three  parts^and  take  them  in 
the  morning  with  intenrals  of  ten  to  fifteen 
minutee,  the  day  before  the  patient  living,  of 
coure»  OQ  a  reduced  diet.  One  to  two  hours 
after  taking  the  preparation  administer  an 
ounce  of  castor  ml.  Have  the  patient  pass  his 
stools  into  a  vessel  filled  to  the  Inim  with  warm 
water  to  avoid  breaking  the  worm. — lb. 

ISOOVTIITEXCE  OF  CFBINE. 

Dr.  White  (La  Bevue  likUeaUy  No.  43, 
1894)  recommends  the  following  formula  in  in- 
continence of  urine  in  children : 

R.  Benaoaetoda,  )  ^-         /»T--rv^io 

SaUoyiate  loda.  /  — aa.....«..(gM.  xv)  1 0 

Sztr.  beUadonna.....». ^ .^(grs.  zxx)  2.0 

Cinnamon  water » (onnoei  ly)  120.0 

A  teaapoonfal  ftrar orfiye  times  a  day. 

—PrUehard.—Ib. 

PREVENTION  OF  IODI8M. 

Dr.  H.  N.  Spencer  recommends  the  follow- 
ing mode,  due  to  Professor  Hardaway,  of  pre- 
scribing iodide  of  potassium;  the  tendency  to 
corjza  is  counteracted  by  the  nux  vomica  and 
ammonia  citrate,  while  the  tonics  prevent  de- 
proBsioQ: 

R.  Iodide  of  potaMinm................. .^oan  etas 

Citrate  of  iron, 

AmnMninm......... **^  rti^mai 

TUiOtore  of  nnx  yomlca....».............^dramB  i] 

Water..^.:.^ — .^euncei  jM 

Oomponad  tinetore  of  dnohona  to  make  up  oonces  iy. 
Dqm»  one  teaepoonftil  in  half  a  glam  of  water  after  meali. 
The  qnantii^  of  iodide  may  be  iocreaied  to  any  deiired  ex-, 
tent  fey  adduig  the  neoenary  amount  of  a  ntnrated  eohitlon. 

— IntemaL  Med,  Mug. 


Reviews. 


Thb  Graphic  Bistort  of  thb  Fair.  With  nearly 
one  thoneand  illii8trati<»if .  240  imperial  quarto 
pages  (11  by  16  inches),  cloth  |4.00  and  in  differ- 
ent binding  ap  to  flO.OO.  Poblished  bj  the 
Graphic  Companj,  358  Dearborxi  itreel,  Chi- 
cago, His. 

We  find  this  work  very  interesting,  so  Car  as  the 
text  is  concerned.  The  illottratioos  oooBtitate  the 
predominant  feature  of  the  work.  Being  photogra- 
vures, some  of  them  have  not  printed  ap  as  dearl j  as 
could  be  wished. 

Where  to  Send  Patishts  Arboad  vor  Water 
Cures  ahd  Cumatio  Treatmert.  By  Dr. 
Thomas  Linn ;  paper,  25  cents.  Geo.  S.  Davis, 
Detroit,  Mich. 

Of  interest  to  those  who  have  patients  wealthy 
enough  to  go  abroad  if  they  are  so  directed. 

The  Modus  Operaitoi  of  QTmnvE  ik  Labor. 
Beprint,  by  R.  B.  McCall,  M.D.,  HamersviUe,  O. 

The  AonoN  and  Uses  of  PENTAii.  By  David 
Cema,  M.D.,  Ph.  D.,  and 

Some  Thoughts  on  Higher  Medical  Education 
AND  Medical  Ethics,  by  the  same  anther. 
Reprints.    1320  Ave.,  £.  Galveston,  Tex. 

Functional  Constipation.  Reprint^  by  W.  Blair 
Stewart,  A.  M.,  M.D.,  Bym  Mawr,  Pa. 

Asexualization  for  the  Prevention  of  Crime 
AND  THE  Arrest  of  the  Propagation  of 
Criminals.  Reprint,  by  F.  L.  Sim,  M.D.,  Mem- 
phis, Tenn. 

Sthavara  :  A  Non-Surgical  Radical  Curb  for 
Hernia,  and 

Instructions  for  the  Use  of  Stqavira  in 
Hernia.  Two  interesting  and  instriictiTe  pam- 
l^lets.  free.  The  Sthavara  Company,  No.  1224 
Bets  Building,  Philadelphia,  Pa. 

The  Nursing  World.  A  monthly  joomal  devoted 
to  the  Theory  and  Practice  of  Nnrsing.  J.  Ed- 
mund Brown,  M.D.,  editor.  Price,  fl.OO  per 
year.    Providence,  R.  I. 

Health.  A  Joomal  of  Practical  Hysiene.  Quart- 
erly. 50  cents  per  year.  The  Heuth  Pablishing 
Co.,  84  Reade  street.  New  York,  N.  Y. 

New  snbscribera  who  send  f  1  noip  for  189^  will  re- 
ceive World  for  the  remainder  of  this  yet  free. 

'' One  Hundred  Years  OF  BusiNBSS  Life.''  W.  H. 
Schieffelin  &  Co.,  New  York.  A  handsomely  il- 
lostrated  pamphlet 

We  oongratolate  the  house  of  W.  H.  Schiefielin  & 
Go.  upon  Uie  completion  of  one  hundred  years  of  suo- 
ceeefui  exj^rienoe  in  proTiding  supplies  for  the  medi- 
cal professiOD.  We  wish  them  a  thousand  years  longer 
of  useful  and  prosperous  existence. 

Readers  can  procure  the  reprint,  ^Hygienic  w.  Drug 
Treatment  for  Typhoid  Fever,''  by  Dr.  Pafl»,  noticed 
in  August  World,  by  sending  25  cents  to  DarweU  & 
Upham,  283  Washington  street,  Boston,  Mass.,  or  by 
sending  10  cents  to  Wm.  Wood  &  Co.,  New  York,  N. 
Y..  for  a  copy  of  The  Medical  Beeord  of  April  28, 
1894^  which  contains  the  artide. 


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THB  MEDICAL  WORLD. 


Wit  and  Wisdom, 

You  use  aoomte  eveiy  dmj  in  your  praodoe.  Send 
ten  cents  to  the  Philadelphia  Granule  Co.,  No.  10 
Bouth  18th  St,  Philadelphia,  Pa.,  for  100  grannies  of 
aoonitine,  the  active  principle  (or  65  cts.  for  1000)  and 
trj  them  instead  of  tne  uncertain  tincture. 

The  Almighty's  Tbsatmb^t  of  Nervous 
Dbbilitt.  When  Elijah  was  utterly  depressed  in 
mind,  and  belived  that  his  brave  attempt  to  create  a 
reformation  in  Israel  had  completelv  failed,  and  that 
there  was  nobodj  left  that  carea  for  the  true  God,  and 
waa  readj  to  die  of  a  brok^dh  eart,  then  Qod  gave  him  a 

auiet  desert  far  from  distraction,  then  a  ^>od  sleep, 
iien  a  comfortable  meal,  then  sleep  again,  then  more 
food,  and  then  a  six  weeks*  vacation.  After  that  he 
recovered  his  spirits  and  was  greatiy  improved  in  his 
reliffious  feeling,  his  faith  in  God,  as  well  as  in  bodilj 
condition.  One  s  religious  moods  may  often  depend 
on  the  condition  of  the  bodj,  if  not  one's  religious 
life.—"  The  Independent." 

For  shaking  palsj  nothing  excels  Tinct.  .fsculus 
Glabra,  i  drachm,  and  Gelerina,  8  ounces.  Teaspoon- 
fnl  everj  two  or  three  hours. 

The  "SiiAKTiKO  HAWDWBrrtHo,"  so  dear  to  our 

J  grandmothers  and  rrandfathers,  has  lon^  been  out  of 
ashion  in  England  and  America.  It  will  soon  be  a 
thing  of  the  past  in  Germany.  There,  however;  the 
chanee  will  not  be  due  to  esthetic  considerations,  it  is  a 
sacrifice  made  to  hygiene.  An  inquiry  set  on  toot  dj 
the  School  Committee  of  Hanover,  at  the  desire  of  the 
Prussian  Minister  of  Education,  leads  to  the  conclusion 
that,  while  a  slanting  handwriting  favors  a  crooked 
position  of  the  writer,  straight  up  writing  forces  him 
to  have  his  copj-book  or  writing- paper  straight  before 
him^  and  thus  helps  the  writer  to  keep  his  bodj 
straight  while  writing.  For  this  reason  slanting 
writing  is  henceforth  to  be  discouraged  in  German 
schools. — British  Medieat  Journal, 

Pipebazike-Bayeb  has  been  extensivelj  employed 
in  the  treatment  of  gouty  affections,  renal  lithiasis, 
hematuria,  and  diabetes,  and  the  testimony  is  mo£t 
favorable  as  to  its  utility  in  these  conditions.  It  can 
be  obtained  of  all  -druggists  in  half  and  one  ounce 
vials  and  also  in  tablets,  and  pamphlet  will  be  furnish- 
ed on  request  by  the  agents  W.  H.  Schiefielin  &  Co. 
of  New  York. 

TBSATMXNT  FOB  MU8CULAB  RHSUMATIBM. 

Case  2. — Mrs.  B.,  the  wife  of  one  of  our  city's  chief 
officials ;  for  years  had  been  a  sufferer  from  the  worst 
Ibrm  of.  muscular  rheumatism  I  ever  saw.  She  was  a 
constant  sufferer  when  she  called  herself  well,  but  when 
the  acute  attacks  came  on,  as  the^  did  two  or  three 
times  a  year,  she  suffered  excruciating  agony  and  the 
illness  lasted  usually  in  spite  of  the  best  treatment  I 
oould  give  her,  from  three  weeks  to  two  months. 

The  cAi^  seat  of  the  rheumatism  was  in  the  inter- 
ooatal  muscles  of  the  chest,  though  eveiy  muscle  of  the 
body  seemed  to  be  affected  more  or  less.  Large  deses 
of  morphine  were  ordered  freqnentiy  to  quiet  her  at 
these  times  and  I  dreaded  each  attacx  for  fear  that  the 
heart  might  become  involved.  In  October  last  she 
had  an  attack,  one  of  the  severest  I  ever  saw.  I  at  once 
gave  her  arsenauro  ten  drops  four  time^  a  day,  with 
such  palliatives  as  were  needed.  Much  to  the  surprise 
and  delight  of  her  family  and  myself,  she  commenced 
to  improve  on  the  fourth  day.  Opiates  were  dropped 
on  the  fifth  day,  she  was  up  and  aoout  on  the  seventh 
day,  and  had  a  rapid  convalescence  from  tiiat  time  on. 
I  ordered  the  arsenauro  continued  t,  i,  d,  and  after  a 


month  all  pain  ceased.  I  met  tier  on  the  street  yes- 
terday, a  healthy,  hu>py  woman  and  a  gratelnl  patieot 
She  still  takes  five  ctrops  of  the  medicine  oooe  a  day 
and  I  propose  to  keep  it  up  for  a  year.  Thir  led  to 
another  caiEe,  her  brother,  Mr.  M.,  American,  aged 
47,  resident  of  Bethel,  Conn.,  who  had  not  been  able  to 
work  for  two  years  Was  all  crippled  up  with  rheu- 
matism, which  was  hereditaiy,  When  he  first  eoosnlted 
me  he  was  not  suflbring  from  an  acute  attack  bat  wm 
in  a  bad  way.  Three  months  treatment  with  arsenaiito 
ten  drops  four  times  a  day,  removed  all  the  pain  and 
the  man  is  now  working  every  day  He  will  take 
five  drops  twice  diily  for  a  year  until  all  the  sympteass 
disappear  and  the  cure  is  complete.  Dr.  W.  C.  Wile,  ia 
N.  k  Medical  Monthly. 

Have  vou  seen  the  portable  air  compressor  adver- 
tised by  Willis  H.  Davis,  Keoknk,  Iowa?  See  U^ir 
adv.  It  has  a  great  many  different  uses.  Is  operated 
by  the  foot 

I  have  giren  Peacock's  Bromidbb  a  thorough  trial, 
and  have  since  then  invariably  prescribed  it  in  prefa^ 
enoe  to  other  preparations  of  itb  kind.  During  my  trip 
across  the  ocean,  I  gave  it  to  several  passengers  who 
suffered  a  great  deal  from  sea-sickness,  with  vefy 
beneficial  resuUs.  J.  WiUfOTH,  Ph.D.,  M.  D., 

New  Orleans,  La. 

The  Rocking  Chair. — An  English  surgeon  savs 
that  people  who  use  rockinff  chairs  most,  get  deaf 
soonest.  Rocking  also  hurts  the  eyes  and  makes  people 
near-sighted. 

Rocking  chairs  are  al«o  a  very  common  cause  or  one 
of  the  factors  in  producing  pelvic  diseases.  The 
contraction,  pressure  and  relaxation  produced  by  sev- 
eral hours  constant  rocking  produces  a  hyperetaie 
condition  of  the  pelvic  ornns.  At  first  the  vaso-moton 
soon  exert  themselves  and  the  vessels  return  to  their 
normal  condition,  but  when  this  is  keep  up  for  yean 
the  vast-motor  control  becomes  less  and  less  till 
congestion  takes  place,  and  the  long  list  of  pdric 
symptoms  follows  A  straight  chair  and  hot  water 
injections  have  cured  a  large  nnmber  of  gyneccrfogieal 
cases  in  our  hands. — MedioiU  Oompend, 

Dr.  Charies  Kelly  Gardner  refiorts  to  The  Modioal 
Age  good  resulto  from  the  use  of  Uqaor  Sedans  (Parke, 
Davis  &  Co.)  in  a  case  presenting  severe  and  obstinate 
derangement  of  the  female  generative  organs,  attended 
with  very  irregular  and  painful  menstruation. 

Db.  Gorduxon,  St  Amand.  Franoe,  says :  I  have 
tried  Aletris  Coidial  in  a  case  of  dvsmoiorrhea.  The 
result  I  obtained  from  the  use  of  the  preparation  was 
excellent— far  better  than  I  obtained  in  the  same 
patient  by  prescribing  the  usual  remedies  employed 
in  such  r  — 


Whkbb  Old  Sol  is  Regular.— Liberia  is  the  only 
more  or  less  civilized  countrv  where  clocks  are  almost 
entirely  dispensed  with.  The  sun  rises  ezacUy  at  6 
A.M.,  and  sets  at  6  p.m.,  throughout  the  year,  and  if 
vertically  overhead  at  noon.— Ivie  Medical  Herald. 

W.  R.  Wabner  &  Co.  will  furnish  gratia,  for 
extreme  cases,  Ingluvin,  to  the  address  of  anv  phy- 
sician who  may  nave  a  case  of  Marasmns,  (%olera 
Infantum  or  sickness  in  Gestation,  for  which  it  if 
claimed  to  be  a  specific. 

BANMETTO  IN  CHRONIC  TROUBLEB  OF  THE 
QENITO-URINARY  ORGANS : 

I  am  pleased  to  stote  that  I  have  used  several  dosen 
bottles  of  Sanmetto  in  my  practice,  and  in  properly 
selected  cases  have  never  eeen  anything  to  equal  tt 
In  pre-senility,  cystitis,  and  in  all  chronic  troobles  of 


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347 


the  rauto-arinarj  organs,  Sanmetto  has  given  entire 
satisraction  to  myself  and  patients. 
Lookout,  La.  R.  M.  Collins,  M.D. 

Dp.  O.  Sohulbb,  of  Berlin,  has  had  excellent 
lesnlts  iji  the  use  of  Diphtheria  Antitoxine-Schering. 
He  injected  it  in  many  incipient  cases  of  diphtheria,  the 
result  being  a  marked  ameuoration  of  the  course  of  the 
disease,  fie  also  injected  it  in  many  cases  exposed  to 
diphtheria,  it  proving  an  efiicient  presentation  to  the 
contagion. 

KXPEN8E  OF  DISFBNSmO  ALKALOIDAL 
PBEPARATIOKS. 

This  is  a  topic  which  can  not  fail  to  interest  all,  for, 
with  the  existing  antagonism  of  the  druggists,  if  for  no 
other  reason,  physicians  will,  for  the  present  at  least, 
be  compellea  to  supply  their  own  medicines. 

Experience  in  an  extensive  general  practice,  embrac- 
ioff  both  city  and  country,  in  which,  inside  and  out- 
side the  office,  practically  everything  is  supplied,  our 
average  expense  does  not  exceed  three  per  cent  of  the 
work  done  on  an  ordinary  range  of  fees. 

Thb  we  hold  is  paid  back  manifold  in  convenience  to 
theprescriber,  in  savins  time,  in  holding  patients,  in 
avoiding  druggists  refilling  of  prescriptions,  in  more 
frequent  consulations,  in  securing  patients  who  prefer 
a  physidao  that  supplies  his  medicines  and  in  th 
ff^eral  satisfaction  of  havinj^  thiuffs  in  ones  own 
hands,  to  say  nothing  about  infinitely  better  success 
and  the  great  saving  to  our  patients,  which  amounts 
in  the  end  to  a  great  saving  to  all  concerned.^— ^(- 
kfdoidal  Clinic 

Akbmia. — I  have  been  using  your  Uemoferrum 
(Steams')  pilloids  with  happiest  results  in  a  case  of 
Anemia.    Keport  from  Dr.  G.  G.  Gk>bar,  Alma,  Wis. 

Send  to  Miagah.,  Warren,  Pa.,  for  samples  of 
medicated  uterine  wafers. 

AXIOMS  OF  HUMAN  LOVE. 

Dr.  Paolo  Montegazza,  a  scholar  of  international 
reputation,  has  made  an  exhaustive  study  of  the  human 
emotions.  Some  of  hb  conclusions  recorded  in  **  The 
Physiology  of  Love,"  are  as  follows : 

To  sav  that  in  life  we  can  love  but  once  is  to  utter 
one  of  the  greatest  effronteries  of  which  love  is  daily 
guihy. 

To  pretend  that  a  prudent  marriage  generates  love 
is  the  same  as  to  sow  pumpkins  and  wish  them  to 
produce  radons. 

To  please  a  woman  is  a  phrase  that  expresses  the 
sum  of  a  hundred  virtues  siid  a  thousand  artifices. 

He  who  has  loved  and  has  been  loved,  even  for  a 
day,  has  no  right  to  curse  life. 

To  preserve  the  love  of  a  man  or  a  woman  it  b 
necessary,  alter  having  won  it,  to  win  it  again  every 
day. 

One  can  love  platonically  for  life,  as  one  can  be  a 
great  man  without  having  ever  won  a  battle,  invented 
a  machine  or  written  a  book ;  but  in  one  case  and  the 
other  humanity  has  the  right  to  ask ,  **  A  quoi  bon  ?" 

It  b  our  own  fault  if  we  are  not  loveiL  Thb  dogma 
it  eternal  as  the  world,  ancient  as  man.  immutable  as 
the  laws  which  govern  the  physics  of  the  universe. 

The  woman  we  love  b  always  an  angel ;  she  is 
mother,  sister,  daughter,  wife.  The  woman  we  do  not 
love  b  only  a  female,  even  were  she  as  beautiful  as  the 
Pomaiina,  as  plastic  as  the  Venus  of  Biilo. 

Waiting  cores  caprices  and  streoghten  true  love, 
waiting  kiUs  falae  loves  and  makes  the  tnie  ones  great 
and  noble ;  to  wait  means  to  be  sincere^  pmdent,  good, 
holy. 


To  love  for  an  hour  b  natural  to  every  animal ;  to 
love  for  a  day  b  natural  to  every  man ;  to  love  for  a 
lifetime  belongs  to  the  angels ;  to  love  for  a  lifetime 
and  one  creature  only  b  of  the  gods. — Pacific  Beoord 
Medical  and  SurgicaL 

The  Medical  Golden  Rule.—-"  I  feel  constrained 
for  once  to  give  vou  a  eolden  rule.  It  b  never  to 
speak  ill  of  any  of  your  Mtemity,  whatever  yon  may 
think.  You  will  do  your  self  no  good,  and  it  will 
only  be  thought  that  you  are  jealous." — Dr.  ChuUr- 
fidia  LeU&n  tohia  Son. 

Nux  vomica  has  long  been  reoo^ized  as  one  of  the 
best  tonics  Send  10  cents  to  the  rhila.  Granule  Co., 
No.  10  South  18th  St.,  Philadelphia,  Pa.  for  100  (or 
65  cts,  for  1000)  ^nules  of  its  active  principles, 
strychnine  or  brucine.  They  are  convenient  for  the 
patient  to  carry  in  the  pocket. 

Dr.  Sam. 

BT  EUGENE  FIELD. 

Down  in  the  old  French  quarter 
(Just  out  of  Bampart  street) 
I  wend  my  way 
At  dose  of  day 
Unto  the  quaini  retreat 
Where  lives  the  Voodoo  doctor. 
By  some  esteemed  a  sham — 
Yet  I'll  declare  there's  none  elsewhere 
So  skilled  as  Dr.  Sam. 

With  claws  of  a  devilled  crawfish, 
The  juice  of  a  pricklj-prune. 
And  the  quivering  dew 
From  a  yarb  that  grew 
In  the  light  of  a  midnight  moool 

I  never  should  have  known  him 
But  for  the  colored  folk 
That  here  obtain 
And  ne*er  in  vain 
That  wizard's  arts  invoke  ; 
For  when  the  Eye  that's  Evil 

Would  him  and  hb'n  damn, 
The  n^^  s  grief  gets  quick  relief 
Of  Hoodoo-Doctor  Sam  I 

With  the  caul  of  an  alligator. 
The  plume  of  an  unborn  loon, 
And  the  poison  wrung 
From  a  serpent's  tongue 
By  the  light  of  a  midnight  moofti 

In  all  neurotic  ailments 
I  hear  that  he  excels, 
And  he  insures 
Immediate  cures 
Of  weird,  uncanny  speUs ; 
The  most  unruly  patient 
Gets  docile  as  a  lamb 
And  b  freed  from  ill  by  the  potent  skill 
Of  Hoodoo-Doctor  Sam  I 

Feathers  of  strangled  chickens, 

Moss  from  the  dank  lagoon, 

And  plasters  wet 

With  spider  sweat 

In  the  light  of  a  midnight 

They  say  when  nights  are  grewsome 

And  hours  are,  oh  I  so  late, 

Old  Sam  steab  out 

And  hunts  about 

For  charms  that  hoodooe  hate ! 

That  horn  the  moaning  river 


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And  from  the  haunted  glen 
He  silently  brings  what  eerie  things 
Giyepeace  to  hoodooed  men — 

llie  tongne  of  a  piebald  possum, 
The  tooth  of  a  senile  coon, 
The  buaiard's  breath  that  pants  for  death, 
And  the  film  that  lies 
On  a  lisard's  eyes 
'Neath  the  light  of  a  midnight  moon  I 

N.  T.  Med.  Exam. 

Hare  yoa  tried  the  cure  for  the  morphine  habit  made 
bj  B.  Keith  &  Co^  75  William  8t,  New  York,  N.  Y.  1 

For  three  chlorides  and  Tri-Iodides,  address  Bens 
A  Henry  Pharmacal  Co.,  Looisrille,  Ey. 

Oolltotiona: 

We  beUere  that  the  experience  of  others  who  supply 
their  own  drucs,  especially  those  who  dispense  the 
alkaloids,  will  hear  us  out  in  the  assertion  that  the 
dispensing  phy^cian  can  coUect  a  much  greater  per- 
centage of  his  fees  than  the  one  who  prescribes.  Most 
of  the  sickness  is  amour  the  poorer  classes,  because 
there  are  many  more  of  Uiem,  and,  too  often  whra  the 
medicines  are  paid  for  there  is  nothing  left  for  the 
doctor.  People  are  not  slow  to  learn  who  cares  for 
them  the  most  pleasantly  and  economically,  but  phy- 
sicians are  too  slow  in  settng  the  inestimable  advantage 
to  themselres  of  dispensing,  especially  when  the 
alkaloidal  preparations  are  lued.  The  pendulum  has 
attained  its  maTJmnm  and  is  now  coming  this  way. 
By  and  by  the  physician  will  practice  medicine,  and 
not  the  dtrk  in  the  corner  drug  store. — The  Alkaloidal 
CUme. 

Atropine,  the  actire  principle,  is  more  efficacious 
than  the  tincture  of  beUaoonna,  but  the  the  trouble  is  to 
dispense  it  accurately  in  the  exceedingly  small  doess 
required.  Send  10  cts.  to  the  liiila.  Granule  Co.,  No. 
10  South  18th  8t.«  Phihidelphia,  Pa.,  for  100  (or  66 
cts.  for  1000)  of  their  elecant,  accurate  and  economical 
granules  of  atropine.  After  using  these  you  will 
nerer  again  go  back  to  the  crude  preparations. 

Mr  Wm.  Eoehlf  of  Erie,  Pa.,  has  bought  out  the 
extenaire  plant  of  the  Gowanda  Paper  Box  Co.,  of 
Gtowanda,  N  Y.  He  manufactures  paper  boxes  of  all 
descriptions.  A  special  feature  is  tne  manufacture  of 
pill  and  powder  boxes  and  lables.  Address  Wm* 
Koehl,  1017  Peach  St.,  Erie,  Pa. 

Mellin's  Food  is  a  prise  artide.  It  receired  highest 
awards  at  the  Worlds  Fair. 

For  Passiflora  Incamata,  the  new  nerve  sedative, 
address  John  B.  Daniel,  84  WaU  St.,  Atlanta,  Ga. 

A  boy  whose  leg  was  repaired  in  New  York  hj 
grafting  some  skin  from  a  dog  complains  now  that  hu 
2iin  bM'ks  easUy. 

<'  I  Have  Found  It" 
Dr.  L.  M.  Roberts,  of  Little  Falls,  Minn.,  writes  Oct 
81st,  1898,  to  Jerome  Kidder  Manufacturing  Co., 
820Broadwav,  New  York:  ^^Dear  8irs:-InstructioBS 
came  to  hand.  Well  I  will  say  that  after  12  years  of 
searching  all  the  shops  of  the  various  manufactur 
after  trying  a  half  dosen  different  makes  for  yeai 
after  seeing  foreign  exhibits— I  have  but  one  wi>rd  to 
apply  to  this  new  ooii  you  have  sent  me  ''Eureka" 


^i 


(which  woid  translated  means  "I  have  found  it"). 
So  far  as  I  have  been  able  yet  to  test  it,  it  is  a  revela 
tion  in  mechanics  and  therapeutio  range — it  is  an 
"  Unicom."* 

Adjectives  fail  me  in  my  effort  to  express  my  appre- 
ciation of  it — how  puny  and  ridiculous  my  erstwhile 
finely  appointed  apparatus  looks  by  side  of  Ic — and 


best  of  all  is  its  simplidtj — multiform  are  its  coils  and 
appointments— yet  as  simple  to  operate  as  <mm  coil, 
household  coil,  and  that  rheostat  u  a  great  thing— 
nothing  like  it  in  anv  other  electrial  apparatus  I  ever 
saw — gives  instant  absolute  control  of  any  current,  and 
so  finely  increased  or  diminished,  that  a  child  caatot 
complam. 

Akdkbsoh,  Ivd  ,  February  Tth,  1893. 

Enclosed  find  Postal  Note,  for  wluch  send  me  one 
double  box  Freligh's  Tablets.  Have  used  samples 
sent  me  and  they  act  like  a  charm. 

Class  of  1874.  Masoh  Y  .  Hmnr,  M.D., 

For  cut  rates  in  first-class  surgical  instruments 
address  I.  Phillips,  Atlanta,  Ga. 

Have  you  yet  tried  Sennine,  the  new  antiseptic  T 
Send  for  sample  to  Dies  Chem.  Co.,  St  Louis,  Mo. 

Your  dyspeptic  patients  should  use  Peter's  Fcp^c 
Essence.  Address,  Arthur  Peter  &  Co.,  Louisville^  Ky. 

California  Fig  Syrup  is  pronounced  the  standard 
family  laxative. 

We  have  always  had  satisftu^ion  with  the  supporters 
and  other  elastic  goods  we  have  purchased  from  G. 
W.  Flavell  &  Bro.,  1006  Spring  Garden  St.,  Phila. 

In  the  treatment  of  gonorrhea  and  gleet  try  the 
soluble  bougies  made  by  Charles  L.  Mitchell,  M.D., 
1016  Cherry  S^  Phila. 

For  a  positive  antidote  for  tobacco  address  F.  H. 
Amlar,  Jackson,  Mich. 

See  the  excellent  adv.  of  the  Ewell  Trass  Co^ 
(Rochester,  Mich.)  in  this  issue. 

See  the  sample  offer,  4  preparations  for  fl.OO,  of  the 
WalkeisGreen  Pharmacal  Co.,  Kanas  City,  Mo. 

Have  you  a  dry  battery?  Write  to  the  Oiloride  of 
SUver  Dry  Cell  Battery  Co.,  Baltimore,  Md. 

Do  not  send  your  hernia  patients  to  the  truss  maker. 
Cure  them  with  Dr.  Walling*s  Hernial  Fluid  and  set 
a  big  fee.  You  make  the  injection,  the  fluid  doss  the 
rest.    See  his  special  offer  in  adv. 

OHBOKIO  ORAHUULB  PHABTHOITIB. 

I  am  better  pleased  with  s^rup  of  hydriodic  acid, 
than  with  any  prepasation  of  iodide  I  h«ve  ever  and. 
Its  prompt  and  permanent  action  in  a  case  of  chronie 
granular  vdiaryngitis  was  simplv  marvelous  to  me.  A 
ShUd  of  six  years  whose  tonsils  had  temained  enlaiged 
for  about  twelve  months  was  given  the  following : 

R.  Syiap  add  hydriodlo  (Host«lley'i)...oiiDe6B  iv 
Signa.— Half  leaspoonftil  in  water  four  tisses  dally. 

After  two  weeks  of  the  above  treatment  the  toniife 
became  imperceptible.  The  syrup  of  hydriodic  add 
is  a  valuable  alterative  and  discutient. 

D.  F.  Dbicfsst,  M.D., 


Madisonville,  Ey. 


HAT  FKTSB. 


Dr.  T.  E.  Beall,  of  Columbus,  Ohio,  controb  obsli- 
of  hay  fever  with  the  following : 


R.  Qjrr  aeldhydrlodSo(Ho8tdley>)^ 
8ig.— Twenty  mlntaDS  in  water  every  two  noma. 

The  worst  cases,  the  Doctor  writes,  will  jiM  to  the 
above  treatment  when  other  medication  fails. 

A  prominent  physician  of  Des  Moinee,  Iowa,  writes 
to  the  Abbtitt  Alkaloidal  Company,  Bavenswood,  di^ 
cago^  as  follows :    '*  The  order  enclosed  marks  the  end 
iOmUmed  <m  not  kttf,) 


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Tltf  Mmemiidrf  thai  a  man  can  use  is  thg  only  real  knowledgt;  the  only  know- 

uSetLu  has  life  and  growth  in  it  and  converts  iUelf  into  fradical  ^wer.     The 

fut  hangs  lihe  dust  about  the  brain,  or  dries  lihe  raindrops  of  the  siones.^TROxnmr 


iThe  Medical:  World. 


If O0ITBZ.T,  by  C  P.  TATXXkR,  If.  D. 


CP.Tati<o&,M.D.» 
J.  J.  Taylor,  M.  D.. 


?Bdi»okb. 


I  to  any  put  of  the  United  States  and  Canada, 
Okb  DoLi.Am.  per  year.  To  England  and  tbe  British 
Ooioniea,  Pivs  Smxiiroa  per  year.  Pottage  free. 
•iBgle  ooplei,  TBir  Cbmts.  Theae  ratea  must  be  paid 
jmwmHaMjFJm  advamd. 


t  always  aopply  baek  numbers.  Should  a  num- 
ber fall  to  reach  a  subscriber,  we  will  supply  another, 
if  aotifled  before  the  end  of  the  month. 

IT  >o  nootiey  to  agenta  for  this  journal  unless  publlaher*s 
letaipt  is  giren. 


ALL  Communications  to 
'THE  MEDICAL  WORLD," 
iSso  Chestnut  Street, 

FHILADHLPHIA.  PA. 


VoL  Xn.         OcroBEB,  1894 


Na  10. 


The  New  DIphtheHs  Anti-Toxine. 

The  progress  of  medical  sdenoe  at  the  present 
time  is  80  rapid  aa  to  almost  make  one  dizacy  to 
keep  pace  with  it  The  particular  field  of 
activity  a  few  yean  ago  was  in  the  isolation 
and  identification  of  tiie  various  specific  dis- 
ease germs  and  the  demonstration  of  their  cans- 
ative  relation  to  the  diseases  m  which  they  are 
fonnd  active.  This  cleared  np  the  mists  in 
which  we  had  heen  groinng  and  showed  ns 
dearly  the  enemy  at  which  we  had  been  firing 
at  random  ibr  ages  and  cycles  that  are  pasi 
This  has  shown  ns  a  better  choice  of  weapons 
and  given  ns  a  far  greater  accuracy  of  aim. 
The  tlMrapeutic  results  are  not  slow  to  follow. 

The  science  of  physiological  chemistry  has 
ghren  ns  scmie  surprising  results,  with  far  more 
praniang  indications  for  the  future,  along  the 
fine  <iat  laid  down  by  the  immortal  Brown- 
flequard.    It  is  to  be  i^retted,  although,  per- 


haps, unavoidable,  that  it  should  have  been 
brought  somewhat  into  disrepute  by  charlatanist 
imitators. 

But  the  particular  field  of  progress  now  seems 
to  be  in  the  domain  of  bacteriological  chemistry, 
in  which  great  achievements  are  being  accom- 
plished. 

The  discovery  made  by  Jenner  years  ago  was 
purely  one  of  empiricism.  He  found  out  that; 
if  he  would  fire  in  a  certun  direction  through 
the  mist,  he  would  hit  the  enemy.  But  he  did 
not  know  who  or  what  the  enemy  was.  Now  we 
know  definitely  not  only  the  small- pox  enemy, 
but  the  hosts  of  others  of  a  somewhat  analogous 
nature.  Having  first  revefded  them  to  us,  the 
bacteriological  laboratory  is  now  preparing  for 
us  the  most  eflBdent  weapon  with  which  to  com- 
bat and,  possibly,  exterminate  these  microscop- 
ical hosts. 

The  profession  is  already  aware  of  the  work 
of  Pasteur  in  elaborating  the  preventive  treat- 
ment of  hydrophobia.  Also,  the  work  of  vari- 
ous investigators  that  demonstrated  the  antag- 
onism of  the  erysipelas  toxines  to  cancerous 
growths.  The  latest  achievement  in  this  Ime  is 
the  prevention  and  cure  of  diphtheria  by  meaai 
of  the  diphtheria  anti-toxine,  which  has  been 
accomplished  by  Prof.  Robert  Koch,  of  Berlin. 

Thus  far  it  shows  a  snooeas  of  100  per  cent 
when  used  as  a  preventative  and  also  when  used 
on  the  first  day  of  the  development  of  the  dis- 
ease ;  97  per  cent  when  used  on  the  second 
day,  its  v|lue  declining  rapidly  when  employed 
after  the  second  day.  Subsequent  experimenta- 
ti<m  may  still  further  perfect  it,  or,  on  the 
other  hand,  experience  with  especially  severe 
epdemics  may  reduce  the  record  of  its  efficiency. 
The  techni|ue  of  the  development  of  the  anti- 
toxine  is  thus  described  by  Dr.  Hermann  M. 
Biggs,  who  was  sent  by  the  dty  of  New  Ycurk. 
to  investigate  the  subject : 

<<  Bacilli  are  taken  from  a  patient  sufifering 
from  diphtheria,  and  after  these  have  have  beeo 


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proven  of  the  genuine  diphtheria  specieB  they 
are  pat  away  in  broth,  and  after  aiz  weeks  a 
new  crop  has  formed.  A  email  namber  of  the 
iMualli  are  injected  under  the  skin  of  the  animal 
which  is  to  be  rendered  immune.  The  swelling 
{irodnced  by  the  injection  subsideB  after  a  short 
time,  and  a  second  and  somewhat  larger  dose  is 
administered.  Thus  the  doses  are  increased 
from  day  to  day  until  the  virus  ceases  to  have 
any  perceptible  effect  on  the  animal  Then, 
when  neither  its  temperature,  appetite,  nor 
digestion  is  afifected,  its  blood  contains  the  anti- 
(oxine,  and  this,  when  injected  into  the  system 
of  the  diphtheria  patient,  has  the  beneficial 
*<effect  above  mentioned.'' 

We  select,  also^  the  following  from  the  longer 
statement  made  by  Dr.  Cyras  Edson,  of  the 
New  York  Gty  Board  of  Health : 

''The  new  antitoxine  treatment  for  diph- 
theria which  has  been  worked  out  in  the  Koch 
Institute  for  Infectious  Diseases  in  Berlin  prom- 
ises to  be  one  of  the  most  important  discoveries 
of  modem  medicine,  and,  so  far  as  can  be 
judged  from  the  data  at  hand,  will  afiford  us 
the  means  for  not  only  protecting  persons  from 
diphtheria  who  have  been  expDsed  to  the  dis- 
ease, but  also  a  certain  means  for  the  cure  of 
the  disease  when  cases  are  subjected  to  treat- 
ment in  the  early  stages. 

"  One  of  the  most  important  and  significant 
features  of  the  treatment  depends  upon  the  ab- 
solutely innocuous  character  of  the  remedy,  it 
having  apparently  no  influence,  either  favorable 
or  unfavorable,  in  health  or  in  disease,  except- 
ing as  to  its  power  of  neutralizing  tha  poison  of 
diphtheria ;  so  while  it  has  enormous  capacity 
for  good,  its  use  is  absolutely  devoid  of  danger. 
The  treatment  is  based  upon  the  following 
observations : 

**  First — In  diphtheria,  death,  as  a  rule,  is 
due  to  the  poisoning  by  a  chemical  substance 
(a  toxine)  produced  by  the  diphtheria  bacillus 
in  the  throat  and  absorbed  by  the  system  from 
the  throat 

"Second — A  certain  degree  of  immunity, 
which  is  temporary  only,  is  afforded  by  one  attack 
of  diphtheria,  ana  this  immanity  is  tiie  result  of 
an  acquired  tolerance  of  the  toxine.  This  ap- 
plies to  both  animals  and  man. 

''Third — If  large  animals,  such  as  horses, 
cows,  goats,  etc.,  are  inoculated  with  minute 
but  increasing  quantities  of  the  *  toxine/  as  de- 
rived from  culnires  of  the  diphtheria  bacillus, 
they  become  gradually  tolerant  to  its  poisonous 
action,  and  will  withstand  the  introduction  of 
larger  and  larger  quantities  through  the  im- 
munity which  is  acquired  from  smaller  doses. 

"Fourth — ^The  immunity  thus  produced  is 


the  result  of  the  development  in  tiie  blood  of 
some  substance  (anti-toxine),  whidi  has  the 
power  of  neutralizing  the  poison  (toxine)  pro- 
duced in  diphtheria,  and  in  animals,  which 
have  been  highly  immunized  (i  «.,  capable  of 
withstanding  very  large  doses  of  the  toxine 
through  repeated  inoculations  of  doses,  minute 
but  constantly  increasing  in  size),  the  blood, 
even  in  small  quantities,  acquires  the  powtf  of 
neutralizing  very  large,  even  fatal,  qomititiei 
of  the  toxine. 

"  Fifth — When  animals  have  thus  been  im- 
munized, blood  is  withdrawn  from  the  circulatioo 
in  quantities  varying  with  the  size  of  the  ani- 
mal, and  is  employed  through  injections  unde^ 
neath  the  skin  for  the  treatment  of  cases  of 
diphtheria,  and  anti-toxine  thus  introduced  neu- 
tralizes the  toxine  absorbed  into  the  drcolation 
of  sick  persons  from  the  throat,  and  thus  ren- 
ders them  artificially  unsusceptible  to  its  actioo. 
By  this  method  it  is  apparently  possible  to  pro- 
tect any  person  from  the  ccmtraotion  of  diph- 
theria wheniie  has  been  exposed  to  the  disease 
and  infected,  if  the  symptoms  have  not  yet  ap- 
peared, and  also  to  cure  nearly  100  per  eeoL  of 
cases  where  patients  are  treated  in  the  early 
periods  of  the  disease.  •  Unfortunately,  how- 
ever, for  the  rapid  and  general  use  of  this  sub- 
stence  for  the  treatment  of  diphtheria,  its  pro- 
duction requires  the  constant  surveillance  of 
skilled  and  trained  men  ;  a  comparatively  long 
period,  often  four  to  six  months,  is  necessary 
to  render  animals  immune  to  the  disease,  so 
that  their  blood  can  be  employed  for  the  treat- 
ment ;  and  finally,  when  thus  rendered  immm^e, 
they  can  furnish  only  sufficient  blood,  as  a 
rule,  to  treat  a  comparatively  small  number  of 
cases.  Therefore,  the  production  of  the  sub- 
stance must  necessarily  be  costly,  and  it  can 
only  be  produced  in  sufficient  quantities  and  be 
placed  at  the  disposal  of  poor  people  by  moni- 
dpal  and  state  sanitary  authorities." 

The  City  of  New  York  has  taken  steps  to  es^ 
tablish  stations  throughout  the  city  for  the  treat- 
ment of  patients  afflicted  with  diphtheria. 


The  Eucalyptus  Tree.— \  Cherished  Idol  Broken. 

According  to  the  investigation  made  by  the 
Department  of  State,  the  anti-miasmatic  prop- 
erties of  the  eucalyptus  trees  are  almost  entirelj 
mythial. 

*^  It  is  even  asserted  that  not  a  single  instance 
of  health  improvement  by  means  of  the  plant 
has  been  satisfactorily  established.  In  Italy  it 
has  been  cultivated  on  a  very  large  scale,  par- 
ticularly in  the  neighborhood  of  Rome,  without 
accomplishing  any  results  convincingly  fiivor- 


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able.  The  popular  notion  that  where  the  enca- 
Ijptus  thriyes  there  can  be  no  malaria  is  so  far 
from  being  correct  that  there  are  natural  for- 
ests of  native  eucalypti  in  Australia  in  which 
pestilential  miasma  reigns  supreme. 

"  One  notable  experiment  was  made  in  1870 
at  a  distance  of  one  mile  from  the  city  of  Rome 
in  a  locality  known  as  the  <  Three  Fountains/ 
where  there  was  an  ancient  convent  In  that 
place  malaria  had  been  so  prevalent  and  de- 
structive of  life  that  it  was  commonly  known  as 
*  The  Grave.'  A  few  monks  made  a  practice 
of  going  hither  every  morning  after  the  sun 
had  cleared  away  the  fog,  planting  as  many 
eucalyptus  trees  as  they  could  during  the  day 
and  returning  to  Rome  in  the  evening.  Seven 
years  later,  owing  to  the  greatly  improved  con- 
dition of  the  dimate,  the  monks  took  up  their 
permanent  residence  at  the  convent  This 
event  made  such  an  impression  that  the  Gov- 
ernment offered  a  reward  for  the  culture  of  the 
eucalyptus. 

<*  Nevertheless,  a  few  years  later,  notwith- 
standing that  55.000  of  these  trees  had  been 
planted  at  the  Three  Fountains,  malarial  fever 
became  as  bad  as  ever  there,'  causing  many 
deaths  in  a  colony  of  ccmvicts  that  had  been  es- 
tablished on  the  spot.  Dr.  Montechiare,  a 
physician  of  Rome,  decided  that  the  efficacy  of 
the  tree  for  the  improvement  of  the  air  was  no 
greater  than  that  of  the  elm  or  pine. 

''Prof.  Cnideli  declares  that  of  all  disease- 
breedbg  germs  the  microbes  of  malaria  are 
most  widely  disseminated  and  most  readily  find 
conditions  suitable  for  their  propagadon,  ex- 
cepting only  the  bacteria  which  cause  blood 
poiscming.  The  malarial  germs  dwell  in  the 
soil  and  are  developed  in  moist  and  warm 
weather.  They  require  a  temperature  of  at 
least  68  degrees  Fahrenheit  in  order  to  multi 
ply  and  diflufe  themselves  in  the  atmosphere. 
Human  beings  then  take  them  into  their  lungs 
in  breathing,  and  in  this  way  they  get  into  the 
blood.  Malaria  producing  soils  are  to  be  found 
in  nearly  every  part  of  this  globe." 

Thorough  drainage  and  cultivation  of  a 
country,  with  destruction  of  all  decaying  vege- 
tation, including  fallen  trees  and  fallen  branches, 
seems  to  be  successful  in  dispelling  malaria. 
The  great  Ohio  Valley  is  said  to  have  witnessed 
this  complete  transformation  within  the  past 
few  years. 

Do  joa  know  of  the  recent  redaction  in  price  of  P. 
0.  Money  Orders  ?  Three  cents  wiU  get  an  order  up 
to  $2.50,  and  five  cents  np  to  $5.00.  This  cont  is  verj 
trifling,  and  it  is  the  safest  way  in  which  to  send 
money  by  mail— it  is  absolately  safe— safer  than  by 
r^pstered  letter,  and  that  costs  eight  cents. 


Qriginal  Gommunioations. 


Short  artldes  on  the  tveatment  of  diae— w,  and  ejipeilcnci 
with  new  remedlet,  are  aoUdted  from  the  profegrion  Sm 
this  department;  also  diflfinilt  cases  for  diagnosii  and 
treatment 

Articles  accepted  must  be  oontrlhttted  to  this  Joomal  . 
The  editors  are  not  responsible  for  views  expressed 
oontributors. 

Oop7  mnst  be  received  on  or  before  the  twelfth  of  ths 
•   month  for  publication  in  the  next  month.     Unnsed 
Manuscript  cannot  be  returned. 


Otrtatnfyiiis 


an  author  tofeeliMmik$ 
fewest  potsihie  words  t  ee 


must  iay  oil  he  keu  to  Maif  im  i     ^  

his  reader  is  sure  toskifthem;  and  in  the  plainest  possikk 
words^  or  his  reader  wut  certainfy  misunderstand  them, 
Gener€My,  also^  a  downright  fact  may  be  told  in  a  piaim 
way:  and  we  want  downrif hi  facts  at  present  more  them 

READ.     REFLECT.     COMPARE.     RECORD. 

Notes  end  Commeiitt. 

Editor  Medical  World  : — On  page  334 
R  M.  N.  describes  a  case  of  epilepsy.  1  would 
suggest  the  bromide  of  lithiam,  20  grains,  three 
to  six  times  a  day.  The  scar  should  be  cul 
loose  from  the  bone,  subcutaneously,  and  kepi 
free  by  daily  massage. 

The  question  asked  by  Dr.  Walling  (page 
334)  is  of  great  importance.  I  think  two  ini»- 
provements  should  be  made  in  the  communion 
service :  the  use  of  individual  cups,  and  the  die- 
use  of  wine.  The  practice  of  passbg  a  cup 
from  lip  to  lip  Hb  filthy,  and  liable  to  transmit 
the  most  loathsome  of  diseases.  There  are  men 
who  must  not  touch,  taste,  handle  or  smell  an  j* 
thing  alcoholic ;  and  for  their  sakes  an  unfer- 
mented  grape  juice  should  be  substituted  for 
wine. 

Dr.  Shaw  ought  to  find  relief  from  the  iodide 
of  rubidium,  with  massage  of  the  joints,  chamois 
skin  underwear,  oil  inunctions  and  the  use  of 
resorcm  in  full  doses,  to  render  the  intestinal 
canal  aseptic  If  not,  she  must  go  to  Southern 
California,  and  stay  there. 

Dr.  Bobb  (page  334)  may  have  a  case  ot 
calculus  on  hand,  and  should  examine  the  pa^ 
tient's  bladder.  If  not,  inject  into  the  urethra  a 
few  drops  of  cocaine  in  petrolatum,  ten  grains  to 
two  drams,  passing  it  into  the  neck  of  the  blad- 
der. 

Dr.  Oehme  may  restore  the  register  of  his 
thermometer  by  heatbg  up  to  105^,  and  then 
plunging  the  bulb  into  cold  water.  But  he  will 
have  to  test  the  instrument  again,  as  it  may  not 
register  correctly.  The  best  way  is  to  get  a  new 
one,  and  do  not  try  to  get  the  mercury  down  by 
jarring  it,  but  only  by  swinging  free. 

WiU  Dr.  W.  F.  (page  336)  give  his  patient 
a  20  grain  suppository  of  quinine  every  other 
day  for  a  week  ?  This  may  clear  up  the  diag- 
nosis.     I  would  take  a  look  at  the  hygienic  i 


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dition  of  the  house  and  grounds  also.  The  solid 
«tick  of  nitrate  of  silver  a3plied  over  the  spine, 
s.  strip  an  inch  wide,  would  be  advisable. 

For  Eli's  case  of  pruritus  (page  335)  I  would 
advise  the  following : 

R.  SodU  Salicylate drains  i 

Add  carbolic drams] 

Ung.  hydrazg.  nitrate ounces] 

If  too  strong,  dilute  with  petrolatum.  Apply 
night  and  morning.  Give  internally  salicylate 
of  soda,  gr.  z,  colchicine,  gr.  y^,  four  times  a 
day.  Tell  him  not  to  eat  too  rich  food  or  drink 
much  cofiee  or  malt  liquor,  or  eat  tomatoes. 

Good  chiropodists  do  not  soften  corns  before 
removing  them.  Those  who  do,  use  liquor  pot- 
assa,  diluted  somewhat 

Dr.  King  might  look  for  a  retropharyngeal 
abscess  or  tumor  springing  from  the  body  of  a 
cervical  vertebra,  or  for  a  thoracic  aneurisnL 

Dr.  Horton  (page  336)  asks  about  the  solar 
cautery.  Take  a  burning-glass,  concentrate  the 
rays  of  the  sun  on  the  affected  part,  and  con- 
tinue until  the  skin  is  reddened. 

Dr.  Sei&s  will  not  find  anything  but  the  knife 
of  use  for  an  osteoma ;  and  he  would  better  not 
wait  very  long  before  using  it 

A  good  chiropodist  will  take  out  a  com  with- 
out pain  or  blood.  The  brown  salve  was  prob- 
ably a  fake.  Aconite,  cocaine  or  iodine  might 
be  used  in  the  way  Dr.  Blythe  suggeetS'  (page 
336),  but  they  are  unnecessary.  Grood  eye- 
sight, a  steady  hand  and  a  sharp  knife,  are  all 
the  requisites. 

William  F.  Waugh,  M.D., 

103  State  st,  Chicago,  Ul. 

£Dr.  Waugh's  excellent  article  on  narcoma- 
nia, detailing  cases,  is  necessarily  held  over,  on 
account  of  being  received  too  late. — Ed.] 


Death  From  Sloughing  of  Both  Hypogastric  Arte- 
ries, and  the  Uraohus,  with  Autopsy. 

Editor  Medical  World  : — Dr.  Skinner,  of 
Cook  County  Hospital,  kindly  invited  me  to 
perform  the  autopsy  on  the  abdomen  of  a  child 
which  died  two  weeks  after  birth.  The  child 
was  brought  to  the  hospital  a  f dw  days  before 
death,  wiUi  obscure  symptoms.  It  was  extremely 
^nuidated,  and  the  ddn  was  of  a  saffron  color. 
The  navel  showed  a  little  secretion,  enough  to 
wet  the  cotton  applied  to  it,  but  it  secreted  so 
little  that  at  the  circumference  the  secretion 
dried,  and  made  the  dressings  adherent  Upon 
opening  the  abdomen,  fluid,  fibrine  and  coagu- 
lated  blood  was  seen  over  two  inches  square. 
There  was  probably  an  ounce  of  blood  in  the 
abdominal  cavity.  A  little  over  half  an  inch 
below  the  navel  there  wi»  a  solid  mass  (I  cut 


into  the  abdomen  an  inch  to  the  left  of  the 
navel).  On  breaking  away  the  mass  it  proved 
to  be  the  lower  border  of  the  omeotum,  which 
was  surrounding  a  necrotic  process  attacldng  the 
two  hypogastric  arteries  and  the  urachus.  Both 
the  arteries  were  entirely  sloughed  away  for 
half  an  inch,  as  well  as  the  urachus.  The  whole 
mass  had  been  entirely  circumscribed  by  the 
omentum — ^the  abdominal  surgeon's  beet  friend. 
Suddenly  the  circumscription  gave  way,  and  the 
child  slowly  bled  to  death,  as  was  shown  by  the 
three  stages  of  blood,  viz :  tough,  fibrinooa,  co- 
agulated fluid.  I  then  careiblly  passed  a  probe 
through  the  umbilicus  into  the  necrotic  cavity, 
showing  that  the  infective  process  came  from 
without  The  infection  was  no  doubt  carried  to 
the  child  by  the  unclean  midwife.  The  yellow, 
saffron  color  of  the  child  was  explained  by  the 
infection  being  carried  up  the  umbilical  veb 
ani  infecdng  the  liver.  On  incising  the  liver, 
its  tissue  was  as  yellow  as  the  skin.  The  liver 
lobes  were  nearly  equal  in  size,  but  the  right 
was  the  larger. 

The  process  was  of  an  intenpe  character,  for 
it  entirely  necrosed  both  the  strong,  thick,  hypo 
gastric  arteries,  as  well  as  the  urachus.  it  was 
not  determined  whether  the  sloughing  extoided 
into  the  bladder,  but  it  reached  almost  to  the 
bladder's  summit 

Thii  case  teaches  how  to  observe  aseptic  care 
with  navel  dressings.  Curiously  (mough,  no 
distinct  peritonitis  could  be  observed,  because 
the  omentum  entirely  surrounded  the  neoiotie 
mass.  The  surrounded  intestines  were  deeply 
oonges^^  The  remarkable  fiMst  that  this  baby 
had  a  long  omentum  (2x2  inches)  is  what  pro- 
longed its  life,  because  it  built  a  barrier  to  pie- 
vent  the  invasion  of  the  infection,  and  success- 
fuUy  oombalted  it  until  the  hemorrhage  from 
perforated  arteries  ended  the  scene. 

The  ignorance  among  iiie  midwives  of  the 
danger  of  infection  is  simply  criminal.  The 
foramen  ovale  was  not  quite  closed  (fourteen 
days),  but  the  valves  of  the  membrane  closing 
the  foramen,  when  pressed  together,  were  water- 
tight Yet  a  fine  probe  passed  the  foramen 
freely.  Byron  Robinson,  M.D., 

34  Washmgton  st,  Chicago,  111. 


Miik  Removes  a  Fishbone  flrom  the  Throat— Coos 

as  an  Aid  in  Cardiac  Dropsy.— Veratrym 

Viridefor  Puerperal  Eclampsia. 

Editor  Medical  World  : — The  following  is 
a  simple  and  effective  procedure  lor  removing  a 
foreign  body,  like  a  fishbone,  from  the  throat: 
Give  about  four  or  six  ounoes  of  milk  to  drinL 
This  can  be  swallowed  usually  with  litUe  diffi- 
culty.     After  about  forty   minutes    give  an 


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emetic  doee  of  sulphate  of  zinc.  The  milk  goes 
down  in  a  fluid  state,  and  easily  passes  the  ob- 
struction; by  a  short  stay  in  the  stomach  it 
becomes  coagulated  into  a  more  or  less  solid 
mass,  and  on  coming  up  forces  the  bone  before 
it.  I  have  not  known  this  to  fail  in  a  number 
of  cases. 

For  obstinate  cases  of  dropsy  (cardiac),  when 
digitalis,  combined  with  the  other  diuretics,  fails 
to  start  the  secretion  of  urine,  and  the  case  is 
going  on  from  bad  to  worse,  I  have  found  that 
in  the  presence  of  coca  the  diuretics  take  power- 
ful effect.  The  urine  is  secreted  abundantly, 
and  the  swollen  legs  and  other  parts  are  reduced 
to  their  usual  size  in  two  or  three  days.  In  a 
case  of  ascites,  where  there  was  much  edema 
also  of  the  legs  and  scrotum,  I  drew  off  the  ab- 
dominal fluid,  but  the  enlargement  of  the  abdo- 
men returned  in  a  few  days.  It  was  such  a 
desperate  case  that  it  seemed  hopeless ;  but  the 
above  treatment  removed  not  only  the  dropsy 
in  the  extremities,  but  also  the  ascites.  This 
was  about  eight  months  ago,  and,  rather  to  my 
surprise,  there  has  been  no  return. 

Up  to  about  one  year  ago  I  Jbad  dreaded  to 
take  up  a  bad  case  of  cardiac  dropsy,  but  I  now 
regard  them  with  pleasure,  for  I  feel  that  I  have 
a  sure  hold  on  a  difficult  condition.  P.  D.  & 
Ca's  elixir  of  coca  acts  better  than  some  other 
preparations  of  coca. 

I  believe  that  tincture  of  veratrum  viride  is 
almost  a  specific  in  puerperal  convulsions  (those 
cases  attended  with  bounding  pulse,  as  most  of 
such  cases  are)  ;  but  it  must  be  given  in  large 
doees  hypodermically— 10  minims — repeated  at 
intervals  of  a  few  minutes  till  30  minims  have 
been  given.  I  used  to  try  chloral,  bromide, 
chloroform  and  bleeding,  and  many  a  time  have 
worked  anxious  hours  over  these  cases,  till,  in 
this  or  some  other  journal,  I  saw  the  suggestion 
in  regard  to  veratrum  viride. 

Brethren,  every  one  of  our  number  has  some 
little  device,  or  valuable  combination  or  proce- 
dure, which  may  seem  to  him  to  be  scarcely 
worth  writing  about,  or  which  he  is  sure  every 
one  knows,  but  which  is  not  known  to  all.  The 
little  ordinary  hints  are  often  most  valuable. 
Let  us  have  them. 

Frank  Van  Allen,  M.D., 

Madura,  India. 


Qiauooma. 


Editor  Medical  World  : — My  only  apolo- 
gy for  presenting  a  paper  on  a  subject  that  pro- 
perly comes  under  the  domain  of  the  specialist, 
18  the  frequency  with  which  the  disease  is  met 
with  by  the  general  physician,  its  treacherous 


nature,  and  the  important  bearing  its  early  re- 
cognition has  on  its  successful  treatment 

The  use  of  terms  unfamiliar  to  the  general^ 
practitioner  have  been  carefully  avoided,  and 
we  will  only  dwell  on  such  points  as  can  be  ob- 
served by  the  family  doctor  without  special^ 
knowledge  or  special  appliances  or  instruments ; 
and  if  you  will  be  enabled  to  make  an  early 
diagnosis  in  the  future  cases  you  meet,  then  the 
object  of  the  writer  will  be  fully  attained. 

CLINICAL  HISTORY. 

The  name,  as  do  many  given  to  diseases  by 
the  older  writers,  comes  from  a  symptom 
(« green  ")  depending  on  the  greenish  reflex, 
from  the  cornea,  which,  by  the  way,  is  not 
the  most  important  symptom. 

In  1862,  Donders  gave  what  is  considered' 
the  best  type  of  the  disease  in  its  simple  form, 
the  chief  symptom  of  which  depends  on  increased' 
hardness  of  the  globe.  With  that  we  notice- 
several  phenomena,  which  need  not  now  occupy 
our  attention.  About  one  person  in  Europe  in 
every  hundred  suffering  from  eye  diseases  has 
glaucoma,  which  percentage  is  not  so  great  in 
the  United  States. 

ETIOLOGY. 

The  disease  is  more  frequent  in  hyperopic- 
eyes,  and  occurs  chiefly  in  persons  over  fifty 
years,  and  in  rare  cases  is  found  in  young  sub- 
jects. It  attacks  both  sexes  with  equal  fre- 
quency, but  is  more  common  among  the  Jewish 
race,  perhaps  from  their  habit  of  marrying  near 
relatives.  Among  them  the  disease  reaches- 
about  four  per  cent  of  all  eye  diseases.  Among 
the  exciting  causes  may  be  mentioned  gout, 
violent  emotional  excitement,  excesses,  insomnia,^ 
heredity,  eye-strain,  rheumatism,  malnutrition,, 
debilitating  diseases,  previous  attacks,  distDa- 
tion  of  atropine  or  hematropine  for  the  purpose 
of  testing ;  also  a  few  cases  have  been  caused 
by  the  use  of  duboisine  and  cocaine,  for  the  same 
purpose. 

The  name  is  now  applied  to  opacity  of  the 
vitreous  humor  or  the  hyaloid  tunic,  manifested 
by  a  grayish  or  greenish  spot,  apparent  through 
the  pupil,  characterized  by  rapidly  increasing 
old  sightedness,  periodical  dimness  of  vision^ 
with  increased  hardness  of  eyeball*  and  anes- 
thesia of  the  cornea  over  its  whole  surface,  or 
in  certain  parts,  besides  several  important 
changes  in  the  eyeball,  which  the  specialist  will 
find  when  the  patient  is  sent  to  him  for  treat- 
ment 

When  inflammatory  symptoms  are  added^ 
then  it  is  called  g,  inflamTnatoria ;  when  the  eye 
is  totally  blind,  g,  absolutum;  when  hemorr* 


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hages  occur,  g.  hemoTrhagicum ;  and  when  that 
form  appears  which  destroys  sight  in  a  few 
hours,  g.  fulminans;  when  it  follows  some 
other  well-known  condition,  disease,  or  operation 
of  the  eye,  it  is  called  Fecondary. 

Symptoms  of  the  simple  progressive  form, 
which,  hy  the  way,  is  the  most  treacherous,  as 
it  comes  on  go  insidiously  that  the  trouble  is 
often  overlooked,  and  attributed  to  other  organs 
or  locations,  may  be  taken  as  a  type  of  all. 
The  moat  important  noticeable  symptom  to  be 
observed  when  you  are  called  to  see  such  a  case, 
is  the  hardness  of  the  eyeball,  and  it  is  well  to 
look  for  it  in  all  cases  of  brow  or  facial  neural- 
gia you  are  called  to  see.  This  hardness  was 
designated  by  Dr.  Bowman  as  T^,  2'^i^2x8_ 
the  first  meaning  that  there  was  questionable, 
the  latter  that  there  was  stony,  hardness.  We 
shall  not  dwell  upon  the  condi  ion  of  cupping 
of  the  optic  nerve  from  pressure,  the  condition 
of  the  veins  or  arteries,  the  narrowing  of  the 
visual  field,  especially  on  the  nasal  side,  the 
loss  of  color  perception,  for  all  these  conditions 
presuppose  special  knowledge  and  special  ap- 
pliances and  instruments ;  but  with  the  above 
we  have  impaired  vision,  which  slightly  im- 
proves during  the  intermission  of  the  disease, 
but  is  more  impaired  after  each  attack,  making 
frequent  changes  of  spectacles  necessary  (espe- 
cially in  hyperopic  or  far  sighted  people)  to 
stronger  ones.  If  you  draw  a  light  film  of  cot- 
ton over  the  cornea  you  will  find  that  it  is 
wholly  or  in  part  anesthetic.  You  will  also 
note  that  the  pupil  is  largely  dilated,  and  doas 
not  respond  readily  to  light ;  that  it  has  a  dull, 
lack-1  aster  appearance,  as  of  grounl  glass;  and 
if  vision  is  still  fair,  the  patient  holds  his  print 
away  from  the  eye,  often  at  arm's  leagth. 

There  may  be  only  a  slight  redness  around 
the  cornea,  or  it  m  ly  be  well  marked.  There 
may  be  little  or  no  pain,  or  it  may  be  so  severe 
as  to  cause  reflex  vomiting  Now,  if  the  stom 
ach  or  liver  is  at  fault,  without  a  careful  ob- 
servance of  the  above  symptoms  you  may  be 
entirely  led  away  from  the  eye,  and  consider 
your  case  one  of  neuralgia,  liver  or  stomach 
disease,  and  prescribe  accordingly,  to  the  detri- 
ment of  your  suffering  patient 

A  mooted  question  for  a  long  time  has  been, 
whether  the  increased  hardness  of  the  eyeball 
depends  on  an  increased  amount  of  secretion,  or 
whether  it  was  due  to  an  interference  with  the 
normal  secretion.  It  is  no  9  generally  believed 
to  be  due  to  the  latter.  Kines  has  demonstra- 
ted in  a  number  of  typical  cases  of  glaucoma, 
that  an  occlusion  occurs  in  the  region  of  the 
ligamentum  pectinatim,  by  the  growing  together 
of  the  cornea  and  the  ciliary  portion  of  the  iris, 
and  further  experiments  on  the  eyes  of  recent 


subjects,  by  straining  fluids,  prove  that  the  nat- 
ural escape  of  the  intraocular  secretions  is  hj 
that  route. 

The  reason  why  youth  is  exempt  so  largelf 
from  glaucoma  is  that  the  diameter  of  the  eye 
ball  increases  from  17  m  m.  to  24  m.m.  between 
youth  and  adult  life,  and  that  the  ball  is  more 
elastic  in  the  former  than  in  the  latter. 

ACUTE   FORM. 

The  acute  form  presents  symptoms  of  an 
acute  inflammation  of  the  eye.  Its  onset  is  sad- 
den, coming  on  at  night,  ofcen  in  gouty  or  rheu- 
matic patients,  sometimes  preceded  by  an  intem- 
perance, a  full  meal,  taking  cold,  excitement, 
and,  as  before  stated,  in  people  with  antero-poe- 
terior  shortening  of  eye  ball,  much  recent  trouble 
often  complained  of  with  their  spectacles. 

The  patient  awakes  with  a  severe  pain  in  the 
eye  (generally  only  one  is  at  first  attacked,  hut 
the  two  may  be  eventually  involved),  extending 
to  the  side  of  the  head,  and,  in  some  patients, 
so  severe  that  it  requires  heroic  doses  of  mor- 
phine or  other  powerful  sedative  to  control  it 
As  a  rule,  vision  rapidly  diminishes  during  an 
attack,  and  may  be,  except  for  quantitative 
perception,  entirely  lost.  Thii  loss  of  vision  is 
due  to  clouding  of  the  vitreous  butnor,  and  may 
rapidly  improve  as  the  tension  diminishes,  to 
become  again  impaired  with  the  next  attack,  or, 
in  the  form  known  as  glaucoma  fulminans,  the 
vision  may  be  permanently  destroyed  in  a  few 
hours. 

CHRONIC   FOBM. 

In  this  form  the  symptoms  are  seldon  severe, 
but  the  vision  impaired  by  each  attack  is  never 
fully  recovered.  The  conjunctiva  now  presents 
few  vessels,  but  a  striking  appearance  is  noted 
in  the  dark  blue  bands  which  ramify  upon  the 
front  of  the  eyeball,  which  gives  the  ^era  a 
leaden  hue,  and  results  from  the  obliteration  of 
the  smaller  arteries  of  the  episcleral  tissue. 

ABSOLUTE  ^OBM. 

The  general  appearance  of  the  eye  in  this  form 
may  be  normal,  or  it  may  degenerate  and 
break  down  from  suppuration  into  a  phthisical 
bulb. 

The  hemorrhagic  form  seems  to  depend  on 
an  atheromatous  conditioi  of  the  vessels  con- 
tained in  the  eyeball,  with  first  obscuration 
from  the  presence  of  blood,  followed  by  pain 
from  pressure  of  the  same. 

8ECONDABY    FORM. 

This  form  may  follow  corneal  ulceration  when 
staphyloma  or  bulging  of  a  part  of  the  eye  ap- 


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pears ;  wounds  with  pinching  of  a  part  of  the 
iris  between  their  edges ;  total  closing  of  the 
pupil  by  attachment  of  the  iris,  called  posterior 
synechia ;  cataract  operations  with  the  forma- 
tion oi  secondary  membrane;  wounds  of  the 
lens,  with  swelling  of  same ;  dislocation  of  lens ; 
growths  of  the  interior  of  the  eye,  or  dropsy  of 
eyeball — hydrophthalmus. 

As  the  case  will  have  reached  the  specialist 
ere  any  of  these  conditions  occur,  we  will  not 
here  consider  them. 

DIAGNOSIS. 

Glaucoma  may  be  mistaken  for  simple  am- 
bliopia,  or  ambliopia  resulting  from  atrophy  of 
the  optic  nerve,  and  at  times  requires  a  nice 
judgment  and  extensive  experience  to  differen- 
tiate. The  tension  or  hardness  of  tie  eyeball 
may  decide  the  question,  but  that  is  not  always 
at  first  well  marked. 

From  other  intermittent  inflammations  of  the 
eye  the  diagnosis  may  be  confirmed  by  the  his- 
tory and  nature  of  the  attack,  the  condition  of 
the  cornea  and  iris,  that  of  the  episcleral  veins, 
and  the  hardcees  of  the  eyeball. 

From  iritis,  by  the  narrowing  of  the  pupil  in 
the  latter,  the  absence  of  hardness  of  eyeball, 
and  the  reflex  lustre  of  the  cornea,  though  at 
time)  we  may  have  both  conditions  together 
present 

From  senile  cataract  (which  may  develop  in 
chronic  glaucoma),  the  diagnosis  is  generally 
made  by  the  clear,  shining  cornea,  the  absence 
of  inflammation,  the  want  of  tortuous  episcleral 
veins,  the  grayish  appearance  of  the  lens,  the 
normal  tension  of  the  eyeball,  the  absence  of 
colored  halo  or  ring  of  varicolored  light,  espe- 
cially when  looking  at  artificial  light;  the 
gradual  loss  of  sight  ih  cataract,  all  tend  to 
make  the  diagnosis  clear. 

From  conjunctivitis,  by  the  presence  of  puru- 
lent discharge  and  the  granular  condition  and 
absence  of  pain  in  the  latter. 

PROGNOSIS. 

The  prognosis  of  glaucoma,  smce  the  intro- 
duction of  iridectomy  and  sclerotomy,  is,  if  the 
case  is  seen  early,  reasonably  good ;  but  if  it  is 
mistaken  for  maturing  cataract,  and  advised,  as 
these  cases  often  are,  to  patiently  await  its 
ripening,  then  the  chance  of  saving  the  remain- 
ing vision  is  in  adverse  proportion  to  the  time 
so  spent 

Should  the  specialist  see  the  case  after  vision 
has  been  greatly  impaired,  he  can  only  hope  to 
save  what  sight  remains.  Some  cases  are 
speedily  checked,  others  simply  delayed ;  while 
others,  despite  the  most  active  measures,  even 


when  seen  early,  go  on  to  permanent  blind- 
ness. 

It  may  be  generally  said  that  the  inflamma- 
tory form  is  the  most  amenable  to  treatment ; 
perhaps  this  is  due  to  its  sudden  onset,  and  the 
appropriate  measures  which  follow  its  early  re- 
cognition, and  the  removal  of  tension  be&  re  the 
pressure  has  interfered  with  the  nutrition  of  the 
optic  nerve  or  caused  adhesion  of  the  iris  to  the 
camea. 

TREATMENT. 

Little  may  be  said  here  about  the  treatment, 
as  the  important  duty  of  the  family  doctor  U  to 
recognize  the  disease,  and  allow  the  case  to  pass 
through  his  hands  to  the  specialist  at  the  earliest 
possible  moment,  as  each  case  requires  the  ex- 
perience which  the  general  physician  is  not 
expected  to  possess  for  its  successful  manage- 
ment I  have  recently  been  called  to  see  a 
lady,  aged  46,  who  was  attacked  three  months 
previously  with  what  was  diagnosed  as  neural- 
gia of  the  brow,  in  mild  but  persistent  form. 
At  no  time  did  she  suffer  much  pain,  but  it 
continued  in  spite  of  the  use  of  ordinary  reme- 
dies. The  eyes  previously  had  never  gi^en 
trouble,  but  a  sister  had  gone  blind  at  about 
the  same  age,  from  the  same  cause,  presumably. 
The  room  during  the  time  had  been  kept  mode- 
rately darkened.  Previous  to  my  visit  she 
found  that  she  could  not  see  people  around  her, 
which  was  the  first  time  attention  was  drawn  to 
the  eyes,  so  I  was  asked  by  the  attending  phy- 
sician to  see  the  case.  On  examination  I  found 
the  pupils  largely  dilated,  irresponsive  to  light, 
cornea  sea  green,  with  ground  glass  dullness, 
stony  hardness  of  eyeball,  and  on  examining 
with  the  opthalmascope,  found  the  right  disc 
deeply  cupped,  the  left  not  so  much  so.  The 
patient  could  count  fingers  scarcely  at  all  with 
the  right  eye,  and  only  four  feet  with  the  left 
I  could  hold  out  little  encouragement  for  an 
operation  on  the  left  eye,  and  none  for  the  right, 
and  advised  that,  before  anything  was  done,  she 
consult  another  oculist.  The  case  passed  out 
of  my  hands  after  that  visit ;  but  had  the  family 
doctor  recognized  the  case  early,  he  would  have 
saved  the  lady  from  years  of  total  blindness, 
and  his  reputation  would  not  have  been  liable 
to  suffer,  for  it  is  a  sad  reflection  to  continually 
think  of  what  might  have  been. 

In  concluding  let  me  say,  in  every  case  of 
head-pain  or  disturbed  vision,  make  it  a  rule 
to  rest  a  hand  on  either  side  of  the  face,  and, 
with  the  index  fingers,  to  palpate  the  ball  as 
you  would  for  pus,  pressing  the  tips  well  into 
the  cavity  over  the  ball,  and  note  the  condition 
of  the  pupil,  the  appearance  of  the  cornea, 
whether    shining  or  otherwise;   look  out  for 


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Blight  eye-dimness  or  pain  of  an  intennittent 
character,  and  if  you  are  unable  to  decide  send 
the  patient  to  some  one  who  has  had  more  prac- 
tice in  that  kind  of  work ;  but  never  let  it  be 
«aid  of  70U  that  jou  allowed  a  patient  to  go 
t)lind  from  glaucoma,  while  yon  were  treating 
him  or  her  for  some  other  disease,  or  waiting 
for  a  supposed  cataract  to  ripen. 

Oil  Gty,  Pa.  W.  F.  Conners,  M.D. 


How  Long  Are  You  In  For  ?— FrMh  Air. 

Editor  Medical  World  : — The  month  is 
August,  the  mercury  is  at  77°  F.  It  is  charm- 
ing out  of  doon ,  and  not  so  bad  within,  if  the 
windows  are  open  top  and  bottom  oq  every 
floor,  front  and  rear,  and  no  screens  across  the 
open  spaces. 

And  yet,  as  I  pass  along  the  street,  I  observe 
no  inhabited  home  enjojdng  the  free  ventilation 
I  have  described.  The  partially  opened  win- 
dows have  screens  in  them,  for  all  the  world  as 
though  the  free  air  was  felt  to  be  dangerous  — 
teeming  with  '*  malaria,"  and  to  be  barred  out, 
for  the  most  part  Surely,  even  on  a  breezy 
day,  seven-eighths  of  the  freshness  is  kept  out 
foy  screens,  and  it  is  far  worse  on  a  still  one. 

There  are  some  characteristics  of  the  average 
man  difficult  to  account  for.  Here  is  one  who 
goes  camping:  out,  hunting  or  fishing,  every 
summer,  and  boasts  of  the  fine  condition  he  ac- 
quires. "  Nothing  like  camping  out  for  health," 
he  declares ;  and  the  chances  are  ten  to  one  that 
he  won't  have  a  window  open  in  his  house,  even 
if  he  can  have  his  own  way.  He  ''  likes  fresh 
air,  but  can't  stand  a  *  draught'"  Jn  other 
words,  beware  of  the  running  stream;  drink 
from  the  stagnant  pool. 

It  is  wonderfully  useful  to  go  camping  in 
summer ,  to  have  even  a  few  weeks  of  free  life 
in  the  open  air;  but  what  is  the  matter  with 
camping  out  in  the  home  all  the  year  around  ? 
It  is  entirely  feasible.  It  is  all  the  time  being 
done  by  the  few  rare  ones  who  have  learned  the 
secret  of  high  healtL 

The  writer's  life  has  been  spent  in  the  study 
of  the  health  question,  and  in  teaching  the  laws 
of  life — the  secret  of  health.  There  is  a  popu- 
lar delusion  that  the  essential  thing  i4  to  avoid 
'<  draughts,"  and  to  keep  warm.  As  this  rule 
is  commonly  practiced,  it  is  almost  wholly  in  the 
interest  of  the  doctors,  though  in  fact  they  do 
not  themselves  realize  the  fact ;  for  the  great 
majority  of  physicians  pursue  the  same  practices 
that  prevail  among  the  laity.  They  smother 
the  ekin  with  excess  of  clothing ;  mistake  day- 
light for  the  breath  (»f  life;  ''night  air"  is 
held  to  be  dangerous,  as  though  any  other  kind 
were  available  between  sunset  and  sunrise,  and 
fresh  nightair  were  not  preferable  to  stale  I 


Such  notions  are  supremely  foolish,  and  if  cor- 
rected, one-half  of  all  the  physicians  in  any 
community  would  be  starved  out  for  want  of 
business.  The  fear  of  "catching  cold"  is  at 
the  bottom  of  nine-tenths  of  all  sicknesses.  It 
leads  to  coddling  practices,  which  promote  dis- 
ease. In  keeping  warm  the  body  is  en- 
feebled, waste  matters  remain  stored  up  in  the 
system,  feverishness  is  the  outcome ;  the  waste 
and  effete  matters  mu?t  be  burned  up  ani  elim- 
inated. Extra  caution  now  increases  the  evil ; 
the  **  malaria  "  (bad  air) — a  misnomer,  as  usa- 
ally  regarded,  though  correct  when  applied,  as 
it  is  by  experts,  to  the  cause  of  disease;  a 
typhoid  condition  is  often  thus  reached,  and 
mistaken  medical  treatment  provokes  a  long, 
painful  and  costly  sickness,  and  often  a  fatal 
one.  When  I  pass  along  the  street  I  feel  like 
asking  every  one  whose  face  I  see  behind  a  shut 
or  screened  window  in  summer,  "  How  long  are 
you  in  for  ?  "  They  seem  to  me  like  prisoDen 
shut  in  for  crime.  How  mucti  of  this  evil  is 
due  to  deficient  hygienic  knowledge  among  phy- 
sicians who  ought  to  be  health  teachers  T 

In  my  own  home  we  have  no  screens ;  win- 
dows are  wide  open  eight  months  in  the  year, 
nearly ;  we  wear  as  little  clothing  as  the  law 
allows— our  young  children  even  less ;  they  are 
often  naked  for  hours  during  the  heat  of  the 
day.  They  go  barefoot  the  year  round,  oat  of 
doors,  in  spring,  summer  and  fall,  but  are  shod 
in  muddy  and  very  cold  weather,  and  they  pre- 
sent a  marked  contrast  in  condition  to  m(»t 
other  children,  in  consequence. 

C.  R  Page,  M.D., 

867  Boylston  st,  Boston,  Mass. 


Clinical  Notes  on  Chorea. 

Editor  Medical  World  : — On  March  27, 
1894,  I  was  called  to  see  M.  M.,  a  colored  girl, 
twelve  years  old,  who  had  been  for  four  weeks 
past,  and  was  stUl,  suffering  from  an  attack  of 
chorea.  The  first  two  weeks  It  was  slight,  and 
the  latter  two  weeks  more  severe.  My  diagno- 
sis was  chorea,  and  prognosis  possible  recovery 
after  some  weeks.  This  child  had  been  afflicted 
about  three  years  previously  with  a  similar  at- 
tack, and  after  treatment  by  local  physiciaiu 
had  been  carried  to  the  Touro  Infirmary  at  New 
Orleans,  and  recovered  in  about  two  weeks* 
time.  When  I  first  saw  this  patient  she  was 
literally  dancing,  with  feet,  hands,  eyes,  head 
and  body  all  endeavoriug  to  move  at  once.  She 
could  not  sit  in  a  chair  but  would  soon  wriggle 
out  If  placed  on  a  bed  she  would  soon  roll 
off,  and  required  one  or  more  attendants  day 
and  night  When  she  fell  asleep,  which  was 
but  a  few  moments  at  a  time,  then  she  was 


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quiet  I  tried  cathartics,  with  violent  purga- 
ti(M),  galvanic  battery,  cold  baths,  qninine,  and 
hydrate  of  chloral  and  morphine,  successively, 
combining  several  of  them  occasionally ;  then 
physostigma.  I  persevered,  with  but  little 
effect,  for  nearly  four  weeks,  when  I  began  to 
use  ailanthus  glandnlosa,  with  black  cohosh 
compound,  alternating  with  hydrate  of  chlora]. 
I  gave  half  a  teaipoonful  of  each  of  the  ailan- 
thus glandulosa  and  black  cohosh  compound 
every  two  hours,  while  awake,  alternating  hourly 
with  chloral  hydrate,  either  by  mouth  or  by 
rectum.  The  patient  then  b^n  to  improve 
steadily,  and  now  (May  22,  1894)  is  able  to 
walk  about,  converse  and  sleep,  as  a  person  in 
good  health.  She  had  no  fever  that  I  could  at 
any  time  detect 

Constipation  existed  during  the  entire  sick- 
ness, except  when  purgatives  were  given.  I 
found  after  some  weeks  that  there  was  sugar  in 
the  urine,  and  then  I  added  fid.  ext  jambul- 
seed  to  the  ailanthus  glandulosa  and  fld.  ext. 
black  cohosh  compound,  and  the  diabetic  symp- 
toms disappeared.  The  patient  has  never  men- 
struated. The  tonsils  were  unusually  large, 
and  the  size  was  slightly  diminished  by  appli- 
cations of  argenti  nitras,  and  later  tincture  of 
iodine.  I  used  Fowler's  solution  of  arsenic 
jifter  the  tenth  week,  ten  drops  three  times  daily. 
The  mouth  and  tongue  became  much  swollen 
because  of  violent  contractions  of  muscles,  and 
for  weeks  she  could  not  speak  so  as  to  be  heard 
distinctly,  but  as  the  disease  began  to  abate  in 
severity  the  language  became  gradually  more 
distinct,  until  now  it  is  in  a  normal  condition. 
The  patient  has  entirely  recovered,  excepting  a 
alight  degree  of  weakness,  due  to  the  prostration 
following  so  long  an  attack  of  violent  action  of 
muscles  and  necessary  course  of  medication  in 
order  to  relieve  her  pathological  condition. 

Lutcher,  La.  R  W.  Seay,  M.D., 


Rules  for  Infant  Feeding. 

Editor  Medical  World: — No  more  im- 
portant subject  can  engage  the  attention  of  the 
physician  at  the  present  season  than  the  feeding 
of  children. 

Care  must  be  exercised  in  the  selection  of  the 
proper  food.  Experience  has  taught  us  to  choose 
substances  closely  allied  to  the  mother's  milk. 
We  therefore  resort  to  animal  milk,  the  compo- 
sition of  which  compares  favorably  with  human 
milk. 

The  fact  that  cow's  milk  is  rich  in  proteids, 
fitts  and  salts,  renders  it  of  practical  importance 
to  modify  it  by  dilution,  so  as  to  resemble  hu- 
man milk.  The  degree  of  dilution  necessarily 
depends  upon  the  character  of  the  milk,  the  age 
and  condition  of  the  child. 


The  following  is  my  rule  for  dilution : 

Age~l  month,  1  part  of  milk  to  3  parts  water. 
"      2  months  1         "        "      2  •* 

"      3       «<      2        "        "      2  " 

it        Q        "3  "  "        2  " 

«  ^  ((  g  <(  <c  2  it 

(I    12       "      6         tt        tt      I  tt 

If  all  the  elements  of  the  milk  are  digested, 
I  gradually  reduce  the  quantity  of  water  to  the 
proportion  of  the  succeeding  month.  Sugar  is 
added,  ten  grains  to  the  ounce. 

The  quantity  prescribed  at  each  feeding 
should  not  exceed  the  capacity  of  the  stomacL 
Dr.  L.  Emmett  Holt's  observations  show  that 
at  birth  the  average  capacity  is  one  ounce,  and 
a  gain  of  one  ounce  per  month  up  to  six  months, 
and  for  every  subsequent  month  one  half  ounce 
up  to  one  year ;  hence  at  this  time  the  stomach 
is  capable  of  holding  nine  ounces. 

In  regulating  the  amount  of  milk  we  should 
not  ignore  the  fact  that  individuals  differ  in 
their  physiological  demands.  The  following 
index  has  been  of  service  to  me  in  adjusting  the 
proper  quantity : 

Age.  Intervals.  Amount. 

1  mo.   Every  2  hrs.  during  the  day.         1  oz. 

2mo8.         "  "  "  2  " 

3  (t  ((  It  it  3  ti 

4  "    Every  2i      "  "  4  " 
g     «<           «             (I                t.  5  ** 

Q       <(  ((  u  «.  (5    " 

7     "     Every  3        '*  "         6  to  8  " 

Q  <(  t(  ((  ti  it  tt 

Q  It  «  ((  a  tt  it 

IQ  ((  ((  «  tt  it  it 

H  it  .(  tt  tt  tt  It 

12  tt  tt  tt  it  tt  ti 

The  milk  should  be  sterilized  and  preserved 
on  ice  during  hot  weather.  If  the  digestive 
powers  of  the  infant  are  impaired,  it  becomes 
necessary  to  predigest  the  milk  by  the  use  of 
some  digestive  agent  I  am  in  the  habit  of 
using  Fairchilds'  Bros,  and  Foster's  peptogenic 
milk  powder. 

To  be  successful  in  infant  feeding,  specific 
rules  must  be  observed  ;  uniformity  in  dilution 
and  scrupulous  care  in  tiie  preparation  of  milk, 
is  indispensable.  Impress  upon  the  mother  the 
importance  of  keepmg  the  nursing  bottle  sweet 
by  the  use  of  borate  of  soda  or  salicylate  of  soda 
and  water. 

In  my  practice  I  use  printed  rules,  that  I 
give  to  the  attendant,  and  insist  on  strict  com- 
pliance with  the  same,  and  thus  avoid  error  and 
neglect.  My  experience  and  success  in  infant 
feeling  warrants  me  in  presenting  the  above 


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rules  to  the  many  readers  of  The  Medical 
World.  H.  F.  Slifer,  M.D., 

North  Wales,  Pa. 
Late  Professor  of  Physiology  in  the  Medico- 
Chirurgical  College,  Philada.,  Pa. 


Suppurative  Appendioitis— General    Peritonitia— 

Spontaneous  Healing  of  a  Feoal  Fistula  by 

Irrigation  of  Colon. 

Editor  Medjcal  World  : — I  take  pleasure 
in  submitting  the  following  case  as  a  pointer  to 
the  numerous  readers  of  The  World,  many  of 
whom  are,  no  doubt,  like  myself,  country  prac- 
titionei  s,  who  cannot  command  the  ever-ready 
facilities  in  emergency  cases,  and  who  do  not 
sport  the  daring  skill  of  our  eminent  brother 
practitioners  in  city  practice;  ergo,  necessity 
forces  us  to  adopt  methods  in  line  with  nature's 
cure. 

The  method  used  in  this  case  was  eminently 
and  rapidly  successful,  as  you  will  see  from  the 
histoiy  of  the  case,  which  I  will  now  proceed  to 
relate. 

Eddie  F.,  aged  ten  years,  was  attacked  sud- 
denly with  appendicitis.  June  17th.  Three 
days  subsequently  I  was  called  in,  and  found 
that  general  peritonitis  had  rapidly  developed 
that  day,  the  20th.  There  was  great  tenderness 
and  tjmpanitis  in  every  portion  of  the  abdomen, 
di&tension  so  great  that  respirations  were  40, 
with  a  spell  or  two  of  decided  dyspnea ;  pulse 
120;  temperature  lOlT  F.  But  worst  of  all 
was  the  condition  of  partial  collapse,  as  evinced 
by  the  cold,  sodden  skin,  clammy  sweat,  abdom- 
inal facies,  etc. 

Feeling  thoroughly  alarmed  for  the  life  of 
my  patient,  Drs.  Baiid  and  Smith,  of  Coperas 
Cove,  were  called  in  next  morning.  Nothing 
satisfactory  could  be  made  out,  because  of  the 
excessive  tenderness  and  great  distension  pre- 
sent everywhere;  and  inasmuch  as  the  little 
fellow  had  rallied  pretty  well  from  collapee, 
operation  was  deferred  for  a  time,  to  watch  the 
progress  of  the  case.  Drs.  Baird  and  Smith, 
however,  agreed  with  me  that  from  the  plain 
statement  ot  the  parents  the  initial  lesion  must 
be  in  the  appendix ;  and,  a^  the  sequel  proved, 

was  ah  initio  a  plain  case  of  appendicitis. 

For  six  days  thereafter  this  case  was  treated 
as  a  case  (f  peritonitis  by  evacuants  and  enemas 
of  hot  water,  glycerine,  etc.  Salines  were  not 
tolerated,  on  account  of  the  distressing  nausea ; 
every  dose  of  saline  purgative  administered  was 
promptly  rejected,  and  brought  on  the  most 
agonizing  irritation  and  suffering  imaginable. 

But  the  remedy  par  excellence  in  controlling 
nausea,  as  an  evacuant,  and  for  its  antiphlogis- 


tic action  on  the  inQamed  peritoneum,  was  calo- 
mel, given  in  the  small  doses  of  ^V  of  a  g  ain 
every  two  hours  regularly,  night  and  day. 

This  grand  rem^y  acted  like  a  charm  in  se- 
curing five  or  six  copious  Stools  of  semi  folid 
fecal  matter  a  day,  without  pain  or  nausea. 

During  this  period  of  six  days  nothing  anoma- 
lous was  noted  more  than  i^ually  occurs  in 
general  peritonitb.  There  was,  of  course,  in- 
creasing debility,  and  on  the  27th,  noting  signs 
of  exhaustion  setting  in.  Dr.  Baird  was  again 
sent  for,  and  we  opeiated  by  incision  directed 
to  the  appendix.  An  attempt  to  aspirate  was 
made,  but  failed. 

A  full  teacup  of  veiy  offensive  pus  was  evac- 
uated very  nicely  by  incision ;  considerable  gas 
blubbered  out  with  the  pus,  but  no  fecal  matter 
at  the  time  of  operation.  The  pus  cavity  was 
thoroughly  cleansed  with  the  peroxide  of  hydro- 
gen, and  a  drainage  tent  of  iodoform  gauze 
inserted  for  a  few  hours.  The  operation  was 
completed  at  3  p.  m.  of  June  27th,  without 
chloroform. 

Cocaine  was  injef*ted  into  the  seat  of  the  ope- 
ration at  6  p.  m.  I  saw  the  little  fellow  again 
and  found  him  in  good  condiiion.  There  was 
no  depression  from  the  oparation.  On  dra^ring 
out  the  iodoform  gauze  a  large  quantity  of  pus, 
gas  and  fecal  matter  escaped.  I  syringed  out 
the  fistula  and  pus  cavity  thoroughly  with  ste- 
rilized hot  water,  and  subsequently  wiih  the 
Ha  02. 

The  drainage  was  dispensed  with  as  unneces- 
sary. For  six  days  thereafter  enormous  quan- 
tities of  pus  and  fecal  matter  discharged  contin- 
uously from  the  fistula,  it  being  necessary  to 
change  the  cloths  and  pads  every  two  hours^ 
and  sometimes  oftener,  so  great  was  the  dis 
charge.  This  copious  discharge  relieved  the 
great  distension  quite  rapidly — in  a  day  or  two 
the  right  half  of  the  abdomen  reduced  down  to 
almost  its  normal  size,  giving  a  very  irregular 
contour  and  singular  appearance  to  the  abdom- 
inal parieties.  The  left  half  of  the  abdomen 
and  epigastric  region  was  still  greatly  distended. 
The  little  patient  is  in  good  spirits,  but  very, 
very  week ;  has  a  little  more  appetite  for  food, 
but  tongue  is  still  very  white  and  rough.  Tem- 
perature running  from  100°  to  101°  —sometimes 
a  degree  or  fraction  higher ;  bowels  acting  the 
natural  way,  also  some  pus  passed  occasionally, 
with  fecal  matter.  Reconstructivee  weie  gi^eo, 
such  as  hypophosphites  comp.  and  a  granule  of 
strychnia,  y^^^  every  two  hours  with  an  occa- 
sional tablet  of  H.  K.  Mulford's  heart  tonic ; 
some  bismuth  was  given  to  control  the  profuse 
evacuations  from  the  alimentary  tract,  and 
Trommer's  extract  of  malt  and  pepsin,  etc.,  etc 

In  about  six  days  after  the  operation  our 


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patient  had  about  gotten  we]l  of  the  peritonitis, 
was  eating  much  better,  and  digesting  nourish- 
ment tolerably  well  for  one  who  was  so  weak 
and  so  near  to  death's  door. 

I  now  directed  my  attention  to  tbe  closing  of 
that  filthy  fistula  Dr.  Baird  wrote  me,  sug- 
gesting that  it  mi^ht  be  a  benefit  to  irrigate  the 
lower  bowel  and  lock  the  bowels  up  with  opium 
for  forty- eight  hours. 

So  on  the  5th  of  July,  I  adopted  the  former 
plan  of  irrigating  the  colon  with  a  half-gallon 
fountain  syringe,  to  which  I  attached  a  bowel 
tube  about  twelve  inches  long.  I  gave  no 
opium,  because  the  poor  little  fellow  had  such 
feeble  digestion,  and  his  tongue  was  still  roughly 
oated,  that  I  actually  dreaded  to  narcotize  him 
in  a  vain  effort  to  stop  those  enormous  evacua- 
tions from  the  alimentary  tract 

It  did  me  good  to  see  the  little  sufierer  emerg- 
ing fr^m  the  "  Dark  Valley,"  and  I  considered 
it  my  duty  rather  to  assist  him  in  gaining  appe- 
tite and  strength  for  a  longer  stay  in  this 
world. 

I  instructed  his  father  (a  very  intelligent 
man  and  an  admirable  nur^e)  in  the  art  of  irri- 
gating the  bowels.  Sterilized  water  was  always 
used,  with  castile  and  other  pure  soap.  The 
foot  of  the  bed  was  elevated  six  inches,  and  the 
hips  of  the  patient  elevated  on  quilts  and  pil- 
bwB,  so  that  the  irrigation  was  thorough.  The 
water  bjected  from  below  ran  out  through  the 
fistula.  This  irrigation  was  performed  every 
three  or  four  hours  through  the  day,  and  onca 
in  the  night  I  quit  making  daily  visits  now, 
as  I  was  needed  more  elsewhere.  Imagine  my 
surprise  when,  in  four  days,  his  father  called  at 
my  offi^  and  informed  me  that  the  dreaded 
fistula  was  almost  healed.  He  stated  that  the 
discharge  of  fecal  ivatter  and  pus  had  ceased, 
and  that  nothing  was  c  )ming  from  the  fistula 
but  a  little  watery  mucus. 

"  This  is  too  gool  to  be  true,"  thought  I ;  so 
I  started  for  the  patient  posthaste  with  ocaine, 
probes,  etc.,  determined  to  f^xplore  and  see  if 
this  were  really  so  I  fully  expected  to  find 
another  abscess  forming  ar  und  the  appendix. 
Bat  no;  the  fistula  had  certainly  healed  up 
tliroughoit  its  whole  tract  It  was  very  diffi 
cult  to  insert  a  small  probe  without  t'^aring  the 
wound  and  causing  hemorrhage,  and  careful 
palpation  showed  that  the  pus  cavity  bad  healed 
up  sound  and  well.  No  m'>re  feces  e^er  passed 
through  the  wound.  In  tvo  weeks  our  little 
hero  was  on  foot  again  and  improving  rapidly. 
By  the  1  it  of  August  he  came  to  see  me,  a  dis 
tance  of  four  miles,  walking  with  a  half-sided 
stride,  it  is  true,  like  a  one-lunged  person.  At 
the  present  writing,  August  10.h,  the  little  fel- 
low is  attending  camp  meeting  with  his  father, 


who  is  a  preacher,  and  is  also  mending  his  awk- 
ward gait  rapidly. 

In  conclusion,  I  would  summarize  a  few 
points  in  the  foregoing  remarkable  case,  namely, 
the  three  periods  of  the  disease : 

1.  Suppurative  appendicitis  and  general  peri- 
tonitis, with  ominous  tendencies  toivard  impend- 
ing death. 

2.  The  fistula  aad  pariod  of  copious  evacua- 
tions, during  which,  as  ic  a)p3ared,  the  pent  up 
dregs  of  diseise  were  literally  po  jrel  out  by  the 
gallon,  aid  at  whish  timB  the  p3ritoaitis  sub- 
sided. 

3.  The  healing  up  of  a  very  bad  fistula  in 
four  days  Was  ever  surge )n  yet  rewarded 
with  a  more  brilliant  result  in  the  trea'm3at  of 
abdominal  fistula  ? 

4.  I  wjuld  here  like  to  give  deserved  praise 
to  the  evacuating  povirer  of  the  mild  chhride, 
which  was  administered  continuously  through 
out  the  first  pariod  of  the  disease. 

You  re  nember  the  great  vital  depresuon  in 
the  beginning,  with  signs  of  impending  death.' 
All  authorities  unite  on  the  fatal  tendencies  of 
suppurative  appandicitis  with  general  peritonitis. 
Herein  the  mild  chloride  brought  the  enemy  to 
hay,  got  up  vital  reaction,  putting  our  patient 
in  a  good  fix,  and  keeping  him  so  until  every- 
thing was  evacuated,  so  that  recovery  could 
take  place  I  rarely  go  into  print,  but  believe 
that  medical  literature  needs  all  such  cases. 

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


Calomel  and  Sulphide  of  Oalolum  for  Croup.— Sul- 
phate of  Magnesia  for  Eozema. 

Edit>r  Medical  World: — On  May  6th, 
1893  at  5  a  m.,  I  was  called  to  see  Charles  B., 
aged  four  years,  suffering  from  membranous 
croup,  and  whom  another  physician  had  been 
treating,  an  1  pronounced  htm  beyond  his  help. 
I  found  him  struggling  in  his  father's  arms, 
breathing  labored  and  whistling,  voice  the  faint- 
est whisper,  face  and  hair  dripping  with  perspi- 
ration, pulse  very  weak,  and  so  fast  that  I  could 
not  time  it ;  temperature  102.  I  told  the  parents 
that  I  had  but  a  faint  chance  to  work  upon,  but 
would  do  my  best  I  had  his  neck  and  breast 
rubbed  thoroughly  with  turpentine,  coal  oil  and 
lard.  Gave  ^^^  gr.  calomel  and  ^^^  gr  calcium 
sulphide  every  hour,  to  ba  continued  eight  hours ; 
flannel  cloths,  wrung  out  of  hot  water,  were  ap- 
plied to  the  breast  and  neck  as  hot  as  cauld  be 
borne,  every  fifceen  minutes,  and  this  hot  appli- 
cation was  kept  up  without  intermission  for 
twenty-four  hours.  The  tqrpentine,  coal  oil  and 
lard  were  rubbad  on  every  three  hours  till  the 
breast  was  nearly  blistered,  and  then  stopped. 
I  applied  to  the  throat,  as  spray,  listerine,  every 


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two  hours.  Grave  egg-nog  and  rich  beef  soup 
alternately  every  hour.  During  the  twenty-four 
hours  he  did  not  sleep  at  all,  but  insisted  on  his 
father  or  mother  carrying  him  back  and  forth 
across  the  room,  and  insisted  on  the  door  being 
kept  constantly  open.  I  tried  him  with  inhaling 
hot  steam,  but  he  struggled  and  resisted  so 
strongly  that  it  was  laid  aside.  In  about  ten 
hours  after  commencing  the  calomel  we  had  the 
thin,  greenish  actions,  and  the  calomel  was  con- 
tinued then  every  ts^o  hours,  with  the  calcium 
sulphide.  For  twenty-four  hours  I  could  see  no 
change  for  the  better  or  worse.  On  the  Tth^  at 
ten  a.  m.,  he  went  to  sleep  while  his  father  was 
carrying  him,  and  slept  nearly  two  hours ;  then 
awakened  and  called  for  something  to  eat,  which 
he  had  not  done  before,  all  food  previously  be- 
ing forced  on  him.  At  12  m.  on  the  7th  I 
noticed  that  his  breathing  was  not  so  labored, 
and  his  cough  was  becoming  loose,  and  that 
tough,  stringy  phlegm  and  mucus  was  raised 
without  much  effort  Perspiration  during  all 
this  time  had  continued,  but  during  the  latter 
part  of  the  7th  was  becoming  lighter.  The 
calomel  was  continued  till  midnight  of  the  7th, 
and  stopped  for  six  hours,  and  begun  again  for 
twelve  hours  longer ;  also  calcium  sulphide.  At 
6.  a.  m.  on  the  8th  his  breathing  was  much  im- 
proved, and  he  was  spitting  up  with  every  cough 
a  thick  yellow  sputa,  in  which  parts  of  the  mem- 
brane could  be  recognized.  From  this  time  on 
his  improvement  was  uninterrupted.  On  the 
10th  and  11th,  shreds  of  the  membrane  one- 
eighth  of  an  inch  wide  by  two  inches  long,  could 
be  washed  out  of  the  sputa  and  easily  recognized. 
The  listerine  was  given  internally  after  noon  of 
the  9th,  a  quarter  teaspoonful  every  three  hours. 
The  first  actions  from  the  bowels  contained  large 
quantities  of  mucus  he  had  swallowed,  and  the 
actions  had  the  odor  produced  by  the  calcium 
sulphide.  On  the  12th  I  discharged  him,  and 
put  him  upon  a  compound  of  iron,  quinine  and 
strychnine. 

In  reporting  this  case,  I  do  so  not  with  any 
vain  spirit,  but  with  the  hope  that  possibly  some 
brother  laborer  may  get  a  suggestion  that  may 
benefit  him  in  a  pinch.  This  is  my  third  case 
successfully  treated,  the  first  being  only  nine 
months  old,  and  falling  into  my  hands  like  the 
above  case,  and  the  second  case  six  years  old — 
all  treated  similarly  with  calomel  internally, 
rubbed  with  coal  oil,  turpentine  and  lard,  and 
hot  applications.  As  soon  as  I  recognize  a  case 
of  membranous  croup,  or  even  suspect  it,  I  at 
once  put  the  case  upon  small  doses  of  calomel 
and  the  calcium  sulphide,  and  keep  it  up  every 
hour  for  twenty- four  hours,  and  then,  after  a 
short  intermission,  begin  again. 

The  above-named  child  is  a  son  of  the  case  I 


reported  in  April  number,  and  who  had  never 
had  syphilis,  as  Dr.  Waugh  suggested. 

That  the  above  treatment  may  prove  aa  suc^ 
cessful  in  the  hands  of  others  is  my  kindest  bope- 
and  I  would  be  largely  repaid  in  return  for  the 
numerous  good  suggestions  learned  every  month 
from  The  World. 

Reasoning  from  cause  to  effect  in  giving  mag- 
nesia sulph.  in  small  daily  doses  for  warts,  which 
will  cause  them  to  disappear  in  a  short  time,  I 
was  led  to  try  a  saturated  solution  in  eczema, 
and  with  the  happiest  effect  The  patient  was 
a  man,  75  years  old.  When  called  to  him  I 
found  him  as  raw  as  if  he  had  been  skinned.  I 
told  him  the  first  application  would  cau&e  con- 
siderable smarting.  I  had  the  saturated  solu- 
tion heated,  and  applied  with  a  soft  cloth  over 
as  much  surface  ad  he  could  endure.  I  allowed 
it  to  dry,  and  dusted  starch  over  it  In  an  bourns 
time  I  applied  it  all  over  him.  I  then  gave 
him  a  teaspoonful  every  three  hours,  till  five 
watery  evacuations  were  secured.  In  six  horns 
I  again  applied  it  to  the  body,  face,  nedk,  arms, 
hands,  legs  and  feet,  with  comparatively  little 
smarting.  Continued  every  six  hours  for  three 
days.  In  that  time  he  began  to  peel  off,  and 
his  skin  was  as  soft  and  white  as  a  babe's.  I 
have  tried  it  in  four  cases  within  the  last  three 
years,  and  three  of  the  cases  are  children.  Is 
it  a  new  idea  with  the  profession,  or  not  ? 

D.  E.  Ruff,  M.D., 

Junction  City,  Or^on. 


Treatment  of  Typho-Malarial  Fever. 

Editor  Medical  World  : — ^In  July  number 
of  The  World,  Dr.  C.  M.  H.  Farrar  asks  for 
pathology  and  classification  of  so  called  slow 
fever.  I  will  leave  this  for  wiser  heads.  Typho- 
malarial  fever  is  name  enough  for  me.  But  I 
wish  to  make  a  suggestion  in  regard  to  treat- 
ment of  this  much  dreaded  disease. 

I  know  that  many  physicians  condemn  qui- 
nine in  this  disease,  but  I  think  they  discard  the 
best  remedy  when  they  do  so.  I  have  had  some 
experience  in  the  treatment  of  this  fever,  and 
have  never  had  a  case  to  run  longer  than 
twenty* seven  days.  I  give  quinine  first,  last 
and  all  the  time. 

After  the  first  week  I  give 

B.  Tr.  mur.  Iron ., « « — gttg.  15 

Fowl,  sol  anenlc »...gtta.  5 

Tr.  nox  Tomica stts.  10 

H    For  one  dose;  given  three  times  dallj. 

I  usually  begin  treatment  with  a  mercuiial 
purge,  if  GMeA  at  the  beginning  of  the  disease, 
then  blue  pill  three  times  a  week.  Later  od, 
turpentine,  if  indicated,  with  proper  support, 


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etc  Other  physicians  around  me  have  cases 
that  run  thirty,  sixty  and  even  ninety  days. 

I  will  give  a  case  in  point,  that  of  a  boy 
eleven  years  old.  I  gave  him  the  usual  reme- 
dies which  appeared  to  have  but  little  effect. 

From  the  twenty  first  to  the  tw^ity-sixth  day 
his  temperature  gradually  increased  from  102^ 
to  105^®;  the  other  symptoms  all  unfavorable — 
tympanites,  marked  subsultus  tendinum,  low 
muttering  delirium,  etc. 

I  decided  that  my  patient  would  die  if  the 
disease  was  not  soon  arrested.  On  the  morning 
of  the  twenty-seventh  day  at  2  o'clock  A.  m., 
the  remission  set  in.  I  administered  ten  grains 
of  quinine  at  once,  and  followed  it  with  five 
grain  doses  every  hour  until  his  temperature 
became  normal,  which  occurred  in  eight  hours 
after  administering  the  first  dose. 

The  fever  did  not  rise  again,  and  he  made  a 
good  recovery.  I  gave  small  doses  of  tincture 
of  gelsemium  with  the  first  four  doses.  Now, 
this  may  be  said  to  be  heroic  treatment,  and 
some  brother  may  say,  not  scientific ;  but  it 
succeeded,  nevertheless. 

I  am  in  love  with  The  Medical  World. 

Swannville,  Tex.      G.  W.  Woods,  M.D., 


Treatment  of  a  Case  of  Typhoid  Fever. 

Editor  Medical  World  :  —On  August  9th, 
ult,  I  was  called  to  see  a  child,  ten  years'  old, 
bedridden  with  typhoid  fever. 

The  child  was  taken  sick  on  or  about  August 
1st,  but  I  was  not  called  in  until  the  ninth  day, 
when  the  following  conditions  were  noted : — 
Temperature  registered  104°  F.;  tongue  was 
furred  and  pointed ;  there  was  headache,  mut- 
tering delirium,  and  the  characteristic  tympan- 
ites ;  no  rash  had  as  yet  made  an  appearance, 
and  none  appeared  later. 

To  lower  the  temperature  I  ordered  a  cool 
acidulated  bath,  and  prescribed  magnesium  sul- 
phate to  get  a  good,  thorough  action  of  the 
bowels,  and  gave  the  following  prescription  : 


B.  QnlnlmB  Bolph.  antlkamnlm aa 


SaloL.. 


,grm8  2 
(grains  zzz) 

gnn  1 

(gialDB  xv) 


Met  Ft.  in  caps.,  Na  XV.  (16). 
81g.   Ona  capsule  every  8  hoiin. 

On  the  second  day  succeeding  my  first  visit  I 
found  that  the  temperature  had  lowered,  and 
that  the  boy  was  doing  well  under  the  treat- 
ment The  same  was  continued,  and  the  epsom 
salts  were  not  spared. 

Liquid  food  was  given  often,  a  little  at  a 
time.  Brandy  was  given  as  often  as  it  was 
deemed  feasible. 


When  the  capsules  were  finished  I  prescribed 
dilute  nitro-muriatic  acid,  in  five-drop  doses, 
also  quinine  and  antikamnia,  made  into  cap- 
sules, containing  one  grain  of  each  drug  respect- 
ively, to  be  given  alternately  with  the  dilute 
nitro  muriatic  acid,  every  two  hours. 

About  the  middle  of  the  third  week  of  the 
disease  the  temperature  was  normal,  and  re- 
mained so,  the  patient  making  a  rapid  and  un- 
interrupted recovery. 

This  is  the  second  case  of  typhoid  that  I  have 
treated  as  above,  and  the  results  of  both  have 
been  gratifying. 

One  drawback  to  the  treatment  of  typhoid 
fever  in  private  practice  is  the  difficulty  of 
securing  the  cool  bath,  so  beneficial  aad  so 
refreshing  to  the  sufierer ;  but  it  is  to  be  hoped 
that  the  people  will  soon  recognize  the  good  re- 
sults of  the  cool  bath,  and  that  they  shall  wil- 
lingly concede  to  the  interests  of  humanity,  as 
advised  by  the  medical  profession  throughout 
the  world. 

Thomas  W.  Stuart- Albine,  B.S.,  M.D., 
Cheboygan,  MicL 


Diosoorea  for  Gall  Stones. 

Editor  Medical  World:— In  the  July 
World,  Dr.  Walter  Tison  asks  for  treatment 
of  a  case  of,  presumably,  biliary  calculi,  and  in 
the  August  number,  page  267,  two  different  pre- 
scriptions are  given.  I  now  b^  to  add  my 
mite  ty  the  treatment  of  this  painful  affection. 
About  eight  years  ago  I  attended  a  lady  who 
suffered  some  years  from  attacks  of  bilious  colic, 
recurring  sometimes  as  often  as  once  a  month, 
attended  with  excruciating  pain.  I  gave  ext 
diosoorea  fl.  (wild  yam)  in  twenty  drop  doses 
four  or  five  times  a  day,  continued  for  about 
four  weeks.  She  has  been  entirely  free  from 
the  trouble  ever  since,  and  is  now  hale  and 
hearty.  I  have  since  used  the  same  remedy  in 
several  cases  with  the  same  gratifjring  results 
and  am  now  inclined  to  look  upon  it  as  a  specific 
in  gall  stones.  During  the  attack  I  gave  hypo- 
dermically  pilocarpine  to  lelax  spasm  and  flood 
the  duct  with  mucus ;  that  failing  to  give  the 
required  relief,  I  administer  morphine  and 
atropine  hypodermically. 

Geo.  Mitchell,  M.D., 

Wallaceburg,  Ontario,  Canada. 


Editor  Medical  Wobld  : — I  have  been  a  reader 
of  the  manj  good  things  in  The  World  for  eight 
jears,  and  it  is  the  only  one  of  mj  journals  that  I 
have  kept  regularly  bound  to  have  in  mj  library. 

Waterloo,  Wis.  O.  C.  Bailey,  M.D. 


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THB  MBDICAX  WORLD. 


An  Operation  for  Horse-Shoe  Fistula. 

Editor  Medical  World  : — Before  referriDg 
to  the  subject  with  which  this  paper  more  espe- 
cially deals,  I  would  like  to  call  attention  to  a 
few  other  important  points  in  rectal  surgery. 

From  observation  I  am  led  to  believe  that 
many  surgeons  do  not  take  sufficient  painp,  when 
operating  upon  a  fistula,  to  lay  open  all  sinuses. 

The  sinus  most  frequently  omitted  is  that 
which  extends  from  the  internal  opening  up- 
wards beneath  the  mucous  membrane,  although 
I  have  observed  the  omission  of  others. 

Another  common  error  in  operating  is  failing 
to  keep  to  the  fistulous  tract  In  such  instances, 
either  from  haste,  impatience,  or  want  of  requis- 
ite expertness  in  manipulation,  the  director  is 
thrust  through  the  sinus  wall  into  the  cellular 
tissue ;  coneequently  the  main  tract  of  the  fistula 
is  left  untouched,  whilst  incisions  through  the 
skin  and  submucous  tissue  are  unnec^sarily 
made. 

In  such  cases  the  results  are  generally  unsat- 
isfactory to  both  the  phjsician  and  patient 

I  would  like  to  state,  in  this  connection,  that 
since  the  preservation  of  the  function  of  the  rec- 
tum should  predominate  in  every  operator's 
mind,  and  that  ofctimes  it  requires  very  superior 
judgment  and  expertness  of  manipulation  to 
maintain  it,  one  should  be  thoroughly  familiar 
with  the  anatomy  and  physiology  of  these  parts, 
as  well  as  the  pathology  of  the  disease,  before 
attempting  a  rectal  operation. 

A  surgeon  may  either  remove  or  destroy  the 
funciion  of  an  eye,  ear,  testicle,  kidney  or  ovary. 
Yet  in  each  instance  the  patient  retains  an  organ 
to  subserve  his  purpose ;  but  he  whose  rectum 
or  sphincter  has  been  destroyed  has  none  other 
to  take  its  place,  and  must  of  necessity  submit 
most  gracefully  to  the  inevitable. 

I  concur  with  Dr  Mathews,  who  says :  "  I 
believe  that  it  requires  a  more  careful  surgical 
operation  to  cure  a  complicated  fistula  in  ano, 
than  almost  any  other  surgical  disease ; "  and  if 
it  is  not  eradicated  by  the  operation,  '^  comes 
nearer  to  getting  the  surgeon  into  disrepute  than 
to  lose  a  case  after  an  abdominal  section."  As 
to  the  disposition  of  the  sinus  extending  above 
the  internal  opening,  surgeons  of  equal  rank 
difier ;  some  maintaining  that  it  should  be  di- 
vided, others  holding  to  the  opposite  view. 

I  should  say,  however,  that  it  all  depends 
upon  the  character  of  the  sinus  and  tissues  in- 
volved. If  it  is  submucous,  slit  it  up.  If  deep, 
involving  the  internal  sphincter  and  other  mus- 
cular tissues,  be  more  conservative. 

The  division  of  both  sphincters  may  leave  the 
individual  with  incontinence  of  feces,  and  ^  such 
a  patient  is  apt  to  be  very  unforgiving,  espe- 
cially if  it  be  a  lady  who  has  been  rendered 


loathsome  to  herself,  and  doomed  to  the  constant 
wearing  of  a  napkiiL" — Kelsey. 

By  the  term  "  horse-shoe  fistula,"  we  mean 
that  variety  which  usually  has  one  or  more  ex- 
ternal orifices  on  either  side  of  the  anus,  and  an 
internal  one  in  the  median  line  behind. 

The  external  openings  may  be  e^ui-distant 
from  the  anus  on  either  side,  or  one  may  be 
near  the  anal  orifice  and  the  other  far  out  on 
the  buttock,  or  situated  anteriorly,  or  there  may 
be  only  one  external  orifice  the  other  being  of 
the  blind  variety.  AKain,  there  may  be  many 
external  openings,  and  in  some  cases  more  than 
one  internal. 

This  fistula  is  generally  due  to  an  abecess, 
situated  between  the  rectum  and  coccyx,  which 
is  prevented  from  breaking  through  the  skin 
immediately  over  it  by  the  fibrous  raphi  extend- 
ing from  the  tip  of  the  coccyx  to  the  anus;  hence 
it  courses  its  way  forwards,  and  opens  usually 
on  either  side  of  the  rectum,  externally,  and 
into  the  bowel,  dorsally,  between  the  two  sphinc- 
ters. 

Doubtless  many  such  cases  have  been  treated 
as  two  separate  and  distinct  fistulse,  and  were 
the  operator  to  recognize  that  he  was  dealing 
with  a  horse-shoe  fistula,  if  he  followed  the  usual 
plans  laid  down  in  the  text-books,  he  would  slit 
up  first  one  sinus,  then  the  other,  at  one  sitting, 
and  in  each  instance  divide  the  sphincter  ob 
liquely,  which  would  almost  certainly  be  followed 
by  incontinence. 

Allingham,  Crips,  Mathews,  Van  Buren  and 
other  authors,  are  anything  but  clear  in  their 
description,  pathology  and  method  of  operative 
procedure  in  this,  the  very  worst  form  of  fis- 
tula. 

The  writer  is  indebted  to  Mr.  Goodsall,  of 
London,  who  first  directed  his  attention  to  the 
origin  and  conformation  and  method  of  opera- 
ting in  this  variety  of  fistula,  and  has  since 
noticed  Mr.  GoodsalFs  observations,  recorded  by 
Kelsey  and  Cooper  and  Edwards.  I  should 
also  like  to  take  this  opportunity  of  thanking 
him,  not  only  for  instruction  in  this  subject,  but 
for  much  information  on  many  points  in  rectal 
surgery. 

In  operating,  Mr.  Qoodsall  passes  a  pipbe- 
pointed  director  through  the  internal  opening, 
and  on  its  point  incises  the  skin  in  the  median 
line  behincC  then  pushes  the  director  through 
and  slits  up  the  tissues  over  it ;  directors  are 
then  passed  in  at  the  external  openings  and  out 
at  the  dorsal  incision,  and  the  tissues  divided. 

This  necessitates  only  one  division  of  the 
sphincter,  and  that  at  right  angles,  which  greatly 
diminishes  the  liability  to  incontinence. 

The  rationale  and  importance  of  this  method 
of  operative  procedure  commends  itself  at  once ; 


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863 


yet  in  many  of  these  cases  we  can  lay  open  the 
fistulous  tracts  and  cure  our  patient  without  di- 
viding the  sphincter  at  all. 

The  mode  of  operating  is  as  follows :  After 
dividing  the  skin  on  the  point  of  the  director, 
as  suggested  by  Mr.  Goodsall,  instead  of  push- 
ing the  director  through  and  dividing  the  muscle 
over  it,  remove  it,  and  curette  this  s'nus  thor- 
oughly ;  then  divide  the  other  fistulous  tracts  as 
above  described.  This  severs  the  attachment 
of  the  sphincter  to  the  coccyx  The  sphincter 
will  then  be  pulled  in  and  upwards,  and  the 
tvalls  of  the  curetted  dorsal  tract  br jught  in 
juxtaposition,  and  they  will  unite,  completely 
obliterating  it 

We  then  have  simply  an  external  wound  to 
deal  with,  which  will  heal  very  readily,  and  the 
danger  of  incontinence  of  feces  is  avoided. 

Observe,  also,  that  the  bowels  may  move  at 
any  time,  and  that  the  excrement  will  not  come 
in  contact  with  the  wound. 

Should,  for  any  reason,  the  dorsal  tract  fail 
to  heal,  laying  it  open  later  will  be  a  simple 
procedure,  and  it  will  not  interfere  with  the 
progress  of  the  case  in  the  least 

J.  R.  Pennington,  M.D., 

103  State  st,  Chicago. 


Chronio  Bright't  Disease. 

Editor  Medical  World: — In  answer  to 
Dr.  M.  F,  Dismaris,  of  Los  Vegas,  N  M.,  I 
have  adxised  him  by  letter  to  report  results  of 
the  following  treatment  in  his  case  of  chronic 
Bri^ht's: 

1st  To  relieve  the  neuralgic  condition,  give 

R.   Bromidla  (Battle's) 

Papice,  ••       aa 

M.  S.  'Teaspoonftil  every  half,  one  or  two  hours,  or  as 
neceflsaty  to  relieve  pain  and  produce  sleep. 

2d.  Continue  the  us  3  of  Basham's  mixture. 
3d.  To  reduce  albumen, 

B.   Hf  diarg.  biniodide. grrain  1-32 

Potasi.  iodide.. grains  x-xv 

Syr.  aurant.  cort qs 

Give  at  one  doae  three  times  daUy  after  meals. 

4th.  All  the  Bufialo  Lithia  Water  he  may 
wa  t  Di.  W.  P.  Smith, 

Gothenburg,  Neb. 


Ske  page  xxii  for  a  good  chance  this  month  to  get 
large  value  for  little  money.  Don't  hesitate  because 
your  subscription  is  not  quite  out.  We  can  credit  joo 
just  as  well  from  the  time  that  your  present  subscrip- 
tion will  expire.  We  would  rather  do  it  now,  for  it 
would  help  to  relieve  the  great  pressure  of  subicrip- 
tions  that  always  comes  to  us  in  December. 


Uremic  Poisoning. 

Editor  Medical  World  : — I  wish  to  repirt 
a  case  that  may  be  of  interest  to  some  of  the 
brethren.  , 

Carrie  G.,  colored,  aged  eighteen  years,  was 
delivered  at  8  a.  m.,  August  5th,  1894,  by  a 
midwife.  About  12  m.  convulsions  set  in.  She 
had  had  no  trouble  in  labor,  nor  in  the  delivery 
of  the  placenta.  Canvulaions  increased  in  fre- 
quency and  duration  until  dark,  having  occurred 
about  every  hour,  when  I  was  called  in.  I 
gave  at  once  per  orem — 

Hydrate  of  chloral grains  x 

Tr.  verat  vlride gtt.  x 

This  was  at  8  p.  m.  At  9  p.  m.  she  became 
rational,  and  called  for  something  to  eat.  This 
was  the  first  time  she  had  noticed  anything 
since  the  firet  convulsion.  During  the  night 
the  convulsioDS  recurred  every  two  or  three 
hours,  lasting  from  a  few  seconds  to  a  minute, 
each  one  being  milder  than  the  one  previous. 
Treatment  during  the  night  was : 

rWoral  hydrate grains  6 

Tf.  Terat  viride ^tt  2 

Tr-buchu fl  dram  1 

every  four  hours,  alternating  with  a  hypoder- 
mic of 

Rulph.  codeia grain  J^ 

Tr.  verat.  Tlr gtL  6 

every  four  hours. 

When  I  left  at  daylight  I  ordered 

Potass,  nitrate graJntx 

Hydrate  of  chloral giains  ▼ 

Tr.  verat.  vlridc gtt.  il 

IT.  buchn... « fl.  dram  1 

to  be  given  every  hour.  I  saw  her  again  at  5 
p.  m.  She  had  had  no  convulsions  since  10.30 
a.  m.  I  continued  the  treatment,  but  increased 
the  interval  between  doses  to  two  hours.  This 
treatment  was  kept  up  for  forty-eight  hours, 
resulting  in  recovery.  Not  havbg  the  proper 
appliances,  I  did  not  examine  the  urine,  but 
presume  I  had  a  case  of  uremic  poison  mg  to 
deal  with.  A.  W.  Vidal,  M.D., 

Fruit  Hill,  8.  C. 


A  Case  of  Puerperal  Convulsions. 

Editor  Medical  World  : — On  August  31st 
I  was  hurriedly  called,  at  five  o'clock  in  the 
momiDg,  from  my  home  to  a  distance  of  eight 
miles,  to  see  Mrs.  C,  the  messenger  stating  that 
she  was  dying  with  fits.  The  husband  met  me 
at  the  gate,  saying :  "  Hurry,  Doctor,  my  wife 
is  dying."  On  reaching  the  bedside  I  found 
her  entirely  unconscious,  and  suffering  from 
fearful  puerperal  convulsions.     I  made  inquiry 


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of  the  midwife,  and  she  stated  that  the  child  was 
bom  at  half-past  twelve  a.  m.,  and  that  she  had 
a  very  easy  time ;  that  it  was  not  an  hour  from 
^he  first  pain  before  the  ohild  was  bom,  and  in 
en  minutes  afterwards  the  afterbirth  was  de- 
livered, and  the  woman  said  she  had  "  never 
^elt  so  well  nor  had  so  easy  a  time  before,"  and 
'this  is  the  fifth  child.  She  rested  well  up  to 
three  o'clock  a.  m.,  when  she  suddenly  went  off 
into  a  convulsion.  She  had  eight  up  to  the 
time  I  arrived.  I  gave  her  a  hypodermic  of 
sulph.  morphine,  gr.  i  ;  sulph.  atropine,  grains 
j^,  but  it  had  no  good  effect.  I  then  ga7e  a 
hypodermic  of  eight  drops  of  tincture  of  verat- 
rum  virile,  which  stopped  them  until  four 
o'clock  p.  m.,  when  they  came  on  again.  I  re- 
peated the  veratrum  viride,  and  they  stopped. 
I  then  put  her  on  aconite  and  gehimlnum  every 
three  hours. 

On  this  date  (September  4th)  mother  and 
child  are  both  doing  well.  I  would  like  to 
know  what  caused  the  convulsions.  Will  some 
of  the  readers  of  The  Wobld  tell  me,  and 
what  you  think  of  the  treatment  ?  If  it  was  not 
the  best,  it  acted  well.  She  was  very  billions. 
T.  D.  Hawkins,  M.D., 

Kmg's  Ferry,  Fla. 


Fatal  Case  of  Post-Partum  Hemorrhage. 

Editor  Medical  World  : — Many  rush  for- 
ward to  your  most  valuable  joumal  to  display 
their  successes,  but  I  come  to  day  to  tell  of  a 
fatal  case  of  po8^partum  hemorrhage. 

I  was  called  on  July  29th,  1894,  at  2  a.  m., 
to  see  Mrs.  D.,  age  17,  primapara,  three  miles 
in  the  country.  I  was  told  before  leaving  that 
the  child  had  been  delivered,  but  the  messenger 
could  not  tell  what  was  the  trouble  ;  so  I  set  off 
post  haste,  and  arrived  in  a  short  time,  and 
found  the  mother  with  uterine  inertia  and  pro- 
fuse hemorrhage.  Upon  vaginal  examination 
I  found  the  placenta  in  situ,  having  never  been 
delivered,  and  the  uterus  and  vagina  filled  with 
blood.  Shock  from  loss  of  blood  was  very  pro- 
found. 

I  immediately  introduced  my  left  hand  into 
the  uterus,  and,  with  my  right  on  the  abdomen, 
kneaded  the  womb  between,  and  at  the  same 
time  gave  fl.  ext  ergot,  dram  ss,  hypodermic- 
ally,  every  ten  or  fifteen  minutes,  until  two 
drams  were  given.  Being  so  far  in  the  coun- 
try, these  were  the  only  means  at  hand  to  check 
hemorrhage.  Slight  contractions  resulted,  and 
the  placenta  was  delivered  and  hemorrhage 
lessened,  bi^t  it  did  not  stop.  Stimulation  was 
not  neglected. 

At  this  time  I  informed  the  family  that  death 


was  inevitable,  and  despatched  her  father  to 
town — ^three  miles — for  ice,  but  told  him  before 
he  left  that  his  daughter  would  be  no  more  ere 
his  return.  She  lay  down  quietly  and  gradu* 
ally  sunk  into  oblivion.  Her  respiration) 
grew  slower  and  slower,  until  death  closed  the 
scene. 

Now,  for  the  first  time,  could  I  indulge  in 
questbns.  She  had  been  taken  in  labor  eighteen 
or  twenty  hours  previously;  everything  pro- 
gressed very  smoothly  until  the  child  was  bom, 
at  1  a.  m ,  when  postpartum  hemorrhage  set 
in,  so  prof  us  3  that  before  she  could  be  removed 
from  the  chamber,  upon  which  she  had  been 
delivered,  blood  accumulated  in  the  vessel  up 
to  half  its  capacity.  The  old  woman,  getting 
alarmed,  sent  three  miles  atler  me,  the  young 
mother  bleeding  all  the  while.  When  I  arrived 
the  bed  was  soaked  with  blood.  Shock  was  so 
profound  that  reaction  never  set  in.  I  had  no 
perchloride  of  iron  with  me,  but  I  did  not  regret 
it,  as  I  felt  assured  that  neither  it  nor  anything 
else  could  have  saved  her  life. 

The  old  midwife  sat  down  in  perfect  amaze- 
ment, and  saw  her  patient  bleed  to  death ;  and 
yet,  some  few  months  ago,  the  Florida  State 
Board  of  Health  were  speaking  of  having  pam- 
phlets printed,  for  distribution  among  these 
midwives,  telling  them  of  antisepsis.  How  can 
you  preach  antisepsis  into  anti  knowledge — ^igno- 
rance? 

How  can  we,  as  physicians,  do  otherwise  than 
condemn  such  laws  ? 

Snead's,  Fla.     W.  Walter  Tison,  M.D., 

[Cases  of  post  partum  hemorrhage  are  occa- 
sionally so  severe  that  nothing  can  check  them. 
The  Doctor  being  on  the  ground,  probably  did 
many  more  things  than  he  takes  time  here  to 
relate.  Yet  we  cannot  neglect  this  opportunity 
to  recall  for  the  benefit  of  the  new  recruits  m 
the  ranks,  some  of  the  measures  that  may  al- 
ways be  resorted  to  for  relief,  often  with  suc- 
cess in  apparently  hopeless  cases,  viz : — Elevat- 
ing the  foot  of  the  bed ;  hot  water  injected  into 
the  uterus ;  vinegar,  or  lemon  juice,  or  turpen- 
tine, injected  into  the  uterus  or  carried  in  with 
a  sponge  or  soft  cotton  cloth ;  pouring  from  a 
height  upon  the  abdomen  alternately  hot  uii 
cold  water ;  compressing  the  abdominal  aorta ; 
full  doses  of  dititalis.  ipecac,  or  opium  until 
effect;  never  give  up  until  patient  is  dead. — 
El).]  

Seb  Dr.  Abbott's  exoelleni  article  in  this  iasae  ob 
"  A  Pocket  Phannacy."  The  cue  which  we  offer  in 
coDnection  with  World  on  page  xxii  includes  all 
the  emergency  drugs  which  he  mentions,  and  many 
others. 


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365 


Antiseptics  Not  Neoeisary  in  Obstetrics. 

Editor  Medical   Word: — As  some  years 
htye  passed  since  I  appeared  last  in  jour  col- 
umns, all,  or  nearly  ail,  your  readers  have  no 
doubt  Imt  sigiit  of  me,  and  to  remind  you  all 
that  I  still  Uve,  and  am  a  constant  reader  of 
The  Wobld,  as  well  as  to  join  the  general 
**  experience  meeting,"  I  again  ask  for  leave  to 
say,  briefly,  my  say  in  regard  to  the  use  of  an- 
tiseptics in  general  obstetric  practice.      I  am 
constrained  to  speak  npw,  for  the  reason  that 
list  night  I  attended  case  No.  2,500  in  labor. 
Have  been  in  active  practice  thirty  years,  have 
met  with  all  the  difficult  labors  it  is  possible  for 
a  physician  to  meet,  excepting  one  requiring 
csesarean    section;     I    have    turned    thirteen 
times,    met    placenta    previa  six  times,   per- 
formed craniotomy  once,  and  met  with   puer- 
peral convulsions    quite   a  number   ot  times. 
I  have  never  washed  out  a  vagina  after  labor, 
and  have  never    made  use  of  an  antiseptic 
agent,  excepting  pure  water,  on  my  hands,  as  a 
wash,  and  have,  in  these  2,500  cases,  never  had 
a  woman  to  die  in  confinement,  or  within  three 
months  after,  and  these  were  deaths  caused  by 
diseases  not  involving  the  genitalia.     Is  there, 
in  this  experience,  any  argument  in  favor  of 
meddlesome  injections  of  the  vagina  and  uterus 
in  post  parium  cases?    I  have  in  these  years 
seen  quite  a  number  of  cases  of  puerperal  fever 
in  the  practice  of  brother  physicians,  having 
been  called  in  consulation,  but  never  had  a  case 
of  that  dread  disease  in  my  own  practice.     My 
woik  has  been  among  the  wealthy,  as  well  as 
among  the  poor ;  among  some  of  the  most  cleanly 
as  well  as  among  those  who  live  in  filth.     I  at- 
tribute much  of  my  good  fortune  in  this  respect, 
1st,  to  my  own  personal  cleanliness,  and  2d,  and 
by  far  the  most  important,  to  my  persistent  and 
emphatic  refusal  to  take  charge  of  a  case  in  ob- 
stetrics while  attending  a  case  of  erysipelas,  or 
after  seeing  a  case  of  puerperal  fever,  for  the 
period  of  at  least  two  weeks  after  attending  a 
case  of  either  of  these  diseases.     My  practice 
has  been  confined  to  village  and  country,  and 
it  may  be  that  country  air  has  helped  the  avoid- 
ance of  many  &taiities ;  yet  I  cannot  endorse, 
with  my  experience  behind  me,  the  much  lauded 
though  meddlesome  vaginal  douche  as  a  part  of 
pod  parium  treatment     My  treatment  of  the 
woman  in  such  cases  is  a  doee  of  two  tablespoon- 
fuls  of  castor  oil,  or  a  tablespoonf ul  of  calcined 
magnesia,  on  the  third  day,  a  careful  regulatioii 
of  diet,  and  the  recumb^t  position  during  at 
least  ten  days  after  delivery,  keeping  the  room 
and  bed  as  clean  as  circumstances  will  permit ; 
though  I  must  confess  I  frequently  find,  on 
making  my  after  visits,  a  room  and  bed  full  of 
odors  not  as  pleasant  as  those  of  roses.     Any 


and  all  advice  I  may  give  to  some  of  these  very 
careless  people  is  a  waste  of  words,  for — "  Doc* 
tor,  you  know  it  won't  do  to  change  bedclothes^ 
or  open  a  door  or  window,  because  she  might 
take  a  dreadful  cold,  you  know." 

I  just  now  recall  a  case  of  post  partum  hem- 
orrhage I  met  with  a  few  years  ago,  in  which^ 
as  usual,  the  bed  was  saturated  with  blood.  On 
my  return  to  see  the  case,  on  the  third  day  after 
delivery,  I  found  the  patient  lying  among  the 
same  clothes  in  the  same  bed,  with  all  the  door» 
and  windows  cloaed ;  and  this  was  in  August 
The  condition  of  the  atmosphere  in  that  room  i» 
better  imagined  than  desciibed;  and  yet  that 
woman,  a  primipara,  was  in  fine  spirits,  and  not 
a  single  bad  symptom  followed.  I  have  attended 
her  twice  since,  and  with  all  this  filthy  careless- 
ness she  enjoys  life  and  child-bearing. 

It  appears  that,  since  this  is  a  natural  pro- 
cess, nature  manages  these  filthy  cases  in  her 
o?m  way,  and  they  all  make  a  speedy  recovery. 
Wm.  B.  Bigler,  M.D., 

East  Prospect,  Pa. 


Decubitus  lii  Labor. 


Editor  Medical  World  v-My  patients  are 
not  required  to  go  to  bed  until  the  waters  break* 
They  may  change,  sitting  and  walking,  lounging 
for  awhile  when  fatigued.  When  they  do  turn 
in  to  stay,  they  lie  on  their  back  or  le/l  side — 
for  obvious  reasons  the  side  is  preferred.  When 
the  head  presents  itself  against  the  perineum,  if 
the  labor  is  progressing  too  rapidly — a  thing 
that  occurs  more  frequently  than  is  generally 
supposed — ^my  patient  is  confined  to  her  back^ 
the  bed  pressing  up  the  coccyx  against  the  too 
fast  descending  head.  To  illustrate  the  contrary 
course,  I  have  been  called  with  the  request  to 
be  sure  and  bring  my  forceps,  to  find  a  case 
hanging  fire  for  hours,  the  patient  fiat  on  her 
back,  insisting  on  dying,  the  attendants  worn 
out.  The  Doctor's  face  brightens  when  he  sees 
my  old  forceps,  which  I  have  owned  upwards  of 
thirty  years,  and  that  have  done  duty,  perhaps,, 
a  dozen  times — half  that  number,  though,  would 
be  nearer  the  mark.  The  patient  is  placed  on 
her  side,  thus  giving  the  coccyx  a  chance  of  get- 
ting out  of  the  way.  Without  any  forceps,  and,, 
what  is  better,  without  any  laceration,  the  child 
is  bom  within  the  next  thirty  minutes.  Doubt- 
less, this  is  nothing  new  to  hundreds  of  the  old 
World's  readers.  But  equally  doubtless,  there 
are  as  many  hundreds  who  will  do  well  to  stick 
a  pin  here.  Jerome  Bruce,  M.D., 

Sanford,  Fla. 


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THE  MEDICAL  WORLD. 


A  Case  of  Spina-Biflda. 

Editor  Medical  World  : — Nine  mont'is  ago 
I  attended  a  lady,  41  years  old,  in  her  eleventh 
conBnement.  The  labor  was  normal,  and  the 
child,  a  male,  weighing  7i  pounds,  was  perfectly 
formed  aside  from  the  existence  of  a  hydro- 
rachis.  or  spiaa-bifida.  The  sac  resembled  a 
large  blister,  about  the  size  of  a  two  cent  piece, 
somewhat  irregular  in  outline,  and  located  over 
the  lumbosacral  articulation.  Around  the 
margin  of  the  sac  the  skin  was  of  a  purplish 
tinge,  and  the  finger  could  detect  the  opening 
where  the  ossification  was  incomplete. 

I  painted  the  sac  thoroughly  with  two  or  three 
coats  of  collodion,  the  contraction  of  which 
diminished  the  size  of  the  sac  somewhat  Over 
this  was  now  placed  a  compress  of  absorbent 
cotton,  held  in  place  by  adhesive  plaster.  The 
collodi  n  was  applied  twice  a  day  for  two  weeks, 
when  the  heavy  crust  of  collodion  was  carefully 
removed.  The  sac  was. almost  obliterated,  the 
skin  being  considerably  irritated.  An  ointment 
of  borated  vaseline  was  rubbed  into  the  skin, 
and  the  cotton  compress  re-applied  for  a  few 
day '.  The  collodion.^as  again  ued  for  a  wee k. 
There  was  now  a  distinct  depression  where  the 
sac  had  been.  A^  bland  ointment  was  applied 
to  the  skin,  and  the  compress  continued  for  two 
monibs  as  a  protection.  At  the  end  of  this 
time  the  child  began  taking  two  grains  of  cjil- 
cium  phosphate  three  times  a  day.  At  the  age 
of  five  m£>nths  the  skin  over  the  site  of  the  sac 
remained  discolored,  but  the  opening  was  closed 
by  cartilaginous  tissue,  and  there  is  no  indica 
tion  of  further  trouble  from  it. 

Waterloo,  Wis.         0.  C.  Bailey,  M.D., 


A  MoMfer. 

Editor  Medical  World:— Dr.  Sherriirs 
case  was  indeed  very  badly  deformed.  I  wish 
to  report  a  case  which  was  of  much  in  teres:  to 
me,  as  well  a)  to  others  who  saw  it 

I  was  called,  May  13th,  to  see  Mrs.  F.  H., 
aged  35,  general  health  good,  mother  of  six 
children.  I  found  her  well  advanced  in  labor, 
but  was  unable  to  make  out  the  presentation. 
The  farther  advanced  the  more  difficult  it  be 
came.  I  finally  concluded  that  it  was  the  head, 
with  some  sort  of  abnormal  growth.  Labor 
became  very  tedious,  pains  hard,  but  little  ad- 
vance. Finally,  after  two  hours  hard  .work,  I 
succeeded  in  delivering  her  of  the  monster, 
which  was  at  full  term,  and  weighed  about  eight 
pounds — a  boy. 

The  first  thing  I  noticed  was  the  abDomal 
growth  on  the  head,  which,  when  supported  by 
the  hand,  assumed  the  shape  of  an  intant*a  bead. 
This  was  located  about  the  nape  of  the  neck, 


extending  slightly  upon  the  occiput,  being  at- 
tached by  a  very  well  farmed  neck,  though 
somewhat  short.  It  was  not  a  perfect  head, 
eicepting  in  shape.  It  had  no  cranial  bones, 
nothing  in  the  way  of  eye?,  ears  or  nose,  except- 
ing a  depression  showing  where  they  should 
have  been.  The  mouth  was  very  imperfectly 
formed,  on  the  interior  of  which  could  be  found 
a  trace  of  the  gums,  but  no  tongue.  By  careful 
examination  this  was  found  to  contain  a  soft, 
brainy  lo^kin^  substance,  and  an  alimentary 
canal.  Strange  to  say,  this  intestinal  caoai 
had  its  outlet  through  the  child's  true  mouth, 
which  gave  it  the  appearance  of  vomiting  the 
meconium. 

Now,  as  to  its  true  head,  which  was  somewhat 
small.  It  would  hi  hard  to  describe  it  fully. 
There  was  the  greatest  non  union  of  bones  I 
ever  met  with — -none  exceping  the  inferior 
maxillary  being  united,  a  id  it  was  non  artica- 
lated  most  of  the  time.  In  any  position  the 
head  was  laid,  the  force  of  gravity  caused  it  to 
assume  a  new  shape. 

The  right  eye  was  very  well  farmed,  the  left 
almost  entirely  missing.  Nose  very  small  ani 
short:  nasal  cavities  extra  large.  The  chest 
was  very  large*  extending  forward.  Under  the 
stethoscope  could  be  distinctly  heard  two  heart- 
sounds — one  un  ler  the  center  of  the  sternum, 
and  about  the  third  and  fourth  ribs,  the  other 
to  the  left  and  below  the  left  nipple. 

Tae  penis  was  of  proper  size,  but  very  abort. 
It  had  the  appearance  of  having  been  cut  off  at 
about  the  junction  of  the  prepuce. 

There  was  only  a  depression  of  the  uretha, 
but  no  passage.  On  the  second  day  I  inserted 
a  smill  sjund,  it  opening  the  way  till  it  reached 
under  the  pubic  bones,  where  it  entered  the  pas- 
sage of  the  uretha.  I  explored  the  passage,  but 
could  not  fiud  any  urinary  bladder. 

On  the  third  day  I  found  an  accumulation  of 
fluid  in  the  abnormal  head.  I  inserted  a  trocar 
and  drew  it  off  It  resembled  urine  very  much, 
which  I  think  it  must  have  been. 

The  monster  lived  four  days. 

Alba,  Tex.  Dr.  W.  H.  Smith. 


Distilled  Water  for  Rheumatism,— Treatment  fw 
Epilepsy.— Treatment  of  Tetanus. 

Editor  Medical  World: — Editor  Joseph 
Medill,  of  the  Chicago  Tribune,  has  formulated 
some  ideas  as  regards  the  cause  and  cure  ef 
rheumatism,  which  I  think  it  would  be  worth 
while  for  sister  Shaw  to  peruse. 

His  idea  is  that  in  the  water  we  drink,  more 
than  anything  else,  we  can  trace  the  cause  of 
rheuma  ism  and  lime  deposits,  and  he  recom- 
mends that  aU  afflicted  people  drink  only  dis 


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tilled  water,  or  that  which  is  most  free  from 
mineral  matter. 

I  know  for  a  fact  that  he  has  been  a  great 
sufferer,  and  from  his  recent  utterances  should 
say  that  he  has  been  successful  in  relieving  him- 
self, hj  strictly  adhering  to  distilled  water.  For 
my  part,  I  use  his  ideas,  with  a  little  quinine 
and  salicylate  of  soda — say  about  gr.  ii  of  each 
at  night.  For  an  external  application  I  use 
lard,  1  lb.;  capsicum  (pulv.),  oz.  iii;  camphor 
gum,  oz.  j  ;  dissolving  the  camphor  in  the  hot 
lard  and  cayenne ;  then  strain  through  cheese 
cloth.  Keep  well  closed  from  the  air.  Apply 
with  gentle  friction.  This,  with  the  free  use  of 
distilled  water,  relieves  mi^t  every  case. 

My  cases  of  epilepsy  do  well,  and  keep  free 
from  any  phase  of  the  trouble  on  the  following : 

IL   Ammopia  bromide. ounce  bs 

Tr.  beUadonna dram  Ii 

Tr.  goMen  seaL ounce  sa 

PM.  ext  ca»8  a. oanoe  i 

M.    8— Teaspoonful  evexr  8  hours  for  three  weeki.   Then 
one  tablespoonfhi  twice  a  day,  in  a  Uttle  water. 

If  people  will  only  be  caref  al  what  they  feed 
epileptics  on,  and  not  give  them  indigestible 
foods,  they  will  find  that  they  will  respond  more 
readily  to  treatment  I  have  one  case  that  has 
been  entirely  free  from  attacks  for  five  years, 
and  I  have  ceased  giving  anything  for  two 
years. 

I  wish  my  friends  would  direct  their  letters, 
stating  their  experience  with  vaccine  in  phthisis, 
to  The  Medical  World — ^not  to  me.  I  am 
convinced,  but  others  are  not 

I  had  a  case  of  tetanus  last  week,  from  the 
remit  of  rusty  nail  in  the  foot.  I  have  Eeen  two 
cases  of  rabies  in  my  life  time,  and  I  fail  to  see 
much  difference  in  the  symptoms. 

Tincture  of  gelseminum,  in  20  drop  doses,  with 
an  enema  of  lobelia,  and  afterwards  acentanilid, 
grains  ten,  one  dose,  has  brought  him  out  all 
right  I  would  advise  this  treatment  in  all 
cases,  especially  the  acentanilid.  I  must  here 
confess  to  having  no  prejudice  against  this  drug. 
It  works  wonderfully,  and  in  confinement  casei, 
where  the  os  will  not  dilate  leadily,  and  the 
pains  are  backward,  a  10  grain  doae  does  the 
business  for  me. 

I  am  almost  totally  deaf  from  thickening  of 
the  drum.  Can  any  one  please  suggest  any- 
thing? H.  S.  Brewer,  M  D., 

Cor.  State  and  Madison  sts.,  Chicago,  111. 


Replies. 

Editor  Medical  World:— To  Dr.  Bobb, 
Pg.  334, 1  would  suggest  that  he  examine  her 
urine  with  the  microscope  very  thoroughly,  and 
also  be  sure  die  has  no  uterine  displacement. 
I  would  not  say  his  diagnosis  is  not  correct,  but 


think  the  microscope  will  tell  him  with  a  cer- 
tainty he  may  not  doubt. 

Dr.  W.  R,  Pg.  335,  does  not  say  whether  he 
has  examined  the  urine  or  not.  Would  certainly 
do  so  if  not.  It  reminds  me  very  much  of  a 
case  where  I  found  an  eroded  condition  of  the 
OS  uteri,  which  I  suspect  he  will  find  if  he  exam- 
ines his  patient  I  would  not  trust  wholly  to  a 
digital  examination,  but  use  the  speculum.  If 
the  spinal  tendeme^s  continues  I  would  apply 
small  blisters  along  the  tender  spots. 

Mr.  Editor,  would  it  not  be  a  good  idea  to 
suggest  to  the  correspondents  to  The  World, 
when  replying  to  the  others,  to  give  the  page,  at 
least,  on  which  the  article  being  answered 
is  found  ?  I  many  times  like  to  refer  to  the  cases 
under  discussion  and  many  times  have  to  look 
through  two  or  three  numbers.  It  would  save  so 
much  time.  I  have  no  doubt  many  others 
experience  the  same  inconvenience. 

F.  H.  Forshee,  M.D., 

McGrawville,  N.  Y. 

[The  Doctor's  suggestion  is  a  good  one.  We 
have,  in  the  past,  made  the  request  of  our 
readers,  but  it  seems  to  have  been  since  forgotten. 
—Ed.] 


Treatment  of  the   Morphine  Habit— Experience 

with  Zinc  Sulpho-Carbolate  in  Typhoid 

Fever— Gastric  Catarrh  Treated  With 

the  Same  Remedy,— Nitrio  Aoid  for 

Remittent  Fever.— Value  of 

Aoetaniiid. 

Editor  Medical  World  :--I  was  treating 
a  case  of  the  morphine  habit  by  the  gradual 
reducdon  method,  when  I  read  Dr.  Waugh*s 
able  article  in  August  World,  and  as  my 
padent  at  that  time  had  taken  no  morphine  for 
forty-eight  hours,  she  was  in  great  agony  from 
pains  in  the  back  and  head,  and  also  complained 
of  aching  of  the  whole  body.  She  had  hot 
flushes  and  considerable  perspiration  at  intervals 
of  one  or  two  hours.  For  the  various  pains  of 
the  body  I  prescribed  Dr.  Waugh's  prescription 
of  aoetaniiid,  sodium  salicylate,  and  ammonium 
bromide,. of  each  five  grains,  to  be  repeated 
every  hour  or  two  until  relief  was  obtained. 
Its  effects  were  most  gratifying,  promptly  reliev- 
ing all  pain  except  the  neuralgia  of  the  fifth 
nerve,  which  appeared  to  be  rather  obstinate. 

I  have  now  under  treatment  four  caeee  of 
typhoid  fever,  two  of  which  are  convalescent, 
all  of  which  were  treated  throughout  the  course 
of  the  disease  with  zinc  sulpho-carbolate.  In 
one  of  the  cases  the  temperature,  on  the  eleventh 
and  twelfth  days,  ran  to  103,  evening  tempera- 
ture ;  bowels  moving  four  and  five  times  in  the 


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course  of  twenty-four  hours.  He  was  taking 
the  zinc  sulphocarbolate  in  2}grain  doses  every 
three  hours.  I  ordered  it  to  be  given  every 
two  hours  until  further  notice.  At  my  next 
visit  I  found  his  temperature  one  degree  lower, 
and  bowels  less  active,  and  all  of  his  symptoms 
better.  This  turn  for  the  better  I  can  only 
attribute  to  the  more  thorough  aseptic  condition 
of  the  bowels,  produced  by  giving  the  zinc  salt 
in  quantities  sufficient  to  produce  the  desired 
effect 

For  a  case  of  gastric  catarrh,  following  la  grippe, 
in  an  aged  lady,  after  trying  nearly  every- 
thing recommended,  I  gave  her  sulphocarbo- 
late of  zinc,  2i  grains  every  three  hours,  and 
bad  the  pleasure  of  seeing  a  rapid  recovery  and 
of  obtaining  the  good  graces  of  the  old  lady,  as 
she  had  become  despondent,  and  had  about 
concluded  that  her  days  on  earth  were  num- 
bered. 

Some  one  recently  asked  what  to  give  instead 
of  quinine  in  remittent  fever.  I  will  speak 
from  experience,  that  dilute  nitric  acid,  given 
in  full  doses  every  four  hours,  will  seldom  dis- 
appoint us  in  curing  a  remittent  or  intermittent 
fever,  if  given  steadily  in  ten-drop  doses  every 
four  hours  for  two  days.  I  frequently  use  it 
in  such  cases,  as  the  patient  is  not  troubled  with 
the  annoying  symptoms  of  cinchonism. 

I  see  some  physicians  are  sa3dng  they  don't 
like  acetanilid — that  it  is  a  dangerous  drug, 
etc.  I  must  say  t*hat  there  is  no  remedy  that  I 
give  oftener  than  acetanilid,  and  that  there  is 
no  single  remedy  that  has  done  as  much  toward 
giving  me  a  start  in  practice,  and  gaining  the 
confidence  of  the  people,  as  the  much-abused 
drug,  acetanilid.  Certainly,  if  given  in  doses 
too  large,  or  not  properly  guarded  by  stimulants 
in  the  weak  and  delicate,  we  may  occasionally 
have  symptoms  of  cyanosis.  But  I  almost  inva- 
riably give  it  in  whisky,  to  counteract  its  de- 
pressing effect  I  mean  in  cases  of  fever.  A 
lady  remarked  to  me  once  that  she  never  saw 
anything  cool  fever  so  quickly  and  so  certainly 
as  "  those  little  white  powders."  She  was  a  very 
intelligent  lady,  and  had  lived  in  large  cities, 
with  exceptional  advantages  of  observation,  and 
she  knew  a  good  thing  when  she  saw  it. 

Dixon,  Ky.  C.  M.  Smith,  M.D., 


Mustard  Platters.— Aoetanilid.— Pruritus  Vulva. 

Editor  Medical  World: — In  the  Septem- 
ber No.  (page  327),  I  see  an  able  article,  headed 
**  Use  and  Abuse  of  Mustard  Plaster."  But, 
Doctor,  we  do  not  care  to  put  mustard  plasters 
on  dead  babies.  If  you  read  my  article  care- 
fully (page  276,  August  World),  you  will  find 


that  also  something  is  done  towards  the  central 
nervous  system.  Theories  are  good  — sometimes 
right,  sometimes  wrong ;  but  practical  success 
must  crown  our  theories,  or  else  they  belong  to 
the  gray  ones.  As  I  have  not  lost  a  siDgle 
case  of  cholera  infantum  for  years,  treated  by 
me  exclusively,  I  will  stand  by  my  treat- 
ment 

*'  Use  and  abuse."  The  same  can  be  said  of 
all  internal  and  external  remedies,  and  I  repeat 
again  that  you  achieve  quicker  results  bf  using 
plasters  than  without  Only  last  week  I  had  a 
case  of  cholera  infantum,  where  I  did  not  use 
the  plaster.  The  next  day  I  was  informed  that 
the  diarrhea  had  improved,  but  there  had  been 
a  steady  retching  until  grandma  put  a  mustard 
plaster  on,  and  then  it  stopped.  Here  Doctor 
Grandma  took  the  cake. 

I  have  used  acetanilid  since  it  became  known, 
and  never  had  any  bad  result^ ;  never  saw  kid- 
ney lesions.  Idiosyncrasy  is  no  cause  for  con- 
demning a  medicine  Give  small  doses,  hourly 
repeated,  and  you  will  have  no  ill  e6fects.  Five 
grains  ought  to  be  the  maximum  adult  dose.  I 
have  used  all  antipyretics,  but  find  acetaailii 
sufficient  in  all  cases,  and  far  superior  to  o.hers. 
In  the  *^  grip  "  time  I  gave  it  to  old  and  young, 
to  strong  and  weak,  with  succass.  Many  excel- 
lent remedies  have  fallen  into  disuse  simply  on 
account  of  indifferent  d  Dsage.  All  our  remedies 
have  different  action  in  different  doses.  I  bold 
it  to  be  the  most  difficult  study  to  master  the 
administration  of  medicines.  Every  practi doner 
should  have  or  make  a  selection  out  of  the  my- 
riads of  medicines  now  in  vogue,  study  their 
actions  to  the  fullest  extent,  and  he  will  be  sur- 
prised how  small  a  supply  is  needed.  For  ex- 
ample: If  you  00 1y  could  obtain  opium,  calo- 
mel, aconite,  quinine,  and  one  powerful  germi- 
cide, can  you  think  of  any  case  that  could  not 
be  properly  and  beneficially  treated,  with  pro- 
per hygiene,  and  the  so  called  domestic  reme- 
dies? 

Wolfgang  Wedel,  in  his  Opiologie,  says  :— 
*^  Sacra  viUz  anchora  circumspecte  ag€nlU>us  ed 
opium  cymba  vero  charonitis  in  manu  imperitj/.** 
It  is  a  double  edged  sword,  a  gift  of  heaven,  in 
the  hand  of  the  master ;  the  deadliest  poison  in 
the  hands  of  the  ignoramus.  The  same  holds 
good  of  all  remedies,  not  even  aqua  pura  ex- 
cepted. 

For  pruritis  vulvse. — First  examine  closely 
for  causes,  kidney  lesions,  especially ;  try  to  cure 
cause  if  possible.  Wash  and  clean  well ;  dry 
parts  with  absorbent  cotton,  vagina  as  well  as 
vulva.  Apply  spirits  of  camphor  on  labia 
majora  and  minora,  and  around  the  clitoris  and 
folds  of  the  frenum.  Lord !  how  it  bums !  bnt 
only  for  a  couple  of  minutes ;  after  five  minutes, 


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paint  well  with  fluid  extract  hammamelis,  and 
jou  give  your  patient  a  speedy  relief,  and  cure 
when  cause  is  curable.     Try  it. 

Colwich,  Kan.  Dr.  John  Zenneb. 


Peculiar  Toleranoe  of  a  Large  Dose  of  Aoetanlid. 

£ditor  Medical  World  : — Seeing  a  number 
of  articles  in  The  World  regarding  acetanilid, 
I  will  repeat  something  I  reported  to  your  jour- 
nal some  years  ago. 

Mrs.  J.  B.,  in  the  habit  of  taking  one  of  the 
^fieryescing  granular  headache  remedies  took 
a  heaping  teaspoonful  of  acetanilid  without  seri- 
ous results. 

I  dipped  up  a  heaping  teaspoonful  from  the 
same  box,  and  found  that  it  weighed  35  grains. 

I  saw  her  one  hour  after  she  had  taken  the 
doce,  not  to  administer  an  antidoie,  but  to  pre- 
scribe for  the  heidache,  which  was  unrelieved. 
Her  pulse  rate  was  fair,  and  she  suffered  no  in- 
convenience whatever  from  the  unusual  doEe. 

Mrs.  B.  is  slight,  nervous,  and  will  weigh  not 
far  from  100  pounds. 

Jab.  M.  Donblan,  M.D., 

Glenwood,  Iowa. 


Acetanilid  Once  More. 


Editor  Medical  World: — I  notice  in  the 
September  World  a  communication  from  Dr. 
D.  BoewelL  I  once  more  want  to  impress  upon 
the  family  of  World  readers  the  importance  of 
this  great  and  certain  antifebrile  remedy,  I 
speak  from  an  experience  of  eighteen  years,  and 
until  within  some  six  or  seven  years  I  have  had 
fever  cases  of  104  or  105,  which  have  troubled 
me  greatly,  for  I  have  failed  to  reduce  the  fever 
in  many  cases  to  an  extent  which,  to  me,  was,  to 
eay  the  least,  discouraging,  except  by  resorting 
to  the  cold  pack,  or  bath,  which,  as  a  rule,  is 
looked  upon  by  the  laity  as  a  dangerous  prooe- 
<iure,  and  one  which  they  would  not  submit  to 
except  by  holding  us  responsible  to  the  extent 
of  almost  a  warrant  of  final  and  rapid  recovery. 
I  was  on  the  lookout  for  a  remedy  in  just  such 
oases,  and  when  I  saw  acetanilid  I  watched  the 
reports  of  its  use  with  fear  and  trembling,  but 
finally  began  its  use  cautiously  in  just  these  high 
febrile  cases,  and  to  my  entire  satisfaction.  For 
some  eight  years  I  have  not  been  once  disap- 
pointed in  its  use.  1  will  say,  however,  that 
for  more  than  a  dozen  years  I  have  been  giving 
leas  doses,  often  repeated,  and  I  used  this  in 
from  2  to  5^grain  doses,  according  to  age  and 
necessity,  and  I  can  truly  say,  with  Dr.  Boewell, 
that  I  have  never  yet  failed  to  reduce  fever, 
and  in  a  way  entirely  satisfactory  to  myself,  and 
especially  so  to  my  patients.     I  therefore  speak 


with  great  assurance  in  this  matter,  and  only 
hope  I  may  induce  others  who  are  hesitating  in 
fear  and  trembling,  an  account  of  reports  which, 
I  am  convinced,  are  very  much  exaggerated 
ftx)m  either  fear  or  a  too  limited  use  of  the 
remedy,  to  pass  opinions  so  strong  as  I  have 
seen  passed.  I  would  not  have  said  more  on 
this  subject,  had  I  not  felt  that  a  great  remedy 
was  being  too  little  appreciated  by  many  of  the 
fraternity,  on  account  of  condemnation  by  a  cer- 
tain few  who,  I  am  now  sure,  have  either  used 
it  too  little  or  too  much  to  be  qualified  t6  con- 
demn it  as  they  have. 

Once  more  I  say,  in  all  high  fevers  give  this 
a  trial,  and  I  am  sure  no  more  will  have  to  be 
said  as  to  its  merits,  for  it  will  speak  for  itself 
in  no  uncertain  tone. 

I  would  suggest  to  the  fraternity  small  doses 
often  repeated  for  safe  and  satisfactory  results 
— not  homeopathic,  but  perceptible,  reasonable 
doses.  A.  R.  Garey,  M.D., 

Ashland,  N.  H. 


A  Case  of  Rabies. 


Editor  Medical  World: — The  following 
account  of  a  case  of  hydrophobia,  occurring  in 
my  practice  while  at  Avondale,  a  suburb  of 
this  city,  nearly  three  years  ago,  may  prove  of 
interest,  not  because  of  anything-  out  of  the 
usual  course  of  the  disease  shown  in  it,  but 
rather  because  it  may  stand  as  a  typical  case  of 
a  unique  and  terrible  disease. 

On  the  morning  of  December  31st,  1891,  I 
was  called  to  see  Henry  Bankwitz,  said  to  be 
suffering  from  difficulty  in  breathing.  On  arri- 
val I  found  the  patient,  a  strong,  vigorous  Grer- 
man,  aged  34,  walking  rapidly  around  the  room, 
swinging  his  arms  mldlj  about,  face  pale,  and 
with  a  distrested  expression,  staring  eyes  and 
gasping  respiration,  the  latter  so  violent  that  he 
could  hardly  speak  at  all — a  singular  and  never- 
to  be-forgotten  sight 

After  a  few  minutes  he  became  calm,  and 
related  the  following  history  in  a  perfectly  cool 
and  rational  manner. 

Five  days  before,  he  had  taken  a  shower  and 
steam  bath  down  town  at  night,  and  then  walked 
home,  feeling  no  ill-efiect  whatever  (as  he  had 
done  the  same  thing  many  times  before)  until 
the  afternoon  of  the  day  preceding  (December 
30th),  when,  while  washing  his  hands  at  a 
watering  trough,  he  suddenly  experienced  a 
sensation  as  of- being  plunged  into  cold  water, 
and  gasped  quickly  for  breath.  He  then  went 
into  a  saloon  for  a  glass  of  beer,  but  was  unable 
to  swallow  it.  On  going  home  immediately 
afterward,  he  found  himself  unable  to  swallow 
food  at  supper-time,  but  had  no  other  bad  symp* 


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toms.  He  passed  a  restless  night,  broken  bj 
frightful  dreams,  from  which  he  would  fre- 
quently wake  with  starts  of  terror,  and  bathed 
in  a  cold  perspiration.  The  bath  haunted  all 
his  dreams,  and  was  the  source  of  all  his  fears. 
About  6  a.  m.  he  had  begun  to  experience  a 
sense  of  suffocation,  and  the  gasping  respiration 
began,  and  had  been  growing  steadily  worse 
till  the  present  (9  a.  m.). 

He  had  always  been  in  good  health,  never 
drank  to  excess,  and  all  his  habits  were  good, 
as  was  also  his  family  history.  His  wife  thought 
he  had  not  been  looking  quite  well  for  a  week, 
but  he  was  not  conscious  of  any  bad  feelings  till 
the  preceding  afternoon.  Temperature  was 
normal,  pbyeical  examination  negative.  He 
could  not  remember,  in  answer  to  my  cautious 
question,  that  he  had  suffered  "any  injury" 
lately.  While  he  sat  quietly  talkmg  I  handed 
him  a  cup  of  coffee  from  the  breakfast  table, 
when  a  sudden  and  startling  transformation 
took  place.  Springing  from  Ms  chair,  and  with 
the  cup  tightly  clutched,  he  began  rushing 
wildly  around  the  room,  gasping  horribly,  and 
making  terrific  but  ineffectual  efforts  to  get  the 
cup  to  his  lips.  Calling  his  wife  into  another 
room,  I  iflquired  if  he  had  been  bitten  lately,  to 
which,  after  a  moment's  recollection,  she  replied 
in  the  affirmative,  a  little  calculation  giving  the 
date  as  six  or  sev^n  weeks  previous,  when  he 
had  been  bitten  on  the  leg  by  a  dog  in  an  alley 
near  Desplaines  street,  but  had  washed  out  the 
slight  wound  with  whiskey,  and  thought  but  lit- 
tle of  it  I  told  her  my  fears,  but  warned  her 
not  to  tell  the  paden^  as  I  wanted  to  be  sure 
my  diagnosis  was  not  obscured  by  his  apprehen- 
sions. My  fears  on  that  score  were  groundless, 
as,  on  my  return  two  hours  later,  I  found  that 
she  had  told  him,  but  he  flouted  the  idea,  being 
satisfied  that  the  shower  bath  (at  the  mere  men- 
tion of  which  a  paroxysm  returned)  was  the  sole 
cause  of  his  trouble. 

Be  grew  steadily  worse  during  the  afternoon, 
the  paroxysms  of  dyspnea  increasing  in  both 
frequency  and  intensity,  and  being  excited  by 
slight  causes,  as  a  sudden  noise,  or  especially 
any  reference  to,  or  sight  of,  water.  He  suffered 
greatly  from  thirst,  but  was  only  able  to  take  a 
few  swallows  of  water,  at  the  expense  of  the 
most  agonizing  efforts,  in  which,  seemingly, 
every  muscle  was  contorted.  From  5  to  8  p.  m. 
he  struggled  and  raved  almost  constantly,  rush- 
ing to  the  window,  crying  for  air,  and  requiring 
the  efforts  of  several  men  to  prevent  him  from 
throwing  himself  out  He  never  attempted  to 
bite  any  one,  but  frothed  constantly  at  the 
mouth.  A  peculiar  hoarse,  croupy  cough  began 
during  the  afternoon,  which  gradually  developed 
into  a  sound  so  closely  resembling  a  bark  as  to 


startle  people  who  had  not  heard  it  from  the 
first. 

After  10  o'clock  he  grew  gradually  quieter 
(he  had  received  about  60  grains  of  chloral 
during  the  evening,  given  by  enema),  and  sank 
into  a  stupor,  from  which  any  slight  sound 
would  arouse  him  to  renewed  spasms,  but  which 
gradually  grew  deeper.  His  last  severe  spasm 
was  at  midnight,  caused,  no  doubt,  by  the  can- 
nonading with  which  the  New  Year  was  ushered 
in.  He  died  at  2.30  a.  m.,  just  thirty  six  hours 
after  the  appearance  of  the  first  symptom  at  the 
water  trough. 

To  the  above  account  there  is  little  to  add. 
Treatment  was  palliative  only,  the  patient  stating 
that  the  hypodermics  of  morphine  and  atropine 
given  gave  the  most  relief  of  anything.  Chlo- 
roform by  inhalation  Was  not  practicable,  owing 
to  constant  and  violent  movements  of  the  head. 
The  maia  interest  centers  in  the  diagnosis,  and 
in  the  question  as  to  Whether  hydrophobia  is  a 
distinct  and  separate  disease.  How  any  one  can 
doubt  it  who  has  ever  seen  a  case  like  the  above 
is  incomprehebsible.  Surely,  a  disease  with  a 
definite  incubation  period,  a  definite  and  ascer- 
tainable cause,  and  a  train  of  marked  and  char- 
acteristic symptoms,  pursuing  its  unvarying 
career  to  a  &tal  end,  has  as  much  right  to 
recognition  as  a  distinct  disease  as  tetanus  or 
scarlatina. 

It  may  be  simulated  by  a  patient  of  nervous 
or  hysterical  tendencies ;  so  may  epilepsy ;  so 
may  pregnancy. 

If,  as  Dr.  Waugh  says,  he  has  never  seen  a 
genuine  case  of  rabies,  it  must  be  set  down  as  a 
curious  instance  of  the  irony  of  fate,  to  withhold 
from  a  man  of  wide  and  varied  experience  a 
sight  of  this  rare  and  curious  disease,  and  vouch- 
safe the  same  to  an  obscure  country  doctor- 
hiding  things  from  the  wise  and  prudent  to  re- 
veal them  unto  babes.  However,  the  Dodor 
is  the  last  one,  I  am  sure,  to  reject  light  from 
any  source.  A  great  and  wise  prophet  once 
received  instruction  from  his  ass,  and  in  the 
history  of  medicme  it  has  often  happened 
that  the  college  has  been  indebted  to  the  cross- 
roads. F.  L.  Robe,  M.D., 

5305  Halsted  street,  Chicago,  111. 


A  Treatment  of  Hydrophobia. 

Editor  Medical  World  : — Your  inquiry  for 
experience  with  hydrophobia  recalls  to  mind  two 
cases  which  came  under  my  observaticm  in  the 
wilds  of  Egypt — Southern  Illinois — some  thirty 
years  ago,  and  which  I  shall  never  forget 

They  were  boys,  about  13  and  18  years  oli 
I  should  judge,  bitten  by  a  dog  which  was  killea 

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several  weeks  previous  to  their  developing  the 
disease,  unmistakably  mad. 

The  youngest  died  after  long  hours  of  struggle 
and  agony,  notwithstanding  h  roic  doses  of 
morphine,  nux  vomica,  etc.,  and  a  liberal  use 
of  chloroform.  While  unconsious  under  the 
anesthetic  he  was  rolled  tight  in  a  stout  sheet 
wet  with  hot  water  to  await  the  next  spasm. 
This  only  seemed  to  aggravate  his  sufferings. 

The  older  boy,  taken  sick  a  week  afterwards, 
was  confined  in  a  very  hot  room  from  which  all 
liquids  were  excluded,  and  was  induced  to  chew 
and  eat  lobelia  leaves  freely  between  the  attacks. 
He  became  weak  as  a  child,  was  unable  to  stand 
or  sit,  sweat  profusely,  enormously,  drank  noth 
ing  for  two  days,  at  the  end  of  which  time  the 
spams  were  less  frequent  aud  severe  and  he  was 
able  to  eat  a  little  food  moistened  slightly.  He 
had  no  attacks  after  the  third  day,  and  was  soon 
around  the  house  perfecJy  well.  During  the 
three  days  he  wa?  kept  helpless  with  the  lobelia, 
using  no  other  medicine. 

This  was  in  1858.  I  have  not  seen  a  case  of 
this  disease  since,  but  have  desired  greatly  to 
have  this  remedy  further  tested* 

J.  H.  Sanborn,  M.D., 

973  Lake  St.,  Chicago,  111. 


Permanganate  of  Potassium  for  Poisoned  Bite  and 
for  Morphine  Poisoning. 

Editor  Medical  World  : — I  was  called  to 
see  Miss  B,  June  28rh  who  was  spider-bitten 
four  hours  l>efore  my  arrival.  I  found  her  suf- 
fering with  severe  pains,  the  limb  quite  badly 
swollen,  and  very  dark  color,  with  lightning 
pains  through  the  body.  I  gave  her  perman- 
ganate of  potassium,  half  grain  every  fifteen 
BdinutPS  for  the  first  hour,  and  after  this  time 
all  pains  ceased.  Fearing  that  the  pains  would 
return,  I  left  two  grains  to  be  given  in  doses  of 
half  grain  ea^h,  every  thirty  minutes,  if  neces- 
sary ;  but  learned  since  that  the  pains  did  not 
return. 

Of  course,  with  this  treatment  I  cauterized 
the  wound  and  poulticed  it 

I  have  used  permanganate  of  potassium  in 
one  case  of  over-dose  of  morphine,  and  it  worked 
wonders  G.  K  Huddle,  M.D., 

Kempner,  Tex. 


Potassium  Pemanganate  for  Opium  Poisoning  and 
Snake  Potsom— Queries. 

Editor  Medical  World  : — Communications 
have  been  coming  to  me  from  all  parts  of  the 
United  States  since  the  appearance  of  the  article 
on  the  *  confirmation  of  the  antidotal  power  of 
potassium  permanganate  against  opium,"  July 


World,"  page  239.     I  here  reply  to  the  fol- 
lowing question : 

**How  did  you  administer  the  pot.  per. — by 
the  mouth  or  hypodermic  needle  ?  "  After  ex- 
amining the  patient  I  found  there  was  no  time 
to  be  lost  to  make  a  known  strength,  but  made 
what  I  supposed  to  be  one- half  a  saturated  solu- 
tion, and  administered  one  half  teaspoonful  doses 
every  five  minutes  by  the  mouth.  I  did  not 
use  the  hypodermic  needle,  for  fear  of  an  ab- 
scess, after  considering  the  patient  in  question. 
The  antidote  acted  likd  a  charm  soon  after  be- . 
gining  its  use. 

I  was  called  to  see  Mrs.  D.  in  confinement, 
January  18, 1894.  After  the  birth  of  the  child 
I  found  that  its  scrotum  and  feet,  from  ends  of 
toes  up  to  one  inch  above  ankle,  were  black,  the 
father  being  a  blacksmith  by  occupation,  and  of 
white  complexion,  as  is  also  the  mother.  The 
qu  stion  was  asked  me,  **  Who  was  the  father  of 
the  child  ?  "  as  her  virtue  was  questioned.  Now, 
will  some  of  your  many  readers  answer  through 
The  World,  what  was  the  cause  of  the  black 
*scrotum  and  feet,  the  other  parts  of  the  body  be- 
ing  perfectly  white  ? 

On  August  30th,  1894,  a  mother  came  run- 
niilg  into  my  office  with  a  child  in  her  arms  that 
had  been  bitten  by  a  rattlesnake  in  each  foot 
and  in  the  left  hand.  The  child  was  very  much 
s  pollen,  and  screaming  with  pain.  Its  feet  and 
hand  were  swollen  all  the  skin  woull  hold,  and 
the  body  was  spotted.  I  then  remembered 
reading  in  The  Medical  World,  June  No., 
page  191,  of  potassium  perminganate  as  an  an- 
tidote in  snake  poison ;  so  I  at  once  prescribed 
the  above  with  very  good  results,  as  eight  hours 
afterwards  the  swelling  had  entirely  disappeared, 
and  the  child  was  better  in  general.  Now  the 
child  is  completely  well. 

I  had  a  case  of  glycosuria,  and  all  symptoms 
have  disappeared  for  some  time,  excepting  a 
pain  in  the  region  of  the  kidneys.  No^  it  is 
aggravated  on  contracting  a  fresh  cold.  Will 
some  of  my  medical  brethren  help  me  by  writing 
me  a  cure,  either  through  this  journal  or  by 
letter  direst?  Dr.  D.  M.  Koontz, 

92  Poplar  st,  Johnstown,  Pa. 


Cases  of  Opium  Poisoning  Treated  With  Apomor- 

phia,  Sulph-Atropia,  Nitro-Glyoerine, 

Strychnia,  Nitrite  of  Amyl,  etc. 

Editor  Medical  World: — May,  1894, 
Charles  Rhinehart,  at  8  o'clock  p.  m.,  took  with 
suicidal  intent,  twenty  grains  of  sulph.  mor- 
phine. I  was  called  to  see  him  next  morning 
at  8  o'clock,  and  found  him  in  an  unconscious 


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condition,  face  livid,  ears  black,  black  and  liver 
splotches  covering  the  surface  of  the  bodj  and 
extremities,  pupils  contracted  to  pin-hole  size, 
respiration  labored,  gasping,  about  one  to  the 
minute,  and  growing  slower  and  more  dilQBcult ; 
pulse  120.  An  empty  morphine  bottle  was 
lying  near.  I  administered  hypodermically  ^ 
gr.  of  apomorphin,  also  ^  gr.  sulph.  atropia  ; 
repeated  the  apomorphin  three  or  four  times  in 
the  course  of  an  hour,  without  effect  Repeated 
atropia  in  thirty  minutes.  Continued  atropia 
every  twenty  to  sixty  minutes  during  the  day 
and  night,  in  gradually  increasing  doses,  until 
12  o'clock  p.  m ,  giving  then  ^V  ST**  ^^^  ^^ 
gradually  decreasing  doses.  I  gave  occasion- 
ally, with  the  atropia,  y^  &^'  ^^  "^^'^  glycerine. 
Gave  alternately  with  atropia  -^  gr.  strychnia, 
with  one  or  two  drams  of  whisky  hypoder- 
mically. 

I  gave  also  three  or  four  doses  of  perman- 
ganate of  potassium  during  the  day  and  night. 
I  administered  by  inhalation  three  drops  of  ni- 
trite of  amyl  occasionally,  to  aid  in  sustaining 
respiratory  powers.  I  resorted  to  artificial  res-* 
piration  when  lespiration  would  flag.  Used 
counter-irritation  with  mustard,  and  flapping 
with  wet  towel. 

Two  hours  after  the  first  dose  of  atropia  the 
pupils  dilated,  respiration  improved,  and  there 
was  some  return  to  consciousness.  I  gave  two 
tablespoonfuls  of  mustard  in  warm  water ;  no 
emetic  effect  at  any  time  during  treatment  No 
stomach  pump  at  hand.  As  soon  as  effects  of 
atropia,  etc.,  would  b^in  to  pass  off,  all  the 
symptoms  of  profound  narcosis  would  return. 
About  3  o'clock  a.  m.  he  became  rational,  and 
stated  that  he  had  taken  20  grains  of  morphine 
with  suicidal  intent  at  8  o'clock  p.  m.,  twelve 
hours  before  I  saw  him.  He  made  a  very  good 
recovery. 

He  said  he  was  out  of  work  and  money,  had 
no  friends,  and  made  up  his  mind  to  shuffle  off 
the  mortal  coil.  The  druggbt  of  whom  he  pur- 
chased the  morphine  says  he  sold  him  20  grains 
for  25  cents. 

I  saw  a  case  on  December  31st,  1893.  Six 
15  grain  capsules  had  been  filled  with  morphine 
in  mistake  for  quinine,  and  five  of  them  were 
taken  from  10  o'clock  a.  m.  to  3  o'clock  p.  m. 
I  saw  the  patient  at  6  o'clock  p.  m  ,  and  gave 
mustard  and  ipecac  emetics,  also  apomorphia, 
^  gr.,  which  acted  well. 

The  treatment  was  substantially  the  same  as 
above  case,  except  in  this  case  all  the  strong 
coffee  was  given  that  the  patient  could  be  in- 
duced to  take. 

It  seems  to  me,  Mr.  Editor,  that  by  adapting 
the  above  measures  to  the  quantity  of  morphine 
taken,  we  can  control  its  effects,  and  prevent  a 


fatal  issue  from  almost  any  quantity  of  morphine 
taken.  Smith  Buford,  M.D., 

Raleigh,  Tenn. 

[The  first  case  seems  to  present  some  unusual 
and  peculiar  features.  1st,  that  a  patient  who 
had  taken  twenty  grains  of  sulphate  of  mor- 
phine should  be  found  alive  twelve  hours  there- 
after unless  accustomed  to  using  morph  ne.  2d» 
that  a  patient  should  ccmtinue  to  live  while  the 
respirations  are  reduced  to  one  per  minute.  3cU 
the  enormous  amount  of  the  priuciple  antidote, 
atropine,  tolerated.  The  same  remarks  seem  to 
be  applicable  to  the  second  case,  also.  The 
question  as  to  the  quality  of  the  morphine  dis- 
pensed also  naturally  arises. — £d.] 


Strychnine  f»r  Snake  Bites 

Editor  Medical  World: — Strychnine  has 
proved  an  antidote  for  iHtes  of  poisonous  snakes. 
August  8th,  we  were  called  to  see  Mra.  W.» 
who,  going  at  noon  to  the  cellar  to  get  milk, 
felt  something  strike  her  in  the  temple.  Ob 
looking  around  she  saw  a  tnake  and  called  to 
her  husband,  who  killed  the  snake  and  pro- 
nounced it  a  copper-head — which  spedes  is  very 
poisonous  in  this  country.  We  arrived  at  four 
o'clock  and  found  Mrs.  W.  semicomatose,  with 
cold  extremities,  pulse  irr^^lar  and  rapid,  and 
eyes  swollen  until  she  could  not  see.  We 
wrapped  her  in  flannels  and  gave  her  hypoder- 
mic injection  of  liquor  strychnise  in  large  dose. 
After  a  quarter  of  an  hour  we  gave  her  another 
large  dose,  say  twenty  minims,  and  within  one 
hour  she  recovered  from  her  comatose  conditiim, 
and  recognized  all  in  the  room.  The  next  day  she 
was  all  right  excepting  some  little  edema  of  the 
head  and  face.  This  is  the  second  case  we 
have  treated  in  the  same  way,  only  the  first  case 
was  bitten  by  a  large  rattle-snake.  We  can, 
by  experience,  recommend  the  strychnine.  The 
patient  can  stand  large  doses.  No  whisky  was 
used  in  these  cases. 

Owsley,  Mo.      Drs.  Harris  &  Draper, 


A  Needle  Passing  Harmlessly  Through  the  Aiiroes- 
tary  Tract, 

Editor  Medical  World. — On  page  290, 
last  issue  of  The  Medical  World,  I  notice  the 
report  of  a  case  of  a  child  swallowing  a  foreign 
body  (a  cent),  by  Dr.  John  M.  Bingay,  Canada. 
'Having  had  quite  a  remarkable  experience 
with  a  case  of  mine  in  this  line,  I  beg  to  o£fer  it 
to  the  readers  of  The  World  for  what  it  may 
be  wortL 

In  the  summer  of  1892  I  was  called  in  sud- 
denly to  see  a  little  negro  girl,  a  bright,  intelli- 
gent child  of  some  ten  years  of  age,  who  bai 


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accidentally  swallowed  an  ordinary  steel  sewing 
needle.  No  symptoms  of  pain  or  other  disturb- 
ances presented  themselves,  and  the  child  seemed 
totally  unaware  of  the  possible  danger  she 
might  be  in.  Supposing,  of  course,  that  I  could 
do  nothing  for  her,  and  had  better  let  it  alone 
and  watch  the  results,  treating  them  if  neces- 
sary, I  had  concluded  to  leave  her,  when  it 
occurred  to  me  that  no  possible  harm  could  re 
suit  from  trying  an  old  remedy,  which  I  had 
often  heard  highly  recommended  as  having 
great  efficacy  in  such  cases.  I  told  the  parents 
to  keep  her  absolutely  quiet,  and  feed  her  on 
mashed  Irish  potatoes,  and  nothing  else,  for 
forty-eight  hours,  excepting  enough  water  to 
enable  her  to  swallow  them  with  ease. 

These  directions  were  followed,  and  in  about 
twenty-four  hourd  the  child  had  a  passage,  ap- 
parently, of  nothing  more  than  effete  and  uncd- 
gested  portions  of  potatoes.  The  mother,  in 
whom  hope  was  very  strong,  and  whose  intelli- 
gence was  quite  above  the  ordinary,  looked 
more  closely  at  the  fecal  discharges,  and  dis- 
covered the  needle  in  the  mas3.  Potatoes  seem 
to  have  a  tendency  to  cling  to  any  hardened 
portion  of  the  ftcal  matter,  and  render  its  pas- 
sage lees  disagreeable,  and  oq  this  occasion,  lit- 
erally cased  the  needle  over  and  protected  the 
alimentary  canal  and  anus  during  its  passage. 

It  is  quite  interesting  to  note  that  the  steel 
had  lost  its  high  elasticity  and  brittleness,  and 
could  be  easily  bent  and  twisted.  It  had  also 
changed  color,  and  was  an  ashy  blue.  These 
changes,  I  judge,  were  due  to  the  action  of  the 
acids  and  alkalies  in  the  alimentary  tract. 

Francis  Lee  Thtrman,  M.D., 

Eastham,  Va. 


The  Comfort  of  the  Sick. 

Editor  Medical  World: — The  following 
hmts,  if  mentioned  in  jour  journal,  will  add 
much  to  the  comfort  of  the  sick.  If  a  child  has 
fever  of  any  kind  or  bowel  trouble,  always  offer 
it  water  before  giving  milk  or  offering  the 
breast  A  child  often  takes  milk  which  its 
stomach  repels,  because  it  is  thirsty. 

If  the  sick  room  is  hot  the  temperature  can 
be  lowered  several  degrees  by  hanging  up  sheets 
which  have  been  wrung  out  in  cold  water,  and 
repeating  when  dry. 

The  mouth  and  teeth  should  be  washed  (wo 
or  three  times  daily  with  salt  and  water  when 
there  is  fever,  and  the  lips  anointed  with  vase- 
line to  prevent  cracking. 

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


Yee,  we  can  still  Bopply  World  and  Philadelphia 
Medical  and  Surgical  Reporter,  both  for  one  year, 
for  $3.25. 


Fatal  Case.— Opinions,  etc. 

Editor  Medical  World: — I  would  like 
to  supply  an  omission,  which  I  inadvertently 
made  in  an  article  in  May  World,  page  175, 
inasmuch  as  criticisms  have  been  made  on  the 
same. 

On  my  first  visit,  recognizing  the  probable 
presence  of  pus  and  the  importance  of  evacua- 
ting it,  I  examined  the  thumb,  in  view  of  mak 
ing  an  incision,  but  it  was  evident  that  no 
inflammatory  debris  of  any  kind  was  present 
The  patient,  however,  assured  me  that  a  few 
drops  of  pus  escaped  the  day  before. 

At  the  point  of  primary  irritation  there  was 
a  discoloration  of  the  skin  about  half  an  inch  in 
diameter,  that  seemed  to  be  due  to  an  excava- 
tion under  the  skin.  The  skin  was  not  broken, 
except  where  the  needle  was  used  On  the  fol- 
lowing day,  however,  I  made  an  incision  to  the 
bone,  opening  the  entire  ball  of  the  thumb, 
nothing  escaping  but  a  few  drops  of  clear 
serum. 

Besides  the  treatment  already  mentioned,  the 
patient  was  given  tr.  chbr.  iron,  in  frequently 
repeated  doses. 

The  husband  says  there  never  was  any  no- 
ticeable coldness  or  palor  of  the  arm,  such  as  an 
arterial  embolism  should  produce;  nor  were 
there  any  symptom?  of  occlusion  of  the  venous 
system.  The  swelling  of  this  arm  was  not  of 
such  severity  as  to  cause,  in  itself,  this  gangren- 
ous procees.  The  shoulder  swelled  some  also, 
followed  almost  immediately  by  black  areas. 
Soon  after  death,  large  dark  areas  formed  on 
her  right  thorax.  Practically,  her  arm  did  not 
pain  her,  the  pain  being  confined  to  her  thumb 
during  the  first  two  or  three  days.  Preceding 
the  formation  of  the  dark  areas,  red  infiltrations 
or  ecchymotic  spots  formed,  first  on  her  wrist, 
and  later  on  the  anterior  aspect  of  her  elbow. 

As  a  urinalysis  was  not  made,  a  diabetic  con- 
dition cannot,  with  certainty,  be  excluded,  but 
I  cannot  disassocia'e  from  my  mind  the  possi- 
bility of  there  having  existed  a  condition  which 
has  been  described  as  purpura  senilis,  requiring 
only  a  torch,  such  as  a  traumatism  or  any  irri- 
tation, to  set  the  fatal  process  aglow.  As  to 
diagnosis,  the  following  opinions  were  expressed 
through  the  press,  and  otherwise : 

Dr.  Waugh  thinks  it  presents  the  ordinary 
history  of  gangrene;  Dr.  Pirnat,  in  August 
World,  thinks  it  a  case  of  malignant  pustule. 
Others  think  it  a  case  of  embo'ism,  with  conse- 
quent gangrene ;  others,  that  it  is  a  case  of  ery- 
sipelas of  the  deep  fascia ;  and  the  diagnosis  of 
blood  poisoning  from  the  felon  has  b  een  made] 
The  above  may  throw  some  light  on  the  sub- 
ject. W.  C.  HoNTZ  M.D., 

Leonida?,  Mich. 


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Rem  irks  on  the  Treatment  of  Marasmus. 

.  Editor  Medical  World  : — Dr.  Waugh, 
page  314,  and  Dr.  Todd,  page  SJd  August 
No.,  give  me  and  the  rest  of  the  World  read- 
ers very  valuable  suggestions  in  the  management 
andj  treatment  of  marasmus  and  other  discrasia 
of  the  system  ably  enumerated  by  Dr.  Waugh. 
Managed  as  herein  directed,  complemented  by 
his  treatment  of  these  intractable  cases,  the  ma 
jority  should  be  cured. 

I  know  Dr.  Tcdd's  treatment  will  meet  many 
indications,  but  in  the  great  majority  of  cases 
we  have  malnutrition  to  coatend  with,  and 
must  cater  to  the  nutritive  needs  of  the  system ; 
and  this  is  where  Dr.  Waugh's  treatment  is  so 
eminently  fitting,  and  is  now  being  demonstrated 
to  me  in  several  cases.  In  diseases,  as  in  all 
else,  we  must  have  a  foundation  on  which  to 
build.  When  this  is  once  accomplished  you 
may  u^e  specific,  indicated  drug  treatment,  if 
ycu  choose.  But  note,  too,  that  infants  and 
children  do  not  bear  drugging  well ;  it  seems 
to  be  disorganizing.  The  vitality  of  a  child  is 
often  benumbed,  digestion  arrested,  bowels 
paralyzed,  with  metastasis  to  the  brain,  delirium 
and  death  And  then  the  doctor  will  sagely 
fay,  "  It  has  gone  to  the  brain." 

My  practice  is  extensive  among  children,  and 
I  am  sure  I  have  frequently  seen  diseases  sap- 
planted  by  drug  pathology.  This  seems  incredi- 
ble, but  it  is  true 

One  more  word  as  to  the  adjuvants  as  a  great 
help  in  the  treatment  of  all  chronic  diseases, 
especially  when  coupled  with  some  profound 
discrasia  of  the  system.  In  those  case^,  where 
drugs  seem  inert,  vitality  at  a  low  ebb,  and, 
may  be,  from  some  unknown  factor  in  the  sys- 
tem, we  must  first  prescribe  a  tissue- builder  as 
maltme,  cod  liver  oil,  etc.,  etc.,  as  pointed  out 
by  Dr.  Waugh.  M.  R.  Peters,  M.D., 

Boiling  Springs,  Pa. 


Teething  Not  a  Pathological  Process. 

Editor  Medical  World  : — There  are  a  great 
many  traditions  and  unscientific  notions  in  re- 
gard to  the  diseases  of  infants,  and  these  have 
been  perpetuated  and  intensified  by  those  prac 
titicmers  who  care  more  for  the  number  of  calls 
that  thev  can  make  in  a  day  than  they  do  for 
the  welfare  of  the  little  life  which  is  just  reach* 
ing  out  after  the  strength  which  shall  bridge 
over,  perhaps,  the  only  deep  and  dangerous 
chasm  which  lies  across  its  entire  pathway  of 
life. 

One  of  these  is  the  idea  which  leaves  them  at 
the  mercy  of  some  tender-hearted  but  cranky 
old  lady,  who  has  had  a  family,  of  which  only 


those  who  were  especially  vigorous  have  sur- 
vived, the  others  having  succumbed,  as  sup- 
posed, to  that  great  bugabo)  of  all  the  anxious 
mothers,  that  natural  process  of  developm^it 
which  prepares  the  child  to  meet  the  increasing 
demands  of  the  body  for  nutriment  —the  erup- 
tion of  the  first  teeth,  which  natural  process,  by 
some,  even  of  the  profession,  is  classed  as  a  dis- 
ease, and  treated  as  such,  to  the  great  detriment 
and  perhaps  torture  of  the  pa  ient. 

We  find  in  the  advertisements  of  the  patent 
medicine  men,  among  the  disea^s  which  are 
cured  by  their  concoctions,  •*  Children's  Teeth- 
ing." The  absurdity  of  the  i  iea  is  toi  appa- 
rent to  need  oomneut  As  well  might  we  class 
the  development  of  the  hair  or  nails  among  the 
ills  of  childhood.  I  know  that  I  may  be  uked 
if  I  have  never  seen  the  gums  swollen  and  the 
mouth  sore,  and  the  little  ones  irritable,  and 
even  convulsed^  and  after  the  ofienling  tooth 
had  beome  visible  these  symptoms  had  subsi- 
ded? Certainly;  and  so  have  I  seen  all  of 
these  symptoms,  and  even  more,  when  there 
were  no  teeth  coming,  and  the  teeth  did  not  ap 
pear  for  three  or  four  months  afterwards 

I  think  it  can  be  laid  doT^n  as  an  a^i  ^m,  tha*: 
a  child  in  good  health  will  cut  its  teeth  with  no 
more  disturbance  than  a  little  more  dfooiing 
and  biting  than  usual ;  and  when  there  is  trou- 
ble with  the  child  it  will  be  more  rea^nable  to 
look  for  some  pathological  condition  as  the  cause 
of  disease  than  to  a  physiological  process,  which 
we  know  causes  so  little  dbturbance  that,  upon 
the  first  discovery  of  the  unexpected  little  white 
incisor,  the  surprise  and  delight  of  the  whole 
family  is  expresse  i  in  the  joyous  exclamatioa 
of  "  baby's  got  a  tooth  I " 

Bridgeton.  R.  I.        H.  J.  Bruce,  M.D., 


Bismuth  Sub-gallate  for  Gastric  Catarrh 

Editor  Medical  World  : — T  noticed  Dr. 
Smith's  query  in  the  September  World  (page 
335),  in  r^ard  to  bismuth  sub  gallate.  I  have 
had  considerable  experience  in  its  use,  and  in 
the  class  of  cases  where  it  is  indicated,  I  believe 
it  far  superior  to  any  other  a^ent  we  have. 

A.  B.,  male,  fifty  one  years  of  age,  suffered 
from  dyspepsia  for  two  years.  He  tried  several 
physicians,  without  raceivin^  any  benefit  His 
weight  was  reduced  from  185  to  157  pounds* 
The  last  physician  he  had  pronounced  it  cancer 
of  the  stomach,  and  with  that  idea  he  failed 
rapidly.  Tie  only  thing;  that  gave  him  any 
relief  was  washing  out  hb  stomach  eix  or  eight 
times  a  day,  and  this  was  only  temporary.  He 
was  constantly  hungry,  and  after  eating  would 
feel  a  little  relief  for  about  two  hours     Bat 


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then  his  suffering  would  begin  again,  severe 
pains  radiating  over  the  entire  abdojnen.  On 
palpation  I  found  a  sensitive  spot  over  the  py- 
loric end  of  the  stomach;  no  evidence  of  a  tumor, 
however.  At  night  he  would  be  hungry  and 
distressed,  as  during  the  day.  He  would  have 
milk  by  his  bedside,  taking  about  half  a  glass 
every  three  hours.  Vomiting  was  not  a  promi- 
nent symptom,  although  he  would  vomit  occa- 
sionally, black  masses  resembling  coffee  grounds, 
and  usually  two  hours  after  eating.  He  had 
frequent  sour  eructations.  I  believe  that  this 
form  of  dyspepsia  usually  results  from  ex- 
cessive mental  labor  and  exhaustion  of  nerve 
force. 

I  began  treatment  by  giving  two  5-grain  tab- 
lets of  bismuth  sub-gallate,  acd  ten  grains  of 
soda  bi-carb.  after  each  meal,  and  discontinued 
the  use  of  the  stomach  tube.  I  saw  the  patient 
three  days  later,  and  he  had  not  improved.  A 
week  a^r wards  I  saw  him  a  little  better  ;  two 
weeks  afterwards  all  symptoms  had  disappeared. 
He  did  not  assist  the  treatment  by  a  careful 
diet,  but  seemed  to  eat  everything.  After  four 
months'  treatment  he  was  apparently  without  a 
symptom ;  the  abnormal  appetite  had  also  left ; 
so  I  discontinued  treatment. 

A  very  remarkable  thing  was  that,  after  im- 
provement began  he  was  not  troubled  with  a 
relapse,  nor  has  he  been  since  treatment  has 
been  stopped,  and  that  is  over  seven  months 
ago.  I  saw  him  the  other  day,  and  he  said  that 
he  weighed  193  pounds. 

I  believe  that  bismuth  sub  gallate  is  the  only 
agent  that  we  have  that  will  permanently  cor* 
rtct  the  above  condition.  I  have  used  it 
many  times  since,  with  the  same  gratifying  re- 
sults. 

In  chronic  alcoholic  gastritis  it  has  no  action. 

If  the  profession  will  give  this  preparation  a 
trial,  I  am  sure  that  they  will  have  a  valuable 
agent  added  to  their  list. 

Dr.  G  Ray  Hoff, 

312  and  313  California  Building, 
Denver,  Col. 


A  Pocket  Pharmacy. 

Editor  Medical  World  : — To  be  provided 
with  a  pocket  pharmacy  that  shall  be  sufficiently 
comprehensive  to  meet  the  variety  of  cases  that 
apply  in  church,  places  of  amusement,  and  on 
the  street,  while  at  the  same  time  it  is  sufficiently 
compact  to  carry  without  inconvenience,  has 
long  been  the  dream  of  the  profession,  never 
realized  until  the  introduction  of  the  alkaloidal 
granules  of  the  active  principle. 

The  writer  of  this,  some  years  ago,  adopted  a 
case,  here  shown,  which  has  been  extensively 


introduced  by  the  various  gianule  manufactu- 
p  rers  until  it  is  car- 
ried, probably,  by 
more  physicians  than 
any  others  one  styles 
of  case  on  the  mar- 
ket. Most  cases  are 
so  large  that  they  are 
^  cumbersome,  and  are 
soon  thrown  aside,  the  physician  trusting  to 
luck  not  to  need  it,  or  to  get  along  with  his 
hypodermic,  or  a  stray  vial  or  so  that  he  may 
chance  to  have  in  his  pocket. 

This  little  case  is  adapted  in  size  and  style  to 
be  carried  in  the  upper  vest  pocket,  where  it 
finds  abundance  of  room  (and  in  the  writer's 
own  pocket  it  leaves  space  to  accommodate  a 
fever  thermometer,  a  fountain  pen  and  a  pen- 
cil). As  will  be  seen  by  the  cut,  it  carries  nine 
vials ;  these  are  of  half* dram  size,  and  will  hold 
100  each  of  the  average  sized  granules — 900 
dcses.     So  you  see  it  is  multum  inparvo. 

With  what  this  shall  be  filled  depends  upon 
the  physician  himself,  his  style  of  practice,  and 
the  cases  he  will  meet  In  my  own  case,  at  this 
season  of  the  year  (I  always  change  a  trifie  to 
fit  the  season),  will  be  found,  1st,  glonoin  (ni- 
tro  glycerine,  or  trinitrin,  as  it  is  sometimes 
called),  gr.  t^^^,  and  of  all  the  remedies  for  an 
emergency  case  this  stands  preeminently  the 
most  important  To  relieve  spasm  from  any 
cause,  to  stimulate  a  flagging  heart,  to  relieve 
syncope  or  pain  from  internal  congestion,  this 
drug  stands  without  a  peer.  A  granule  chewed 
and  allowed  to  absorb  from  the  tongue,  or  dis 
solved  in  a  teaspoonful  of  hot  water,  and  poured 
between  the  set  teeth  of  a  spasmodic  patient, 
relieves  like  magic,  and  is  often  curative  in 
itself.  Its  action  is  to  dilate  the  skin  capillaries, 
causing  a  rush  of  blood  to  the  surface,  relieving 
congested  nerve  centers. 

2d,  and  not  less  important,  is  the  "  king  of 
pain,"  morphine,  which  I  carry  in  granules  of 
yV  gf-  each.  Nothing  need  be  said  on  the  uses 
of  this  drug,  except  that  where  a  quick  efiect  is 
needed,  the  same  is  hastened  by  solution  in  hot 
water,  and  the  use  of  the  hopodermic  thereby 
avoided. 

I  will  mention  hyoscyamine  3d,  and  strych- 
nine arseniate  4th.  Pages  might  be  written  on 
the  use  of  these  two,  but  I  wUl  simply  suggest 
the  action  of  the  first  to  relieve  pain  and  spasm 
by  dilatation  of  constricted  circular  muscle 
fibres,  as  in  colic,  dysmenorrhea,  asthma,  etc., 
and  the  sustaining  action  of  the  last,  which 
would  indicate  its  use  to  guard  against  relapse, 
with  all  remedies  applied  to  the  relief  of  acute 
conditions  attended  by  a  faltering  of  any  organ. 
Nausea  is  often  quickly  overcome  with  a  gran 


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ule  of  zinc  sulpho  carbolate,  gr.  ^,  and  so  I  num- 
ber this  5th  ;  with  codeine,  gr.  ^^^  ^^'  ^^  ^^^ 
not  only  relieve  a  worrying  child,  suffering  with 
pain  and  languor  from  a  decomposing  dinner 
taken  into  a  stomach  not  ready  to  receive  it, 
but  many  'other  conditions  that  will  present 
themselves.  Aconitine  amor.,  gr.  ywt,  in  this 
naming,  comes  7th,  giving  its  tisual  first  place  to 
glonoin,  but  is  none  the  less  useful  for  all  that. 
It  should  be  added  to  the  treatment  of  all  con- 
ditions attended  with  fever.  The  size  h3re 
given  is  adult  dosage,  but  with  judgment  may 
be  used  undissolved  at  all  ages  from  ten  years 
up ;  in  other  cases  it  should  be  dissolved  in  water 
in  appropriate  quantity.  This  leaves  two  more 
loop?,  whi:h  are  occupied  by  calomel,  gr.  |,  and 
digitalin,  gr.  -^j.  With  this  assortment  we 
cannot  only  meet  emergencies,  but  can  do  a 
large  percent  of  an  extensive  practice ;  and  the 
case  is  so  small  and  compact  that  its  presence  is 
often  forgotten  until  the  need  arrives  when  it 
proves  itself  ''a  little  giant,"  as  Eome  have 
<»lled  it 

To  be  always  prepared  is  the  duty  of  the  phy- 
sician. It  pays  in  more  ways  than  one,  and 
Ihow  this  can  be  accompli  she  1  to  the  best  ad  van 
tage  should  be  a  matter  of  more  than  passing 
interest 

I  shall  be  glad  to  answer  any  questions  that 
may  arise  in  this  connection  by  personal  letter 
or  through  The  World. 

W.  C.  Abbott,  M.D., 

Kavemwood,  Chicago,  111. 


Discoveries  Confirmed. 

Editor  Medical  World: — I  take  great 
pleasure  in  endorsing  Dr.  Taylor's  formula  for 
diarrhea,  which  was  lately  reprinted  by  one 
who  has  used  it.  I  have  used  it  lately  in  two 
serious  cases  with  "magical"  results.  I  refer 
to  the  bismuth  chalk  nutmeg  and  zinc  mixture. 
Try  it 

I  am  inclined  etrongly,  from  a  few  cases 
within  a  few  months,  to  attribute  hemorrhage 
to  quinine. 

One  man  to  day  called,  and  spoke  of  having 
passed  one  teaspoooful  of  clear  blood  from  his 
bladder  after  taking  two  grains  of  quinine  every 
four  hours  for  two  days.  I  never  saw  such 
quantities  of  bloody  expectoration  in  my  life, 
as  one  man  raised  to  whom  I  gave  sixty  grains 
of  quinine  in  forty  eight  hours  for  pneumonia. 

By  the  way,  I  endorse  that  treatment  for 
pneumonia  where  that  Western  physician  advises 
thirty  to  sixty  grains  of  quinine  in  the  first  stage 
and  first  day  of  the  disease.  Since  using  it  and 
also  since  discarding  whi&key  in  treatment,  I 
haven't  lost  one  case  cf  pneumonia. 

While  we  are  about  it,  why  do  not  we  physi- 


cian's believe  Dr.  Abbott  when  he  says  that, 
"alcohol  has  no  place  in  modem  therapeutics?" 
I  have  practiced  on  that  line  for  the  last  two 
years,  and  thank  Grod  I  find  alcohol  is  growiog 
beautifully  less  in  physicians'  prescription?. 

Who  can  tell  whether  the  alcohol  kills  the 
disease  or  the  disease  the  alcohol  ?  Prove  it,  if 
you  can,  either  way. 

Perhaps  another  discovery  I  have  confirmed 
as  valuable,  is  the  knee  chest  posture  in  chang- 
ing mal  presentations.  I  certainly  can  testify  as 
to  its  utility  from  actual  experience. 

I  have  discovered  that  many  of  our  old  reme- 
dies are  belter  than  the  new  ones.  We  can  try 
the  new,  but  we  should  stick  to  the  old  ones 
when  we  have  used  them  su<3cessfully. 

The  fickle  minded  Athenians  were  alwayi 
looking  after  "  something  new,"  like  our  village 
gossips ;  but  the  practice  of  medicine  demands 
a  sober  conservatism  which  is  too  little  used. 

Essex,  Vt  W.  W.  Styles,  M.D, 


Pneumonia  and  ita  Treatment. 

Editor  Medical  World: — After  reading 
the  discussion  of  a  paper  on  the  treatment  d 
pineumonia,  by  Drs.  William  Baily  and  J.  A 
Larabee,  before  the  State  Medical  Soc'ety  of 
Kentucky,  I  am  induced  to  contribute  my  mite 
through  your  valuable  journal,  if  you  will  per- 
mit me  the  space. 

Pneumonia  is  only  prevalent  in  this  locality 
in  the  form  of  an  epidemic.  We  hare  a  few 
ca§e9  of  congestion  of  the  lungs,  which  resemble 
the  first  stige  of  pneumonia  very  much,  and 
renders  the  diagnosis  difficult  This  condition 
has  induce  1  physicians  to  call  it  sporadic  pneu- 
monia. 

I  believe  pneumonia  to  be  the  result  of  the 
iitroductioQ  of  the  pneumococcus  during  respi- 
ration. That  this  germ  predisposes  to  pneumo- 
nia is  evident.  And,  like  other  germs,  it 
attacks  the  system  when  vitality  is  the  lowe^ 
I  believe  this  will  explain  why  pneumomtii 
attacks  more  frequently  between  midnight  and 
day.  About  this  time  the  vitality  is  lees  and 
the  elimination  of  waste  is  less. 

The  treatment  of  this  disease  should  vary, 
according  to  the  conditions  present  In  the  fint 
stage  a  full,  bounding  puke  is  an  indication  for 
veratrum. 

While  I  do  no'  believe.that  a  weak  pulse  or 
feeble  circulation  contra  indicates  veratrum,  I 
think  quinine  and  strychnine  should  be  added 
to  the  prescription. 

I  almost  invariably  use  calomel  in  the  begio- 
ning  of  pneumonia  as  a  defibrinizer,  aid  laige 
draughts  of  water  to  promote  diaphoresis. 

I  highly  eodorse  Dr.  Larabee's  remarks  in 


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377 


regard  to  strychnine  in  this  disease,  as  a  stimu- 
lant, respiratory  and  cardiac. 

I  believe  I  have  saved  life  by  the  use  of  this 
drug  hypodermicaliy,  at  that  critical  period 
when  the  fever  ends  by  crisis,  after  the  patient 
was  unable  to  take  it  by  the  stomach. 

In  the  language  of  Dr.  Larabee,  "  I  believe 
that  there  should  be  more  attention  paid  to  this 
drug,  as  I  think  it  is  the  best  respiratory  stimu- 
lant that  we  have  at  our  command.'' 

I  have  never  been  able  to  see  where  alcohol 
is  beneficial  a^  a  stimulant,  in  this  or  any  other 
asthenic  condition.  Try  strychnine  as  your 
stimulant,  and  be  convinced. 

Argyle,  Tex.         B.  L.  Craddock,  M.D., 


Diseases  Cured  by  the  Electric  Light. 

Editor  Medical  World: — It  has  been 
shown  by  careful  scientific  demonstration  that 
river  water  usually  contains  fewer  noxious  germs 
than  the  water  obtained  from  wells.  It  has 
also  been  ascertained  that  water  contaminated  by 
unwholesome  substances  or  germs  of  disease  will 
become  reasonably  pure  by  placing  in  the  open 
air  exposed  to  the  sun ;  whereas,  if  suffered  to 
remain  stationary  and  excluded  from  the  air 
the  baneful  elements  will  be  increased  and 
become  more  liable  to  induce  disease.  The 
purifying  agent  is  the  air  and  light ;  in  more 
scientific  speech,  the  actinism  diffused  by  the 
rays  of  the  sun.  Scientists  have  conjectured 
other  causes  for  this  purification,  but  later 
experiment  has  8ho¥ni  conclusively  that  light, 
apart  from  heat,  is  superior  to  them  all.  Pro- 
fessor Ward  of  England  has  obtained  from  his 
studies  the  same  results  and  has  declared  that 
among  the  different  colored  light  rays  the  blue  are 
the  most  effective  in  the  destroying  of  bacteria. 
This  fact  leads  to  the  important  one,  that  the 
Electric  Light  will  accomplish  the  same  result 
Indeed,  it  will  exert  a  similar  beneficial  influence 
upon  the  human  body,  when  applied  properly 
and  scientifically,  destroying  contagion  of  every 
character,  eradicating  whatever  contamination, 
correcting  diseased  condition,  ''sweating  out" 
the  morbific  elements  and  imparting  renewed 
life.  The  law  is  simple ;  the  mode  of  application 
is  artful  and  skillful.  The  great  question  is 
how  to  conserve  health  and  adjust  diseased 
conditions,  and  any  agency  which  can  succeed 
b  accomplishing  this  deserves  the  thoughtful 
attention  of  every  true  physician. 

Newark,  N.  J.  G.  Meeker,  M.D., 

.    ,  late  of  N.  Y.  Poly  linic. 


Technique  of  Using  Solar  Cautery 

Editor  Medical  World'. — Dr.  Horton  of 
Batavia,  N.  Y.  asks  in  last  numl)er  as  to  use  of 
solar  cautery.  1st,  purchase  one,  two,  or  three 
magnifying  lenses  (circular)  of  different  sizes ; 
purchase  them  on  a  day  when  the  sun  is  shining 
brightly  so  that  jou  can  test  them  and  see  that 
the  suns  rays  are  focused  into  a  very  small  space; 
all  glasses  will  not  focus  properly,  so  you  may 
have  to  order  a  new  set  of  glasses  at  the  man- 
ufacturers. Having  your  glasses  all  right, 
provide  yourself  with  a  one  half  ounce  vial  of 
four  per  cent  cocain,  with  a  small  camels  hair 
brush,  and  a  few  squares  (two  and  a  half  inches) 
of  white  paper,  common  writing  paper  will 
aoswer,  in  the  center  of  which  a  square  hole  is 
cut  neatly.  Now  seat  your  patient  in  the  proper 
light,  where  you  can  secure  as  direct  rays  of  the 
sun  as  possible,  arrange  a  towel  about  the  neck : 
if  the  mole  or  wart  or  capillary  aneurism  is  on 
the  face,  so  that  the  light  affects  the  eyes, 
then  bandage  the  eyes  with  a  handkerchief,  then 
moisten  the  mole  or  wart  thoroughly  with  the 
cocain,  then  place  over  the  mole  the  square  of 
paper  within  the  opening  in  the  center  that  the 
mole  will  just  pass  through,  then  with  your 
glass  focus  the  light  and  heat  rays  directly 
upon  the  growth  that  is  to  be  removed.  If  a  wart, 
you  can  bum  it  level  with  the  skin,  and  it  will 
smoke  and  sizzle  and  no  harm  done  to  the  patient, 
and  if  burned  level  with  the  skin  no  treatment 
will  be  necessary  later.  If  a  mole,  it  will  not 
smoke  but  you  must  burn  to  a  blister,  and  a 
little  beyond ;  a  second  treatment  may  he  neces- 
sary; don't  bum  too  deeply  lest  you  leave  a  scar. 
Don't  tell  your  patient  it  will  not  hurt,  for  it 
will,  but  remove  glass  as  soon  patient  can't 
bear  it  and  pain  subsides  almost  instantly. 
After  the  treatment  is  completed,  anoint  the 
burned  space  with  ointment.  I  use  ozone  oint- 
ment, and  give  small  one-half  ounce  box  of 
ointment  to  patient  and  direct  him  to  use  it  two 
or  three  times  a  day  until  healing :  asking  him 
to  call  again  in  a  week  or  ten  days.  Moles  as 
large  as  a  marrowfat  pea  will  need  two  or  three 
treatments. 

Last,  but  not  least  don't,  forget  your  fee. 

Wakefield,  Mass.         D.  8.  Coles,  M.D., 


8eb  page  xxii  for  advantageou)  terms  this  month 
for  Dr,  Wauffh's  **  Manual  of  Treatment  by  Active 
Principles  and  New  Remedies  " 


For  Epilepsy. 

Editor  Medical  World  : — In  regard  to  the 
epilepsy,  August  No.,  page  334,  I  prescribe 
tartar  emetic,  2  drams,  in  simple  cerate,  rubbed 
down  the  spine,  until  the  back  bone  is  covered 
with  pustules.     Give  a  cathartic  daily. 

Dr.  W.  F.,  page  335,  might  try  the  same 
thing.  Dr.  C.  K.  Cullen, 

Barton  Heights,  Richmond,  Va. 


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THE  MEDICAL  WORLD. 


On  the  Ifijeotion  Treafmont  of  Hernia— Formula. 

Editor  Medical  World: — I  notice  with 
pleasure  the'increasing  interest  taken  in  the  cure 
of  hernia  by  the  subcutaneous  injection  of  some 
kind  of  fluid.  The  objection  to  ail  these  arti- 
cles on  the  cure  of  rupture  is  the  one  fact  that 
none,  so  far  as  I  have  met  in  the  various  journal 
Hrticles,  give  the  formula  of  the  injection  fluid 
in  full,  io  that  any  one  can  make  it.  Novr, 
fellow  M.D.'s,  let  us  have  some  of  the  best  rup- 
ture treatments  known  to  the  profession  given 
through  The  Medical  World,  and  give  the 
treatment  and  formula  in  full,  so  that  all  can 
understand  it.  All,  eo  far  as  I  have  observed, 
have  some  speciflc  medicine  to  sell.  This  I  de- 
plore, as  I  don't  believe  it  is  right  I  have 
treated  a  good  many  cases  of  rupture  very  sue 
cessfully  in  the  past  twelve  years.  Here  is  the 
formula :  Zmc  sulphate  c  p ,  from  grs.  x  to 
grs.  XV  ;  aqua  dist  ounces  j.  inject  in  the  umal 
wiy  from  gtt.  v  to  gtt  xv  once  a  week.  Apply 
some  good  truss  that  will  hold  perfectly,  and 
continue  this  treatment  from  four  to  twelve 
weeks,  and  a  cure  will  result  in  all  well  selected 
cases,  in  all  persons  not  over  sixty  years  of  age. 
This  treatment  cost  me  $200.  Like  most  every- 
thing in  medicine,  I  suppose  there  has  been 
much  improvement  in  the  paet  twelve  years.  If 
so,  I  should  like  to  know  it  So  I  hope  we 
shall  hear  through  The  World  the  very  best 
treatments,  so  that  all  may  be  benefitted. 

I  must  say  that  the  more  I  read  The  Medi- 
cal World  the  better  I  like  it  In  fact,  it  is 
oae  of  the  very  best  journals  that  I  read. 
Wishing  it  everj  success,  I  remain,  as  ever, 

Stockton,  Cal        A.  L  Foreman,  M.D., 

[We  referred  the  above  letter  to  Dr.  Wal- 
ling, who  sent  the  following  reply  to  Dr.  Fore 
man :  —Ed.] 

A  number  of  substances  have  been  experi- 
mented with,  and,  indeed,  used  in  the  treatment 
of  hernia  by  the  injection  methol.  Iodine, 
carbolic  acid,  oak  bark,  zinc  sulphate,  as  spoken 
of  by  Dr.  Foreman,  and  even  some  of  the 
strong  mineral  acids. 

The  dijQBcuUy  has  been  to  And  a  preparation 
that  would  not  be  apt  to  do  more  harm  than 
good.  We  must  remember  that  we  are  dealing 
with  delicate  structures,  and  an  abscess,  or  a 
severe  inflammation,  that  would  be  of  small 
moment  elsewhere,  in  the  inguinal  region  is  a 
serious  matter. 

No  wonder  that  the  method  fell  into  disrepute, 
when  we  consider  the  substances  injected,  and 
the  slipshod  methods  used,  resulting  in  perito- 
nitis, abscesses,  or  other  disastrous  complica 
ti^ns. 

It  is  just  here  that  chemistry  comes  to  our 
aid.     Substances  that  are  harmful  or  obnoxious 


when  used  by  themselves,  may  be  rendered  very 
useful,  or  even  pleasant  by  a  judicious  oombi 
nation  with  other  chemicals,  or  by  combining 
tleir  elements  differently. 

For  instance :  oil  of  rose  and  oil,  or  spirits  of 
turpentine,  are  both  hydrocarbons,  the  first  hav- 
ing the  formula  C^ «  H»*,  and  the  latter  C*'* 
H^  ®,  showing  the  vast  difference  in  the  product, 
by  reason  of  the  chemical  arrangement  of  the 
elements. 

It  u  in  this  manner  that  a  safe  and  satisfac- 
tory preparation  for  injection  is  made,  i.  «.,  by 
skillfully  arranging  the  different  substances  so 
as  to  get  the  desired  effect  without  unpleasant 
reactions. 

I  herewith  give  the  formula  for  my  fluid,  all 
my  preparations  being  non-secret : 

R.  Complex  salts  of  aldehyde » »«iM)  per  et 

Lido  etbylate  of  goal  lOol 30 

Hulpho-tannate  of  ztnc 2<)       ** 

Free  guaiacol -  5       " 

Beechwood  creosote. » 16      ** 

These  rare  and  expensive  chemicals  are  sepa 
rately  prepared,  ani  then  combined  in  strict 
conformity  with  their  respective  affinities  and 
dosage,  and  dissolved  in  an  antiseptic  medium. 

The  finished  product  is  most  admirably 
adap'ed  to  the  desired  end,  viz.:  the  radical 
cure  of  re  iucible  hernia  by  the  injection  method. 
The  treatment  is  not  limited  to  age,  if  the  patient 
be  vigorous. 

"  Why  not  tell  us  exactly  how  you  gf  t  this 
combination,"  says  the  Doctor,  **soanyof  us 
can  make  it?"  It  would  be  almost  impossible 
to^inake  it  plain.  It  re][uires  thorough  labora- 
tory training  to  properly  manipulate  chemicals. 
Then  too,  even  if  I  could  make  it  perfectly  in- 
telligible, the  Doctor  can  buy  the  fluid  at  a 
cheaper  rate  than  he  could  possibly  make  it  on 
a  small  scale. 

The  physician  operating  upon  hernia  wants, 
and  must  have,  a  remedy  Uiat  has  all  the  requis 
ites — ^safety,  efficiency,  keeping  qualities,  and 
that  has  been  well  tested.  He  also  needs  a  spe- 
cial syringe,  with  a  trocar  and  canula  needle. 
He  may,  thus  armed,  operate  with  safety  and 
success. 

What  was  considered  to  be  good  surgery  ten 
or  twenty  years  ago,  is  not  allowable  now.  It 
has  even  been  said  that  a  work  on  surgery  five 
years  old  is,  to-day,  practically  worthless  This 
shows  the  rapid  advances  that  are  being  made. 
The  injection  treatment  of  hernia,  with  new  and 
safe  chemicals,  is  one  of  these  forward  move- 
ments Wm.  H  Walling,  M.D., 

1606  Green  st.,  Philada.,  Pa. 


Please  do  not  send  any  more  orders  for  "  Offidtl 
Formulse  of  American  Hospitals."  The  U<  edition 
is  now  completely  ezhaui'ted. 


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THE  MEDICAL  WORLD. 


379 


The  Latest  Remedy  for  Itching  Gums  in  Teething. 

Editor  Medical  World  :—  One  of  our  local 
M.D.'s  says  that  the  l>est  remeiy  for  itchiDg 
gums  is  the  braips  of  a  cotton  tail  rabbit,  killed 
in  the  dark  of  the  moon,  brains  to  be  rubbed  in 
to  the  gums  and  held  to  the  fire!  M.D., 

Texas. 


Quii;  Qepartmenl 


QaeitioM  are  aoUcited  for  this  Colunui.  Communlcatloiu 
not  aooompanled  by  the  proper  name  and  address  of  the 
^ter  (not  necessarily  for  publication),  will  not  be 
notKed. 

Th/egrtai  number  of  requests  Ibr  private  answers,  for  the 
information  and  benefit  of  the  writer,  makes  it  necess- 
ary for  us  to  charge  a  fee  for  the  time  required.  Thte 
fte  wiU  be  from  one  to  five  dollars,  aoomllnff  to  th« 
amount  of  research  aiul  writing  recpured. 


Editor  Medical  World: — Will  some  bro- 
ther M.  D.  be  kind  enough  to  describe  a  typical 
case  of  paresis,  giving  course,  duration  and  best 
treatment? 

Would  be  glad  to  know  the  causes,  also,  and 
what  symptooos  constitute  the  differential  points 
between  paresis,  nervous  prostration  and  neu- 
rasthenia. J.  1.  T.  Long,  M.D., 

Allen,  Md. 


Editor  Medical  World:— Will  some  of 
the  readers  of  The  Medical  World  kindly 
give  me  advice  in  the  treatment  of  patients  suf- 
fering from  the  effects  of  handling  giant  pow« 
der,  and  inhaling  its  smoke  after  blasting  in 
mines?  F.  K.  Lord,  M.D., 

Port  Wine,  Cal. 


Editor  Medical  World  : — I  have  a  case  in 
which  I  need  some  help.  It  is  a  case  of  dys- 
menorrhea (sometimes  it  is  more  of  an  amenorr- 
hea), complicated  with  dyspepsia.  I  have  used 
everything  that  I  can  think  of,  and  everything 
I  have  heard  of,  with  only  temporary  benefit. 
The  patient  U  eighteen  years  of  age,  single,  a 
brunette,  delicate,  inclined  to  be  anemic,  lack- 
ing in  energy.  She  is  not  under  treatment  just 
now,  but  it  will  not  be  long  before  I  will  be 
called  in  again.  I  would  like  to  get  some  new 
ideas  on  the  subject 

Fruit  Hill,  S.  C.         A.  W.  Vidal,  M.D., 


Editor  Medical  World  : — Can  you,  through 
your  practical  monthly  magazine,  give  me  your 
idea  regarding  the  treatment  of  the  following 
case: 

Bev.  A ,  age  29 ;  total  paralysis  of  both  vocal 
cords  after  preaching  two  or  three  sermons  a 
Sunday.     Muscles  of  throat  contract  spasmodi- 


cally, as  do  also  the  pectoral  musclcF,  at  fifteen 
minute  intervals.  Stridor  on  deep  inspiration ; 
no  cough ;  general  health  is  good. 

When  a  boy,  the  whooping  cough  left  his 
vocal  apparatus  quite  weak.  Five  years  ago 
he  preached  two  sermons  a  day  for  twelve 
months.  Then  one  a  day  fur  another  twelve 
months.  From  that  time  until  the  present  his 
throat  has  troubled  him  nearly  all  the  time. 
Electricity,  massage,  heat,  cold,  and  various 
gargles  have  been  tried,  but  without  any  notice- 
able good  resulting. 

Is  there  anything  but  cessation  from  the  use 
of  his  vocal  apparatus  that  will  bring  reliei  ? 

Any  information  you  may  publish  will  be 
thankfully  received. 

La  Fayette,  111.     W.  A.  Warner,  M.D., 

[Such  cases  usually  receive  benefit  from  the 
abdominal  respiration,  as  set  forth  in  the  Lem- 
uel White  system  of  elocution.  Miss  Julia 
Orum,  1522  Chestnut  street,  Philadelphia,  will 
give  necessary  information. — Ed.] 


Wanted^-OiagnosU  and  Treatment. 

Editor  Medical  World: — Would  you  please 
put  the  following  case  in  your  valuable  jour* 
nal: — 

Miss  C,  aged  27,  has  been  delicate  all  her 
life.  Came  to  me  about  six  we«»ks  ago,  with 
pain  in  shoulder  and  slight  numbness  down  the 
arm  and  fingers.  ]  n  two  weeks  after  I  was  sent 
for  to  come  and  see  her,  and  found  her  in  the 
following  condition :  One  degree  of  fever  above 
normal,  with  right  arm  shaking  violently, 
which  would  last  about  two  minutes,  and  there 
would  be  an  intermission  of  about  one  minute ; 
then  the  hand  would  begin  and  shake,  extend- 
ing up  the  arm  ;  the  biceps  muscle  would  knot 
up  like  a  ball.  Her  family  history  shows  ner- 
vous, delicate  people.  My  diagnosis  was.  ane- 
mia of  the  spine,  and  I  treated  accordingly. 
She  began  to  improve  rapidly,  drawing  all 
stopped  except  once  every  two  days,  in  one  of 
the  limbs,  and  she  looked  much  better.  She 
said  she  felt  better  than  she  had  in  a  long  time. 
I  was  called  again  in  three  weeks,  and  found 
her  temperature  half  a  degree  above  normal, 
with  drawing  and  jerking  all  overall  the  limbs  ; 
even  the  mouth  would  twitch.  She  thought 
that  she  was  choking — something  felt  like  a 
ball  in  the  throat ;  and  she  would  turn  around 
in  the  bed  two  or  three  times  when  the  muscles 
would  draw.  Pressure  on  the  ovaries,  she  said, 
caused  pain,  then,  again,  she  said  not  There  is 
one  tender  spot  about  the  lumbar  region  of  the 
spine.  She  eats  well,  and  when  she  sleeps — 
which  she  does  sometimes  all  night— there  is  no 
drawing  or  twitching.  She  complains  of  pain 
in  the  side.     Her  heart  is  normal. 


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Now,  brother  ph)  siciaDS,  give  me  your  diag- 
nosis and  treatment,  either  by  mail  or  through 
The  Medical  World. 

H.  Hanson,  M.D., 

Cedar  Hill,  Jeff'n  Ck).,  Mo. 


Editor  Medical  World: — Will  some  of 
your  many  intelligent  contributors  suggest 
something  untried  for  a  diarrhea  occurring  only 
at  night,  when  the  party  is  relaxed  in  sleep — a 
young  girl,  fourteen  years  of  age,  vigorous  and 
large  for  her  age,  mentally  strong,  never  men- 
struated. I  have  supposed  it  was  caused  by 
feeble  contractile  power  of  the  anal  sphincters. 
Careful  attention  to  diet,  light  suppers,  bowels 
moved  naturally  once  daily.  Have  given  ^ 
grain  of  strychnia  three  times  daily,  injections 
of  nitrate  of  silver,  previously  washing  out  the 
bowel,  and  lastly  have  given  an  astringent  and 
opium  mixture  with  the  strychnia,  which  alone 
seems  to  help  temporarily.  I  would  say  that  I 
have  tried  a  fractional  portion  of  a  grain  of 
sulphate  of  copper,  sulpho  carbolate  of  zinc,  and 
arsenite  of  copper,  singly,  at  times.  Case  has 
continued  for  two  years. 

Will  some  one  give  me  a  diagnosis  and  cause, 
with  treatment. 


Rahway,  N.  J. 


R  B.  Silver,  M.D., 


Editor  Medical  World  : — Will  the  editor, 
or  some  one  of  the  many  readers  of  The  Medi- 
cal World,  give  a  list  of  the  explosive  medi- 
cines, and  explain  why  the  two  following  drugs 
exploded  with  such  violence  ? 

The  first  was  an  ounce  bottle  half  full  of  C. 
P.  nitric  acid.  Had  been  using  out  of  the  bot- 
tle at  different  times  for  the  past  twenty  months 
with  glass  rod  and  pipette,  but  kept  tightly 
corked  with  glass  stopper  when  not  in  use,  but 
had  not  made  use  of  any  of  the  acid  for  a  month 
previous  to  the  explosion,  which  occurred  about 
10  o'clock  one  night  in  July  last  The  tempe- 
rature in  the  office  at  the  time  was  80^  F.  The 
acid  exploded  with  a  report  of  a  well  loaded 
shot  gun.  The  bottle  was  sitting  in  the  pigeon- 
hole of  an  old-fashioned  desk,  with  the  lid  closed. 
It  threw  back  the  lid  and  tore  out  the  partition 
between  it  and  the  adjoining  pigeon  hole, 
breaking  the  bottle  into  thousands  of  frag- 
ments. 

The  second  exp!ofiion  was  a  one- pound  bottle  of 
peroxide  of  hydrogen,  of  thick,  heavy  gla's  and 
wrapped  in  heavy  shipping  paper.  It  occurred 
on  the  6th  instant,  at  3  p.  m.  The  temperature 
of  the  room  was  82^  F.  The  bo  tie  had  been 
laying  on  an  open  shelf  in  the  office  since  June 
6th  last,  and  had  not  been  opened  or  disturbed 
since.     I  had  just  left  the  office  and  was  in  the 


adjoining  room,  when  a  terrific  report  was  heard, 
with  falling  of  glass  all  over  the  room.  Four 
empty  quart  bottles  were  standing  on  the  same 
shelf,  in  front  of  the  bottle  of  peroxide,  which 
was  lying  down,  and  all  were  broken  into  thou- 
sands of  pieces,  some  of  the  pieces  of  glass  im- 
bedding into  the  walls  of  the  room. 

Now,  what  could  have  caused  the  above  ex- 
plosions T  The  bottle  of  peroxide  passed  through 
the  long,  hot  summer,  when  the  temperature  of 
the  room  was  100^  and  upwards  at  difiereut 
times.  I  consider  the  explosion  of  either  verj 
dangerous,  and  that  I  made  a  lucky  escape  with 
the  last  one. 

Answer  and  explanation  through  your  valu- 
able journal  would  be  very  gratefully  received. 

I  take  eight  medical  journals,  but  I  like  The 
World  the  beet  for  information.     It  has  given 
me  many  times  a  helping  hand  in  the  darkest 
hours  of  need.      Benj.  F.  Shipley,  M.D., 
University  of  Maryland,  1883, 

Alpha,  Md. 

Explosive  compounds  result  &om  the  admix- 
ture of  powerful  oxidizing  agents  with  sub- 
stances which  are  readily  oxidizable.  The  most 
important  members  of  these  two  classes  are  as 
follows : 

Oxidizers.  Oxidizable  or  eombustihle. 

Nitric  acid.  Chromic  acid.  Glycerin,  sugar,  alcohols. 

Free  hydrochloric  acid  Oils  and  ethere. 

Nitro-hjdrochloric  acid.  Sulphur  and  Sulphides. 

Potassium  chlorate.  Dry  organic  sabstancee. 

Potassium  permanginate.  Phoephorus. 

Explosions  have  resulted  from  mixing  fluid 
extract  of  uva  ursi  with  certain  samples  of  spirit 
of  nitre,  chromic  acid  with  glycerin^  permangan- 
ate of  potassium  with  glyceririf  nitric  acid  with 
glycerin  ^  nitrate  of  silver  witn  creasote,  oxide  of 
silver  in  pill  with  extract  of  gentian,  potassium 
chlorate  with  glycerin,  and  tincture  of  the  chlo- 
ride of  iron.  Chloride  of  lime  triturated  with 
sulphur  in  a  mortar  has  exploded,  so  also  has 
calcium  or  sodium  hypophosphite  when  tritura- 
ted alone.  Tincture  of  iodine  with  ammonia 
forms  the  iodide  of  nitrogen,  which  is  highly 
explosive,  especially  if  triturated  in  the  presence 
of  water.  Catechu  and  potassium  chlorate  in  a 
dentifice  have  exploded  in  the  mouth  from  the 
friction  produced  by  a  dry  tooth-brush. — PoUer. 


A  constant  reader  sends  us  the  following.  The  sug- 
gestion is  a  good  one. 

'*  Your  journal  is  but  one  of  a  number  that  I  take 
but  I  always  read  it  with  an  interest  second  to  that 
excited  by  no  other.  Yet  its  value  would  be  greatly 
augmented  if  your  correspondents  would  always  give 
dose  and  frequency  of  administration  of  remedies  in  re- 
porting cases.    Please  stir  them  up  on  this  line." 


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381 


Oorreotion. 

Editor  Medical  World: — In  September 
No.,  page  328,  "  For  Gall  Stones,  with  Jaun- 
dice,"  you  make  me  say,  *'  chlorate  soda,"  which 
k  incorrect  It  should  read,  '*choleate  of 
eoda."  Jno.  H.  Ferguson,  M.D., 

Mine  La  Motte,  Mo. 


Correotion. 
Editor  Medical  World: — In  September 
World,  page  333,  in  the  prescription  Uie  dose 
of  ext.  opii.  should  be  "dram  J,"  instead  of 
'<  grains  3."  This  is  the  fluid  extract  of  Parke 
IHvis  &  Co.,  strength  6  grains  morphia  to  the 
ounce.  R  T. 

Editor  Medical  World  :— If  Dr.  W.  F., 
page  335,  September  World,  will  use  the  fol- 
lowing prescription,  he  will  relieve  the  hyper- 
emia of  the  brain  and  spinal  cord,  and  cure  his 
patient : 

.   R,   Pot  brom......... ounces  n 

Ext  ergot. » fl.  drams  iiss 

Bxt.  geisomlam fl.  dram  i 

Elixir  simple^. qs. ad ounces  iv 

M.    SIg.— I  dram  three  or  four  times  a  day,  in  water. 

If  the  temperature  runs  high,  use  one  drop  of 
tincture  veratrum  every  hour,  until  reduced  to 
normal.  C.  H.  Francis,  M.D., 

Lake  Forest,  111. 


Editor  Medical  World  : — I  have  long  had 
a  theory  that  surgical  shock  was  caused,  in  a 
measure,  by  contact  of  metal  instruments  with 
the  nerves,  on  electrical  principles.  That  they 
do  have  some  such  effect  is,  I  think,  proved  by 
the  experiment  of  st)pping  the  heart's  pulsations 
by  the  mere  touching  of  a  metal  point  to  the 
upper  part  of  iU  septum,  and  which  doubtlessly 
acts  by  disturbing  its  electrical  economy. 

I  merely  make  this  suggestion  in  hopes  that 
some  one  may  take  the  matter  up  and  prove  it 
by  a  comparative  experiment,  by  using  knives 
of  toughened  glass  or  other  material  The 
neurometor  would  probably  be  the  beet  instru- 
ment for  measuring  the  comparative  shock  pro- 
duced. H.  R.  . 

O Editor  Medical  World: — ^Can  you  give 
formula  of  Gray's  Ointment,  put  up  at  Nash- 
ville, Tenn.  ?  Dr.  J.  P.  Shearon, 
Robinsonville,  Miss. 


Editor  Medical  World  :— Will  you  kindly 
give  the  formula  for  viavi  cerate  and  capsules, 
used  in  the  treatment  of  diseases  of  women? 
They  have  agents  and  offices  in  every  large 
city  in  the  Union,  and  claim  such  wonders,  as 
all  do  m  that  kind  of  business.  It  is  made  in 
San  Francisco,  Chicago,  and  New  York  City. 

West  Detroit,  Mich.     L.  K  Ellis,  M.D., 


Editor  Medical  World  : — On  the  3d  inst. 
Mrs.  C.  came  to  my  office  suffering  intense  ago- 
ny with  her  hands.  Bhe  had  been  making  pep- 
per mangoes,  and  had  her  hands  in  the  peppers 
for  several  hours.  Bhe  informed  me  that  she 
had  tried  all  the  ordinary  remedies,  as  lard, 
cream,  white  of  egg,  etc.,  and  that  all  eeemed  to 
make  the  burning  worse,  nothing  giving  relief 
but  immersing  them  in  cold  water. 

Thinking  that  exclusion  of  air  would  give 
relief,  I  applied  a  balsam,  but  in  ten  minutes 
had  to  remove  it,  as  it  only  made  them  worse. 
I  then  tried  several  things,  but  without  avail. 

Remembering  hoir  nicely  fluid  extract  of 
grindelia  robu&ta  had,  in  my  hands,  relieved 
the  pain  of  poison  oak,  I  be^m  applying  grin- 
delia, and  in  half  an  hour  the  burning  had 
ceased.  However,  the  fingers  were  badly  swol- 
len, and  stiff. 

Now,  I  want  some  one  to  tell  me  what  will  re- 
lieve "  pepper  burns." 

Dover,  Mo.  R.  R  L.  Hitt,  M.D., 

Current   Medical   Thought. 

The  Propagation  of  Rabies. 

People  have  often  wondered  how  hydropho- 
bia is  kept  in  existence,  since  animals  cannot 
spontaneously  <*go  mad/'  but  can  only  contract 
the  disease  from  another  case.  A  reflection  on 
the  nature  of  the  disease  itself  makes  the  solu- 
tion of  the  problem  quite  easy.  In  some  parts 
of  the  country  the  disease  exists  among  wild 
animals  and  is  by  them  occasionally  conveyed 
to  domestic  animals  entirely  unknown  to  their 
0¥niers.  Again,  a  dog,  in  one  of  his  trips  out 
at  night,  is  bitten  by  a  rabid  dog  or  other  ani- 
mal, returns  home  before  morning,  and  no  one 
knows  of  the  occurrence.  Some  weeks  there- 
after he  develops  the  disease.  In  view  of  this  the 
natural  wonder  is  that  rabies  is  not  more  gener- 
ally prevalent.  This  may  be  accounted  for  by 
the  fact  that  so  small  a  proportion  of  animals 
bitten  by  rabid  animals  are  actually  inoculated, 
there  being  so  many  circumstances  that  may 
prevent  them  from  inoculation. 


We  are  pleased  to  note  that  our  genial  friend 
and  co-temporary,  the  Medical  Mirror,  has 
adopted  a  new  and  improved  title-page.  There 
was  no  room  for  improvement  in  the  contents, 
which  are  always  bright,  spicy  and  interest- 
ing. 


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THE  MEDICAL  WORLD. 


Tablets  or  granules  placed  under  the  tongue, 
and  dissolved  there,  will  produce  almost  as 
prompt  an  effect  as  if  given  hypodermicallj.  If 
first  dissolved  in  a  teaspoonful  of  hot  water,  and 
then  taken  into  the  mouth,  as  so  often  stated  in 
these  columns  for  several  jears  past,  the  effect 
wUl  be  still  more  prompt. 


The  Influence  of  Alcohol,  Glycerine  and  Olive  Oil, 
on  the  Action  of  Oitinfeotants. 

Lend  summarizes  in  the  British  Medieal 
Journal  the  results  of  a  series  of  researches  as 
follows : 

1 .  Alcohol  in  the  absence  of  water  neutralizes 
all  bactericidal  power  on  the  part  of  sublimate 
or  phenol,  with  regard  to  anthrax  snores,  and 
the  bactericidal  action  is  not  exercised  until  the 
dilution  of  the  alcohol  with  water  becomes 
greater  than  two  per  cent  in  the  case  of  1  in 
1000  sublimate  solution,  or  than  seventy  per 
cent,  in  the  case  of  carbolic  acid.  The  length 
of  time  to  which  the  spores  were  subjected  to  the 
action  of  the  solutions  was  twenty  four  hours  in 
the  case  of  sublimate,  and  forty  eight  hours  ia 
that  of  phenol. 

2.  Glycerine  has  a  similar  impeding  action, 
interfering  with  the  action  even  of  a  2  in  1000 
solution  of  sublimate,  if  the  proportion  of  water 
be  les)  than  forty  per  cent  In  the  case  of  phe- 
nol it  is  still  more  manifest 

3.  Phenol  and  lysol  dissolved  in  olive  oil 
have  no  disinfectant  action  when  tested  as  above. 

4.  In  the  preparation  of  a  disinfecting  fluid, 
one  ought,  therefore,  to  avoid  the  addition 
either  of  alcohol,  glycerine  or  fats. — Canada 
Lancet. 


Sulphanilio  Acid  in  Catarrhal  AfTeotiona  of  the 
Upper  Air-Paaaagea. 

Dr.  A.  Valentin  (Sem,Med.,  1894;  XIV,  p. 
180),  according  to  the  author,  the  internal  use 
of  SuLPHANiLic  Acid  acts  very  favorably  in 
coryza  and  catarrhal  laryngitis.  In  acute  cor- 
yza  it  brought  about  in  two  hours  a  considerable 
diminution,  and  often  even  complete  disappear- 
ance, of  the  swelling  of  the  turbinated  bones,  of 
serous  secretion,  and  of  redness  of  the  mucous 
membrane. 

An  equally  good  result,  it  is  asserted,  is 
attained  in  acute  laryngitis.  Sulphanilic  acid  is 
said,  besides,  to  quickly  calm  the  pain  caused  by 
catarrh  of  the  tympanum,  without,  however, 
accomplishing  a  complete  cure  of  that  affection. 
Finally,  this  medicament  is  reported  to  suppress 
neuralgiform  pain  accompanying  divers  other 
catarrhal  affections— particularly  those  of 
grippal  origin,  but  to  exercise  no  action  on 
genuine  neuralgias. 


The  author  prescribes  the  medicament  in 
solution,  as  follows : 

B.   Sulphanilic  acid,  C.  P 10  gme.  (2K  dramf) 

Sodium  bicarbonate 8.5    "       (2%    "     ). 

Water 200    "       (6>^fl.  or) 

2-1  tablegpoouAili  dailj,  In  one  or  two  slngie  dofiea. 

It  is  stated  that  sulphanilic  acid  may  ordi- 
narily be  taken  in  such  doses  for  a  long  dme 
without  causing  digestive  disturbances.  In  some 
cases,  however,  its  prolonged  use  ultimately 
provokes  diarrhoea. — Amer  Med,  Surg.  BuUetiru 

The  Value  of  Combining  Heart-tonica. 

Convallaria  majalis  is  a  simple  cardiac  tonic 
and  a  safe  remedy.  Its  action  is  similar  to  that 
of  digitalis,  but  not  so  marked.  It  causes  slowing, 
and  increases  the  force  of  the  heart-beats.  But 
it  will  frequently  be  found,  in  lessening  com- 
pensation, that  each  of  the  foregoing  drugs 
individually  fails,  and  disappoints  us  after  a 
time.  Then  a  combination  of  all  three  often 
produces  an  effect  little  short  of  marvellous. 
Once  or  twice  in  recent  years  I  have  been  called 
in  consulation  over  casea  of  advance  mitral 
disease,  in  which  central  failure  has  shown  itself 
by  extensive  dropsy  of  the  limbs,  cedema  of  the 
lungs  and  liver,  and  a  general  water-logged 
condition  of  the  system.  On  inquiry  of  my 
colleagues  in  attendance  as  to  the  exhibition  o( 
digitalis,  the  reply  has  been,  "He  has  had  it.** 
A  similar  response  has  been  given  in  the  case 
of  strophanthus  and  convallaria.  But  they  had 
not  been  given  collectively — and  when  this  was 
done,  benefit  speedily  accrued  to  the  patient, 
and  credit  to  his  medical  advisers. — Dr.  Taylor, 
in  The  Clinical  Journal 


Croup  and  all  Croupous  Diaeaaea  Curable  by 
Pilooarpin. 

Carl  Sziklai,  (The  Journal  of  Laryngology, 
Rhinology  and  Otology,  July,  ISOJi.),  in  an 
elaborate  thesis  read  before  the  Ecole  de 
Medicine  in  Paris,  in  which  he  describes  the  an- 
atomico-pathological processes  observed  in  croup 
and  its  differentiation  from  diphtheria,  concludes: 
1.  Pilocarpin  is  a  specific  for  croup  and  all 
croupous  diseases,  i.  e.,  croupous  laryngitis,  croop- 
oua  bronchistis,  croupous  pneumonia,  croupous 
nephritis,  croupous  cystitis,  etc.,  eta  2.  The 
action  of  pilocarpin  commences  at  once.  In 
laryngitis  crouposa  cure  is  obtained  in  a  few 
hours;  in  pneumonia  crouposa  in  two  or  three 
days.  3.  The  result  is  certain,  whether  taken 
by  mouth  subcutaneously  injected];  also  applied 
as  suppositories  or  globuli  vaginales.  4.  In 
an  advanced  stage  of  larjngiiis  crouposa,  with 
imminent  danger  to  life,  subcutaneous  injection 
is  preferred  to  internal  administration.  5.  By 
pilocarpin  not  only  is  duration  of  disease  notably 
shortened,  but  mortality  is  oil,    6.     In  suitable 


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THE  MEDICAL  WORLD. 


383 


cases,  given  early  enough,  it  has  a  preventive 
action.  7.  Pilocarpin  can  be  given  in  twice 
officinal  dose  without  fear  of  ill  effects. 

The  author's  experience  with  this  drug  in 
treatment  of  croupou'  diseases  extended  over 
ona-hundred  cases.  His  conditions  and  obser- 
vations were  corroborated  by  Herr  Hofrat 
Biederl  of  Hagenan,  and  Eschevich  of  Graz. — 
Medical  Herald, 


Traatmant  of  Chronic  Malaria  Toxemia. 

In  a  paper  published  in  Sanative  Medicine  by 
V.  Berry,  M.  D.,  of  Wagoner,  Indian  Territory, 
after  giving  a  description  of  Malarial  disease  in 
that  locality,  the  author  out  lines  treatment  as 
follows: 

The  prognosis  in  mild  cases,  and  many  of  the 
severer  forms  is  good,  providtd  you  can  control 
your  patient  You  can  almost  make  the  state- 
ment a  maxim  that  **  all  cases  complicated  by 
ascites  will  end  fatally."  I  love  to  see  the  first 
one  end  otherwise.  Those  cases  in  which  the 
spleen  and  liver  have  reached  the  highest  degree 
of  enlargement  usually  terminate  fatally,  but 
may  linger  many  months,  or  even  years  yet  they 
finally  succumb  to  the  malady  direct  or  some  of 
it?  complications. 

In  treatment  the  old  Thomsoaian  steam  bath 
comes  first  I  had  almost  as  soon  undertake  to 
live  without  eating  as  to  treat  these  cases  with- 
out the  vapor  bath.  As  medication  I  order  the 
the  following  (both  prescriptions  for  adults); 

B.   Podoph>llln » gr.  yi 

Leptsndrin gr.  y 

CA|«ici  polv ^ gr.  11  n 

3>Ui  bicarbonatls ....gr.  zr 

M.  Flat  cap.    No «. vl 

8ig.   One  every  nl^ht  till  tongae  begins  to  clean. 

Along  with  this  physic  I  order: 

R.   Qainina  lolAta gr.  xl  (40.) 

Tr.  capsid « ....irams  It 

AclcM  lactici q.  •. 

M.  Flat  801.  etadde: .« ~ — 

Tr.  Oentlanse drams  111 

Tr.  Warburgi q  s  ounces  Iv 

61g.   Tea«poonral  ever/  3  hours  throughout  the  day. 

Before  going  further  allow  me  to  say  that 
these  two  prescriptions  have,  for  the  last  two 
years  proved  almost  unfailing  remedies  in  my 
hands  in  a  great  number  of  cases  of  intermittent 
fever.  Of  coarse  in  the  treatment  of  chronic 
telluric  poisoning  our  medication  will  have  to 
extend  over  a  long  period  of  time,  and  it  will  be 
absolutely  necessary  for  some  cases  to  change 
climata  There  are  a  great  many  cases  that  end 
fatally  that  would  recover  without  medication  if 
a  high  and  dry  climate  were  sought  Of  course 
the  necessary  hygienic  regulations  have  to  be 
enforced  and  among  the  most  important  of  these 
is  to  never  allow  your  patient  in  the  open  air 
after  sunset  If  the  room  is  a  damp  one  a  fire 
should  be  keep  in  the  evening  even  in  summer. 


In  r^ard  to  diet,  all  fruit  should  be  interdicted 
except  that  that  is  known  to  be  absolutely  fresh 
and  uot  over  ripe.  Milk,  and  fresh  beef  and 
game  well  cooked  constitute  the  most  wholesome 
food  for  these  patients.  A  liberal  quantity  of 
cool,  acidulated  water  is  helpful,  lemonade  being 
the  best  of  which  the  writer  has  a  knowledge. 
These  patients  need  encouragement.  It  is  med- 
icine to  them.'' 


For  Pimples  and  Black  Heads. 

It  la  stated  that  a  lolion  of  alcohol,  three 
ounces,  salicylic  acid,  one  drachm,  will  cause  a 
prompt  disappearance  of  pimples  and  comedones. 
— Med.  Summary, 

Morphinomania  Cured  In  Twenty-flve  Days. 
M.  Gomby  reported  the  case  of  a  young  woman, 
aged  22  years,  who,  since  an  attack  of  pelvic 
peritonitis  that  occurred  in  February,  1891, 
had  contracted  the  habit  of  injecting  subcutan- 
eously  0.25  gramme  (4  grains)  of  hydrochlorate 
of  morphine  per  diem  in  twenty  doses.  When 
admitted  on  April  5  of  this  year,  into  the  Tenon 
Hospital,  she  had  reached  an  extreme  degree  of 
cachexia,  and  she  was  covered  with  abscesses 
and  the  scars  of  euch,  due  to  the  use  of  the 
hypodermatic  needle.  From  the  first  day  the 
daily  dose  of  the  drug  was  reduced  from  0.50 
(71  grains)  to  0.06  gramme  (1  grain),  given  in 
three  doses.  Bhe  was  given,  at  the  same  time, 
a  mixture  containing  0.10  gramme  (If  grains) 
of  sparteine  sulphate,  0.50  gramme  (7}  grains) 
of  caffeine,  and  0.50  gramme  (7}  grains)  of 
sodium  benzoate,  the  whole  to  be  taken  in 
twenty-four  hours.  This  daily  dose  was  contin- 
ued up  to  May  1st,  when  the  morphine  was 
totally  discontinued.  At  this  date  the  condition 
of  the  patient  had  undergone  a  complete 
transformation,  and  the  improvement  his  con- 
tinued up  to  the  present  M.  Gomby  considers 
the  case  cured. — Lancet,  May  19  1894  — Uni. 
Med.  Jour. 


SALICYLATED  IRON  MIXTURE. 

R.  SodU  MllcTlatlf drami  It 

Tlnot  fern,  chloridl f  dranu  It 

Addl  dtrld gn.  x 

Qlyoerinl »^ ....f  oanoee  Ifs 

OL  gauUherls minims  tUJ 

Uq.  ammon.  dtratls q.  a.  ad.  f  ounoei  It 

M.    Sol  860.  ark  Dos.fdramlorfdiamsfj. 

Dissolve  the  citric  acid  and  sodium  salicylate 
in  the  liquor  ammonise  citratis.  To  the  gly- 
cerin add  the  tincture  of  chloride  of  iron,  and 
then  mix  the  two  solutions,  to  which  is  finally 
added  the  oil  of  gaultheria.  One  or  two 
drams  of  mucilage  of  acacia  would  be  a  valu- 
able addition  with  which  to  emulsify  the  oil  of 
gaultheria. 


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THB  MEDICAi  WORLD. 


In  this  prescription,  reaction  takes  place  be- 
tween the  ferric  chloride  and  SDdium  salicylate, 
resulting  in  double  decomposition,  giving  salicy- 
late of  iron  in  first  solution.  Care  should  be 
taken  to  keep  the  liquor  ammonise  citrads  in 
slight  excess,  in  order  to  have  a  perfectly  clear 
solution  of  salicylate  of  iron. 

Dose.— One  or  two  teaspoonfuls. 

This  pretcription,  known  as  the  Mistura  Ferri 
Salicylata  (salicylated  iron  mixture)  is  used 
principally  in  the  treatment  of  chronic  cases  of 
rheumatism  or  rheimiatoid  arthritis  in  which 
anemia  or  other  evidence  of  impaired  nutrition 
is  a  distinct  feature.  It  is  likewise  employed 
in  acute  tonsilitis  of  rheumatic  origin,  and  in 
acute  articular  rheumatism  in  anemic  subjects, 
especially  if  the  patient  has  suffered  from  one 
or  more  previous  attacks. 

The  ordinary  dose  in  chronic  cases  in  adults 
is  a  dessertspoonful  four  times  a  day ;  in  acute 
cases,  the  same  dose  is  given  every  two  hours 
until  tinnitus  is  produced  or  decided  ameliora- 
tion has  occured,  when  the  dose  is  diminished 
or  the  intervals  between  doses  lengthened. — 
PhilcL  Polyclinic, 


CERTAIN   ANTIDOTES. 


F.  Schilling  states  that  the  ill-effects  of  the 
salicylates  can  be  counteracted  by  the  simulta- 
neous administration  of  ergot  Conversely,  he 
has  employed  with  success  salicylate  of  sodium 
in  a  grave  case  of  ergotism.  He,  therefore, 
recommends  the  salicylate  as  an  antidote  to 
ergot 

He  also  recognizes  nitrate  of  amyl  as  an 
antidote  to  cocaine.  In  a  case  of  intoxication 
caused  by  the  inhalation  of  about  i  drachm  of 
nitrite  of  amyl  the  injection  of  i  drachm  of  a 
five  per  cent  solution  of  cocaine  caused  a  rapid 
disappearance  of  the  symptoms. — Med.  BtUletin, 


PAINFUL    CARDIAC   SENSATIONS. 

When  these  occur  in  the  gouty,  old  people, 
or  smokers,  Liegeois  has  derived  benefit  from 
the  use  of  tincture  of  pisddia  erythrina  (Jama- 
ica dogwood)  in  the  daily  dose  of  forty  to  sixty 
drops  continued  for  three  weeks  or  a  month. — 
La  Med.  Mod. 


SALICYLATE   OF  SODIUM   IN   CANCER. 

In  a  case  where  the  bone  had  become  in- 
volved, secondary  to  cancer  of  the  breast,  Aik- 
mann  obtained  decided  relief  of  pain  by  the 
administration  of  salicylate  of  sodium,  in  doses 
of  ten  grains  three  times  a  day.  Large  doses 
of  opium  had  been  given  in  vain. —  Glasgow 
Medical  JoumaL 


FOR   ENLARGED   PROSTATE   GLAND. 
(Dr.  C.  W.  Marpliy  ) 

R.  Tercbene « «. q.  s 

Big. :  Ten  to  fifteen  drops  on  infBu,  an  hour  after  meals. 

R.   Boiloaoid.,  (5.gr.  tab.) — .^q.s 

Slg. :  Two  before  each  meal. 

These  two  remedies  in  enlarged  prostate  wftb 
sequential  chronic  cystitis  give  more  relief  than 
any  other  remedies  I  have  ever  tried*  Regn* 
late  the  bowels  with  cascara. 


CHRONIC  CYSTITIS. 

Mr.  Martin  Chevers  writes  to  the  Mediocd 
Press  that  in  a  troublesome  case  he  witnessed 
prompt  relief  from  the  use  of  a  combination  as 
follows : 

R.  Tlnot  ooUinsoniee » drams  11 

Copalbse drams  lij 

Llq.  morfilx.^ ^ ....drams  as 

liq.  potassffi „ ^ ounces  ss 

01.  menth.  pip minims  ilj 

Aq.  campa ad  ounces  vj 

Big. :  One  tablespoonfol  every  three  hours. 

—Med.  Bulletin. 


FOR    NEURALGIA. 

R.  Ferrl  tartiratt „ ., gr,  IJ 

QulninsB  sulphatls gr.  n 

Addi  tartaric. «. 

Extract  nuds  Tomlcse aa.  gr.  »s 

Mlsoe  et  flat  pilula.    Slg. :  Take  i  three  times  a  day. 

—  Gross  Med.  CoU.  Bvlletin. 


Potassium  Bichromate  in  Gastric  AfflBotfons. 
Dr.  T.  R  Fraier. 

.  In  his  address  at  the  recent  International  Med- 
ical Congress,  the  author  stated  that  he  had  cured 
eighteen  obstinate  cases  of  dyspepsia  and  nine 
cases  of  simple  ulcer  of  the  stomach,  by  the 
internal  use  of  Potassium  Bichromate  (previously 
recommended  by  Vulpian  against  certain  gas- 
tropathias). 

The  medicament  was  administered  in  pills  or 
doses  of  5  milligrammes  1  ctg.  (i-i  gni.)  three 
times  daily,  between  meals  — when  the  stomach 
was  as  empty  as  possible.  Its  effect  was  shown 
more  or  less  rapidly  by  the  disappearance  of 
pain  and  vomiting ;  and  complete  cures  were  had 
after  variable  periods— according  to  nature  of 
the  case. 

The  author  states  that,  in  gastric  affectionfl,. 
potassium  bichromate  acts  locally  as  an  antiseptic 
and  analgesic,  but  it  does  not  exert  any  hsemoK 
tatic  action  in  hsematemesis. — Amer.  Med.  Sur^. 
Bulletin. 


Inula  Campagna. 

Elecampane  has  long  been  used  by  the 
peasantry  in  Ireland  and  on  the  Peninsula  as  a 
specific  in  consumption,  wooping  cough,  and 
various  enteric  affections.  Its  active  principle, 
Helenin,  has  recently,  been  advocated  by  the 
physicians  of  the  general  hospitial  at  Madrid  in 


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885 


the  treatmeBi  of  tuberculosis.  It  is  certainly  a 
powerful,  non-irritatiDg  antiseptic,  of  great 
value  for  intra-uterine  injection,  and  for  de- 
stroying the  bacilli  in  ozsena,  anthrax,  and  all 
puruloit  discharges.  It  is  used  as  arf  antiseptic 
as  a  1  in  1,000  or  i  in  1,500  solution,  and  has 
no  toxic  properties.  Ferran  lauds  its  properties 
in  destroying  the  comma  bacillus  of  cholera,  and 
Baesa  says  it  will  cure  infantile  diarrhoBa  in 
doees  of  1  12  gr  ,  and  the  summer  diarrhoea  of 
adults  in  doses  of  2  grs.,  quicker  than  any  other 
remedy.  Whitla  says  of  this  product,  from  one 
of  our  oldest  friends,  that  ''it  promises  from 
the  Spanish  accounts  of  its  use  to  become  one  of 
our  most  valuable  therapeutic  weapons." — 
Facifie  Med.  Rec, 

The  other  day  I  stopped  for  a  moment  in  the 
oflto  of  a  prominent  specialist  of  this  city  and 
to  my  surprise  found  him  ''putting  up"  med- 
icine for  a  wailing  patient  He  said  the  cost  is 
80  little,  and  the  trouble  so  slight,  while  the 
patient  pays  $3.00  for  the  office  consultation 
s6  much  more  cheerfully  than  if  merely 
handed  .a  perscription,  that  it  is  the  best  practice 
to  follow.  And  upon  investigation  I  find  that 
a  large  number  of  the  physicians  of  this  city  are 
today  carrying  a  small  stock  of  medicine  for 
office  practice.  This  is  a  good  thing.  It  causes 
the  city  phvsidan  to  become  acquainted  with  the 
medidnes  he  prescribes,  makes  him  consider 
palatability,  and  use  all  efforts  to  afford  a  happier 
dosage.  And  it  is  a  practice  pleasing  to  the 
patron. — CUnique. 

Resoroin  for  Whooping-Cough. 

In  a  letter  to  Sanative  Medicinef  after  very 
sensibly  justifying  the  use  of  resordn  (a  mildly 
toxic  drug,  but  against  which  no  death  is 
charged,  idthough  as  much'  as  150  grains  have 
been  tak^  by  citing  the  number  of  actively 
and  even  virulently  pois  >nous  drugs  that  are  in 
authorized  use  among  their  sect  (the  Physio- 
Medical  is(s)  as  quinine,  hydrastive,  sanguinaria, 
lobdia,  Phytolacca  etc.,  Dr.  H.  F.  Nichols,  of 
Attica.  N.  Y.,  gives  the  following: 

"  Now  the  use  I  have  made  of  resorcin  has 
principally  been  in  pertussus,  and  in  that  disease 
it  has  proved  itself  almost  a  specific. 

In  the  case  of  my  o^m  children,  when  almost 
the  whole  town  was  coughing,  they  commenced 
with  the  rest  and  seem^  destined  to  follow  the 
usual  course,  but  I  prepaaed  a  syrup ; 

R.  RdOTCln M MM gn.  xl. 

Sjr.  tola..... ounces  It. 

M.  Sg  Teaspoonfiil  every  two  hours  or  oftener 

if  necessary  to  control  the  paroxysms;  this  for  a 

child  4  to  6  yeara  old.     Thev  coughed  about 

five  or  six  days  quite  hard  and  then  the  cough 

diminished  and  by  the  10th  day,  ceased  entirely. 


And  I  have  given  it  to  babes  three  and  four 
months  old  with  like  jgood  results.  (Dose  about 
one  half  size.) 

I  should  not  hesitate  to  give  more,  if  indica- 
tions seemed  to  require  it  I  should  like  you  to 
test  this  remedy  and  the  profession  also  and 
report" 

State  Medioal  Examinations. 

An  independent  State  examination,  aside  from 
the  college  diploma,  is  required  in  Alabama* 
Arkansas,  Florida,  Maryland,  Minnesota,  Mis- 
sissippi, New  Jersey,  New  York,  North  Carolina, 
North  Dakota,  Pennsylvania,  South  Dakota, 
Texas,  Utah,  Virginia,  Washington,  and  portions 
of  the  Indian  Territory.  The  second  list,  we  are 
informed,  where  the  examination  is  apt  to  be 
little  more  than  a  form,  simply  requiring  a 
registry  of  diplomas  after  they  have  been  sup- 
ervised by  State  examining  boards.  State  boards 
of  health,  or  officers  of  the  county  court,  and 
an  independent  examination  is  not  obligatory, 
includes  the  States  of  California,  Colorada, 
Connecticut,  Delaware,  Illinois,  Iowa,  Missouri, 
Montana,  New  Mexico,  Oklahoma,  Oregon, 
Tennesee,  West  Virginia  and  Vermont  Maine, 
New  Hampshire,  Massachusetts  and  Rhode 
Island  have  no  legal  regulations. — Med,  Sum- 
mary, 

CHEMISTBT  TO  RaOXRXRATB  THS  WOBU). 

In  a  receot  address  before  the  manufactarlDg  chem- 
ists of  Paris,  M.  Berthelot  indulged  in  some  extraordi- 
nary dreams  of  what  ohenustry  is  to  do  for  this  world 
of  oars.  He  said  that  by  utilizing  the  central  heat  of 
the  earth,  which  can  readily  be  procured  br  means  of 
shafts  sunk  to  the  dej^th  of  8000  to  4000  metres— 
which  modem  engineering  can  di^  with  litrle  trouble 
— from  these  water  will  be  obtauied  hot  enongh  to 
keep  all  possible  machinery  ffoing  at  the  smallest  ex- 
pense, and  it  would  be  an  untHiling  nonroe  of  meohan- 
loU  and  electrical  energy.  With  snch  a  source  of  heat 
all  chemical  transforiaation  wonld  be  easy.  This  pro- 
daction  of  alimentary  matter  will  be  one  consequence. 
This  production  is  resolved  in  principle,  and  has  been 
for  forty  years,  by  the  snytheses  of  grease  and  oib. 
That  of  hydrates  of  carbon  is  going  on,  and  that  of 
nitrogenous  substances  is  not  far  on.  When  energy 
can  ^  obtained  thus  cheaply,  food  can  be  made  from 
carbon  taken  from  carbonic  acid,  hydrogen  taken  from 
water,  and  nitrogen  from  the  air.  What  work  the 
vegetables  have  so  far  done  science  will  soon  be  able 
to  do  better,  with  far  greater  profusion  and  indeoend- 
ently  of  seasons  or  evil  microbes  of  insects.  There 
will  be  then  no  passion  to  own  land,  beasts  need  not 
be  l$red  for  slaughter,  man  will  be  milder  and  more 
moral,  and  barren  regions  may  become  preferable  to 
fertile  as  habitable  places,  because  they  will  not  be 
pestiferous  from  ages  of  maturing.  The  reim  of  chem- 
istry will  beautify  the  planet  There  will,  under  it, 
be  no  need  to  disfigure  it  with  the  geometrical  works 
of  the  agriculturist,  or  with  the  grime  of  factories  and 
chimneys.  It  will  recover  its  verdure  and  flora.  The 
earth  will  be  a  vast  pleasure  garden,  and  the  human 
race  will  live  in  peace  and  plenty. — Ifew  OrUam 
Picayune. 


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Formulas. 


BUPPOBITOBIEB  FOB  PB08TATITIB. 
(Ullmum.) 

E-  lohthyol gr.J 

Extract  beUadoima ....gr.  12 

Cacao  batter » ^.4liaiiii  4 

Make  10  BuppoBltorleB.  .^       _  ^ 

DiiectloiiB .  jntrodace  into  the  rectum  one  or  two  snp- 
porftoriee  dally,  after  an  eYacaatloii  of  the  bowelt. 


FOB  PBIAPIBM. 


E.  Camphor  monobromlde. 

Lapmin ~ -... 

Label :  Divide  Into  10  powders, 
thioogh  the  nlfl^t,  If  needed. 


gr.  30 

-.gr.  100 

One  at  bedtime,  and  one 


LOTIOK   FOB  SCBOTAL  ECZEMA. 

(CampbelL) 

Iodoform - - drams  8 

Ztno  oxide.. 
Spirit  camphor.. 


lis 
..fl  drams  8 


I&e  water fl  drams  12 

Linseed  oil fl  drams  12 

Directloos :  Apply  at  night   Let  the  patient  wear  a  gua- 
peniory  bandage. 

FOB  OBSTINATE  VAGINISMUS. 
(DeSinety.) 

B.  Thymol « «....«- .gr.  % 

T^JomX  belladonna. gr.  8 

Potaskinm  bromide....— — gr.  8 

Cacao  hotter^...- drams  1 

Make  one  rappoaitory.  ^' 

—  Western  DruggtsL 


PLEUBISY. 


B.  Gnaiaoolpare... 
Tlnct.  iodine.... 


.drams  J 


..drams 


Paint  ihe  whole  of  this  liquid  each  evening 
on  the  afiected  ride.  The  temperature  quickly 
ffdls,  an  abundant  perspiration  takes  place, 
and  the  effumon  soon  becomes  absorbed. — Pre- 
mripHoru 


FOB  WHOOPING  COUGH. 

In  whooping  cough  try  the  following : 

B.  Ammon.  bromide. „....drams  Ij 

FL  ext  chesinutleaves.....^. — .ounces  J 

Tr.  Belladonna « drams  ss 

Syr.  tolu ounces  1) 

Byt,  Sim.  q.  s ......^ ounces  Iv 

M.    big.   Teaspoonftl  eyery  two  or  three  hours. 


COUGH. 


In  severe  paroyxsms  of  coughing  from  what- 
ever cause,  a  tablespoonful  of  glycerine  in  hot 
milk  or  cream  will  give  speedy  relief. 


tng. 


PILIJ3  FOB   CHBONIC  BBONCHITIS. 

B.  Ammonil  chlorldi gr.  xt 

Anunon.  oarb ; g'-  »▼ 

Puly.  ipecac gr  "} 

Morph.  hydrochloratis « gr.  i 

Mucilaginis  acadae ...^..q.  s 

M.    Divide  into  10  pi.ls ;  one  to  be  taken  night  and  mom- 

— Medical  Press  and  Circular. 


A  PBEBCBIPTION  FOB  INTEBMllTKNT  FBVEE. 

B.  Salicylate  of  quinine......................^ gr.  zx 

Syrup  of  oiange....».....^.........^......onnoei  ii 

Bum ^... oonoea  in 

Simple  syrup „ ounces  Hi 

M.  A  oigiBertspoonAil  erery  hour  for  eight  hours  pdor  U> 
the  attack  in  quotidian  fever,  t  velve  hours  prior  in  tertiaa 
fever,  and  ilftoen  hours  before  the  attack  in  quartan  fever. 

— Journal  de  Midedne  de  Paris, 


AN   EXCELLENT  ALTEBATIVE   AND   ''BLOOD 
MEDICINE." 

E.  Syr.  sarsaparlllse  comp .........^ f.  os.  iJ 

Ext.  burdock  fld....« £  o»-  il-2 

Est  tarax.  fid » ...„.t  os.  j 

Svr.  add  hydriodic,  (HosteUey's)... X  oc.  j 

M.    Big.   Teaspoonftal  tnree  times  daily. 


Wit  and  Wisdom. 


AOABIGIN  FOB  NIOHT-8WBAT8. 

In  an  article  in  the  Brooklyn  Medical  Journal^  Dr. 
Henry  Conkling,  discussinff  in  detail  the  varioua 
drags  that  are  u^ed  to  control  night-sweats  in  phthisis, 
thus  gives  the  palm  to  Agaricin : — 

Agaricm, — ^This  was  the  moat  sacoeasfnl  of  all  the 
dra^.  It  produced  most  ezcellait  resulta  i^  yomig 
sobjecta.  Under  its  nse  the  skin  remained  in  a  diy 
condition,  without  sospicion  of  any  kind  of  cutaneous 
activity.  It  is  very  suocessful  in  cases  where,  daring 
its  use,  the  sweating  had  diaappeared,  and  had  re- 
turned after  the  dno^  had  been  discontinued  for  a 
time.  Repetition  did  not^  weaken  its  power.  Of  all 
the  remedies  it  acted  best  in  the  first  few  adminirtra- 
tions.  Subsequent  ones  sometimes  failed.  It  can  be 
used  for  any  length  of  time  and  has  no  disadvantages. 

Agaricin  was  given  in  pill  form,  gr.  1-12;  one  pill 
at  bedtime,  or  a  pill  late  in  the  afternoon,  and  a 
second  in  four  or  ^re  hours.  This  remedj  dimin- 
ished the  sweating  in  one-eighth  of  the  administra- 
tions, stopped  it  in  three- fourths,  and  failed  in  the 
remainder. 

[Send  10  cents  for  a  trial  one  hundred  (or  90  cents 
for  one  thousand)  granules  of  Agaricin,  to  the  Phila- 
delphia  Granule  Co.,  10  South  18th  street,  Philadel- 
phia, Pa.] 

Whek  it  occurs  in  the  winter  it  b  called  infloensa. 
In  the  summer  it  is  known  as  hay  fever. 

Mklun's  Food  has  become  a  recognized  standard 
among  those  who  are  well  informed. 

See  the  offer  on  advertisiuff  psge,  and  send  for 
sample  of  Maltine  with  Coca  Wine. 

Fob  Syphilis  prescribe  Mercauro.  Made  by  Chas. 
Roome  Parmele  Co.,  41  Piatt  street.  New  Yorl^  N.  Y. 

As  a  milk  producer  use  Kutrolactis.  See  adv.,  and 
send  for  simple  to  Nutrolactis  Co.,  93  Warren  street, 
New  York,  N.  Y. 

Fob  Passiflora  Incamata,  the  nerve  sedative,  ad- 
dress John  B.  Daniel,  wholesale  druggist,  Atlanta,  Ga. 

Old  L^dy:  What^s  that  awful  smell?  Arkansas 
Farmer:  That's  the  fertilizer  we're  putin'  on  the  field 
yonder.  Old  Lady:  For  the  land^Bsakel  Fanner: 
Yes,  'm.—Ark,  Tom  CaL 

Couldn't  Fobget  Them.— "  Mary,"  said  the  sick 
man  to  his  wife  when  the  doctor  pronounced  it  a  esse 
of  smaU-poz,  **  if  any  of  my  oreditors  call,  tell  thaa 


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that  I  am  at  laat  in  a  condition  to  give  them  some- 
thing." 

See  the  handsome  pocket  case  advertised  by  H.  E. 
Mulford  Co^  2132  Market  street,  Philadelphia,  Pa. 

Fob  snpporters,  elastic  stockings,  and  all  such  goods, 
address  G.  W.  Flavell  &  Bro.,  1005  Spring  Garden 
street,  Philadelphia,  Pa. 

Have  yon  tried  the  treatment  of  the  morphine 
habit  by  the  use  of  ^vena?  Made  by  B.  Keith  A  Co., 
76  WiUiam  street,  New  York,  N.  Y. 

Fob  literatnre  regarding  the  Diphtheria  Anti-Toz- 
ine  Solution-Sobering,  address  Sdiering  &  Glatz,  65 
Maiden  Lane,  New  York,  N.  Y. 

Fob  dyspepsia  try  the  new  agent,  Seng,  made  by 
Snltan  I>nig  Co ,  St  Loois,  Ma 

Pboud  Mothsb  :  To  think  I  should  be  the  mother 
of  a  Congressman.  Sympathetic  Neighbor:  Oh,  I 
wouldn't  worry.  If  he^s  not  led  astray  by  someyouhg 
•cbool  girl,  people  wUl  forget  it  in  time. 

PoMPOiTS  professor  (to  his  class  in  medical  uniyer- 
dty) :  ^  The  patient  you  observe,  voung  gentlemen, 
has  one  perfect  eye,  whereas  the  other  is  thrown  in- 
ward toward  the  nose,  causing  a  painful  obliquity  of 
Tision.  In  this  instance  you,  Mr.  Finkbone,  may  rise 
and  tell  Uie  class  what  you  would  do." 

Mr.  Finkbone  (after  a  pause) — **  I  presume  I  would 
look  just  as  cron-eyed  as  he  does.^ 

Fob  trusses  and  other  eoods  in  that  line,  send  to 
the  Hastings  Truss  Co.,  224  South  9th  street,  Phila- 
delphia, Pa. 

Send  for  a  trial  box  of  Medicated  Uterine  Wafers 
to  Miagah  &  Co.,  Warren,  Pa. 

Send  for  sample  of  Dyspepsia  Tablets  to  the  P.  J. 
Noye^  MTg  Co.,  Lancaster,  N.  H. 

Fob  Hydrosone,  prescribe  Charles  Marchand's 

SxE  adv.  of  Parke,  Davis  &  Co.,  under  table  of 
contents,  this  issue. 

"  What  b  the  action  of  disinfectants  ?  "  was  asked 
of  a  medical  student  "  They  emell  so  bad  ihat  the 
people  open  the  door  and  fresh  air  gets  in,"  was  the 
reply. — New  Idea, 

A  doctor  practices  on  his  patients,  but  a  musician 
practices  on  the  patience  of  others. 

Fob  cat  rates  in  surgical  instruments,  address  I. 
Phillips,  Atlanta,  Ga. 

Fob  nervous  exhaustion,  try  Horseford's  Acid 
Phosphate. 

Whbh  yon  want  a  purified  form  of  opium,  use 
Svapnia.  Sample  from  Charles  N.  Crittenton  Co., 
116  Fulton  street,  New  York,  N.  Y. 

Fob  fine  electric  batteries  send  to  Mcintosh  Bat- 
tery and  Optical  Co.,  141- 143  Wabash  avenue,  Chicago, 

Use  Chionia  for  biliousness.  Sample  from  Peacock 
Cheoiical  Co.,  St.  Louis,  Mo. 

The  most  important  surgical  operation  on  record  is 
Lansing  Micliigan. — Ikehange, 

Possibly ;  but  Cutting  South  Carolina  sounds  as  if  it 
must  have  been  quite  an  operation.    As  a  physiologi- 


cal freak,  which  is  undoubtedly  authentic,  the  specta- 
cle of  Sir  John  Suckling  must  have  been  curious.— 
Beeord, 

Miss  Gofast:— What  is  good  for  a  big  head, 
doctor  ? 

Db.  Pillbox  . — Lobster  salad  and  a  quart  of  cham- 
pagne.    But  what  do  you  want  with  a  big  head  ? 

Fob  sample  of  Unguentine,  the  new  sumcal  dress- 
ing and  soothing  ointment,  address  Nor?rich  Pharma- 
cal  Co.,  Norwich,  N.  Y. 

SYBT7P  of  Figs— the  family  laxative. 

Fob  fine  vaginal  suppositories  for  the  treatment  of 
leucorrhea,  address  the  Abbott  Alkaloidal  Co.,  Bavens- 
wood  P.  O.,  Chicago,  IlL 

Fob  Typhoid  Fevsb:— R  Antikanmia,  Salol,  aa. 
dram  as.  M.  Make  into  12  capsules.  Sig.  One  every 
8  hours.— Dr.  Bush,  Va.  Med,  Monthly, 

We  use  Weinhagen*s  thermometers.  Send  for  cata- 
logue. H.  Weinhagen,  22  and  2i  North  William 
street,  New  York,  N.  Y. 

Signs  of  ak  Impboyembnt.—^  How's  jour  wife 
this  morning.  Mister  Dufi^ ?  *' 

'*Begorrabut  I  think  she's  gettin'  bettber.  She 
has  just  t'rowed  me  out  iv  her  room  an'  I  hear  her 
chasin'  his  rivtince  round  wid  a  shovel ! " 

Fob  a  practical  portable  air  compressor,  address 
Willis  H.  Davis,  Keokuk,  Iowa. 

Fob  the  ''Common  Sense"  Medicine  Case,  address 
Western  Leather  MTg  Co.,  126  to  137  Bees  street, 
Chicago,  IlL 

The  babies  grow  up  to  bless  Dr.  Julius  Fehr, 
Hoboken,  N.  J.,  for  his  Baby  Powder. 

Fob  hollow  suppositories  and  for  glycerine  supposi- 
tories, send  to  Hall  &  Buckel,  218  Greenwich  street. 
New  York,  N.  Y.    Sample  free. 

An  incident  occurred  the  other  day  in  one  of  the 
bacteriological  laboratories  in  this  city  that  is  really 
too  good  to  be  kept. 

One  of  the  students  was  asked  the  question :  ''What 
parasite  frequently  infests  the  vagina  ?  " 

In  all  seriousness  the  rising  young  bacteriolcwbt 
promptly  and  confidently  answered,  '*  spermatozoa." 

The  questioner,  I  suppose,  had  in  mmd  the  tricho- 
monas vaginalis,  an  ovoid  flagellate  infusorium  not 
sufficiently  well  known  if  one  may  judge  from  an 
incident  that  occurred  some  years  since.  A  lady 
patient  charged  her  dentist  with  rape  during  anes- 
thesia. 

At  the  trial,  a  physician,  posing  as  an  expert,  testi- 
fied to  finding  spermatozoa  in  the  vagina,  and  on  this 
testimony  the  innocent  dentist  was  found  guilty  and 
condemned  to  a  long  term,  ten  years  I  think,  in  the 
penitentiary,  dying  there  whUe  serving  out  his 
sentence. 

Several  yeATs  after  his  death  the  weuld-be  scientific 
doctor  whilst  visiting  the  Universitv  was  casually 
shown  a  slide  of  spermatozoa  by  Dr.  Formad. 

*'  Are  those  spermatozoa?"  he  anxiously  inquired. 

"  Why,  certainly,"  was  the  reply. 

He  said  no  more,  left  the  city  at  once,  and  the  next 
heard  about  him  was  that  he  had  conmiitted  suicide 
through  remorse. 

One  cannot  help  regretting  that  he  had  not  shot 
himself  before  his  fatal  testimony, — Times  and BeffisUr, 


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We  have  heard  people  say, 
Turn  about  is  fair  play ; 
So  the  drinkers  should  now  be  ahftainers. 
Two  dollars  should  be 
The  exaet  legal  fee, 

And  the  doctors  should  toke  the  retainers. 
8mn>  to  Geo.  C.  Frye,  chemist^  Portland,  Maine, 
for  the  dyspepsia  remedy,  Pancreo-Bismuth  and  Pepsin. 
Fob  tFric  Acid  cases  try  Lithiated  Hydrangea,  send 
to  Lambert  Pharmacal  Co.,  6t  Louis,  Mo. 

SxND  for  sample  of  Stewart's  Pile  Ointment  to 
Fred.  W.  Stewart,  Oswego,  N.  Y. 

OuB  friend,  Mr.  Charlce  H.  Adams,  the  renowned 
traveler  and  l«fcturer,  sUted  to  us  that,  in  a  recent  trip 
across  the  At  antic,  he  and  all  the  members  of  his 
party  found  Wm.  B.  Warner's  Bromo-Soda  an  abso- 
lve specific  for  seardckness. 

J.  H.  Brdbbist,  M.D.,  A  R,  of  Cumberland,  Iowa, 
says: 

Papine  is  a  perfect  anodyne.  One  old  lady  said 
she  had  not  had  one  fair  night's  rest,  because  of 
chronic  rheumatism,  for  three  months.  Papine,  one 
teaspoonful,  gave  a  good  night's  rest,  with  no  nausea, 
nor  dull  feeling  next  day.  I  have  given  Papine  to 
patients  who  knew  they  could  not  take  morphia,  and 
they  never  had  a  symptom  to  make  them  think  any 
preparation  of  opium  had  been  taken.  Wherever 
morphia  is  indicated,  Papine  is  much  more  so. 

Cklxiuna  is  indicated  in  nervous  dyspepsia,  accom- 
panied by  severe  headache,  nausea,  acute  pain  in  tbe 
epigastrium,  etc. 

KocHESTBB,  N.  Y.,  February  26th,  1893. 
Hate  used  Freltgh*s  Cough  and  Constituent  Tablets 
in  three  obstinate  cases  with  succei<8:  restoration  to 
health.    I  eonfidently  recommend  them.    Am  using 
Freligh*s  Tonic,  and  get  good  results 

S  H.  MoBBis,  M  D. 

Phela.  Gbaitoub  Co.,  10  South  18ih  street,  Phila.: 
—Be  goftd  enough  to  keep  me  ad\rised  of  any  changes 
in  or  additions  to  your  littt.  I  have  learned  to  expect 
from  your  granules  very  prompt  and  certain  rcHuits. 
MuBBAT  Galt  Mottbb,  M.D.,  24  E.  Chestnut  bireei, 
Lancaster,  Pa. 

Ah  unfair  thing  in  this  world  is  t>  at  we  never  know 
there  is  an  ounce  of  prevention  until  we  have  taken 
our  pound  of  cure. 

IH  certain  industries  in  which  extreme  and  vairing 
t^nperatnree,  and  excessive  dampneflb  or  dryness  have 
caused  iroubieeome  skin  irritations,  Lorvtin  has  proved 
itself  a  very  excellent  soothing  and  healing  medium. 
The  champed  or  irritated  parts  of  tne  skin  are  either 
bandaged  over  night  with  a  five  per  cent  (x>retin 
gause,  or  preferably,  are  rubbed  with  a  five  or  ten  per 
cent.  Loreuu  talcum  powder.  All  itching  of  the  skin 
dhiappears  at  once.  This  treatment  has  also  proved 
efiectual  in  caaes  of  Eciema.— PAor.  BundscKau. 

Whbm  you  have  occasion  to  ortttciibe  a  food  for  an 
infaai  patient,  whose  mother  cannot  properly  provide 
for  it,  or  when  the  chilu  is  being  weantd,  or  for  a 
ohilo  suflering  from  mal  nutrition  through  any  cause 
•r  frs>m  Chopra  Infantum,  Marasmus,  or  other  troubles 
which  aflect  its  powers  le  digest  and  assimilate  nour- 
ishment, remtmber  that  HorUck  s  Malted  Milk,  man- 
ufactured by  Horlick's  Food  Co,  Kacine,  Wis.,  is 
provided  especially  for  the  use  of  uhytdcians  in  such 
I  and  wul  answer  the  puipose  if  any  food  can. 


of  the  uhemist*s  laboratory  are  coming  to  light,  and  it 
may  m  time  replace,  to  a  oonsideraUe  extent  at  least, 
other  forms  of  iodine  intended  for  internal  use  Tiie 
reai>on  for  the  increased  popularity  of  syrup  of  hydri- 
odic  acid — ^it  is  usually  pre^Mired  as  a  syrup— may  be 
found  in  the  fact  of  t&e  decided  improvement  in  the 
method  of  manufacture,  by  which  a  preparatioii  of 
considerab  e  stability  is  produced. 

Among  the  more  successful  of  the  manufacturings 
chemical  firms  in  producing  an  elennt  and  pemuoMent 

F^rup  of  this  acid  are  W.  H.  Ho<dley  &  Co.,  d 
hiladelphia,  Pa.  They  have  for  the  past  six  or 
seven  years  been  making  a  preparation  by  direct  union 
of  the  two  component  parts  (k  the  compound,  under 
conditions  favorable  to  their  union,  and  inoorporatiii^ 
this  with  glycerin;  They  were  probably  toe  first 
manufacturers  to  use  glycc^n  as  a  vehicle  for  hydri- 
odic  add,  though  when  their  preparation  was  first 
put  on  Uie  market  it  was  prepared  as  a  syrup,  and  tlie 
name  ^mp  of  hjrdriodic  acid  hsis  been  retained. 

The  hydrogen  iodide  is  cart«nly  more  agreeable  to 
administer  than  (Mtassium  or  sodium  iodide^  and  maaj 
physic>ans  think  it  exerts  a  more  permanent  alteratiTe 
influ'  nee  thsji  any  other  iodine  compound. — DrmggiMbf 
(XrtMiar, 

VABIOUS  OUmOAL  tJSD  OF  ABISTOL. 

In  a  very  instructive  lecture  on  '^  Surgical  Nursings 
after  Abdominal  Operations'*  4elivered  at  the  New 
York  Post-Graduate  Medical  School,  Dr.  Bobert  T. 
Morris  remarks  a^  follows:  **  The  dressings  are  not  to 
be  moved  as  long  as  the  patient  has  not  dii^rranged 
them,  or  pain,  fever,  and  discomfort  generally  call  for 
it  In  about  fourteen  days  they  can  be  removed  aod 
the  wound  dressed ;  if  pus  is  present,  ferret  it  oot 
wi  h  peroxide  of  hydrogen,  dust  with  Aristol,  cover 
with  gauze,  then  a  layer  of  absorbent  cotton  or  wood 
wool,  then  either  use  adhesive  strips  or  Kpica  bandage 
to  keep  dressing  in  place;  the  nze  and  condition  of 
the  wound  will  determine  you  in  this." 

''  The  samp  e  of  Ponca  Compound  which  you  were 
kind  enough  to  send  me  gave  such  satisfaction  that 
I  have  continued  to  prescribe  it  in  the  class  of  cases 
for  which  I  first  used  i ,  namely :  Chronic  Metritis^ 
1  have  also  secured  satisfactory  results  from  its  use  in 
Ovarian  Neuralgia  as  well  as  m  inflammations  involT- 
ing  those  organs."  Wic  J&  Robbih&  M.D. 

1406  New  York  ave^  N.  W.  Washington,  D.  C. 

Address  Mellier  Drug  Co.,  St  Louis,  Mo. 

Db.  I.  B.  GiLBEBT  of  Philaddpbia  wrttiBg  for 
MeHiaU  Shmmary  for  Junesays:  *  Iconsider SemmeUowB 
a  remedy  )or  prostatic  derangements  en  inently  oaafoL 
After  two  years  tise  of  it  in  my  practice  1  have  beoons 
very  favorably  impressed  as  to  its  merits,  its  sotkm 
upon  the  prostate  gland  comes  nearer  a  speotfio  than 
any  other  remedy  with  which  I  am  familiar;  it 
rel  eves  cases  of  irritaiable  bladder  anc  difficult  mictu- 
rition iU  old  men  so  as  to  make  life  much  mors  ooas- 
fortable.  1  am  now  using  it  in  gonorrhea  siter  the 
inflammatory  stage  has  passed,  with  good  lesuUs. 

NBBYOU8   HBADAOHB. 

R.  Williams,  Surgeon,  69  Vauxhall  Road.  liver- 
pool,  England,  says :  1  obtained  very  good  lesolti 


HYDBIODIO  AOn)  87BUP. 

A  preparaUon  once  little  used  but  now  in  constant 
demand  and  becoming  daily  more  popular  is  hydragen 
io^de  or  hydriodic  add.    The  yirtues  of  this  product 


from  the  use  of  Cderina  in  cases  of  nervous  headaehs 
arising  from  general  debility.  The  patients  sssds 
rapid  progress V  taking Oelerina  In  teaspoon^  doass, 
thrice  daily.  Ordinary  treatment  had  failed  to  |in 
much  relief  or  satisfacaon  prsvioos  to  takinsr  OekfiBa. 
In  conclusion,  1  consider  the  preparatioii  will  aotia 
any  way  disappoint  any  physioian  in  its  thenpeflfeio 
sfi«ou  bet  will  be  found  a  redaUe  remedy  for  the 
purposes  indicated. 


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9B#  kmtmiMb^g  thai  a  man  can  use  is  the  onfyreai  kmntfUdge;  tne  only  know- 

Mg§  tSai  has  life  and  growth  in  it  and  converts  itulf  into  practical  power.      TTu 

rut  hanjrs  like  dust  about  the  brain,  or  dries  like  raindrops  off  the  stones.-^FvLOXJDW;. 


iThe  Medical  World. 


BCONTHLT,  by  C.  P.  Tatixul,  M.  D. 


C  P.  Tayi^or,  M.  D., 
J.  J.  Tayi«o&»  M.  D., 


I  Editors. 


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ABBBBM  all  COMMUXaCATIOKS  TO 

"THE   MEDICAL  WORLD," 

tSao  Chestnut  Street, 

PHIUkDBLPHIA.  PA. 

VdL  Xn.       NovEMBEB,  1894.         Na  11. 

Urio  Aoid:  An  Importsnt   PsthologiosI  Fsotor. 

In  the  praodoe  of  medicine  it  is  of  the  utmost 
importaiioe  that  we  aocorately  estimate  the 
Tmiious  pathological  factors  that  have  caused  or 
that  complicate  the  disease  we  are  called  upon 
to  treat  Formerly  we  recognized  malaria  prom- 
inenilj  as  such  a  fiustor,  and  the  anti  malarial 
remedies  entered  largely  into  the  treatment 
nwre  is»  however,  a  far  more  prevalent  factor 
thMi  has  been  almost  entirely  over  looked  by 
the  vast  working  body  of  the  profes&ion — the 
acoomulation  of  uric  acid  in  the  system. 

Uno  add  is  a  product  of  tissue  metabolism, 
and  its  formation,  in  minute  quantities,  cannot 
be  entirely  prevented.  Its  ehmination  in  the 
urine  in  normal  health,  in  proportion  to  the 
amonnt  of  urea  eliminated,  is  as  one  to  hirty- 
three^  or  a  total  amount  of  about  eleven  grains 
of  urio  acid  daily.  When  the  daily  production 
of  urie  add  exceeds  this  proportion,  or  the  daily 


elimmation  falls  short,  there  Ib  a  corresponding- 
accumulation  of  it  in  the  system. 

Some  of  the  causes  of  its  over  production  are,, 
that  form  of  imperfect  digestion  that  allows  the 
fermentaiion  of  a  portion  of  the  food,  over-eat- 
ing, excess  of  meats  and  other  nitrogenous  foods 
in  the  diet,  excessive  use  of  fried  foods,  the  use 
of  malt  drinks  or  rich  wines,  and  sometimes  even 
tea  and  coffee.  Often  there  is  no  demonstrable- 
cause  other  than  an  inherited  constitutional  ten* 
denoy  to  its  excesrive  formation. 

Some  of  the  prindpal  causes  of  its  defideot 
elimmation  are,  habitual  constipatiim,  deficient 
urinary  secretion,  neglect  to  keep  the  skin  in 
good  working  condition  and  defident  aeration  of 
the  blood  by  shallow,  imperfect  breathmg. 

The  symptomatic  manifestations  of  uric  add 
are  legion.     When  we  reflect  that  it  is  a  chem- 
ical irritant  and  hence  may  initate  any  of  the 
sensitive  membranes  of  the  body,  the  possibly 
wide  scope  of  its  effects  may  be  understood.     In. 
addition  to  that,  it  may  be  preseot  in  such  quan- 
tities as  to  form  salts  aod  depodt  in  the  tissues 
and  thus  become  a  physical  irritant.     Thus  it 
may  produce  the  various  grades  of  irritation  up 
to  active  inflammation.     Its  manifestations  are 
seldom  conttaot.  but  are  most  often  period  cal, 
as  the  blood  varies  from  time  to  time  in  ite 
degree  of  alkalinity,  and  hence  in  its  pomer  to 
hold  the  exoe  s  of  uric  add  in  solution.     The 
various  pains  in  joints  and  muscles  that  have 
been  called  sub  acute  rheumatism  are  true  uric^ 
acid  manifestations.     The   periodic  headaches 
are  nearly  always  the  irritation  of  the  nervous^ 
system  by  uric  ac'd.     The  unaccountable  peev- 
ishness or  irritabil  ty  of  a  usually  amiable  per* 
son  is  generally  due  to  the  same  cause.     Epi- 
lepsy, neuralgia,  melancholia  and  other  nervous 
and  mental  manifestations  freqaeotly  occur  from 
this  cause     Be^ularly  recurrent  throat  inflam- 
mations, weakness  and  irregularity  of  the  heart, 
cold,    dead  fingers    and    toej,  frequently  find 
thdr  cause  principally  in  this  pathogenic  el^ 


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Bient.  Urticaria  and  various  other  skin  erup- 
"tions,  if  not  originally  caused  by  uric  add,  are 
nearly  always  greatly  aggravated  and  prolonged 
by  it  Renal  and  vesical  calculi  are  sometimes 
ibrmed  from  this  element  Thus,  we  see  that  its 
manifestations  may  be  quite  varied,  according 
4o  the  peculiar  cooetitution  of  the  individual. 
£ven  in  many  of  the  grave  acute  disorders,  as 
inflammatory  rheumatism,  pleurisy,  meningitis, 
it  constitutes  a  strong  pathological  element 
Moreover,  the  condition  of  fever  tends  to  throw 
mn.  unusual  amount  of  this  element  into  the  cir- 
eulation;  hence  all  our  fever  mixtures  should 
include  some  good  uric  add  eliminant. 

Now,  what  may  be  done  for  all  this  ? 

In  the  first  place,  we  should  endeavor  to  pre- 
Tent  its  excessive  formation,  and  for  this  pur- 
pose we  will  give  a  few  suggestions. 

The  diet,  in  health  and  disease,  must  be  regu- 
lated as  to  quantity  and  quality.  The  patient 
fliust  eat  no  more  than  can  be  completely  digested. 
The  quantity  of  nitrogenous  foods  should  be  lim- 
ited and  vegetables  should  largely  predominate 
in  the  diet  Of  course,  the  food  should  be  thor- 
oughly masticated  and  prepared  for  easy  diges- 
tion. The  mind  and  body  should  be  free  from 
work  during  the  first  hour  of  digestion.  If  the 
digestion  is  espedally  weak,  the  mineral  adds 
and  even  peptic  ferments  after  meals  may  be 
lued  for  awhile,  until  the  power  of  the  digestive 
organs  can  be  improved.  However,  this  should 
not  be  done  to  enable  one  to  digest  an  unneces- 
HHuy  amount  of  food.  Whatever  particularly 
disagrees  should  be  totally  avoided  Greasy 
pastry,  fruits  cooked  with  sugar,  wines,  beers, 
and  alcoholic  liquors  aire>geners»Hy  to  be  avoid- 
^ei.  Yeasty  bread  iaalso  quite  injurious.  Tea 
andcofiee  are  not  good  for  uric  acid  people. 
Milk  is  an  excellent  article  of  diet  If,  at  the 
^ose  of  the  normal  period  of  digestion,  there  is 
evidence  of  incomplete  digestion,  a  copious 
drink  of  hot,  antiseptic  alkalme  water  should 
be  taken.  The  alkali  should  be  gradually  re- 
duced until  finally  the  water  is  taken  without 
it 

In  the  second  place,  we  should  endeavor  to 
inromote  its  free  and  normal  elimination.  Con- 
'fllipation  must  be  corrected —at  first  by  hot  ene- 
viata  until  we  train  the  bowels,  by  habit  or  by 


laxative  treatment,  to  become  normal  withoot 
them.  The  kidneys  must  be  kept  freely  active, 
best  by  copious  draughts  of  pure  water,  but  with 
suitable  alkaline  diuretics  when  necessary.  The 
skin  must  be  kept  in  a  perfectly  acting  condi- 
tion. For  this  purpose  avoid  over-clothing  and 
employ  frequent  stimulating  baths.  Ammonia 
in  the  water  for  cleansing  purposes  and  salt 
rubbed  on  the  skin  for  stimulating  purposes  are 
very  good  aids  in  the  treatment  The  occadonal 
hot  vapor  bath  or  even  the  wet  pack  are  very 
valuable  for  the  purpose  of  eliminating  this 
agent.  The  lungs  should  be  accustomed  to  full, 
free,  deep  breathing,  and  should  be  fumiabed 
with  pure  air.  The  restraining  influencea  of 
the  corset  preventing  entirely  the  abdonunal 
action  in  breathing,  is  a  goo  1  fhctor  in  the  pro- 
duction of  the  uric  add  diathesb  in  women.  If 
the  occupation  does  not  require  plenty  of  exer- 
dse,  it  should  be  taken  voluntarily. 

But  we  generally  find   the  patient  sick,  and 
requiring  active  treatment     For  this  purpose 
the  alkaline  diuretics  are  best  aided  by  the  wet 
pack  or  vapor  batL    The  alkalies  that  aie  be^ 
in  the  order  of  their  merit,  are  potassium,  mag- 
nesium,  sodium,   lithium  and  calcium.     The 
salicylate  or  dtrate  of  potassium,  sulphate  of 
magnesium,  salicylate,  phosphate  or  benzoate  dt 
sodium,  benzoate  or  carbonate  of  lithium  and 
chloride  of  calcium  are  the  respective  salts  tha 
will  be  found  most  generally  useful.     The  lith- 
ium salts  are  not  so  valuable  in  this  treatment 
as  their  reputation  would  indicate.   When  acute 
pain  is  present  a  bromide  may  be  chosen  with 
advantage.     The  alkalies  should  not  be  g^veo 
too  long,  and  no  one  should  be  used  to  the  ex- 
clusion of  others.     Many  of  the  vegetable  elim- 
inants,  as  podophyllin,  leptandrin,  stillingia,  hy- 
drangea, cascara,  colchicum,  rhubarb,    diinia- 
phila,  are  valuable  in  this  condition,  taKiing 
both  to  prevent  the  formation  and  also  to  elim- 
inate uric  add. 

These  remarks  are  intended  only  to  direct  the 
mind  of  the  practising  ph3rdcian  to  this  sul^ect 
and  lead  him  to  remember  this  factor  as  a  po»- 
Ue  cause  or  complication  in  cases  he  is  called 
upon  to  treat  The  suggestions  above  given  will 
f  unush  an  out  line  guide  for  the  further  study 
of  this  great  and  important  subject 


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THE  MEDICAL  WORU). 


89A 


0«r  ProfMslon  and  The  People. 

"  In  three  yean/'  bajb  tbe  GleveUnd  OiU- 
•0k  **  the  people  of  New  Zealand  enacted  the 
following  reforms:  Government  ownership 
of  railways,  telegraphs,  telephones  and  insur- 
ance; graduated  income  tax;  exemption  of 
homes  from  taxation;  discooragement  of 
alien  ownership  of  land  by  leyying  an  absen- 
tee tax ;  restoration  of  the  land  held  for  spec- 
ulative purposes  to  the  people  by  a  heavy 
graduated  land  tax,  «  *  *.  Besides  the  hours 
of  labor  have  been  reduced  to  a  minimum 
and  a  maximum  rate  of  wages  has  been  fixed 
for  GoTemment  employes,  a  splendid  srstem 
of  factory  inspection  has  been  introauced, 
the  contract  Sjrstem  has  t»een  practically  abol- 
ished, and  many  municipal  reforms  have  also 
been  introduced.  *****  New  Zealand, 
according  to  Oonsular  reports  and  reliable 
Australian  newspapers,  is  to-day  the  most 
prosperous,  contented  and  happy  little  coun- 
try under  the  starry  heavens.  There  are  few 
paupers  and  no  monopolies ;  there  is  a  grati- 
fying decrease  in  drunkenness,  prostitution 
and  crime,  and  the  UMurious  practices  of  a 
few  years  ago  have  been  discontinued.'' 

Does  the  aboye  quotation  seem  strange  in 
these  oolnmns  ?  Perhaps  you  are  saying  men- 
tally, *<I  thought  The  Medical  World  was 
devoted  to  the  interests  of  the  medical  profes- 
noD."  So  it  is.  And  the  above  will  be  found 
in  line.  The  life  force  of  the  medical  profes- 
oon  is  not  confined  entirely  to  therapeutics. 
Incidentally,  please  see  editorials  in  the  Cincin- 
nad  Lancet  Clinic  for  July  7th,  July  14th,  July 
2l8t>  July  28th,  et  seq ;  also,  the  Medical  Mirror 
for  August,  page  385,  for  patriotic  expressions 
upon  current  events,  in  which  physicians  as 
well  as  all  other  citizens  must  feel  an  interest 
The  September  issue  of  the  last  mentioned 
charming  magazine  is  given  up  largely  to 
descriptions  of  California  life  and  scenery  by 
its  gifted  editor.  We  feel  certain  that,  on  this 
account,  the  many  subscribers  to  the  Mirror  will 
not  underrate  the  value  of  that  issue.  Instead, 
this  is  the  particular  issue  that  will  be  passed 
around  to  the  members  of  the  family  and  to  the 
friends,  and  finally  be  preserved  with  special 
care.* 

The  general  fact  that  the  medical  profession 
is  devoted  to  the  prevention  and  cure  of  the 
physical  ills  of  humanity  is  true.  The  readers 
«f  these  pages  need  not  be  reminded  of  the 


*Those  who  are  not  subscribers  to  the  Mirror  don't 
lul  to  send  ten  cents  to  Dr.  I.  N.  Love,  3642  Lindeli 
Boulevard,  St.  Louis,  Mo.,  for  a  copy  of  Sept.  Mirror, 


many  instances  (A  the  aknost  magical  relief 
from  pain,  return  to  health,  Ac,,  constantly.  oo> 
curring  in  their  own  experi^ce.  The  profea- 
sion  is  devoted  to  this  noble  work.  But  this  ia^ 
not  the  only  side  to  this  matter. 

The  profession  must  live  while  it  works.  It» 
work  must  be  lor  t&e  people  whatever  their  cob* 
dition.  But  that  brings  us  to  the  question  of 
the  physician's  interest  in  the  condition  of  ha<*^ 
manity.  Let  ua  glance  over  this  oonditioif 
during  the  past  twenty-five  years.  In  that 
time  we  have  seen  the  development  of  the 
millionaire  and  the  tramp.  We  have  seen  the 
resources  of  this  country  gradually  aecumulate 
in  the  hands  of  the  few,  leaving  the  many  de- 
pendent or  destitute.  Yet  the  physician's  work 
does  not  diminish.  He  must  still  minister  U> 
the  ills  of  humanity ;  and  from  humanity  he 
must  get  his  support  But  the  masses  are  be^ 
coming  less  and  le«  able  to  pay  him.  The 
prices  received  by  the  farmer  for  his  produce 
are  becoming  lower  and  lower,  and  the  me- 
chanic's opportunity  for  employment  is  becoming; 
more  and  more  precarious.  Reductions  in  wagee 
and  lock-outs  are  becoming  numerous,  while  the 
piling  up  of  profits  goes  merrily  on.  Conse* 
quently,  the  income  of  the  average  pracdcinjp 
physician  has  been  shrinking,  while  his  work 
remains  as  great  as  ever,  or  increases.  What 
are  we  coming  to  f  A  sodety  made  up  of  mil^ 
lionaires  and  impoverished  masses  is  the  least 
desirable  for  a  physician.  A  millionaire  ccm- 
tributes  only  a  small  share  of  his  just  portion  to 
the  support  of  the  medical  profession ;  while  the 
impoverished  masses  cannot  contribute  their 
share ;  yet  the  work  of  the  profession  remains 
the  same.  What  the  medicsJ  profession  Wanta 
is  prosperous  masses.  The  masses  produce  the 
wealth,  and  why  should  it  not  stay  with  ihem  f 
Now,  look  at  the  quotation  at  the  head  of  thia 
article  again.  Can  we  not  learn  some  lessone 
from  that  distant  isle  of  the  sea?  Does  it  not 
suggest  many  things  that  we  need  ?  Your  fiisk 
question  will  be,  "How  can  we  get  themf'^ 
Certainly  not  by  indifference  and  inaction* 
Every  citizen,  whatever  his  profession  or  busi* 
ness,  has  a  public  duty  to  perform.  Physiciane 
are  no  exception^  Indeed,  we  have  seen  that 
their  interests  are  especially  and    peculiarljr 

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892 


THB  MBDICAI,  WORIJ). 


linked  with  those  of  the  massee  of  the  people. 
Then  let  m  work  with  those  masses  for  their 
highest  prosperily.* 

*See  Review  columns  of  this  issue  for  suggestive 
iiteimture. 

Doctors  in  Publio  Affairs. 
The  following  physicians  are  reported  to  be 
•congreBsional  candidates:  Dr.  L.  F.  Weaver, 
•of  Niles,  Mich.;  Dr.  Bernard  Groeser,  of  Le 
Mbts,  Iowa;  Dr.  J.  A.  Hatch,  of  Kentland, 
Ind.,  and  Dr.  M.  F.  Merchant,  of  Ellendale, 
North  Dakota.  The  present  Legislature  of 
Virginia  is  said  to  contiun  eight  physicians.  Dr. 
MoGallum  is  candidate  for  Mayor  of  Ner  York 
<dty.  We  think  it  etnmently  fitting  and  proper 
that  educated,  high  minded  physicians  should 
take  an  active  interest  in  the  welfare  of  their 
native  land.  We  hope  that  their  influence  and 
voting  power  will  ever  be  wielded  in  the  interest 
of  the  useful  common  people,  and  towards  the 
overthrow  of  the  corrupt  money  power. 

A  Most  Sensible  and  Soien'iftc  Tendency. 

It  wUl  be  observed,  in  reading  the  excellent 
fpapers  presented  at  the  recent  meeting  of  the 
American  Climatoligical  Association,  held  in 
Washington,  D.  C,  May  29  to  June  1, 1894,  that 
'<the  whole  tendency  of  opinion  during  the  entire 
-sessions  seemed  to  be  towards  physiological  treat- 
ment,— the  use  of  therapeutic  means  which  are 
in  the  line  of  natural  processes,  rather  than  the 
'Use  of  drugs, — substances  which  are  foreign  to 
^e  organism.'' 

Chiidren  of  Drinl^ers. 

The  Quarterly  Journal  of  Inebriety  gives  the 
Tiewsof  a  specialist  on  this  subject,  with  obser- 
vations with  12  families  of  drinkers  and  12  of 
temperate  people.  We  tabulate  the  observa- 
tions below : 

Drinkers.  Temperate, 
l^umber  of  children,  57  61 

Deaths  under  1  week  old,        25  6 

Idiots,  5  0 

Dwarft  (stunted  in  growth),      5  0 

Epileptics,  5  0 

Ghoiea,  ending  in  idiocy,  1  0 

Deformed  and  diseased,  5  0 

Hereditary  drunkards,  2  0 

One  of  the  above  is  counted  under  two  cate- 
gories, leaving  only  10  of  the  children  of  drink- 
*er8  showing  normal  constitutions. 


tothkjoaiMlM^ 
'for  TlewB  f  lyntd  b§ 


Original  Qommunioations. 


Short  artlclM  on  the  tfcatment  of  JtoeMMumd 
with  new  remedies,  ue  solicited  fiom  the 
this  depertment ;  also  difficult  caiet  for 
treatment. 

eatides  accepted  must  be  «onl 
The  editors  are  not 
contributora. 

Oopj  mnst  be  received  on  or  before  the  twdfth  of  thi 
month  for  jmblicatiott  in  the  next  ruynth.  Uanaetf 
Manuacript  cannot  be  retnmed. 

St  sayaUkekas  to  tar  in  tJU  fewest  foniku  words^et 
his  reader  is  sure  to  sJMtkem:  and  in  the  piainest  p^uHk 
words^  or  his  reader  wnU  eertainh  wsisumdersiamd  ikem. 
Generally,  also,  a  domrnrigkifacffoaybe  toid  im  a  ptaim 
way:  and  we  want  dowmrigki/uts  eu  Present  mmre  tkam 


READ.     REFLECT.     COMPARE.     RECORD. 

Cases  of  Narcomania.— Nofes  on  the  Treatmant 
of  Afooholism. 

Editor  Medical  Wobld. — ^I  have  thought 
it  advisable  to  describe  a  few  cases  to  iliostiate 
my  methods  of  treating  naiocMnania,  and  the 
great  variety  there  is  in  the  individoab  who 
present  themselves  for  treatment  No  two 
cases  require  the.  same  management,  mora]  or 
hygienic ;  while  it  is  most  difficult  to  lay  down 
general  prindplee  tbat  will  not  be  totally  out  of 
place  in  some  instances. 

Case  I.  Mrs.  W.»  26  years  old,  married,  had 
ODO  child  and  two  miscarriages ;  began  taking 
morphine  for  dysmenorrhea,  and  had  taken  it 
for  seven  years,  reaching  8  grains  daily.  She 
also  smoked  cigarettes.  Bdbre  coming  to  me 
she  had  leduced  her  daily  dose  to  one  grain, 
taken  in  two  portions.  Examination  on  admis, 
don :  cigarette  heart ;  os  uteri  lacerated,  right- 
ovary  tender,  purulent  leuoorrhea.  Ist  day : 
i  gr.  morphine,  y^  gr.  atropine,  at  8  a  m., 
i  gr.  morphine  and  jj^  atropine,  at  8  p.  m. 
The  atropine  irritates  the  bladder. 

2d  day :  ^  gr.  momhine  twice  to>day.  Had 
a  fur  day,  ate  welL  Took  one  bottie  alkaline 
bromide  water.  Colden's  beef  tonic  every  three 
hours. 

3d  day :  Slept  none.  Bowek  loose ;  nriiie 
scanty.  ^  gr.  morphine,  6  grs.  quinine,  in 
morning ;  i  gr.  evening.  Alternated  Colden't 
and  Bovinine  all  day.     Ate  fairly  welL 

4th  day:  Slept  fairly.  Abstinence  symptomfl 
marked ;  chilly,  sneezing,  aching  and  depres- 
don.  i  gr.  morphine  and  -j-H  phyeostigBiiDe 
in  momiog.  Bovinine  every  2  hours ;  onde  of 
zinc  and  sUver ;  better  than  yesterday. 

5th  day :  Very  restiess  till  1  a.  ul,  when  she 
had  30  grs.  sulphonaL  Physoetigmine  at  9,  2, 
4  and  9.  Bovinine,  Colden's  and  una  Ate 
preUy  well.  At  10  and  12  p.  m.  had  80  gn. 
sulphonal.     Slept  all  night. 


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393 


6th  day :  11  a.  m.,  cold  bath ;  milk  and  coffee. 
12,  Golden's  and  zinc  valerianate.  Very  ner- 
vooB  and  stupid.     Slept  till  3  p.  m.  soundly. 

4  p.  m.,  one  drachm  Fellows'  syrup  hypophoe- 
phites.  Bovinine  every  two  hours.  6  p.  m., 
appetite  for  dinner  fair.  10  p.  m.,  better :  took 
a  short  walk ;  no  pain ;  lees  nervous ;  no  ciga- 
rettes to-day.     15  grs.  sulphonal. 

7th  day :  No  drugs  to-day  except  Fellows' 
syrup  and  zinc  valerianate.  At  10  p.  m., 
12  grs.  sulphonal.     A  good  day. 

8th,  9th  and  10th  days,  no  drugs  but  Fel- 
lows' syrup  and  rhubarb  ;  strength  and  spirits 
rising  rapidly.  Took  apomorphine  and  bro- 
mide of  arsenic  to  stop  I  longing  for  cigarettes, 
which  they  did,  completely,  in  three  days. 

During  the  remainder  of  her  stay  she  im- 
proved steadily  and  returned  to  her  home  27 
days  after  admission.  The  next  menstrual 
period  passed  with  little  pain,  taking  vibumin  ; 
but  at  the  next  she  suffered  so  severely  that  I 
gave  her  iodoform  and  codeine,  relieving  her 
and  arousing  no  desire  for  opiates. 

Case  IL  6.  D.,  36  years  old,  physician ;  ad- 
diction for  three  years ;  cause,  sciatica.  Height, 

5  feet,  7}  inches;  weight,  178  pounds;  ple- 
thoric. On  admission  was  taking  an  ounce  of 
laudanum  daily,  in  two  doses,  with  occasional 
injections  of  morphine.  Subject  to  occipital 
neuralgia,  rheumatism  and  cerebral  hyperemia. 
A  large  meat  eater  and  water  drinker ;  of  gigan- 
tic strength ;  subject  to  uricemia.  Ordered 
alkolo-bromide  water,  with  half  a  drachm  of 
pure  sodium  salicylate  daily.  After  taking 
this  and  reducing  tixe  doses  of  laudanum  some- 
what, he  determined  to  quit  at  once,  and  took 
no  more.  He  suffered  severely,  but  bore  it 
with  a  patient  endurance  that  won  our  admira- 
tion. He  went  home  in  eight  days  and  has 
smce  continued  well.  He  wrote  us  he  had  a 
bad  attack  of  palpitation  of  the  heart,  but  he 
''let  it  palpitate."  The  typical  morphine  fiend 
is  supposed  to  be  thin,  timid,  ipsincere  and 
nerveless,  but  I  have  found  a  large  proportion 
of  them  to  be  fat,  plethoric  men,  robust  and 
vigorous,  with  plenty  of  grit,  and  absolutely 
truthful  and  trustworthy.  These  men  are  al- 
ways willing  to  make  a  gallant  fight  for  liberty, 
and  never  return  when  once  freed.  Finer  men, 
with  better  endowment  of  nerve,  I  have  never 
met 

Case  lU.  6.  W.,  physician,  aged  32  years. 
I  cannot  give  the  history  in  detail  as  it  would 
occupy  too  much  space.  His  father  and  mother 
had  been  opium  users,  and  he  had  inherited 
from  father  and  grand&ther  a  neuralgia  of  the 
gravest  form,  clavus,  with  a  rapid  tapping  felt 
on  the  inside  of  the  skull  in  both  parietal  re- 
{^ons,  the  whole  head  becoming  dark  red,  the 


eyes  congested  and  sight  obscured  by  red  cloud» 
and  flakes.  He  bad  been  addicted  for  many 
years,  and  bad  been  to  several  sanatoria ;  eacb 
time  relapsing  in  about  seven  months.  The 
last  time  he  went  to  an  Eastern  specialist,  in 
whose  plaoe  he  learned  to  use  cocauie,  and  came' 
home  uncured,  but  fully  stocked  with  the  tricks 
interchanged  by  patients  in  that  school  of  vice. 
He  took  on  entering,  30  grs.  morphine  and 
10  grs.  cocaine  daily,  with  8  oz.  whiskey  at 
midnight,  in  one  dose.  The  v  morphine  wa» 
taken  in  three  doses,  hypodermically ;  the  coca- 
ine in  little  injections,  tc^en  almost  continuously, 
every  few  minutes. 

The  cocaine  was  withdrawn  within  one  week  '^ 
the  morphine  and  whiskey  gradually  diminished, 
as  rapidly  as  could  be  done  without  arousing 
the  terrible  headaches.  Whenever  the  reduc- 
tion was  too  rapid  the  headache  would  reappear, 
throwing  into  the  background  all  the  ordinary 
abstinence  symptoms.  When  the  doee  had 
been  cut  to  one  grain  per  day,  laudanum  was 
substituted,  and  after  a  few  days,  codeine  hypo- 
dermically. This  proved  at  first  insufficient  to 
prevent  the  neuralgia,  even  when  given  up  to 
seven  grains  per  day,  and  a  little  morphine  was 
added.  The  neuralgia  came  on  in  the  wske  of 
the  ordinary  abstinence  symptoms,  verifying  an 
observation  of  Anstie  that  any  cause  of  depres- 
sion may  serve  as  an  exciting  cause  of  the  par- 
oxysms. It  was  found  necessary  to  establish 
him  on  a  plane  of^  say,  three  grains  of  codeine 
daily,  continue  this  for  a  week,  then  drop  a 
little  and  rest  there,  habituating  his  brain  by 
degrees  to  a  smaller  quantity  of  the  drug^ 
When  he  had  taken  two  grains  of  codeine  daily 
for  a  week,  the  dose  was  gradually  lowered  to> 
i  grain  an4  then  dropped  entirely.  The  neu- 
ralgia did  not  reappear  in  the  worst  form,  and 
after  a  day  of  suffering  and  a  sleepless  night,  he 
was  free.  During  th^  three  months  required  to* 
reach  this  result,  many  means  were  employed  to- 
relieve  the  neuralgia,  but  all  failed.  Physos- 
tigmine  relieved,  but  occasioned  toxic  symptoms. 
Strychnine,  arsenic  and  quinine  could  not  be* 
borne,  his  brain  being  exceedingly  irritable. 
Feeding,  hygeinic  management  and  a  moderate- 
use  of  baths  were  beneficial.  The  only  tonics- 
that  were  continuously  well  borne  were  the  food 
products,  Bovinine  and  Phospho  Albumen. 

After  the  complete  withdrawal  of  codeine, 
the  building  up  processes  were  continued,  witb< 
rest,  quiet,  and  by  degrees  easy  work  was  al- 
lowed. This  is  still  being  continued,  and  it 
will  not  be  judicious  for  him  to  resume  full  pro- 
fessional work  for  a  year,  and  then  it  must  be 
in  a  dty.  To  send  such  a  man  back  to  a 
sparsely  settled  country  district,  where  he  i» 
constantly  driving,  not  seeing  his  bed  for  a  week 


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at  a  time,  is  to  push  him  inevitably  back  into 
the  slough  from  which  he  has  emerged. 

This  case,  from  the  failure  of  the  previous 
efforts,  and  the  hereditary  neurotic  defect,  is  one 
of  th<«e  rarely  cured  in  sanatoria.     It  is  impor- 
tant as  showing  how  greatly  one  must  modify 
the  ordinary  methods  to  meet  the  exigencies  of 
exceptional  cases.     Furthermore,  I  have  never 
met  a  habitue  whom  I  felt  to  be  more  worthy 
of  saving,  in  whom   brighter  possibilities  were 
obscured  by  the  fatal  clouding  of  the  brain  by 
morphine.     Bright,  intelligent,  alert,  secretive, 
of  unusual  capability  as  a  physician,  and  fertil- 
ity in   resources,  this  man   was  intended   for 
something  better  than  wallo¥dng  in  the  slough 
of  narcotism.     And  yet,  when  one  sees  a  man 
cast  in  such  a  mould,  debased  by  drugging,  losing 
his  birthright  of  mentality,  quenching  the  divine 
spark,  lowering   his  manhood  and  becoming  a 
self  indulgent,    untrustworthy,    tricky,     moral 
weakling,  one's  whole  being  liies  up  in  angry 
protest  against  the  terrible  demoniac  thing  that 
so  debases  and  brutalizes  Grod*s  noblest  work. 
Would  that  I  could  inspire  in  my  fellows  my 
own  horror  of  this  thing,  and  my  own  pride  in 
restoring  such  men  to  this  world,  for  usefulness. 
If  only  every  pbysician  who  reads  these  lines 
were  to  seriously  bestir  himself  to  rescue  such 
of  these  unfortunates  as  come  within  his  reach, 
and  to  guard  against  making  others  habitues. 
And  if  those  who  make  a  practice  of  treating 
narcomania  would  only  give  more  attention  to 
the  rebuilding  of  character,  the  restoration  of 
moral  strength,  and  make  the  relief  of  suffeiing 
a    secondary    consideration.      When    patients 
have  been  taking  the  opiate  a  long  time,  and 
especially   when  they  have  added  cocaine  or 
other  drugs  to  the  morphine  addiction,   this 
method  cannot  be  pursued.     It    is    necessary 
then    to   proceed  most  gently,   watching    the 
symptoms  closely  and  making  the  descent  by  a 
series  of  steps  instead  of  a  declivity.     These 
patients  cannot  respond  to  stimuli ,  they  do  not 
react  well,  and  require  the  utmost  tenderness 
in  their  management.     More  time  is  required, 
and  after  the  cure  they  must  not  be  put  to  work 
for  a  considerable  period,  until  the  nervous  sys- 
tem has  been  restoi^  to  good  condition.   When 
the  dose  has  been  reduced  to  i  grain  daily,  phys- 
ostigmine  should  be  substituted,  and  continued 
until  the  patient  is  ready  to  drop  it  voluntarily. 

ALCOHOLISM. 

An  observation,  new  to  me,  may  be  old  to 
many  of  the  good,  practical  members  of  our 
great  World  family.  In  treating  a  man  for 
alcoholism  I  wanted  to  put  something  in  bis 
whiskey  to  sicken  him,  and  so  gave  a  little  fluid 
extract  of  ipecacuanha — about  20  minims.     It 


did  not  nauseate  him,  but  he  went  to  sleep  and 
slept  all  night  This  seemed  curious,  as  he  had 
previously  taken  40  grain  doses  of  chloral  and 
of  sulfonal,  without  inducing  sleep.  Next  day, 
I  gave  him  the  same  dose,  without  the  whiskey, 
and  he  slept  all  day.  Following  this,  for  a 
week  I  put  him  to  sleep  every  night  on  the 
ipecacuanha,  and  he  had  the  best  week's  sle^ 
he  had  had  lor  years.  I  gave  the  fluid  extract, 
10  to  30  minims,  in  a  spoon  with  no  water,  and 
directed  him  to  lie  perfectly  quiet  for  five  min- 
utes after  taking  the  medicine,  in  order  to  avoid 
nausea  and  vomiting.  This  is  the.  way  to  give 
ipecacuanha  for  the  grave  forms  of  dysent^. 
Now  if  this  drug  will  give  sleep  in  such  cases  it 
is  of  importance,  for  we  know  that  very  oft«i 
they  resist  such  drugs  as  opium,  chloral  and 
bromides,  until  such  huge  doses  have  been  taken 
that  life  is  endangered  thereby. 

This  patient  gave  evidence  of  paresis,  becom- 
ing very  generous  and  fabulously  wealthy 
whenever  he  was  drinking ;  and  it  may  be  that 
in  other  cases  the  ipecacuanha  may  not  do  so 
well.  I  would  like  to  know  if  any  one  else  gets 
such  results.- 

As  to  the  appetite  for  alcohol,  the  ipecac- 
uanha had  not  the  slightest  perceptible  effect, 
differing  in  this  respect  from  apomorphine,  tar- 
tar emetic,  and  especially  lobeline,  the  latter 
exerting  a  pronounced  influence  over  some  al- 
coholics. But  in  spite  of  all  medication,  this 
man  drank  until  he  wanted  to  stop,  when  he 
did  stop. 

How  can  any  one  dare  to  say  any  man's 
soul  is  dead  ?  I  call  to  mind  a  patient  whom  I 
attended  for  years  for  alcoholism,  with  varying 
success,  with  many  and  repeated  relapses.  It 
was  his  custom  to  retire  to  his  room  widi  a  full 
supply  of  whiskey  and  drink  until  he  could 
dnnk  no  more,  and  nature  revolted.  He  used 
to  say  he  abhorred  the  taste  of  liquor  and 
wished  he  could  get  it  down  his  throat  with  a 
stomach  tube,  to  avoid  tastipg  it  At  the  end 
of  a  debauch  more  prolonged  and  apparency 
more  hopeless  than  any  previotis,  this  man*i 
will  awoke  and  he  said:  "I  will  not"  Then 
was  the  time  to  c^me  to  the  aid  of  the  shattored 
nerves,  and  strengthen  by  every  means  known 
to  science  or  to  religion,  the  new  resolution. 
This  man  kept  his  wonl,  and  for  five  years  has 
been  an  honorable  member  of  sodety,  a  total 
abstainer.  Without  suffering?  No!  Many 
a  battle  was  fought  before  the  fierce,  overmas- 
tering thirst  for  rum  was  overcome  and  the  de- 
mon throttled.  But  it  taught  me  never  to  des- 
pair of  the  possibilities  of  the  individual  soul. 
It  is  not  all  physical.  .  No  one  can  say  that  the 
degenerated  nerve  tissue  in  that  man's  brain 
was  miraculously  healed.     There  was  no  mira- 


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de,  but  a  regular  stand- up  fight  between  the 
good  and  the  evil  in  that  man ;  and  it  was  the 
power  of  the  spirit  that  conquered  matter. 

A  criticism  of  my  recent  papers  on  morphin- 
ism in  this  journal  has  taught  me  how  very  dif- 
ficult it  is  for  one  to  give  an  intelligible  idea  of 
his  views  to  another,  when  the  latter  does  not 
meet  him  on  the  same  plane  of  comprehension. 
i/Ly  critic  objects  to  my  remark  about  the  secret 
of  success  being  sedation.  I  think  he  never 
treated  a  case,  or  more  than  one,  or  he  would 
have  recognizdd  that  as  the  morphine  is  removed 
the  nerves  exhibit  a  peculiar  hyperesthesia, 
that  makes  very  slight  irritation  exquisitely 
painfuL  This  requires  nervous  sedatives  ;  and 
here  is  where  experience  steps  in  to  show  the 
difference  between  alcoholism  and  morphinism. 
For  the  toning  agents,  strychnine,  &c ,  and  ar 
terial  stimulants,  such  as  gold  and  mercury,  so 
useful  in  keeping  up  tonicity  in  alcoholism,  in- 
crease the  hyperesthesia  of  the  narcomaniac  and 
aggravate  bis  sufferings.  But  the  gentleman 
has  got  one  idea  so  good  that  he  may  be  par 
doned  for  not  recognizing  this  state,  and  that  is 
the  value  of  hyper  nutrition.  When  he  has 
learned  to  combine  full  feeding  with  nerve  se- 
dation, he  will  have  mastered  the  A  and  B  of 
his  alphabet  But  this  is  not  all.  He  goes  on 
to  invoke  the  Divine  mercy  on  the  unfortunates 
for  whom  I  prescribe  the  cold  bath.  His  candid 
opinion  has  been  perused  with  the  greatest  de- 
light by  the  unhappy  victims  now  languishing 
in  my  dungeons,  and  the  amount  of  fun  they 
are  having  over  it  at  my  expense  disarms  any 
sense  of  anoojance  I  might  have  felt  at  the  evi- 
dent misrepresentation.  During  the  reduction 
period  and  at  its  end  the  warm  bath  is  of  the 
utmost  value  in  alleviating  suffering.  But 
after  the  hyperesthesia  has  been  subdued  and 
the  stage  of  languor  supervenes,  the  time  has 
come  to  rouse  up  the  flagging  energies  and  in- 
vigorate the  body.  Then  the  cold  bath  comes 
into  use ;  dreaded  at  first,  but  soon  a  delight  to 
the  patient,  as  he  feels  its  benefits.  At  first 
great  care  is  taken  to  secure  reaction  by  vigor- 
ous toweling,  exercise  and  hot  drinks ;  and 
often  the  first  genuine  drug-free  sleep  comes 
after  the  patient  is  snugly  tucked  in  between 
warm  blankets,  after  the  bath.  It  is  the  rare 
exception  for  patients  to  leave  me  who  are  not 
enthusiastic  in  their  appreciation  of  the  cold 
bath. 

I  must  acknowledge  the  force  of  the  gentle 
man's  objection  to  my  description  of  narcoma- 
niacs as  weaklings,  &c.  This  is  true  only  of  a 
class  :  the  class  who  never  come  willingly  to  be 
cored.  Among  the  cases  that  have  come  to  me 
for  release  from  narcotic  slavery  have  been 
some  of  the  noblest  specimens  of  manhood  I 


have  ever  met.  Men  of  strong  will,  fiill  of 
grit,  far  above  the  average  of  intelligencer 
whose  bondage  has  been  of  accidental  origin 
and  who  display  a  fortitude  in  suffering  thafc 
wins  my  highest  respect  and  regard.  When  a 
man  refuses  to  take  anything  to  alleviate  the 
pain,  only  asking  of  me  the  assurance  that  he 
will  not  die,  I  take  my  hat  off  to  such  men.  I 
have  never  met  their  superiors. 

Letters  and  letters!  The  charge  of  $1.00 
for  replies  by  mail  only  increases  their  number. 
I  have  taken  an  assistant,  and  yet  we  are  too  busy. 
The  inevitable  end  looms  up :  my  little  private 
sanitorium  will  become  a  large  incorporated  en- 
terprise, with  a  corps  of  helpers  to  manage  the 
business  interests  and  assist  me  in  the  profes- 
sional work.  Thi£  will  enable  me  to  give  more 
time  to  consultation  and  operative  practice. 
Since  coming  to  Chicago,  I  have  made  a  num- 
ber of  flying  trips  through  the  country,  where 
my  brethren  desired  my  assistance ;  and  with 
the  Sanitorium  firmly  established,  I  expect  to 
make  these  trips  whenever  I  can  take  the  time. 
At  present  I  am  arranging  for  a  raid  into 
Texas,  to  occupy  a  week. 

William  F.  Waugh,  M.D., 

103  State  St,  Chicago. 


Tho  Ideal  Method  for  the  Radical  Cure  of 
Varicooele. 

BY  G.  FRANK  LYDSTON,  M.D.,  OF  CHICAGO. 

FrofesMr  of  the  Suiglcal  DiMases  ol  the  Oenito-niinary  Or- 
gans and  Syptillology  in  the  Chlcag)  College  of  PhyalclanA 
and  Sargeons ;  Medical  Director  and  Sorgeon  in   . 
ohATge  of  the  Masonic  Hospital,  etc 

Editor  Medical  World  : — The  radical  treat- 
ment of  varicocele  is,  it  seems  to  me,  a  field  for 
operative  surgery,  which  has  by  no  means  re- 
ceived its  due  meed  of  consideration  sine 3  the 
introduction  of  modem  aseptic  and  antiseptic 
technique.  As  is  well  known,  varicocele  is  not 
an  intrinsically  dangerous  affection,  and  in  view 
of  the  disastrous  results  which  in  times  past 
have  quite  frequently  attended  attempts  at  the 
radical  cure  of  the  disease,  the  impression  among 
general  practitioners  is  quite  general  that  the 
disease  should  be  a  noli  me  tangere.  The  con- 
sequence is  that  patient  after  patient  is  advised 
to  undergo  the  inconvenience  and  unsightlinesa 
of  a  large  varicocele  and  the  annoyance  of  con- 
stant wearing  of  a  suspensory  bandage,  to  say 
nothing  of  the  functional  disturbances  of  the 
generative  apparatus  which  the  disease  produces, 
rather  than  to  undergo  an  operation.  The  dis- 
ease may  be  rendered  endurable  if  the  patient 
be  sufficiently  Job  like  and  philosophical ;  ergo, 
the  knife  of  the  surgeon  is  a  thing  to  be  ab- 
horred.    In  witneedng  some  of  the  operations 


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that  are  done  for  varicocele,  even  at  the  present 
time,  I  am  myself  inclined  to  believe  that  the 

Ctient  had  in  some  cases  better  bear  those  ills 
has  than  fly  to  others  that  he  knows  not  of. 
fiut  this  is  a  fault  of  individual  surgical  tech- 
nique and  not  of  radical  treatment  per  se.  The 
^fiort  all  along  the  line  of  the  surgical  treatment 
of  varicocele  has  been  to  devise  some  means  of 
operation  which  should  be  simple,  devoid  of  dan- 
ger and  truly  radical  in  its  effect  All  of  the 
earlier  operations  have  been  open  to  serious 
criticism  from  all  of  these  standpoints  The 
^ariou)  subcutaneous  operations  of  which  the 
operation  of  enroulemerd  of  Vidal  de  Cassis  was 
the  progenitor,  are  open  to  quite  serious  objec- 
tions. The  operation  is  done  in  the  dark  ;  it  is 
by  no  means  so  simple  as  would  appear,  and 
while  the  results  are  excellent,  the  danger  of 
involving  in  the  ligatures,  etructures  which  ren- 
der the  operation  disastrous,  counterbalance  the 
arguments  in  favor  of  the  operation  based  upon 
its  many  successes.  like  most  bloodless  operar 
tions,  it  is  one  which  the  incompetent  man,  who 
is  always  ready  to  rush  into  danger  that  he  can- 
not see,  is  quite  likely  to  undertake,  often  with 
most  disastrous  results.  Superfluous  structures 
are  always  embraced  by  the  ligatures ;  indeed, 
it  is  a  practical  impossibility  to  limit  the  embrace 
of  the  ligature  to  the  veins  which  we  wish  to 
occlude.  A  very  serious  objection,  anent  the 
tendency  of  incompetent  men  to  undertake  the 
operation  on  account  of  its  bloodlessness,  is  that 
there  may  seem  to  be  much  less  necessity  for 
radical  asepsis  and  antisepsis  than  in  the  various 
forms  of  cutting  operations,  when  as  a  matter  of 
fact,  the  danger  of  sepsis  is  much  greater  with 
the  subcutaneous  deli^Uion  of  the  veins  than  in 
the  open  operation,  if  the  latter  be  properly  per- 
formed. The  Astiey  Cooper  operation,  as  modi- 
fied by  Henry,  was  at  first  hailed  with  delight 
as  a  »Etfe  and  sure  means  of  accomplishing  a 
radical  cure  of  varicocele.  I  confess  with  due 
<x>ntrition  that  I  myself  fell  in  with  the  proces- 
fdon  of  enthusiasts  who  believed  implidtiy  in 
the  accuracy  of  all  the  reports  published  upon 
this  operation.  I  reported  from  time  to  time 
certain  cases  of  radical  cure  by  ablation  of  the 
scrotum.  Most  of  the  cases  of  my  early  opera- 
tions of  ablation  of  the  scrotum,  to  which  I  have 
access  at  the  present  time,  would  bear  reporting 
again  as  excellent  illustrations  of  the  fallacy  of 
the  operation  from  the  standpoint  of  a  radical 
cure.  I  will  not  discuss  the  question  of  my  own 
technique  of  ablation  of  the  scrotum,  but  to  fore- 
stall the  insinuation  that  I  have  not  done  the 
operation  thoroughly  I  will  state  that  when  the 
operation  in  my  hands  is  completed  it  will  puz 
zle  the  novice  to  get  tissue  enough  to  cover  the 
testes.     My  experience  alone  is  not  to  be  taken 


as  a  criterion  of  the  ultimate  success  of  the  ope- 
ration, but  I  will  state  that  I  have  at  present 
under  observation  a  case  operated  upon  some 
years  ago  by  a  celebrated  American  Surgeon, 
and  reported  by  him  as  a  radical  core,  in  which 
there  is  not  only  a  recurrence  of  the  varicocele, 
but  more  functional  disturbance  resulting  there- 
from than  existed  prior  to  the  operation.  An 
illustration  of  this  case,  which  appears  in  my 
monograph  upon  varicocele,  speaks  for  itaelf. 
It  must  not  be  understood  that  I  condemn  the 
operation  of  ablation  of  the  scrotum.  In  slight 
varicoceles  with  elongation  of  th6  scrotum  in 
young  subjects  jn  whom  the  normal  tonus  of  the 
dartos  muscle  has  not  been  completely  destroyed, 
and  in  whom  there  is  a  strong  indication  for  a 
psychic  impression  by  operative  measures,  the 
operation  of  ablation  of  the  scrotum  offers  a 
means  of  relief  which  is  at  once  suflidentiy  radi- 
cal and  perfectly  safe. 

Operations  involving  a  free  incision  of  the 
scrotum,  exposure  and  resection  of  the  veins  are 
usually  followed  by  severe  ecchymoees,  consid- 
erable swelling  and  occasionally  by  atrophy  of 
the  testes.  I  will  acknowledge  that  I  have  per- 
formed this  operation  in  numerous  instances  and 
have  had  but  one  case  of  atrophy  of  the  testicle. 
Even  in  this  case  infection  of  the  wound  by  the 
patient  thrustinfir  his  fingers  underneath  the 
dressing  and  scratching  the  part  with  his  nails 
was  probably  the  source  of  the  difficulty,  bat  I 
nevertheless  feel  that  such  extensive  mauling 
about  and  handling  of  the  testicle,  cord  and  sur- 
rounding tissue  should  be  avoided  where  possibleu 
Several  years  ago  I  began  operating  according 
to  a  method  outlined  in  my  monograph  on  vari- 
cocele. I  will  state  that  while  revising  the  prorf 
of  this  work  my  attention  was  called  to  an  ope- 
ration performed  by  Mr.  A.  B.  Barrow,  of  Lmi- 
don,  which  was  very  similar  to  my  own«  I  gave 
Mr.  Barrow  credit  for  his  operation  in  a  foot 
note  in  my  published  work.  His  operation  ia 
somewhat  similar  to  mine,  but  differs  in  some 
important  details  of  the  technique,  the  method 
of  dressing,  and  the  method  of  shortening  tJw 
coid. 

TECHNIQUE  OP  THE  OPERATION. 

The  pubes,  scrotum,  perineum  and  thighs  are 
thoroughly  shaved,  scrubbed  and  irrigated  with 
a  bichloride  solution.  Sterilized  towels  are  ar> 
ranged  around  the  parts,  so  that  only  the  8cro> 
tum  and  the  tissues  over  the  external  inguinal 
ring  are  exposed.  Cocaine  is  used  for  ane^esii. 
As  a  rule,  I  use  not  more  than  forty  minims  of 
a  two  per  cent  solution,  and  twenty  minims  of 
a  four  per  cent  solution  of  the  drug.  The  dn^ 
is  dissolved  in  a  one  per  cent  solution  of  carbolic 
add,  and  latterly  I  am  incorporating  ^  of  * 


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gram  >6f  mtiftte  of  Btrychnia  with  it  as  a  matter 
of  precauticm,  aHhough  in  some  years'  constant 
use  of  lihe  drug  I  have  never  had  any  accidents. 
A  few  minims  -ef  a  two  per  cent,  solution  are  in- 
jected at  four  or  five  points  a  short  distance 
from  the  proposed  line  of  indsion.  Twenty 
minims  of  a  four  per  cent  solution  are  injected 
with  a  needle  directly  in  the  line  of  the  incision. 
Within  five  minutes,  as  a  rule,  the  parts  are 
BuflSdently  anesthetized  to  proceed  with  the  ope- 
ration. An  incision  from  three-quarters  of  an 
inch  to  an  inch  and  one- half  in  length,  varying 
with  the  amount  of  fat  present,  is  made  with  a 
•scalpel  direcdy  over  the  external  ring.  This  is 
made  in  the  direction  of  the  longitudinal  axis  of 
the  cord.  The  cord  and  its  envelopes  are  ex- 
posed, and  a  careful  dissection  brings  the  veins 
into  view.  These  may  be  ligated  in  situ  in 
flight  cajies.  I  prefer,  however,  to  draw  the 
•cord  out  of  the  incision  by  means  of  a  blunt 
hook  to  a  sufiBdent  distance  to  enable  me  to 
fttSB  the  index  finger  beneath  it  The  cord  and 
testicle  are  now  thoroughly  under  control  and, 
if  necessary,  the  testicle  can  be  extracted  through 
a  one-inch  incision  where  there  is  only  the  ave- 
rage amount  of  adipose  tissue  present  Should 
it  be  neoeesary  to  do  so,  the  superficial  tissues 
may  be  incised  a  little  more  freely.  A  careful 
diseedion  of  the  veins  is  made,  the  vas  deferens 
being  isolated  and  kept  out  of  the  way.  In 
the  simpler  cases,  where  the  cord  is  not  greatly 
elongated,  a  ligature  of  aseptic  silk  or  silk- worm 
.^t,  the  former  being  the  more  manageable,  is 
tightly  tied  about  the  veins  just  an  inch  below 
-the  level  of  the  external  ring.  The  second  liga- 
ture is  applied  at  a  point  two  inches  or  more 
(according  to  the  length  of  the  cord)  lower  down. 
It  is  well  not  to  get  the  lower  ligature  too  near 
•the  testicle,  else  serious  disturbance  of  its  nutri- 
tion may  result  It  is  better,  in  case  there  is  a 
^Mcondary  plexus  of  varicose  veins,  at  the  lower 
4Uid  posterior  portion  of  the  testicle,  to  apply  a 
third  ligature  to  them  than  to  attempt  to  include 
them  all  in  a  single  ligature  below.  The  liga- 
tures are  cut  short,  the  cord  and  testicle  dropped 
or  drawn  back  into  place,  this  being  readily  ac- 
complished by  pressure,  and  traction  upon  the 
testide  through  the  scrotum.  In  cases  in  which 
the  cord  is  very  long  and  it  seems  desirable  to 
shorten  it,  two  courses  are  open  to  the  surgeon. 
One  is  to  resect  the  veins,  approximate  and  tie 
^e  stumps  of  the  cord.  The  other  and  better 
way  in  most  instances  is  to  make  a  loop  of  the 
induded  vdns,  the  extremities  of  the  loop  cor- 
fenxmding  to  the  upper  and  lower  ligatures. 
Where  it  is  intended  to  make  a  loop  in  this 
fariiion,  the  ligatures  are  left  long  so  that  they 
amy  be  readUy  tied  together.  It  may  seem 
io  some  rather  absurd  not  to  excise  the  included 


loop  of  veins,  but  I  believe  that  in  the  majority 
of  cases  the  results  are  somewhat  better  than 
after  exdsion.  In  a  general  way,  the  less  trau- 
matism inflicted  upon  the  tissues  of  the  cord  the 
better.  I  believe,  moreover,  that  in  freeing  the 
veins  prior  to  ligature,  it  is  not  well  to  make  an 
extensive  dissection  of  the  cord.  The  area  of 
vdns  included  in  the  loop  of  cord  between  the 
ligatures  do  not  apparently  undergo  necrosis, 
but  degenerate  into  a  fibrous  cord  which  is  ap- 
parent* for  a  time,  but  finally  entirely  disap- 
pears. It  will  be  understood  that  I  have  no 
serious  objection  to  excision  of  the  included  loop 
of  cord ;  mdeed,  I  have  followed  this  plan  on 
many  occasions,  but  I  believe  that  allowing  the 
loop  to  remain  in  the  manner  above  outlined  is 
a  more  conservative  procedure.  In  case  it  is 
dedded  to  remove  the  included  veins  the  stumps 
may  be  mummified  by  the  application  of  a  thin 
film  of  iodoform,  or  the  Paquelin  thermo  cautery 
may  be  applied  to  the  stamps  prior  to  tying  the 
proximal  and  distal  ends  together. 

It  is  permissible  to  irrigate  the  exposed  struc- 
tures with  sterilized  y^ater  before  restoring  them 
to  the  scrotum.  This  may  be  done  as  a  matter 
of  precaution,  although  I  do  not  believe  that  it 
is  absolutely  necessary.  All  hemorrhage  having 
stopped,  and  this  as  a  rule  amounts  to  very  little, 
such  small  vessels  as  may  have  been  cut  and 
occluded  with  the  pressure  forceps  having  be- 
come cloeed  with  fine  sutures  of  silk  or  catgut, 
three,  or  at  most,  four  stitches  applied  very 
close  together  will  suffice.  The  wound  bdng 
thoroughly  dry  is  sealed  with  iodoform  collodion. 
No  further  dressing  is  absolutely  necessary,  per- 
haps, but  it  is  my  custom  to  put  on  a  T- bandage 
aod  support  the  scrotum  with  absorbent  cotton. 
As  a  rule  the  patient  need  not  be  confined  to  the 
bed  longer  than  four  or  five  days  to  a  week. 
In  exceptional  cases  two  weeks  may  be  necessary. 
In  some  instances  I  have  had  some  difficulty  in 
keeping  the  patient  in  bed  after  the  third  day. 
In  cases  in  which  the  scrotum  is  very  lax  and 
pendulous,  it  is  my  custom  to  ablate  a  portion 
of  it,  either  at  the  time  of  tho  first  operation 
or  a  few  days  thereafter. 

I  unhesitatingly  endorse  this  operation  as  the 
simplest,  most  sdentific  and  safest  of  all  the 
radical  operations  which  I  have  tried.  With  an 
experience  of  twenty-six  cases  operated  on  by 
this  method,  and  something  like  seventy-five 
cases  by  various  other  methods  of  operation,  I 
feel  that  I  have  some  foundation  for  my  confi- 
dence in  the  method  described.  It  is  practically 
subcutaneous,  having  all  the  advanta^^  of  the 
subcutaneous  operation, — espedally  where  no 
resection  of  the  cord  is  performed, — and  has 
none  of  its  dangers  or  disadvantages.  In  these 
days  of  aseptic  surgery  it  is  asserted  that  a  four- 


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inch  incision  is  no  more  dangerous  than  a 
one  inch  incision.  This  is  not  approximately 
true,  but  other  things  being  equal,  when  the 
object  to  be  attained  can  be  as  readily  accom- 
plished through  a  short  incision,  it  is  to  be  pre- 
ferred. A  short  incision  is  at  least  much  less 
dangerous  as  it  is  smaller  in  dimensions.  It 
will  be  understood  that  I  believe  firmly  in  the 
free  use  of  the  knife  where  it  is  necessary  in 
all  instances  to  accomplish  the  object  in  view, 
but  there  are  occasions  where  smaller  incisions 
are  surgically  much  more  artistic  and  conser- 
vative. G.  Fbank  Lydston. 
Chicago. 


Burns,— Maggots  in  Wounds. 

Editor  Medical  World: — Thinking  that 
the  folio ^ng  cases  may  be  of  benefit  to  the  pro- 
fession, and  especially  to  the  younger  members, 
I  will  briefly  refer  to  them. 

I  was  called  to  the  oldest  American  emigrant 
to  California  (1828)— N.  G.  Pryor,  of  Los 
Angeles,  California.  During  an  epileptic  fit  in 
1849,  he  fell  down  before  his  still  and  was 
dreadfully  burned  from  his  neck  to  his  knees, 
and  involving  the  whole  skin,  extending  to  both 
sides.  Before  I  reached  him  the  Spanish  na- 
tives had  applied  a  poultice  of  fresh  cow's  man- 
ure to  the  bum.  This  poultice  moderated  the 
agonies  of  pain,  and  with  morphine  in  large 
doses  the  sufferer  experienced  some  relief.  A 
diarrhea  set  in,  and,  owing  to  the  sphincter 
muscles  of  the  anus  being  partly  burnt  off,  fre- 
quent passages  could  be  stopped  only  by  insert- 
ing a  plug  of  a  greasy  cloth. 

The  first  two  weeks  was  a  battle  for  life,  and, 
though  near  death's  door,  he  commenced  mend- 
ing. The  skin  came  off  in  three  days.  There 
being  no  linseed  oil  in  the  place,  olive  oil  was 
used  as  a  substitute.  As  the  sphincter  healed 
there  was  a  growing  contraction,  and  a  silver 
tube  was  put  in  the  bowels,  and  answered  the 
purpose.  Being  compelled  to  go  into  the  coun- 
try for  several  days,  the  patient  was  unfortu- 
nately letl  with  a  doctor  who  neglected  him. 
The  family  then  called  in  an  ignorant  Qerman 
doctor,  who  said  tbat  the  patient's  rectum  would 
close  entirely  unless  the  sphincter  was  cut  This 
was  submitted  to.  and  in  half  an  hour  the  epi- 
leptic fie  returned,  which  had  not  been  the  case 
for  over  six  weeks.  As  fast  as  one  fit  was  over 
another  would  come  on,  and  in  thirty  six  hours 
death  came  to  the  patient's  relief. 

During  most  of  the  six  week's  sickness,  night 
and  day,  I  was  wilh  hioL  He  was  convalescing 
fioely,  and  could  go  about  on  his  crutches.  He 
had  promised  me  one  thousand  dollars,  and 
would  have  paid  it,  but  for  the  malpractice  of 


cutting  the  sphincter  of  the  anus.  As  it  re- 
sulted, the  administrator  on  the  estate  paid  me 
only  three  hundred  dollars — ^not  a  fee  of  one 
dollar  and  fifty  cents  for  a  prolonged  visit 

On  returning  from  California  via  Nicaragua, 
in  1857,  Walker,  the  American  filibuster,  was 
near  the  end  of  his  career.  His  forces  were 
driven  back  to  the  isthmus  between  San  JuaD^ 
at  Greytown,  and  San  Juan  on  the  Pacific.  The 
last  of  10,000  Americans  were  dying  of  chronio 
diarrhea  from  want  of  proper  food  and  shelter, 
and  from  exposure  to  all  weathers.  He  had  an 
armed  vessel,  which  fired  into  a  Nicaraguan 
vesselof-war.  The  ball  exploded  the  magazine, 
and  of  a  hundred  men  on  board  nearly  every 
one  was  more  or  less  burnt  Many  were  killed 
outright,  while  many  others  lost  their  eyesight 
and  the  skin  on  different  parts  of  the  body. 
About  sixty  of  these  unfortunates  were  put  on- 
der  a  shed  and  laid  down  on  the  filthy  soil,  and 
covered  themselves  with  it  to  ease  their  suffer- 
ings. The  surgeon  had  no  morphine  or  dress- 
ings for  these  men,  and  with  little  or  nothing  to 
eat,  they  died  in  agonies  of  pain,  extending  over 
two  weeks. 

The  guilt  of  Buchanan's  administration  in 
allowing  this  freebooter  to  go  to  Nicaragua  and 
carry  on  his  infamous  slaughter  of  helpless  na- 
tives, in  order  to  form  a  slave  empire,  was  well 
known  and.  is  a  sad  commentary  on  American 
civilization. 

Another  case  of  burning,  from  the  explosioD 
of  a  kerosene  lamp  in  the  hands  of  a  lady  in  ber 
seventh  month  of  pregnancy,  was  not  severe. 
But  the  fright  brought  on  labor  pains.  These 
pains  could  not  be  stopped.  Tried  the  decoctioii 
of  blackham,  which  had  succeeded  in  several 
cases,  but  in  vain.  Also  tried  to  open  the  os 
uteri  with  Barnes'  rubber  dilators,  but  failed. 
At  that  time  there  were  no  metalic  dilators. 
After  six  days  of  suffering  the  lady  died  unde- 
livered. 

Another  case  of  explosion  of  a  kerosene  lamp 
in  the  hands  of  a  negro  woman,  resulted  in 
severe  burning  of  the  face,  arms  and  breast 
She  was  improving  for  a  week,  but  while  she 
and  the  nurses  weie  asleep  she  became  fly-blown. 
Maggots  soon  appeared  in  many  of  the  burnt 
places,  and  came  from  the  nostrils  and  from  her 
mouth.  Injections  of  a  decoction  of  elderberries 
and  leaves  brought  away  hundreds  of  them,  but 
the  woman  died,  being  eaten  up  by  them.  Tar- 
pentme  killed  many  of  them  near  the  surface, 
but  when  deep-seated  it  was  not  used,  as  the  kill- 
ing of  so  many  would  have  resulted  in  absorp- 
tion and  blood  poisoning. 

In  crossing  the  plains  in  1849,  one  of  the 
company  was  convale^cina^  from  typhoid  fever, 
but  became  fly-blown,  but  we  had  no  turpentine 


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THE  MBDICAX  WORIJ). 


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nor  eMerberries.     Gave  weak  injections  of  salt 
water,  and  of  copperas,  but  nothing  availed. 

Daring  the  civil  war  I  attended  a  large  nam- 
ber  of  Confederate  soldiers,  and  treated  many 
of  them  with  decoction  of  elderberries  and 
leaves,  but  no  deaths  occurred  from  this  cause 
in  my  hands.  While  in  the  small  pox  hospital 
(not  under  my  attendance)  I  saw  many  soldiers 
with  maggots  in  their  wounds,  and  doubtless 
many  of  them  died  from  them.  The  ^nch 
was  so  great  that  nurses  did  not  attend  to  them 
as  they  should  have  done. 

While  in  California,  a  young  man  had  his 
thigh  broken  by  the  kick  of  a  horse.  A  fellow- 
townsman  and  a  doctor  put  on  long  splints,  and 
after  taking  his  horse  and  his  watch,  valued  at 
three  hundred  dollars,  left  him  among  ignorant 
Spaniards,  who  fed  him  for  over  two  months. 
At  that  time  I  returned  from  the  East,  and  was 
told  of  the  young  man's  misfortune.  The  frac- 
tured femur  had  mended,  but  with  an  inch  of 
shortening  of  the  limb.  On  removing  the  band- 
age from  the  foot,  I  found  half  of  it  eaten  off 
by  maggots.  To  save  the  man's  life,  Chopart's 
operation  was  necessary,  and  the  fragment  of 
his  foot  healed  up  very  satisfactorily.  Of  course, 
he  was  lame  for  life. 

C.   R.  CULLEN,   M.D,, 

Barton  Heights,  Richmond,  Va. 


Dentition  a  Physiologioal  Process  with  Patholo- 
gioal  Expression. 

Editor  Medical  World  : — In  reference  to 
Dr.  Bruce's  article,  '^Teething  not  a  pathologi- 
cal Process,"  page  374,  I  must  take  some  ex- 
ceptions. 

While  I  admit  that  dentition  is  a  physiolo- 
gical process,  yet  owing  to  changed  conditions, 
how  often  it  becomes  pathologicfd  in  its  ezpres* 
sion,  like  parturition,  etc.  A  condition  which 
the  tables  of  mortality  show  carry  ofi  4.8  per 
cent,  of  children  under  12  months,  and  7.8  be- 
tween the  ages  of  1  and  3,  I  think,  should  re- 
ceive due  attention  from  all  careful  phjsidans. 
For  the  benefit  of  those  who  may  not  have 
given  the  subject  of  pathological  dentition  much 
thought,  I  quote  from  the  American  System  of 
Dentistry,  vol.  Ill,  pages  326-327,  with  the 
editor's  consent : 

"  lilany  who  admit  that  dentition  may  ezer- 
dse  an  influence  on  the  etiology  of  the  diseases 
of  infancy  assume  that  the  explanation  of  de- 
ranged action  is  to  be  found  only  in  the  direct 
pressure  of  the  advancing  tooth  upon  the  fibrous 
tissue,  which  fact  is  always  to  be  determined  by 
local  signs.  It  is  ddubtless  true  that  there  is 
generally  some  such  external  evidence,  but  it 


does  not  follow,  because  there  is  no  local  mani- 
festation, that  therefore  dental  evolution  can 
have  no  relation  to  a  pathological  condition. 

Hyperemia  of  the  gums  is  perhaps  generaly 
caused  by  the  eruption  of  the  teeth  proceeding 
more  rapidly  than  the  absorption  of  Uieir  int^- 
umental  covering.  But  the  direct  pressure  of 
the  advancing  tooth  upon  the  fibrous  integu- 
ments is  not  the  only  nor  the  principal  factor 
in  disturbance  of  equilibrium  in  pathological 
dentition.  The  most  curious  complications  are, 
it  is  reasonable  to  suppose,  caused  by  the  resist- 
ance of  the  gums,  and  consequent  pressure  upon 
the  nervous  and  vascular  supply  of  the  pulp, 
giving  rise  to  severe  and  unremittmg  pains,  a 
true  toothache,  comparable  only  to  that  exquis- 
ite torture  which  is  experienced  in  after  life 
from  an  exposed  and  irritated  pulp. 

The  condition  when  a  tooth  is  thus  situated  is 
not  unlike  that  which  is  found  in  whitlow — vas- 
cular and  resistive  tissue  bound  down  by  un- 
yielding coverings.  If  such  a  perversion  of  this 
physiological  process  is  possible,  there  can  be  no 
question  as  to  the  extent  of  the  mischief  which 
may  result — ^an  irritability  of  the  general  sys- 
tem which  finds  expression  in  loss  of  appete, 
sleeplessness,  nausea,  thirst,  fever,  diarrhea  or 
constipation,  convulsions,  paralysis  and  other 
serious  lesions,  many  of  which,  as  strabismus  or 
epilepsy,  remain  throughout  life. 

It  is  not  surprising  Uiat  those,  who  hold  this 
theory  generally  assumed  and  taught,  that  the 
direct  pressure  of  the  advancing  tooth  upon  the 
fibrous  tissue  is  the  explanation  of  all  symptoms 
attributable  to  pathological  dentition,  should 
underrate  the  distress  and  danger  which  may 
occur.  But  the  severity  of  the  disturbance  fre- 
quently witnessed  suggests  a  more  curious  com- 
plication, and  a  consideration  of  the  conditions 
justifies  a  giaver  diagnosis. 

It  must  be  remembered  that  at  the  period  of 
eruption  the  roots  of  the  teeth  are  yet  incom- 
plete. Instead  of  the  conical  termination  and 
minute  foramen  which  characterize  perfected 
tooth,  the  aperture  is  nearly  as  large  as  th6 
root  itself,  and  then  when  the  sensitive  pulp, 
made  up  of  connective  tissue,  blood-vessels  and 
nerves,  is  in  a  condition  of  irritation  because  of 
the  morbid  activity  of  the  process  of  dentition, 
augmented  vascular  and  nervous  action,  there 
may  be  produced  a  hyperemia  sufficient^  pos- 
sibly, to  cause  the  protrudon  of  a  part  of  the 
mass  from  the  incomplete  aperture  of  the  root, 
giving  abundant  cause  for  extreme  constitu- 
tional disturbance.  •  .  .  That  the  resist- 
ance of  the  gum-tiEsue  is  the  occasion  of  the 
constitutional  disturbance  so  often  seen  in  teeth- 
ing children,  appears  probable  in  view  of  those 
cases  in  which,  diough  there  be  no  local  indica- 


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THB  MBDICAI.  WORLD. 


tion  of  trouble,  every  untoward  Bymptom  disap- 
pears promptly  after  lancing  the  gums  over  the 
tooth  or  teeth  next  in  order  of  eruption/' 
Dundee,  N.  Y.  J,  M.  Ovbnshire,  D.D.a, 


Another  Peroxide  of  Hydrogen  Explosion. 

Editor  Medical  World  : — I  had  another 
bottle  of  peroxiQe  of  hydrogen  to  explode  last 
night,  throwing  glass  all  over  the  cellar  floor. 
The  bottle  was  the  remaining  one,  left  from  the 
lot  bought  last  June  (3  bottles),  explamed  in 
my  previous  letter.  After  the  first  one  had  ex- 
ploded, several  days  ago,  I  quickly  and  carefully 
removed  this  one  to  the  cellar,  where  it  is  rather 
oool,  temperature  about  60  degrees.  One  bottle 
was  opened  soon  after  the  purchase  (last  June) 
and  I  had  been  using  out  of  it  occasionally 
through  the  summer.  The  other  two  bottles  were 
left  on  separate  shelves  in  my  office  and  were  not 
opened  or  disturbed,  as  described,  when  the  ex- 
plosions occurred.  The  above  peroxide  was 
manufactured  by  a  reliable  firm  of  Philadelphia. 
What  can  be  the  cause  ?  I  have  been  using 
peroxide  of  hydrogen  in  my  practice  for  seven 
years  with  great  success  and  never  had  a  bottle 
to  burst  before.  Is  it  because  they  were  lying 
on  the  shelf  so  long  that  the  gas  was  generated 
by  time  and  caused  the  explosion?  If  so,  is  it 
not  dangerous  for  the  manufacturer  to  keep  on 
hand  a  stock  jof  it  for  any  length  of  time? 
Both  of  the  above  explosions  would  certainly 
have  been  dangerous  to  life  or  limb  if  any  one 
had  been  present.  Let  us  hear  a  voice  from 
The  World  on  the  subject. 

Alpha,  Md.        Bekj.  F.  Shipley,  M.D., 


Souteilaria  for  Rabies. 


Editor  Medical  World: — I  find  several 
references  to  hydrophobia.  Perhaps  this  might 
interest  and  also  help  some. 

In  1833  or  '34  Dr.  McMillen  was  practising 
in  Western  New  York.  One  day  he  stopped 
at  my  father's,  his  dog  being  with  him.  As  he 
was  about  starting  he  pointed  to  the  dog,  and 
said :  "  About  six  weeks  ago  that  dog  was  bitten 
by  a  mad  dog."  He  then  said  that  he  killed 
the  mad  dog.  He  saw  him  bite  his  dog,  a  three 
year  old  colt,  three  cows  and  several  sheep.  He 
caught  all  the  sheep,  and  found  marks  of  bites 
on  eight  or  ten  or  them,  and  on  the  dog,  colt 
and  cows.  He  put  the  second  cow  bitten  in  a 
pen,  and  also  the  bitten  sheep  in  pens — ^two  in 
one,  and  the  retnaining  six  or  eight  in  another. 
They  were  fed  and  watered  regularly.  He  pre- 
pared medicine  and  gave  it  to  the  dog,  colt,  first 
and  third  cows  bitten,  and  six  or  eight  of  the 
sheep.     He  gave  none  to  the  second  cow  and 


two  sheep  bitten.  The  cow,  the  two  sheep  he 
gave  no  medicine  to,  and  four  or  five  other 
sheep,  had  had  the  diisease  and  died  ;  but  none 
that  he  gave  medicine  to  had  had  any  sign  of 
the  disease.  The  medicine  he  used  was  the 
Scutellaria  lateriflora.  I  was  standing  near,  and 
heard  all  he  said.  My  recollection  is  that  he 
gave  a  decoction,  about  one  oudoe  of  dry  herb, 
to  the  dog  and  each  sheep,  and  four  ounces  to- 
each  cow  and  the  colt  He  thought  it  sure  cure- 
if  given  for  three,  four  or  five  days  before  the^ 
disease  commenced  to  show. 

Burlington,  Iowa.      W.  H.  Davib,  M.D., 


An  Overlooked  Symptom  of  Rabies. 

Dr.  Bruce,  of  Sanford,  Fla.,  writes  as  fol- 
lows :  During  my  boyhood,  my  father  kept  a 
large  kennel  of  fox  hounds,  and  I  became  veiy 
faimliar  with  dogs  and  their  ways.  I  have- 
seen  quite  a  number  of  rabid  dogs.  It  is  a 
mistake  to  suppose  that  the  first  symptom  is  a 
disposition  to  ramble.  On  the  contrary,  for  the- 
first  day,  after  the  poison  begins  its  deadly 
work,  the  dog  assumes  a  typical  coil  in  whidb  he- 
sleeps  away  the  first  day.  Then  he  begins  to 
ramble  far  and  wide.  There  is  something  very 
peculiar  about  that  coiL  Once  seen  it  will 
never  be  forgotten.     It  cannot  be  discribed. 


Water  Treatment  of  Scarlet  Fever. 


Editor  Medical  World: — J.  C.  McAllis- 
ter, M.D.,  Driftwood,  Pa.,  wants  to  hear  hota 
any  one.  who  has  had  similar  experience  as* 
himself  with  the  cold  water  treatment  in  scwrlet 
fever,  and  in  responding  to  his  suggestion  I 
herewith  submit  the  following  case  to  you  for  his 
benefit  and  for  the  medical  profession  generally. 

I  was  called  suddenly,  January  Ist,  1884,  to- 
see  a  girl  fifteen  years  of  age,  sixteen  miles- 
away,  who  was  having  malignant  scarlet  fever, 
arriving  just  at  sunset 

Finding  that  another  medical  brother  bad 
been  treating  her,  who  would  not  be  preaent 
until  next  morning,  and  who  had  considend 
her  hopeless,  I  proceeded  to  make  the  fbUowing 
diagnosis: 

1st,  profound  coma,  so  complete  that  extreme 
agitation  could  not  make  the  least  impreasioD  or 
get  any  eense  of  feeling  or  evidence  of  life,  except 
Uiat  she  was  breathiog  and  that  her  body  w«» 
warm.  2nd,  pulse  140.  3rd,  temperature  105^ 
and  the  skin  of  a  dark  purple  hue ;  throat  very 
much  swollen,  bleeding  and  covered  with  fala^ 
membrane.  Not  waiting  to  make  any  more  dis- 
coveries (the  other  doctor  having  prescribed  the- 
ordinary  remedies  given  in  similar  cases,  with* 
out  any  apparent  results),  I  immediately  pro- 


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401 


cured  a  cotton  sheet,  put  it  in  a  tub  of  cold 
water  drawn  from  the  well  near  by,  and  aflter 
holding  it  near  the  fire  long  enough  to  take 
^way  a  poedble  shiver  which  she  might  get  by 
applying  it  to  the  body,  laid  it  on  a  rubber 
blanket  and  put  her  on  it  with  her  body  entirdy 
naked.  At  the  same  time  I  gave  her  a  large 
spoonful  of  brandy  and  water,  a  small  quaatity 
at  a  time,  for  it  was  almost  impossible  for  her  to 
swallow.  After  having  done  this,  she  did  not 
yet  show  any  sign  that  we  had  done  anything ; 
stilly  in  the  short  space  of  one- half  hour  the  tem- 
perature stood  103^,  pulse  120.  We  re-applied 
the  cold  sheets  every  thirty  minutes  until  it  was 
finnecessary  to  use  them  any  more.  In  twenty- 
four  hours  the  pulse  was  100,  temperature  100^, 
and  her  mind  was  all  right  again,  and  she  went 
<m  to  complete  recovery. 

By  this  result  I  am  thoroughly  convinced  that 
a  great  many  bad  cases  might  be  cured  if  seen 
in  time,  and  if  doctors  would  drop  the  idea  that 
-cold  water  would  <*  drive  the  rash  in  and  kill 
the  patient''  Such  cases  will  die  unless  extreme 
measures  are  resorted  to  at  once. 

The  doctor  in  aiteoilaiice  said  he  would  not 
dare  to  use  it,  one  reason  being  that  her  monthly 
periods  were  on  and  he  feared  suppression,  but 
the  treatment  had  no  influence  on  them  in  the 
least.  G.  W.  Reynolds,  M.D., 

Madrid,  N.  Y. 


Another  Tattimonial. 


Editor  Medical  World  : — I  can  add  to  the 
testimony  of  J.  C.  McAllister,  M.D.,  of  Drift- 
wood, Pa.,  as  to  the  efficacy  of  the  cold  bath  in 
scarlet  fever.  On  September  2Ist  I  was  called 
•eight  miles  to-  see  a  girl  thirteen  years  old  with 
scarlet  fever.  Temperature  105^  ;  sore  throat 
and  other  symptoms  of  severity.  Had  been  sick 
one  day.  I  gave  mercury,  acetanilid,  aconite, 
nox  vomica  and  gelsemium.  The  patient  was 
in  a  malarial  section,  therefore,  the  treatment 
had  to  be  directed  aocordiDgly.  Quinine  was 
also  given.  I  was  recalled  the  next  day  and 
found  all  the  symptoms  more  malignant,  with 
fever  105^.  The  antipyritica  would  not  control 
the  temperatura  I  applied  cold  water  sponge 
to  Bjpme  with  constant  fanning ;  in  a  short  time 
the  patient  became  quiet  and  dropped  into  a 
refreshing  sleep.  From  this  time  she  improved. 
I  used  iron  and  quinine  application  for  the  sore 
throat  A.  B.  Bishop,  M.D., 

Lockesburg,  Ark. 


Sxx  page  xzii  for  adyantageons  terms  this  month 
tor  Dr.  Tf  au^'t  ^  Manual  of  Treatment  by  Active 
Principlea  and  New  Bemedies." 


Write  up  liitsretting  Csaea.— Fever  of  the  Weatem 

Prsiriea.— Active  Principle  Qranulea  ~Sul- 

pliide  of  Calcium  for  Qlyooauria. 

Editor  Medical  World  : — Do  you  know,  I 
have  not  written  a  word  for  The  World  in 
nearly  a  year  ?  and  I  feel  that  one  dollar  is  poor 
renumeration  for  all  the  good  I  get  out  of  it  I 
would  most  earnestly  advise  the  younger  read- 
ers  of  The  World  to  write.  Take  notes  of 
your  cases  and  report  them.  You  do  not  know 
how  little  you  do  know,  or  how  crude  your  ideas 
are,  until  you  attempt  to  put  them  on  paper.  It 
will  make  you  a  closer  reader,  a  better  reasoner, 
hence  a  better  doctor.  I  say  this  from  experi- 
ence not  egotism.  So  here  is  my  mite  of  con- 
tribution. 

Here  in  the  West  our  fevers  are  changing 
from  the  intermittent  and  remittent  of  sod 
shanty  and  branch*  water  days,  to  those  of  a  con- 
tinued type.  In  eighteen  years  I  can  only 
count  some  ififteen  cases  of  undoubted  typi- 
cal typhoid  fever,  as  to  duration  and  classi^ 
symptoms.  I  have  either  learned  to  treat  them 
better — jugulate  them — or  they  do  not  come  my 
way. 

A  fever  that  does  not  yield  to  quinine  in 
antiperiodic  doses,  along  with  proper  evacuant 
treatment,  in  forty-eight  hours,  has  some  morbid 
element  besides  malaria.  8o  I  cut  down  my 
quinine,  add  aoetanUid,  caffeine  bromide  and 
zinc  sulpho-carb.  in  capsules.  I  alternate  this 
with  the  improved  spts.  mindererus  made  as  fol- 
lows: 

B.    Add  saUcyllo  (Arom  oil  of  wintergreen) 

Ammonia  carbonate. aa......» dra.  fj 

Aqna  cfitTfymnmi ^ ounoei  iv 

H. Big.  Shake.   Dose;  One teaYpoonTal every  Uuee or fonr 
houn.  altemating  with  the  caDtalei. 

I  have  combined  a  heart  tonic,  an  anti- ther- 
mic, analgesic  and  a  bovrel  antiseptic.  Now 
what  result  do  I  get?  This.  My  patient  has 
a  flat  belly,  no  tympanites,  no  tendehiees,  no 
gurgling  in  right  illiac,  no  diarrhoea,  (will  some 
one  please  tell  us  how  to  spell  loose  bowels  with- 
out the  diphthong  ?)  No  delerium,  once  in  a 
while  a  little  nose  bleed,  with  a  fever  of  a  tem- 
perature of  one  hundred  and  three  to  four  and 
a  half  in  the  start,  and  instead  of  ascending,  the 
temperature  is  lowered  from  one-half  to  one  de- 
gree, then  is  stationary  for  a  day  or  two,  gradu- 
ally declining  into  convalesence.  They  are  sick 
for  ten  days  or  two  weeks ;  not  bad,  and  best  of 
all,  they  get  well. 

Our  fevers  this  fall  (1894)  have  developed 
something  new.  A  burning  pain  at  the  pit  of  the 
stomach  with  bulging  of  the  epigastrium,  in- 
tense nausea  and  vomiting,  total  loss  of  appetite, 
obstinate  constipation,  pulse  one  hundred  and 
twenty,  temperature  one  hundred  and  two  and  a 


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THE  MfiDICAX  WORLD. 


half  to  four  and  a  half,  as  liable  to  be  as  high  in 
the  morning  as  in  the  evening  and  vice  versa  ; 
tongue  covered  with  a  thick  dirty  white  fur  ;  in 
the  beginning  it  cleans  ofi  and  leaves  a  brown 
streak  on  the  base  and  centre,  with  red  edges  ; 
accompanied  with  a  constant  hawking  and  spit- 
ting of  a  thick,  tenacious  mucus. 

This  fever,  if  seen  early,  may  be  controlled 
in  from  fi  e  to  seven  days.  I  call  it  a  gastric 
catarrhal  form  of  fever.  It  is  not  an  intermit- 
tent, remittent,  typhoid  or  that  misnomer  be- 
hind which  so  many  hide,  '*  typbo  malarial." 

The  way  some  of  The  World  family  write 
•ne  would  thmk  that  with  Dosimetry  the  medi- 
cal milenium  was  at  hand.  Go  slow,  Brethren, 
and  while  I  always  expect  to  be  young  enough 
to  be  a  student,  yet  I  think  I  am  old  enough  in 
practice  to  at  least  give  good  advice. 

Now,  do  not,  beoiuse  one  case  recovers  with 
granules,  throw  away  your  fluid  extracts,  tine- 
tores  and  powders  and  go  wild  over  the  new 
system  of  therapeutics.  You  may  lose  your 
patient  and  have  to  «  eat  crow "  mentally  for 
awhile.  Take  up  a  few  remedies  at  a  time, 
try  th  m,  feel  your  way,  and  do  not  rush  into 
print,  lauding  them,  because  the  first  case  you 
prescribe  them  in  recovers. 

Remember  that  the  inherent  power  of  nature 
tends  to  recovery  in  most  diseases.  That  some- 
olie  writes  that  a  certain  remedy,  or  combination 
of  remedies  will  cure  certain  diseapes,  and  stops 
at  that,  makes  it  no  recommendation  to  me. 

But  when  he  describes  a  given  pathological 
condition  or  train  of  symptoms,  and  shows  wly 
he  thinks  they  accomplidhed  the  end  sought,  and 
it  looks  reasonable,  1  copy  it  in  my  case  book. 
Just  a  line  (for  instance,  **  Pertussis,"  see  Mei> 
lOAL  World,  Nov.  No.,  Ih9l"}. 

Then  the  first  time  I  get  stuck  on  a  case,  I 
will  avail  myself  of  a  consultation  that  does  not 
lesson  my  patient's  financial  ability  to  pay  me 
hj  about  ten  dollars. 

I  am  feeliofi:  my  way  with  dosimetric  gran- 
ules so  far  with  encouraging  results. 

Try  a  few  of  thoee  anodynes  for  irritable, 
edlicky,  teething  babies ;  the  laxatives  for 
chronic  constipation ;  the  uterine  tonic  for  ill- 
delined  female  complaints,  where  they  won't 
submit  to  an  examination.  Then  there  are  the 
defervescent  and  trinity  granules  for  the  acute 
stage  of  ft  vers,  they  lower  pulse  and  tempera- 
ture. When  that  happens  give  your  quinine  or 
other  antithermic  and  anti  petiodic. 

Have  any  of  The  World  readers  ever  tried 
calcium  sulphide  in  glyoosuiia  ?  I  have  been  a 
preacriber  of  calc.  sulp.  for  fourteen  years  in 
supurative  conditions  and,  acting  on  the  anal- 
(^y  that  in  carbuncles,  and  those  afflicted  with 
suooessive  crops  of  boils,  we  have  a  glycoeuric 


condition.  I  tried  it  in  a  case  of  saorharine 
diabetes  in  conjunction  with  opium.  This 
patient  had  lost  forty  pounds  in  weight,  was 
drinking  about  four  gallons  of  water  daily, 
urinating  in  proportion  and  had  a  voracious 
appetite.  Urinal j  sis  showed  an  abundance  of 
sugar,  specific  gravity  ten  forty  five.  Three 
months  treatment  brought  sugar  down  to  a  faint 
trace,  her  weight  increased,  specific  gravity  fell 
to  ten  twenty,  urination,  thirst  acd  af^petite 
diminished  proportionally.  She  moved  away 
and  I  lost  track  of  her. 

But  the  three  months  I  treated  her  made 
more  improvement  than  hoped  for  when  I  com- 
menced treatment. 

If  any  one  of  you  have  tried  it  please  report 
Mulvane,  Kan.  Dr.  W.  K.  Harris. 

[We  can  say  to  the  Doctor  that  we  have  long 
sin  e  eliminated  the  diphthong  from  our  scien- 
t  fie  vocabulary,  except  ng  where  it  is  nece«ary 
to  indicate  Latin  plurals  We  spell  it  diarrhea. 
—Ed.] 


Merita  of  Aoeianilid. 

Editor  Medical  World: — I  notice  some- 
thing said  in  yf)ur  j  )urpal,  as  well  as  others,  in 
regard  to  acefanilid.  I  find  it  especially  good 
for  certain  troubles,  such  as  acute  rheumatism. 
I  am  able  with  fi/e  to  ten-grain  do^es  to  cod- 
trol  acute  rheumatism  within  twenty  ftmr  hoars, 
but  find  it  necessary  to  continue  to  give  it, 
though  less  frequently,  and  finally  when  the 
pain  ceases  and  I  have  stopped  the  medicine, 
I  order  my  patients  to  return  to  it  again  when 
they  feel  the  least  sign  of  its  coming  back. 

One  young  lady  who,  when  I  was  first  called, 
could  bar  ily  move  a  limb,  was  up  aud  around  the 
house  the  next  day.  Others  I  have  seen  the 
same.  I  have  never  had  any  trouble,  ezoopt 
in  one  or  two  cases  with  organic  disease  of  w 
heart,  ia  which  I  was  obliged  to  lessen  the  dose 
on  account  of  \tn  being  too  depressing  and  oaos- 
ing  a  little  cyanotic  appearance. 

1  have  teste!  it  in  typhoid  fever,  bat  find 
other  medicines  better.  I  find  that  it  is  jost 
like  all  other  medicines,  there  are  certain  things 
it  can  do  and  ceitain  things  it  can  not  do. 

H.  A.  FiSKE,  M.D., 

East  Longmeadow,  Mass. 


Do  jon  know  of  the  recent  r(diicti'>n  in  price  of  F- 
O.  Money  Oiders?  Three  cents  will  get  an  order  op 
to  $2.50,  and  five  c«>nt8  up  to  $5  00.  Thb  cqhI  in  vtrj 
triflin»r,  and  it  is  the  safest  way  in  which  to  mod 
monejr  hy  mail  •  it  is  abnolutely  safe — SMfer  than  bf 
registered  letter,  and  that  costs  eight  oeots.' 


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403 


A  Suggestion  In  Regard  to  Medical  Degrees  and 
Qualifloationa  for  Praotioe, 

Editor  Medical  World  : — Permit  me  to  add 
a  few  words  to  the  discussion  now  going  on  in 
jour  columns*  on  the  subject  of  State  examina- 
tions, qualified  physicians,  etc.  I  have  long  held 
the  opinion  that  the  peculiar  anomaly  of  physi- 
cians receiving  on  their  graduation  the  highest 
lienor,  the  supreme  and  most  honorable  title, 
viz..  Doctor,  that  it  is  in  the  power  of  the  college 
to  bestow,  should  be  done  away  with.  Others 
receive  the  degree  of  Bachelor  on  completing 
the  course  of  the  undergraduate.  Why  should 
the  medical  men  be  granted  a  higher  one?  I 
t)elieye  that  the  degiee  of  M.£ ,  Bachelor  of 
Medicine,  should  be  conferred  on  all  graduates, 
of  medical  schools  who  have  completed  a  pre- 
ecribed  course  and  complied  with  certain  require- 
ments, that  such  a  degree  should  permit  the 
bearer  to  practice  his  profession  for,  say  five 
years,  at  the  end  of  which  time  he  should  be 
obliged  to  stand  an  examination  for  the  Doc- 
torate. This  examination  should  be  complete 
and  exhaustive.  It  should  be  practical  and  cal- 
colated  to  show  the  capabilities  of  the  candidate 
as  a  practitioner  of  medicine  and  surgery.  The 
examiners  should  be  men  of  national  reputation, 
and  when  the  ordeal  shall  be  successfully  passed 
the  candidate  should  be  a  full  fledged  Doctor  of 
Medicine,  free  to  pursue  his  vocation  anywhere 
in  the  United  States.  There  should  be  a  clause 
making  it  obligatory  on  all  Bachelors  of  Medi- 
cine to  take  the  examination  for  the  Doctorate 
et  the  time  stated,  and  failing,  to  have  the  privi- 
lege of  re- examination  a  year  afterwards,  at 
which  time  a  failure  would  preclude  the  candi- 
<late  from  another  trial  in  less  than  three  years. 
A  third  failure  would  end  the  matter,  and  while 
the  person  would  not  be  debarred  from  practic- 
ing, it  would  be  as  a  Bachelor  and  not  a  Doctor 
of  Medicine.  The.  advantages  of  such  a  liiw 
would  be  a  reward  to  stiive  for— a  degree  higher 
than  the  one  held,  so  recognized,  and  more,  a 
degree  the  possession  of  which  the  public  would 
soon  understand  meant  higher  attainments.  Be- 
sideB  this,  a  national  board  of  medical  emam- 
inerVy  with  well  defined  functions,  the  license  of 
which  would  confer  the  right  to  practice  in  any 
states  would  put  a  stop  to  the  everlasting  tui- 
mml  and  strife  now  gone  through  at  nearly  every 
session  of  the  legislatures  of  the  different  States. 
More  than  all,  t^he  degree  of  Doctor  of  Medicine 
would  have  a  value,  would  confer  on  the  fortu- 
nate possessor  thereof  an  honor  ar  d  a  prestige 
now  unfortunately  not  accorded  him. 

Ked  Creek,  N.  Y.        S.  M.  Ward,  M.D., 


New  tubsciibers  who  send  $1  now  for  1895,  will  re- 
ce  ve  World  for  the  remainder  of  this  year  Aw. 


Paresis. 

Editor  Medical  World  :— Paresis,  general 
paralysis,  paralytic  insanity,  and  paralytic  de- 
mentu^  are  all  names  applied  to  a  variety  of 
insanity  which  is  also  a  true  cerebral  disease. 
Besides  the  i^bove  names,  this  variety  of  insanity 
is  known  among  the  laity  as  softening  of  th^ 
brain,  and  is  the  only  variety  of  insanity  in 
which  the  post-mortem  examination  will  confirm 
the  diagnosis.  I  consider  the  definition  given 
by  Clouston  among  the  besL  He  says  paresis 
is  a  disease  of  the  cortical  part  of  the  brain, 
characterized  by  progression,  by  the  combined 
presence  of  mental  and  motor  symptoms,  the 
former  always  including  mental  enfeeblement 
and  mcDtal  facility,  and  almost  always  delusions 
of  grandeur  and  ideas  of  morbid  expansion  or 
self  satisfaction ;  the  motor  deficiencies  always 
including  a  peculiar  defective  articulation  of 
words,  and  always  passing  through  the  stages  of 
fibHllar  convulsions,  incoordination,  paresis 
and  paralysis  ;  the  diseased  process  spreading  to 
the  whole  of  the  nerve  tissue  of  the  body ;  being 
as  yet  incurable,  and  fatal  in  a  few  years. 

The  prodromal  period  of  paresis  usually  lasts 
about  a  }  ear,  but  may  be  much  shorter  or  longer. 
At  this  time  the  individual  is  full  of  extrava- 
gant projects,  is  considered  a  *•  hail  fellow  well 
met,"  being  generous  to  a  fault  with  strangers, 
though  tyranical,  and  breaking  out  in  causeless 
fits  of  anger  at  home.  I  had  a  patient  who 
spent  six  hundred  dollars  on  a  supper  to  total 
strangers,  whom  he  picked  up  on  the  streets, 
and  next  day  punished  his  little  girl  severely 
for  some  imsginary  extravagance.  The  most 
prominent  feature  at  this  stage  is  a  silly  boast- 
fulness,  manifesting  itself  in  boyish  claims  of 
superior  qualifications  for  almost  every  and  any 
position  in  life.  I  had  an  insurance  agent  who 
claimed  to  be  the  finest  barber  and  physician  in 
the  world,  and  it  was  with  great  difficulty  that 
his  family  prevented  his  fitting  up  a  fine  barber 
shop.  He  claimed  that  he  could  take  out  an 
eye  and  place  it  in  the  back  of  the  head,  so  one 
could  see  both  wa}s.  A  book  agent  told  his 
wife  that  he  was  the  greatest  prize  fighter  of  the 
age,  and  was  very  angry  because  she  would  not 
permit  him  to  publicly  challenge  Corbettt  Two 
physicians  called  upon  a  brother  physician  in  a 
neighboring  town,  and  left  him  in  thorough  dis- 
gust, vowing  they  would  never  speak  to  him 
again.  He  told  them  his  horse  could  go  a  mile 
in  thirty  seconds,  and  that  he  was  the  greatest 
living  physician,  having  just  diecovered  a  sim- 
ple remedy  which  was  a  specific  for  every  known 
disease.  Two  months  later  this  man  was  sent 
to  the  hospital,  and  soon  after  died. 

In  most  cases  of  paresis  the  diagnosis  is  easy. 
The  principal  symptoms  to  bear  in  mind  are 


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THB  MEDICAL  WORLD. 


delusions  of  grandeur,  difficulty  in  speaking 
certain  words,  and  the  peculiar  walk.  All  pa- 
retics believe  that  they  are  immensely  wealthy, 
are  enjoying  the  best  of  health,  and  are  going 
to  do  sometibing  wonderful  and  impossible.  If 
I  had  all  the  money  that  had  been  promised  me 
by  these  people,  the  combined  wealth  of  all  the 
rich  people  in  the  world  would  be  but  as  a  drop 
in  the  bucket  in  comparison.  One  patient  made 
me  a  present  regularly  every  morning  of  a  check 
for  ten  thousand  dollars,  good  on  any  bank  or 
post-office  in  the  world.  Another  tells  me  that 
he  has  a*  large  block  in  the  city  full  of  money, 
and  that  I  can  help  myself  whenever  I  choose. 
Another  asked  me  to  let  him  have  my  keys,  so 
he  could  get  out  When  I  told  him  I  would 
be  discharged  if  I  did  so,  he  became  very  angry, 
telling  me  I  was  the  boss  fool  of  the  age. 
"  Why,'*  he  said,  "I  will  give  you  more  money 
than  you  can  make  here  in  a  lifetime." 

The  difficulty  in  speech  consists  in  mixing'the 
consonants,  using  b  for  p,  t  for  d,  and  m  for  n.  A 
paretic  cannot  say  "  truly  rural,"  or  "  Per^rine 
Pickle."  In  fact,  these  words  are  the  routine 
test  for  paresis.  Another  is,  to  see  if  he  can 
recognize  pepper  by  the  sense  of  taste.  A  pa- 
retic has  a  peculiar  rolling  walk,  caused  by  put- 
ting his  feet  far  apart  in  walking.  If  you  have 
ever  seen  a  person  walk  on  boaid  ship  you  have 
it  exactly. 

If  you  once  see  a  paretic  walk,  you  can  never 
forget  this  symptom.  Another  symptom  is  the 
epileptiform  seizures.  Nearly  all  paretics  have 
convulsions  resembling  epilepsy,  and  usually  die 
in  one  of  these  convulsions. 

The  cause  of  paresis  is  still  an  unsettled  ques- 
tion. In  my  own  experience,  syphilis  is  the 
cause  in  a  majority  of  cases.  It  is  very  difficult 
to  get  the  history  in  these  cases.  When  you 
see  a  paretic  who  has  been  a  commercial  trav- 
eler, a  fast  horse  man  or  a  railroader,  it  is  not 
necessary  to  have  a  sworn  statement  from  a 
physician  that  he  has  treated  the  patient  for 
syphilis. 

There  is  no  treatment  for  paresis,  as  far  as  a 
cure  is  concerned.  The  case  will  move  along, 
gradually  growing  worse,  and  the  patient  will 
eventually  die,  regardless  of  the  most  heroic 
treatment.  I  have  had  the  best  success  in  pro- 
longing life  and  ameliorating  the  symptoms  with 
the  iodides.  If  you  have  a  case,  I  would  advise 
the  iodide  treatment,  for  your  patient  may  have 
a  lucid  interval,  and  you  will  receive  great 
credit  for  your  skillful  treatment.  I  have  a 
patient  now  who  has  been  out  on  a  visit  for  six 
months.  His  wife  thinks  he  is  entirely  recov- 
ered, but  he  is  not — simply  a  ludd  interval,  and 
it  is  only  a  question  of  time  when  he  will  return. 


One  patient,  a  physician,  had  a  lucid  interval 
lasting  two  years,  and  practiced  his  profession 
during  a  part  of  the  time.  He  came  ba(^ 
however,  and  died  here.  A  hypodermic  injec- 
tion of  Conine,  gr.  yj-^,  will  usually  stop  the 
convulsions  for  the  time  being.  Sometimes  there 
is  hemiplegia  after  a  convulsion,  which  passes 
away  without  treatment  The  average  dura- 
tion of  a  case  of  paresis  is  from  six  months  to 
three  years. 

No.  9465  was  admitted  June  6,  1893 ;  age 
45,  married ;  nativity,  Indiana ;  height,  5  feet 
8  inches ;  weight,  154 ;  occupation,  horse  dealer; 
nervous,  not  hereditary ;  no  history  of  syphilis. 
For  the  past  year  he  has  been  very  busy,  irregu- 
lar in  habits,  traveled  much,  dissipated,  kept  a 
woman  who  practiced  the  French  method  on 
him.  Has  had  four  wives,  from  three  of  whom 
he  is  divorced.  Lately  very  sociable,  and 
always  ready  for  a  lark.  Has  jcnned  several 
secret  orders,  and  takes  great  interest  in  the 
meetings.  Qave  one  order  a  banquet  at  his 
own  expense.  Indulged  in  excesses  of  all  kinds. 
Made  many  expensive  presents  to  casual  ac- 
quaintances. Had  a  slight  attach  of  hemiple- 
gia. Was  arrested  for  trying  to  demolish  the 
furniture  in  a  bawdy-house.  Had  on  several 
occasions  constructed  a  system  of  weights  and 
pulleys  to  make  horses  trot  fast  (in  truth,  no 
horse  could  walk  with  them  on).  Tiied  to  form 
a  company  to  build  the  finest  race  track  in  the 
world.  When  admitted,  had  delusions  of  great 
wealth.  Said  he  had  just  bought  one  hundred 
fast  horses,  and  had  the  finest  stock  farm  in  the 
world.  Has  made  forty  thousand  dollars  in  the 
last  two  days.  Cannot  say  "truly  rural"  ex- 
cept very  slowly.  Cannot  distinguish  pepper 
by  taste.  Rolling  walk.  Had  his  first  convul- 
sion in  October,  followed  by  slight  hemipl^ia, 
which  soon  passed  away.  Had  five  convulskms 
in  December.     Died  in  September,  1894. 

F.  M.  WnjBS,  M.D., 
Central  Indiana  Hospital  for  Insane, 
Indianapolis,  Ind. 


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Barefooted  Chiidren.— The  Cruelty  of  Shoes  and 
Stookingt. 

Editor  Medical  World: — About  twenty 
years  ago  the  writer  was  traveling  I  through 
Pennsylvania,  and  he  recalls  a  sight  which,  at 
the  time,  caused  his  blood  almost  to  boil  with 
indignation,  such  as  "  S "  seems  to  have  felt 
when  he  saw  a  barefooted  boy,  according  to  the 
February  Medical  World,  in  which  is  a  slip 
on  "Cruelty  to  Children."  At  a  little  railway 
station^  while  waiting  for  my  train^  I  saw  a 
group  consisting  of  a  man,  woman  and  three 
children.  The  children  were  barelegged,  and 
wore  tiny  slippers  and  short  socks,  although  the 
aeaaon  was  fall  and  the  weather  quite  cold.  I 
have  often  wished  of  late  that  I  could  find  that 
man  and  woman,  the  parents,  I  suppose,  of  those 
three  children,  that  I  might  humbly  confess 
myself  an  idiot  for  my  thoughts  at  that  time, 
and  the  expressions  I  used  in  speaking  to  other 
on-lookers,  and  for  neglecting  to  address  them 
personally  with  request  for  their  reasons  for 
what  seemed  to  all  observers  so  strange  and  un- 
hygienic in  their  management  of  their  children. 
I  hope  that  ''S"  has  had  the  advantage  of  Mr. 
Farquar's  explanauon,  and  that  he,  or  she,  has 
already  made  due  apology  for  the  blundering 
judgment,  and,  moreover,  that  he  will  give  his 
own  children  a  fair  chance  to  grow  and  thrive 
naturally,  at  least  up  till  the  age  when  they 
will  naturally  conform  to  what  is  regarded  as 
the  conventionalitiee  of  adult  dress. 

Dr.  Thom's  article  in  The  World  for 
July  is  a  very  significant  contribution  on 
this  subject,  and  £  will  mention  the  case 
of  a  Maryland  physician,  whose  name  and  ad- 
dress I  am  sorry  not  to  be  able  to  give,  whose 
first  three  children  died  of  diphtheria,  after 
brief  lives  in  nice  warm  stockings  and  high 
shoes,  and  whose  next  three  children  died  of 
nothing,  but  lived  healthy,  happy  lives,  bare- 
footed. 

On  one  occasion  the  passengers  on  a  railway 
train  through  Maryland  manifested  a  great  deal 
of  virtuous  indignation  at  the  sight  of  a  ten- 
year-old  lad,  barefooted,  although  his  mother 
and  sister,  who  accompanied  him,  gave  evidence 
of  wealth  and  refinement  The  boy  himself 
was  a  rollicking  fellow,  and  appeared  perfectly 
comfortable,  though  walking  up  and  down  the 
platform  at  every  stop,  and  the  weather  quite 
oold,  even  to  the  point  of  freezing.  A  news- 
paper man  had  the  courage  and  good  sense  to 
interview  the  ladies  on  the  subject  of  the  bo/s 
oueer  drees,  and  elicited  the  story  concerning 
tne  premature  death  of  the  boy's  predecessors, 
who  might  have  been  his  living  brothers  and 
riaters  if  their  had  had  as  fair  a  chance. 

My  own  children — I  refer  to  my  present  fam- 


ily (my  first  three,  and  their  mother,  were  all 
helped  into  the  grave  through*  my  ignorance  of 
the  hygiene  of  clothing,  my  notion  at  that  early 
time  being  that  the  principal  thing  was  to  keep 
them  warm  with  heavy  flannels,  and  thick  stock- 
ings and  heavy  boots ;  and,  moreover,  I  came 
near  following  them  years  ago,  with  my  craze 
for  flannels) — my  three  children  are  now  aged, 
respectively,  four  years,  two  and  a-half,  and  one 
year,  and  they  have  been  barefooted  all  the  year 
round,  and  every  year  since  they  came  to  us, 
except  out  of  doors  in  very  cold  or  muddy 
weather. 

Our  first,  bom  in  June,  1890,  was  kept  very 
comfortable  throughout  the  hot  summer,  and  to 
many  sensible  observers  she  taught  a  lesson  a» 
to  how  to  keep  down  the  death-rate  of  infants 
during  the  heated  term ;  but  I  found  that  my 
views  of  infantile  comfort  could  not  be  carried 
out  without  something  bordering  on  martyrdom 
through  the  tenderheartedness  of  certain  other 
observers,  who  were  shocked  at  our  "cruelty.** 
A  complaint  was  actually  lodged  with  the  agent 
of  the  S.  P.  C.  C,  by  some  good,  ignorant  soul^ 
a  "  lady "  whose  name  we  never  learned,  but 
who  doubtiess  felt  sure  that  she  was  doing  6od'» 
service  in  the  cause  of  little  innocents.  It 
chanced,  however,  that  my  little  book,  "How 
to  Feed  the  Baby,*"  (and  how  to  dress  it  and 
otherwiee  manage  it),  was  dedicated  "to  the 
Society  for  the  Prevention  of  Cruelty  to  Chil- 
dren,'' and  the  complainant  had  to  be  content 
with  Mr.  Fay's  assurance  that  in  case  the  doc- 
tor's litUe  girl  got  frostbitten  during  the  sum- 
mer, he,  the  cruel  parent,,  should  be  taken, 
care  of  I 

Since  then  two  others  have  come  to  be  bro* 
'thers  to  that  little  girl,  and  all  are  in  splendid 
health,  while  more  than  eight  thousand  other 
little  ones,  bom  within  that  time  in  this  city^ 
have  been  well-shod  and  stoekinged  and  flan<^ 
nelled,  and  have  died  under  five  years  of  age. 
I  might  add  that  these  little  unfortunates  were 
also  "well-fed,"  as  ours  have  not  been  (!), 
since  we  take  as  much  pains  to  keep  food  out  of 
them,  upon  occasion,  as  to  supply  it  when  needed ; 
and  that  is  another  point  upon  which  good  peo~ 
pie  difier.  With  too  many  the  one  single 
thought  seems  to  be  to  see  how  much  their  cMl- 
dren  can  be  got  to  swallow,  and  little  thought 
given  as  to  possible  digestion  and  assimilation. 

In  warm  weather  we  should  strive  to  keep 
the  children  cool,  and  it  is  simply  stupid  to  scold 
about  the  heat,  and  impious  to  pray  for  a  cool 
wave,  while  putting  on  to  the  children  a  single 
thickness,  of  even  cotton,  more  than  the  law  de- 
mands for  decency,  when  they  are  on  the  street, 
or  on  exhibition  before  a  mixed  company ;  and 
even  then,  when  the  company  is  composed  o£: 


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406 


THE  MEDICAL  WORLD. 


really  high  miDded  and  sympathetic  friends,  an 
absolutely  naked  babe  is  regarded  as  the  very 
essence  of  sweetness  and  beauty.  Only  the  pru- 
ritnt  prude  ceuld  imagine  anything  indecent 
about  it.  In  winter,  with  living  rooms  at  70** 
F.,  we  are  in  summer  weather,  or  at  least  that 
is  about  the  temperature  we  would  like,  and  the 
less  dothing  worn  by  old  or  young,  the  better 
they  will  be  off.  "  Winter  flannels''  have  no 
function  indoors  in  warm  rooms,  except  to  smo- 
ther the  skin  and  make  a  sort  of  molly-coddle 
of  a  person,  and  make  him  feel  the  cold  more 
when  he  goes  out  into  it  I  have  taught  scores 
^f  the  most  particular  sort  of  men  to  abandon 
the  use  of  underwear,  on  the  score  of  the  nasti- 
ness  of  this  inner  suit,  prevtenting  the  free  ingress 
of  f^h  air  needed  to  disinfect  the  foul  elimina- 
tions of  the  skin.  Enough  fresh  air  will  disin- 
fect the  contents  of  a  privy  vault  thrown  upon 
the  lawn,  in  time;  but  with  ordmary  flannels 
the  skin  is  compelled  to  breathe  sewer-gas,  so  to 
say,  and  extra  labor  is  put  upon  the  lungs  and 
other  excretory  organs.  Having  been  free  from 
under  garments  for  several  years  (since  1880, 
in  fact),  winter  and  summer,  I  find  that  I  am 
not  at  all  fussy  about  wearing  an  overcoat  in 
winter,  except  on  extremely  cold  days,  and  even 
then  I  am  certain  that  I  shall  not  ''  catch  cold  " 
if  I  dispense  with  it  upon  occasion,  even  if  I 
ehiver  for  want  of  ft 

And  by  all  the  laws  of  consumption,  taking 
heredity,  and  my  condition  not  many  years  ago, 
into  account,  I  ought  to  have  been  dead  with 
that  disease  long  ago ;  whereas  now,  at  fifty- 
four,  I  can  distance  most  of  the  young  men  for 
a  cross-country  run,  long  or  short,  and  this  is 
the  result  of  employing  the  ''roughing  it"  treat- 
ment and  having  done  with  coddling.  This 
rule,  rationally  applied  in  the  care  of  children, 
will  always  work  well.  They  should  be  dressed 
according  to  the  weather,  not  always  according 
to  the  season  of  the  year,  by  rule  of  thumb ;  for 
we  often  have  "  unnaturally  warm  weather  "  in 
winter,  when  the  cold  weather  bundling  is  in- 
sufferable, and  even  barbarous.  The  danger 
from  heat — fe verbis  always  to  be  put  before 
that  from  cold.  ''  Colds,"  themselves,  are  really 
fevers,  losal  or  general,  and  due  to  excess  in 
diet  and  clothing,  as  a  rule.  And  on  this  I 
claim  no  patent,  for  it  has  been  held  as  the 
opinion  of  the  most  learned  men,  durmg  every 
generation  from  that  of  Chrysostom  to  the  pre- 
sent time.  Dr.  fieojamin  Franklin  taught  it. 
(See  «*  Essays,"  p.  '2i6.) 

A  visitor  at  Harwaden  recently  discovered 
and  reported  that  **the  hygienic  treatment  of 
little  Dorothy  Drew,  Gladstone's  grand-daugh- 
ter, extends  so  far  that  she  goes  barefoot  winter 
and  summer,  indoors  and  out,  except  in  the  very 


coldest  and  muddiest  times,  and,  living  on  m 
very  plain  diet,  she  is  irrepressibly  healthy  &nd 
happy." 

If  this  is  good  enough  for  the  family  of  the 
Premier  of  England,  it  is  also  good  enough  for 
John  Smith's  family,  and  since  it  is  not  at  all 
expensive,  but  rather  tends  to  save  the  expense 
of  doctors,  drugs,  funerals,  and  that  sort:  of 
thing,  why  cannot  even  the  plain  people  have 
the  full  benefit  of  it? 

Charles  E   Page,  MD., 

867  Boykton  st.,  Boston,  Mass. 


Points  in  Rabies. 


In  a  private  letter  to  the  Editor,  afler  reading 
the  editorial  in  September  World,  Dr.  Paol 
Gibier,  President  of  the  New  York  Pasteur  In- 
stitute, writes  as  follows : 

<<The  virus  of  hydrophobia  does  not  appear  in 
the  saliva,  as  proved  by  experiment&  before  «x 
to  ten  days  previous  to  the  animal's  showing 
signs  of  the  disease." 

"It  is  a  remarkable  fact  that  in  some  oaaes  the 
dog.  when  commencing  to  be  affected  with  hydro- 
phobia, may  present  a  very  dangerous  symp- 
tom,  viz :  he  becomes  much  more  affectionate 
and  tries  to  caress  and  lick  the  hands  and  face 
of  its  master.  If  this  person  has  an  abrasion 
of  the  skin,  the  licking  may  be  just  as  dangerous 
as  a  bite.  Another  interesting  detail  is  Uie 
paralytic  form  of  the  disease,  or  dumb  rabies, 
which  may  affect  the  dog  from  the  beginning. 
The  animal  will  not  make  any  attempt  to  bite 
anybody  unless  he  is  provoked,  and  he  will  re- 
main motionless  in  a  dark  comer  until  death 
comes." 


For  tlie  Diarrhea  of  Relaxation. 

Editor  Medical  Wori.d  : — In  reply  to  Dr. 
E.  B.  Silver,  in  The  Medical  World  for  Oc- 
tober, page  380,  I  will  say  that  in  his  ease  of 
diarrhea,  if  he  will  give  his  patient  fld.  ext. 
chaparro  amargoso  in  five  drop  doses  before 
meak  and  ten  drops  at  bedtime,  and  also  liquor 
potassii  arsenitis  in  five-drop  doses  after  meals 
and  apply  electricity  over  the  abdomen  and 
spinal  column,  I  think  he  will  notice  an  im- 
provement in  his  patient  ere  long. 

Oak,  Neb.       Chas.  O.  Robinson,  M.D., 


See  page  xxii  for  a  good  chaooe  this  month  to  get 
large  value  for  little  money.  Don't  hesitate  becaoae 
your  subscription  is  not  quite  out.  We  can  credit  jou 
just  as  well  from  the  lime  that  your  present  snbacrip- 
tion  will  expire.  We  would  rather  do  it  now,  for  it 
would  help  to  relieve  the  great  pressure  of  subscrip- 
tions that  always  comes  to  us  in  December. 


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407 


Phenio,  Aoid  for  Pruritus  Vulva. 

Editor  Medical  World:— On  page  868, 
October  World,  Dr.  John  Zenner  gives  U8  an 
exoelleDt  remedy  for  pruritus  vulvae,  and  I  wish 
to  recall  to  <be  minds  of  The  World  readers 
another  which  I  think  is  equally  efficient,  and 
one  that  is  always  close  at  hand ;  being  foun  I  on 
the  shelf  and  in  the  saddle  bags  of  the  country 
praptitioner,  as  well  a)  in  the  medicine  case  of 
our  city  brothers.  I  allude  to.phenic  acid,  used 
as  follows : 

B.   Ad  H  carbolioL « «..Rtte.  xlj 

VMellne  or  lard ouocee  ss  to  J 

M.  Mk  Thoroughly  cleanee  the  partu  with  soap  and  soft 
water,  then  apply  the  ointment  three  or  four  times  daily  and 
at  bed  ime. 

The  patient  will  complain  of  slight  burning 
upon  application,  but  this  subsides  in  a  few  sec- 
onds, leaving  your  patient  perfectly  free  from 
pain  and  itching.  Try  it,  brethren,  and  be  con- 
yinced.  P.  A.  Melick,  M.D., 

Horton,  Mo. 


Maternal  ImpreMions. 


Editor  Medical  World:  —  Dr.  D.  M. 
Koontz,  page  371,  October  World,  cites  a  case 
of  maternal  impres8ion^>-the  father  being  a 
black  smiih. 

The  subject  of  maternal  impressions  has  been 
discussed  Irom  time  to  time  and  is  no  nearer  a 
solution  than  it  wafe  before.  The  first  case  ex- 
cited wonder,  so  will  the  last  one,  because  of  its 
infrequent  occurrence,  in  the  animal  kingdom 
it  is  common' and  dates  back  to  bible  times. 
God  knotrs  the  cause  thereof,  but  we  don't.  I 
don't  think  a  negro  could  have  begotten  that 
kind  ot  a  baby. 

What'is  the  ar'tion  of  potassium  permanganate 
in  morphine  poisoning  or  snake  poisoning? 

Minerva,  O.  Dr.  C.  Mantey. 


Mitarnal  Impressions.— A  Case  of  Poisoning. 

Editor  Medical  World: — While  in  a 
country  store,  1  was  asked  by  the  merchant  to 
go  to  his  house  and  see  his  baby's  face,  which 
had  some  kind  of  an  eruption,  and,  while  there 
to  notice  its  ear  marks.  I  did  eo,  and  at  the 
point  about  equidistant  from  the  top  to  the  lobe 
of  the  ears  the  helix,  for  nearly  or  quite  a  half 
inch,  was  gone  &5  ir  it  had  been  done  purposely 
from  both  ears.  After  I  returned  to  the  store 
the  father  told  me  that  he  had  a  young  sow  that 
was  trying  to  give  birth  to  her  pigs  and  could 
not ;  he  remarked  to  the  mail  carrier  about  it 
who  told  him  t  >  cut  a  pretty  good  notch  out  of 
both  ears  of  the  sow  and  bleed  her  pretty  freely 
and  she  could  pig  all  right  Me  did  so  and 
went  to  the  house  and  told  his  wife.  She  went 
to  the  pen  to  see  what  had  been  done  to  the 


little  sow's  ears.  This  was  during  the  early 
part  of  the  woman's  pregnancy.  Whether  or 
not  cropping  the  sow's  ears  had  anything  to  do 
with  marking  the  baby  I  will  leave  the  reader 
to  judge. 

WHAT   KIND   OF   POISONING   WAS   ItT 

Some  time  ago,  I  was  called  hurriedly  to  see 
a  man  that  was  said  to  be  very  sick.  Before 
reaching  the  house,  which  was  iour  miles  away, 
I  met  the  same  messenger  asking  me  to  hurry, 
as  the  man  was  cold  and  blue.  I  (aid  to  my- 
self, '  He  has  congestion." 

History. — He  leit  home  in  the  morning  after 
eating  breaktast,  about  five  o'clock,  feeling  in 
his  usual  health.  About  nine  o'clock  he  com- 
menced vomiting,  and  soon  his  bowels  com- 
menced to  act  Vomiting  and  purging  contin- 
ued. After  a  while  cramping  of  muscles  came 
on  and  continued  up  to  the  time  I  saw  him,  at 
three  o'clock  in  the  afternoon.  I  found  him 
pulseless,  almost  speechless  and  resf)iration» 
shallow,  very  restless;  »kin  was  bathed  in  a 
cold  sweat ;  surface  was  blue.  He  had  intense 
thrist ;  had  vomited  blood  a  few  times ;  said  he 
could  not  see  anything.  I  gave  him  20  drops 
of  laudanum,  5  graius  of  qiinine  sulph.,  in 
about  2  ounces  of  whiskey,  bathed  the  whole 
surface  with  red  pepper  tea  and  used  frictions 
with  the  bare  hand.  In  the  course  of  an  hour 
things  had  changed  fur  the  better  and  in  two 
hours  he  was  in  very  good  shape.  I  continued 
him  on  laudanum,  bismuth  and  leai  1  left 
him  at  five  o'doclc,  but  had  scarcely  got  home 
when  a  messenger  said  that  my  patient's  brother 
that  I  had  just  left  was  sick  and  wanted  me  to 
go  and  see  him,  as  he  was  the  same  as  his 
brother,  vomiting  and  purging  and  cramping. 
I  found  him  cramping  most  furiously.  WiSi 
the  sari  e  treatment  that  I  gave  the  first  one  I 
quieted  all  the  symptoms  except  the  cramping^ 
of  the  muscles;  these  would  return  when  the 
laudanum  would  give  out  While  I  wa8  work- 
ing with  this  patient,  I  was  called  into  another 
room  to  see  a  liitle  girl  that  was  vomiting  and 
purging  the  same  as  the  others.  A  good  large 
dose  of  tr.  opiL  put  her  to  bed  and  I  beard  noth- 
ing from  her  until  morning,  when  she  was  not 
feeling  exactly  well,'  but  1  went  home  and  never 
heard  anything  more  from  \  er  than  that  she 
got  along  all  right  The  family  procured  8'>me 
beef  on  Fridav.  The  last  of  it  was  cooked  for 
breakfast  on  Monday  morning,  which  was  eaten 
at  about  five  o'clock.  The  first  patient  took 
si  k  about  liine  o'clock,  four  hours  alter  eating 
his  breakfast ;  the  others  of  bis  family  eating 
the  remainder  of  the  beet  for  dinner,  at  twelve 
o'clock.  The  second  one  took  sick  about  ^ve  in 
the  evening,  and  the  third  one  a  couple  of  houn 


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THB  MBDICAI.  WORLD. 


later.  They  had  no  arsenic  or  antimony  about 
ihe  house. 

Could  this  beef  have  become  tainted  so  as  to 
produce  such  a  chain  of  symptoms  ?  Some  of 
the  symptoms  simulated  arsenic  and  antimony 
poisoning.  I  would  like  to  know  what  all  these 
bad  symptoms  originated  from.  I  stayed  with 
my  patients  about  eighteen  hours  and  left  them 
in  very  good  shape  and  comfortable,  when  I 
left  to  to  see  some  other  patients  and  go  home, 
when  some  outside  meddling  was  done  and  I 
was  supplanted  by  a  homeopath,  and  was  told 
by  parties  that  went  there  to  help  nurse  that 
the  second  one  that  was  taken  had  c(mvulsions 
and  most  furious  crampings  of  the  muscles. 

Lone  Jack,  Mo.  R.  P.  Eoons,  M.D., 

The  Color  of  Negro  Children  at   Birth.— For 
Abdominal  Pain. 

Editor  Medical  World  : — In  reply  to  Dr. 
Koontz,  October  World,  page  371,  I  would 
«ay  that  in  my  obstetric  practice  the  scrotum  in 
new  bom  infants  of  African  descent  was  always 
black,  otherwise  they  were  just  like  white  babies. 
Now  will  some  one  tell  us  how  to  distinguish 
the  new  born  female  infants  of  colored  people 
from  the  Caucasian. 

Dr.  Vidal's  case,  page  379.  Best  in  horizon- 
tal position  and  camphor  in  some  form. 

R.  PU  opU.. gr.  i 

Camph ^ « grr.lj 

or  chloroform  internally,  the  sheet  anchor  in 

abdominal  pains.     A  good  formula  is  chloro- 

dyne  in  dram  i  doses.     There  is  generally  more 

or  less  gastric  disturbance  at  time  of  menses. 

The  following  formula 

R.    Tr.  nnx  vomica. ».minlms  x 

OU  cloves minims  IJ 

Spt.  chloroform minims  xxz 

French  Brandy draml 

This  amount  after  meals  for  a  few  days.  For 
Anemia,  elixir  of  iron,  calisaya  and  strychnine. 
If  the  above  will  not  cure,  dilate  the  cervix. 

Luisdale,  Pa.  Dr.  Annetta  Eicatz. 

Monstrosity.— Epidemic  of  Carbuncle. 
Editor  Medical  World: — Seeing  reports  of 
monstrositiee  in  The  World,  I  will  report  one 
I  saw  in  the  summer  of  1887.  Dr.  Campbell 
was  the  attending  physician,  and  through  him  I 
was  persuaded  to  give  fifteen  cents  to  see  the 
curiosity.  Male,  bom  May  1887  in  Logan, 
O.,  no  legs ;  at  the  acetabulum  it  looked  as  if 
there  had  been  an  amputation,  only  much  nicer 
than  human  hands  could  do.  The  lower  end  of 
trunk  was  the  shape  of  the  smallest  end  of  an 
egg.  The  right  arm  off  midway  between  the  el- 
Imw  and  shoulder,  much  nicer  stump  than  any 
surgeon  could  leave.  Left  arm  was  perfect 
only  the  hand  had  but  the  stump  and  index  fin- 
ger. The  child  was  bright  and  in  every  other 
way  perfect    The  parents  were  poor  and  started 


out  to  make  their  fortune  with  the  babe,  when  it 
took  the  whooping  cough  and  died  somewhere 
in  the  Northeast 

September  3,  J.  B.,  aged  15,  came  to  the 
oflSce  with  quite  a  swelling  in  the  right  angle  of 
his  mouth  ;  four  days  later  I  saw  him  again, 
and  found  a  malignant  carbuncle,  which  ex- 
tended from  the  lips  to  the  angle  of  the  jaw. 
A  few  days  later  it  opened  in  three  places  on  the 
inside.     In  two  weeks  it  was  well. 

September  5th,  Mrs.  M.,  aged  22,  came  to 
the  office  with  a  swelling  on  the  upper  lip, 
which  she  thought  was  caused  from  toothache. 
On  examination  I  found  it  to  be  a  carbuncle 
Four  days  afterwards  it  broke  in  two  places  and 
did  not  heal  up  entirely  for  two  weeks. 

September  6th,  Mrs.  C,  aged  36,  reported  at 
the  office  with  a  large  swellmg  on  her  face  just 
in  front  of  the  angle  of  the  jaw,  right  side.  On 
examination  I  found  it  to  be  a  carbuncle.  A 
few  days  later  it  broke  in  three  places  on  the 
inside  and  in  two  weeks  was  well. 

September  10th,  Mrs.  S.,  aged  56,  came  to 
the  office  with  a  swelling  of  the  middle  finger. 
On  closely  examining  it  I  found  it  to  be  a  car- 
buncle. Three  days  later  she  came  to  the  (rf*- 
fioe.  The  finger  was  swollen  from  the  tip  to 
the  metacarpophalangeal  articulation  so  tight 
and  caused  so  much  pain  that  I  decided  to  open 
it,  which  I  did  on  the  palmer  surface  of  the  sec- 
ond phalanx.  Only  a  very  small  amount  of 
pus  with  blood  came  out  A  few  days  later  it 
opened  in  two  other  places,  viz :  on  tiie  palmer 
surface  ot  the  last  and  first  phalanges.  I  saw  it 
to-day,  October  5th,  and  it  is  still  suppurating 
and  looks  as  if  the  entire  muscular  tissue  would 
slough  away. 

October  3,  Mr.  R.  sent  for  me  to  come  into 
the  country  three  miles  quickly,  as  his  son,  aged 
20,  was  dying.  On  seeing  the  boy  I  found  Urn 
with  an  upper  lip  the  size  of  six  ordinary  lips. 
They  told  me  his  lip  had  been  swelling  for 
about  five  days.  The  boy  had  such  severe  pains 
that  I  suppose  he  fainted,  as  he  was  rational 
when  I  arrived.  I  have  not  seen  or  heard  from 
him  since.  The  treatment  was  only  quinine 
with  hot  poultices  to  the  part.  One  peculiarity 
about  these  is  that  all  were  on  the  right  side,  and 
each  one  in  a  peculiar  place.  Some  may  doubt 
the  diagnosis,  but  I  say  if  ever  there  was  a  car- 
buncle these  were.  Ashhurst  says  that  carbon- 
cles  rarely  come  excepting  on  the  back  of  the 
neck  or  the  shoulder  blades,  but  he  has  seen 
them  on  the  face  and  upper  lip ;  when  on  the 
the  face  or  upper  lip  they  are  very  serious  and 
often  prove  fatal.  Erichsen  says  the  same,  ex- 
cepting that  he  has  seen  them  on  the  abdomen 
and  on  the  arm.  T.  R.  Masok,  M.D., 

Sugar  Grove,  O. 


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THB  MBDICAi  WORLD. 


409 


That  Boycott, 

AsHYiLLE,  N.  C,  Sept.  9.—The  American 
PharmaotfQtical  Association  to-day  voted  to 
boycott  numufactnrers  who  furnish  physi- 
cians with  their  manufactured  products  for 
use  in  dispensary  prescriptions.  It  is  claimed 
hy  the  druggists  tiiat  year  by  year  the  doc- 
tors^ are  getting  more  and  more  into  the 
habit  of  filling  their  own  prescriptions  and  ' 
xiispensing  drugs  from  their  offices,  greatly  to 
the  detriment  of  the  prescription  business  of 
the  drug  stores.  The  resolution  authorizing 
the  boycott  was  the  work  of  Professor  Whit- 
ney, of  Boston,  and  was  adopted  without  di»- 
fient 

Editor  Medical  World  : — The  above  clip- 
ping from  the  daily  Chicago  Inter-  Ocean  shows 
which  way  the  wind  is  blowing,  and  the  a<;tion 
of  the  American  Pharmaceutical  Association 
«hoald  be  carefully  noted  by  physicians. 

Wholesale  druggists  and  manufacturers  who 
will  sell  direct  to  phyncians  at  the  same  prices 
as  they  sell  druggists  should  receive  our  patron- 
age and  encouragement,  while  those  who  will 
not  do  so  should  be  most  carefully  avoided. 

The  above  challenge,  thrown  down  by  the 
A  P.  A.,  should  be  taken  up  by  the  physicians 
of  the  country  and  most  thoroughly  discussed. 
It  is  becoming  more  and  more  apparent,  as  the 
years  come  and  go,  that  physicians  will  eventu- 
ally be  compelled  to  dispense  their  own  medi- 
dnes  entirely,  and  hence  we  are  interested  in 
Ae  outcome  of  this  question. 

Brethren,  let  us  hear  from  you  through  the 
<x>lumn8  of  The  World. 

Ldsbon,  la.  K  Burd,  M.D., 


Aikaioidal  Notes. 


Editor  Medical  World: — I  have  just 
spent  an  evening  with  The  Medical  World, 
in  which  I  see  numerous  valuable  articles  from 
old  friends,  to  say  nothing  of  others  from  those 
whose  names  are  less  often  seen.  Among  these 
last  I  wish  particularly  to  mention  the  letter 
from  Dr.  F.  L.  Rose,  so  graphically  describing 
a  case  of  rabies.  In  vividness  of  description, 
and  clearness,  aptness  and  force  of  expression, 
I  look  upon  this  as  one  of  the  best  It  should 
be  widely  quoted  as  a  word-picture  of  this  dread 
(but  fortunately  rare)  disease.  I  never  saw 
one,  and  sincerely  hope  I  never  shall. 

It  makes  me  thrill  with  a  degree  of  pleasure 
never  experienced  except  by  one  who  has  worked 
long  and  patiently,  to  secure  the  recognition  of 
«ome  great  truth,  and  see  the  same  gradually 
gaining  ground  ;  to  see  how  often  the  granule 
and  tablet  of  the  active  principle  is  being  men- 
tioned in  your  pages.  It  is  an  omen  dear  to  me, 
and  all  others  who  have  worked  with  me  along 
this  line. 


As  I  have  read  your  pages  I  have  noted 
many  points  on  which  I  would  like  to  write,  but 
it  is  so  hard  to  stop  when  I  talk  to  the  World 
brotherhood,  that  my  space  is  filled  before  I 
have  hardly  begun. 

Dr.  RufPs  suggestion,  page  359,  of  washing 
an  eczematous  patient  with  a  saturated  solution 
of  epeom  salts,  is  new  to  me.  I  have  long 
looked  upon  its  internal  use  as  my  sheet  anchor 
(using  it  in  effervescent  form^  known  as  "  Seid- 
litz  Salt"),  but  this  method  is  novel,  and,  no 
doubt,  a  valuable  suggestion.  This  salt  enters 
largely  into  complexion  lotions,  and,  if  good 
there,  why  not  as  Dr.  Ruff  suggests?  I  2iall 
try  it  at  the  first  opportunity. 

He  also  mentions  sulphide  of  calcium  for 
croup.  There  you  set  me  going  again,  Doctor, 
for  that  is  a  pet  of  mine.  Early  in  the  year  I 
reported  several  cases,  either  to  The  Medical 
World  or  in  the  Allcahidal  Clinic  It  must 
be  pushed  hard,  and  supported  with  vital  in- 
citants. 

In  connection  with  this  let  me  say,  don't  for- 
get calcium  sulphide  when  treating  eruptive 
conditions,  acute  or  chronia  I  have  just  had 
the  satisfaction  of  saving  a  life  with  this  drug, 
properly  supported.  It  was  a  case  of  septicemia, 
following  vaccination.  When  the  child  came 
into  my  hands  she  was  anemic,  emaciated,  and 
averaged  a  pustule  for  every  square  inch  of 
body.  These  had  existed  in  successive  crops 
for  nearly  six  months.  She  is  now  ruddy,  in 
good  flesh,  and  the  sores  nearly  all  well.  Time, 
six  weeks. 

I  want  to  thank  Dr.  Styles,  page  376,  for  his 
support  of  my  position  on  the  alcohol  question. 
We  shall  have  more  company.  Dr.  Styles,  by- 
and-by,  and  then  there  will  be  leas  drunkard- 
making  pharmacy  and  practice.  Dr.  Styles 
also  speaks  of  the  knee  chest  position  for  cor- 
recting mal-presentations.  Good!  I  recall 
having  a  patient  in  this  position  to  replace  a 
prolapsed  cord  and  applying  the  forceps  without 
change.  I  never  did  it  so  eajuly.  Try  it  some- 
time, friends.     It  will  surprise  you. 

One  word  more  to  all  the  brotherhood.  Don't 
fail  to  contribute  your  experience  to  current 
medical  literature.  The  busiest  men  often 
write  the  most.  We  know  of  no  better  educator 
than  putting  one's  thoughts  on  paper. 

W.  C.  Abbott,  M.D., 

Bavenswood,  Chicago,  111. 


Editor  MsDioAL  World  : — I  have  been  a  reader 
of  the  many  good  things  in  Thb  World  for  eight 
years,  and  it  im  the  only  one  of  my  journals  that  I 
have  kept  r^g^olarly  boond  to  have  in  my  library. 

Waterloo,  Wis.  O.  C.  Bailst,  M.D. 


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410 


THB  MBDICAI.  WORLD. 


Eleotrloity. 

Editor  Medical  World  : — Electricily,  when 
in  the  hands  of  an  intelligent  manipulator,  ifl  as 
docile  and  tractable  as  clay  when  in  the  hands 
of  the  potter  ;  but  it  U  delusive,  unwieldy  and 
dangerous  when  in  the  hatds  of  the  ignorant 

As  a  therapeutic  agent  it  has  no  equal,  but 
electro- medical  science  is  handicapped  by  a 
number  of  ii^ould  be  authorities  on  the  subject, 
who  are  endeavoriug  to  mislead  the  students  by 
recommending  them  to  procure  apparatus  that 
is  not  suitable  for  their  work,  by  advising 
methods  of  procedure  that  they  have  never 
t  tried,  nor  can  they  give  any  good  authority  for 
their  recommendation,  and  the  result  is  when 
such  authorities  are  consulted  failure  is  sure, 
ot  the  failures  exceed  by  far  the  successes. 

I  will  not  attempt  to  offer  correction  to  the 
numerous  errors  that  have  been  published  on 
this  subject,  but  I  do  desire  to  call  the  reader's 
attintion  to  the  main  points  that  are  essential, 
and  that  we  may  more  readily  become  master 
of  the  situation  and  conditions  and  ignore  all 
positive  recommendations  of  electrical  dosage. 

We  know  that  certain  physiological  effects 
are  produced  under  certain  conditions,  the  effect 
alwajs  varying  with  the  conditions,  and  it  is 
almo>t  impossible  to  find  three  per  cent,  of  the 
oonditioDS  alike,  and  dissimilar  effects  should 
always  be  expected. 

We  are  told  that  there  is  no  interpolar  action 
when  electricity  is  applied  to  the  body ;  and 
yet  if  we  pass  a  medicaiiou  of  any  kind  by  the 
cataphoric  process  into  the  body,  we  find  the 
medicine  diverging  from  the  anelectrotonic  zone 
and  again  converging  at  the  catelectrotonic 
zone,  if  it  be  chemically  negative,  and  we  find 
less  of  the  chemical  at  the  positive  or  anelectro- 
tonic zoue  than  at  the  other,  but  w^  will  find 
traces  of  the  mediciue  in  the  di  ection  or  path 
traversed  by  the  current  Yet,  in  spite  of  this 
phenomenon,  our  authorities  say  that  we  have 
no  inter  polar  action.  They  also  tell  us  that  a 
Farad ic  coil  produces  a  to  and  fro  current, 
which  meat  s  that  it  has  no  polarity,  in  spite  of 
the  fact  that  when  the  terminals  are  placed  in  a 
solution  of  iodide  of  potassium  we  prove  dis* 
tinctly  that  one  pole  shows  the  usual  brown  de- 
posit while  the  other  one  is  free  from  such 
discoloration. 

As  electro-medical  science  is  only  in  its  in- 
fimcy,  I  would  caution  the  reader  to  adopt 
information  given  by  others  with  great  caution, 
as  it  is  not  alwa}  s  reliable. 

1  would  advise  the  beginner  to  learn  the 
sden  ^  of  electro  physiology  thor  »ughly,  eh  ctro- 
medical  units,  eUctro- physics,  and,  after  this 
knowledge  is  obtained,  to  administer  electrical 
dosage  aocordmg  to  his  own  judgment,  and  he 


will  soon  learn  the  proper  current  for  the 
various  conditions  as  they  present  themaelveB^ 
and  he  will  be  able  to  use  it  more  intelligently 
and  with  better  success  than  if  some  would-be 
authority  on  this  subject  was  searched  for  infor- 
mation. 

I  will  also  say  a  few  words  in  r^ard  to  the 
best  apparatus  for  our  work.  I  would  advise 
the  intending  purchaser  to  procure  a  cell  that 
will  give  the  largest  volume  of  current  with  the 
least  possible  chance  of  getting  out  of  order. 
For  an  office  battery  I  would '  recommend  the 
diamond  carbon,  the  Laclede,  or  any  such  type 
of  cell  that  has  the  negative  element  made  out 
of  retort  ooke  ;  but  not  one  with  the  interven- 
ing porous  cup,  as  it  cuts  down  the  volume  doe 
to  the  resistence  of  the  cup. 

The  next  thing  to  be  considered  is  our  switch 
board.  What  should  we  have  on  it?  This 
question  we  must  answer  by  oomuliing  oar 
pocket  book.  It  is  best  for  us  to  buy  a  good 
one,  that  we  may  be  done  buying  so  far  as  the 
switch  board  is  concerned,  but  we  must  have 
on  it  a  galvanic  circle  with  a  cell  selector  switch. 
We  should  have  a  button  for  each  cell,  but  we 
could  get  along  without  serious  injury  to  the 
battery  with  one  button  for  each  two  cells.  A 
milliamperemeter  should  be  used,  as  it  guides 
us  in  all  of  our  applications,  besides  being  a 
tell  tale  for  our  batteries.  We  should  also  have 
two  proportionate  coils,,  that  is,  one  coil  mad^ 
of  coarse  wire  and  the  other  with  fine  wire,  and 
two  vibrators,  one  for  slow  interruptions,  and 
the  other  ghould  be  a  high  tension  vibrator. 
This  is  the  least  number  of  parts  that  should  be 
on  our  switch  board.  We  could  add  with  ad- 
vantage a  coil  rheostat  and  a  galvanic  inter- 
ruptir.  With  such  a  switch  board,  it  is  aU 
that  should  be  desired.  Forty  cells  is  the  num- 
ber most  desirable.  With  this  number  attached 
to  such  a  plite  as  described,  electro  therapeutics 
can  be  scientifically  practiced. 

If  we  desire  a  portable  bittery,  I  recommend 
the  bichromate  of  potash.  While  it  is  a  con- 
stant sorce  of  annoyance  yet  with  a  little  trouble 
on  our  part  in  looking  afcer  it  occasionally,  we 
can  keep  it  in  good  order.  This  battery,  as  made 
by  most  of  the  mstrument  makers,  gives  about 
2  volt  amperes,  and  if  we  would  make  a  note 
of  the  following  facts,  much  trouble  and  annoy- 
ance would  be  saved :  Put  in  new  solution  after 
using  25  times ;  never  allow  the  battery  to  have 
over  three  days  rest  without  use ;  never  allow 
the  crystals  to  accumulate  by  evaporation  of 
your  liquid ;  if  the  battery  has  been  resting  for 
a  week  or  longer,  clean  the  zincs  with  a  solu- 
tion of  sulphuric  acid  and  water,  1  of  acid  to  7 
of  water  :  be  sure  that  your  battery  fluid  con- 
tains sulphate  of  mercury.     I  think  an  18  oell 


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411 


galvanic  is  sufficient  for  a  portable  battery.  As 
tor  a  Faradic  battery  I  would  prefer  a  plate 
made  with  two  coils  on4t,  built  proportionately. 
In  regard  to  a  proportionate  coil,  I  will  say 
that  its  construction  is  made  upon  the  following 
principle  or  laws  gosrernin^  induction. 

(1)  Xhe  application  of  a  simple  periodic  im- 
pressed electromotive  force  produces  a  simple 
periodic  current,  moving  under  an  effective 
electromotive  force  of  self  induction,  which 
causes  the  primary  current  to  lag  behind,  by 
an  angle  of  lag. 

(2)  The  field  around  the  primary,  and  there- 
fore the  induction  through  the  secondary,  is  ii^ 
consonance  with  the  primary  current,  and  the 
impressed  electromotive  force  in  the  secondary 
is  in  quadrature  with  the  primary  current 

In  other  words  a  periodic  current  is  set  up  in 
the  primary  circuit,  which,  though  of  the  same 
time  or  duration,  the  impressed  electromotive 
force  differs  from  it  in  phase. 

A  wave  of  counter  force  is  produced  in  the 
primary  circuit  by  the  inductive  action,  which 
does  not  coincide  with  the  impressed  electromo- 
tive force,  nor  with  the  primary  curr^t. 

A  wave  of  magnetism  is  produced  in  the  iron 
core  which  lags  behind,  in  quadrature,  with  the 
primary  current,  or  what  is  known  as  40  de- 
grees of  phase. 

The  maximum  magnetization  of  an  iron  body 
without  molecular  strain  is  equal  to  32,000  lines 
of  magnetic  force.  But  molecular  strain  can  be 
accomplished  with  20,000  lines  of  magnetic 
force  in  close  grained  iron  by  interrupting  the 
producing  power.  In  the  Faradic  coil  we  ha7e 
a  variable  magnetic  force  of  from  5  000  to 
20,000  lines,  according  to  the  quality  of  iron 
core.  In  hard  iron  more  coercive  force  is  re- 
<|uired  than  soft  iron,  to  produce  molecular 
change  in  it ;  therefore  sjfc  iron  is  preferable 
for  such  purposes. 

If  we  have  a  lag  of  90  degrees  in  our  iron 
core  so  we  should  have  the  game  lag  in  all  our 
currents,  to  produce  the  proportionate  currents 
and  to  prevent  molecular  strain  in  any  part  of 
our  coils.  This  can  only  be  accomplished  by 
making  the  primary  coil  proportioaate  to  the 
iron  core,  and  the  secondary  coil  proportionate 
to  the  primary. 

After  deciding  on  the  size  of  wire  to  be  used 
as  a  primary  coil,  we  then  select  a  wire  eight 
Qombers  finer  (American  guage)  and  ten  times 
the  length  of  our  primary. 

The  advantage  of  this  style  of  coils  over  the 
Che  long  wire  coils  and  the  old  fashioned  or  mi- 
raculous Faradic  batteries  are  that  it  gives  us  a 
coil  built  upon  scientific  principles,  capable  of 
giring  us  the  greater  volume  of  electricity 
without  any  strain  in  any  part  of  it.     Volume 


being  the  curative  part  of  this  wonderful  agent, 
it  is  certainlf  preferable  to  the  practitioner. 

When  we  make  our  coils  out  of  proportion 
we  have  a  loss  or  an  apparent  gain  of  current 
strength.  If  the  length  of  secondary  be  in- 
creased, we  add  resistance,  which  uses  up  the 
volume  of  current,  and  by  increasing  the  num- 
ber of  ampere  turns  we  increase  its  pressure  or 
voltage,  thereby  having  an  apfwrent  increase  of 
current  strength,  but  wiping  out  the  most  essen- 
tial part  of  the  t^lectrical  current 

In  Faradization  electrolytic  action  is  pro- 
duced, the  large  wire  coil  being  more  marked 
than  the  finer  one,  but  not  as  distinct  as  from 
the  cell  direct 

The  high  tension  vibrator  is  a  ribbon  fastened 
at  both  ends,  and  is  capabh  of  producing 
50  000  pulsations  per  minute.  This  vibrator, 
when  connected  with  a  suitable  coil,  is  capable 
of  producing  local  anesthesia,  and  has  a  great 
sedative  effect  on  account  of  its  short  lengii  of 
wire,  comparatively  speaking.  A  series  of  ex- 
periments were  made  by  Prot.  Caldwell^  of  this 
city,  and  myself,  with  long  wire  coils,  short 
wire,  large  wire,  and  fine  wire ;  but  we  found 
that  the  coils  made  upon  scientific  principles 
were  the  best.  With  a  high  tension  proportion- 
ate coil  at  a  seance  of  five  minutes  duration, 
anastheeia  was  produced  lasting  two  minutes, 
while  a  coil  of  the  same  wire  one  mile  long,  with 
the  same  power,  &c,  lasted  scarcely  one  min- 
ute. 

All  these  experiments  will  be  given  in  detail 
at  some  future  time. 

Theoretically,  the  effect  accomplished  in  pro- 
duciog  electrical  anesthesia  is  a  succession  of 
rapid  blows  upon  the  ends  of  sensory  nerves,  a 
concentration  and  partial  destruction  by  electro- 
lytic action,  destroying  their  power  of  conduct- 
ing sensation.  I  think  this  is  fully  proven  in 
such  cases  as  ovarian  and  uterine  spasms,  in  all 
fprms  of  neuralgia,  facial,  lumbar,  intercostal, 
brachial,  or  pelvic  paios. 

The  muscular  vibrator  is  essential  for  con- 
tracting the  muscles.  The  coil  is  wound  with 
course  wire  so  as  to  more  fully  saturate  the 
muscle  with  this  agent,  making  the  contraction 
more  marked.  The  automatic  interrupter  is 
the  principal  part  of  a  Faradic  coiL  If  our  in- 
terrupter is  properly  adjusted,  we  can  contract 
a  particular  muscle  without  interfering  with  its 
neighbor,  when  the  conductor  is  covering  both 
muscles.  H.  C.  Sample, 

145  Ontario  St,  Chicago,  IlL 


Editor  Medical  World  : — I  have  been  an  oninter- 
rapted  sabecriber  to  The  World  ever  sinoe  the  first 
number  was  published,  and  cannot  now  do  without  it 

Sharon,  Ga.  A.  C.  Davdson,  M.D. 


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THB  MBDICAi  WORLD. 


The  Injection  Treatment  of  Hernia. 

Editor  Medical  Wobld  : — The  oommunicar 
tion  of  Dr.  Foreman,  page  378,  Medical 
World,  impels  me  to  say  I  have  taken  much 
interest  in  the  treatment  of  hernia.  I  wrote 
Dr.  Walling  after  reading  one  of  his  articles  in 
The  World.  His  answer  was  somewhat  simi- 
lar to  that  of  Dr.  Foreman.  I  sent  him  ten 
dollars,  for  which  he  sent  me  a  syringe  and  one 
ounce  of  his  fluid. 

I  have  used  it  in  one  case  and  I  believe  my 
patient  is  cured,  but  it  is  too  early  to  say  posi- 
tively. 

A  medical  friend  of  mine  bought  a  cure  used 
by  Dr.  J.  A.  Comingor,  a  hernia  specialist,  of 
Indianapolis,  with  which  he  says  he  has  cured 
five  cases. 

The  instrument  he  uses  and  mine  are  the 
same,  he  says.  The  name  of  the  manufacturer 
is  not  to  be  found  on  any  part  of  my  instrument 
or  the  case  so  far  as  I  can  see. 

My  friend  gave  me  the  following  fc^rmula, 
which  he  says  he  uses : 

R.  Catbolto  aoid 

Paie  glycerine aa  drams  UJ 

Tine,  iodire,  a.  8.  p ^ .drams  11 

Premasganate  of  potassium gr.  j 

Caromel ..^ grs.  x 

Mix  carbolic  acid  glycerine,  add  iodine  and  caromel ;  then 
add  potash  In  crystaL 

Let  the  mixture  stand  two  weeks  and  then 
use. 

The  usual  antiseptic  precautions  should  be 
taken  with  the  instrument  by  washing  it  with 
alcohol  before  and  after  uting.  Also  shave  and 
wash  the  surface  where  the  injection  is  to  be 
made,  and  finally  seal  the  wound  with  collodion. 
My  fkiend  said  there  was  no  use  of  doing  that, 
but  I  prefer  to  obey  Dr.  Walling's  instructions. 

The  method  commends  itself  to  my  judgment 
and  I  believe,  as  Dr.  Walling  says,  that  any 
case  that  can  be  held  up  by  a  truss  can  be 
cured  by  this  method  of  treatment. 

I.  B.  Washburn,  M.D., 

Rensselaer,  Ind. 


Viburnum  and  Veratrum  for  Puerperal  Eclampsia. 

Editor  Medical  World: — On  September 
12th,  J.  B.,  living  11  miles  from  town,  sent  a 
note  to  me,  stating  that  his  wife  had  just  been 
delivered  of  a  healthy  child,  attended  by  two 
midwives,  a  negro  and  white  woman,  and  that 
his  wife  was  having  convulsions.  I  sent  a  four- 
ounce  bottle  of  tr.  viburnum  prunifoliutn,  add- 
ing Norwood's  tr.  veratrum  viride  in  the  pro- 
portion of  12  drops  to  the  teaspoonful,  and 
directed  to  give  a  teaspoonful  every  two  hours 
till  relieved.  J.  B.  was  in  to-day,  and  said  the 
medicine  acted  like  a  charm ;  that  his  wife  had 


four  convulsions  while  the  boy  was  gone  for  the 
medicine,  that  he  gave  her  a  dose  as  soon  as  he 
returned,  and  that  she  had  no  more  symptoma 
of  convulsions,  and  has  gotten  on  well.  The 
mixture  was  only  continued  for  a  few  doses. 
Try  this  prescription.  In  this  note  he  said  she 
was  not  flooding,  and  she  did  not  and  would  not 
with  the  vib.  combination. 
Preecott,  Ark.  R  L.  Hinton,  M.D. 

Qui^  £)e|>artment. 

Itnestlotts  are  solicited  for  this  Cohimn.  Comnranicatioiw 
not  aooompanicd  by  the  proper  name  and  addreu  of  Uie 
wi^er  (not  neoessarily  for  publication),  wiU  not  be 
noticed. 

The  mat  niunber  of  requests  for  private  answers,  for  tli* 
information  and  benefit  of  the  writer,  makes  it  iirrr— 
atyforustochaxsea  fee  for  the  time  reqldxed.   TUb 
fee  will  be  frcmi  one  to  fire  dollars,  according  to  ths 
amount  of  researdi  atid  writing  reqmred. 

Statistics  Wanted. 

[Dr.  Bumside  Foster,  St  Paul,  Minn.,  asks 
through  the  medical  press  generally,  the  follow- 
ing inibrmation  from  his  professional  brethren. 
In  replying  kindly  mention  where  you  saw  the 
announcement — Ed.] 

For  the  purpose  of  securing  reliable  sta- 
tbtics  on  the  subject  of  the  marriage  of 
syphilitica,  I  desire  to  enlist  the  a&sistanoe 
of  those  of  our  readers  who  have  bad  ex- 
perience which  will  be  of  value  in  deteimining 
the  period  when  this  disease  ceases  to  be  cona- 
municable  and  inheritable.  I  shall,  therefore, 
esteem  it  a  great  favor  on  the  part  of  any  phys- 
ician who  wUl  send  me  answers  to  the  following 
questions,  and  due  credit  will  be  given  in  a 
future  publication  to  those  who  desire  to  aid  me 
in  this  work. 

1.  What  is  the  latest  period  from  the  date  of 
the  initial  lesion  that  you  have  known  the  dis- 
ease to  be  communicated  by  a  patient  who  has 
been  from  the  first  under  your  ol)servalion  ? 

2.  What  is  the  latest  period  from  the  date  of 
the  initial  lesion  that  you  have  known  (a)  a 
syphilitic  man  or  (b)  a  syphilitic  woman  to  be- 
come the  parent  of  a  syphilitic  child. 

3.  Have  you  ever  known  syphilis  to  be 
either  communicated  or  handed  down  at  a  later 
period  than  four  years  from  the  date  of  initial 
lesion  by  an  individual  who  has  been  constantly 
under  your  observation  during  that  time  ? 

In  answering  these  questions  i  should  like  a 
brief  but  complete  history  of  each  case  and  an 
account  of  the  treatment  that  had  been  pursued. 
I  hope  by  this  means  to  obtain  the  experience  of 
a  liurge  number  of  observers  and  to  reach  a 
fairly  reliable  conclusion  as  to  the  time  when 
we  may  safely  permit  our  syphilitic  patients  W 
marry. 


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THE  MEMCAI,  WORLD. 


413^ 


Hydrophobia- Statittiot  Dttired. 

Dr.  Charles  W.  Dulles,  4101  Walnut  street, 
Philadelphia,  has  published  in  various  journals 
the  following  request :  I  wish  to  ask  that  my 
profiBSsional  brethren  will  communicate  to  me 
the  occurrence  of  cases  of  so-called  hydrophobia 
in  their  practice  for  the  year  1894,  ^m  Janu- 
ary Ist,  and  so  on  until  the  end  of  the  year? 

I  would  like  in  all  cases  to  learn :  1,  the  sex 
and  age  of  patient ;  2a,  the  kind  of  animal  that 
IB  credited  with  the  inoculation ;  26,  its  state  of 
health ;  2e,  the  provocation  to  bite  (if  any  ex- 
isted) ;  2(2,  the  reasons  why  the  animal  was  (if 
it  was)  deemed  rabid ;  3,  the  seat  of  the  bite 
(or  other  mode  of  inoculation)  ;  4,  the  fact  and 
method  of  cauterization  (if  any) ;  5,  the  time 
betwenn  the  inoculation  and  the  outbreak ;  the 
symptoms  of  the  outbreak — the  occurrence  of 
mania  or  imitation  of  dog  actions ;  7,  the  reqie- 
dies  used,  and  doses,  with  their  Beeming  effects ; 
8y  the  issue  of  the  case  and  when  death  occurred ; 

9,  the  investigations  made  to  exclude  the  pres- 
ence of  disease  other  than  so-called  hydrophobia ; 

10,  the  findings  on  autopsy — if  one  was  held. 

I  shall  aclmowledge  in  future  publications 
aid  received  in  continuing  my  studies  in  regard 
to  this  subject 

Send  all  replies  to  the  Doctor  direct 


Editor  Medical  World: — Please  give  a 
remedy  for  hot  flashes,  and  the  cause  of  the 
same,  at  the  menopause.  Subscriber. 

Editor  Medical  World  : — I  would  like  in- 
formation  in  a  case  of  palsy — shaking  of  the 
right  arm  in  a  man  of  forty-five.  He  thinks  it 
was  caused  from  overwork.  I  hope  some  of  the 
many  readers  of  your  valuable  journal  may  give 
me  help  in  his  case.  ]  find  many  valued  sug- 
gestions in  The  World. 

Evansville,  Ind.        J,  F.  Blount,  M.D., 


Editor  Medical  World: — Please  tell  me 
how  to  prevent  the  tonsils  of  the  throat  from 
rising  every  time  the  patient  takes  a  little  cold. 

I  have  a  patient,  aged  twenty  years,  light 
complexion,  black  hair,  blue  eyes,  in  whom  the 
least  exposure  will  cause  the  tonsils  to  rise. 
During  the  last  eight  months  they  have  risen 
four  times,  and  when  they  commence  I  cannot 
stop  or  prevent  them.  Sometimes  they  both  rise  at 
the  same  time,  and  nearly  close  the  air  passage. 

Please,  any  of  the  readers  of  The  World, 
help  me.  J.  H.  Reynolds,  M.D., 

Sandy  Mush,  N.  C. 

[CSironic  tonsillitis.  Applications  of  glycerine 
or  glycerite  of  tannin,  or  other  antiseptic  prepa- 
ration of  glycerine,  the  best  application.  In  the 
beginning  of  an  attack,  guaiao,  as  an  internal 


remedy,  and  as  a  gargle,  is  very  valuable.— 
Ed.] 

Editor  Medical  World: — Coal  tar  prepa- 
rations should  be  used  with  caution.,  especially 
with  children  and  persons  with  wc^  hearts. 
Speaking  from  experience,  I  have  seen  a  child 
in  coUaj^e  from  a  5-grain  dose  of  acetanilid. 
Still,  I  do  not  think  them  any  more  dangerous 
than  some  other  medicines  we  use— good  when 
indicated  and  in  proper  doses,  all  of  them. 

Will  some  one  be  kind  enough  to  give  me  the 
most  approved  method  of  treating  ulcer,  situated 
on  the  leg  near  upper  end  of  lower  third  of  tibia? 
Patient,  female,  white,  age  thirty,  mother  of  two 
children,  received  a  blow  on  the  limb  two  years 
ago.  Ulcer  is  very  large — about  the  size  of  a- 
man's  hand. 

What  is  good  for  gastralgia?  Female,  white,- 
age  thirty- three,  no  children ;  at  times  will  belch ^ 
up  wind,  and  nothing  agrees  with  her';  then  all 
will  seem  to  be  well  for  a  time,  only  to  return^ 
again.     She  is  anemic. 

Clarkson,Ok.Ter.    J,  D.  Kernodle,  M.D., 

Editor  Medical  World  : — Three  weeks  ago 
a  child  was  brought  to  my  office  for  examina- 
tion and  treatment  Age  three  years.  Six 
months  ago  the  parents  noticed  a  slight  enlarge- 
ment of  the  abdomen,  which  continued  to  grow 
worse,  with  swelling  of  the  feet  and  legs.  This 
swelling  continued  till  it  prevented  the  button- 
ing of  the  shoes.  The  swelling  remained  about 
one  month,  when  it  disappeared.  At  present  no 
swelling  is  noticeable  of  the  feet  or  legs,  but  the 
abdomen  is  distended  until  it  is  very  prominent 
and  hard.  There  is  marked  dyspnea — in  fact^ 
the  difficult  breathing  is  the  most  aggravating: 
symptom. 

The  appetite  is  good,  but  at  times,  after  eat-> 
ing,  vomiting  comes  on. 

When  I  first  saw  the  child  its  tongue  was-  ^ 
coated  brown,  and  at  present  there  is  a  lights 
coat  on  the  tongue.     The  heart  seems  to  be  all 
right,  only  slightly  disturbed  by  pressure  of  alv 
dominal  contents.     No  organic  lesions,  as  I  can  > 
detect     Has  some  fever  at  nisrht,  but  I  think 
this  fever  is  brought  on  by  restlessness,  due  to 
the  dyspnea.     The  parents  say  that  breathing  . 
seems  more  difficult  at  night 

Bowels  are  irregular — at  times  a  diarrhea, 
with  cramping,  but  the  chUd  plays  about  the  - 
house  most  of  the  time,  and  looks  very  well 

If  this  brief  history  will  afford  me  a  diagnosis 
I  will  be  very  thankful.     I  am  a  young  man, 
with  only  a  few  months  of  experience,  and  we  - 
are  the  ones  in  need  of  help. 

Cory,  Ind.  M.  A.  Boor,  M.D.r 

[Possibly  enlarged  spleen.  Re^  0ubject  up. 
—Ed.] 


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414 


THB  MEDICAI,  WO^D. 


Editor  Medical  World  : — I  have  a  patient 
one  year  old,  a  bright  little  boy,  who  seems  to 
be  healthy.  But'  he  strains  and  groans  every 
time  he  has  an  action,  whether  hard  or  soft. 
Please  advise  me  what  to  do  for  him.  It  is 
worse  whAi  the  feces  are  hard. 

W.  B.  FORMAN,  M.D.,- 

River  Junction,  Fla. 


Editor  Medical  World  : — Will  some  one  of 
'  the  many  readers  of  The  World  kindly  give 
me  treatment  and  diet  for  *<  bilious  intestinal 
catarrh."  with  which  I  have  been  bothered  all 
summer,  the  color  of  my  stock  being  very 
changeable,  sometimes  greenish,  yellow,  dark 
grey,  slate  color,  or  clay  color ;  consistency  of 
stool  always  soft,  sometimes  frothy,  passage 
usually  twice  a  day.  I  have  become  considera- 
bly emaciated,  with  loss  of  strength. 

Any  help,  either  by  private  letter  or  through 
The  World,  will  be  gratefully  received. 

G.  Frederick  Bismarck,  M.D., 

Chauncey,  111. 


Editor  Medical  World  : — I  noticed  in  the 
July  World,  '94  a  treatment  for  expulsion  of 
tape  worm,  by  Dr.  Hinton,  of  Prescott,  Ark. 
September  3(i  I  tried  the  same  on  a  case,  a 
girl,  11  years  old. 

About  twenty  minutes  after  taking  the  first 
bottle,  she  became  drunk,  as  she  called  it  I 
was  called  in,  but  when  I  arrived  she  had  re- 
covered. Sie  had  been  pa]e,  eyes  protruded, 
talked  incoherently  and  could  uot  be  aroused 
for  some  time.  The  bowels  moved  and  part  of 
the  worm  passed,  but  not  all.  The  parents 
would  not  allow  the  second  bottle  to  be  taken. 

If  the  Doctor  will  advise  how  to  proceed  with 
the  same  treatment  I  will  be  grateful. 

Mitchell,  S.  D.  B.  A.  Bobb,  M.D., 


To  Abort  SyphillU. 

Bichloride  of  mercury  (10  grains  to  one 
ounce)  painted  on  a  chancre  as  soon  as  it  ap- 
pears kilk  all  specific  germs,  and  there  will  be 
no  systemic  manifestations.  Then  you  will  only 
have  a  local  sore  to  heal. — Med.  Summary. 

[Important  if  true. — Ed] 

Our  Bapplj  of  WOBLDS  for  April  and  May,  1894,  Is  exhausted, 
and  many  new  subscribers  want  them  to  complete  their  files. 
Those  having  either  of  the  above  to  spare  kindly  send,  and  we 
will  send  any  other  desired  (except  August)  in  return.  Par^ 
tlcularly  Minnesota  and  CalUomia  pbysidans,  to  whom  we 
sent  May  number,  kindly  return  In  exchange  for  the  present 
number,  unless  you  wish  to  subbcribe  for  the  entire  year  of 
l^94. 


Current   Medical   Thought- 
Apparent  Cure  of  Rsbiet. 

The  editor  of  The  Medical  Age  very  kindlj 
calk  our  attention  to  the  followinfi^  presented  at 
the  Wayne  County,  (Mich  )  Medical  Sodety  : 

«  Doctor  Gunsolus  reported  a  caee  of  hydro- 
phobia, or  a  disease  closely  resembling  it  The 
patient,  a  boy  fourteen  years  old,  had  been  bit- 
ten on  the  ear  by  a  dog.  When  seen  he  was 
barking  and  attempting  to  bite  those  aroand 
him.  He  had  no  pharyngeal  spasms,  and  was 
able  to  swallow  all  through  his  illness.  Large 
doses  of  hyoecyamus  and  chloral  were  required 
to  quiet  him.  Simaba  cedron  in  three  minim 
doses  was  then  given,  and  the  paroxjaniB 
ceaeed." 


Water  in  Typhoid  Fever. 


Urge  your  patients  to  drink  a  great  deal  of 
cold  water.  The  more  I  practice  thiB  plan,  the 
more  I  am  convinced  of  it?  beneficial  effects.  In 
many  cases  I  have  learned  my  patients  to  drink 
five  quarls  of  cold  water  in  twenty  four  hours, 
and  I  think  to  realize  the  full  benefits  of  this 
plan,  it  should  be  carried  to  this  extent.  There 
are  no  contiaindicadons  to  this  treatment.  Manj 
observers  believe  that  its  beneficial  effects  on  a 
feeble  heart  are  well  marked.  In  this  conditicm 
it  certainly  can't  be  contra-indicated.  The 
lowering  of  the  fever,  disappearance  of  the  dry- 
ness of  the  tongue  and  mouth,  sedative  effects 
on  the  nervous  system,  and  the  eliminative 
functions  of  the  kidneys  are  easily  observed. 

This  plan  facilitates  the  oxidation  of  toxines 
and  aids  nature  in  removing  or  eliminating  the 
refuse  material  which  always  accumulates  in 
the  system  in  continued  fevers,  a  natural  result 
of  an  impaire  1  organic  function.  You  can  ob- 
serve, as  evidence  of  the  increased  activity  of 
the  kidnejs  and  skin,  the  great  quantities  of 
urea  that  is  eliminated  by  the  kidneys;  its  quan- 
tity fluctuates  with  the  amount  of  water  taken 
into  the  system.  This  method  is  very  pleasant 
and  acceptable  to  the  patient  Of  course  it  does 
not  influence  the  course  or  direction  of  the  dis- 
ease. — Charlotte  Med,  Jour. 


Treatment  of  tlie  Typkoid  State. 

Dr.  Juhel-Renoy,  of  Paris,  stated  that  all 
infectious  diseases  may  assume  the  typhmd  as- 
pect, and  when  this  occurs  rehrigerant  treatment 
ia  indicated.  The  method  of  this  refrigerant 
medication  must  vary  according  to  the  result 
which  it  is  desired  to  obtain.  It  is  vastly  supe- 
rior to  any  other  procedure  in  all  forms  of  inac- 
tions  fever ;  it  reduces  the   total  morality   of 


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THB  MBDICAL  WORLD. 


415 


typhoid  fever  to  7  per  cent ;  of  typhoid  erysipe- 
las to  9  per  cent ;  of  malignant  scarlatina  to 
14  per  cent  ;  of  ataxoadyo  imic  measles  to  an 
almost  inappreciable  figure.  The  mortality  of 
adynamic  grippal  pneumonia  is  reduced  one- 
half  by  coll  baths,  and  small- pox,  when  treated 
in  this  way  from  the  start,  is  much  milder  in  its 
course.  The  ways  in  which  cold  baths  bring 
about  the  disappearance  of  the  typhoid  condition 
are  numerous,  but  that  which  se^ms  to  be  the 
most  important  as  well  as  the  moat  constant  is 
the  urinary  crisis,  an  indication,  when  it  occurs, 
•f  an  early  cura —  Universal  Med.  Jour. 


Cold  Compresses  in  Pulmonary  Disease. 

M.  le  Gendre  stated  that  in  the  course  of  all 
aonte  diseases  of  the  respiratory  passages,  and 
in  certain  acute  stages  of  chronic  diseases  of 
the  same  region,  active  hypersemia  is  an  im*- 
portant  factor  in  determining  the  aggravation 
of  the  local  and  general  condition.  In  cases 
where  snch  hypersemia  occurs,  he  has  found  pre- 
ferable to  all  other  repulsive  measures  the  per- 
manent wrapping  of  the  thorax  in  compresses 
soaked  in  cold  water,  wrung  out  so  as  to  be 
merely  damp  and  covered  with  a  thin  oil-doth. 
These  compi  esses  should  be  renewed  every  quar- 
ter of  an  hour,  then  every  half-h  >ur  or  hour, 
according  to  the  conditi  m  of  the  patient  This 
18  the  hydropathic  method  of  German  authors, 
and  isof  especial  value  in  infantile  therapeutics, 
as  it  nflay  be  used  for  the  youngest  child,  con- 
tinued as  long  as  necessary,  and  resumed  when- 
ever theie  is  a  return  of  the  congestion.  It  di- 
minishes d)  spuoea  more  rapidly  than  any  other 
measure,  by  slowing  and  aoop  ifying  the  respi- 
ratory movements  and  by  counteracting  the  hy- 
perthemia  and  the  nervous  disturbances  accom- 
panying it,  such  as  excitement,  insomnia,  and 
refusal  to  take  food. 

M.  Rendu  has  made  use  of  the  wet  pack  sinte 
1884,  and  has  found  that  it  causes  a  great  im- 
provement in  grave  broncho  pneumonia.  He 
does  not  use  the  same  method  as  M.  le  Gendre, 
but  leaves  his  patient  in  the  pack  for^two  or 
three  hours.  In  the  fir^t  half  hour  there  is  a 
peripheral  elevation  of  temperature,  to  which 
snrceeds  a  stige  of  reaction,  with  perspiration 
and  considerable  diuresis.  It  is  possible  that 
the  action  is  not  the  same  as  that  obtained  by  M. 
le  Gendre,  but  the  efiects  are  excellent  and  the 
procedure  is  perfectly  harmless 

M.  Kichardiere  has  treated  sixty  cases  of 
brmcho  pneumonia  after  measles,  during  the 
preeoit  year,  at  the  Trousseau  Hospital  and  has 
had  excellent  results  with  the  wet  pack.  An 
important  fact  is  that  the  temperature  does  not 
ftninediately  fall,  but  that  the  nervous  phe- 


nomena are  quieted  and  abimdant  sweating 
occurs. 

M.  le  Gendre  replied  that  he  used  the  wet 
pack  in  certain  cases,  but  that  hC;  Jbelieved  the 
method  he  had  just  described  to  before  simple 
and  more  rapid  in  action;  besidei^  it  may  be 
continued  for  some  time.  He  htfL  used  fresh 
compresses  upon  the  chest  for  eifiht  days,  in 
some  cases.  In  this  respect  it  is  b^^r  than  the 
wet  pack.  * 

M.  Rendu  considered  it  superior  to  blisters, 
in  that  it  caused  diaphoresis  and  diuresHS. — La 
Medeeine  Modeme. —  Univ,  Med,  Jowr» 


Speolflc  Cireotions  for  Using  Water  In  Nervous 
,  Diseases. 

Ance^thesia  (cutaneous.— Short  cold  jet  and 
fan  douches  of  strong  pressure  to  the  ansesthetic 
areas.  Temperature,  50^  to  70^  Duration, 
one  minute.     Daily. 

Angio -paralytic  hyperidrosia  of  thefeeL — ^Pro- 
longed cold  foot-bath  with  chafing,  or  fan 
douche  of  cold  water  to  the  feet  Tempera- 
ture, 60^.  Duration,  twenty  minutes  for  bath, 
five  minutes  for  douche. 

Chorea — Cold  plunge  beginning  at  90^ 
daily  reducing  until  70^  is  reached.  Ifansemic, 
spinal  spray,  jet  or  fan  douches,  at  first  warm 
until  patient  becomes  accustomed  to  them,  then 
gr^iually  reduced  to  60^  or  hO""  (Duval). 

Epilepsy, — Cold  shower  baths  and  cold  sponge 
baths  daily  are  beneficial.  The  shower  baths 
should  be  rain-like  in  character — that  is  not  too 
forcibl&  In  many  case^  a  morning  and  evening 
bath  (the  **  half  bath '')  proves  very  serviceable. 
The  '<  half  bath"  is  taken  in  a  bathtub  only 
half  filled  with  water,  and  when  taken  should 
be  accompanied  by  energetic  rubbing  of  the 
patients  by  an  attendant.  This  bath  lasts  five 
minutes,  and  the  temperature  should  not  be 
under  tO°  ard  not  over  TO"*  F.  Whei^  there 
is  evidence  of  hyperseoaia  and  increased  blood- 
pressure  in  the  heal,  the  cold  cap  is  useful. 

While  these  are  the  general  indications  for 
hydrotheraphy,  certain  measuns  are  often  of 
use  at  the  time  of  seizures.  During  a  fit  or 
during  a  sMus  epthj^us  it  will  be  observed 
that  there  is  one  of  two  Vascular  conditions 
present :  either  the  face  is  pale  and  there  are 
fflgns  of  brain  ansemia,  and  in  this  case  warm 
wet  compresses  should  be  applied  to  the  head 
and  genitals,  accompanied  by  friction  of  the 
trunk  ilpward,  the  body  being  placed  with  head 
low  and  arms  uplifted ;  or  there  is  turgeeceuoe 
of  vessels  in  the  head,  the  face  is  red,  the  caro- 
tids beat  strongly,  and  under  such  conditions  a 
contrary  procedure  is  indicated — cold  compresses 
to  the  head,  neck  and  genitals,  strong  wet  beat- 


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416 


THE  MEDICAL  WORLD. 


ing  o£  the  feet,  with  a  high  position  of  the  head. 
I^ly  applicationB  for  thirty  seconds. 

Headaches,  neuralgias  and  migraines, — If 
ansemia,  heating  cephalic  compresses  (wring  out 
thin  linen  bandages  in  very  cold  water ;  wrap 
head  in  oapelline  manner,  and  cover  with  one  or 
two  layers  of  dry  linen  or  flannel.)  Apply  at 
bed- time.  Upon  removal,  envelop  head  in  dry 
cloth  and  ij&b  it  dry.  If  hypersemlo,  l^g  ban- 
dages (a  piece  of  toweling  a  yard  long  is  dipped 
in  cold  water  atone  end — one  third — thoroughly 
wrung  out  and  wrapped  closely  about  each  leg, 
eo  that  the  wet  surface  is  next  the  ekin  and  the 
dry  portion  envelops  the  wet  two  or  three  times  ; 
or  wet  stockings  may  be  put  on  and  covered 
with  dry  towels  )  These  are  applied  at  bed- 
time and  retained  through  the  night.  In  many 
lieadaches,  especially  of  a  congestive  character, 
«  prolonged  cold  foot-bath  (twenty  minutes,  60^) 
or  the  fan  douche  to  the  feet  (five  minutes,  60^) 
is  very  palliative. 

Hysteria. — For  erethetic  type:  Wet  pack, 
60°  to  70°,  for  one  hour  or  more,  followed  by 
massage  (Putnam  Jacobi)  ;  or  the  rain-bath  at 
75°  to  65°  for  thuiy-five  seconds  daily  at 
Itwenty  pounds  pressure  (Baruch).  — Dr.  F. 
Peterson  in  Amer.  Jour.  Med.  Scu 


fiiohromate  of  Potassium  as  an  Expectorant. 

At  this  season  of  the  year  our  readers  should 
brush  up  their  knowledge  of  this  useful  drug  in 
affections  of  the  respiratory  tract.  Dr.  J.  R 
Weaver,  in  the  Med.  Record,  states  that  bichrcv- 
mate  of  potassium  is  especially  useful  in  both 
laryngitis  and  bronchitis,  if  secretion  is  stringy 
and  hard  to  raise.  After  the  second  or  third 
dose  the  expectoration  becomes  loose  and  easy, 
and  rapidly  disappears,  and  with  it  the  lodi 
trouble  which  is  its  cause.  In  tonsilitis,  where 
the  onset  is  rapid,  the  tonsils  rough,  raw  and 
angry-l6oking,  with  mucopurulent  secretions 
exuding  from  the  follicles,  he  values  the  drug 
more  highly ;  also  in  cases  of  non-diphtheretic, 
paeudomembranous  tonsilitis,  this  remedy  is  so 
sure  in  its  effects  as  to  merit  the  title  of  specific. 
In  treating  laryngitis  and  bronchitis  with  this 
remedy  one  must  be  cansful  not  to  use  it  too 
strong — ^not  more  than  one  grain  well  triturated 
to  throe  or  four  ounces  of  water,  a  teaspoonful 
every  one- half  to  two  hours.  But  in  tonsilitis 
the  finely  powdered  bichromate  should  be  added 
to  the  water  until  the  latter  is  of  a  dark  lemon 
or  light  orange  shade,  and  of  this  a  teaspoonful 
should  be  given  every  hour.  In  these  cases  the 
only  limit  to  the  administration  of  the  drug  is 
nausea.  If  this  symptom  appears,  lessen  the 
dose.  After  the  third  or  fourth  dose  improve- 
ment should  be  noticed. 


How  to  Bandage  a  Finger. 

The  bandage  ordinarily  put  on  a  -finger  m 
unsatisfactory.  It  gets  loose,  slips  off,  luid  m 
generally  bungling  from  super-abnnduice  of 
material. 

I  have  used  the  following  described  bandage 
for  some  years  with  much  satisfaction,  especiaUj 
for  fingers  caught  between  bumpers  in  ooupling 
cars.    This  bandage  remains  firm  while  the  hsM 


luni. 


Jill, 


(iii! 


''i  d 


ihWi 


i;iii!,l!i, 


H '111!  ill 

I 


Ir.' 
ill 


is'l 


,li 


is  in  use.     A  man  with  a  pinched  finger  otbaa 
returns  at  once  to  work. 

Measure  a  piece  of  cloth  twice  the  length  of 
the  finger,  and  cut  square.  Fold  the  cloth  dcMH- 
ble,  and  cut  as  shown  in  Fig.  1.     Open  tke 


m-^ 


^^'^ 


w 

y<^^ . 

r 

..V^/' 
■■'<■'/// 

f  --^  f 

ng.  2. 

bandage  and  place  in  position,  as  shown  in  Fig. 
2,  the  hand  lying  palm  down  cm  your  knee. 
Then  turn  down  the  flap  over  the  finger  and  tie 
the  first  set  of  tails  over  it  in  one  knot,  leaving 
the  ends  loose,  to  be  covered  by  the  tying  of  tlie 
second  set  of  tails  (See  Fig.  3).    The  renudiiiiig 


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THE  MEDICAI.  WORU). 


417 


tmOM  are  tied  in  the  same  way,  making  a  doable 
knot  in  the  last  set.  In  tying  the  tails  draw 
I  mug,  but  not  too  tight    This  makes  a  neat, 


Fig.  8. 

finn.  and  very  satisfactory  bandage.  When  once 
used  it  will  demonstrate  its  advantage. — Dr. 
Hermance,  IntemationcU  Jour.  Surg. 


Castration  for  Hypartrophied  Prostate. 

.  Dr.  J.  William  White  and  others  recommend 
oostration  as  a  cure  for  hypertrophy  of  the 
prostate  gland  in  those  past  middle  Ufe.  The 
gland  shrinks  or  atrophies  after  removal  of  the 
testes.  This  is  analogous  to  the  removal  of  the 
ovaries  in  cases  of  fibroid  tumors  of  the  uterus, 
which  operation,  we  believe,  does  not  stand  as 
high  now  as  when  it  was  first  put  forth. 


Aooidentai  Swallowing  of  a  Phial.— Natural  Ex- 
pulsion. 

Bt  Joseph  Benjamin,  medical  practitioner, 
Ahmedabad,  India. 

A  Brahmin  boy,  age  12,  was  brought  to  my 
dispensary  at  about  6  p.  m.  on  the  27tii  Septem- 
ber, 1893.  It  was  reported  that  he  had  acci- 
dently  swallowed  a  glass  phial,  about  2i  inches 
long,  and  as  thick  as  the  index  finger  two  hours 
before.  No  pain  or  uneasiness  was  complained 
of.  His  father  desired  that  a  purgative  should 
be  given  to  hasten  the  exit  of  the  phial,  but  in- 
sAaad,  be  was  strictiy  advised  to  keep  the  boy  on 
simple  solid  food,  as  that  would  in  time  facili- 
tate the  easy  expulsion  of  the  foreign  body.  The 
next  day  the  boy  had  a  stool  in  the  morning 
as  usual,  and  as  the  phial  was  not  to  be  seen, 
the  father  seemed  very  anxious  about  it  The 
following  morning  the  phial  came  away  with 
the  stool,  38  hours  after  it  was  swallowed,  with- 
out having  caused  a  single  pang  or  any  uncom- 
fbrtableness. 

Remarks. — ^This  case  is  remarkable  for  the 
ease  with  which  the  phial  was  accidentiy  swal- 
lowed by  the  lad,  as  well  as  for  its  natural  and 
p^inlfloa  expulsion  after  38  hours. — Indian 
MedLRez. 


Insanity  fN>ni  Stress  of  Oooupation. 

Spratimg  (^N.  Y.  Medi  Jour.)  reports  fifly- 
seven  cases  of  insanity  occuring  among  siik-mill 
employes  brought  to  one  asylum  from  a  city  in 
New  Jersey  of  less  than  one  hundred  thousand 
^inhabitaots.  Fifty-seven  per  cent  of  the  casea 
were  due  to  over  work.  He  says  <*  Stress,  di- 
rect, continuous,  and  powerful^  was  the  sole 
cause  in  the  majority  of  these  cases.  It  waa 
applied  in  different  ways :  Long  hours  daily 
spent  in  managing  complex  and  delicate  ma- 
chinery ;  one  person  sometimes  doing  the  work 
of  two  or  more  ia  order  to  increase  his  earnings; 
insufficient  mental  relaxation  and  rest ;  ^suffio- 
dent  out-door  exercise ;  the  accuracy  and  com- 
plexity of  manual  motion,  and  mental  applica- 
tion constantly  required.  The  vitiated  atmos- 
phere and  poor  food  are  the  prime  factors  in  the 
production  of  so  many  cases  of  insanity  among 
this  class  of  people. 

"  I  recall  the  case  of  one  young  woman  twen- 
ty-four years  of  age,  bright,  vigorous,  and  in- 
dustrious, who,  after  doing  the  work  of  three 
persons  in  one  of  these  mills  for  some  months, 
in  order  to  support  a  widowed  mother  BnS 
several  brothers  and  sisters,  broke  down  witb 
paresis,  and  was  placed  in  an  asylum,  where  she 
died  in  less  than  a  year  after. 

**  The  number  of  cases  of  insanity  that  come 
fiom  these  mills  is  increasing  annually.'' — 
Phila.  Polyclinic. 

Brave  Words. 

In  a  paper  in  the  Bulletin  of  the  American 
Academy  of  Medicine^  on  the  subject  of  *'  The 
Sources  of  the  Defective,  Dependent  and  Delin- 
quent Classes,"  by  Dr.  Bayard  Holmes,  of 
Chicago,  we  find  the  following  : 

<*  Of  the  involuntary  able-bodied  dependents, 
I  do  not  dare  to  speak  my  mind.  It  seems  to 
me  that  the  medical  profession  ought  to  bring 
an  indictment  against  that  method  of  doing  bus- 
iness—of exploiting  labor — which  keeps  one- 
fourth  of  our  men  idle  all  the  time,  all  our  men 
idle  onesixth  of  the  time,  all  men  at  work  long 
hours  when  at  work  at  all,  and  still  puts  into 
factories  and  shops  children  and  women.  It  is 
the  settied  policy  of  capital  to  have  at  hand  a 
large  body  of  idle  starving  workmen.  When 
they  are  not  at  hand,  capital  expands  itself, 
rushes  business,  imports  labor,  and  then  shuts 
down  and  starves  the  laborers.  From  this  con- 
dition of  warfare  in  business,  from  the  idle 
workers  necessary  to  wage-slavery,  results  our 
great  burden  of  voluntary  and  involuntary  able- 
bodied  dependents." 

Every  medical  man  who  reads  this  has  a  per- 
sonal responsibility,  in  proportion  to  his  influ- 
ence and  opportunities,  to  use  his  endeavors  to 
bring  about  a  rational  change  in  this  system . 


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THE  MEDICAL  WORLD. 


N«w  Intrauterine  Electrode. 

(Abstract of Leotoie by G.  8.1fehwanger, Profeaiior  of'Elee- 
tro-PhyslOB  at  the  Pk>«t  Q  aduate  Medical 
School  of  Chicago ) 

''  You  have  been  shown  in  a  former  lecture  in 
this  course  the  physical  fact  that  the  electric 
current  ezerts  its  greatest  force  at  the  point 
where  contact  is  the  most  perfect,  and  dur- 
ing the  time  allotted  us  to  day,  we  shall  endeavor 
to  show  you  the  therapeutic  application  of  this 
fact 

In  applying  the  galvanic  current  to  the  en- 
dometrium for  the  various  conditions  in  which 
it  is  of  ^iervice,  it  has  been  the  rule  to  use  an 
intra-uterine  electrode  that  will  well  fill  the 
canal  and  insulate  it  with  soft  rubber  muff  or 
otherwise  so  the  current  cannot  come  in  contact 
with  the  vaginal  walls ;  but  this  insulation  you 
will  observe,  onlyextendstothe  external  oeand 
when  the  electrode  is  in  situ,  it  is  grasped 
tightly  at  the  point  where  it  comes  in  contact 
with  the  OS  internum  and  we  have  the  density 
of  current  at  that  point,  just  where,  in  most 
cases,  we  do  not  want  it,  and  the  result  is  that 
before  the  endometrium  is  scarcely  attacked  by 
the  current  above  the  internal  os,  we  have  at 
that  point  deep  cauterization,  with  the  after  re- 
sult of  a  tense  and  hard  cicatrix,  if  the  positive 
po\jB  has  been  used,  or  softer  and  more  pliable 
ficar  tissue  if  the  negative,  either  of  which  is  lia- 
ble to  produce  its  quota  of  suffering  for  the  un- 
happy patient 

In  our  judgment  this  method  of  intrauterine 
application  of  galvanism  has  caused  much  after 
trouble,  which  in  many  cases  is  more  difficult 
to  deal  with  than  the  original  condition  for 
which  we  used  the  current  In  other  words, 
and  briefly,  we  make  the  patient  worse,  and  of 
course  draw  adverse  criticism  both  to  ourselves 
and  the  remedy. 

To  avoid  this  cauterization  at  the  internal  oe, 
I  have  had  the  Mcintosh  Battery  Company 
make  an  electrode  which  is  admirably  adapted 
for  either  positive  or  negative  intrauterine  gal- 
vanization. 


end  is  a  hard  rubber  olive,  screwed  on  ti^htlj 
so  as  to  ho*d  the  block  tm  tube  in  place.  These 
electrodes  are  made  with  a  staff  having  a  diam- 
eter of  3  and  5  millimeters,  and  the  pieces  of 
.  block  tin  tubing  have  active  surfaces  varying 
^  from  2  to  4  square  centimeters,  which  makes  tlie 
electrodes  of  the  concentration  type  after  the 
stjle  of  those  devised  by  Dr.  Franklin  H.  Mar- 
tin, which  require  a  current  of  25  ma  for  every 
square  centimeter*of  surface  exposed.  The  hard 
rubber  insulation  on  the  point  prevents  the  pos- 
sibility of  making  a  sore  and  sometimes  a  hole 
in  the  uterine  walls  as  you  will  recollect  from 
previous  teaobing  thatthe  electric  current  U  apt  to 
concentrate  at  a  point.  The  electrode  here  shown, 
howpver,  differs  from  that  of  Dr.  Martin  in  that 
it  is  made  of  block  tin,  while  his  is  made  of 
platinum  wire,  and  we  have  found  that  block 
tin  is  almost  as  non-oxidiable  as  platinum  and 
has  the  advantage  of  beinjgr  much  cheaper,  and 
if  it  should  be  possible  after  long  usage  that 
the  block  tin  becomes  roughened,  2be  tube  can 
easily  be  replaced  by  anoUier  of  similar  length 
and  thickness.  The  electrode  also  has  the  facf- 
ulty  of  being  easily  cleaned  which  cannot  be 
said  of  some  other  intrauterine  electrodes. 

You  will  observe  by  this  method  that  it  is 
possible  to  cauterize  the  cavity  of  the  body  of 
the  uterus  whether  infantile  or  five  inches  or 
more  in  depth  without  the  internal  os  coming 
directly  in  contant  with  the  current." 

6354  Maryland  Ave.,  Chicago. 


The  staff  consists  of  a  brass  rod,  No.  12  B  & 
S.  gauge,  ten  inches  in  length,  insulated  with 
hard  rubber  covering  which  has  been  vulcan- 
ized on  the  metal,  thus  avoiding  all  chance  of 
getting  septic  matter  between  the  insulation  and 
the  brass  rod.  A  shoit  distance  from  the  dis- 
tal end,  a  piece  of  block  tin  tube  is  slipped  on 
that  closely  fits  the  rod.     At  the  extreme  distal 


For  Pleurisy. 

A  "paint"  composed  of  one  part  of  pure 
guaiacol  and  seven  parts  of  tincture  of  iodine  is 
applied  in  quantities  of  one  ounce  at  a  time,  over 
and  about  the  (eat  of  the  trouble.  It  is  said 
that  the  temperatui;e  quickly  falls,  an  abundant 
perspiration  takes  place,  and  that  the  effusion 
soon  becomes  absorbed. — Drug  Circular, 


Tht  Plain  Truth  About  Active-Principle  Medica- 
tion. 

As  is  well  known,  our  readers  became  inter- 
ested in  that  advance  in  scientific  treatment 
known  as  Dosimetric  or  Alkaloidal  Medica^ 
tion,  almost  with  its  ffrst  introduction,  several 
jears  ago.  We  at  once  recognized  in  it  a  dis- 
tinct step  in  the  progress  of  medical  science,  and 
opened  our  pages  freely  to  a  discussion  df  its 
merits,  and  also  fair  statements  ot  whatever  im- 
perfections it  might  possess.  We  leceive  so 
many  questions  from  our  readers  regarding  this 
subject,  which  we  cannot  answer  by  personal 
letter,  that  we  deem  it  well  to  give  a  brief  re- 
sum6  of  the  entire  subject  as  we  see  it,  and  as  it 
is  developed  up  to  the  present  date.  Active 
practitioners  are  busy  at  work  every  day  with 


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419 


these  remedies,  bringing  out  more  and  more,  in 
actoal  experience,  the  advantages  of  this  method 
of  medication.  This  practice  does  not  require  a 
new  medical  edacation.  The  physician  who 
knows  his  crude  drugs  well  must  have  S3me 
knowledge  of  their  active  principles,  as  he  knowd 
that  the  medicinal  action  is  produced  by  them. 

The  purely  scientific,  and  hence  most  truly 
practical,  physician  knows  perfectly  well  the 
advantages  in  the  use  of  the  alkaloids  over  that 
of  the  crude  drugs  from  which  they  are  derived. 
(The  profession  has  long  recognized  this  prin- 
ciple by  the  use,  for  example,  of  quinine  in- 
stead of  the  bark. )  This  onl>  is  accurate  and 
scientific  medication.  It  insures  that  the  patient 
will  get  the  remedy.  If  the  crude  drug,  or  a 
Gkilenical  preparation,  is  given,  this  cannot  be 
insured,  as  it  may  not  be  of  the  standard 
strength — in  fact,  it  may  even  be  entirely  inert. 
Thep  the  stomach,  as  a  chemical  laboratory, 
may  be  in  imperfect  order,  and  may  elaborate 
the  active  principles  from  the  drug  but  slowly, 
or  even  not  at  all ;  or  its  activity  may  be  sus- 
pended temporarily,  and  when  it  is  again  re- 
sumed the  patient  may  get  a  cumulative,  toxic 
dose  of  the  desired  active  principle.  Hence  the 
advantage  of  obtaining  the  active  principle  in 
the  chemist* s  laboratory. 

But  the  chief  practical  difiSsulty  in  giviog 
the  alkaloids  in  their  powdered  form  is  that 
they  are  so  powerful,  and  hence  require  such 
minute  doses,  that  it  is  difficult  to  obtain  an  ac- 
curate dosage  of  them  in  practical  dispensiog. 
In  the  case  of  many  of  them  the  required  dose 
is  almost  microscopical.  This  difficulty  o(  cor- 
rect subdivision  is  entirely  met  by  using  accu- 
rately prepared  dosimetric  granules.  The  very 
name,  "Dosimetric,"  means  "in  measured 
doeee.''  Properly  made  granules  are  reliable, 
accurate,  convenient  and  inexpensive 

We  say  "inexpensive''  advisedly,  as  the 
most  of  these  remedies  cost  the  physician  no 
more  made  up  into  granules  than  the  drug  itself 
would,  bujring  at  retail,  and  they  cost  him  far 
less  than  the  same  materials  would  cost  the  pa- 
tient if  dispensed  to  him  by  a  druggist  upon 
prescription.  Of  course,  this  is  not  true  of  a  few 
of  the  very  cheapest  drugs,  as  calomel,  for  ex 
ample,  in  which  the  cost:  of  making  into  Ihe 
granule  form  is  greater  than  the  cost  of  the  ma- 
terial. But  in  most  of  the  active  principles  the 
profit  of  the  granule  manufacturer  is  only  the 
difference  between  the  wholesale  and  retail  price 
of  the  materials.  Taking  the  granule  prices 
per  thousand,  with  discounts  off,  we  find  that 
the  average  cost  of  the  number  of  granules  usu- 
ally di^pcnosed  at  one  visit — from  10  to  25 — 
is  from  about  one- half  a  cent  to,  in  extreme 
cases,  five  cents.    You  can  eanly  collect  from 


five  to  twen^-five  cents  extra  for  them,  if  you 
desire  to  do  so ;  but  their  influence  otherwise  on 
your  practice  will  be  so  beneficial  that  you  can 
well  afford  to  make  no  charge  for  the  medicines. 
However,  on  this  subject  Dr.  Juettner,  of  Cin- 
cinnati, says  as  follows : 

"  Medicine  shouM  not  be  given  away  to  any 
and  everybody  under  any  and  all  circumstances. 
People,  as  a  rule,  ascribe  little  value  to  that 
which  they  get  for  nothing.  Every  patient 
should  be  made  to  pay  for  every  granule,  pill 
or  tablet  he  or  she  receives.  The  price  may  be 
made  to  appear  nominal  if  compared  to  the 
enormous  rates  of  the  retail  druggist,  yet  it  may 
cover  the  a'  tual  cost  of  the  medicine  over  and 
over  again.  The  writer's  plan  of  charging  a 
certain  fixed  price  for  an  office  call,  including 
all  medicines  furnished,  has  proven  very  satis- 
factory. No  patient  his  ever  complained  about 
the  charge  of  a  few  dollars  for  medicine,  added 
to  a  bill  for  services  durmg  a  sick  spell  lasting 
one  or  more  weeks.  The  contemplation  of  what 
the  size  of  the  drag  bill  would  have  been  if  the 
physician  had  written  prescriptions,  speedily 
awakens  in  a  malcontent  or  disgruntled  patient 
a  sense  of  appreciation  for  his  medical  atfendant 
With  a  practical  and  methodical  individual  the 
plan  (^  dispensing  his  own  medicines  should, 
under  any  and  all  circ  imstanoes,  prove  a  pay- 
ing investment,  aside  from  the  numerous  other 
advantages  it  affords." 

The  amount  you  invest  for  granules  should 
increase  your  practice  to  a  far  greater  extent 
than  the  money  so  expended,  even  if  it  should 
extend  to  several  hundred  dollars  a  year.  Have 
your  cabinet-maker  make  you  a  neat  office 
cabinet,  with  shelves,  or  buy  one,  and  invest 
sufficient  to  fill  it  with  a  well-selected  list 
of  granules;  then  keep  it  constantly  sup- 
plied. You  are  then  really  prepared  for  prac- 
tice. The  man  who  "  timidly  puts  in  one  toe 
and  draws  back  with  a  shiver,"  spending  a  dol- 
lar and  a  half  or  two  dollars  a  month  for  a  few 
granules  of  two  or  three  varieties,  does  not  really 
know  what  the  general  adoption  of  granules  can 
do  for  him.  Neither  does  he  know  the  science 
of  buying.  The  man  who  buys  his  granules  by 
the  hundred  pays  nearly  twice  as  much  as  one 
who  buys  by  the  thousand.  The  man  who  buys 
C.  O.  D.  in  small  amounts,  or  on  credit,  loses 
the  transportation  charges  and  the  cash  discounts. 
The  saving  of  all  this  expense  alone  makes  quite 
a  neat  sum  in  the  course  of  a  year.  It  pays  a 
physician  just  as  well  as  any  one  else  to  be  a 
practical  business  man. 

Bemg  aware  of  the  fact  that  there  are  many 
theories  advanced  by  recognized  advocates  of 
Dosimetry,  that  to  the  average  doctor  seem  too 
ethereal  and  visionary,  accustomed  as  he  is  to 


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fall  dosage  and  positive,  unmistakable  effects, 
we  applied  to  the  manufacturers  who  publish 
the  largest  list  in  the  world  of  these  remedies — 
the  Philadelphia  Granule  Company — for  a  frank, 
candid  statement  of  the  practical  use  of  the  vari- 
•ous  granules,  as  shown  by  their  business  expe- 
dience. 

The  following  granules  are  found  to  be  the 
most  practical,  and  are  in  everyday  use  by 
practicing  physicians.  The  action  and  uses  of 
the  meet  of  them  are  so  well  known  to  the  pro- 
fession, that  it  is  not  deemed  necessary  to  enu- 
merate them.  The  full  dose  is  not  intended  to 
be  represented  in  one  granule.  From  two  to  six 
granules  are  usually  required  when  the  full  phys- 
iological dose  is  immediately  required.  The  better 
method  is  to  give  the  small  dose  frequently, 
until  the  desired  result  is  jeached.  This  nearly 
always  requires  a  smaller  amount  of  the  drug, 
and  causes  less  shock  and  injury  to  the  system. 

Aconitine  (amorphous).  The  -^-^  grain  is 
the  size  in  almost  universal  use. 

Atropine  sulphate,  gr.  ^  and  ^. 

Agaricin.  To  check  profuse  sweating,  espe- 
/dally  in  phthisis. 

Acid  arsenious,  gr.  y^  and  ^. 

Apomorphine,  gr.  ^.  Emetic,  expectorant. 
This  drug  deteriorates  with  agCr  whether  in  tab- 
let, solution  or  granule.  Doctors  should  pur- 
<hase  only  a  smaJl  quantity  at  a  time. 

Brucine,  y^.  One  of  the  alkaloids  of  nux 
"vomica.     An  excellent  systemic  tonic. . 

Caffeine  citrate,  gr.  ^.  Heart  and  nerve  tonic 
and  diuretic. 

Calomel,  gr.  -^  and  ^.  The  medium  dose  of 
calomel,  repeated  every  hour  or  half  hour,  is  a 
most  efficient  remedy  in  nausea,  biliousness, 
catarrhal  conditions  of  the  alimentary  tract,  and 
inflammation  of  the  respiratory  passages. 

Codeine  sulphate,  gr.  ^y  and  ^.  One  of  the 
alkaloids  of  opium.  One  of  the  best  and  safest 
nerve  sedatives.  Especially  valuable  for  chil- 
dren, and  for  use  in  abdominal  and  pelvic  dis- 
eases.    In  diabetes,  to  reduce  sugar. 

Gcutine  gr.  y^.  Alkaloid  of  conium,  or 
spotted  hemlock. 

Colchicine,  gr.  yj^.  Useful  in  gout,  pletho- 
ric conditions  and  uricemia,  and  for  the  head- 
aches accompanying  them. 

Copper  araenite,  gr.  y^  and  y^'^^^.  Very 
useful  in  diarrhea,  dysentery,  intestinal  colic, 
and  in  all  septic  conditions  of  the  intestinal 
tract 

Digitalin,  amorphous,  gr.  ^.  The  physi- 
cian should  study  digitalis  in  his  materia  medica 
carefully  before  using  this  preparation.  For 
the  full  action  of  digitalis,  the  powdered  leaves 
should  be  given ;  for  action  upon  the  heart  alone, 
digitalin  j  for  the  diuretic  action  only,  the  infu- 


sion is  the  most  reliable  preparation,  containing 
a  larger  proportion  of  digitonin,  the  especial 
diuretic  agent  in  the  drug. 

Ergotin,  gr.  ^  This  drug  is  not  very  oeartm 
or  reliable. 

Emetine,  gr.  ^irr'  ^^  active  prindf^e  of 
ipecac. 

Gelseminine  muriate,  gr.  7^.  The  action 
and  uses  of  gelsemium  are  well  known  to  the 
profession.  Qetseminine  well  represents  the 
drug.  This  granule  represents  only  about  one- 
fourth  of  the  medium  dose  of  the  drug.  From 
two  to  four  granules  may  be  considered  the  full 
dose  for  immediate  effect. 

Glonoin  (nitro- glycerine),  gr.  ^hf  ^^' 
spasmodic  siezures,  fainting,  convulBionB,  ure- 
mia, angina  pectoris,  heart-failure,  shock,  etc 

HyoKsyamine  (crystals),  gc.  •^.  A  most 
valuable  gnftiule  in  mania,  nervous  or  mental 
excitement,  chorea,  nervous  or  irritable  coughs^ 
and  as  a  safe  sedative  for  children. 

[ron  arseniate,  gr.  ^.  This  is  an  exoell^t 
form  of  administering  iron  for  tonic  effect. 

Iodoform,  gr.  i. 

Lithium  benzoate,  gr.  |^.  As  an  antiaeptie 
diuretic. 

Macrotin,  gr.  ^.  Resinoid  of  dmicifuga. 
The  well-known  uses  of  cimicifuga  are  too  exten- 
sive to  be  enumerated  here,  covering,  as  they 
do,  a  wide  range  of  disused  conditions. 

Mercury  biniodide,  gr.  ^ ;  also  bichloride, 
gr.  y^.     Most  useful  antiaeptie  alteratives. 

Morphine  sulphate,  gr.  ^  and  other  morphine 
salts. 

Physostigmine  salicylate  (eserine),  gr.  ^f  • 
The  alkaloid  of  the  Calabar  bean. 

Phytolaccin   gr.  \. 

Potassium  bichromate,  gr.  ,y. 

Pilocarpine,  gr.  ^.  (See  remarks  under 
gelseminine  ) 

Podophyllin,  gr  ^. 

Quasseme,  gr.  ^V 

Quinine  hydroferrocyanate,  gr.  ^. 

Quinine  arseniate,  gr.  ^7. 

Quinine  valerianate,  gr.  J^. 

Sparteine  sulphate,  gr.  ^j  and  gr.  |-. 

Strophanthin,  gr.  yoVir*  Valuable  heart 
tonic. 

Strychnine  arseniate,  gr.  y|^  and  ^. 

Strychnine  sulphate,  gr.  y^  and  ^. 

Tartar  emetic,  gr.  ^7. 

Veratrine  sulphate,  gr.  y^. 

Zinc  phosphide,  gr.  ^.     Nerve  restorative. 

Zinc  sulpho-carbolate,  gr.  |. 

There  are  many  granules  besides  those  in  the 
above  list  that  the  physician  will  occasionally 
need.  Each  one  must  make  his  own  selection 
of  remedies,  suited  to  his  peculiar  methods  of 
practice. 


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One  of  the  manj  advantages  of  these  gran- 
alee  is  that  thej  are  particularly  convenient  to 
dispense,  especially  in  office  practice,  where  they 
may  be  given  the  patient  in  small  dispensing 
vials  or  pill  boxes,  to  be  carried  in  the  vest 
pocket.  At  the  bed  side  they  may  be  dispensed 
in  the  same  or  in  domestic  vessels,  as  table  salt 
ceUars,  individual  butter  plates,  etc.,  according 
io  the  ingenuity  of  the  physician.  For  patients 
who  like  to  think  they  are  getting  large  doses 
of  medicine  the  granules  may  be  disp^ised  by 
diflBolving  the  required  number  in  a  bottle  of 
oolored  water,  syrup  or  other  menstruum,  and 
directing  it  to  be  taken  in  appropriate  doses. 

Of  course,  it  is  not  intended  that  the  physi- 
cian shall  renounce  all  other  remedies  excepting 
those  that  can  be  procured  in  the  form  of  gran- 
ules. Many  very  useful  drugs  are  not  practical 
in  that  form ;  the  bromides  and  other  coarse 
salts,  for  example.  These  the  physician  must 
prescribe  whenever  he  considers  them  necessary 
for  the  welfare  of  his  patients. 

Combination  granules  are  a  great  conveni- 
ence in  the  case  of  drugs  that  are  very  fre- 
quently required  to  be  administered  together. 
Besides  being  much  more  convenient  to  dispense 
one  granule  than  several  they  are  much  more 
economical.  But  a  combination  granule  is  a 
formula,  or  prescription,  and  you  must  exercise 
your  own  judgment  as  to  whether  you  want  to 
use  it  or  not.  As  with  prescriptions  in  general, 
they  may  be  suited  to  the  case  in  hand,  or  they 
may  not  Their  value  depends  upon  the  ability 
of  the  physician  who  prescribes  them,  as  well 
as  upon  that  of  the  one  who  formulated  them. 
Hence  manufacturers  usually  do  not  guarantee 
the  efficacy  of  combination  granules  as  being 
curative  of  the  diseases  in  which  they  are  used. 
They  only  guarantee  that  they  contain  the  drugs 
they  purport  to  contain,  and  that  successful 
physicians  have  found  those  combinations  useful 
in  the  greater  proportion  of  the  conditions  for 
which  they  are  recommended.  This  fair  statement 
is  more  reasonable  and  more  truthful  than  the 
absurd  claims  too  often  made  by  medicine  pro- 
prietors that  their  preparations  are  unfailing 
apedfics.  We  have  evidence  that  the  combination 
granules  are  very  valuable  when  properly  pre- 
scribed. These  granules  are  not  a  test  of  the 
value  of  the  active  principle  form  of  medication ; 
they  are  only  a  test  of  the  prescription.  For 
this  reason,  the  manufacturers  usually  decline  to 
send  samples  of  combination  granules.  Hence, 
for  ti  test  of  the  alkaloidal  method  of  medica- 
tion, select  only  granules  of  well  known  single 
drags,  whose  action  can  be  thoroughly  tested. 

It  strikes  us  that  there  are  some  impractical 
granules  on  the  lists  of  the  various  manufact- 
urars;  as,  for  example,   borado  acid,  gr.  i. 


creasote,  gr.  ^,  nickel  bromide,  gr.  1,  pepsin  in 
mmute  doses  and  a  number  of  others.  We  sup- 
pose that  some  physicians  think  they  get  results 
from  these  seemingly  insufficient  doses,  else 
there  would  never  have  been  a  demand  for 
them.  But  it  is  not  necessary  that  all  physicians 
using  dosimetric  granules  go  to  this  extreme. 
The  positive  therapeutist  can  find  abundant 
material  for  efficient  dosage  in  the  list  above 
given,  and  he  will  find  that  convenience,  economy 
and  directness  will  be  subserved  by  their  use. 

Formulas. 


FOB  RHEUMATISM. 

The  following   prescription  is  recommended 

by  the  Journal  de  Mideeine  de  Paris  : 

E,  Salol » «........«..« 

Btherii. ............^la  p.  iv 

CoUodii - p.  XXX 

M.   Big.— To  be  painted  about  the  painftd  and  inflamed 
Joint 

— Therapeutie  Gazette, 

AN   INJECTION   IN   DYSENTERY. 

B.  Acid,  boiio ounces  m 

"   tannic gr.  xlv 

Tlnct  opii...... « gtt.  XV 

Aquse .« OJ 

M.   To  be  given  after  a  doM  of  castor  oil,  for  the  porpoae 
of  washing  out  the  boweL 

— Tlierapeutic  Gazette, 

CORN  CURE. 

B.   Cocaine  hydrochlOTate »..2grB 

Salicjrlio  add 80  grs 

Alcohol .».. ».. 120  minims 

Solid  ext  cannibis  indlca 8  gna 

Collodion 120  minims 

Apply  to  the  oom  by  *ny  convenient  means. 

FOR   BRONCHORRHEA. 

B.  Copaiba drams  iU 

Tinotorse  chloroform  composiUe.» Jn  xx 

MncUaginis  aoadaB diams  vli 

LiquorUi  potasNB drams  j 

Aqun  dnnamomi...... ...Ad  ounces  vUJ 

Misoe  et  flat  mistura. 

An  eighth  part  to  be  taken  three  times  daily. 


—  Western  Medical  Reporter. 


HEADACHE. 


Magnesium  phosphate,  two  grains  every  hour, 
has  b^n  successful  in  relieving  obstinate  hemi- 
crania. 


A   PILL   FOB   ANEMIA. 

Prof.  Eilefsen  (ia  Semaine  Medicate,  No. 
24,  1894)  recommends  the  following  pill  in 
anemia : 

R.  Iron  reduced  by  hydrogen » 

Powdered  camphor aa  6 1  o  drams  J  v 

Extr.  gentian 5 )  o  drams  J  ^ 

MudlMe  gum  arable »a.  s 

Suflicient  for  ninety  pills.  Tiro  to  three  pilhi  three  times 
a  day. 

He  has  found  this  formula  of  value  both  in 

anemia  and  in  chlorisis,  especially  when  they 


Digitized  by  V^OOQ^lC 


422 


THB  MEDICAX  WORLD. 


are  accompanied  by  cardiac  disturbances,  as 
weakness  and  irregalaritj  of  the  pulse. — Med. 
and  Surg.  Reporter. 

CEMENT  FOB  CELLULOID. 

It  may  be  cemented  hj  moistening  it  with 
glacial  acetic  acid  and  pressing  the  parts  firmly 
together  for  a  few  minutes. 

Another  cement  for  celluloid  is  composed  of 

Parts. 

B.  Campbor « 1 

Shellac 6 

Alcohol ., 80 

— Drug.  Oirc 

FOE   PAINFUL   DYSPEPSIA. 

R.  Btamntlil  sabnltrat gr.  x 

Magnes.  carbonat gr.  Z7 

liq  Potaasie minims  x 

Acid,  hydtocyan  dil minims  ilj 

Tinct.  EiDgibens » minims  v 

Aq.  menth.  pip.,  q.s. ad.  f  ounces  J 

M.  For  one  dose.  To  be  re;  eated  two  or  tbree  times 
daily.    Shake  weU. 

--Ther.  Gaaette. 

FOR   DIPHTHEBIA. 

B.  Caflblne « gr.  xx 

Sodll  bicarb „ gr  v 

Aquse » q.a  ad.  f  onnoee  i] 

M.    ttig.— Apply  locaUy  as  a  spray  to  the  membiane. 

Nitrate  of  silver  stains  are  easily  removed  by 
painting  the  part  with  iodine  and  then  washing 
in  dilute  aqua  ammonise. 


FOR  PYELITIS. 


Dr.  H.  W.  Moore,  724  South  Twe  *ty  second 
street,  Philadelphia,  Pa.,  used  with  especially 
gratifying  results  in  Pyelitis  : 

B.   "  Sander  A  Sons  "  Eucalyptol 
Big.— Three  drops  three  times  a  day. 

In  a  case  of  an  old  sore  leg,  the  following 
formula  had  been  used  with  great  benefit : 

B.   Hydrarg.  chior.  mtt dramatis 

Bacalyptol  (^tender  &  Sonb) drams  li 

i*ulvisopU ».. drams  ijs 

Vaseline ounces  ii 

M.    S.— Apply  night  and  morning. 

MALABIAL   CACHEXIA. 

In  cases  of  Malarial  Cachexia,  after  cbills 
have  been  broken — the  following  will  be  found 
of  much  eervice  in  building  up  the  system  and 
preventing  the  return  of  attacks : 

B.  Tlnct.  ciochonss  comp onnces  ij 


M. 
meals. 


Ext  euoalmos  fid drams  j 

"'    potassiian 

capdci  fid 

Syr.  acidhydriodicXHostelley  V),ad.  ounces  tU] 


Llq. 


faraen drams  i  J 

dci  fid dtams  1 


Slg.— TeaspoonfUl' in  water  three  times  dally,  after 


Pi^SKOLA. 


Dr.  Eccles,  in  Druggists*  Circular,  states  the 
following,  after  repeated  careful  analysis  and 
thorough  investigation,  fully  set  forth  in  the 
article  from  which  this  is  selected. 


''Paskola  can  be  practically  duplicated  by 

the  following  formula : 

B.  Glucose  pyrop »^ 1  pound 

Hydrochloric  add 50  drops 

SuJphurous  add,  u.  s.  p.  (Areshly  pre- 
pared) ..„„.. ^ ^.........6  or  Sdroya 


BBONCHO  PNEUMONIA. 

For  the  cough : 

B.  Anttpyrln gr.  vltf 

Synip  of  cinchona ^..onnoesj 

Syrap  of  eucalyptos „ ^ drams  x 

Peppennint  water .ounces  iss 

M.    Teaspoonfbl  every  hour. 

If  there  is  a  tendency  to  collapse : 

B.  Acetate  of  ammonium ». ».dimms m 

Malaga  wine ^ ounces  IJ 

Symp  of  ether ^ drams  t 

Peppermint  water drams  x 

M.   TcaspoonAil  every  hour. 

During  convalescence : 

B.   Syrup  of  cinchona dram  x 

Syrup  of  terpine ounces  iss 

Syrup  of  iodide  of  iron.. ., ounces  Ij 

Peppermint-water ounces  iss 

M.    A  teaspoonAil  thrice  daily. 

La  Tribune  Med. 


Reviews. 


The  Public  Owkebship  op  Monopolies.  By  Prof. 
Frank  Parsons,  of  the  Law  Department  of  BostoD 
University,  author  of  **Oar  Country's  Need,*^ 
"  The  World's  Best  Books,''  etc.    Paper,  10  cents. 

We  haye  read  this  work  with  great  interest,  and 
confess  to  the  fact  that  we  have  re-read  it  seyeral 
times.  It  treats  in  a  most  fascinating  manner,  and 
with  exhaustive  information,  of  some  of  the  great 
qaestions  that  are  coming  before  the  Ajuerican  people 
for  early  settlement.  Every  Americin  citizen  should 
read  it 

The  Philosophy  of  Mutualism.  Bj  the  same  au- 
thor.   Paper,  10  cents. 

This  is  a  charming  stady  of  our  social  life,  what  it 
should  be,  and  perhaps  may  sometime  become.  It 
takes  an  advanced  viow,  recognizing  the  fondamenta) 

Srinciple  of  brotherhood  as  it  should  be  applied  in  all 
epartments  of  human  activity.  All  students  of  hnman 
society  (and  all  doctors  are  such)  should  read  and 
circulate  it. 

The  above  (wo  books  by  Prof,  PanoTis  will  be  tent  yo« 
free,  if  you  will  send  reqxiest  {mentioning  thif  nolke)  to 
Mr.  B.  Franklin  Hunter,  1100  Pine  street,  Philadd- 
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Ten  Men  of  Money  Island.  By  F.  8.  Norton. 
Paper,  10  cents. 

This  book  gives,  in  a  simple,  narrative  form,  the 
fundamental  principles  of  the  trade  relations  of  man- 
kind. It  may  truly  be  called  a  "  Primer  of  Finance." 
While  as  plain  and  homely  in  its  style  a9  '*  Pilgrim's 
Progress,'^  yet  it  is  so  interesting  that  yon  will  not 
want  to  lay  it  down  until  finished. 

The  Bank  of  Venice.  By  Hon.  John  Davisw 
Paper,  10  cents. 

This  is  a  valuable  historical  aocoimt  of  the  most 
remarkable  and  sucoessfol  financial  experiment  known 
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monstrates  that  metals  are  not  at  all  nf  cessary  as  a 
eircalating  medium,  nor  as  a  basis  of  a  circalating  me- 
dium. 

These  two  books  will  be  sent  upon  receipt  qf  price, 
10  cents  each,  by  addressing  American  Economic  Re- 
form Society,  1202  Pennsylvania  Ave.,  N.  W.,  Wash- 
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Turn  Senile  Heart:  Its  Symptoms,  Sequelae  and 
Treatment.  By  George  William  Balfour,  M.D., 
LL.D,  F.  E.  C.  P.  E.,  F.  E.  S.  E.  Cloth,  300 
pages,  price  $1.50.  Macmillan  &  Co.,  I^ew 
York. 

This  is  a  most  admirable  work,  dealing  in  an  able 
manner  with  a  subject  not  heretofore  treated  with 
sufficient  importance.  The  weak  heart  of  the  aged 
may  be  so  treated  and  guarded  that  life  may  be  made 
comfortable  and  considerably  prolonged. 

Text  Book  op  Anatomy  and  Physiology  fob 
Nurses.  By  Diana  Clifford  Kimber,  graduate  of 
Bellevne  Training  School.  Goth,  268  pages, 
price  $2.50.     Macmillan  &  Co.,  New  York. 

The  physician  will  recognize  the  importance  of  his 
oarses'  knowing  enough  of  the  leading  facts  of  anatomy 
and  physiology  to  enable  them  to  discharge  their 
ilnties  intelligently.  This  book  fulfills  the  purposes 
of  such  instruction  in  a  satisfactory  manner,  and  will 
be  found  a  very  useful  volume. 

XHEBAPEtTTIOS :  IT8  PbIKCIPLES  AND  Pbaoticje.  By 
H.  C.  Wood,  M.D^  LL.D.,  Professor  of  Thera- 
pentics,  e^c.,  in  the  University  of  Pennsylvania. 
Ninth  edition,  completely  revised.  Cloth,  1,007 
pages.    J.  B.  Lippinoott  Co.,  Philadelphia. 

f?8o  much  has  been  said  of  Professor  Wood's  work  in 
previous  editions,  that  we  can  only  repeat  here  the 
favorable  opinion  in  regard  to  this,  the  ninth  edition. 
No  other  author  treats  of  the  subiect  of  physiological 
action  in  minute  detail  under  each  drug. 

Syllabus  op  Lectubes  on  Human  Embbyology: 
An  Iniroduciion  to  the  Study  of  Obstetrics  and 
Oynsecology,  For  Medical  Students  and  Practi- 
tioners. With  a  Glossary  of  Embryological 
Terms.  By  Walter  Porter  Manton,  M.D.,  Pro- 
fessor of  Clinical  Gyniecology  and  Lecturer  on 
Obstetrics  in  the  Detroit  College  of  Medicine; 
Fellow  of  the  Royal  Microscopical  Society,  of  the 
British  2jOological  Society,  American  Microscopi- 
cal Society,  etc.,  etc.  Illustrated  with  seventy 
(70)  outline  drawings  and  photoengravings. 
12mo,  cloth,  126  pagei,  interleaved  for  adding 
notes  and  other  Ulustrations,  $1.25  net.  Phila- 
delphia: The  F.  A.  Davis  Co.,  publishers,  1914 
and  1916  Cherry  street. 

This  will  prove  a  most  useful  book  for  the  student 
of  obstetrics,  as  well  as  interesting  to  practitioners  who 
wish  to  keep  up  with  the  advancements  of  recent  years 
in  this  branch  of  science. 

A  Manual  op  Human  Physiology  :  Prepared  espe- 
cially for  students.  By  Joseph  H.  Raymond, 
A.M.,  M.D.,  Professor  of  Physiology  in  Long 
Island  College  Hospital.  Cloth,  382  pages,  pro- 
fusely illustrated;  price  $1.25.  W.  B.  Saunders, 
925  Walnut  street,  Philadelphia. 

Thb  work  is  not  a  "  quiz-compend,"  but  a  dear, 
concise  statement  of  the  principles  of  physiology.  As 
such  it  will  be  of  use  to  those  students  who  do  not 
wish  to  read  the  longer  treatises  during  the  lecture 
course. 


Essentials  op  Diseases  op  the  Eab.  By  E.  B. 
Gleaflon,  B.S.,  M  D.,  of  the  Medico  Chirurgical 
College.  Philadelphia.  Cloth,  illustrntt^d,  147 
pages ;  price  $1  00.  W.  B.  Saunders,  926  Walnut 
street,  Philadelphia. 

If  the  general  practitioner  cannot  lake  the  time  to 
study  the  longer  complete  treatises  on  the  ear,  this 
work  by^rofessor  Gleason  will  prove  very  useful. 

Domestic  Economy.  By  Mary  A.  Spangler,  M.E.L. 
Cloth,  262  pages.  Published  by  the  anchor  at 
Canton,  O. 

A  careful  reading  of  this  able  and  most  charming 
work  gives  the  impression  that  the  title  i"  not  a  ver^ 
accurate  indication  of  the  contents  of  the  book  It  is 
really  a  philosophical  consideration  of  woman's  work 
in  life,  and  its  ethical  and  economical  position  as  com- 
pared with  other  branches  of  work.  It  announces  and 
clearly  demonstrates  some  fundamental  principles  not 
heretofore  generally  rec  gnised,  the  most  prominent 
of  which  being  that  woman,  in  her  domestic  employ- 
ment, is  most  decidedly  a  producer — a  manufacturer— 
and  as  such  her  work  should  be  recognised,  properly 
recompensed,  and,  so  far  as  possible,  placed  under  pro- 
per economic  conditions  as  regards  improve!  ma- 
chinery and  motive  power  and  wholesale  production. 
Trulv,  a  recognition  of  this  principle  will  ^ive  us 
another  distinct  step  on  the  road  from  barbarism  to- 
ward civilization.  Mrs.  Spangler  is  to  be  congratula- 
ted for  the  brave  words  she  has  uttered.  The  chapter 
on  "Co  operative  Housekeeping"  is,  in  our  opinion, 
the  best  one  in  the  book.  We  take  the  liberty  of  add- 
ing the  foUowiug  quotation  from  the  work : 

'*  The  doctrine  that  a  temperate,  chaste,  and  pnn^ 
life,  both  before  and  after  marriage,  is  essential,  will, 
in  course  of  time,  be  universally  taught,  and,  as  under- 
stood and  obeyed,  will  point  as  a  beacon  light  to  the 
tree  of  life,  whose  leaves  shall  heal  the  nations." 

Home  Tbeatment  op  Catabbhs  and  Colds.  By 
Leonard  A.  Deesar,  M.D.  Cloth,  118  pages. 
Published  by  the  Home  Series  Publishing  Com- 
pany, New  York. 

This  is  a  work  giving,  for  the  use  of  the  laity,  the 
methods  of  treatment  current  with  the  members  of  the 
profession  who  have  given  considerable  attention  to 
the  diseases  under  consideration. 

Physician's  VisrriNa  List,  1894-6.  Sent  free  by^ 
Antikamnia  Chemical  Co. ,  St.  Louis,  Mo. 

"  An  Intba  Mubal  View,*'  a  very  artistic  brochure, 
has  been  received  from  The  Curtis  Publishing 
Company,  Philadelphia,  publishers  of  The  Ladie^ 
Home  Jowrnal, 

As  the  title  indicates,  the  booklet  gives  us  glimpses 
of  the  interiors  of  the  JoumaPs  offices,  and  Pome  idea 
of  the  work  carried  on  there.  The  numerous  illustra- 
trations,  showing  the  commodious  and  well-fitting  offi- 
ces, And  the  accompanying  text,  giving  us  some  insight 
into  the  work  in  the  different  bureaus,  requirins  a  force 
approximating  four  hundred  employees,  indicate  the 
wonderful  success  which  The  Laditi  Home  Journal  has 
achieved  in  an  almost  incredible  short  time.  The  first 
number  was  issued  in  December,  1883,  so  that  less 
than  eleven  vears  have  elapsed  since  Mr.  Curtis  con- 
ceived the  idea  which  has  developed  into  so  vast  an 
enterprise.  In  this  short  tune  its  merit  and  steadv 
improvements  in  all  departments  have  received  such 
recognition  that  its  circulation  has  reached  the  enor- 
mous average  of  about  700.000 — the  largest  magazine 
output  in  the  world.    The  brochure  also  describes  at 


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THE  MEDICAL  WORLD. 


0ome  length  the  work  of  printing  and  bindin^r  the 
Journal,  which  is  carried  on  in  a  separate  building. 
**  An  IntrarMoral  View  "  will  be  sent  to  any  one  who 
will  address  The  Cartis  Publishing  Co.,  and  inclose 
four  cents  in  stamps  for  postage. 

We  wibh  to  congratulate  our  old  friend,  Dr.  Sam. 
Cochran,  upon  the  great  beautj  and  evident  success  of 
his  Louuville  Medical  Monthly,  Send  for  asao^le  copy 
and  you  will  be  delighted. 


Wit  and  Wisdom. 

Haio  regards  a  majority  of  cases  of  perityphlitis  as 
rheumatic  or  gouty,  and  claims  excellent  results  from 
the  use  of  salicylates. — Kan^  Med,  Jour, 

BABE  FEET  ABE  HEALTHY. 

Many  country  people  go  barefooted  during  the  hot 
season,  not  for  the  saice  of  health,  but  as  a  matter  of 
economy.  The  efiect  is  to  give  the  pedal  organs  a 
chance  to  grow  naturally,  and  at  the  same  time  to  pro- 
mote the  health  of  the  whole  body.  That  it  has  its 
disadvantages  cannot  be  denied — a  thorn  in  the  foot, 
a  bruise  now  and  then,  are  the  results. 

Going  barefooted  is  coming  more  generally  into 
vogue,  not  as  a  matter  of  economv,  but  for  health*s 
sake.  It  is  found  that  the  tender  feet  of  those  who 
never  expose  them  to  any  hardship,  but  keep  them 
housed  aU  the  year  round,  are  direct  causes  of  ill- 
health,  of  colds,  of  weakness  of  the  eyes,  and  many 
other  minor  troubles.  So,  to  remedy  this,  patients 
are  advised  to  go  barefooted  a  little  while  daily,  in 
their  rooms,  in  the  yard,  at  the  seaside  for  two  or 
three  hours  when  on  the  beach,  and  wherever  they 
can  without  trouble.  Those  who  cannot  do  it  can  take 
substitutes  by  washing  the  feet  every  night. — Dnig. 
Cir, 

FIKSAPPIJE8  IN  DIPHTHEBIA. 

A  Southern  writer  says,  in  regard  to  a  severe  case : 
"  A  ripe  pineapple  was  gotten,  and  the  juicA  expressed 
and  given  in  teaspoonftu  doses,  slowly.  It  seemed  to 
clear  the  throat,  swallowing  was  easier,  and  in  a  few 
hours  the  child  was  sleeping.  Kecovery  followed. 
The  pineajpple  was  used  in  a  number  of  cases  subse- 

Suently*  with  succew,  in  the  same  neighborhood,  and 
le  people  think  it  better  than  medicine.'' 

Why  do  the  combination  granules  of  the  Philadel- 
phia Granule  Company  give  such  excellent  results? 
Because  they  actually  contain  the  full  amount  of  the 
pure  and  active  drugs  called  for  on  their  labels.  You 
cannot  depend  upon  this,  nor  upon  accurate  subdivi- 
sion, if  yon  have  the  same  prescriptions  put  up  at  the 
drug  store.  Besides  that,  they  would  cost  you  from 
five  to  ten  times  as  much.  Address,  No.  10  South 
Eighteenth  street. 


[Written  for  The  Mxdical  Wobld.] 


A  Retrospect. 


TO  DR.  J.  H.  Y.      BY  DB.  J.  J.  B. 


I've  had  boils  and  carbuncles  and  felons  as  well. 
And  other  ills  to  which  flesh  is  prone — 
Ock  hone !    Och  hone ! 


But  they  cannot  compare— they're  a  mere  bagatelle 
To  the  horrible,  terrible  tale  of  woe 
Of  a  single  fistula  in  ano— 
Ah  no  I    Ah  no ! 

n. 

The  doctor  comes  in  so  smiling  and  nice — 
*'A  little  incision  only  nrmakel" 
Landsake  I    Landsake  I 
You're  devilish  lucky  if  three  will  suffice  I 
To  brace  yourself  up  a  horn  or  two  ti^e; 
The  effect  came  for  me  an  hour  too  late— 
Tooiatel    Too  late  I 

III. 
Should  you  have  an  enemv,  don't' wish  him  dead ! 
I  know  a  more  terrible  doom  by  far, 
Ha-ha r    Tralal 
To  glut  your  revenge  just  wbh  him  instead. 
As  the  burden  of  your  anathema, 
A  fistula  I    A  fistulsrla-la ! 
Brooklyn,  N.  Y.,  Aug.,  1894. 


CUBE  FOB  SOFT  00BN8. 


A  good  treatment  is  said  to  be  to  bathe  and  dry  the 
foot,  and  then  paint  the  offending  com  with  a  i  solu- 
tion of  silver  nitrate,  r^)eating  this  application  every 
fourth  or  fifth  day.  In  the  meantime  the  toes  shonld 
be  kept  apart  by  a  pledget  of  cotton,  smeared  with  a 
zinc-petrolatum  ointment — Southern  Clinic, 

Spbciai«  diploma  of  honor  and  gold  medal  was 
awarded  to  Mellin's  Food  at  the  California  Midwinter 
Exposition,  1891 

Not  satisfied  with  ofiering  Maltine  alone  to  the  pro- 
fession, which,  bv  the  way,  is  an  article  of  the  highest 
merit  in  its  field,  the  Maltine  Company  have  oiered 
us  many  combinations — as  Maltine  with  cascara,  and 
many  others,  all  highly  usefuL  Now  thev  come  with 
a  new  one — Maltine  with  Coca  Wine.  Its  value  at 
once  suggests  itself  to  you.  Seldom  is  one  needed 
without  the  other.  Too  much  alcohol  has  to  be  taken 
with  the  ordinary  coca  wine.  Of  this  combinatioD 
some  one  graphically  says:  'The  coca  boosts  the  pa- 
tient, and  the  maltine  furnishes  the  peg  that  prevents 
him  from  slipping  back."  See  advertisement  on  page 
ii,  and  send  tor  samples  as  there  offered. 

The  sulphate  of  aluminum  is  the  new  iniection  for 
gonorrhea— one  part  to  600  or  1000  of  distilled  water. 
— Kan,  Med,  Jour, 

The  Chloride  of  Silver  Dry  Cell  BaUery  Company, 
Baltimore,  Md.,  make  an  elegant  and  efficient  Faradic 
battery,  complete,  for  only  |20.  Send  for  deecriptiye 
circular. 

Send  to  W.  H.  Schieffelin  &  Co.,  New  York,  N. 
Y.,  for  pamphlets  r^arding  the  new  chemical  pro- 
ducts. 

Send  to  Mic^jah  &Co.,  Warren,  Pa.,  for  medicated 
Uterine  Wafers. 

Tby  the  Avena  Morphine  treatment  prepared  by  & 
Keith  &  Co.,  75  William  street.  New  Yorit,  N.  Y. 

The  Atlas  Chemical  Co.,  216  Main  street,  Cincin- 
nati, 0.,  make  a  rheumatic  preparation  called  Mexi- 
can Bear's-Claw  Berry  Lotion.    Send  for  particulan. 

BESTOBATION  OF  HARDENED  BUBBSB. 

Rubber  goods  which  have  become  hardened  by  age 
may  be  restored  to  almost  the  original  softness  iif 


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simply  soakiig  in  a  water  of  ammonia,  dila'ed  with 
twice  its  Imllr  of  fresh  water,  and  that  this  does  not 
iigare  the  rubber  in  anj  way,  and  restores  th^  elas- 
ticity. Usually,  soaking  from  ten  minutes  to  half  an 
hour  it  quite  sufficient  ^ter  drying,  the  whiteness 
may  be  restored  by  dusting  well  with  chalk  or  kaolin. 

HABITUAL  MISCARRIAGE. 

Dr.  Basquinet,  Jupile,  near  Liege,  Belgium,  says : 
*'  I  tried  Aletris  Cordial  in  the  case  of  a  woman  who 
had  had  several  miscarriag-  s  at  the  end  of  five  months, 
and  who  is  now  again  pregnant,  having  reached  the 
seventh  month.    Thanks  to  Aletris  Condial." 

For  the  treatment  of  Hernia,  write  to  the  Hemo- 
sine  Chemiod  Co.,  Rochester,  Mich. 

Ths  filixir  Six  Iodides  is  prepared  by  the  Walker- 
Green  Pharmacal  Co.,  Kansas  City,  Mo. 

This  is  the  season  for  whooping  cough.  Send  |1 
for  a  box  of  Pertussu  Tablets,  to  Dr.  W.  H.  Walluag, 
1606  Green  street,  Philadelphia. 

Atrofhtb,  the  active  principle,  is  more  efficacious 
than  the  tincture  of  belladonna,  but  the  trouble  is  to 
dispense  it  accurately  in  the  exceedingly  small  doses 
required.  Send  10  cts.  to  the  Phila.  Granule  Co.,  No. 
10  South  18th  St.,  Phila ielphia,  Pa.,  for  100  (or  66 
cts.  for  1000)  of  their  elegant,  accurate  and  economical 
granules  of  atropine.  After  using  these  you  will 
never  again  go  back  to  the  crude  preparations. 

Dbal  with  I.  Phinips,  69}  MThitehaU  street,  At- 
lanta, Ga.,  for  cut  rates  m  surgical  instruments. 

Ths  belief  is  becoming  more  general  amonj^  physi- 
cians that  tuberculosis  is  a  non  inheritable  disc^. — 
JTofi.  Med,  Jour, 

Flvw  Extract  of  Kola  U  a  valuable  tonic  stimu- 
lant, indicated  in  nervous  depression.  Unfortunately, 
however,  it  is  acrid  and  bitter  in  taste,  and  taken  in 
this  form  is  decidedly  unpalatable.  Messrs.  Frederick 
Steams  8l  Co.,  of  Detroit,  Mich.,  have  devised  a  com- 
pound which  they  call  *^  Stearns^  Kola  Cordial." 
which  is  one- fourth  the  strength  of  the  Fluid  Extnu^ 
each  fluidounce  representing  120  g'ains  I'f  Kola,  but  is 
free  from  the  acrid  bitterness  of  the  drug.  It  possesses 
the  agreeable  odor  and  characteristic  taste  of  true  Ko- 
la, and  as  a  stimulant  is  prompt  and  active. 

Physicians  desiring  to  test  ihis  new  product  will  be 
forwarded  sufficient  samples  for  clinical  test  on  re- 
quest. 

For  the  antiseptic  treatment  of  Hernia,  address  the 
Sthavara  Co.,  1224  Betz  Building,  Philadelphia. 

See  advertisement  of  Litmus  Pencil.  It  will  detect 
one  part  of  acid  or  alkali  to  100,000  parts  of  the  fluid 
tested,  while  ordinair  litmus  paper  will  detect  only 
in  the  proportion  of  one  part  to  about  1400. 

Will  fast  perhaps  a  lifetime ;  always  at  hand  and 
convenient 

See  forms  for  prescription  blanks,  bill-heads,  etc.,  in 
'*  The  Physician  as  a  B.isiness  Man.*'  It  is  important 
that  the  physician  have  good  prmted  matter.  Wm. 
Koehl,  Erie,  Pa ,  dUkes  a  soecialty  of  physicians' 

Jrintinff.    See  his  full  page  advertisement,  page  xix, 
uly  World,  and  his  smaller  adv.  this  issue. 

Every  preventive  of  substitution  is  a  safeguard  to 
the  phybician  and  his  patients.  Antikamnia  is  now 
protected  by  a  very  ingeniou<9  devire.    A  monogram  b 


impressed  upon  eaeh  tablet  to  insure  its  genuineness. 
See  adv.  in  tnis  i^ue. 

KKTRORRHAOIA. 

T.  Henson  Smith,  L.  R.  C.  P.  A  L.  R.  C.  S.  &  L. 
M.,  Reddish  G  een,  near  Stockport,  England,  says : — 
*'I  have  found  the  Aletris  Cordial  useful,  chiefly  in 
cases  of  irregular  and  difficult  menstruations.  In  one 
case,  a  girl  of  twenty,  who  has  been  under  my  treat- 
ment a  year  with  irregular  and  painful  menstruation, 
I  have  been  able  to  afford  complete  relief  by  giving, 
the  Aletris  Corditil  in  teaspoonful  doses,  commencing 
about  two  da^s  before  the  period,  and  during  the  time, 
of  menstruation.  I  have  also  tried  it  in  a  case  of  dys- 
menorrhea, with  megrimes.  The  result  has  been  to 
remove  the  dysmenorrhea  and  relieve  the  headache. 
I  have  found  it  beneficial  in  many  uterine  i 


John  S.  Lynch,  M.D.,  Professor  Principles  and 
Practice  of  Medicine,  and  Clinical  Professor  of  Heart, 
Throat  and  Lu  gs  in  College  of  Physicians  and  Sur- 
geon*, writes : 

"  Dr.  J.  A.  Mc  Vrthur.  My  Dear  Doctor :— I  take 
this  occasion  to  sa^  that  I  used  the  Syrup  of  Hypo- 
phosphites,  both  in  the  in  an  i  ou'-patients'  depart- 
ments, and  in  all  cases  with  very  decided  benefit.  In 
every  case  emaciation  was  arrested,  and  in  some  there 
was  a  decided  gain  of  flesh  and  strength,  w  th  a  oor- 
respondiog  improvement  in  the  cough  and  other  symp- 
toms. 

^  *'  1  now  prescribe  it  habitually  in  my  private  prac- 
tice, and  always  with  henHU  when  the  esses  are  properly 
selected." 

CA90ARA   8AQRADA  FOR  THX  SLIKINATION  OF  URIO 

Acn>. 

It  seems  to  be  the  accepted  opinion  that  the  path- 
ology of  uric  acid  is  more  a  matter  of  defective  elim- 
ination than  of  eioessive  formation.  Osier  says: — 
^*  Certain  symptoms  arise  in  connection  with  defective 
food  or  tissue  metabolism,  more  particularly  of  the 
nitrogenous  elements;  and  thb  faultv  metabolism,  if 
long  continued,  may  lead  to  gout,  with  nratic  deposits 
in  the  jointp,  acute  inflammations,  and  arterial  and  re- 
nal disease" 

Not  getting  the  des*red  results,  I  was  led  to  drop  all 
the  to  called  autilithics,  and  rely  simplv  and  solely 
upon  a  single  remedv — Cancara  Fia«rada.  Repeated 
tiials  have  convinced  me  that  the  multy  metaoolism 
is  more  quickly  remedied  with  this  drug  alone  than 
with  any  other  or  combinations. 

Mrs.  G.,  aged  55,  was  for  years  subject  to  uric  add 
storms,  and  without  getting  relief.  I  exhibited  the 
aromatic  fluid  extract  Cascara  made  by  Parke,  Davis 
&  Co.,  in  ten  to  fifteen  drop  doses,  two  or  three  times 
duly,  as  demauded,  finally  settling  down  to  one  single 
dose  at  the  close  of  the  day.  The  efft*ct  was  not  at 
once  appa'^ent,  but  within  two  weeks  there  was  marked 
amelioration  of  the  aggravated  symptoms,  and  in  four 
weeks  the  swollen  joints  had  a'most  resumed  a  normal 
appearance,  the  sorene  s  havin^^  nearly  disappeared. 
At  this  writing  ^two  months  having  elapsed)  there  is 
no  complaint  whatever,  but  the  remedv  is  continued. 
No  change  was  made  in  the  diet,  as  I  desired  to  more 
fully  test  the  remedy,  and  am  fully  satisfied  that  the 
good  results  were  due  solely  to  the  Cascara.  I  have 
tried  other  brands  of  Cascara,  but  they  have  not  been 
satisfactory,  hence  I  have  come  to  regard  the  fluid  ex- 
tract above  alluded  to  as  the  onlpr  one  upon  which  I 
can  confidentlv  rely.  It  never  fails,  hence  my  prefer- 
enoe.~DR.  W.  H.  Walling,  in  the  Medical  amd  Sur^ 
gical  Beporter,  July  14th,  1894. 


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THB  MBDICAL  WOiaD. 


Hobsfo^d's  Acid  Phosphate  is  a  standard  tonic  in 
MTToos  dyspepsia  or  exhaostion.  Sample  to  physi- 
cians who  will  par  express  charges.  Romford  Gnemi- 
eal  Works,  Providenoe,  R^  I. 

Ws  have  been  acquainted  with  Horlick's  Malted 
Milk  sinee  its  introdaction.  We  regard  it  as  a  Talaa- 
Me  article.  Samples  to  physicians  Horlick's  Food 
O^,  Raeine,  Wis. 


irOKTHIiT  PATXSNTB. 


A  {Physician  in 
Mid  statements : 


MiBSoari  has  this  on  his  bill-heads 


'  We  must  hare  monthly  payments,  if  we  do  your 

practice.    If  there  is  any  mistake  in  thb  account, 

)  call  on  us  and  we  will  cheerfully  correct  it." 


Whin  you  want  to  give  iodine,  give  Hostelley's 
%rnp  of  Uydriodic  Add. 

FKMAIiB  XZTEBNAL  OXKITAL  0BOAK8. 

In  tiie  N.  Y.  Jour,  of  Oyn,  and  ObsteL  for  A^^, 
Dr.  D.  S.  Lamb,  of  the  Army  Medical  Museum, Wash- 
ingtcm,  contributes  a  criticism  on  the  current  anatomi- 
cal descriptions  of  the  external  genitals  of  woman. 
He  tinds  that  the  external  genitalia,  including  e^en 
the  Taffina  itself,  are  not  covered  by  mucous  mem- 
brane, out  by  a  modified  skin.  He  also  finds  that  the 
Iburchette  is  formed  by  the  labia  minora. 

The  Mellier  Drug  Gompanj,  of  2112  Lucas  Place 
and  721  Locust  street,  St  Louif,  appreciating  the  ten- 
dency towards  a  general  decline  in  values,  take  the 
initiatiye  with  their  Elliott  Saddle- Bags,  and,  as  will 
be  seen  by  their  advertisement,  make  the  following 
TeiT  low  prices:— Small,  24  vials,  $6.00;  large,  80 
vials,  $7.00,  extra  large,  $8.  Upon  receipt  of  price 
the  Elliott  Saddle-Bags  will  be  delivered,  charges  pre- 
paid, to  the  nearest  express  office. 

Fob  Biliousness,  Jaundice,  etc.,  use  Peacock's 
Chionia. 

Fob  first  clais  Trusses  and  woven  fabric  Supporters 
■end  to  G.  W.  Fiavell  &  Bro.,  1005  Spring  Garden  St., 
Philadelphia. 

Samples  of  Syrupus  Roborans  and  Peptic  Essence 
to  physicians  who  will  piy  charges.  Adoiess  Arthur 
Peter  &  Co.,  Louisville,  Ky. 

Pat  had  a  sore  leg,  and  went  to  the  doctor.  After 
examining  him  the  doctor  said :  '*  Your  blood  is  bad ; 
I  must  give  you  some  pills." 

'*  Pfwat  good  will  that  do,  docthur  ?  "  asked  Pat, 
**  pfwin  the  sore  is  below  the  ind  of  me  bowel  ? '' 

Thb  family  laxative  is.  Syrup  of  Figs. 

Thb  new  nerve  sedative,  Passiflora  Incamata,  is 
prepared  by  John  B.  Daniel.  84  Wall  street,.  Atlan- 
ta, Ga. 

Of  ▲  rich  old  man  of  Boston,  Mass.,  it  is  said  that 
he  has  reached  the  age  of  83  years  without  ever  hav- 
ing taken  any  medicine.  It  must  not  be  th  ught, 
however,  that  he  never  called  in  medical  men ;.  on  the 
contrary,  he  seems  to  have  had  recourse  to  his  doctor 
whenever  he  had  the  slightest  ailment.  He  had  all 
the  prescriptions  religiously  executed  at  the  pharma- 
oisf  fl,  only  ne  never  swallowed  the  drugs,  but  carefully 


put  them  away  in  his  cupboard.  To-day  he  finds  hioi- 
self  the  possessor  of  a  most  original  oolkction — ^1,90^ 
bottles  of  sundry  medicines,  1,870  boxes  of  variooa 
powders,  and  870  boxes  of  pills. 

Fob  a  Faradic  Battery,  gotten  up  on  new  lines,  m^ 
dress  Jerome  Kidder  Mf  g  Co.,  820  Broadway,  Neir 
york,N.Y. 

Tby  the  treatment  of  gonorrhea  prepared  hy 
Charles  L.  Mitchell,  M.D.,  1(^6  Cherry  strMt,  PhiU- 
delphia. 

OHBONIC  OYBTITIH  AHD  PB08TATI0  XNLABOBiaBBTL 

I  have  given  SanmeUo  a  thorough  trial  in  chronie 
cystitis  with  prostatic  enlargement,  and  find  it  superior 
to  all  other  remedies.  It  not  only  relaxes  the  spas- 
modic condition,  but  has  a  soothing  effect  on  the  mo* 
cons  membranes  of  urethra  and  bliSlder.  All  my  pa* 
tients  speak  more  favorably  of  Sanmetio  Uian  of  maj 
other  remedy  they  have  ever  used. 

Independence,  Ky.  T.  T.  Metcalf,  M.D., 

BEMABKABLB  USB  OF  BIGABBONATB  OF  SODIUM. 

Dr.  Robert  G.  Feck,  of  Hamilton,  N.  Y.,  writes:— 

"  WUliam  G ,  who  resides  in  the  town  of  Dekalb^ 

near  Hamilton,  St.  Lawrence  County,  N.  Y.,  was  suf^* 
fering  from  disease  of  the  stoisiach  about  twenty-fire 
years  ago.  He  states  that  he  spent  all  his  earnings  in 
doctoring  till  about  twenty-one  years  ago,  when  he- 
tried  saleratus,  which  gave  him  relief.  Since  then  he 
haa  used  it  constantly,  and  is  now  usis^  the  twen^- 
second  hundred  pounos.  He  carries  it  with  him. 
wherever  he  goes.  He  is  sixty-one  years  of  age,  the 
father  of  eleven  children,  and  does  all  the  work  of  a 
farm  of  one  hundred  and  ten  acres,  except  an  occa- 
sional extra  help.  He  purchases  his  naleratos  by  the- 
barrel.  These  statements  are  authentic,  as  inquiij 
will  prove.  The  saleratus  is  taken  in  a  dry  state.  Ai 
first  It  was  taken  in  small  quantities,  but  now  in  dose* 
of  one^half  ounce,  and  to  the  quantity  of  over  Un> 
pounds  a  week.*''— Afed  Bee 

Send  for  literature  regarding  Tri-Iodides  and  Three 
Chlorides,  to  Kens  &  Henry  Pharmacal  Co.,  Lonia* 
vUle,  Ky. 

Send  $1.00  for  sample  and  formula  of  Amlar's  T(K 
bacco  Antidote,  to  F.  H.  Amlar,  Jackson,  Mich. 

May  llth,  1898. 

Cough  and  Constituent  Tablets  should  be  in  th»> 
hands  of  every  physician.  I  am  still  using  Preligh'a 
Tonic,  and  there  b  none  better  The  Cough  Tabkte 
will  control  cough  when  all  else  fails.  Oonatitneiik 
Tablets  do  their  work  nicely  and  promptly.  Am  still' 
using  them  in  mv  own  familv  with  best  results.  Pr^ 
scriM  Cough  Tablets  every  day. 

Class  of  1874.  Mason  Y.  Hunt,  M.D. 

Stalb  bread  is  much  more  healthy  than  fresh  bread.. 
Fresh  bread  is  more  palatable,  but  when  chewed  it 
becomes  doughy,  is  rolled  up  in  a  bail,  which  entera 
the  stomach  coated  over  with  a  glairy  mueus,  and  i» 
very  difficult  for  the  stomach  juices  to  penetrate. — 
Kan,  Med.  Oour, 

^  Sick  persons,  particular! v,  should  be  kept  clean  in- 
side and  out.  Agents  should  be  used  that  wiU  render 
the  juices  of  the  body  aseptic  interpaily  by  destroyiaii 

{Continued  <m  next  leof.) . 


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7S#  kmmlidf$  that  a  man  can  use  is  the  onfyreai  knawUdg^e;  the  onlyknaw* 
Uigt  tfaikas  H/jfand  growth  in  it_  and  converts  iM/  into  practical  power. 


The 


rut^hangslihe  dust  about  the  brain^  or  dries  Hhe  raindrop  e^ff  the  stones.-'-lhjausm^ 


iThe  Medical  World. 


MoirTHi.T,  by  C  p.  TATX^om,  M.  D.  , 


J.J.  Tayw)r,  M.D., 


?EDcroRS. 


I  to  aaj  p«rt  of  the  United  States  and  Canada, 
Otrm  DoiXAK  per  year.  To  England  and  the  British 
Ooioaica,  PrvB  Shixxxnos  per  year.  Postage  free. 
•faigle  copies,  Trn  Csim.   These  rates  most  be  paid 

WccasiMt  always  sQpidy  back  Bvmben.  Should  a  num- 
ber fiiU  to  ftmsSk  a  subscriber,  we  will  supply  another. 
If  aollfied  before  the  end  of  the  month. 

tiij  ao  asoney  to  agents  for  this  ioumal  unless  publisher's 
wcelpt  is  given. 

ABBSBM  AZX  COMMUmCATIOirS  TO 

**THE  MEDICAL  WORLD." 

X530  Chestnut  Street, 

PHILADELPHIA.  PA. 

VoL  Xn.       Dbcbmbbb,  1894.        Na  12. 

The  year  has  rolled  aronnd  again,  and  with 
this  iasoe  thousandB  of  subscriptions  for  this  pub- 
lication expire.  The  notice,  **  Your  subscription 
expires  with  this  number,"  will  be  found 
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World  been  worth  its  price  to  you  during  the 
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please  don't  procrastmate.  If  you  wish  to  econo- 
mize, send  13  for  four  years ;  if  times  are  pinch- 
ing you  unusually  hard,  send  25  cents  or  50 
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Uhdaiy  than  to-morrow. 


The  TypheM  9tate. 

In  the  progress  of  a  case  of  typhoid  fever, 
when  the  intestinal  uIcms  are  discharging  their 
products  into  the  bowel,  to  be  fh>m  there  ab- 
sorbed  and  carried  into  the  circulation,  a  condi- 
tion of  the  patient  develops  known  as  the  '' ty- 
phoid state."  It  is  characterized,  in  its  typical 
form,  by  extreme  debility ;  low,  muttering  de- 
lirium; dry,  brown  or  blackish  diminished 
tongue ;  diy,  cracked  lips ;  sordes  on  the  teeth ; 
weak,  fluttering  pulse  ;  loss  of  control  of  urine 
and  feces ;  impairment  of  speech  and  degluti- 
tion ;  muscular  trembling  and  twitching ;  pick'^ 
ing  at  the  bed  clothes  or  imagmary  objects ; 
breathing  shallow  and  frequent;  blttntii^g  of 
the  special  senses,  as  manifested  by  dimness  of 
vision,  slight  deafness,  and  impaired  taste  and 
smell;  capillary  congestion  and  stagnati<Mi  of 
the  venous  circulation,  leading  to  low  grades  of 
superficial  inflammation  and  the  formation  of 
bed-sores ;  Joss  of  muscular  control,  allowing 
the  patient  to  constantly  rink  towards  the  foot 
of  the  bed.  In  many  cases  this  extreme  devel- 
o(»nent  does  not  occur,  a  much  milder  form 
being  observed. 

Until  recent  developments  in  pathology  were 
made,  the  cause  of  this  condition  was  not  known, 
although  the  dinical  fact  was  well  recognized. 
It  was  formerly  taught  that  the  cause  was  the 
long  continuance  of  high  temperature.  Now  it 
is  conceded  that  the  cause  of  the  phenomena 
of  the  typhoid  condition  (as  also  of  the  pro- 
longed high  fever  itself)  is  found  in  a  pro- 
found poisoning  of  the  central  nervous  sys- 
tem by  the  ptomaines  or  '<anti-toxines"  devel- 
oped by  the  disease  germs  at  the  seat  of  their 
activity,  and  carried  throughout  the  system  by 
the  blood.  These  ptomaines  are  the  products  of 
the  life-processes  of  the  specific  diseasegerms, 
and  are  destined  in  time,  if  they  do  not  idll  the 
patient,  te  destroy  the  germs  themselves.  The 
germs  of  each  one  of  the  infoctious  diseases  man- 
ufacture a  ptomaine   pecuHar  to  themsslves. 


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'which  18  poisoQOUB  alike  to  the  patient  and  to  the 
tgcnoB.  If  the  patient  tuooessfully  reoBts  the 
fXHsoningy  he  recovers. 

This  ccmstitutes  the  '< self-limiting"  nature  of 
the  disease,  and  explains  why  we  do  not,  even 
without  treatment,  go  on  having  typhoid  fever, 
«niaU-pox,  or  any  one  of  those  diseases  forever, 
H)r|antil  death  ensues,  when  once  we  contract  it 
This  shows,  also,  the  prindple  upon  which  we 
iiopesome  time  to  be  able  to  fight  these  diseases 
with  their  own  weapons,  so  to  speak,  and  to 
£naUy  exterminate  them,  somewhat  as  Jenner 
laid  down  the  lines  in  smallpox,  Pasteur  in 
ralnee,  and  Behring,  Aronson,  Boux  and  others 
are  now  endeavoring  to  do  in  diphtheria. 

The  typhoid  state  was  so  named  because  it 
£nds  its  most  complete  development,  its  typical 
cxpresdon,  in  that  specific  intestinal  ulceration 
•called  typhoid  fever,  and  constitutes  almost  a 
•certain  phase  of  that  disease. 

However,  it  is  a  teud  which  is  too  often  over- 
looked, that  it  may  also  occur  in  many  other 
diseases.  Taking  a  view  of  the  cause  of  the 
condition,  as  stated  above,  we  can  readily  see 
that  it  may  occur  in  any  acute  inflammatory 
affection  in  which  the  ptomaines  found  in  the 
products  of  inflammation,  not  readily  escaping 
fnmi  the  system,  are  absorbed  into  the  circula- 
tion in  sufficient  quantities  to  overwhelm  the 
nervous  system.  The  previous  deb'dity  of  the 
patient  is  a  predisposing  factor  in  the  causation 
of  this  condition. 

Thus  we  may  have  the  typhoid  state  develop- 
ing in  typhus  fever,  in  severe  cases  of  malarial 
fever,  pneumonia,  meningitis,  enteritis,  dysen- 
tery, erysipelas,  smallpox,  hepatitis,  pleurisy, 
peritonitis,  nephritis,  cystitis,  and,  in  short, 
wherever  there  is  inflammation  of  such  area 
«nd  intenaty,  as  to  produce  poisonous  products 
sufficient,  being  absorbed,  to  seriously  impress 
the  vitality  of  the  patient 

It  is  a  confusing  mistake  to  call  the  disease 
^'typhoid"  this  and  '«typho"  that,  as  if  it  had 
changed  into  a  different  disease.  It  is  better  to 
say  that  it  is  the  disease  in  question  with  the 
development  of  the  "typhoid  state,"  or  state  of 
acute  anti-toxine  pdsoning  of  the  qrstem*  Of 
couiae^  the  coincidence  may  occur^  although  it 
is  extremelyittxie,  that  a  peisoa  may  faeoeme  iii^ 


fected  with  true  typhoid  fever  germs  while  irii^ 
with  some  other  acute  disease. 

Then  let  us  study  our  cases  of  acute  inflam* 
matory  fevers  over  again,  always  with  a  view 
to  the  possible  development  of  the  typhoid  con- 
diticm. 

This  brings  us  to  a  consideration  of  the  pre- 
vention and  treatment  of  this  condition. 

The  diseases  in  which  the  typhoid  state  is 
likely  to  develop  should  be  treated  somewhat 
along  the  following  Unes : 

1.  The  seat  of  the  inflammation  should  be 
cleansed  and  disinfected,  if  it  should  be  in  a  lo- 
cation that  can  be  reached  by  approprials 
cleansing  antiseptic  agents. 

2.  The  fever  and  inflammation  should  be 
reduced  and  kept  as  low  as  possible.  This 
may  be  done  by  the  suitable  employment  of 
water  and  by  the  defervescent  remedies,  acon- 
ite, veratrum,  digitalis,  nux  vomica  (represented 
best  by  their  respective  alkaloids)  and  other 
drugs.  Phosphorus  is  an  excellent  drug  to  use 
in  supporting  any  fever  treatment 

3.  The  eliminating  organs  must  be  kspi  fredy 
at  work. 

4.  A  good  antiseptic  agent  should  be  admia- 
istered  to  counteract  the  poison  in  the  circula- 
tion. For  this  purpose  the  hjrpo-sulphites  and 
the  sulphides  (especially  sulphide  of  calcium) 
are  eminently  useful.  Chloral  is  an  excellent 
drug  for  this  purpose  in  cases  where  its  sleep- 
producing  property  and  its  effect  upon  the  heart 
are  not  contra-indicated.  The  antiseptic  Sfnces, 
as  cinnamon,  and  the  balsamic  oils,  are  often 
useful  in  this  connection.  Alcohol  is  valuable 
for  this  purpose,  wherever  a  better  drug  cannot 
be  found.  Quinine  is  frequenlty  used  for  this 
indication. 

5.  The  system  may  have  to  be  str^igthened 
and  stimulated  for  a  time,  to  enable  it  to  elim- 
inate the  poiscm  as  fast  as  developed.  Nutrit- 
ion should  be  constantly  and  carefully  attended 
to.  Suitable  tonics  and  stimulants,  as  araeniate 
of  strychnine,  quinine,  iron,  the  mineral  addi^ 
etc.,  should  be  employed.  Baptioa  and  atropine 
are  often  serviceable.  Other  means  of  treatmsnt 
will  suggest  themselves  to  the  ingenn^  of  the 
phymdan,  according  to  ihe  dzeamstaaoss  ef 
each:case^ ::..  .  ■.>? 


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The  purpose  of  this  article  will  be  served  if  it 
wiU  lead  the  reader  to  anticipate  the  possible 
danger  of  this  state  in  all  such  casei  and 
to  00  manage  his  caaes  as  to  prevent,  as  far  as 
poasible,  its  development 


Aoouraoy  in  Disease  Nomencisture. 

Most  things  are  given  a  name  while  our 
knowledge  of  them  is  yet  imperfect  In  regard 
to  a  disease,  the  name  is  generally  derived  from 
the  most  prominent  and  obvious  symptom,  re- 
gardless of  what  may  be  its  true  nature  or  cause, 
as  subsequently  revealed  by  scientific  pathology. 
Thus,  for  example,  we  have  cholera,  derived 
from  the  Greek,  **chola8,  the  bowels,  and  **rrheo, 
to  flow  " ;  literally,  "  a  flowing  from  the  bowels." 
Not  a  scientific  cognomen,  surely,  and  yet,  up  to 
the  present  time  this  name  is  about  as  good  as 
any  that  could  be  given  it ;  for,  although  the 
**  flow  from  the  bowek  "  is  only  an  incident  of 
the  disease,  it  is  by  far  the  most  obvious  and 
prominent  one,  and  may  well  serve  as  the  name 
until  pathologists  have  finally  settled  their  con- 
troversy (now,  we  hope,  so  nearly  settled)  and 
have  established  beyond  dispute  the  true  and 
constant  cause  as  well  as  the  essential  nature  of 
the  disease. 

Typhoid  fever  affords  another  excellent  ex- 
ample. Its  name,  given  in  an  earlier  period  of 
medical  history,  simply  means  ^*  resembling  ty- 
phus." Now,  that  we  have  demonstrated  its 
eflsential  character,  an  ulceration  of  that  portion 
of  the  intestinal  tract  known  as  Beyer's  patches, 
and  its  specific  cause,  the  typh6id  bacillus,  we 
are  prepared  to  give  it  a  more  accurate  name — 
one  that  will  present  within  itself  a  true  picture 
of  the  disease.  This  should  always  be  tiie  aim 
of  medical  nomenclature,  as  it  facilitate!  accu- 
racy  of  thought  and  efficiency  in  treatment 
The  haUt,  especially,  of  naming  diseases  and 
symptoms  after  the  men  who  first  demonstrated 
tbem  should  be  discontinued.  Due  credit  may 
be  given  by  a  brief  paragraph  of  history  in  the 
oonsideratiim  of  the  disease  in  works  on  practice. 
There  should  be  a  careful  revision  of  disease 
nomenclature  every  decade  by  a  competent  com- 
mittee, establishing  accurate  scientific  names  as 
soon  as  the  progress  of  the  science  will  justify 
it 


Hydrophobia  in  Aiabama. 
Dr.  D.  L.  Wilkinson,  of  Prattville,  Ala.,, 
recently  made  a  very  thorough  investigation  in* 
regard  to  the  prevalence  of  rabies  in  that  State,, 
publishing  the  results  of  the  investigation  in  the^ 
Ala.  Med.  and  Surg.  Age.    The  investigation  dis* 
closed  the  fact  that  there  is  a  great  and  increas- 
ing prevalence  of  the  disease  in  the  State — the^ 
death  of  twenty-nine  htiman  bemgs  and  a  large- 
number  of  domestic  animals  within  a  compara- 
tively recent  time  being  reported.    The  treat- 
ment  by  morphine,   chloral    and  chloroform,, 
proved,  of  course,  of  no  avail  One  case,  treated^ 
with  McDade's  tincture  as  a  prophylactic,  did 
not  contract  the  disease.     Inmiediate  cauteriza- 
tion with  nitrate  of  silver  is  reported  to  have- 
saved  two  cases.    In  the  case  of  one  child  the- 
incubation  period  was  reported  as  only  ten  days. 
In  the  case  of  another  child  it  was  182  days. 
In  one  case — that  of  a  man  twenty-one  yearsv 
old — the  mad-stcme  proved  a  complete  failure. 
Dr.  J.  R  Wilkinson,  of  Autauga  County,  re- 
lates the  following  symptoms  in  animals  af-- 
fected: 

''The  horse  died  with  symptoms  of   blin<t 
staggers.     The  cows  fought  everything,  pawed 
the  earth,  ran  against  fences,  hooked  trees  and 
everything  in  reach.     The  hogs  bit  fence-rails^ 
sticks,  and  everything  thrust  at  them.     Both^ 
hogs  and  cows  were  very  restless  prior  to  the  - 
attack.     All  food  was  refused.     Water  aggra- 
vated the  symptoms.     There  was  no  fever  or 
eruption,  and  no  immoderate  action  of  either  ^ 
liver  or  kidneys.     The  salivary  glands  secreted 
profusely.    Convulsions,  reeembUng  strychnine^ 
poisoning,  ensued  shortly  before  i&aitiL" 

A  hog  rooted  up  one  of  the  cows  that  war- 
buried,  and  in  twdve  days  died  of  rabies.  The^ 
milk  of  cows,  used  up  to  the  time  of  taking  the- 
disease,  had  no  bad  effect  on  those  using  it 

The  theory  of  the  manner  of  perpetuating  the- 
disease,  advanced  by  us  in  October  World^ 
page  381 — wild  animals  in  their  hidden  denr- 
being  the  fbd  of  recurrent  infection — is  appa- 
rentiy  borne  out  by  the  history  of  rabies  in  Ala- 
bama. Methods  of  stam[Mng  out  the  disease,, 
quite  similar  to  those  advised  in  our  article  ii^ 
September  World,  are  recommended. 


As  we  go  to  press  earlier  than  usual  this  month,  a^ 
great  many  interesting  artides  are  neecssarily  h«lcl' 
oyer  until  next  issue. 


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Short  ftrtldes  on  the  treatment  of  dtoeaae»,  and  ezperienoi 
with  new  remedies,  are  solicited  from  the  profession  fot 
this  department ;  also  difBlcnlt  cases  for  diagnosis  and 
treatment 

Articles  accepted  most  be  contributed  to  this  journal  omh. 
The  editors  are  not  responsible  ibr  views  expressed  v§ 
contributors. 

Copy  must  be  reoeired  on  or  before  the  twelfth  of  ths 
month  for  publication  in  the  next  month.  Unused 
Manuscript  cannot  be  returned. 

Ctriainly  it  is  gxetOtnt  dise^i^tt/br  an  author  io  feel  thai  kt 
must  say  all  he  has  to  sav  in  the  fewest  possibu  words^  m 
his  reader  is  sure  to  ship  them;  and  in  the  plainest  posrihU 
wordst  or  his  reader  mul  certainly  misunderstand  them. 
Generally^  also^  a  downright  fact  may  he  told  in  a  plain 
way:  and  we  utant  downright  futseU  present  more  thorn 
-'%jnhing  «bi.— Rt] 


READ.     REFLECT.     COMPARE.     RECORD. 

AffiBotiont  of  the  Breatt^Repliet  to  Inquiries.— 
Atrophy  of  the  Penlt. 

Editor  Medical  World: — Watch  the  be- 
gumings  of  disease,  especially  when  the  female 
breast  is  ooncerned.  A  joimg  ladj,  just  ov^r 
her  fir^t  coQfiDement,  applied  to  me  for  a  small, 
tender  lump  in  the  right  breast,  in  the  gland 
tissue  below  the  nipple.  There  was  also  sore 
neas  of  the  nipple,  and  pain  throughout  the  gland 
when  nursing.  I  believe  there  was  a  tendency 
to  plastic  inflammation  of  the  milk  ducts,  in- 
creased by  the  afflux  of  blood  occasioned  by  the 
"  draught"  I  covered  the  lump  with  a  bit  of 
belladonna  plaster,  applied  silver  nitrate,  five 
grains  to  the  ounce  of  distilled  water,  to  the 
nipple,  and  had  the  breast  gently  rubbed  every 
day  with  warm  oil,  containing  biniodide  of  mer- 
cury, five  grains  to  the  ounce.  Internally  she 
took  two  grains  of  quinine  sulphate  and  a  tea- 
epoonfiil  of  Hostelley's  syrup  hydriodic  acid 
three  times  daily.  She  got  well  slowly,  the  lump 
being  still  perceptible  in  three  weeks,  but  entirely 
gone  in  two  more. 

Would  this  have  developed  into  an  abscess  ? 
I  think  80,  as  the  skin  over  the  tumor  was  red, 
and  presented  the  appearance  of  approaching 
euppuration.  In  another  case  of  sore  nipples 
instant  relief  followed  the  application  of  bismuth 
subnitrate,  mixed  with  water  to  a  creamy  con- 
flistenoe.  Pencilling  the  cracks  with  tincture  of 
benzoin  is  also  effectual  at  times.  The  inflamed 
oipple  should  be  kept  clean,  protected  and  sup- 
ported. The  child's  mouth  should  be  examined, 
and  aphthous  spots  cured.  The  half  sh(  It  of  an 
English  walnut  is  a  good  shield  to  keep  the 
clothes  from  rubbing  the  sensitive  nipple. 

A  woman  came  to  me  once  with  a  scirrhus 
cancer  on  the  right  breast,  several  inches  above 
the  nipple,  and  entirely  disoonnected  with  the 
gland.  She  attributed  it  to  the  pressure  of  a 
dentist's  elbow  ui  extracting  a  tooth.     The  sore- 


ness occasioned  by  this  pressure  was  felt  for  a 
long  time,  and  gradually  the  tumor  appeared. 
I  removed  the  tumor,  but  the  disease  reappeared 
in  the  scar. 

Another  woman  had  scirrhus  of  the  right 
breast,  involving  the  gland.  The  operation 
was  very  bloody,  many  ligatures  being  requited 
for  the  vessels.  The  disease  reappeared,  and  I 
was  preparing  for  a  second  operation,  when  an 
injudicious  visitor  informed  the  patient  her  dis- 
ease was  cancer.  That  dread  word  killed 
her.  She  became  delirious,  took  to  her  bed,  and 
died  in  a  week.  At  her  death  she  was  fat  and 
full-blooded,  the  disease  had  not  attacked  any 
vital  organ,  and  she  wa^  not  exhausted  by  pain, 
loss  of  sleep,  or  innutrition.  What  killed  her? 
Fright     . 

Another  case:  A  lady,  about  twenty- four 
years  old,  full-blooded,  as  so  many  cancer  pa- 
tients are  (indeed,  Bnmdbent  attributes  cancer 
to  the  too  free  use  of  meat,  genehiting  a  special 
and  undue  power  in  the  epithelium,  which  grows 
in  instead  of  out,  crowds  upon  and  chokes  the 
weaker  tissues  underneath,  reaches  the  lymphat- 
ics, and  travels  along  these  channels  to  the  lym- 
phatic glands.  Here  the  hyperplastic  epithelial 
cell  establishes  itself,  nests,  grows,  and  a  cancer 
is  developed).  Well,  this  lady  had  two  large 
masses  in  the  right  breast  I  removed  the  whole 
organ,  the  tumors  involving  the  gland  substance 
deeply.  The  wound  was  dressed  and  sealed  up 
antiseptically.  At  the  usual  time  I  opened  the 
dressings,  and  union  was  perfect.  Two  days 
later  the  breasts  swelled,  the  scar  gave  way  at 
one  point,  and  opened;  bleeding  set  in,  and 
continued  four  days,  until  menstruation  brgan. 
Through  the  opening  suppurative  bacteria  pene- 
trated, converting  the  whole  inner  wound  into 
an  abscess  cavity.  This  was  washed  out  wiih 
Marchand's  peroxide  of  hydrogen,  the  wound 
closed  by  compresses  and  bandages,  and  the 
suppuration  soon  healed.  All  went  well  until 
the  next  menstrual  period  occurred,  whoi  the 
breasts  again  swelled.  By  this  time  I  had 
learned  that  similar  phenomena  had  occurred  at 
previous  menstrual  periods,  even  habitually. 
Strong  emmenagoguei  were  given,  and  the  con- 
gestion of  the  breasts  subsided.  This  appean 
to  me  to  be  a  true  case  of  vicarious  menstraa- 
tion,  and  I  have  not  been  able  to  find  another 
instance  of  such  an  incident  occurring  just  in 
time  to  spoil  a  beautiful  operation  for  removal 
of  the  breast  Without  it  I  believe  there  would 
have  been  not  a  drop  of  pus. 

Two  years  have  elapsed  without  a  return  of 
the  cancer. 

Is  there  any  foundation  for  the  belief  that 
tomato  eating  causes  cancer?  That  excess  in 
meat  eating  does,  I  am  convinced ;  and  that  it 


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doee  so  by  ftimuIatiDg  the  epitbelium  uodulj. 
For  fome  penoDS  suffer  an  eruption  of  itching 
tubercles  or  papules  on  the  skin  when  they  take 
too  much  meat  or  milk.  Others  suffer  in  this 
way  from  shell  fish,  and  I  have  bad  more  than 
one  case  of  eczema  that  would  not  be  cured  un- 
til the  patient  quit  the  ufe  of  tomatoes,  and 
reappeared  whenever  he  ate  them  again  If  (be 
skin  can  be  irritated  into  eczema,  lichen  or  urti- 
caria by  such  fooda  why  may  not  the  irritation 
ib  other  cases  be  such  as  to  affect  the  epithelium, 
and  cause  that  hyperplastic  ingrowth  of  its  cells 
that  constitutes  cancer?  At  any  rate,  people 
who  find  that  tomatoes  irritate  their  skins  would 
better  not  eat  them  ;  and  the  tame  caution  holds 
good  as  to  other  foods. 

This  question  as  to  the  epithelial  origin  of 
cancer  is  of  great  importance  in  operating.  In 
my  first  case  quoted  you  wiJl  see  Uiat  there  was 
absolutely  no  connection  with  the  gland  in  the 
first  tumor,  or  in  the  second  forming  afier  the 
removal  of  the  first  When  cancer  reappears 
after  removal,  it  is  in  the  scar,  in  the  lymphatic 
glands,  or  in  nodules  under  the  skin  near  the 
scar.  The  late  S.  W.  Gross  was  accustomed  to 
ezankine  the  cbest  carefully,  and  mark  with  ink 
every  nodule  be  could  detect  In  operating,  he 
carried  his  incision  outside  of  every  such  mark, 
and  removed  all  the  nodules  and  the  skin  cover- 
ing them,  allowing  the  wound  to  heal  by  granu- 
lation. 

It  is  a  good  method,  and  I  have  had  fewer 
returns  of  the  disease  after  this  operation  than 
after  any  other.  When  the  skin  is  lifted,  how- 
ever, is  the  time  to  search  for  nodules,  as 
many  can  then  be  found  that  cannot  be  felt 
through  the  ikin.  If  this  be  done,  and  the 
axilla  examined  from  the  inside,  the  results  of 
the  removal  are  quite  favorable,  more  than  one- 
half  ^the  cases  being  permanently  cured  by  a 
nngle  operation. 

Recently  I  have  had  a  number  of  cases  that 
present  an  apparent  atrophy  of  the  penis.  The 
organ,  when  erect,  has  its  usual  volume,  and  is 
capable  of  nerfbrming  its  functions  satisfactorily, 
but  when  flaccid  is  smaller  than  previously.  In 
fact,  more  than  one  man  has  told  me  he  feared 
it  would  disappear  altogether.  In  each  case 
there  was  a  diminution  of  sexual  appetite,  and 
of  the  sensation  during  the  orgasm.  One  man 
said  there  was  no  longer  any  pleasurable  sensa- 
tion. I  have  not  found  any  constant  pathologi- 
cal condition  present  in  all  the  cases ;  but,  like 
angina  pectoris,  it  seems  to  accompany  any  affec- 
tion of  the  organs.  For  instance,  I  have  noted 
this  atrophic  condition  accompanying  varicocele, 
urethral  stricture,  long  prepuce,  enlarged  pros- 
tate, disease  of  the  prostatic  urethra,  atrophy  of 
the  testicles,  and  cystitis.     My  first  thought  was 


that  the  atrophy  was  the  result  of  diminished 
use  as  this  appeared  to  precede  the  atrophy  in 
the  first  case.  But  why  does  not  hypertrophy 
follow  the  inordinate  exercise,  of  this  orga'h  ?  I 
think  the  lessened  use  of  the  organ  is  an  effect^ 
and  not  a  cause,  of  the  atrophy.  The  worst 
thing  about  these  cases  is,  that  instead  of  having 
the  faulty  condition  s^t  right  by  a  little  surgical 
treatment,  these  men  are  apt  to  resort  to  sexual 
stimulants — a  most  pernicious  class  of  medica- 
ments, that  ought  to  be  ruled  out  of  medical 
practice. 

"Subscriber"  (page  813)  wants  a  remedy 
for  flushes  at  the  menopause,  and  their  cause. 
Remedy :  macrotin,  gr.  ss,  three  to  rix  times  a 
day.  Cause:  the  dimcultjr  of  re-establishing  an 
equilibrium  in  the  circulation,  after  the  system 
has  been  many  yeanf  accustomed  to  the  monthly 
flow. 

Dr.  Blount,  I  understand  (page  413),  wants 
a  remedy  for  shaking  pftlqr.  Doctor,  if  you  find 
one,  let  us  know  of  it  Try  rubbing  with  hoi 
goose-grease,  daily. 

Dr.  Eernodle  (page  413)  should  strap  his 
patient's  leg  to  support  the  ulcer ;  apply  iodo- 
form ointment  if  tender ;  if  not,  apply  bovinine, 
on  a  bit  of  absorbent  cotton,  keeping  the  ulcer 
constantly  wet  with  it  For  the  gastralgic  case, 
give  subourbonate  of  iron,  10  to  20  grains,  three 
times  a  day,  with  a  dram  of  epsom  salts  every 
third  morning,  in  a  pint  of  cold  water,  on  first 
arising. 

Dr.  Boor's  case  (page  413)  may  have  dropsy, 
when  the  abdomen  will  be  dull  on  percussion. 
If  so,  test  the  urine  for  albumen ;  give  milk  diet, 
acetate  of  potaBsium  and  benzoic  acid.  If  not, 
it  is  hepatic,  and  tapfflng  will  be  necessary.  The 
umbilicus  will  then  project  If,  however,  the 
abdomen  be  tympanitic  on  percussion,  the  rem&> 
dies  are  carminatives. 

Dr.  Forman  (page  414)  may  find  a  con- 
tracted anal  sphincter  in  his  patient's  case.  Di^ 
late  by  introdudng  the  6nger. 

Dr.  Bismarck  (page  414)  would  find  small 
doses  of  podophyllm,  gr.  ^V*  ^^'^^  ^^^7>  ^f 
value,  eapecially  if  he  would  keep  to  a  diet  of 
hot  skimmed  milk  for  a  week,  and  avoid  taking 
cold  or  too  much  exercise.  About  20  grains 
sulpho-carbolate  of  zinc  per  diem  would  be  a 
good  adjuvant 

I  am  writing  this  letter,  not  in  my  Chicago 
home,  but  sitting  in  Dr.  Taylor's  charming  resi- 
dence in  Philadelphia,  shadowed,  alas,  by  the 
recent  death  of  his  lovely  wife.  During 
the  week  I  have  been  attending  the  courts  as  a 
witness  in  a  railway  case,  where  some  of  the  first 
medical  men  of  this  city  are  arrayed  on  either 
side.  I  have  felt  strongly  how  w  ise  it  would  be 
if  our  students  could  attend  such  trials,  and  see 


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THE  MEDICAL  WORLD. 


^hat  a  terror  is  the  witness  stand  to  the  igno- 
vant,  and  how  easy  to  the  well-informed. 

The  chilly  rains  of  the  last  two  days  seem  to 
liave  developed  an  epidemic  of  coughs.  Had  I 
the  space  I  would  like  to  write  a  chapter  on 
<x)u^hs,  their  varieties,  meanings  and  treatment; 
why  opium  helps  one  and  makes  another  worse, 
•etc.,  eta  But,  as  Rudyard  Kipling  says,  that 
is  another  story,  and  my  friend,  the  editor,  says 
it  must  wait  till  next  month.  Why  not  have  a 
symposium,  then,  on  cough,  and  each  of  us  con- 
^bute  his  favorite  methods  of  treatment  ? 

William  F.  Waugh,  M.D., 

103  State  St,  Chicago. 


Danger  in  Milk  and4ts  Products. 

Editor  Medical  World  : — Milk  and  milk 
"products  are  in  very  general  use  in  all  civilized 
"Countries.  -Milk  is  considered  the  type  of  a  per- 
fect food,  containing,  as  it  does,  all  the  proxi- 
•mate  principles  necessary  for  the  growth  and 
sustenance  of  the  human  body.  Infants  are 
raised  on  it,  and  it  is  the  basis  of  many  prepared 
infant  foods,  whose  strongest  claims  are  that  they 
:are  nearly  identical  with  the  standard  average 
of  mother's  milk.  Probably  no  one  article  of 
-diet  is  more  frequently  prescribed  for  invalids 
•by  physicians  than  milk  in  some  form.  Good 
'omlk,  pure  milk,  cannot  be  too  highly  recom- 
onended. 

But  current  events  remind  us  not  infrequently 
><that  impure  milk  and  its  products  are  sources  of 
•disease,  and  sometimes  the  cause  of  death. 

It  may  not  be  unprofitable  to  consider  some 
of  the  elements  of  danger. 

And  first,  as  to  the  cow.  Tuberculosis  in 
-cattle  is  widely  prevalentr  It  occurs  most  fre- 
<)uently,  perhaps,  in  thoroughbred  cows,  due, 
probably,  to  in-and-in  breedmg,  or  too  much 
Jiousing  and  pampering.  During  the  past  year 
.-many  choice  herds  of  blooded  cattle  in  this 
tState  have  been  examined  by  official  inspectors, 
^<x>ndemned  and  slaughtered,  because  they  were 
infected  with  tuberculosis.  Even  with  the  most 
<areful  official  scrutiny,  milk  from  tuberculous 
^<x>ws  has  been  delivered  to  innocent  customers 
for  family  use,  and  for  the  feeding  of  young 
•children.  Within  the  past  month  a  well-known 
milk  company,  that  derives  part  of  its  supply 
from  Orange  County,  in  this  State — a  county 
with  a  world- wide  reputation  for  its  dairy  pro- 
<lucts — discovered  that  milk  from  tuberculous 
herds  was  being  delivered  at  one  of  its  stations. 
While  the  high  reputation  of  this  company  is  a 
guaranty  that  the  impure  milk  was  detected  and 
•irejected  at  the  earliest  possible  moment,  there  is 


good  reason  for  dosely  scrutinizing  the  prodaot 
supplied  by  less  watchful  and  less  scrupulous 
purveyors. 

That  tuberculosis  in  cattle  may  be  conveyed 
by  milk  and  beef  to  human  beings,  is  too  well 
established  to  admit  of  a  doubt.  It  has  been 
said  that  in  some  countries,  and  among  certain 
sects,  where  meat  and  milk  are  not  used,  there 
is  no  trace  of  tuberculosis  among  such  people. 
I  am  unable  to  verify  this,  but  I  think  it  is  pos- 
sible, if  not  highly  probable. 

A  well-authenticated  case  of  tubercular  trans- 
mission occurred  recently,  not  far  from  New 
York  aty. 

A  few  months  since  a  grandchild  of  the  late 
Rev.  Henry  Ward  Beecher  died  from  tubercu- 
lar meningitis.  The  diagnosis  was  beyond 
doubt,  but  the  cause  or  source  of  the  diseaae 
was  not  evident  No  probable  cause  presented 
itself  to  the  attending  physicians.  The  parents 
were  healthy,  the  surroundings  excellent  80 
carefully  had  the  child  been  reared,  that,  among 
other  precautions,  a  thoroughbred  and  costly 
cow  had  been  purchased  to  furnish  the  supfdy 
of  milk  for  the  family.  Finally,  the  attentioa 
of  the  physicians  was  turned  towards  the  sooroe 
of  the  milk  supply.  The  family  cow  was  a(qia- 
rently  healthy,  but  a  veterinarian  was  caUed, 
and  on  examination  it  was  conclusively  proved 
that  the  choice  cow  had  tuberculosis,  and  that, 
beyond  doubt,  she  was  the  cause  of  the  illness 
and  death  of  the  child.  Not  every  case  can  be 
so  directly  traced  to  its  source,  but  the  le«oa 
from  this  one  indicates  that,  beyond  doubt,  there 
have  been  many  such. 

Having  good,  healthy  cows,  the  next  thing  is 
to  see  that  the  stables  and  surroundings,  per- 
sons and  utensils,  are  always  scrupoloady 
clean. 

The  ideal  rosy-cheeked,  tripping  milkmaid, 
*  with  white  cap  and  apron,  is  found  chiefly  in 
poetry  and  painting.  The  actual  milkmaid  is 
more  likely  to  be  a  son  of  Erin,  or  of  the  sod, 
who  smokes  his  dhudeen  while  he  pulls  the  taps 
of  the  waiting  kine,  and  mingles  his  tobaooo- 
smoke  with  the  lacteal  fluid.  Should  the  cow 
be  clean  and  the  pail  clean,  the  usual  process  of 
straining  is  little  more  than  a  formality.  Un- 
fortunately, however,  many  stables,  ysjrds  and 
cows  are  filthy  beyond  description.  Chunks  of 
manure  and  sodden  straws  drop  from  the  cows 
into  the  milk-pails,  making  a  mild  infusion  of 
manure — a  sort  of  lactate  of  feces.  Strainiiig 
will  remove  the  coarser  particles,  but  the  pro- 
duct is  not  pleasant  to  contemplate  as  an  article 
of  diet  for  delicate  stomachs. 

Nor  U  the  odor  of  such  stables  suggestive  of 
the  classical  "sweet  breath  of  the  kine."  It 
soon  makes  the  uninitiated  long  for  a  breath  of 


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433 


^resh  air.  In  this  aroma,  so  pungent  and  pene- 
"trating,  the  milk  can  hardly  escape  being  af- 
fected. 

Now,  this  picture  of  dairy  stables  and  sur- 
roundings is  strictly  within  the  lines  of  truth, 
although  it  almost  causes  one's  gorge  to  rise  at 
the  thought  of  it. 

If  this  be  true  of  a  proportion  of  country  and 
•dry- feed  dairies,  how  infinitely  worse  are  the 
«will*milk  stables,  where  cows  are  stall-fed  on 
brewers'  grains,  until  the  cows  become  a  mass 
•of  toothless,  stump-tailed  rottenness.  Swill-milk 
feeding  has  been  somewhat  diminished  since  the 
3iotable  crusades  of  the  illustrated  papers  some 
jemB  ago,  but  it  is  by  no  means  totally  sup- 
pressed. 

On  the  outskirts  of  this  city,  in  a  land-locked 
^>a8in9  stands  an  old  ramshackle  cow  stable,  be- 
side a  nasty,  stinking  pond-hole,  that  takes  the 
•drainage  from  the  stables  and  other  buildings. 
Here,  in  warm  weather,  may  be  seen  the  cows 
up  to  their  bellies  in  the  liquid  filth,  fighting 
-their  natural  enemies,  the  flies.  The  deadly 
odor  fiom  this  abominable  place  is  only  too  ap- 
parent a  quarter  of  a  mile  away. 

Near  the  bam  stand  fancy-painted  milk  wag- 
ons, bearing  the  legend,  '*  Pure  Orange  County 
Milk."  How  fortunate  those  families  that  can 
get  "  one  cow's  milk  "  from  this  choice  dairy,  on 
which  to  rear  the  infant  struggling  with  denti- 
tion, cholera  infantum  and  marasmus  I ! 

That  typhoid  fever  is  conveyed  in  milk  is 
only  of  too  common  occurrence.  Among  recent 
outbreaks  of  this  kind  were  those  at  Bamegat 
Bay,  and  Montclair,  N.  J. 

In  Montclair  more  than  a  hundred  persons 
had  typhoid  from  milk  that  came  from  a  single 
dairy,  and  there  were  many  deaths.  If  I  re- 
member rightly,  the  owner  of  the  dairy  himself 
:also  fell  a  victim  to  the  disease. 

Before  the  epidemic  was  recognized,  in  one 
family  of  my  acquaintance  several  members  ap- 
peared to  suffer  from  a  sort  of  ill-defined  mala- 
ria. Partly  of  their  own  accord,  and  partly  by 
■the  doctor's  advice,  they  refrained  somewhat 
from  the  ordinary  table  food,  and  lived  chiefly 
upon  milk  diet,  as  better  suited  to  their  ailing 
condition.  This  proved  to  be  particularly  un- 
fortunate, as  the  more  milk  they  used  from  the 
infected  dairy,  the  more  typhoid  germs  they  took 
Into  their  systems,  for  the  infect^  milk  was  the 
cause  and  the  aggravation  of  their  illness.  Of 
Ibis  fiimily  five  members  had  typhoid  fever,  and 
three  died. 

How  susceptible  milk  or  cream  is  to  putre- 
faction or  chemical  changes,  is  shown  by  the 
<M8e8  of  wholesale  poisoning  by  ice  cream,  that 
are  of  no  unusual  occurrence.  For  a  long  time 
these  sudden  cases  of  illness  following  picnics 


and  festivals  were  ascribed  to  intentional  poi- 
soning by  evil-minded  persons.  Sometimes  it 
was  believed  that  the  poison  came  in  the  vanilla 
or  other  flavoring  extract  used  in  the  manufac- 
ture of  the  cream. 

Finally,  however,  the  true  nature  of  the 
changes  leading  to  the  production  of  the  pto- 
maine, tyrotoxicon,  was  definitely  determined  by 
Prof.  Vaughn. 

This  poison  is  possible  also  in  butter  and       ^ 


That  cheese  may  carry  the  germs  of  diphthe- 
ria has  been  very  recently  shown  by  the  discov- 
ery by  Dr.  Beebe,  of  New  York,  in  a  consign- 
ment of  cheeses  from  a  creamery  in  the  interior 
of  this  State.  The  explanation  is  that  a  farmer, 
who  supplied  milk  from  which  the  cheese  was 
made,  had  a  case  of  diphtheria  in  his  family. 
After  mingling  with  the  affected  persons  he 
milked  his  cows,  and  through  him  the  germs  of 
the  conta^on  were  communicated  to  t^e  milk, 
and  none  of  the  processes  of  cheese-making  serv- 
ing to  eliminate  them,  they  appealed  in  ue  ul- 
timate product — ^the  cheese. 

Butter  may Jikewise  be  infected  with  various 
diseasegerms,  either  by  being  the  product  of 
tuberculous  cows,  by  exposure  as  milk  or  cream, 
in  the  processes  of  butter- making,  or  even  by 
unclean  storage  after  it  is  made. 

It  is  highly  j^robable  that  many  germ- diseases 
of  obscure  origin  have  been  disseminated  through 
milk  and  its  products.  The  sources  and  modes 
of  conveyance  of  the  diseases  have  been  so  re- 
mote, so  subtle  and  unsuspected,  as  to  escape 
detection,  and  thus,  doubtless,  has  arisen  the  idea 
that  certain  communicable  diseases,  as  scarlatina, 
diphtheria,  typhoid,  etc.,  have  originated  de  novo 
— have  resulted  without  a  specific  cause — a 
germ  disease,  without  the  essential-producing 
germs.  The  failure  has  been  in  properly  tracing 
such  diseases  to  their  real  source. 

The  aim  of  this  cursory  resume  of  this  sub- 
ject is  not  to  discountenance  the  proper  use  of 
wholesome  dairy  products.  If  I  could,  I  would 
first  reach  the  dairyman,  and  urge  him  to  be 
wise^  careful  and  discriminating,  in  even  the 
smallest  particular  relating  to  milk,  butter  and 
cheese.  I  would  arouse  the  consumer  to  the 
vital  importance  of  knowmg  the  source  of  his 
dairy-products,  how  manipulated,  in  what  con- 
dition they  are  presented  for  consumption. 

Last,  but  not  least,  it  is  the  duty  which  phy- 
sicians owe  to  their  patients,  to  make  themselves 
familiar  with  all  the  varying  phases  of  this  sub- 
ject, and  when  milk  is  directed  as  an  article  of 
diet,  to  insist  upon  its  coming  from  a  pure  source, 
properly  handled,  and  properly  prepared  for 
mfants  and  invalids. 

Brooklyn,  N.  Y.         Benj.  Edson,  M.D. 


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434 


THE  JUDICAL  WORLD. 


University  of  Pennsylvania  Notes, 

(Reported  exprenly  for  Thx  Medical  ^obld  ) 

Dr.  Pepper  insists  upon  a  very  guarded  prog- 
nosis as  to  duration  in  gastric  cancer,  citing 
numerous  cases  terminating  in  two  months, 
others  lasting  five  years  and  over.  The  fre- 
quent rallying  from  what  seems  imminent  death 
is  explained  by  the  sloughing  of  the  cancerous 
mass  and  its  passage  into  the  intestine — ^thus 
freeing  the  pylorus,  and  being  followed  by  tem- 
porary relief  and  improvement  only  to  be  suc- 
ceeded by  fresh  growth  and  obstruction. 

Sulpho-carbolafe  of  zinc  is  now  named  fre- 
quently in  the  lectures. 

Dr.  Hirst  says  that  any  one  should  be  able 
to  make  a  dia^oeis  in  cases  of  extra-uterine 
pregnancy  before  rupture  of  the  gestation  sac, 
as  follows : 

1.  An  exquisitely  tender  tumqr  usually  fixed 
in  Douglas'  pouch. 

2.  Patient  gives  history  of  regular  menstrua- 
tion for  a  time,  followed  by  irregular  flows  or 
even  entire  cessation.  This  is  followed  by  free 
or  even  constant  bleeding.  * 

3.  This  bleeding  is  accompanied  by  the  pas- 
sage per  vaginam  of  lumps  of  uterine  decidua, 
always  described  by  the  patient  as  lumps  of 
flesh. 

4.  The  fixation  is  due  to  inflammation  before 
tiie  presence  of  serious  symptoms,  and  the 
doughy  feel  is  pathognomonic  when  found. 

5.  Constant  pain  in  the  groin  should  put  the 
physician  on  guard  at  once,  and  a  thorough 
examination  can  not  fail  to  reveal  the  condition. 

Dr.  Ashhurst  says  an  operation  should  im- 
mediately follow  the  diagnosis  of  glaucoma. 

Dr.  Penrose  eeals  the  wound  in  laparotomy 
cases  with  aseptic  gauze  and  oelloidir,  followed 
by  the  regulation  aseptic  dressing  and  bandage. 

To  the  three  causative  factors  of  pachymenin- 
gitis. Dr.  Wood  adds  that  of  gout.  That  is, 
sunstroke,  traumatism  syphillis  and  gout 

In  making  autopsies.  Dr.  Cattell  suggests 
that  parties  (including  "our  good  friend,  the 
undertaker")  except  those  immediately  en- 
gaged in  the  work  of  the  poet  mortem,  should 
be  excluded  from  the  room. 

Dr.  Ashhurst  says  no  splints  are  so  good  as 
the  old  reliable  thin  wood  with  plenty  of  cotton 
and  bandages.  The  results  from  these  are 
better  than  results  from  the  elaborate  apparatus 
of  the  shops,  besides,  they  can  be  procured  at 
any  home. 

Dr.  Penrose  objects  fitrongly  to  the  use  of 
tents  at  any  time,  but  says  if  practitioners  will 
use  them,  that  the  tupelo  should  be  selected  and 
subjected  to  thorough  sterilization  before  use. 


In  spite  of  the  Hyderabad  Commission,  Dr. 
Wood  reiterates  the  statement  that  ether  does 
kill  by  steppage  of  respiration. 

The  death  of  Prof.  Goodell  was  sincerely 
mourned  by  both  faculty  and  students.  The 
students  marched  in  a  body,  with  uncovered 
heads,  in  the  rear  of  the  funeral  cortege  to  the 
grave. 

But  one  University  man  failed  in  the  reooii 
Pennsylvania  State  Board  examination. 

Dr.  Duhring  says  that  the  man  who  under- 
stands eczema,  understands  for  practical  pur- 
poses, dermatology. 

The  alcohol,  chloroform  and  ether  mixture, 
(ACE  mixture),  is  declared  by  Dr.  Wood  to 
be  an  <'  abomination  of  abominations,"  because 
you  are  never  sure  of  the  composition  of  the 
vapor  you  are  administering. 

The  Allis  inhaler  for  anesthetics  is  used  in 
all  operations  at  the  University. 

Dr.  J.  W.  White  asserts  that  a  positive  diag-- 
noeis  of  chancre  can  not  always  be  made  without 
the  aid  of  confrontation. 


Replies  to  Some  November  Queries. 

Eklitor  Medical  World: — ^The  case  moi- 
tioned  by  Dr.  J.  F.  Blount,  of  Evanaville,  Ind., 
in  the  November  World,  of  a  man  of  forty-five 
with  a  shaking  right  arm,  that  the  patient  him- 
self believed  to  be  due  to  overwork,  is  so  meagre 
in  detail  that  the  disease  cannot  be  classified.  It 
may  be  a  case  of  paralysis  agitans.  If  the  Doc- 
tor will  look  up  tiiis  flection  he  may  find  what 
he  wants.  It  may  be  an  occupation  neurosu. 
It  may  be  due  to  any  one  of  a  number  of  Iocs) 
causes  in  the  brachial  pexus,  or  in  the  cord,  or 
even  in  the  brain.  He  will  probably  do  his 
patient  little  good  without  judicious  galvanism 
three  times  weekly.  To  tins  should  be  added 
good  tonic  treatment  Sleep  should  be  insured 
by  appropriate  remedies.  I  would  also  suggest 
to  the  DkKStor  that  he  study  his  patient  very 
carefully,  and  note  whether  there  is  commencing 
tremor  in  other  parts  of  the  body,  and  also  to 
learn  the  exact  muscle  groups  affected,  froai 
which  he  can  learn  the  nervous  origin.  The 
sensibility  of  the  skin  must  also  be  noted. 

Dr.  J.  D.  Kemodle,  of  (Dlarkson,  Ok.  Ter^ 
desires  to  know  a  good  treatment  for  a  large 
chronic  leg  ulcer.  I  would  suggest  a  daily  five 
per  cent  carbolic  acid  washing,  and  the  wearing 
of  a  Martin's  pure  rubber  bandage  all  the  time 
that  she  is  out  of  bed.  To  this  local  stimulating 
and  supporting  treatment  should  be  added  ss 
much  rest  as  possible,  tonics,  and  the  securing  ot 
free  elimination.  The  Doctor's  gastralgia  case 
has  periodicity.  Is  this  connected  ¥rith  the  i 

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Iron  and  small  doses  of  the  bichloride  of  mer 
cory  after  meals,  should  help  the  anemia.  The 
gastralgia  and  belching  of  gas  are  perhaps  due 
to  a  removable  cause.  If  not,  or  if  this  cannot 
be  found,  I  would  suggest  i  grain  doses  of  the 
extract  of  nuz  vomica  and  ten  grains  of  charcoal 
after  meals.  To  this  might  be  added  some  good 
artificial  digestant 

The  above  correspondents  give  very  few  data 
upon  which  to  return  advice.  Peculiarities  of 
soil  and  climate  should  be  given,  especially  if 
the  neighborhood  be  malarial. 

The  free  and  easy  correspondence  of  The 
World  gives  it  a  family  appearance,  exempli- 
fying fratemalism  in  medicine.     I  am  glad  to  be 
one  of  you,  and  only  regret  that  I  came  so  late, 
A.  H.  P.  Leuf,  M.D., 

2353  N.  17th  st,  Philadelphia. 


Cold  Water  Treatment  of  Scarlet  Fever, 
^itor  Medical  World: — I  have  read 
with  great  interest  letters  from  Doctors  McAl- 
lister, Reynolds  and  Bishop  with  regard  to  the 
cold  water  treatment  of  scarlet  fever.  Of  course, 
we  all  use  it  with  benefit  externally  and  inter- 
nally, but  we  feel  very  reluctant  to  go  so  far  as 
in  the  case  narrated  by  Dr.  Reynolds.  The 
result  justified  the  meaus;  if,  however,  the 
patient  had  died,  the  doctor  would  have  had  the 
credit  of  killing  her.  I  had  a  case  in  my  own 
family  about  twenty-five  years  ago  which  came 
out  all  right,  but  uufortunately  I  could  not 
claim  any  credit  for  the  happy  result  In  the 
month  of  December  and  very  cold  I  had  two 
little  children,  the  cook  and  nursemaid,  and  my 
groom,  a  lad  of  eighteen  or  so,  down  with  scarlet 
fever,  a^nd  it  is  of  the  last  mentioned  I  wish  to 
write.  One  day  I  had  been  away  since  morn- 
ing on  horseback,  and  came  home  dead  tired 
alK>ut  7  P.  M.  I  opened  the  stable^door,  let 
the  horse  go  in,  and  then  hastened  to  see  my 
dck  folks.  As  I  passed  through  the  kitchen, 
the  bul  got  up  from  the  dof  a,  and  seeing  me  so 
thoroughly  done  out,  asked  me  to  let  him  go  and 
look  alter  the  horse.  I,  of  course,  forbade  him, 
for  he  was  then  as  red  as  a  lobster,  with  sore 
throat  and  all  the  accompaniments  of  the  dis- 
ease. After  satisfying  my  anxiety  about  the 
flick  ones,  I  started  for  the  stable,  when  I  heard 
a  voioe  calling  <*  Doctor,  doctor."  I  saw  that 
the  boy  and  lantern  were  missing,  and  it  flashed 
into  my  mind  that  he  had  set  the  bam  on  fire. 
I  rushed  out  there, when  I  heard  the  voice,  much 
muffled,  behind  me.  This  U  what  had  happened. 
Going  to  the  well  with  pole  and  bucket,  the 
curb  being  thick  with  ice,  he  had  slippe  1  in, 
and  was  in  fifteen  feet  of  ice-cold  water,  holding 
on  with  hands  and  toes,  and  only  his  head  out 
of  water.     I  hustled  down,  grabbed  him  by  the 


hair,  pulled  him  up  and  dragged  him  indoors. 
Then  made  a  rousing  fire  in  the  stoVe,  rubbed 
him  until  he  began  to  get  warm,  administered  a 
glass  of  hot  toddy,  wrapped  him  in  hot  blankets, 
got  him  to  bed,  and  watched  him  with  fear  and 
trembling  all  night  Next  morning  I  found 
the  rash  all  gone,  no  sore  throat ;  to  all  appear- 
ance fit  for  work. 

He  did  go  to  work  in  about  a  week,  as  there 
was  DO  desquamation.  I  have  had  lots  of  cases 
of  fever  since  that  time,  and  ha^e  lost  some 
valuable  lives  by  that  dreadful  disease,  and 
many  times  I  have  been  tempted  to  try  the  cold 
water  in  an  equally  heroic  manner,  but  had  not 
the  courage  of  my  convictions. 

Augustus  Robinson,  M.D., 

Annapolis  Royal,  Nova  Scotia. 

Death  from  Swallowing  a  Pleoe  of  QIass  whioh 
Lodged  in  the  Esophagus. 

Editor  Medical  Wobld  : — I  was  called  in 
consultation,  Monday,  September  24th,  last, 
about  9  A.  M.,  to  see  Miss  A.,  age  between  15 
and  16  years,  and  found  her  restless,  pale  and 
no  pulse  at  wrist  She  died  in  a  few  minutes. 
I  obtained  the  following  history  from  her  par- 
ents: 

A  year  ago.  last  August,  she  attended  a  picnic 
and  while  opening  a  glass  sealer  containing 
tomatoes,  it  was  accidently  broken  in  several 
fragments.  She  partook  of  the  tomatoes  and  in 
some  unaccountable  way  swallowed  a  piece  of 
the  glass.  She  vomited  some  blood  at  the  time 
and  complained  of  slight  pain  in  the  gullet  A 
doctor  was  consulted,  but,  as  he  could  not  find 
any  trace  of  it  in  the  throat,  concluded  that  it 
had  passed  into  the  stomach.  Ever  after  she 
had  some  difficulty  in  swallowing  solid  food,  par- 
ticularly meat  Appetite  fairly  good,  but  has 
been  looking  somewhat  pale  during  the  i»8t 
summer  and  complaining  at  times  of  feelmg 
weak.  A  physician  wfs  not  consulted,  her 
mother  supposing  that  all  her  complaints  wese 
due  to  her  age  (as  she  had  never  menstruated) 
thus  loosing  sight  of  the  real  cause  (as  most 
mothers  do  with  girls  of  tender  years.)  She 
had  frequently  complained  of  a  soreness  just 
back  of  the  articulation  of  the  clavicle  with  the 
sternum  on  the  left  side.  She  attended  Sunday 
school  on  the  afternoon  previous  to  her  death 
and,  while  on  her  way  home,  complained  to  her 
associates  of  a  strange  feeling,  but  ate  a  fairly 
good  tea,  soon  after  becoming  quite  rick  at 
the  stomach  and  vomited  blood,  wUch  was  kept 
up  fit  intervals  to  the  time  of  her  death,  the  fol- 
lowing mommg.  In  all  about  one  pint  of  blood 
was  vomited.  No  blood  passed  through  the 
bowels  until  just  about  the  time  of  death. 

Post  mortem,  24  hours  after  death :     Bowela 


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completely  distended  with  blood,  except  the 
daodenum,  which  only  contained  a  small  quantity; 
also  a  small  quantity  in  the  stomach ;  none  had 
escaped  into  the  thoracic  or  abdominal  cavities. 
The  bowels,  stomach  and  all  other  organs  ex- 
amined were  in  a  normal  and  healthy  condition. 
On  following  up  the  esophagus  from  the  stom- 
ach and  just  about  opposite  the  upper  end  of 
the  sternum,  I  found  an  irregular  piece  of  glass, 
which  £  removed  from  that  organ.  It  measured 
3ixl  inch  and  no  doubt  had  laid  there  for  over 
thirteen  months,  finally  causing  hemorrhage 
and  death. 

The  point  of  interest  to  the  surgeon  for  con- 
sideration is,  was  this  a  fair  case  for  esophagot- 
omy  at  so  low  a  point?  and  if  so,  the  chances  of 
success?  I  trust  that  some  of  your  many 
readers  may  be  able  to  give  the  benefit  of  their 
experience  and  opinions  on  this  matter. 

Geo.  MrroHELL,  M.D., 

Wallaceburg,  Ont.,  Can. 

Typhoid  Fever. 

Editor  Medioal  Wobld: — ^The  following 
report  is  from  memory  of  a  case  of  a  young  man 
who  was  taken  with  a  chill  on  August  19th, 
1890: 

There  was  intense  headache,  accompanied 
with  diarrhea,  pulse  was  62,  full  and  bounding, 
temperature  103^.  This  continued  to  the  23d, 
when  the  pulse  changed  to  65  per  minute,  with 
no  change  in  character;  temperature  104^.  On 
the  sixth  day,  pulse  still  bounding  at  77,  tem- 
perature 105^;  on  the  seventh  day,  pulse  82, 
temperature  106^.  The  pulse  now  seemed 
smoother,  with  temperature  unaltered  until  the 
fourteenUi  day. 

The  pulse  from  the  seventh  to  the  fourteenth 
day  ranged  from  94  to  100  per  minute,  except 
the  eleventh  and  twelfth,  when  it  was  120.  The 
bowels  moved  regularly  once  a  day  from  the 
eighth  to  the  twenty-second  day,  with  the  pecu- 
liar yellow  ochre  color,  and  semi-liquid,  charac- 
teristic of  typhoid  fever.  The  bowels  were 
tympanitic  throughout  the  course  of  the  fever. 

I^m  the  fourteenth  to  the  twenty- fourth  day 
the  pulse  did  not  vary  much  from  100,  and  the 
temperature  from  104i**  to  105^ 

On  the  twenty-fourth  day  a  profuse  hemorr- 
hage set  in,  showing  a  large  amount  of  bowel 
surface  involved.  This  lasted  forty-two  hours, 
reducing  my  patient  to  death's  door.  On  the 
twenty-seventh  day  hemorrhage  again  com- 
menced, though  not  so  plentifully  as  at  first, 
lasting  forty-eight  hours.  On  the  thirty-fifth  day 
the  bowels  moved  tardily,  but  quite  naturally; 
not  much  fever ;  appetite  was  fair;  and  conva- 
lescence declared. 

The  treatment  was  supportive :  quinine,  bran* 


dy  and  milk ;  for  febrifuge,  tincture  of  aconite:* 
tincture  of  gelseminum,  and  sponging  witB 
water.  I  could  not  perceive  that  there  was  any 
action  produced  by  the  aconite.  I  therefore 
increased  the  aconite,  using  it  singly.  It  war 
increased  one  drop  every  four  hours  until  the 
patient  was  taking  five  drops  every  hour.  A 
mixture  of  turpentine  and  sweet  oil  was  applied 
to  the  abdoilaen,  which  perceptibly  lessened  the 
bloating. 

Suppositories  of  opium  and  tannin  were  used 
to  control  the  evacuations.  This,  with  ice  to  the 
head,  comprised  the  general  treatment. 

Ergot  was  given  during  the  periods  of 
hemorrhage,  in  15-drop  doses.  I  write  thir 
because  of  the  great  length  of  duration  of  the 
case.  C.  L.  Ormsbee,  M.D.. 

Greene,  R.  I. 


Permanganate  of  Potattium  Again  at  an  Antldete^ 
to  Morphine, 

Editor  Medical  World  : — ^Please  allow  me 
space  in  your  columns  to  report  another  yioCoory 
for  permanganate  of  potassium  in  morphine  pm- 
soning.  October  11th,  8  p.  m.,  Mrs.  K.,  age26r 
by  mistake  took  morphine,  gr.  viiL  I  was  called 
at  8.80  p.  UL,  and  found  the  patient  asleep ;. 
pupils  contracted,  pulse  50,  and  we  were  nnable 
to  awaken  her.  I  gave  i  gr.  muriate  of  apo- 
morphine,  hypodermatically;  then  iv.  gr.  of  per- 
manganate of  potassium,  hypodermatically ;  re- 
peated the  mur.  apomorphine,  followed  by  par- 
tial emesiB  ;  gave  nitro-glyoerine,  y^  gr.,  hypo- 
dermatically, and  repeated  the  injection  of  per- 
manganate of  potassium.  By  10.30  p.  ul  the 
patient  was  awakened,  so  that  I  was  able  to 
leave.  The  patient  made  a  good  recovery,  and 
was  about  her  house  the  12th  inst 

Eeeler,  Mich.  8.  Stevenb,  M.Dm 


Pneumonia  and  its  Treatment.— Rapid  Recovery. 

Editor  Medical  World: — I  was  called  to 
see  Mrs.  F.  on  the  evening  of  October  lltb, 
about  eight  o'clock.  I  found  her  with  a  distinct 
rigor.  She  was  in  a  sitting  posture  in  bed,  with 
the  bedding  covering  her  body,  head  and  face. 
I  requested  her  to  lie  down,  and  she  said  she 
couldn't,  on  account  of  such  awful  pidn  she  had 
in  her  side.  After  pleading  awhile  with  her  she 
consented  to  lie  down,  but  with  great  difficulty* 
She  said  she  had  been  chilly  oft  and  on  for  sev* 
eral  days.  She  vomited  in  early  part  of  even- 
ing. On  examination  she  showed  the  following 
symptoms :  First  of  all,  she  is  pregnant  four 
months.  Headache  (frontal) ;  tongue  dean : 
eyes  suffused  ;  bowels  regular ;  pulse  100  (fiill 
and  bounding)  ;  temperature  103^  ;  respiratkuier 
40  per  minute ;  sharp,  lancinating  pain  in  left 


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rside,  rmming  to  shoulder.  The  pain  would  be 
.mugmented  on  inspiration.  On  percussion,  the 
lungs  were  apparently  cleur.  On  auscultation, 
~fine  crepitant  rales  were  found  in  lower  part  of 
left  lung.  She  coughed  a  great  deal ;  expecto- 
ration tMck  and  frothy. 

I  ordered  sad-irons  heated,  and  applied  to 
back  and  feet,  to  break  the  chill,  and  a  mustard 
plaster  over  left  lung.  Internally,  spts.  etheris 
nitrosi,  drams  ss,  and  tr.  veratrum  viride  (Nor- 
wood's), gtts  iv,  taken  every  two  hours.  Also, 
pulv.  ipecac  comp.,  gr.  z,  to  produc^  perspira- 
tion and  lessen  pain. 

I  arrived  the  following  morning,  October  12, 
cat  9  (/dock,  and  found  her  lying  upon  her  back. 
She  said  die  was  still  suffering  pun,  and  that 
she  could  not  move.  She  rested  very  little  dur- 
ing the  night  Had  pain  all  night.  She  com- 
menced to  perspire  about  midnight  very  freely. 
-She  had  headache ;  pulse  100 ;  temperature 
101-}^ ;  respirations  36.  Cough  still  very  loose, 
-with  free  expectoration.  The  expectoration  is 
well  mixed  with  blood — ^the  characteristic  rusty 
.sputum. 

Loud  crepitant  rales  over  left  lung  (more  at 
base  than  apex).  Shortness  of  breath.  I  diag- 
nosticated the  case  as  one  of  pneumonia  in  first 
stage,  with  a  patch  of  the  pleura  involved,  it 
being  the  pleural  involvement  that  produced 
sach  sharp^  lancinating  pain. 

Now  I  changed  my  treatment  somewhat  I 
^ordered  a  cantharidal  cerate  blister  over  the  left 
long,  and  allow  it  to  remain  eight  hours.  Gon- 
iinue  the  spts.  etheris  nitrosi  and  tr.  veratrum 
^viride,  but  instead  of  takmg  it  every  two  hours 
she  should  take  it  every  three  hours.  Also, 
.-anmionia  carbonate,  grains  vii,  every  three 
.hours. 

.    I  called  again  October  13th,  at  10  a.  m.  She 
rested  well  all  night     No  headache. 
Still  cough,  with  bloody  expectoration. 
Pain  very  much  less. 

Pulse  90  (soft  and  compreesible)  ;  heart  fee- 
ble ;  temperature  99^ ;  respirations  30,  very 
xnndi  fuller  and  deeper ;  no  perspiration  ;  bow- 
•els  moved  naturally ;  consolidation  of  lower  left 
lung. 

I  stopped  the  giving  of  the  arterial  sedative, 
and  gave  tr.  digitalis,  gtts.  vii  every  four  hours. 
I  added  ammonia  muriate  to  the  ammonia  carb. 
mixture.  I  gave,  also,  strychnine  sulph.,  gr.  •^, 
Ihrice  daily. 

I  called  again  in  the  afternoon  of  October 
14tlL  She  said  she  had  rested  well  the  previous 
mght  In  the  early  part  of  the  evening  her 
bowels  became  bad,  and  moved  several  times, 
with  a  great  deal  of  gas  accompanying  each  pas- 
«ge. 

Cough  less  frequent,  and  not  so  much  expec- 


toration, but  still  streaked  with  blood.  No  pain. 
Lungs  beginning  to  dear  up,  but  stUl  some  con- 
solidation, which  reveals  itself  on  percussion. 
Pulse  72 ;  temperature  normal ;  respira- 
tions 26. 

Not  considering  it  necessary  to  call  on  the 
15th,  I  called  on  October  16th,  at  9  a.  ul  To 
my  greatest  surprise  I  found  her  sitting  up.  She 
said  she  felt  real  well,  with  the  exception  of 
some  cough.  The  expectoration  is  thick,  tena* 
clous,  yellow,  and  no  blood.  Pulse  84  ;  tempe- 
rature normal ;  respiration  24.  A  good,  natu- 
ral movement  from  bowels.  The  lung  is  still 
gradually  clearing  up.  Here  and  there  you 
will  find  some  moist  rales.  Her  appetite  is  get- 
ting good. 

I  gave  her  ammonia  muriate  and  mist  gly- 
cyrrUza  comp.,  and  a  tonic,  and  discharged  the 
case. 

Now,  I  think  I  had  a  fully-developed  case  of 
pneumonia,  with  all  the  symptoms  well  delinea- 
ted. On  the  fifth  day  from  the  time  I  was  first 
called  she  was  ritting  up. 

Churchtown,  Pa.         D.  W.  Styeb,  M.D., 


Saloi  vs.  Sulpho-Carbolate  of  Zino  at  anllntottinal 
Antiteptio  in  Enteric  Fever. 

-Editor  Medioal  World: — ^The  following 
are  two  cases  of  enteric  fever  treated  with  sol- 
pho-carbolate  of  zinc,  followed  with  distressing 
mnptoms,  which  disappeared  by  discontinuing 
the  zinc  preparation  and  substituting  salol : 

Cass  L — Male,  age  22,  previous  history  ex- 
ceptionally good.  Had  never  been  sick  in  his 
life.  After  a  diagnosis  (which  can  only  be 
made  by  prescribing  anti-malarial  treatment, 
and,  this  being  followed  by  no  abatement  of  the 
disease,  the  typical  symptoms  of  typhoid  fever 
appearing,  which  does  not  usually  occur  before, 
the  seventh  day),  the  patient  was  put  upon  the 
usual  dietetic  treatment,  and  the  amelioration  of 
distressing  symptoms,  and 

S.  Zlnd  Sulplio  Oarbolatii giains  zxr 

Ft  oap.No.  X....... ^ ^.. 

8iff.~Tbke  one  every  three  or  four  hours. 

This  was  kept  up  for  twelve  hours,  when  the 

patient  began  a  persistent  vomiting,  which  could 

not  be  controlled  so  long  as  the  capsules  were 

taken,  but  would  disappear  by  discontinuing 

them,  and  would   reappear  by   taking   them 

again. 

The  zinc  preparation  was  substituted  by  said 
in  5  grain  capsules,  every  three  or  four  hours. 
Patient  made  an  uninterrupted  recovery  in  thirfy 
days. 

Case  II. — ^Female,  age  34,  previous  history 
not  very  good.  She  was  very  corpulent,  weigh- 
ing about  200  pounds.  Had  been  treated  for 
some  "  uterine  trouble  "  and  ''  heart  troubla'^ 
But  this  was  the  most  typical  case  I  ever  saw. 


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She  had  every  symptom,  it  seemed  to  me,  that 
is  pictured  to  us  in  text  books.  I  gave  precisely 
the  same  prescription  in  this  as  in  the  former 
case,  with  the  same  results  intensified  by  diarr- 
hea  and  hemorrhage  from  the  bowels.  I  stopped 
the  sulpho-carbolate  and  gave  salol,  as  in  the 
former  case,  and  the  patient  recovered  in  twenty- 
eight  days. 

I  wish  to  say  this  about  the  use  of  the  zinc : 
I  believe  it  caused  the  stomachic  irritation  in 
both  cases,  and  that  it  irritated  the  inflamed  por- 
tion of  the  stomach,  and  w|is  indirectly  the  cause 
of  the  hemorrhages. 

I  also  wish  to  say  this  about  the  me  of  salol : 
I  have  used  it  in  quite  a  number  of  cases  with- 
out a  bad  result,  and  believe  it  pre-eminently 
the  drug  to  use  as  an  intestinal  antiseptic,  and 
especially  do  I  believe  in  it  in  the  treatment  of 
typhoid  fever,  for  the  following  reasons :  It  is 
an  antipyretic,  and  does  not  afiect  the  heart 
centers  in  medidnal  doses.  It  is  not  dissolved 
nor  taken  up  by  the  stomach  ;  hence  it  does  not 
interfere  with  stomachic  digestion,  which  is  a 
most  commendable  point  in  its  favor.  It  does 
not  seem  to  irritate  the  bowels.  It  does  disin- 
fect the  stools,  because  it  dissipates  the  bad  odor. 
But  there  is  one  other  fact  about  it,  which  I 
think  is  very  pleasing  and  beneficial  to  the  pa- 
tient, viz. :  The  drug  is  partly  eliminated  by  the 
kidneys,  therefore  1  think  it  is  antitoxic  in  sep- 
tic poisoning.  For  two  reasons  I  think  this,  if 
it  is  eliminated  by  the  kidneys,  why  would  it 
not  have  a  germicidal  effect  upon  the  bacteria 
in  the  bloc^?  It  is  a  diuretic,  consequently  it 
assists  in  eliminating  the  toxic  principles  from 
the  body. 

Its  physiological  action  on  the  kidneys,  I 
think,  is  the  only  point  to  be  watched  in  its  ad- 
ministration. If  at  any  time  the  urine  gets 
smoky,  discontinue  the  salol  a  few  hours.  I 
have  given  20  grains  per  day  for  an  indefinite 
time,  without  any  bad  results. 

J.  HuNTON  Peak,  M.D., 

Louisville,  Ky. 


Conflrmation  of  Remedies.— Treatment  of  Soariet 
Fever. 

Editor  Medical  World  : — Some  time  ago  I 
copied  two  prescriptions  for  scarlet  fever  in  my 
casebook — one  from  the  January  number,  1890, 
the  other  from  the  June  number,  1891. 

One  is  chloral  hydrate,  grains  30 ;  syr.  lactu- 
carim  and  cinnamon  water,  of  each  1  ounce. 
Dose,  teaspoonful  every  two  to  four  hours. 
This  dose  for  a  child  of  two  or  three  years  of 
tge. 

The  other  was  acetanilid,  grains  7  ;  acid  sali- 
cylic, grains  xx.     Divide  in  powders  No.  ten. 


For  a  child  four  years  old,  give  one  powder 
every  three  hours. 

Three  weeks  ago  I  attendel  two  typical  cases. 
The  symptoms  were  a  bright  scarlet  rash  all 
over  their  bodies,  strawberry  tongue,  swelling  of 
glands  at  angle  of  jaws  inflamed  and  swoUai 
fauces,  sore  throat,  difficulty  in  swallowing, 
membrane  on  tonsils  and  fauces ;  pulse  150  in 
one,  and  145  in  the  other.  The  temperature  in 
twenty-four  hours  came  down  to  one  hundred 
and  two  or  two  and  a-half  in  the  afternoons,  and 
to  one  hundred  and  one  to  one  and  a-half  in 
the  mornings. 

One  had  cloudy,  scant  urine  for  a  few  days, 
when  she  began  to  peel  ofl.  The  other  had 
rheumatic  arthritic  of  wrists  and  ankles. 

Could  the  symptoms  or  sequelse  leave  any 
room  for  doubt  as  to  diagnosis  ? 

As  there  was  nothing  incompatible  in  the  two 
prescriptions,  I  alternated  them — a  doee  of  one 
every  tiiree  or  four  hours,  then  tbe  other,  giving 
a  little  closer  during  the  afternoons  and  length- 
ening out  during  the  mornings.  They  sat  up 
in  bed  playing  with  their  dells  most  of  the  time, 
or  else  dozed,  lazy  and  comfortable,  under  the 
influence  of  chloral. 

As  a  topical  application  to  their  throats,  I  used 
double  strength  cinnamon  water,  with  boris  add 
to  make  a  saturated  solution ;  spray  throat  and 
nostrils  every  hour  or  so. 

With  the  acetanilid  prescription  I  combined 
caffeine  bromide,  one  part  of  caffeine  to  four  of 
acetanilid. 

Another  thing.  All  this  bug  aboo  about  ace- 
tanilid depressing  the  heart  is  nonsense  (if  used 
rightly).  I  always  combine  it  with  caffeine.  I 
have  used  pounds  and  pounds  in  the  last  four 
years,  and  not  the  first  symptom  of  collapse  or 
heart  failure.  It  U  the  analgesic  and  antither- 
mic, above  all  others,  combined  in  this  way,  for 
headache,  fever,  la  grippe,  etc  My  morphme 
bottle  has  been  empty  for  months. 

Mulvane,  Kan.        W.  K  Harris,  M.D., 


Abuse  of  Clothing. 

Is  he  a  bom  idiot?  No,  the  man  was  bom 
all  right,  and  he  is  bright  enough  now,  but  he 
ha)  been  misled,  says  an  expert  hygienist,  Dr. 
Charles  R  Page,  of  Boston.  In  the  first  place, 
he  was  bom  naked  one  hot  summer  day,  and  he 
was  quite  comfortable  until  the  nurse  got  at  him 
and  piled  on  about  fourteen  folds  of  flannel, 
when  he  became  very  fussy.  He  was  quite 
sick  before  cold  weather  came,  and,  indeed, 
thousands  like  him  died  outright,  as  has  hap- 
pened every  summer,  and  **  from  the  heat,"  too, 
as  is  acknowledged. 

However,  being  too  tough  to  kill,  he  grew  up 
to  manhood,  and  is  now  a  lawyer  (or  broker,  or 


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builder,  or  merchant,  or  brainy  editor,  or  very 
likely  a  doctor ;  for  there  are  hundreds  of  him), 
and  he  uses  his  wits  in  almost  every  other  mat- 
ter than  that  of  dressing  for  comfort  and  health. 
He  does  not  dare  to  keep  comfortable  in  hot 
weather,  fiom  fear  of  '<  catching  cold ! " 

Have  you  seen  him — ^the  man  with  an  over* 
coat  on  in  warm  weather  ?  ''  Is  that  all  ?  "  No, 
if  that  were  all,  no  one  could  question  his  sanity, 
for  in  society  we  must  be  covered,  though  he 
would  be  a  long  way  off  in  his  hygiene  to  imag- 
ine that  clothing  is  in  iteclf  healthful  at  all  times. 
No,  that  is  not  alL  The  man  has  on  a  full  suit 
of  clothes  under  the  top-coat ;  moreover,  under 
this  suit  he  has  etill  another — an  inner  suit  of 
flannel  (Lord  help  him  I),  and  it  is  of  this  most 
absurd  abuse  of  clothing,  at  a  time  when  every- 
body, himself  included,  is  crying  out  with  bit- 
terness, even  with  oaths,  perhaps,  and,  alasl 
many  with  the  meanings  of  despair,  against  the 
iieat,  that  I  complain.  Flying  in  the  face  of 
Providence,  this  man  has  on  twelve  to  fifteen 
pounds  of  clothing  in  several  layers,  that  you 
may  smell  him  a  block  away. 

What !  is  he  also  a  dirty  man  ?    Not  in  the 
conventional  sense — far  from  it     He  bathes  all 
over  every  morning ;  he  takes  a  soap-suds  bath 
frequently;  a  Turkish  bath  every  week,  and 
«V€n  sponges  all  over  with  rosewater  as  a  finish, 
and  he  changes  flannels  daily ;  but  still  he  can- 
not keep  clean.     He  drove  me  out  of  an  orches- 
tra stall  the  other  night     He  was  elegantly 
dressed,  with  immaculate  linen,  creased  trowsers, 
lovely  boutonaire— everything,  in  fact  to  please 
the  eye ;  still,  no  air  could  reach  his  skin  to  dis 
infect  its  natural  emanations.     He  did  remove 
hia  top- coat  after  awhile,  for  he  felt  as  though 
be  would  drop  dead  if  he  didn't  shed  something ; 
but    it    eeemed    a    little    rash,  with    all   the 
"draughts"  about!     To  be  sure,  every  puff  of 
fresh     air     felt    decidedly    comforting,     but 
'*  draughts"  are  so  dangerous,  you  know;  and 
if  he  had  an  attack  of  pneumonia  within  a  week 
he  attributed  it  to  those  little  currents  of  pure 
air  which  gave  him  the  only  suspicion  of  comfort 
he  had  had  for  the  entire  day — pneumonia,  a 
recognized  filth-disease,  the  product  of  foul  mat- 
ters which  accumulate  within  the  ori^anism,  from 
unhygienic  practices,  to  one  of  which  I  have 
alluded — the  fault  of   misleading  advice,   as 
« Stick  to  your  flannels  till  they  stick  to  you." 
"  Better  iAe  your  top-coat  along,  the  weather 
may  change ; "  (and  if  a  comfortable  breeze 
should  spring  up,  he'll  bar  it  out  by  putting  on 
the  overcoat,  or  he  may  wear  it  as  '*  the  easiest 
way  of  carrying  it  I ") ;  "  Look  out  for  draughts" 
(in  other  words,  beware  of  the  rock  spring — 
drink  from  the  stagnant  pool) ;  "  Take  care  and 
dot  catch  cold*'  (that  is,  accumulate  heat  till 


you  have  a  fever),  and  so  on  to  the  end  of  the 
chapter. 

But  while  we  are  on  this  topic  of  clothes,  let 
me  ask  why  we  should  wear  an  inner  suit  at  all 
— we  who  are  much  of  the  time  indoors,  where 
it  is  always  practically  summer?  The  topcoat 
U  a  sensible  garment  for  cold  weather,  whm  we 
go  out  in  winter,  if  then  it  is  really  cold  enough 
to  warrant  it ;  but  we  can't  reooove  the  under- 
flannels  when  we  come  in,  no  matter  how  hot 
the  living  rooms  may  be ;  nor  can  we,  like  the 
ordinary  laborer,  throw  off  our  coat  and  sit  in 
our  shirtsleeves,  though  we  oflen  wish  we 
might 

Even  in  a  hot  spell  in  winter,  when  the  mer- 
cury remains  for  days  at  summer  heat  as  it  does 
at  times  almost  every  winter,  the  flannel  wearer 
doesn't  dare  to  change  for  Jight-weight  under^ 
wear,  much  less  wear  none  at  all  for  a  time. 
The  writer  settled  this  problem  for  himself  over 
fifteen  years  ago,  by  stripping  off  the  heaviest  of 
Morley's  Scotch  flannels  for  good,  and  has  worn 
neither  underehirt  nor  drawers,  winter  nor  sum- 
mer, since.  Moreover,  he  has  induced  ft  great 
many  bright  men  and  women  to  dispense  with 
these  skin  smothering  garments,  and  keep  them- 
selves comfortable  indoors  thereby,  usiog  outer 
garments  as  needed  for  out  door  comfort  The 
beauty  of  it  is,  that  it  works  to  a  charm  every 
time,  and  every  one  who  tries  the  experiment  is 
delighted  wiih  the  results. 

Intestinal    Obttruotton.— Diet  In   Intestinal    Dlt- 
•stet. 

Editor  Medical  World  : — Reading  Dr.  C. 
R.  Cullen's  very  valuable  article  in  the  July 
number  of  The  World,  on  intestinal  obstruc- 
tion, calls  to  mind  some  of  my  own  experience 
?rith  intestinal  obstructions. 

When  we  consider  the  length  of  the  intestines 
and  the  amount  of  fecal  matter  they  habitually 
o(n)tain,  the  wonder  is  that  they  are  not  more 
frequently  obstructed !  Then  there  are  certain 
seasons  when  they  occur  oftener  than  at  other 
times,  and  this  without  any  reference  to  the 
summer  months,  when  vegetables  and  fruits, 
containing  many  seeds,  are  eaten.  Last  winter 
there  were  an  unusual  number  of  such  cases  in 
St.  Louis  and  vicinity. 

I  followed  a  suggestion  I  foimd  in  Dr.  Do- 
bell's  work,  "Diet  and  Regimen,"  page  188, 
namely,  <*  Pass  a  flexible  rubber  tube,  Well  lu- 
bricated, as  far  up  the  bowels  as  possible ;  then, 
if  the  patient  has  strength  to  endure,  place  him 
in  the  knee-elbow  position,  and  slowly  inicct  a 
pint  or  a  pint  and  a-half  of  warm  olive  oil ;  if 
he  has  not  strength  to  keep  in  the  knee-elbow 
position,  elevate  the  hips  with  piUows,  then  inject 
the  oil.     Pass  a  tape  around  a  clean  (boiled) 


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BpoDge,  about  the  size  of  a  cocoa  nyt,  and  as  soon 
as  the  tube  is  withdrawn  push  this  sponge  as  far 
up  the  rectum  with  jour  fingers  as  you  can  (of 
course,  the  sponge  should  be  wet),  leave  the  ends 
of  the  tape  outside  of  the  anus ;  let  the  sponge 
remaili  in  the  bowels  from  six  to  ten  hours,  and 
when  it  is  withdrawn  and  the  oil  acts — if  it  will 
—  then  follow  immediately  with  half  a  gallon  or 
more  of  hot  water." 

Last  winter  I  was  called  in  consulation  to  see 
a  girl  about  fifteen,  who  had  been  suffering  from 
obstruction  several  days.  Some  four  or  five  of 
these  oil  enemas  were  given,  besides  a  number 
of  simple  water  injections.  The  patient  recovered 
after  a  very  serious  illness. 

Another  case,  in  an  old  lady,  was  relieved 
with  electricity,  after  the  usual  methods  had 
failed.  One  pole  of  the  battery  was  placed  to 
the  anus  and  the  other  passed  up  over  the  as- 
oending,  transverse  and  descending  colon. 

June  19th,  1894, 1  was  called  to  see  a  large, 
corpulent  lady,  with  an  excessively  weak  heart 
She  was  suffering  with  a  most  excruciating  pain 
in  the  liver,  and  torpid  bowels.  The  case  was 
diagnosed  gall-stones  by  Prof.  R,  and  I  thought 
his  diagnods  correct  I  had  hot  water  enemas 
given,  got  her  to  drink  half  a  glass  of  olive  oil, 
and  gave  bryonia,  in  water  every  half 
hour ;  then,  as  the  pain  grew  more  bearable, 
lengthened  the  interval  of  the  dose  to  one  and 
two  hours. 

June  20th,  she  drank  another  half  glass  of 
olive  oil,  and  a  trained  nurse  injected  a  pint  of 
olive  oil,  as  described  above,  wluch  Mrs.  L.  re- 
tained ^e  hoars;  th^  the  sponge  was  with- 
drawn, and  copious  enemas  of  hot  water  were 
given.  I  instructed  the  nurse  to  watch  for  gall- 
stones ;  none  passed,  but  in  four  or  five  days  a 
great  deal  of  very  black,  vuKsid  bile  passed. 

June  24th,  her  heart  got  very  weak  I  could 
scarcely  hear  it  beat,  and  pulse  was  very  thready; 
I  gaye  her  a  tablet  of  trinitrin,  -^th  of  a  grain. 
She  soon  rallied,  and,  with  the  aid  of  liquid 
diet,  made  a  good  recovery.  She  was  in  my 
office  September  10th,  looking  well,  and  said  she 
felt  perfectly  well 

I  have  never  found  any  medicine  that  gives 
such  relief  for  a  weak  heart  in  anarsaca,  as 
trinitrin  (nitro-glycerine).  During  the  exces- 
sive prostration,  when  the  heart  is  weak,  I  think 
nothing  is  as  important  as  a  fluid  diet.  Doubt- 
less, fcdl  meals  of  meat  and  vegetables  in  this 
condition  of  the  heart  has  caused  many  deaths. 
The  action  of  trinitrin  is  temporary,  but  is  a 
great  thing  to  hold  life  until  the  tissues  can  take 
on  new  energy. 

I  have  found  two  grain  tablets  of  trypsin  an 
excellent  thing  for  simple  borborygmus.  Unless 
we  pay  more  attention  to  digestion,  we  will  have 


no  means  of  preventing  many  bowel  troubles* 
Sir  William  Roberts,  in  his  little  book  on  "Di- 
gestion  and  Diet,"  says :  '^Proteids  are  attacked 
by  the  digestive  ferments  at  two  points  in  the 
alimentary  canal — by  pepsin  in  the  stomach  and 
by  trypsin  in  the  small  intestine."  Roberts  and 
Bernard  *'  look  on  gastric  digestion  as  a  hasty 
preparatory  process,  introductory  to  the  more 
perfect  intestinal  digestion."  See  R.  on  "  Diet,*' 
pages  53  and  54.  Pancreatic  extract  is  a  better 
digestive  ferment  for  milk  than  pepsin.  If  the 
distress  comes  on  within  an  hour  and  a  half  or 
two  hours  after  a  meal,  I  give  pepsin  ;  but  if  a 
longer  interval  ensues  I  give  pancreatic  extract 
The  food  ought  to  be  out  of  the  stomach  in  two 
hours.   - 

Another  suggestion  I  get  on  diet  in  bowel 
troubles,  from  Dr.  R  O.  Shakeepear's  report 
on  cholera  in  Europe  and  India,  1890,  page 
634.  He  says :  ''  A  simple  culture  of  the  chol- 
era bacilli,  of  little  virulence,  by  adding  albumen 
of  white  of  egg  endows  that  culture  fluid  with 
toxic  qualities  which  it  did  not  acquire,  or  ac- 
quires only  after  a  long  time.  Thus  a  culture 
forty  eight  hours  in  egg  albumen  becomes  suffi- 
ciently toxic  to  kill  two  of  three  guinea-pigs, 
and  to  make  the  third  very  sick ;  whilst  fimr 
weeks  of  aerobic  culture  in  bouillon  produces  a 
liquid  which  has  scarcely  any  virulence."  The 
clear  deduction  here  is  not  to  eat  eggs  during  a 
cholera  epidemic,  and  not  to  allow  ^gs  as  a  diet 
in  any  lerious  disease  of  the  bowels. 

We  do  not  know  how  many  patients  are  killed 
by  bacilli  and  ptomaines,  etc.  Professor  W.  & 
Christopher  says  that  it  is  proteid  foods  that  give 
the  putrid  odor  to  stools  in  **  summer  complamt^ 
He  says  (page  48)  :  '*  I  take  a  child  six  months 
old,  with  putrid  diarrhea,  and  give  it  anrow- 
root,  rice  or  crackers,  or  baked  potato,  but  not 
milk." 

One  more  ca«e :  A  young  assistant  surgeon 
(R.),  during  the  war,  filing  to  get  his  patient's 
bowels  to  move  with  drastic  cathartics  and  in- 
jections, gave  a  two-drop  dose  of  croton  oil — still 
no  movement— and  after  ten  days  or  more,  in 
sheer  desperation  (to  give  his  patient  relief  from 
pain),  gave  him  two  grains  of  opium.  Next 
morning,  to  the  doctor's  great  surprise,  his  pt* 
tient  had  a  copious  stool. 

Was  this  "  a  good  swifl  simile  t " 

All  good  physicians,  of  any  school,  know  that 
physical  obstructions  must  be  overcome  by  me- 
chanical means.         J.  C.  Cummikgs,  M.D., 

St  Louis,  Mo. 

Teething. 

Editor  Medical  World  :— The  fond  mother 

finds  an  excuse  for  the  misdeeds  of  her  baby  in 

the  time-honored  plea  that  he  is  teething ;  and 

this  has  been  held  up  as  a  shield  against  any 


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criticism  of  the  tempera  and  many  iDfirmitiee  of 
small  homanity.  The  cry  of  wolf  we  have 
learned  may  be  so  often  raised  that  it  loses  all 
efficacy ;  and  from  being  a  sort  of  universal  sol- 
vent, or  explanation  for  all  the  ills  of  childhood, 
it  has  come  to  be  scouted  as  of  no  importance  at 
all ;  and  so  the  pendulum  has  swung  to  the 
other  side,  and  instead  of  explaining  everything, 
it  explains  notliing.  Physicians  now  are  deny- 
ing that  it  is  possible  for  the  process  of  teething 
to  produce  any  troubles  ;  it  is,  they  say,  a  phy- 
siological process,  and  so  they  pooh-pooh  the  pos- 
sibility of  any  harm  coming  from  that  source. 
That,  however,  is  not  very  good  reasoning. 
There  are  a  variety  of  physiological  processes 
which,  nevertheless,  make  a  good  deal  of  dis- 
turbance in  the  system.  Labor  is  a  physiologi- 
cal affair,  and  is  somedmes  performed  with  a 
minimum  of  pain,  but  as  every  physician  and 
aome  women  know  to  their  cost,  tliere  are  cases 
of  dystocia.  The  doctor  who  has  cut  his  wis- 
dom teeth  may  have  learned  that,  however  much 
of  a  physiologic^  process  it  may  be,  it  is  yet  no 
joke.  How  any  one  who  has  seen  a  child  with 
gums  swollen  and  hot  to  the  touch,  biting  <m 
anything  which  comes  his  way,  with  the  head  as 
hot  as  the  mouth,  rolling  it  in  very  evident  dis- 
tress, and  then  seen  the  same  child  after  the 
gums  have  been  lanced,  with  every  indication 
of  ease  and  comfort,  will  with  difficulty  be  per- 
suaded that  there  was  nothing  the  matter,  or 
that  nothing  has  been  done  to  give  relief. 

It  is  well  for  physicians,  of  ^l  men,  not  to  be 
carried  off  their  feet  by  every  wave  of  new 
opinifHi.  He  who  is  turned  about  by  every 
breath  of  new  doctrine  is  likely  to  be  but  a 
.poor  guide  for  others.  There  are  many  new 
nofci(»is  in  medicine  in  these  days,  some  of  one 
sort  and  some  of  another ;  and  it  is  not  always 
eai^  to  know  what  to  accept  and  what  to  reject ; 
M  it  is  better  to  be  a  little  conservative,  or  even 
old-fogyish,  rather  than  to  be  in  haste  to  put  in 
practice  all  the  schemes  which  are  evolved  from 
the  fertile  brains  of  our  ingenious  friends  in 
their  speculative  moods.  To  illustrate:  Sir 
Joseph  Lister,  the  inventor  of  antiseptic  sur- 
gery, after  advancmg  several  absolute  specifics 
for  the  prevention  of  sepsis,  and  chasing  his 
theory  through  as  many  different  phases,  has 
veiy  nearly  given  over  the  controversy,  and 
we  are  led  to  believe  that  *'  bugs "  are  not  so 
very  dangerous  after  all.  Not  long  ago  there 
was  a  great  cry  about  antiseptic  midwifery; 
and  every  woman  who  was  confined,  no  matter 
under  what  circumstances,  must  be  subjected  to 
the  same  role  of  douches  and  injections.  That 
these  injections,  administered,as  they  are,  by  peo- 
ple often  more  zealous  than  discrete,  are  not 
without  danger,  has  been  demonstrated  in  some 


cases  of  death,  and  in  some  cases  of  uterine 
colic.  Of  late  we  hear  less  than  formerly  of' 
the  extreme  antiseptic  method,  and  shall  proba- 
bly hear  even  less  in  the  future.  What  a  happ^r 
day  it  will  be  for  the  profession  (not  to  speak  of 
the  laity)  when  its  members  learn  to  practice  it 
as  the  painter  Opie  did  his  art  when  he  mixed 
his  paints—"  With  brains,  sir," 

But  to  return  from  this  digression  : — one  of 
the  most  elaborate  and  pretentious  of  recent 
works  on  the  diseases  of  children,  Keating'» 
Cyclopedia,  after  pages  of  special  pleading  to 
show  that  dentition  is  a  natural  and  therefore 
a  perfectly  easy  process,  does  at  last  admit  that 
it  does  sometimes  hurt  to  have  wisdom  teeth. 
Now,  I  am  not  contending  that  many  of  the  ail* 
ments  which  are  popularly  attributed  to  teething: 
are  not  fictitious  ;  that  goes  without  saying,  butt 
this  only,  that  they  are  not  entirely  imaginary. 

That  the  local  inflammation  of  the  gums  should) 
extend  to  the  lower  digestive  organs,  and  thence- 
we  should  get  diarrhea  or  vomiting ;  or  to  th^ 
nervous  system,  producing  irritabUity,  or  evei» 
convulsions,  does  not  seem  so  entirely  an  unrea- 
sonable a  thing  as  some  of  our  friends  would, 
have  us  think.     Loss  of  sleeps  want  of  appetite^, 
indigestion  of  food,  are  quite  serious  matters  for- 
the  delicate  organization  of  a  child ;  and  cer- 
tamly  they  may,  any  or  all  of  them,  be  due  tO) 
dentition.     We  all  know  that  the  nervous  sjrs* 
tem  of  a  child  is  sensitive  to  impressions,  which 
may  be  propagated  from  any  source  of  irrita- 
tion, that  its  stability  is  easily  overthrown;  leti 
us  not,  then,  make  Ught  of  what  may  be  a  seri- 
ous matter ;  and  while  we  seek  rightly  to  disa- 
buse the  anxious  mother  of  her  unneoessarj 
fears,  we  should  not  forget  that  there  are  possi- 
ble dangers,  of  which  some  of  these  8ymptom»* 
are,  or  may  be,  the  danger  signals.    If  we  have 
disregarded   them  ouraelves,   and   taught    the 
mother  to  do  the  same,  it  may  be  made  an  un- 
welcome   reproach    when  sudden  discMse  has- 
stolen  in  unobserved,  because  of  a  false  security 
we  have  given  to  the  mother. 

I  have  not  written  this  for  the  older  members- 
of  the  profession,  but  for  those  who  have  some- 
thing to  learn  and  who  may  not  be  beyond  the 
advice  of  one  whose  many  years  ought  at  least 
to  **have  made  him  sage."  The  practice  of 
medicine  is  not  easy,  at  bes^  and  the  fewer  false 
notions  one  has  to  unlearn  the  better.  The 
great  trouble  is  to  hold  an  even  balance,  and 
while  we  strive  to  have  a  mind  hospitable  to  new 
ideas,  yet  we  must  learn  to  hold  them  in  sus- 
pense till  tested.  But  in  such  case  what  would 
become  of  all  the  new  remedies,  which  are  sa< 
very  successful  while  they  are  new  ? 

H«  A\  Gabrikgton,  M.  D., 

Bristol,  Conn,- 


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AntUepsU  and  Puerperal  Fever. 

Editor  Medical  World: — Dr.  William 
Bigler  says  he  has  attended  2500  casee  of  labor 
and  has  jet  to  encounter  his  first  case  of  puer- 
peral fever  in  his  own  practice.  A  veiy  fortu- 
nate coincidence,  I  must  say,  he  having  never 
made  use  of  antiseptics  in  obstetric  practice. 
He  says  he  attributes  much  of  his  good  fortune 
in  these  cases  to  his  own  personal  cleanliness^ 
and  his  refusing  to  attend  obstetric  cases  while 
attending  a  case  of  puerperal  fever  or  erysipelas 
for  a  period  of  at  least  two  weeks  thereafter. 
Oood  practice,  indeed.  Cleanliness  is  next  to 
godliness,  and  cleanliness  is  the  base,  the  foun- 
<lation  of  asepds ;  indeed,  surgical  cleanliness  is 
asepsis  itself.  There  cannot  be  a  much  better 
record  than  the  above.  Antiseptic  midwifery 
cloes  not  show  a  better  one. 

It  is  said  that  *'it  is  a  long  lane  that  never 
turns,"  and  "in  time  of  peace  prepare  for  war." 
So  I  think  if  the  Doctor  would  go  one  step 
farther  and  make  use  of  antiseptics  as  laid  down 
by  Playfair  in  his  latest  edition  on  midwifery, 
and  then  if  he  ever  had  a  case  of  puerperal 
fever  in  his  own  practice  he  could  wash  his 
hands  and  say,  as  Pontius  Pilate  said  of  Jesus, 
^*I  am  innocent  of  the  blood  of  this  man" 
(woman).  I  am  doubly  interested  in  Doctor 
Biglei's  letters,  first,  from  the  fact  that  I  have 
not  been  so  fortunate  as  the  Doctor  has,  in  hav- 
ing no  casee  of  puerperal  fever  follow  my  ob- 
etetric  cases.  I  have  been  practicing  medicine 
ten  years,  and  in  that  time  1  have  had  four 
cases  of  puerperal  fever  in  my  own  practice,  and 
three  of  them  the  present  year— one  in  March, 
one  in  July,  and  the  last  one  in  September.  So, 
as  you  see,  there  was  an  interval  of  three 
months  between  the  first  and  second  cases,  and 
one  month  from  second  to  the  third  case,  I  was 
at  those  times  not  attending  any  cases  of  zymotic 
troubles. 

The  first  case  lollowed  a  slow,  tedious  labor 
with  post  partum  hemorrhage.  The  second  de- 
veloped ^ter  delivery  of  a  primipara  with  for- 
ceps after  she  had  been  in  labor  about  fifteen 
hours,  having  had  in  that  length  of  time  seven 
or  eight  severe  eclamptic  attacks.  She  was  de- 
livei^  with  forceps  without  any  rupture  of  p*  r- 
ineum  or  other  accident  more  than  a  severe 
hemorrhage  and  another  convulsive  seizure.  I 
immediately  introduced  my  hand  inside  the 
uterus  for  the  purpose  of  removing  all  dots, 
and  also  a  moment  later  introduced  a  handker- 
chief saturated  with  vinegar  and  another  with 
turpentine,  while  Dr.  Hardwick  who  was  called 
in  consultation,  kneaded  the  uterus,  and  in  less 
time  than  it  takes  to  tell  it  the  hemorrhage  had 
ceased.  The  third  case  developed  on  the  fifth 
<lay  after  a  tardy  labor  in  a  primipara.    All  re- 


covered with  an  average  duration  of  twenty  two 
days.  Having  had  three  casee  this  year,  and 
some  of  my  brother  practitioners  have  hi^l  sev- 
eral cases,  I  have  come  to  the  conclusion  that 
nothing  must  be  left  undone  that  would  tend  to 
prevent  its  further  occurrence  in  my  practice ; 
consequently  I  have  resolved  to  adhere  strictly 
to  the  following  rules : 

Ist.  Refuse  all  obstetric  cases  while  attending 
puerperal  fever  eases,  erysipelas,  scarlet  fever, 
or  any  of  the  zymotic  affections. 

2nd.  The  use  of  strict  antiseptic  measures  in 
each  case  in  r^ard  to  myself  and  patient 

3nL  The  use  of  Kelly's  rubber  pad  in  each 
case  to  insure  more  perfect  cleanliness  of  patient 
and  bed. 

I  will  have  each  patient,  on  my  arrival,  to 
bathe  vulva  and  adjacent  patts  with  warm 
water  and  soap,  then  with  a  bichloride  solution, 
then  use  a  vaginal  injection  with  a  solution  of 
the  same,  and,  instead  of  using  lard,  oil  or 
glycerine  to  annoint  the  fingers,  use  carbolized 
vaseline.  In  the  meantime,  I  will  wash  my 
hands  and  forearm  in  warm  water  and  soap  and 
scrub  my  nails  with  a  nail-brush  and  again  wash 
my  hands;  this  time  in  a  solution  of  bichloride 
of  mercury.  And  each  time  before  making  an 
examination  dip  my  hands  in  an  antiseptic  solu- 
tion, ready  at  the  bedside.  I  will  also  havediie 
nurse  to  use  the  same  antiseptic  precautions. 

In  regard  to  the  after  treatment,  it  is  my  ajpinr 
ion  that  the  use  of  the  warm,  vaginal  douche 
can  do  no  harn\,  and  that  it  adds  to  the  comfort 
of  the  patient,  and  if  there  are  perineal  lacer- 
ations or  abrasions  it  does  a  great  deal  of  good 
toward  preventing  septic  infection.  Then,  if  I 
have  puerperal  fever,  I  will  feel  like  I  have 
done  my  duty. 

Dixon,  Ky.  C.  M.  Smith,  M.  D., 

Some  Uses  for  Hyosoyamine. 

Editor  Medical  World  : — I  wish  to  state 
to  the  readers  of  The  Wobld  a  few  usee  I  find 
for  hyoscyamine,  which  I  do  not  often  see  mm- 
tioned  in  the  medical  journals. 

I  never  fed  fully  equipped  to  attend  an  ob- 
stetric case  unless  I  have  granules  of  hyoecyam* 
ine  and  strychnia  sulphate  or  arseniate  in  my 
little  folder.  If  I  am  called  to  a  case  and  find 
the  patient  in  the  first  stage  of  labor,  with  oe  and 
soft  parts  not  fiilly  dilated  or  dilatable,  I  lay 
down  four  or  five  granules  of  hyoeeyamine  and 
order  one  to  be  taken  every  fifteen  or  twenty 
minutes.  If  the  pains  are  not  strong  and  regu- 
lar, I  place  beside  them  the  same  number  of 
strychnia  granules  and  order  them  to  be  taken 
in  conjunction.  What  do  I  expect  to  accom- 
plish? I  expect  to  find  the  oe  soon  lapidly 
dilating,    the    pains    becoming     regular    and 


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stroDg— the  former  aooomplished  by  the  hyoB- 
cyamine,  the  latter  by  the  strychnia — and  the 
duration  of  the  first  stage  of  labor  very  much 
shortened  ;  the  good  not  stopping  there,  but  the 
second  stage  is  likewise  accomplished  with 
greater  ease  and  rapidity.  I  am  satisfied  that 
the  duration  of  labor  has  been  wraderfully 
shortened  in  many  cases  by  the  above  means. 
The  modus  operandi  is  very  simple  and  need 
not  be  here  given.     Try  them. 

In  a  very  severe  case  of  typhoid  fever  which 
I  attended  two  years  ago,  I  was  confronted  with  ^ 
retention  of  urine  in  my  little  patient  of  twelve 
or  thirteen  years.  To  have  applied  the  usual 
treatment,  namely,  catheterization,  would  have 
required  an  anesthetic  or  strapping  down.  In 
my  dilemma  I  thought  of  the  relaxing  effect  ot 
hyoscyamine  and  gave  a  granule  every  fifteen 
minutes  until  patient  voided  his  urine.  It  gen- 
erally required  four  or  five  doses,  but  I  never 
fiftiledto  relieve  my  patient  Upon  the  same 
principle  of  action  as  in  above  cases,  I  find 
many  uses  for  hyoscyamine. 

Stockton,  N,  J.  J.  H.  Fretz,  M.D., 


Hereditary  Malformation.— A  Case  of  Atavism. 

Editor  Medical  World  :— On  the  morning 
of  October  18th,  1894,  I  was  called  upon  to 
visit  Mrs.  R,  in  her  fourth  confinement  An 
examination  revealed  the  presentation  of  the 
head  and  the  labor  progressing  in  a  normal  way. 
The  child,  after  being  bom,  was  found  to  weigh 
twelve  pounds,  and  in  a  perfectly  normal  con- 
dition except  a  deformity  of  the  feet,  that  fprm 
of  club  foot  known  as  taUpes  varus,  in  both  feet 
The  left  foot  was  so  much  curved  over  toward  the 
leg  that  a  very  acute  angle  was  formed  between 
the  leg  and  inner  side  of  foot,  and  the  sole  of  the 
foot  faced  the  child.  I  commenced  the  treat- 
ment of  the  case  by  electricity  and  splints  during 
the  first  week  of  life  and  so  think  I  shall  get  a 
geod  result  In  the  cases  of  two  more  children 
in  the  same  family,  there  was  present  phmosis,  for 
which  I  operated.  On  tracing  the  family  history 
back  to  the  third  generation,  I  find  that  one  or 
two  cases  of  club  foot  were  to  be  found. 

T.  E.  COURTRIGHT,  M.D., 

Kirkersville,  Licking  Co.,  Ohio. 

You  naturallj  want  your  medical  friends,  whether 
liTinn  near  you  or  in  some  other  part  of  the  coontrj, 
to  read  the  same  journals  that  joa  read.  When  send- 
ing joar  sabecription,  send  the  names  and  addresses 
of  such,  and  if  not  already  subscribers  we  will  send 
The  World  to  them  three  monthefree,  hoping  that  they 
will  then  become  permanent  subscribers.  It  makes 
no  difference  how  many,  nor  where  they  live.  Send 
the  aames  and  addresses  of  all  your  medical  friends 
that  you  wish  to  become  regular  subsoribers  to  Thb 
MiDiOAi.  WoBU),  and  we  will  give  them  a  good  op- 
portonity  by  doing  as  above  ofimd. 


A  Oase  of  Post-Partum  Eclampsia. 

Editor  MsDiCAL  World  : — I  have  not  before 
troubled  you  with  communications,  though  I 
have  received  much  benefit  in  past  years  from 
the  columns  of  your  journal ;  but  recently  a  case 
of  postpartum  eclampsia  occurred  in  my  prac- 
tice, presenting  some  points  which,  I  hope,  may- 
interest  others  as  well  as  myself. 

The  patient  was  a  young  primiparaj  who  had 
neglected  my  orders  to  bring  frequent  specimens 
of  urine  during  the  last  weeks  of  pr^nancy. 
She  was  delivered  of  twins  after  an  easy  labor, 
at  eight  and  a  half  months.  Amniotic  fluid  had 
a  dktinctly  urinous  odor.  Loss  of  blood  was 
considerable,  but  not  alarming.  Gave  fid.  e^t 
ergot,  dram  i,  after  labor,  and  dram  is  more 
before  leaving  her  (apparently  all  light)  an  hour 
later,  because  there  was  some  tendency  to  uter* 
ine  relaxation.  Three  hours  later,  convulsions, 
checked  afier  the  third  by  veratrum  viride 
(Norwood's),  dram  i,  by  mouth,  and  several 
hypodermics  of  m  zx  each  After  the  second 
convuhion,  about  two  p.  m.,  I  withdrew  an 
ounce  or  two  of  urine,  none  having  been  passed 
since  the  previous  evening. 

Violent  vomiting  of  enormous  quantities — 
gallons  in  all,  I  should  say! — of  bile-stained 
fluid,  cao^e  on  after  the  third  convulsion,  and 
lasted  continuously  for  hours,  accompanied  later 
by  frequent  ill-smelling,  watery  stools.  Never- 
theless, the  pulse  was  frequent,  small,  rather 
hard,  and  the  hypdermics  of  veratrum  were 
continued  at  internals  for  several  hours,  until 
six  in  all  had  been  given. 

By  this  time  the  vomiting  was  less  distressing 
(lime  water  had  been  freely  given,  and  mustard 
applied  externally  to  pit  of  stomach,  but  nothing- 
else),  and  the  last  two  iojections  did  not  increase 
it  After  the  last  hypodermic  the  pulse  slowly 
went  down  to  60,  becoming  intermittent  Sub- 
sequent recovery  was  uneventful. 

The  following  thoughts  suggest  themselves  for 
consideration :  » 

1.  Had  the  ergot  any  effect  in  producin^jf  the 
uremic  outbreak?  Eigot  increases  the  blood 
pressure  by  contracting  the  arterioles,  we  are 
told.  An  extraordinarily  large  amount  of 
veratrum  (dram  i  by  mouth  and  fully  twice 
that  amount  hypodermically  in  about  four  hours) 
was  necessary  to  reduce  the  rate  and  tension  ot 
the  pulse,  and  even  then  it  did  not  fall  below 
60.  I  therefore  think  the  ergot  was  injurious 
in  this  case,  if  not  the  direct  cause  of  the  con- 
vulsions, and  that  ergot  should  always  be  used 
with  great  care,  if  at  all,  in  cases  in  which  there 
was  any  edema  or  anything  else  to  suggest  renal 
insufiSciency. 

2.  After  the  vomiting  had  set  in,  was  it  ne- 


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<oee8ar7  to  continue  the  administration  of  the 
^eratrum? 

The  vomiting,  and,  later,  the  purging,  ap- 
speared  to  be  a  **  critical  discharge,"  and  not  due 
to  the  veratrum,  since  it  diminished  in  spite  of 
the  continued  administration  of  the  drug.  I  felt 
cat  least  safe  in  giving  the  veratrum  while  the 
pulse  continued  hard  and  rapid. 

3.  The  decidedly  urinous  odor  of  the  amni- 
otic fliud,  and  the  unusually  active  condition  of 
^e  kidneys  of  the  infants  for  a  few  days,  make 
it  probable  that  the  uremia  of  the  mother  was 
partly  held  in  check  by  the  healthy  renal  func- 
0!3on  of  the  fetuses.  Perhaps  that  may  account 
for  some  cases  of  po«^partum  eclampsia.  I  do 
«iiot  remember  seeing  this  mentioned  before. 

"Anob  Diez." 


^n  Interesting  Gate  of  HydatHbrm  Degeneration 
of  tlie  Chorion. 

Editor  Medical  World:— On  September 
'5th,  I  was  called  to  see  Mrs.  M.,  a  farmer's  wife. 
She  was  thirty  years  old,  had  aborted  in  her  first 
pregnancy,  and  had  since  borne,  without  much 
vtiouble,  four  children,  now  living  and  healthy. 
She  sta^  that  she  bad  been  having  uterine 
hemorrhage  for  about  three  months,  sometimes 
more,  sometimes  leas,  but  daring  this  period  was 
never  entirely  free  from  a  show.  She  did  not 
"think  that  she  was  pregnant,  and  I  could  not 
positively  make  out  that  she  was,  but  I  thought 
that  she  was.  She  had  been  taking  fl.  ezt  ergot, 
prescribed  by  another  physician,  which  I  tMnk 
was  proper  to  give,  but  the  ergot  did  not  stop 
'the  flowing ;  it  caused  uterine  contractions  and 
unbearable  pain.  I  gave  her  a  few  morphine 
pills,  and  next  day  sent  her  some  fl.  ezt  vibur- 
num prunifolium,  with  the.  direction  to  take  it 
until  I  heard  from  her.  I  got  word  in  about  a 
week  that  she  was  still  flowing  some,  but  was  a 
great  deal  better.  This  was  the  last  I  heard 
from  her  until  I  was  called  in  great  haste  on 
October  6th.  I  found  her  in  labor,  with  the 
membrane  ruptured,  and  the  discharge  of  a  very 
great  amount  of  fluid,  and  the  birth  of  portions 
of  a  decomposed  fetus.  By  ezanination  I  dis- 
covered a  breech  presentation  of  a  second  fetus, 
which  I  soon  delivered.  The  placenta  was  ex- 
pelled in  due  time,  also  a  great  amount  of 
hydatid-like  vesicles.  This  fetus  was  apparently 
from  five  to  six  months  old,  and  lived  a  few 
seconds  after  birth.  The  maternal  surface  of 
its  placenta  was  covered  to  a  great  extent  with 
clusters  of  vesicles,  which  extended  in  to  the 
eulcL 

The  peculiarity  of  this  case  is  the  continual 
real  hemorrhage,  instead  of  sanguineous  watery 
discharges,  and  the  great  extent  of  the  degene- 
rated diorion   of    the  second  yet-living  fetus. 


Might  this  case  not  be  an  additional  pointer  that 
cystic  degeneration  of  the  chorion  is  not  the  re- 
sult of  a  dead  fetus,  but  that  the  death  of  the 
fetus  is  caused  by  the  diseased  chorion  ?  Is  it 
not  very  probable  that  the  chorion  of  this  first- 
born, partly  decomposed  fetus,  was  diseased 
while  the  fetus  was  still  living,  as  well  as  the 
chorion  of  the  second-bom,  yet  living  fetus?  The 
first-bom  fetus  was  apparently  only  about  a 
month  younger  when  it  died,  as  was  shown  by 
the  decompoMd  parts,  but  the  symptoms  of  hy- 
datiform  d^;eneration  date  at  least  three  months 
*back.  G.  L.  Stebcpbl,  Med.  Pract, 

Macedonia,  Iowa. 


Comprestion  of  tiie  Abdominai  Aorta  in  Post-Far- 

tum  Hemorrbage.— A  Safe  and  Ever-Ready 

Remedy. 

Editor  Medical  World  : — ^I  am  astonished 
that  so  little  is  said  of  the  great  value  of  com- 
pression of  the  abdominal  aorta  in  severe  poil- 
partum  hemorrhages.  It  is  the  stop-cock,  and 
18  the  only  reliable  remedy  at  those  dreadfol 
moments  when  the  life's  fluid  of  a  loving  mother 
is  rapidly  (cUo  et  eeleriter)  escapmg,  brinj^ 
her  unto  the  valley  of  death.  There  is  no  time 
leflb  for  any  medicine  to  act,  not  even  ergot  or 
ergotine  hypodermically  excepted.  (Atropine 
I  never  tried.)  Compress  the  abdominai  aorta 
immediately  above  the  fundus  uteri,  firmly  with 
your  closed  fist ;  keep  it  there  till  nature  has 
time  to  react,  and  you  will  never  faiL  Mean- 
while you  have  all  the  time  and  chances  to  ad- 
minister any  and  all  the  remedies  you  may  wish 
to.  My  favorite  prescription  is  a  full  dose  of 
fl.  ext  ergot  and  strychnine,  with  the  additiim 
of  opium  or  morphine,  to  quiet  the  frightened 
patient  J.  Pirnat,  M.D., 

Evansville,  Ind. 


Cord  tlie  Limbs  for  Hemorrliage. 

Editor  Medical  World  : — ^I  notice  on  page 
364,  Dr.  W.  Walter  Tison's  case  of  postpartun 
hemorrhage. 

For  nose  bleed,  when  all  other  remedies  fidl, 
card  one  or  both  arms  above  the  elbow.  For 
hemorrhage  from  the  uterus  or  rectum,  c(»d 
both  legs  above  the  knee  tightly,  and  ffive  equal 
portions  of  tincture  of  cinnamon  and  eigot  fl. 
ext,  teaspoon  doses  every  hour ;  but  you  will 
not  have  to  give  more  than  one  dose ;  the  hem- 
orrhage will  be  arrested  before  the  first  dose  has 
time  to  take  effect. 

Milton,  CaL  J.  R  Simms,  M.D., 


See  page  xxiy,  or  on  back  of  yearly  index,  for  ad- 
TantageooB  terms  this  mooth  for  Dr.  Wangh'f  "M  aasal 
of  Treatment  by  Active  Principles  and  Sew  Bemediei.'' 


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Post-Partum  Hemorrhage. 

^Bditor  Medical  World  : — Dr.  Tiaon's  case 
<page  364)  calls  attention  to  the  often  criminal 
negligence  of  the  midwife.  This  is  no  doubt 
due  to  their  ignorance.  Two  years  ago  I  was 
<alled  to  a  case  in  which  the  mother,  as  a  mid- 
wife, had  delivered  her  daughter  scnne  hours  be- 
ibre.  When  the  patient  was  ezsanguinated, 
and  in  a  critical  condition,  I  was  hastilj  sum- 
ononed  (12  miles  distant).  I  foun<f  an  adherent 
placenta,  and,  after  stimulating  the  patient,  I 
introduced  mj  hand  and  removed  it  There 
was  no  bleeding  after  mj  arrival,  nor  had  there 
heea  any  for  an  hour  previous.  The  patient 
<x>ntinued  to  toss  her  hands  and  arms  in  great 
Bgoajf  and  in  an  hour  aft»r  my  arrival  she 
^ed. 

The  mother  finally  realized  her  Qegligence  in 
the  case,  and  shifted  the  blame  onto  me  (besides 
never  having  paid  me  for  the  night  visit).  A 
brother  practitioner  also  told  her  that  the  "  ope- 
ration "  I  performed  in  removing  the  placenta 
Idlled  the  patient 

In  a  later  case  of  poet-partum  hemorrhage,  I 
am  sure  I  saved  the  patienf  s  life  by  the  injec- 
tion into  the  uterus  of  hot  vinegar,  after  all 
-other  methods  had  failed  to  ch^  the  flow. 
These  cases  are  desperate,  and  always  tax  the 
Jmowledge  and  skill  of  the  doctor  to  their  utmost 
We  should  ever  be  prepared  to  meet  these  acci- 
dents promptly,  and  treat  them  quickly  and  vig- 
orously. 

In  twenty  years'  experience  this  is  the  first 
time  I  ever  uised  vinegar.  It  is  an  old  remedy, 
.^and  a  very  effectual  one. 

W.  N.  Sherman,  M.D.,  Ph.D., 

Merced,  Cal. 


Pott-Partum  Hemorrhage. 

Editor  Medical  World  :  — Post-partum  hem- 
<orrhage  is  said  to  be  preventable,  and  therefore 
no  physician  is  now  justified  to  let  his  patient 
•die  from  such  a  cause  without  giving  her  the 
benefit  of  all  resources  within  his  knowledge. 
To  gain  and  to  apply  such  knowledge,  he  must 
keep  abreast  of  the  times  by  reading  and  study- 
ing current  medical  literature. 

The  causes  of  postpartum  hemorrhage  are : 
^  Inertia  and  atony  of  the  uterus,  inversion  of  the 
same,  intra-uterine  growths,  a  diseased  placenta, 
a  placenta  adherent,  or  small  portions  retained. 
OUier  causes  may  be  found  in  a  short  funis, 
irregular  contractions,  and  a  constitutional  ten- 
dency to  bleed. 

The  treatment  must  necessarily  depend  upon 
the  proper  cause.  In  atony  or  inertia  the  sim- 
2>le  introduction  of  the  hand  to  remove  coagula 


will  frequently  be  followed  by  contractions, 
pecially  if,  with  the  other  hand,  pressure  is 
applied  over  the  uterus.  The  introduction  of 
pieces  of  ice,  or  of  vinegar,  turpentine  or  iodine, 
within  the  uterine  cavity,  or  the  uterine  douche 
with  hot  water,  will  induce  contractions,  but  the 
use  of  the  per  salts,  like  chloride  of  iron,  is  to  be 
deprecated.  It  is  true  that  the  solution  will 
coagulate  blood  promptiy,  but  it  fills  the  cavity 
with  a  mass  of  hard  clots  of  decomposiDg  blood, 
which  renders  absorption  of  septic  matenal,  and 
the  development  of  septicemia,  possible. 

But,  now,  suppose  that,  after  using  all  these 
agents,  the  hemorrhage  still  continues — ^what 
then? 

The  writer  of  this  has  saved  the  life  of  one 
woman  by  applying  one  pole  of  a  Faradic  bat- 
tery upon  the  sacrum,  the  other  over  the  uterus, 
and  using  the  strongest  current  Another  pa- 
tient he  has  saved  by  Dukrsen's  method.  Tak- 
ing narrow  strips  of  iodoform  gauze,  he  intro- 
duced them  into  the  uterus  till  the  cavity  was 
filled,  letting  one  end  hang  in  the  vagina. 
Twenty 'four  hours  afterwards  he  removed  the 
uterine  tampon,  washed  out  the  cavity  with  a 
solution  of  bichloride  of  mercury}  1  in  10,000, 
winding  up  with  a  douche  of  hot  water.  When 
properly  introduced,  the  gauze  will  [nress  upon 
the  bleeding  sinuses  and  stop  the  hemorrhage. 

When  retained  portions  of  placenta  are  the 
the  cause,  they  must  be  removed  by  scraping 
the  cavity  with  a  Thomas'  blunt  curette,  and 
removing  the  debris  by  a  proper  douche. 

An  EagUsh  method,  as  published  in  the  BriL 
Med.  Jour.,  will  be  of  service  in  extreme  cases. 
Introduce  the  left  hand  intp  the  vagina,  clench- 
ing the  fist  and  having  the  palmar  side  upper- 
most With  the  right  hand  the  uterus  is  ante- 
flexed  and  thrown  forward,  so  its  anterior  aspect 
rests  upon  the  clenched  fist  in  the  vagina.  Con- 
tinuous pressure  can  now  be  made  by  the  right 
hand  upon  the  posterior  aspect  of  the  uterus, 
pressing  both  the  anterior  and  posterior  walls  of 
the  organ  until  coagulation  takes  place,  closing 
the  bleeding  sinuses.  Should  the  uterus  be  con- 
tracted, but  still  hemorrhage  continue,  then  we 
must  examine  the  parts,  when  we  may  find  some 
laceiation  in  the  vulvar  canal,  or  a  lacerated 
cervix.  In  either  case  apply  pressure  by  means 
of  compresses  upon  the  bleeding  points. 

Smyrna,  Tenn.       H.  J.  Warmuth,  M.D., 


Dr.  Jos.  G.  WhitehUl,  of  Los  Angles,  Oal.,  a 
practitioDer  of  fifty  years  ezperieooe  and  himself  a 
veteran  medical  editor,  writes  as;  ^  1  desire  to  express 
my  appreciation  of  your  journal,  and  think  jonr 
styling  it,  '* A  practical  Medical  Monthly"  highly 
appropriate.'' 


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THE  MEDICAL  WORLD. 


Alkaloidal    Notes.  —  Hemorrhage  and    Collapse 
from  Misoarriage:— Treatment. 

Editor  Medical  World:— One  morniDg, 
about  ten  days  ago,  I  was  called  in  haste  to  see 
Mrs.  F.,  who  had  been  flowing  for  some  days  in 
the  course  of  a  miscarriage.  She  had  not  lost 
an  unusual  amount  of  blood  but,  being  natur- 
ally rather  weak,  was  suflering  considerable  de- 
pression therefrom.  This  morning  a  terrific 
gush  came  on,  from  which  she  ftinted  and  a 
messenger  was  hastily  sent  to  summon  me.  I 
found  her  in  complete  collapse.  Perfectly 
pulseless  at  the  wrist,  cold,  cli^my  and  as  white 
as  the  sheet  she  lay  upon,  but  conscious.  With- 
out a  moment's  delay  I  elevated  the  foot  of  the 
bed  about  eight  inches,  removed  the  placenta, 
which  was  lying  in  the  cervix,  intrcduced  my 
placental  forceps  and  with  a  quick  turn  cleaned 
the  uterus  of  all  debris,  while  the  family  was 
heating  the  water  I  had  ordered.  This  occu- 
pied perhaps  five  minutes.  The  hot  water  be- 
ing brought,  I  immediately  dissolved  two  gran- 
ules of  glonoin  y^r.  -^  and  four  of  digitalin  gr. 
^  each,  and  injected  under  the  skin.  I 
then  gave  two  granules  of  strych.  arseniate  gr. 
Y^  in  hot  solution  by  the  mouth,  and  sur- 
rounded my  patient  wiUi  bottles  filled  with  hot 
water.  Tlus  occupied  some  fifteen  minutes.  In 
about  five  minutes  after  the  injection,  a  little 
improvement  was  noticed,  from  the  quick  effect 
of  the  glonoin,   no  doubt    I  then  took  two 

f  lasses  and  put  in  each  ten  teaspoonfuls  of  water, 
n  one  I  put  ten  granules  of  glonoin,  in  the 
other  ten  granules  of  itrych.  arsaniate  and  ten 
of  glonoin,  with  instructions  to  give  a  teaspoon- 
ful  alternately,  every  fifteen  minutes.  There 
was  no  more  flow,  and,  being  busy,  and  know- 
ing full  well  what  to  expect  of  the  medicines  I 
had  prepared  and  the  proceedures  instituted,  I 
left,  promising  to  be  back  in  two  hours.  The 
medicines  were  kept  up  faithfully  and  on  my 
return '•!  found  a  slight  radial  pulse  and  my 
patient  feeling  better  in  every  way,  I  continued 
the  treatment,  increasing  the  interval  between 
the  medicines  to  one-half  hour  and  gave,  with 
each  dose  a  teaspoonful  of  liquid  peptinoids. 
Visiting  again  that  evening,  I  found,  as,  I  ex- 
pected, marked  improvement  The  glonoin  was 
now  omitted,  the  bed  dropped  nearly  to  a  level, 
and  my  patient  put  upon  strych.  arseniate  gr. 
y^,  iron  arseniate  ^,  digitalin  ^,  one  each 
every  two  hours  with  a  tablespoonful  of  the  liquid 
of  peptonoids  above  mentioned.  This  was  contin- 
ued during  two  or  three  days,  but  after  twenty- 
four  hours  the  peptonoids  was  replaced  by  oyster 
soup,  broth,  etc  With  this  my  patient  went  on 
to  an  uninterrupted  recovery  and  at  this  writing, 
ten  days  after  the  accident,  she  is  sitting  up  and 
feeling  about  as  well  as  usual. 


I  give  this  to  emphasize  the  importance  of  a 

physician  always  being  prepared  for  whatever 

may  meet  him,  as  well  as  the  greater  utility  of 

the  active  principles  and  newer  ranedial  agents. 

W.  G  Abbott,  M.D  , 

Ravenswood,  Chicago,  Dl. 


Give  Complete  Titles  to  Your  Arfloles. 

Editor  MhEDiCAL  World: — Johnson  says 
''  Knowlege  is  of  two  kinds — we  know  a  subjeipi 
ourselves  or  we  know  where  we  can  find  infor- 
mation upon  it''  A  week  hardly  ever  passes 
but  that  the  writer  is  forced  to  refer  to  the  files 
of  The  World  for  information  on  some  sub- 
ject, and  he  often  finds  it  a  tedious  and  time- 
taking  process  to  get  it  from  the  index,  owing 
to  the  fact  that  contributors  to  that  journal  fail 
to  head  their  articles  in  such  a  way  that  any 
idea  of  the  subject  of  an  article  can  be  had  from 
its  caption. 

This  is,  in  my  opinion,  all  that  keeps  The 
World  from  being  an  ideal  journal,  and,  as  we 
all  owe  it  to  The  World,  in  consideration  of 
the  vast  amount  of  practical  knowledge  we  re- 
ceive from  its  pages,  the  writer  would  suggest 
that  each  article  be  so  named  that  some  idea  of 
its  subject  matter  may  be  had  by  reference  to 
the  index. 

This  would  increase  the  value  of  the  files 
(which  accumulate  in  the  o£Sce  of  its  subscrib- 
ers) more  than  any  other  improvement  that 
can  be  made. 

The  captions  that  fi)llow  are  from  its  index 
and  convey  no  idea  of  the  subject  matter  of  the 
articles  to  which  they  refer:  ''CSase  Import- 
ant," "A  Novelty,"  "Notes  and  Replies," 
"Random  Thoughts,"  "For  Ourselves  and 
Otiiers,"  "  Troublesome  Case,"  "  Was  it  Origi- 
nal," "My  Experience,"  ''A  Question  of 
Right,"  "  Not  up  to  the  Mark,"  "  A  Successful 
Surgical  Operation,"  "Information  Given," 
"  A  Review  of  the  Field,"  "  Certain  AnticJbtes," 
"  Pointless  Pointers,"  "  How  Does  He  live," 
*« Bottled  Health,"  "Discoveries  Confirmed," 
and  so  on  ad  infinitum,  all  of  which  convey  no 
idea  of  the  subject  matter  treated  on. 

Oflen  wishing  to  refer  to  some  article  which 
he  remembers  that  he  has  seen  in  The  World^ 
the  busy  doctor  rushes  to  the  files  of  that  journal 
and,  not  being  able  to  find  the  article  in  iti 
index,  and  not  having  the  time  to  search  all  its 
pages  he  gives  it  up  with  a  feeling  of  disap- 
pointment 

The  writer  feels  sure  that  the  Editor  will  give 
us  a  little  more  of  his  valuable  space  (should  it 
be  necessary),  if  contributors  will  only  make 
the  captions  of  their  articles  a  source  of  infor- 
mation as  to  the  subject  treated  on. 


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447 


Much  of  the  informatioQ  treated  on  in  these 
journals  can  not  be  had  from  any  number  of 
text  books  and  is  too  valuable  to  be  lost  by  such 
aegliffence.  "  Half  of  our  knowledge  we  must 
snatch — ^not  take"  is  as  true  a  thing  as  Pope 
ever  said,  and  applies  to  the  physician  more 
than  to  any  other  class.  So  let  us  all  try  to  make 
The  World  even  more  valuable  by  preserving 
the  gems  its  pages  are  filled  with  available  for 
immediate  practical  use. 
^  Bellevue,  Tex.  Chas.  H.  Whiting, 

[The  suggestion  ma^e  by  Dr.  Whiting  is  a 
very  useful  one,  indeed.  Yet,  like  so  many  of 
the  profession,  the  Doctor  did  not  take  his  own 
prescription ;  he  did  not  give  any  title  at  all  to 
the  above  article.  This  should  always  be  done 
by  the  author,  fully  and  completely,  as  the 
editor  may  not  please  the  author  in  giving  titles 
to  his  articles.  The  title  should  name  every 
different  subject  treated  in  the  article. — Ed.] 


Boycott  Again. 

Editor  Medical  World  — I  am  rather  glad 
to  see  the  Boycott  spoken  of  on  page  409  of 
November  World,  for  I  am  very  well  aware 
what  the  result  will  be — ^that  all  sensible  doc* 
tors  who  do  not  already  keep  their  own  medi- 
cines, will  in  the  future  do  so. 

For  many  years  it  has  been  very  customary 
for  many  druggists  to  refill  any  and  every  pre- 
flcription  they  may  have  in  their  possession,  no 
matter  whether  requested  to  do  so  by  the  physic- 
ian or  not,  and  in  fact,  no  matter  whether  it 
was  for  the  original  person  who  had  it  filled 
first.  In  fact,  it  is  a  common  thing  in  some 
localities,  for  druggists  to  refill  or  put  up  some 
physician's  prescriptions  for  another  patient  who 
may  call  with  a  case ;  for  instance,  with  gonor- 
rh€A,  without  even  telling  the  patient  it  is  best 
to  see  a  doctor.  Indeed,  I  have  known  drug- 
gists to  tell  patients  that  it  was  not  necessary  to 
eee  a  doctor,  for  they  (the  druggist)  could  give 
them  something  just  as  good.  I  have  to  my 
actual  knowledge  known  my  own  prescriptions 
to  be  filled  25  or  30  times ;  that  was  years  ago, 
for  I  keep  all  my  own  medicines  now. 

Solomon  Gty,  Kan.      Dr.  I.  E.  Latton, 

Treitmeiit  of  Paralysis  Agftans. 

Editor  Medical  World:— The  following 
in  reply  to  Dr.  J.  F.  Blount's  request  in 
November  number. 

Your  case  of  paralysis  agitans  should  be 
thoroughly  investigated  as  to  history,  both  per- 
sonal and  ancestral,  occupation  and  habits.  G^ 
All  the  data  you  possibly  can  even  though  they 
be  apparency  utterly  worthless.  Give  your 
man  the  closest  mental  and  physical  examina- 
tioii  you  are  able  to« 


Nervous  diseases  are  traceable  to  apparently 
ridiculous  (?)  (to  the  unthinking)  sources,  some* 
times.  Is  he  a  marble  worker,  brass  moulder, 
worker  in  copper«smelting,  brass,  tinsmithing  or 
painter,  or  paint  mixer,  or  in  ground  materials, 
where  lead  or  copper  ate  used  as  ingredients  or 
are  used  at  alff  Simple  loark  without  traumat- 
ism or  shock  to  a  part  does  not  cause  paralysis 
of  a  part,  according  to  (lowers,  and  according 
to  the  teaching  of  my  former  instructor,  Pro£ 
Preston,  of  Baltimore.  Find  out  all  you  can 
that  can  be  of  causative  importance. 

The  treatment :  The  part  itself  should  have 
as  much  rest  as  possible.  (3entle  massage  of 
the  muscles  directed  from  the  origin.  B^^ 
first  with  stroking.  Then  for  internal  treat- 
ment use  Indian  Ii^p. 

Morphine,opiuin,hyoscy  amine^  hyoscin,solanin, 
all  are  temporary,  but  Lidian  hemp  and  arsenic 
give  or  have  given  in  the  cases  I  have  seen,  the 
best  results.  Be  careful  not  to  exhaust  the 
patient.  If  he  is  overworking  he  must  find 
some  way  to  lessen  the  strain.  Try  the  cannabn 
indica  alone.  Work  up  to  the  physiological 
effect,  fully.  You  can  use  opium  in  combina- 
tion, but  don't  use  arsenic  so.  After  the  drug 
has  had  a  fair  trial,  then  try  the  arsenic  (by 
mouth,  not  hypodermatically.)  Perhaps  the 
white  arsenic  will  act  more  quickly.  As  to  dose, 
no  one  can  advise  you.  You  can  get  that  better 
yourself.  Begin  small  and  work  up  to  the  full 
phyriological  effect,  then  recede  a  little  and  stay 
there.  Please  report  progress.  I  am  glad  to 
hear  through  The  World  from  any  brother 
who  is  dealing  with  nervous  diseases,  as  they 
are  my  hobby.  W.  R  Avis,  M.D., 

New  Haven,  Conn. 


A  Case  of  Appendicitis  Cured  by  Medical  Treat- 
ment. 

Dr.  H.  S.  Brewer,  of  Chicago,  writes  us  ot  a 
case  of  appendicitis,  in  which  an  operation  was 
thought  advisable  by  the  attending  physician 
and  consultants,  five  in  all.  The  case  was  very 
severe,  with  greatly  developed  tympanites.  Dr. 
Brewer,  being  called  in  as  a  consultant,  admin- 
istered a  tablespoonful  of  coal  oil  beaten  up 
with  the  white  of  an  egg.  This  was  in  a  very 
short  time  followed  by  the  escape  of  gas,  the 
case  ending  in  recovery.  Jn  relating  die  case 
the  doctor  does  not  demonstrate  the  diagnosis, 
nor  does  he  give  any  mention  of  treatment 
beyond  the  single  dose  of  coal  oil. 


Editor  Mbdioai.  World  : — I  have  been  a  reader 
of  the  many  |[ood  things  in  Ths  World  for  eight 
Tears,  and  it  is  the  only  one  of  mj  joamals  that  I 
have  kept  regaiarly  bound  to  have  in  mj  librair. 

Waterloo,  Wis.  O.  C.  Bailby,  M.D. 


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THB  MBDICAL  WORU>. 


The   Rtaton  Why   Peroxide  of  Hydrogen  Fre- 
quently Explodes.— Poieoned  Beef  at  a  Cause 
of  Dr.  Koon't  Gates. 

Editor  Medical  World  : — In  answer  to  the 
qnery  of  Dr.  Shipley  in  the  November  issue  of 
The  World,  I  offer  the  following  well-known 
diaracteristics  of  this  antiseptic : 

Peroxide  of  hydrogen  (Hg  Oj)  is  made  by 
decomposing  barium  dioxide  by  sulphuric  add, 
the  equation  being  Ba  Oj+Hj  So4=Ba  S04+ 
Hs  O2.  The  resulting  solution  is  concentrated 
by  evaporation.  In  this  state  it  is  a  clear  liquid, 
prone  to  decomposition,  the  least  rise  of  temper- 
ature causing  effervescence  due  to  escaping 
oxygen  gas.  Pure  anhydrous  Hj  O^  is  a 
chemical  curiosity.  On  receiving  samples  of 
this  article,  it  is  a  rare  occurrence  upon  opening 
a  bottle  that  the  cork  is  not  forced  out  by  the 
pressure  within ;  this,  however  slight,  is  an  indi- 
cation that  the  solution  has  parted  with  some  of 
Hb  oxygen,  either  by  organic  matter  being  pres- 
ent in  Uie  solutipn  or  more  frequentiy  by  heat  I 
see  that  the  doctor  purchased  his  supply  in  June. 
Above  59^  F.  the  solution  is  slowly  decom- 
posed ;  at  68^  F.  it  changes  rapidly;  the  warmth 
of  the  hand  imparted  to  the  bottle  will  cause 
cixjgai  to  be  liberated.  Now,  as  the  great- 
est factor  is  heat  in  the  decomposition,  it  is 
Site  evident  that  the  temperature  of  a  summer 
y  is  all  that  oould  be  desired  to  effect  the  lib- 
eration of  oxygen,  and  it  is  a  mere  question  of 
the  pressure  increasing  within  the  bottles  until 
an  explosion  occurs.  Keeping  these  bottles 
tightly  corked  is  a  fruitful  source  of  explosions. 

PTOMAINES  MAY   HAVE  BEEN   THE  CAUSE. 

In  answer  to  Dr.  Koon,  I  would  say  that  the 
production  of  a  ptomaine  formed  by  the  action 
of  bacteria  on  organic  matter  had  taken  place  in 
the  beef  that  was  consumed  by  the  poisoned 
parties.  The  symptoms  of  poisoning  by  certain 
ptomaines  are  identical  with  those  he  describes. 
Pupilary  dilatation  and  immobility,  with  paraly- 
sb  of  the  accommodation,  is  a  characteristic 
sjrmptom  of  ptomaine  poisoning  from  tainted 
meats,  sausage  or  fish.  W.  Robert, 

Fort  Meyer,  Va.     Hospital  Steward,  U.  &  A. 

[Peroxide  of  hydrogen  is  subject  to  the  same 
kind  of  change  as  is  champagne,  the  gas 
liberated  being  oxygen  instead  of  carbonic  add 
gas.  No  one  would  think  of  keeping  champagne 
in  a  temperature  of  98^  and  expect  to  enjoy  the 
sparkling  beverage  afterwards. — Ed.] 


Bo  jou  know  of  the  recent  reduction  in  price  of  P. 
O.  Monej  Orders  7  Three  cents  will  set  an  order  up 
to  $2.50,  and  Ave  cents  up  to  $5.00.  This  coHt  is  very 
trifling,  and  it  is  the  safest  waj  in  which  to  send 
■lonej  by  mail— it  is  abeolutelj  safe — safer  than  bj 
registered  letter,  and  that  costs  eight  cents. 


Credentitfs  for  Praotlce^— The  Importance  of  th^ 
Money  Question  to  Physicitns. 

Editor  Medical  World  : — Doctors  are  talk- 
ing about  State  and  inter-State  Boardeof  Exam- 
ination. Let  each  State  have  its  own  law ;  then 
let  there  be  a  United  States  Army  examination 
open  to  everybody,  and  let  this  be  good  in  any 
State  in  the  Union  by  consent  of  the  State 
Boards.  Our  own  schools  6f  medicine  are  a» 
good  as  those  of  other  lands,  and  we  should 
stand  upon  our  dignity.  It  is  more  than  amus- 
ing to  hear  some  very  common-place  doctor,  who 
is  practising  upon  an  uncertified  cryptogamic 
diploma,  imported  by  him  free  ot  duty,  talk 
about  the  superiority  of  foreign  schools,  wbeo 
two-thirds  of  the  text-books  used  in  his  schoob 
are  written  by  American  authors,  hock  oyer 
the  lists  of  authors  on  surgery,  gynecology  and 
other  subjects,  used  in  the  continoital  schoolsr 
and  feel  proud  of  our  American  colleges  for  hav- 
ing started,  if  not  having  made,  such  men. 
Cfmada  discounts  our  diplomas.  There  is  but 
one  way  to  cure  such  concdt  Make  every  mais 
who  practices  in  the  United  States  pass  an  ex^ 
amination  by  a  State  Board,  or  show  a  United 
States  diploma.  Never  for  a  minute  think  that 
the  doctors  of  this  country  are  not  superior  t» 
the  average  importation.  Collegiate  training  ie 
not  all,  however.  An  examination  is  the  proper 
test,  and  if  a  candidate  passed  the  United  Staler 
Board  he  could  be  accepted  by  the  SUsU  Bomd 
without  examination.  In  tins  way  the  utmost 
harmony  could  exist  between  State  and  National 
Boards. 

Now  about  money  matters.  Doctors  ai» 
learning  that  they  muH  think  a  little  opon  the 
currency  question,  and  they  must  oilighten  their 
patrons  to  the  point  that  they,  too^  have  a  right 
to  think  upon  political  matters.  No  quettioQ  ift 
politics  should  be  too  complicated  for  an  intdii* 
gent  voter  to  understand;  If  professional  pdi- 
tidans  omtinue  the  toola  of  money  speoulaton^ 
it  will  not  be  long  until  amateur  politicians 
will  come  to  tlie  front  L^  us  have  a  currency 
based  upon  our  tax*  rolls ;  upon  the  amount  ot 
property  in  the  country ;.  upon  the  amount  (rf* 
goods  to  be  moved,  and  the  amount  of  business 
to  be  transacted.  Money  should  be  issued 
directly  by  the  govemm«[it»  and  based  upon 
actual  value.  We  need  more  money  now  than 
we  did  twenty  years  ago.  It  takes  more  mooey 
to  make  change  for  a  large  store  than  it  does  for 
a  candy  stand.  Property  is  pl«ity — ^is  theie- 
currency  enough  to  go  between  ?  No  currencf 
is  as  unstable  as  gold.  Money  is  not  value— it 
is  merely  a  certificate  of  value.  The  aasessmeot 
roll  affords  the  basis  and  shows  the  credit  of  the- 
country.  We  may  find  new  mines  of  gcdd  any 
time ;  then  what  will«  be  the  standard  f    Ti» 


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tax-TolL  Doctors,  people  look  to  us  as  educated 
meo.  Let  us  study  these  questions,  and  let  us 
educate  our  clients.  One  point  more:  let  no 
man  discount  the  credit  of  Uncle  Samr  No  dol- 
lar in  gold  ever  bought  any  more  farm  products 
than  does  the  silver  dollar  of  to  day.  How  is 
that  for  honest  money  ?  Doctors,  who  sees  more 
want  and  poverty  than  do  we  in  our  daily  work  ? 
£Siall  we  be  with  our  people  in  their  sorrow,  and 
then  delegate  the  power  to  think  for  them  to 
mexx  who  deep  while  we  work?  No !  we  must 
help  our  people,  that  they  may  be  able  to  help 
us.  Victor  Hugo  says  poverty  is  darkness. 
liet  us  have  light. 

Michigan.  A.  M.  Erican,  M.D., 


Replies  to  November  Queries. 

Editor  Medical  World. — Thb  World  is 
tlmajB  ready  to  defend  and  uphold  the  profes- 
aioD.  We  need  something.  Just  feel  in  your 
pockets,  and  you  will  understand  it  Our  work 
does  not  grow  less,  but  our  income  does.  Let 
us  all  talk  about  this  matter,  and  try  to  find  a 
rare  remedy. 

[The  doctor  evidently  has  reference  to  the 
editorial  in  November  World,  "Our  Pro- 
fenon  and  the  People."— Ed.] 

To  Dr.  J.  D.  Eemodle,  page  413,  November, 
1894, 1  would  recommend  the  followiag 

usual  REMEPIEB  FOR  PAIN. 

Iron  by  hydxofoi n.  n 

AlMDlO gr.  1-100 

Qniola  lolpbu gr,m 

BtrjrehiiSft. gr.  1-200 

One  to  two  After  eech  meaL 

For  the  ulcer,  the  treatment  will  depend  on 
the  conditions — whether  indolent  or  irritable. 
If  an  indolent  ulcer — and  I  presume  it  is— cau- 
terize the  edges  with  argent!  nit,  then  poultice 
nnlil  edges  are  soft  (use  elm  poultice).  Then 
gtrap,  and  keep  drawing  edges  closer  together. 
Cleanse  every  few  days  with  hydrogen  peroxide. 
If  edematous,  keep  bandaged.  Keep  ulcer 
•overed  with  the  following  powder : 

R.  Iodoform. «.. diamsU 

Ae.  Boncie. drams  Ij 

GbudMnildiA  mlpti ~ dntmB  u 

Willow  obarooai..... ouncei  J 

M. 

This  has  given  me  satisfaction  in  a  number  of 
caiea.  Some  ulcers  require  an  application  of 
jequirity,  especially  those  that  will  not  start  to 
heal  with  ordinary  treatment 

To  Dr.  W.  B.  Formin  (page  414)  :  I  have 
liad  a  number  of  such  cases  in  small  children — 
one  of  them  was  my  own.    I  have  relieved  all 


by  giving  rectal  injections  once  a  day  of  warm 
water  and  glycerine,  and  giving  internally 

R,   Bfr.  Thei  aiomai onnoea  ti 

F  S.  caaoarn  sagrada ooncee  ■<< 

F.  E.  Jnglans « ounceB  j 

M.    Sig.~Half  to  one  teaspoonfol  three  times  a  day. 

To  Dr.  G.  F.  Bismarck  (page  414)  t  Your 
case  certainly  will  improve  if  you  will  use  anti- 
septics, as  naphthalin,  salol  or  zinc  sulpho-carbo- 
late.  Use  also  reoonstructives,  as  iron,  arsenic 
and  strychnine. 

To  subscriber  (page  413)  :  Hot  flashes  at 
menopause  are  due  to  vasomotor  disturbance; 
Give  iron,  valerian,  bromides,  zinc  valerianate, 
and  rel  eve  constipation. 

To  Dr.  J.  H.  Reynolds,  (page  413):  The 
editor's  suggestions  are  good.  I  have  aLso  had^ 
happy  results  from  the  following  old  formula: 

R.  Tr.  gualao  ammon.,  i       ..  ^«.«.  u* 

Tr.  opU. dnuns  11 

Aq.  Clnnamomi ad  f.  ounces  Ti<] 

M.    Big.— Gaigle  every  fifteen  or  twenty  minutes. 

To  Dr.  Koons  (page  407) :  Your  patient's 
sickness  was,  in  all  probability,  due  to  ptomaine 
poisoning. 

Dear  editor :  Keep  talking  reform  iii  the  in- 
terest of  the  profession,  and  of  the  laboring  peo- 
ple generally.  J.  T.  Barnbtt,  M.D»^ 

Hardinsburg,  Ind. 


Other  Uses  of  the  Finger  Bandage. 

Editor  Medical  World:— The  many- tailed^ 
finger  bandage  suggested  by  Dr.  Hermance,  and 
illustrated  in  The  Medical  World  of  Novem- 
ber, may  be  used  with  considerable  advantage 
upon  the  arms  and  legs,  especially  in  adjusting 
splints  where  it  is  desirable  to  clothe  the  limb  is 
thinly  as  possible,  in  orler  thus  to  examine  the 
fracture  without  disturbing  the  dressing,  and. 
keep  the  parts  cool. 

C.   E   BOYNTON,   M.D., 

Buena  Vista,  Oregon. 


Correction. 

Editor  Medical  World  : — On  page  367, 
October  World,  to  my  treatment  for  epilipeey 
should  be  added  aqaa  month,  q.  s.  ad.  oz.  vL  A 
teaspoonful  in  water  every  three  hours,  for 
three  weeks,  then  a  tablespoonful  in  water  twice 
a  day.  H.  S.  Brewer,  M.D., 

Chicago. 


Editor  Medical  World  :— The  M^ical  Worixi 
binders  to  hand  and  volumes  bound.  Thanks.  Be- 
sides making  a  handsome  addiiion  to  the  library, 
they  make  it  so  convenient  when  referring  to  the 
journals.  I  would  not  be  without  them  now  for  maoj 
times  their  cosL  W.  J.  Cooper,  M.D., 

Crockett,  Miss. 


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Qui;  D€t>ortinent. 

S|it£«tloiifl  are  lolldted  ibr  this  C6lniim.  Commnxilcatioai 
not  acoomiMuiled  by  the  proper  name  and  address  of  the 
writer  (not  neceasarily  fbr  publication),  will  not  be 
noticed. 

t)&e  great  number  of  requests  fbr  private  answers,  for  the 
information  and  benefit  of  the  writer,  makes  it  necess- 
ary for  us  to  charge  a  fee  for  the  time  required.  This 
lee  will  be  from  one  to  five  dollars,  aoooiding  to  ths 
•mount  *^  <v»9«irch  asuS  writinflr  T«qnir»><^ 

A  Gate  for  Diagnosis. 

Editor  Medical  World  :~SeeiDg  an  e{M- 
demic  of  carbuncle  reported  in  the  Noyember 
WoBLD,  I  am  led  to  report  a  case  of  a  carbon- 
culouB  nature,  but  which  has  left  a  doubt  in  the 
minds  of  some  of  the  attending  physicians  as 
to  its  true  diagnosis. 

The  patient,  a  male,  age  about  24  years, 
small  and  of  a  scrofulous  diathesis,  was  taken 
with  a  chill  on  September  6th,  followed  with 
high  fever.  Four  days  later  a  severe  pain 
commenced  in  the  region  of  the  right  plura  and 
liver.  A  large  blister  was  applied,  which  re- 
moved the  pain,  to  return  in  the  left  side. 

About  this  time  a  swelling  of  the  upper  lip 
made  its  ap{^rance,  but  in  the  meantime  his 
temperature  ranged  from  103  to  104  i  F.  with 
a  remission  occuring  at  irregular  intervals. 

This  swelling  of  the  upper  lip  was  supposed 
to  have  originated  from  a  small  papule  on  the 
lip,  which  was  there  before  the  iniatory  chill, 
but  had  attracted  no  attention,  as  they  were  of 
common  occurrence  on  his  face  and  chest 
After  the  pain  in  the  left  si^e  of  the  chest  had 
been  removed  with  turpentine  stupes,  he  began 
to  complain  of  a  severe  pain  near  the  right 
infra- orbital  foramen,  over  which  the  swelling 
had  extended  from  the  papule  on  the  lip.  This 
swelling  at  about  the  fifteenth  day  was  enor- 
mous, involving  the  upper  lip  and  right  side  of 
face,  extondirg  to  the  eye  and  temple  as  high  as 
the  superior  border  of  the  ear.  This  swelling 
was  of  a  dark  red,  purplish  hue.  It  had  piessed 
the  jaws  apart  and  protruded  between  the  teeth 
into  the  buccal  cavity. 

The  mucous  membrane  of  the  lip  and  jaw 
had  sloughed  about  the  fifteenth  day  of  his  ill- 
ness, soon  after  which  several  openings  were 
seen  on  the  inner  side  of  the  lip.  Not- 
withstanding the  induration  of  the  swelling, 
there  were  a  half  dozen  punctures  made  in  it 
with  a  history,  letting  out  a  few  drops  of  pus  at 
each  puncture.  These  punctures  were  made  in 
the  most  prominent  portion  of  the  jaw.  They 
were  dr^sed  every  twelve  hours,  by  in- 
jecting peroxide  of  hydrogen  into  the  openings, 
which  communicated  freely  with  each  other. 

A  cough  and  expectoration  soon  followed  this 
and  about  the  25th  day  an  abcess  of  the  left 
pleural  cavity  made  its  opening  into  the  left 


lung,  almost  producing  suffocation  ;  since  thai  a 
profuse  expectoration  has  been  present 

About  this  time  the  inferior  border  of  the 
left  ulna  became  inflamed,  and  subsequently 
formed  a  large  swelling,  with  the  appearance  of 
fluctuation,  but  an  incision  got  only  a  few  drops 
of  pus. 

This  is  the  eleventh  we(k  of  his  illness.  Since 
the  first  puncture  was  made,  there  has  been 
more  or  less  discharge  of  pus  from  the  face, 
lungs  and  from  the  numerous  abroesaes  formed 
on  various  parts  of  the  body.  The  abscesses 
that  are  developing  now  are  attended  with  pain 
and  swelling,  but  no  redness. 

For  the  first  three  weeks  there  was  much  ner- 
vous disturbance.  The  face  has  healed,  and 
fever  almost  subsided,  but  there  are  four  laige 
abscesses  developing  novr.  The  jaw  did  not 
slough. 

I  would  like  very  much  to  hear  from  some  of 
the  readers  through  The  World.  Was  it  pheg- 
monous  erysipelas  or  was  it  a  carbuncle  followed 
by  pyemia  ?  B.  L.  Craddock,  M.D., 

Argyle,  Tex. 


Editor  Medical  World  : — May  I  ask  for 
the  best  treatment  for  membranous  croup,  fol- 
lowing diphtheria  ?  I  have  tried  mercury,  cal- 
cium sulph.,  pilocarpine,  iodide  of  lime,  but  lost 
every  case. 

Also,  what  can  I  (?o  to  relieve  creaking  joints, 
in  which  there  seems  to  be  a  scarcity  of  synovial 
fluid?  J.  G.  Steiner,  A.M.,  M.D., 

Knox  Dale,  Pa. 


Editor  Medical  World  : — May  I,  through 
your  valuable  columns,  bring  a  case  before  your 
many  readers,  which  has  caused  me  considmble 
anxiety  and  worry?  The  case  does  not  present 
symptoms  and  signs  enough  for  me  to  make  a 
positive  diagnosis,  therefore  treatment  is  un- 
certein.  I  shall  be  glad  for  any  suggestions  as 
to  probable  diagnosis  and  treatment,  also  as  to 
any  means  of  obtaining  more  light  on  the  case. 

Last  March,  Mr.  L.,  age  58,  previous  health 
and  family  history  good,  was  suddenly  taken 
with  peculiar  sensations  in  his  right  arm,  extend- 
ing the  whole  length,  down  into  the  little  and 
ring  fingers. 

Numbness,  weakness,  and  tingling  sensations 
manifested  themselves.  In  a  few  days  symp- 
toms appeared  in  the  head,  viz :  feeling  of  full- 
ness, heaviness,  and  much  confusion  of  ideas — 
«  pain  in  the  mind,*'  as  he  called  it  He  could 
not  express  his  ideas,  forgettmg  certain  words, 
and  his  memory  failed  to  some  extent ;  also  some 
vertigo. 

In  July  he  went  to  Minneapolis,  Minn.,  and 


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THE  MEDICAX  WORLD. 


451 


was  examioed  by  a  doctor  there,  and  was  given 
8ome  electricity,  which  did  not  benefit  him  any, 
and  his  arm  became  somewhat  stifi,  his  hand 
being  drawn  sidewise  toward  the  body.  He  has 
now  been  under  my  care  for  over  two  months. 
I  have  examined  him  three  times,  and  find 
scarcely  any  symptoms  or  signs  of  brain  irrita- 
tion or  hyperemia.  His  arm  and  hand  are  bet- 
ter, but  he  now  has  a  sharp  pain  in  the  arm  on 
twisting  it  suddenly. 

The  confusion  of  ideas,  although  a  little  bet- 
ter, is  still  very  bad,  and  his  memory  is  still 
poor. 

He  ki  u^  and  attends  to  business  (grain  and 
s6ed  business).  Has  no  trouble  with  aoy  other 
organ  of  body ;  appetite  good  and  bowels  regu- 
lar.    No  fever,  and  average  pulse  78®. 

I  have  used  strychnine    sulph.,   potassium 
iodide,  arsenic,  besides  other  general  tonics  and 
alteratives,  and  all  to  no  apparent  effect. 
'  Mitchell,  So.  Dak.        B.  A.  Bobb,  M.D., 


Editor  Medical  World: — Mrs.  D.,  aged 
20,  married  at  16,  has  one  child.  On  July  9th 
she  worked  hard  in  the  harvest  field,  got  very 
hot  and  drank  a  great  deal  of  cold  water,  but 
did  not  perspire  any.  July  i5th,  while  riding, 
she  strained  her  back  by  the  horse's  giving  a 
sadden  start  July  19th,  headache  came  on, 
lasting  three  or  four  days,  with  some  aching  and 
pain  in  limbs.  July  2l8t,  paralyns  of  right 
limb ;  left  limb  followed  next  day.  July  29th 
I  saw  her  for  the  first  time,  and  found  the  fol- 
lowing conditions :  Temperature  99®,  pulse  88, 
tongue  furred,  some  headache,  severe  pain  in 
hip  joints  and  back,  soreness  of  last  three  lumbar 
vertebrse  on  the  left  side.  I  drew  ofi  three 
pints  of  dark-colored  urine.  Bowels  constipated, 
pelvic  organs  normal,  appetite  poor.  The  blad- 
der and  rectum  remained  paralyzed  for  two 
weeks.  Some  movement  of  left  foot  The  tem- 
perature varied  between  99°  and  100°.  At  the 
end  of  four  weeks  the  temperature  and  pulse 
were  normal,  appetite  good,  and  she  could  sleep 
very  well.  Sensation  was  not  impaired.  Re- 
flexes were  abolished.     Urine  negative. 

Her  previous  attendant  said  she  was  threat- 
ened wiUi  typhoid,  and  the  paralysis  was  due  to 
the  quinine  (12  grs.  per  day). 

October  30.— She  feels  well  in  every  way, 
sits  up  most  of  the  time,  but  still  the  paralysis 
remains,  with  considerable  edema  of  feet  and 
ankles.  No  wasting  of  muscles.  There  were 
no  symptoms  oi  hysteria  at  any  time. 

I  am  using  the  Faradic  battery,  potassium 
iodide  and  strychnine.  Was  it  due  to  injury  to 
the  motor  tract  of  the  spinal  cord,  or  was  it  hys- 
terical? 


In  reply  to  query  in  the  November  WoftLD,. 
page  413,  the  hot  flashes  of  the  menopause  is  & 
vasomotor  neurosis,  and  can  be  controlled  by 

R.  Ext.  Oelaem.  fid gt.  ii 

Kxt.  Brgot,  fld « gt.  V 

PotBcomla « gr.  x 

M.    fflg.—Three  timet  a  day. 

In  reply  to  Dr.  J.  D.  Kemoile,  same  page, 
for  gastra^ia,  I  recommend  two  drops  Fowler's 
solution  before  meals,  and  bismuth  subnitrate 
several  hours  before. 

Minerva,  Ohio.  Dr.  Karl  Mantey, 


Editor  Medical  World: — I  have  been  a 
subscriber  to  your  valuable  journal  for  the  last 
two  years,  and  am  delighted  with  the  practical 
manlier  in  which  you  deal  with  matters 

I  am  a  physidan  of  many  years  standmg,  but 
have  never  been  able  to  settle  in  my  own  mind, 
and  certainly  not  to  that  of  many  of  my  patients, 
what  was  the  right  course  to  pursue  in  a  certain 
class  of  ca^es  in  which  I  have  been  consulted, 
and  by  declining  to  comply  with  their  wishes 
have  been  coolly  informed  by  them  (sometimes 
my  best  patients),  "  Very  well ;  if  you  will  not, 
I  kmw  who  will!"  Or,  ** Doctor  so-and-so 
will  do  it  for  me."  In  some  cases  it  is  the  last 
I  see  of  them ;  in  others  I  have  been  called  by 
them  in  a  few  days,  to  attend  them  either  in 
abortion  or  miscarriage,  sometimes  brought  on 
either  by  themselves  or  some  one  eke,  from  the 
use  of  some  kinds  of  drugs  or  mechanical  instru- 
ments. 

A  few  days  ago  I  attended  a  very  estimable 
lady  in  abortion,  brought  on  by  herself  at  the 
second  month.  She  is  educated  and  refined, 
and  moves  in  good  society,  but  they  are  very 
poor.  They  have  already  three  children,  and 
it  is  about  all  they  can  do  to  support  what  they 
have  already,  and  to  have  others  would  be  a 
hardship  which  she  felt  she  could  not  endure. 
I  could  not  find  out  what  she  had  done,  herself, 
or  what  had  been  done  for  her,  to  bring  it  on, 
but  when  called  I  found  her  flowing  freely—in 
fact,  she  had  nearly  bled  to  death,  but  is  now 
slowly  recovering. 

I  have  another  patient,  a  milliner,  who  has 
all  she  can  do  to  support  herself  and  one  child 
and  a  worthless  husband.  She  is  now  pregnant 
again,  and  in  the  second  month.  I  was  con- 
sulted as  soon  as  she  found  out  her  condition, 
and  was  besought  with  tears  to  help  her  out  of 
her  trou  ble.  Unless  something  is  done  to  relieve 
her  in  a  legitimate  (/)  way,  she  will  resort  to 
some  desperate  measures,  as  she  declares  she  will 
never  bear  another  child  at  term. 

What  is  the  proper  course  for  me  to  adopt  in 

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.-such  cases?  and  is  there  any  medicine  or  rem- 
:«ed7  known,  outside  of  mechanical  interference, 
that  will  empty  the  womb  of  its  contents  in  a 
<x>mparatively  harmless  manner  to  the  woman 
lieiself? 

I  shall  be  exceedingly  thankful  if  you  can 
enlighten  me  as  to  the  proper  and  satisfactory 
tnanner  of  dealing  with  such  cases,  and  shall  be 
^lad  to  hear  from  you,  either  by  private  com- 
tnunicadon  or  through  The  World,  as  I  am 
certain  that  the  information  I  seek  will  be  thank- 
fully received  by  a  great  many  perplexed  phy- 
ddans  besides  myself.  Perplexed. 

[This  letter,  from  an  earnest,  conscientious 
physician,  is  of  vital  interest  to  all  physicians, 
And  to  all  humanitarians  as  well. 

It  can  only  be  said  at  the  outset  that  to  even 
^consider  the  advisability  of  committing  an  abor- 
tion or  causing  a  miscarriage  is  entirely  out  of 
rthe  question.  Every  instinct  of  humanity  is 
against  it,  and  it  is  well,  also,  that  the  laws  of 
sodety,  of  state  and  of  church,  all  agree.  Even 
^the  irrevocable  physical  laws  of  nature  are 
.jigainst  it,  and  follow  its  perpetration  with  the 
severest  penalties.  The  medical  profeesion  has, 
hj  common  consent,  placed  itself  squarely  in  line 
with  the  law  and  the  highest  ethics  on  this  ques- 
vticm. 

^ut  ther$  is  another  phase  of  the  subject  that 
Siill  bear  a  more  extended  consideration — the 
advisability  of  preventing  an  undesirable  preg- 
nancy from  occurring.  Each  child  has  a  right 
to  be  bom  under  favorable  conditions  for  its 
^constitutional  vigor  and  for  its  proper  support 
4md  training.  Each  child  should  be  alike  wel- 
come and  desired  by  both  parents,  and  the  pa- 
rents should  bring  themselves  into  suitable 
health  and  financial  circumstances  to  be  able  to 
^o  justice  by  the  expected  child,  before  they 
assume  the  responsibility  of  allowing  a  concep- 
tion to  occur.  These  principles,  it  seems  to  us, 
must  appeal  to  the  higher  moral  sentiments  of 
all  who  give  them  serious  consideration. — Ed.] 


To  Cause  Conception.— Query. 
Editor  Medical  World:— Is  there  any 
known  means  of  causing  a  woman  to  become 
impregnated  who  has  always  been  barren? 
Very  oflen  I  have  given  women  tonics,  and  by 
thus  improving  their  condition  barren  women 
have  conceived,  and  women  that  thought  they 
were  **free*'  have  found  themselves  again 
**  caught,"  so  that  I  have  quite  a  local  reputa- 
tion ;  but  in  every  case,  so  far,  my  success  has 
been  purely  accidental.  I  know  that  correcting 
any  abnormality  about  the  uterus  tends  toward 
this  happy  event,  but  what  I  am  anxious  to  know 
is,  if  there  is  any  mediciue  that  will  tend  to  cause 


a  woman  to  become  impregnated,  when  we  < 
not  see  any  reason  why  she  is  barren — ^whea 
there  is  no  abnormality  that  we  can  find,  when 
she  and  her  husband  both  appear  healthv  and 
virile  ?  I  have  no  axe  to  grind,  and  merely  ask 
that  I,  as  well  as  others,  may  be  benefited,  and 
may  thus  bring  happiness  to  many  barren  house- 
holds. 

I  would  like  to  get  the  views  of  the  editotf 
and  of  that  encyclopedia  of  medical  knowledge, 
Dr.  Waugh,  as  well  as  from  all  others  who  may 
be  able  to  throw  a  ray  of  light  on  the  subject. 

Luster,  N.  C.         K  H.  Bowliko,  NLu^ 


[Sterility  caused  by  non-fertility  of  the  i 
can  be  remedied  only  by  conducting  the  < 
from  the  husband's  standpoint.  Otiea  the 
treatment  of  an  old  epididymitis  by  electrioitj 
or  by  massage  will  succeed  in  opening  up  a  sealed 
vas  deferens,  and  thus  render  the  semen  agau 
fertile.  The  treatment  of  sterility  that  depeods 
upon  abnormal  formation  of  the  parts,  as  elon- 
gated, conical  os  uteri,  must  be  surgical  in  its 
nature.  Sterility  may  be  caused  by  an  aerid 
leucor^hea,  destroying  the  vitality  of  the  sper- 
matozoa. A  cure  of  tiie  leucorrhea  will  remove 
the  difficulty.  A  strongly  alkalinized  va^^Ml 
injection  (bicarbonate  of  soda)  previous  to  coi- 
tion, may  occasionally  protect  the  life  of  the 
spermatozoa.  Often,  when  both  Fallopiaa 
tubes  have  been  sealed  by  inflammation,  the 
stenosis  may  be  removed  by  electrical  treatment, 
massage,  or  the  use  of  the  special  uterine  took 
drugs,  as  pulsatilla,  aletris,  dioscorea,  helonkB, 
etc.  The  greatest  patience  and  ingenuity  mnit 
be  observed  to  learn  the  exact  cause  of  the  sis- 
rility,  and  to  employ  remedies  suitable  to  the 
case. — ^Ed.] 

Formufss  Requested. 

Woolley's    Morphine    Antidote.      Umalffla 
Indian  Eemedies. 


Editor  Medical  WoRLi) : — I  should  like  t» 
know  the  best  means  to  arrest  the  too  free  i 
of  the  kidneys  with  children  under  adult  s 
I  mean  up  to  puberty — during  night,  to  keep 
them  from  drowning  themselves  in  their  own 
water.  The  patients  are  enjojring  good  healtk 
in  every  other  respect 

Pennmgton,  Tex.       Ej:nn£TH  Thomboh. 


Correotion. 

Editor  Medical  World  : — In  the  artide  ef 
October  number,  page  368,  I  should  have  said» 
after  quoting  Wolfgang  Wedel,  "To  this  Dr- 
Hirfeland  adds :  <  It  is  a  double  edged  sword,'" 
etc.  Dr.  John  Zenkbb, 

CJolwich,  Elan. 


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453 


Editor  Medical  World  : — I  would  like  to 
mak  the  cause  of  the  following  described  tumor, 
filled  with  a  straw-colored  fluid : 

E.  G.,  a  man,  came  to  me  with  a  lump  on  his 
■kmll,  and  on  examination  I  found  it  movable, 
and  that  it  fluctuated.  I  aspirated  and  drew 
oil  two  drams  of  a  straw-  colored  fluid.  I  couldn't 
gei  any  history  of  its  ever  having  been  injured 
in  any  way.  J.  A.  Philipsen,  M.D., 

Ifiles,  Kans. 


Editor  Medical  Wobld  :— R.  P.,  aged  21, 
to  me  June  15th,  1893,  with  an  old  leg 
nicer.  There  was  no  history  of  any  constitu- 
tkmai  trouble.  Have  known  the  family  person- 
mUy  myself  for  many  years.  No  other  symptom 
of  diBMse  except  marked  anemia.  I  have  tried 
•▼«iy  remedy  I  have  ever  heard  of,  but  without 
sucoess.  The  anemia  has  entirely  disappeared, 
bal  the  ulcer  remains  the  same. 

Will  some  of  the  many  readers  of  The 
World  give  me  the  treatment  they  find  most 
•ueoessful  ?         Bob't  L.  Goodbred,  M.D., 

Mayo,  Fla. 


Diagnosis  Wtnted. 


Editor  Medical  World  : — Will  some  of  the 
brethren  diagnose  my  case?  I  was  called  to  see 
a  girly  age  16,  taken  with  chill,  with  high  fever 
following;  very  marked  photophobia,  with 
severe  h^ache,  extending  down  her  spine ; 
Toy  tender  all  over  abdomen  and  left  side.  On 
peroussion  I  found  marked  tenderness  at  the 
mjpex,  of  the  left  lung  ;  no  cough,  no  expectora- 
tion ;  some  delirium ;  at  first  she  was  constipa- 
ted ;  fever  was  not  regular,  but  did  not  seem  to 
be  periodic,  reaching  105^.  This  condition  lasted 
about  ten  days,  when  the  fever  left  her,  and  she 
seemed  to  make  a  fair  recovery,  but  took  a  re- 
lapse and  went  through  about  the  same  train  of 
symptoms,  lasting  about  ten  or  twelve  days 
longer.  She  yielded  to  the  usual  febrile  treat- 
B6Dt  fairly  well. 

In  regud  to  her  previous  history :  she  only 
has  her  menses  about  three  times  a  year,  at 
which  times  it  is  attended  with  severe  dysmen- 
orrhea. She  is  now  convalescing  very  nicely, 
birt  is  very  weak.  I  did  not  make  any  exam- 
ination of  internal  organs. 

If  ow,  will  some  reader  of  The  World  give 
diagnosis?  W.  H.  Prentice,  M.D., 

Stanton,  Kansas. 


Editor  Medical  World  : — What  is  meant 
by — or,  rather,  how  do  we  make — a  per  cent 
solation  ?  For  instance,  a  4  per  cent  solution, 
a  1  to  500,  1  to  1,000,  1  to  10,000,  etc  Please 


give  formula  in  the  next   number  of   Thc 
World.  J.  N.  Taylor,  M.D., 

Lynchburg,  Tenn. 

[Take  the  required  number  of  units  of  th& 
solid  or  active  substance,  add  enough  water  or 
required  solvent  to  dissolve  it,  then  continue  add- 
ing the  water  or  other  solvent  until  you  bring 
the  total  amount  up  to  100  units.  For  exam- 
ple :  to  make  a  4  per  cent  aqueous  solution  of 
cocaine,  take  4  grains  of  cocaine,  add  enough 
water  to  dissolve  it,  then  add  enough  more  water 
to  bring  the  amount  up  to  100  minims.  For  a 
larger  quantity  take  larger  units,  as  drams  or 
ounces.  For  example :  to  make  a  4  per  cent 
solution  of  ammonium  chloride,  take  4  ounces 
of  the  salt,  add  enough  water  to  dissolve  it,  then 
add  enough  water  to  make  it  equal  100  fluid 
ounces. 

1  to  500,  1  to  1,000,  etc.,  have  a  diflerent 
meaning.  In  this  case  you  add  1  part  of  the 
active  ingredient  to  500  parts  (or  units)  of  th& 
solvent,  etc. — £d.] 


Editor  Medical  World  : — Will  some  one^ 
of  the  many  readers  of  The  World  please  give^ 
me  some  information  in  regard  to  diagnosis  and 
treatment  of  the  following  case :  Man,  age  50,. 
received  bullet  wound  in  top  of  head  in  1863 ; 
has  been  paralyzed  in  lower  limbs  and  lower 
half  of  body  since  that  time ;  his  general  healtb 
has  been,  and  is  now,  fairly  good.  He  suflered 
with  a  diarrhea  a  few  months  last  winter. 

About  three  months  ago  he  b^an  to  com- 
plain of  a  burning  sensation  in  the  tips  of  hia 
toes  and  fingers.  This  has  been  growing  worse» 
till  now  he  can't  rest  on  account  of  it ;  can't 
sleep ;  has  lost  flesh.  No  objective  symptoms 
of  his  trouble.  Cold  water  applied  to  the  parts 
does  more  toward  temporary  relief  than  any- 
thing else  tried,  except  to  put  him  under  influ- 
ence of  opiates. 

I  would  be  glad  of  any  information  in  regard 
to  diagnosis  and  treatment  of  this  case.  I  am  a 
young  practitioner  and  recent  subscriber  to  your 
journal.  W.  E  Hancock,  M.D.,. 

Pen  Hook,  Va. 


Our  yearly  index  aoeompoMteMthUistue.  Please  notice  that  th» 
index  does  not  crowd  out  any  part  (tf  the  regxdar  reading  matter. 
Betidee  the  index,  we  hoped  to  ffheeome  extra  pagesqf  reading 
matter  in  this  imie,  aa  much  valuable  matter  i$  coming  in.  We 
tefUmakemore  roomor  eondeneCt  in  future  ;90  continue  $ending 
your  otteervatUme  at  the  bedeide.  We  are  ail  members  qf  a  va$i 
medical  society  spread  ail  over  the  eountry^wUh  monthly  meetings 
ion  paper,)  and  dues  only  $1  per  year.  If  you  receive  help 
from  itf  you  owe  something  in  return.  This  is  the  waiy  in 
which  our  profession  has  been  buOt  up.  R  is  the  way  in  teMcA  we 
must  oontimue  to  build.  Send  Hmdy  artides  when  possible.  For 
example^  January  is  the  time  cM^ftyfor  lung  troubles;  and  Jan* 
nary  istuewm  be  very  interesting.  Don't  miss  it. 


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THB  MSDICAX*  WORLD. 


^ 


Current   Medical   Thought. 

Caioium  Chloride  for  Pneumonia. 

This  drug  has  been  repeatedly  advised  in 
these  pages,,  and  now,  in  the  beginning  of  the 
season,  we  bring  it  forward  again. 

Crombie^  in  the  Practitioner^  recommends  the 
employment  of  calcium  chloride  in  the  treatment 
of  lobar  pneumonia.  Of  22  cases  of  average 
severity  treated  with  this  drug,  but  one  (and 
that  in  a  child  in  which  both  lungs  were  in- 
volved) termiaated  fatally.  From  5  to  15 
grains  were  administered  to  adults  every  four 
hours.  The  cases  ran  a  mild  course  and  were 
characterized  by  the  subsidence  of  the  temper* 
ature  almost  to  the  Eormal  after  the  lapse  of 
two  or  three  days'  treatment  (notwithstanding 
the  continuance  of  the  physical  signiB),  and  by 
an  absence  of  the  distress  and  danger  associated 
with  high  temperature.  In  several  of  the  cases 
the  disease  was  arrested  in  the  stage  that  it  had 
reached  at  the  time  the  treatment  was  instituted. 
In  explanation  of  the  action  of  calcium  chloride 
in  the  treatment  of  pneumonia,  it  is  suggested 
that  the  drug  may  neutralize  the  toxic  action  of 
peptones  or  albuminoids  circulating  in  the  blood. 


Apomorphine  for  Asphyxia.~Abortive  Treatment 
for  Pneumonia. 

Dr.  Thomas  J.  Pugh,  of  Hearne,  Texas, 
recommends  apomorphine,  hypodermically,  one- 
fifth  grain,  for  asphyxiation  by  gas.  He  thinks 
the  same  treatment  would  be  of  great  service  in 
asphyxiation  by  drowning.  The  following  is 
his  treatmmt,  published  in  Tex.  Med.  Jour.y  for 
acute  pneumonia ; 

''  In  the  incipient  stage  of  pneumonia,  when 
the  breathing  is  labored,  the  pulse  rapid,  skin 
dry,  temperature  high,  I  have  found  one  tenth 
grain  pilocarpine,  combined  with  one  fourth 
grain  morphia,  to  be  sufficient  to  bring  about 
resolution  and  put  the  patient  on  the  rolul  to 
speedy  recovery.  Of  course,  the  alimentary 
tract  must  be  looked  after,  and  indications  filled, 
and  there  is  nothing  better  for  this  purpose  than 
six  grains  calomel,  in  two  grain  doses,  one  dose 
every  hour  and  a  half  until  all  are  taken,  fol* 
lowed,  if  necessary,  by  castor  oil  and  turpentine. 
This  is  my  abortive  treatment  for  pneumonia." 


Treatment  of  Acute  Bronchitis. 

Most  therapeutists  say  that  in  the  first  stage 
of  acute  bronchitis,  where  the  mucous  membrane 
is  hyperemic  and  dry,  the  only  appropriate 
drugs  are  the  liquifying  expectorants,  of  which 


citrate  of  potash  may  be  taken  as  the  type ;  and 
above  all,  opium  should  be  avoided.  Experi- 
ence, however,  in  the  children's  dispensary  of 
the  University  Hospital,  as  well  as  in  private 
cases,  does  not  bear  out  this  testimony  as  to  the 
harmf  ulness  of  opium ;  for  while  dtrate  of  pot- 
ash and  its  analogues  will  safely  carry  the  dis- 
ease into  its  second  stage,  a  judicious  combina- 
tion containing  opium,  in  many  ca^es,  will  abort 
the  process,  so  that  it  never  reaches  the  second 
stage,  and  the  little  patient  may  be  practically 
cured  in  forty  eight  to  seventy-two  hours. 

The  prescription  which  will  meet,  perhaps, 
the  largest  percentage  of  cases  when  seen  in  the 
first  stage,  is  the  following :  For  a  child  four  to 
seven  years  old : 

R.  Vini  anOmonll « m.  fij 

Syr.BcUlae, 

Syr.  Ipeoao aa m  t. 

Morp&«8alph ^.  1  64 

MifLglTC  oomp q  s f.  antmi 

M.    8ig.~svei7  two  liomi. 

If  the  child  is  not  seen  until  the  second  stage 
is  well  developed,  or,  perchance,  the  disease  luis 
become  subacute,  opium  should  be  omitted,  and 
the  ipecac  and  squills  replaced  by  some  more 
stimulating  expectorants,  as  syr.  senega  and  am- 
monium chloride.  The  following  mixture  will 
be  found  a  good  one : 

R.   AmmoDii  ohloridL ^^ ^gr.  iij 

Syr.  senegae „ : m.  v 

Syr.  pran.  Ylig 

Mi»t  glyc  ooinp..........«a f.  ooacea  88 

M.    Big.— Erery  three  botuB. 

If  the  secretion  remains  thick  and  tenaoeoos, 
potassium  iodide  in  three  grain  doses  may  be 
added  to  the  above  prescription,  for  its  known 
action  in  liquifying  mucous  secretions. — Dr. 
W.  H.  Price,  in  Med.  and  Surg.  Reporter. 

Treatment  of  Tuberouloait  by  Sucoinio  Aoid. 

At  a  meeting  of  the  Academy  of  Medicine, 
M.  Lancereaux  reciilled  the  faet  that  in  March 
of  last  year  he  had  communicated  to  the  socie^ 
a  work  of  Dr.  8.  Caravias  relative  to  the  treat- 
ment of  tuberculuds  by  substances  wUch  pro- 
duce succinic  acid  in  the  organism,  and  which, 
for  that  reason,  have  been  oalled  suodnogenic. 
Among  such  substances  are  raw  meat,  ttSs,  bi- 
malate  of  calcium  benzoic  add  and  its  saltan 
non-acidified  pepsin,  asparagin,  carrots,  green 
peas,  etc 

We  may  inquire.  What  is  the  action  of  soc- 
cinic  acid?  Is  it  effective  by  destroying  the 
microbe?  Dr.  Caravias  considers  it  idle  to 
think  that  any  substance  carried  by  the  blood 
can  exert  an  influence  upon  the  tuberculous 
matter  which  incloses  the  microbes.  As  this 
matter  is  destitute  of  vessels,  it  cannot  be  acted 
upon  by  any  drug.  The  succinic  add,  there- 
fore, has  no  effect  upon  the  tuberculous  matt^» 


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455 


but  upon  the  tissue  in  its  vicinity,  where,  hj 
virtue  of  its  antiseptic  power,  it  prevents  inva- 
sion hy  the  bacillus.  Li  other  words,  the  add 
modifies  the  soil,  allowing  the  tuberculous  de- 
posit to  pass  through  all  its  stages,  .and  be  elim- 
inated by  the  expectoration  which  may  be  sdm- 
ulated  by  the  use  of  expectorant  medicines. 

Since  the  first  communication,  Lancereaux 
has  reported  to  the  academy  the  notable  ame- 
lioration which  this  treatment  has  produced  ip 
nearly  all  the  tuberoulobs  patients  upon  whom 
it  has  been  tried.  He  declared,  in  fact,  that, 
excepting  those  cases  in  which  all  intervention 
was  useless,  on  account  of  too  extensive  a  de- 
struction of  the  diseased  organs,  relief,  and  at 
least  apparent  cure,  bad  been  obtained  at  a 
period  not  far  removed  from  the  beginning  of 
the  malady.  He  would  not  venture  to  dum 
an  absolute  cure,  because,  before  we  can  make 
such  a  positive  assertion,  a  certain  number  of 
years  must  elapse.  If,  at  the  end  of  three  or 
four  years,  no  renewed  tuberculous  manifesta- 
tions supervene,  it  may  be  surely  claimed  that 
the  treatment  proposed  by  Dr.  Caravias  is,  in 
fact,  efficadoos.  It  is  a  rational  method,  and 
always  well  supported  by  the  patients.— La 
MSdecine  Moderne, — Med.  Bulletin, 


Points  to  be  Remembered  In  Reotal  Surgery. 

[The  following  are  Dr.  Oatman's  views.  Our 
readers  may  look  over  them,  and  cross  out  those 
they  do  not  believe,  in  thdr  experience,  to  be 
correct  The  table  is  then  a  convenient  one  for 
future  reference. — £o.  Medical  Wobld.] 

Remember — 1.  To  operate  upon  all  cases  of 
fistula  where  there  is  suffident  vitality  or  nutri- 
tion to  heal  the  wound,  always  dividicg  the 
fibrous  membrane  at  the  bottom  of  tract  and 
packing  wound  to  the  bottom,  for  the  purpose  of 
healing  by  granulation. 

2.  To  always  open  abscess  early  to  prevent 
fistula  in  ano. 

3.  If  you  operate  on  fistula  in  a  tubercular 
patient,  give  him  the  benefit  of  a  doubt 

4.  That  you  should  never  fail  to  examine 
your  patient  thoroughly  for  small  arms  leading 
out  from  the  main  track,  and  examine  for  an 
associate  stricture,  which  may  be  the  cause  of  the 
fistulous  tract 

5.  That  you  are  never  to  cut  the  sphincter 
but  once  in  any  operation,  and  be  careful  to 
warn  your  patient  of  the  danger  of  inconti- 
nence. 

6.  That  you  are  to  confine  your  patient  in 
bed,  not  trusting  to  the  care  of  a  nurse  (exclu- 
sively). Tuberculous  cases  should  be  an  excep- 
tion to  the  rule — giving  them  moderate  ^xerdse 
and  fresh  air. 


7.  That  physiological  rest  is  the  first  prindple 
in  the  cure  of  all  diseases. 

8.  That  varicosed  veins  are  not  hemorrhoids 
imtil  they  have  passed  through  the  stage  of  in- 
flammation and  plastic  exudation. 

9.  That  hemorrhoids  that  don't  protrude  don*  t 
demand  an  operation,  as  a  rule. 

10.  That  uncomplicated  hemorrhoids  have  no 
pain. 

11.  That  there  is  a  differential  diagnosis  to  be 
made  between  hemorrhoids,  prolapse  of  the 
bowel,  and  polypus.^ 

12.  That  the  ligature  is  simple  in  applica- 
tion, free  of  dang^,  and  certain  in  its  results. 

13.  That  you  are  to  transfix  the  base  of  the 
large  pile,  and  not  the  small  one,  cutting  off 
two  thirds,  and  tjring  tightly  to  prevent  hemorr- 
hage. 

14.  That  there  are  two  forms  of  external 
piles— one  you  can  cut  off,  the  other  you  can 
ligate. 

15.  That  you  are  always  to  remove  all  com- 
plications at  the  time  of  removing  the  hemorr- 
hoids. 

16.  That  you  are  to  remove  all  external  tagis 
during  the  operation  for  internal  hemorrhoids. 

17.  The  capillary  or  strawberry  pile,  for  dan- 
ger may  come  to  the  lot  of  your  patient. 

18.  The  Mathews  tampon,  which  is  simple  in 
construction  a  ad  easy  in  application. 

19.  Hysteria  to  be  a  disease  when  applied  in 
rectal  surgery,  having  for  its  causes  a  change  in 
quantity  or  quality  of  blood,  and  a  change  in  the 
solids  consequent  thereon. 

20.  The  reflexes  in  diseases  of  the  rectum, 
for  you  will  find  a  pathological  cause  somewhere 
along  the  telegraphic  line  of  the  lumbar  or  sac- 
ral plexus. 

21.  That  an  operation  on  disease  in  the  con- 
tiguous organ  will  relieve  the  protean  symptoms 
in  the  rectum 

22.  In  connection  with  the  reflexes,  the  small 
fistulous  tract  beneath  the  mucoua  membrane, 
the  sensitive  nerve,  the  denuded  epithelium, 
and  notiiing  but  patience  and  perseverance  by 
the  use  of  the  probe,  will  reveal  the  organic  le- 
sion in  question. 

23.  The  irritable  ulcer  or  fissure,  located  on 
the  S(}hincter  muscld,  caused  by  a  denudation  of 
the  epithelium,  does  not  heal  for  the  want  of 
physiologicil  rest 

24.  Divulsion  cures  it 

25.  Ulcers  in  the  rectum  are  oftener  caused 
by  constipation,  and  a  locked* up  liver  action, 
than  any  other  known  cause. 

26.  That  ulcers  in  the  rectum  are  not  caused, 
as  a  rule,  by  dysentery. 

27.  That  when  you  give  them  physiological 
rest  and  remove  the  cause,  or  pull  out  the  nail. 


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THE  MEDICAI,  WORLD. 


as  Professor  Carpenter  has  so  thoroughly  im- 
pressed upon  your  mind,  they  will  heal. 

28.  The  sigmoid  flexure  as  a  receptacle,  and 
liable  to  ulcerations,  which  you  may  cure  by 
medicines  of  a  disinfecting  and  cleaning  nature, 
to  be  used  through  a  Wales  bougie. 

29.  The  claasification  of  stricture :  acquired, 
the  result  of  inflammation ;  congenital,  which  is 
not  a  stricture  proper,  but  an  atresia,  the  result 
of  an  arrest  of  development 

30.  That  there  are  simple  tubular  or  valvular 
strictures  of  a  benign  nature,  that  are  amenable 
to  treatment  by  gradual  dilatation,  to  be  used 
indefinitely,  or  we  might  say  as  long  as  the  pa- 
tient has  an  existence.  * 

31.  One-half  of  all  the  strictures  in  the  rec- 
tum are  syphilitic. 

32.  That  in  all  malignant  strictures  of  the 
rectum,  nothing  short  of  colotomy,  inguinal  pre- 
ferred, will  spare  your  padenf  s  Ufe  for  a  short 
time,  and  no  operation,  only  wh^n  suggested  by 
the  patient 

33.  Syphilitic  stricture  in  its  indpiency  should 
be  treated  constitutionally. 

34.  Tuberculoeed  strictures,  where  the  lungs 
are  badly  involved,  are  to  be  let  alone. 

35.  That  all  strictures,  no  matter  where  loca- 
ted, are  the  result  of  inflammation,  with  plastic 
efiusion  or  infiltration. 

36.  That  prolapsus  ani  is  a  disease  confined 
more  especially  to  childhood,  and  where  it  oc- 
curs in  the  adult  it  is  the  lingering  result  of 
x^dhood  misfortune. 

37.  That  you  may  mistake  prolapsus  for 
hemorrhoids,  and  only  a  clear  understanding  of 
an  anatomy  of  the  parts  will  lead  you  to  a  dif- 
ferential diagnosis. 

38.  You  are  to  select  Mathews*  method  for 
relief  in  the  adult ;  palliative  astringents,  with 
strapping,  for  children. 

39.  Pruritus  ani  is  the  result  of  nervo-reflex 
actions  and  filthy  habits. 

40.  That  it  is  the  most  formidable  of  all 
diseases,  as  far  as  cure  and  treatment  are  con- 
cerned. 

41.  That  you  should  relieve  the  cause,  and 
by  the  use  of  campho-phenique  and  temperance, 
or  total  abstinence  from  the  use  of  alcoholic 
drink  and  tobacco,  you  may  cure  the  disease. 

42.  The  rules  that  you  are  to  be  governed 
by,  quantity  and  quality  of  blood,  physiological 
rest,  thorough  asepsis  and  antisepsis. — Dr.  Oat- 
man,  in  St.  Louis  Medical  Era, 


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nUe  {76  cte.)  on  **  The  Physician  as  a  business  Man^*  if 
you  send  order  along  vnih  your  subscription  /or  next  year. 

The  regular  price  is  fl.OO;  so  embrace  this  opportunity 
now. 


TREATMENT  FOR  OSTEOMALACIA. 

Dr.  Orthmann  has  collected  fifteen  recent 
cases  of  castration  for  osteomalacia,  with  twelve 
recoveries.  He  reports  a  case  operated  upon  by 
himself  three  years  ago  with  striking  sucoeasy 
and  believes  this  disease  is  a  tropho-neurosia 
originating  in  the  ovaries. —  Western  MedHUal 
Jour, 


A   PROMISING   TREATMENT   FOR   OONBUMFTION. 

A  girl  of  13,  in  the  last  stages  of  rapid  con- 
sumption, was  brought  to  Dr.  Elremiansky,  a 
professor  in  the  University  of  Kharkov,  in  Rua- 
sia,  last  February.  She  was  treated  with  three 
preparations  used  simultaneously,  pure  white 
aniline,  a  preparation  of  analine  and  thenol, 
and  one  of  aniline  and  essence  of  pine,  which 
she  was  made  to  inhale  deeply  and  slowly.  At 
first  only  ten  to  twenty  inhalations  a  day  were 
administered,  but  gradually  they  were  incieaocd 
to  200.  Under  this  treatment  and  a  special  diet 
the  child  is  now  said  to  be  in  perfect  health. 
—CoU,  and  Clin.  Rewrd. 


Bisulphite  of  Sodium  in  Acute  Catarrhal  Diteaaea. 

As  has  heretofore  been  recommended  in  these 
pages,  use  a  saturated  solution  of  pure  bisul- 
phite of  sodium,  a  tablespoonful  every  hour  vn- 
til  the  intestinal  gases  manifest  the  presence  of 
sulphurous  add  gas,  in  all  cam  of  coryza,  influ« 
enza,  tonsilitis,  etc.  This  treatment  is  adviaed 
by  Dr.  C.  M.  Fenn,  of  San  Diego,  Cal. 


The  Surgery  of  the  Qail-Biadder  and  Bile-Doofay 
with  Brief  Notes  of  Seventy-Eight  Caaea. 

Robson  (British  Medical  Journal^  April  28, 
1894,)  speaks  of  the  most  prominent  symptoina 
and  complications  of  cases  of  cholelithiaina  which 
have  come  under  his  observation  : 

1.  Spasms  or  biliary  colic- without  jaundice, 
the  attacks  being  repeated  at  longer  or  shorter 
intervals. 

2.  Collapse  due  to  the  intensity  of  the  pain. 

3.  Spasms  followed  by  evaneecent  jaundice. 

4.  Pain  followed  by  persistent  jaundice  and 
enlargement  of  the  liver. 

5.  Hydrops  of  the  gall-bladder  without  jaan* 
dice. 


Oodeia  in  Diabetes  Meliitis. 

Bates  (Med.  &  Surg.  Reporter)  reports  twe 
cases  in  which  at  least  temporary  recovery  oc- 
curred and  sugar  disappeared  entirely  from  the 
urine  under  the  use  of  codeia,  strydmine,  and 
podophyllin;  with  a  strict  diet,  excluding 
sweets  and  starchy  foods.  In  this  preacription, 
he  regards  codeia  as  the  most  important  ingre- 
dient — Phiku  Polyclinic 


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THE  MEDICAL  WORI.D 


457 


Morbid  Conditions  of  the  Heart,  and  How  to  Treat  Them. 


DiBBASB. 


Simple      Dilata- 
tion, 


Simple     Hyper- 
trophy, 


Conduaion  by  Dr.  W.  C.  Cahall, 
EvnjB  TO  BS  Mbt. 
Muflde  weak  and  yielding;  from 
increased  intra-ventricalar  pres- 
sure during  diastole. 


Shorten  diastole,  invigorate  the 
tone  and  contractile  power  of 
muscle. 


'  Over-developed  and  over-acting 
mosde.  Increased  vigor  and  fre- 
quency of  contraction,  and  in- 
creased arterial  tension. 


Ameriean   Medico- Surgieal  BtUleiin, 

Drugs  which  best  Mebts  thbbb  Evils. 
'  Cactus, 

Atropia, 

Caffeine, 

Strychnia, 

Digitalis, 

Ergot 

VeratrumViride,  1  Reduce  rate  and  rapidity  of  ven- 
Aconite,  >  tricular    oontractions  and  lessen 

Bromides,  J  arterial  pressnre. 

Nitro-glycerine.    I  Reduces  peripheral  reaisUnoe  and 
,     "^  i  lessens  arterial  pressure. 


JLortic    Stenosis,  - 


wAortic   Regurgi- 
tation, 


Mitral    Stenosis, 


Increased  intra-ventricular  j^res- 
sore  from  excess  of  blood  retained 
and  inflowing  from  auricle  during 
diastole,  venous  engorgement,  and 
lessened  arterial  tension. 

Passive  dilatation  of  left  ventricle, 
the  result  of  regurgitating  blood 
during  diastole.  Lowered  arterial 
tension  resulting  in  ill-nourished 
heart  muscles. 

Dutention  and  dilatation  of  left 
auricle  from  inability  to  empty 
itself  during  diastole.  Venous 
engorgement  and  lowered  arterial 
tension. 


Mitral    Regurgi< 
tatioQ, 

Tricuspid  R^nr- 
gitation, 


r  do.,         do.,         do. 

-j  together   with  a  dilated    hyper- 

l  trophy  of  the  left  ventricle. 

Distension  and  dilatation  of  right 
auricle  from  regurgitation  of 
blood.    Venous  stasis. 


Cactus, 
Atropia, 
Caffeine, 
Cocaine. 

Cactus, 
Atropia, 
Caffeine, 
Cocaine, 

Digitalis, 

Strophantus, 

Strychnia, 

Sparteine, 

Adonidine, 

Convaliaria, 

Ergot. 

do. 


do. 


I  pressure. 

Strengthen  and  lengthen  systole 
and  shorten  diastole.  Raise  ar- 
terial tension  and  lessen  venovs 
stasis. 

Strengthen  and  lengthen  systole 
and  shorten  diastole.  Increase 
arterial  pressure  and  deliver  more 
blood  to  impoverished  heart- 
muscles. 

Invigorate  the  heart-muscle  and 
lengSien  diastole,  incr^udng  arte- 
rial pressure  and  relieving  veoeo* 
engorgement.  Intra  •  auricular 
pressure  decreased. 

d).,  do.,  do. 


do., 


do., 


do. 


Treatment  of  Crushing  Injuriea  of  the  Extremities. 

Dr.  P.  RecluB  (La  Semaine  MedieaU,  No.  41, 
1804,)  in  theee  forms  of  iDJuries  employs  as  an 
antiseptic  salve,  the  following  formula : 

K.  Salol 


ResorolDe,  aa. 12 

▲ntlpyrine,  aa....... 12 

Boric  Add 20 

Iodoform 1 

Vaseline «. 160 


0(dnunlij) 
Odiamifl) 
0  \  diam  V ) 
0ig;i8.xv) 
0  (onnoe  v) 


Treatment  for  Varix. 

1.  Avoidance  of  standing  position  as  much  as 
possible.     No  garters. 

2.  Constant  wearing  of  an  elastic  stocking. 

3.  Taking  during  fifteen  days  each  month  at 
meals  a  pill  of 


BrgoCine 
EsEtHaa 


Hamamelis  aa... 


..g«.5i 


After  a  few  whifis  of  chloroform  to  render 
the  patient  slightly  insensible,  the  crushed  ports 
are  washed  with  water  at  55-60^  irrigating  with 
sufficient  force  to  wash  out  the  dots,  foreign 
bodies,  dirt,  etc.,  and  to  reach  all  the  pockets. 
Then  this  salve  is  applied  on  pieces  of  sterilized 
gauze  which  are  tucked  into  all  the  crevices, 
the  whole  wound  is  then  covered  with  the  salve, 
and  over  this  abeorbent  ootton  is  placed.  This 
dressing  is  renewed  every  five  to  six  days.  It 
is  advisable  to  apply  either  a  splint  or  a  plaster 
of  Paris  bandage.  When  the  injury  has  not 
been  too  severe  one  may  sometimes,  with  this 
treatment,  succeed  in  saving  the  entire  limb. 
Otherwise  amputation  may  be  delayed  until 
partial  cicatrization  has  taken  place  and  a  better 
stump  is  obtained. — Med,  and  Surg.  Rep. 


— THmes  and  Register. 


Immediate  Cure  of  Corneal  Uloer. 

This  consists  in  the  application  of  a  wafer 
(cachet)  placed  on  the  cornea ;  then  closing  the 
eyelid  with  iodoform,  ootton  and  a  bandage, 
which  remains  in  place  for  several  days.  The 
(»chet  is  made  of  gelatine,  saturated  solution  of 
boric  acid^  and  impalpably  powdered  iodoform. 

It  is  wet  with  a  solution  of  boric  add  before 
using.  Gcatrization  occurs  in  three  days  even 
in  bad  cases.  The  rapid  effects  are  most  likely 
due  to  the  destruction  of  the  micro-organisms. 
La  France  Med. — Times  and  Register. 


ScB  pa^  xxiv.  or  back  of  yearlj  index,  for  a  good 
dianoe  this  month  to  get  large  value  for  little  money. 


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Sptoial  Advantages  of  Aoatanilid  in  Surgery. 

At  the  close  of  an  article  on  the  use  of  ace- 
tanilid  in  medicine  and  saigery,  in  the  Jour, 
Amer.  Me^  Association,  Dr.  G.  W.  Woods, 
Medical  Inspector  of  the  United  States  Navy, 
gives  the  following  suoimary  of  its  surgioid 
advantages : 

''It  is  cleanly,  odorless,  antiseptic,  desiccant, 
hemostatic,  stimulant,  alterative,  non-toxic  prac- 
tioftlly,  larting  in  its  effects,  if  intermitted,  does 
not  crust,  easily  removed,  and  it  acts  in  these 
ways  when  peifect  cleansing  of  a  wound  is  im- 
practicable ;  while  it  is  a  perfect  substitute  for 
iodoform  at  an  insignificant  cost,  and  is  not  in- 
jured or  altered  by  moisture,  as  it  may  be  satu- 
rated with  water;  and  being  drained  and  dried, 
is  found  to  be  unaltered. 

''With  these  advantages,  acetanilid  should 
be  welcomed  to  the  outfit  of  all  surgeons,  but 
especially  to  those  of  the  army  and  navy,  this 
simple  enumeration  of  its  excellencies  seeming 
certainly  to  demonstrate  its  special  adaptation  to 
the  field  and  campaign  work  of  the  former,  and 
similar  duty  in  connection  with  landing  parties 
and  shore  duty  of  the  latter ;  in  time  of  war,  its 
application  to  all  wounds  being  soothing,  bene- 
ficial, avoiding  the  necessitv  of  immediate,  care- 
ful antiseptic  cleansing,  and  permitting  of  delay 
in  completing  the  final  surgiod  attention  in  most 
cases  a  delay  often  as  necessary  as  desirable  on 
shipboard,  on  account  of  the  rolling  of  the  ship 
or  stress  of  weather." 


Formulas. 


FOB  TOOTHACHE. 

E.  JtaithoU..» ^ „..diuiiB  2 

AioohoL oaooesl^ 

OU  of  doyei. ^ ~ ^..mlniini  16 

Tincture  of  aconite.....^ „....<lraiiu  8 

Chloroform ^..tfram  1 

M  a^deuiM  oat  the  oaylty  thoroughly  (prefeiably  by 
syiinglng),  and  apply  on  cotton.  Also,  lub  a  little  on  the 
gamB. 

HoBchton,  Ga.     L.  Cyrus  Allen,  M.D., 
—Med.  Brief,  Nov.,  18,  page  1325. 


R.  Anaionlnm  lalicylate ^ grains  40 

Ammoninm  carbonate ^ gialn824 

Ammoninm  chloride.......... .....grains  80 

Fld.extiactofooca »....». f  drama  4 

Glycerine  (or  nrmp  of  bitter  orange,  or 

syrup  of  wfld  cherry) »..f  ounces  1% 

Water  enough  to  make........... ...f  ounces  4 

Mix 
Dose— Tablespoonful  every  three  or  four  houn>. 

.  This  is  found  to  be  a  useful  routine  prescrip- 
tion in  the  ordinary  run  of  broDchial  "colds '' 
atteniing  the  dispensary. — Dr.  S.  SolibCohek 
in  Philcu  Polyelinic 


M. 

mouth. 


FOR   FETID  BREATH. 

Sodii  bicarb „.- «... 

Saccharine aa »...drams  j 

Add.  Balicyllc». m.... ....dramsl 

Alooholis.. „ f  ounces  Tj 

Sig.—A  teaf poonfU  in  a  glass  of  water  to  rin»  the 

—Ex. 


Koch's  treatment  for  erysipelas : 


R.  Creolin „... dram  i 

lodofbrm ounces  ts 

Lanolin. drams  x 

M.  Ft  Ung. 

— Med.  Mirror. 


GENERAL   DEBILITY. 

In  those  cases  of  general  debility  characterized 
by  loss  of  fcleep,  dimness  of  virion,  poor  appetite, 
tendency  to.  shun  society,  patient  unrefreshed  by 
sleep,  etc.,  the  following  will  be  lound  of  great 
service : 

R.  Syrup  add  hidrlodio  (HosfeeUey'O-onnces  ▼> 

Hydrarg*  hichlor. grainsss 

LIq.  potMsU  arsenit. »...»..  ...drams  ^ 

M.  8ig.~TeaspoonAil  three  times  daily,  in  water. 

In  chronic  bronchitis  the  above,  wftii  alight 
modifications  to  suit  the  particular  case  under 
treatment,  will  be  found  to  give  results  of  the 
most  satisfactory  nature. 


EMOLLIENT  OINTMENT  IN  MEASLES  AND  SCAR- 
LATINA. 


FOR  BRONCHIAL  COLDS 

• 

R.  Phenyl  salicylate. dram  1 

Terpin  hydrate. drsm  1 

Codein  sulphate. grains  2 

Mix. 
Make  twenty  capsules  (or  pills).     Dose— One  eyery  four 
hours. 

This  formula  (variously  modified)  is  used  in 
the  treatment  of  "  bronchial  colds,"  of  the  bron- 
chitis of  influenza,  of  acute  and  subacute  pleu- 
rsy,  and  of  febrile  exacerbations  with  pleuritic 
or  pneumonitic  phenomena  in  the  course  of  pul- 
monary tuberculosis. 


R.  Anhydrous  LanoUn dpaits 

Vaselin.. 8    " 

DistUled  water. « 4     " 

Apply  cYery  three  hours. 

— Klein,  Ther.  Monatsh 


Dr.  George  Brown,  14i  Whitehall  St,  At- 
lanta, Ga.,  U8ed  in  hypertrophic  rhinitis,  with 
splendid  effect,  the  following : 

R.  Olel  VaseUnI .1 

Llq.  AlboUni. aa. ounce  ij 

Camphor  mentholinl diams  j) 

Eucalyptol  (Sander  &  Son'^) drams  j 

M.    8.~Use  as  a  spray  with  atomiser  ( jovered ). 


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459 


IN  SEXUAL  IMPOTfiNCE  OF   WOMEN. 

Xzl  Nux  Vomica.....  \  ^^  •*<*•  ^  gme.  (H  dr.) 

Aqneoofl  ext.  aloes » 60  ctg.  (10  gm.) 

DlTide  into  100  pills.   Two  or  three  daily. 

— Dr,  Hammond, 


FOR  CONJUNCTIVAL   HYPEREMIA. 

B.    Bodoacid gr.  x 

Hjrdroohlorate  of  cocaine gr.  ij 

Rose-water......«». f  ounce  m 

Distilled  water. ».....£ ounce  m 

81g.    Use  freely  three  tlmef  a  day. 


— Hayem*  givea  the  following  prescripdoii  for 
the  lelief  of  acute  oorjz  a: 

B.  Add.  carbolic 

Aqus  ammonia jul dram  IJss 

Alcohol « dr^m  v 

Aqns  destil ». ounce  J 

M.   Big;  Inhale  from  scTeral  drops  upon  a  piece  of  bibulous 
paper. 

*Rev.  de  Laryngol,  d'Otol.  et  de  Rhinol.,  in  Boiton 
Jfed,  and  Surg.  Journal. 


FOR  SUBACUTE  CONJUNCnVITIS. 

B.   Biborate  of  sodium. ...gr.  viij 

Camphor  water 

Distilled  water,  of  each f  ounce  J 

Sig.   Ten  drops  applied  every  four  hours. 


FOR  PULMONARY  TUBERCULOSIS. 

^  SMhol  } — -....--..»«   • 

Acldi  arseniosi gr  il 

StrychninoB  nitrat gr.  J 

Atropina  sulphat gr.  % 

GS^.Sbte*°"  }wq.».»tnpll.nacxx..M 
8.— One  from  four  to  six  times  daily. 

— Maximowicz, — I  b. 


The  following  formulas  are  recommended  by 
Mittendorf : 

FOR  SIMPLE  BLEPHARITIS. 

B.   Bed  oxide  of  mercury gr.  x 

Vssellne.. f  ounce  ss 

Sig.   Apply  to  the  adge  of  the  lid  at  bedtime. 

Or, 

B.   Ammoniated  mOTonry........ .....^r*  xx 

Powdered  camphor ,^ gr.  x 

Vaseline f  ounce  ss 

Sig.    Apply  at  night 

Or, 

B.    Solution  of  snbacetate  of  lead gtt  x 

Ointment  of  rose  water dram  UJ 

Sig.    To  be  used  for  the  more  chronic  Ibrms  of  maiginal 
blepharitis. 

— Therapeuiic  OwteUe. 


Si  Louis  City  Hospital  Formui». 
Dr.  Heine  Marks,  M.D.,  Superintendent 

PNEUMONIA  mixture. 

R.     Liquor,  ammon.  acet 100.0  (drams  xxt) 

Spur,  ather.  nltr 50  0  (dram  xiiSB) 

Spir.  camphor 8  83  (dramlj 

Tr.  gentian.....^ 60.0  (dram  xiiss 

Tr.  beUadonn. i.88  (gr.  60) 

Fl.  ext.  bryonia 2  0  (grs.  xxx) 

Water  or  syrup  qu.  s.  ad ..............JiOO.O  (Oj) 

M.  a~20cc  (dram  V)  ererv  two  to  four  hours  and  one- 
twentieth  of  a  grain  of  sulphate  of  strychnia  three  times 
dftlly  fonr  ten  days,  or  until  physiological  eflGwts  are  produced. 

ACUTE  INFLAMMATORY  RHEUMATISM. 

B,     Addsalicyl « 66.0  (ounces U) 

Potash  bicarb 66.0  (ounces  ij) 

M.  Place  in  mortar,  dissolve  in  water  until  efltoresoenoe 
ceases,  add: 

Liquor,  ammon.  acet 100  0  (dram  xxv) 

FLext  cascarasagrada.arom.33.8:}(aram  wiUm) 

OlyoennL 200.0  (ounces  tIM) 

Water  qu.  s.  ad .600.0  {6}) 

M.  &— lOcc  (dram  iis^)  every  two  to  six  houis;  when 
patient  perspires  freely,  every  six  hones. 

COLD  POWDER. 

B.     Camphor 64.0  (ounces  ii) 

Ammon.  carb .....60.6  (dram  xiiss) 

Pulv.  opli 12.72  (dram  ill) 

Potass,  sulph — 121.76  ounces  It 

Powd.  ipecac 8.26  (grs.  50) 

M.  f.  pulv.  8.— ThU  powder  Is  used  whenever  Dover's 
powder  Is  indicated  and  to  alleviate  the  cough  of  phthisis  and 
pneumonia 


FOR  AMENORRHEA. 

B.   Hydraigyri  chloridi  corrodvL .gr.  % 

Sodil  arseniatis........ gr.j 

Ferrl  sulphatis  exslccata gr.  xxx 

Potasri  carbonatis gr.  xv 

Extiactl  nuciB  vomica gr.  y 

Divld.inpll.xxx 
i.   Sig.   One  pill  to  be  taken  before  each  meaL 

— PraetUianer, 


FOR  PAINFUL   PHARYNGITIS. 

B.    Morphlna  sulphatis. »..gr.  It 

Addl  carbolicC dram  m 

Add!  tanmci dram  m 

Olycerlnl dram  It 

Aqu»......„ ».dramiv 

Ft.  Bolut. 
M.   dig.   Paint  the  throat  two  or  three  times  daUy. 

— MediccU  Press, 


FOR  PSORIASIS. 


B. 


lohthyoL 

Add.  salioyllo. 

Add.  pyvogallio... 

VasellnV".V.V.'."'.7.V. 
Adipls.» 


.2K 


M. 


aa gins.S0 

A  powerful  ointment,  to  be  used  in  small  quantities. 

— Med.  and  Surg.  Reporter, 


Formulas  in  eye  practice. 

FOR  MILD  CONJUNCTIVITIS. 

B,    Boric  add. « «.gr.  x 

Biborate  of  sodiiun. gr.  Iv 

Distilled  water........ f  ounce  J 

8lg.   Use  finely  three  times  a  day. 


Your  know  ovr  invariable  rule  to  cross  off  names  as  soon 
cu  subscription  expires,  wUess  suh^oripiion  is  renewed.  This 
is  the  straight  forward  business  way^  and  ii  pleases  all 
btttiness  people.  So  ^  the  legend,  "  Your  Subscription 
Expires  with  this  Number*'  appears  on  the  outside  of  your 
WoBLD  this  month,  don*t  expect  the  January  number  until 
we  have  heard  from  you. 


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Reviews. 


AimUAIi  OF  THE  UNIVEBaAIi  MkDICAL  SciKNOES.  Bj 

Chas.  R  Sajous,  M.D.,  and  a  large  C(»rp6  of  colla- 
borators. Five  handsome  yolumesy  price  $15.00. 
The  F.  A.  Davis  Co.,  1914  Cherry  St.,  Phila. 

We  admire  thb  most  excellent  work  and  gladlj 
note  its  arrival  each  jear.  It  is  like  an  annual  medi- 
cal journal,  giving  the  best  of  the  year's  literature  in 
the  various  departments  of  the  science  of  medicine  and 
smgery.  It  would  be  impossible  for  a  physician  to  do 
the  amount  of  reading  and  research  that  would  be  re- 
quired to  obtain  the  information  herein  presented,  even 
if  he  had  all  the  medical  journals  and  punphlets  of  the 
world  before  him  for  that  purpose.  This  is  the  faith- 
ful work  of  intelligent  editors,  placing  before  the 
reader  only  the  best  out  of  the  vast  mass  of  medical 
literature. 

A  Vasvajj  of  Modesn  Sxtbgeby,  QsineBAL  Aim 
Opsbatiys.  Bv  John  Chalmers  DaCoeta,  M.D. 
809  pages,  276  illustrations,  18  full-page  colored 
plates;  doth,  $2.60.  W.  B.  Saunders,  925  Wakiut 
St  Phila.,  Pa. 

We  have  examined  this  work  with  ipeat  care,  and 
find  that  it  is  clear  and  plain  in  diction,  up  to  the 
latest  date  in  theory,  and  is  in  every  way  a  desirable 
work  for  thoee  who  need  a  new  work  on  general  sur- 
geiy. 

We  acknowledge  with  thanks  the  receipt  of  a  copy 
of  the  fine  artistic  work  **The  Discovery  of  Hot 
Springs,  Ark.,  by  DeSoto^'  from  Dr.  Thomas  R  Hol- 
land, Hot  Springs,  Ark.,  Chairman  Committee  of 
Arrangements  of  Uie  Miss.  Valley  Med.  Association. 

Thx  Pockbt  Anatomist.  By  C.  Henri  Leonard,  A. 
M.,  M.D.,  Prof,  of  Gynecology  Detroit  College  of 
Medicine.  Leather,  300  pages,  198  illustrations, 
postpaid  $1.00.  The  Dlustrated  Medical  Journal 
Co.,  Publishers,  Detroit,  Mich. 

The  eighteenth  edition  of  this  popular  anatomy  is 
now  before  us;  it  is  printed  upon  thin  paper  and 
bound  in  flexible  leather  so  as  to  be  specially  handy 
for  the  pocket.  The  illustrations  are  photo-engraved 
from  the  English  edition  of  Gray's  Anatomy,  so  are 
exact  as  to  their  details.  Three  large  editions  have 
been  sold  in  England,  teetifyine  to  its  popularity 
there,  and  some  sixteen  thousand  copies  have  been 
sold  in  this  country.  It  briefly  describes  each  artery, 
vein^  nerve,  muscle  and  bone,  besides  the  several 
^peaal  organs  of  the  body.  It  contains  more  illustra- 
tions than  any  of  the  other  small  anatomies. 

A  Synopsis  of  the  Practice  of  Medicine  for 
Practitionbbs  and  Students.  By  William 
Blair  Stewart,  A.M.,  M.D.,  Lecturer  on  Therapeu- 
tics ;  late  Instructor  on  Practice  of  Medicine  in 
the  Medioo-Chirurgical  College  of  Philadelphia ; 
Demonstrator  in  the  Philadelphia  School  of  Ana- 
tomy, etc  Cloth,  484  pages,  price  $2.75.  E.  B. 
Treat,  5  Cooper  Union,  New  York,  N.  Y. 

Our  acquaintance  with  the  talented  young  author  of 
this  work  gives  us  all  the  more  confidence  in  recom- 
■Muding  it  to  those  who  need  a  late  review  of  the 
modem  facts  and  methods  in  the  practice  of  medicine. 

For  interesting  and  important  pamphlets  (free) 
rejAiding  your  duties  and  privil^res  as  a  citizen, 
address,  Mr.  B.  Franklin  Hunter,  1100  Pine  Street, 
Philadelphia,  Pa. 


Wit  and  Wisdom. 


THE  OOLOB  OF  NEQBO  BABII8. 

Editor  Medical  World  :— In  November  World, 
Dr.  Annetta  Kratz,  replyiqg  to  Dr.  Eoonts,  says  that 
the  scrotum  of  the  male  negro  baby  is  always  blade. 
This  reminds  me  of  a  good  joke  on  a  distiittuish  legal 
gentleman  who  once  graced  the  bench  i&-l^rth  Caro- 
lina. 

In  a  case  of  disputed  paternity  before  the  jndge,  the- 
lawyers  were  disputing  as  to  whether  the  infiuit  wa» 
white  or  a  negro,  when  the^udge,  who  was  one  of  the* 
"rough  and  r^y"  kind,  said  '^don't  you  know  that  a 
nej^ro  child's  scrotum  is- always  black?  Hand  me  the 
child,"  and  proceeding,  without  ceremony,  to  investi- 
gate the  matter  for  himself,  to  his  chagrin  and  the* 
great  amusement  of  the  lawyers,  he  found  it  was  ft- 
female  child,  and  that  his  test  was  not  applicable  ii> 
that  case.  It  seemed  not  to  occur  to  him  to  inquire  as- 
to  the  sex  of  the  baby.  D.  S.  Ellis.. 

Ashland,  Va. 

Many  cases  of  spermatorrhea  and  nocturnal  eniis*» 
sions  have  been  permanently  relieved  by  treatment 
with  the  <<Sexoal  Sedative*'  and  ''Sexual  Tonic*^ 
Granules  of  the  Phila.  Granule  Ox  No.  10  S.  18th  St. 
Only  25  cents  per  hundred  each. 

The  state  of  the  mouth  shonld  be  carefully  looked 
after  before  beginning  a  mercurial  course.  Teeth  with 
caries,  irregular  edges,  and  deposits  of  tartar  abonl^ 
the  roots  will  show  evidence  of  ptyalism  mocH  sooner 
than  if  they  were  in  a  healthy  condition* 

For  Stiychnme  Granules,  send  to  the  PUIa.  Graaultf 
Co.,  No.  10  8.  18th  St  Only  10  cents  per  hundred 
or  65  cents  per  thousand. 


A  DOCTOR  MUST  NOT  AND  SHOULD  NOT 

Depend  wholljr  upon  subjective  symptoms  for  his 
diagnosis  or  let  his  patient  dictate  treatment  or  rem-^ 
ediee. 

Be  agitated  by  the  praises  or  criticisms  of  the  patient's^ 
friends  or  buoy  up  a  hopeless  case. 

Make  a  display  of  his  instruments  or  experiment,  or 
exhibit  his  skill,  till  he  is  personally  requested  to  do  so. 

Pretend  that  he  is  more  dever  than  his  fellow  prac- 
titioner, or  allow  a  look  or  act,  when  in  consultation, 
show  that  he  is  displeased  or  thinks  himself  smarter 
than  his  consultant 

Encourage  or  initiate  the  slander  of  his  professional 
brethren  or  indulge  in  intoxicants  or  narcotics. 

Promise  to  cure  a  patient  in  any  given  time  or  that 
the  malady  will  never  return,  or  that  to-morrow'a 
fever  will  not  rise  as  high  as  it  is  to-day. 

Promise  to  call  at  an  exact  specified  time  or  forget 
to  pay  a  visit. 

Be  afraid  to  tell  the  troth  or  pnblidy  inveirii  against 
what  he  practises  in  private^  or  say  one  thing  and 
mean  another. 

Betray  his  patients'  trust,  or  take  advantage  of  their 
weaknesses. — Indian  Journal  of  Phagwaey, 

So  FAR  as  the  number  of  students  is  ooncemedr 
Philadelphia  is  the  medical  center  of  the  Vmfed 
Sutes.  There  are  2,400  students,  of  which  975  are  in 
the  University  of  Pennsylvania ;  700  in  Jctferson ;  325 
in  Hahnemann ;  800  Medico-Chiirurgioal ;  200  women. 
—N.  r.  Med.  Times. 

Dr.  Angelo  Bblloml  of  Ital^,  has  good  results 
from  the  use  of  Bromidia  in  vomiting  of  pregnancy,  in. 
delirium  tremens  and  other  nervous  affections. 


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Bbomo  Soda  holds  its  own  on  its  merit  For  ner- 
▼OOB  headache  and  stomach  headache,  insomnia,  brain 
<ii«,  debility,  rertigo,  and  headache  after  taking  opium 
or  morjf hine  it  has  but  few  eqoals,  if  an j  snpoiors. 
And  it  IS  '^  nice^  to  take  and  the  effect  is  like  magic 
in  the  majoritj  of  oases.  It  is  one  of  Uie  things  one 
^doee  not  like  to  be  without  night  or  daj. 

Charles  L.  Luiclet,  L.R.  G.P.L,L.liL,etc.yete., 
Oi.  PortUnd  street^  London,  W.,  England,  ssts:  H 
fasTe  no  hesitation  in  stating  that  SctmneUo  is  one  of 
<ihe  most  important  remedies  of  the  present  daj  for 
-diseases  of  the  genito-urinary  tracts-haying  had  ample 
experience  of  its  use  in  eonorrhea  and  acute  <^rstitis, 
in  both  of  which  kind  of  cases  it  acted  in  a  most  mar- 
velous and  rapid  manner.  I  prescribe  ScmmeUo  in 
*«Tei7cafle  where  it  is  indicated^  and  it  has  always 
t>een  rich  in  results,  and  well  deserves  all  that  is  said 
of  it.'' 

Double  B&idgeb,  Tevn.,  June  iS^SQZ, 
doubU 


Send  me  by  maiL  one  double  box  of  jour 
Tablets,  Cough  andf  Constituent    Enclosed  find  dieck 
#or  same.    The  sample  box  is  doing  grand  work  for  a 
C>atient  with  Incipient  Phthisis. 

Class  of  1886.  W.  H.  Tuoexb,  Jb.,  M.D. 

80MA10SE  IN  ACUTE  AFFBCTIOKS. 

In  an  article  on  the  nourishment  in  acute  affections, 

fublished  in  the  New  York  Jfedioal  Ttmes,  September, 
894.  Dr.  Alfred  K.  Hills,  one  of  the  editors  of  this 
journal,  writes  as  follows: 

'fThe  most  perfect  preparation  of  the  albumoses  jet 
produced  is  furnished  us  from  Oermanj,  under  the 
iHune  of  Somatose. 

Somatose  is  a  jeUowish,  fine,  mnular  powder, 
readily  soluble,  perfectiy  odorless  and  practically  taste- 
less, containing  the  nutritire  qualities  of  meat  minus, 
Che  fflutinous  material,  hi,  creatin,  xanthin,  etc.  The 
vmm  dose  of  Somatose  is  a  teasooonful  or  a  dessert 
^[>oonful  dissolved  in  a  cup  of  milx,  sou]^,  grape  juice, 
with  or  without  the  addition  of  effervescing  water.  It 
lias  been  found  that  this  agent  diminishes  nitrogenoos 
waste,  replaces  the  albumen  of  the  or^^ism,  and  one 
|>art  is  eaual  to  six  parts  of  beef  devoid  of  fat 

It  is  claimed  to  be  indicated  in  all  acute  diseases 
where  a  food  rich  in  albumen  and  readily  assimilated 
is  required,  and  I  have  found  it  of  especial  service  in 
•cases  where  the  peptones  were  declined  on  account  of 
4heir  odor  and  taste." 

Unequal  dilatation  of  the  pupUs  is  rcffarded  by 
Dentree  as  a  sign  of  great  value  in  the  duignosiB  of 
fMnUnonary  tuberoulo^  It  is  present,  he  says,  in  the 
^oigority  of  cases  of  this  disease. 


We  have  had  entire  satisfaction  with  the  goods 
tought  from  G.  W.  Flavcll  &  Bro.,  1006  Spring  Gar- 
den St,  Phila.;  manufacturers  of  trusses,  supporters, 
Mastic  goods,  etc. 

Seed  to  B.  Keith  A  Co.,  75  William  St,  New  York, 
for  information  regarding  treatment  of  morphinism. 

The  distinguished  brother  of  the  senior  member  of 
4lie  firm  of  the  Hastings  Truss  Co.,  224  a  9Ui  St, 
Phila.,  was  recentljr  ele^ed  Governor  of  Pennsylvania 
hf  the  largest  migoiity  ever  received  bv  any  state 
•ofikmr  of  the  United  Stetes.  However,  The  Hastings 
Trms  Company  still  keeps  the  best  of  trusses  and 
supporters  at  the  same  old  stand. 

]CBLLDr*8  Food  carried  off  the  honors  at  the  Oali- 
€<niiia  mid-winter  expositioB. 

Fm  sderosis  prescribe  Meicauio. 

Juuut  FsHEf 8  Baby  Powder  if  a  i 


SBzra>  to  Micajah  A  Co.,  Warren,  Pa.,  for  a  sample 
of  medicated  uterine  wafers. 

FATS  AND  OUJB. 

If  the  digestive  organs  of  your  patient  are  unable  to 
digest  and  assimUate  fats  and  oils,  then  he  needs  8emg, 
two  or  more  teaspoonf  als  before  each  meal.  Ko  person 
will  have  consumption  whose  digestive  apparatus  is 
able  to  digest  fats  and  oils. 

Fob  a  good  instrument  for  the  iigection  treatment 
of  hernia,  addiesB  Samuel  A.  Crocker  A  Co.,  117  W. 
5lh  St,  Cmicinnati,  O. 

We  always  keep  a  supplv  in  our  office  of  the  pile 
ointment  made  by  Fred.  W.  Stewart,  Oswego,  N.  Y. 

The  corysa,  cough,  rheumatism  and  heart  tonic 
sranules  made  and  originated  by  the  Philadelphia 
Granule  Co.,  10  S.  18th  St,  are  very  reliable  and 
efficient    Only  25  cents  per  100. 

NudJOH  solution  is  the  new  phvsiolofcical  remedy. 
Sendto  Pkrke,  I>avisdE  Co.,  Detroit,  Mich.,  for  infor- 
mation. 

Fob  cut  rates  in  surgical  instruments^  address,  I. 
Phillips,  69|  WhitehaU  St,  Atianta,  Ga. 

We  use  Weinhagen's  thermometers.  Address,  H. 
Weinhagen  22  and  24  WUliam  St,  New  York,  N.  Y. 

Ajty  one  who  understands  the  formula  of  Celerina 
must  have  a  high  regard  for  it  as  a  valuable  nerve 
tonic.  Full-sised  botUe  free  if  vou  will  pay  express 
charges.    Address,  Rio  Chemicsl  Co^  St  Loub,  lio. 

We  have  always  been  pleased  with  the  cases  and 
other  goods  purchased  of  the  Western  Leather  Co., 
125  Bees  St,  Chicago. 

Was  Not  Spoiubd  by  Pbobpebitt.— A  newspaper 
paragraph  is  going  the  rounds  to  the  ^ect  that  a 
Scotch  girl  named  Lithegow  reooitiy  gratuated  from 
the  medical  school  of  Ann  Arbor  University  with  a 
very  fair  reuord.  Immediately  following  the  event 
came  the  hews  that  an  uncle  had  died  in  Glasgow, 
Scotland,  and  left  her  a  fortune  variously  estimated  at 
$650,000  to  1800,000.  The  young  doctress  exhibited 
no  surprise  or  emotion  on  receiving  the  announcement^ 
but  merelv  said :  ^hat  will  enable  me  to  relieve  the 
wants  of  the  poor,  without  any  regret  for  the  locB  of 
my  time  and  labor.'' — Jour,  if  iht  Amer.  Med,  Ab^%. 

Of  the  use  of  Peroxide  of  Hydroffen,  Prof.  Kasten- 
bine  says :— Of  the  various  brands  of  commercial  diox- 
ides I  have  examined,  I  find  Marchand's  to  be  the  one 
which  yields  the  largest  amount  of  available  oxmn 
under  all  conditions  of  exposure^  and  the  one  which 
contains  the  minimum  percentage  of  free  add.  All 
the  marketable  articles  I  have  seen  are  free  from 
barium  compounds,  but  the  majority  do  not  come  up  to 
the  15  volume  standard,  but  are  6,  8, 10  and  12  volume 
solutions. 

I  WILL  unhesitatingly  say  that  I  consider  Peaoook's 
Bromides  much  superior  to  the  ordinaiy  bromidei^ 
and  thechionia  I  believe  to  be  an  extremely  success- 
ful preparation  of  a  veir  valuable  therapeutic  agent 
I  have  used  both  with  excellent  success,  John  J. 
Shaw,  M.D.,  Plymouth,  Mass. 

At  the  Antwerp  World's  Fair  Expodtion,  Wm.  B. 
Warner  A  Co^  of  Philadelphia,  were  awarded  the 
Grand  Prise  for  the  purity  and  excellency  of  their  pre- 
parationB. 

Sxbabe'b.  Kola  Cordial  is  a  new  and  valuable  to«lE 
stimulant  Samples  free  if  you  pay  express  ohaiges. 
Frederick  Stciani^  A  Co.,  Detroit,  Mioh. 


Tom,  fuluiible  MppoiilorieB  send  to  Hall  A 


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218  Graenwhich  8t,  New  York,  N.  Y.    Sample  dozen 
fne  if  70a  mention  Ths  Mxdical  World. 

Fob  nerrons  exhmostion  try  Horaefoid's  Acid  Phoe- 
^ate.  Sample  ifjou  pa/  exprefls  chaigea.  Rumford 
Chemical  Works,  Providoioe,  K.  I. 

We  have  need  Horiick's  Malted  Milk  with  satisfac- 
tion.   Sample  free.    Horlick's  Food  Co.,  Racine,  Wis. 

DYBMKXrORBHXA  AKD  MSTBOBRHAGIA. 

''An  unmarried  ladj,  aged  85,  with  a  preyionalj 
good  personal  history  r^guding  her  raienU  health, 
called  npon  me  a  few  months  since,  seeidng  relief  from 
drsmeoorrhea  and  metrorrhagia.  Bearing^  in  mind 
the  formida  of  ponca  oompooma  and  being  impressed 
with  its  application  for  the  conditions  presented,  I 
mscribed  the  preparation  in  doses  of  one  tsblet  t  i.d. 
The  al^imal  conditions  rery  soon  responded  favor- 
ably to  this  treatment  The  painful  menstruation  im- 
proved and  the  menses  became  more  rmilar.  She 
took  the  tablets  as  directed -for  two  or  Uiree  weeks 
and  later  on  expressed  herself  as  very  much  relieved. 
I  saw  her  a  few  days  since  and  she  said  that  now 
during  her  menstrual  periods,  she  experienced  little 
or  no  pain.'' 

Belcher  Hyde,  M.D. ,  282  Macdonough  St,  Brooklyn, 
N.Y. 

Ths  Pubasubeb  ahd  Rswasbs  of  ▲  Phybioian's 
Lrwm. — In  his  commencement  address  at  Lafayette 
College  last  June,  Dr.  William  W.  Keen,  of  Philadel- 
phia, gave  the  following  picture  of  the  pleasure  and 
tatis&ietion  of  the  busy  ph^dan,  which  we  reprint  at 
the  request  of  another^ eminent  professor : 

"SirSpeocer  Wells,  as  the  net  result  of  hia  first 
1000 ovariotomies  added  20,000  years  to  human  life; 
and  so  far  has  modem  surgery  surpassed  this  result 
that  eveiy  thousand  similar  operations  to-day  adds 
not  less  than  80,000  years  to  human  life!  Think 
wluit  one  of  these  lives  means,  as  the  pale  cheek  re- 
gains its  color,  the  fe^le  pulse  its  force,  strength  suc- 
ceeds weakness,  each  dsf  records  a  gain,  and  finally 
health  is  re-established.  The  tender  father  rf  turns  to 
his  usual  pursuits;  the  adored  mother  once  more  be- 
comes the  centre  of  loving  care  of  her  family ;  the  be- 
loved diild  is  restored  to  the  famUy  circle  with  ruddv 
health,  rescued  from  the  valley  of  the  shadow  of  dea'h 
itself.  The  hushed  voices,  the  soft  tread  of  the  sick- 
room have  given  plice  to  (he  laughter  rf  health; 
the  mists  of  sorrow  are  driven  away ;  the  anxious 
alarms  of  disease  have  vanished.  What,  think  you, 
can  equal  the  Joy  of  the  physician,  as  he  views  this 
happy  transformation  7  Who  is  a  dearer,  more  cher- 
ished, more  welcome  friend  than  he?  Who  finds  a 
warmer  place  by  the  fireside  and  in  the  very  hearts  of 
his  patients?    No  one  can  adequately  appreciate  his 

Srofimnd  joy,  hb  daily  delight,  his  ^p^  gratitude  to 
le'GKver  of  ev^nr  good  and  {>erfect  gift'  Oh,  my 
friends,  it  is  a  bfeesed  profession,  a  divine  calling, 
wUh  a  heavenly  recompense  on  eaiih  T* — The  /Sbniea- 


A8THMA. 

B.    8jT.  ^oid  Hyditodlc..(Ho8telley*8)...oance8  lias 

^.  Senega. ounoei  11 

nd.  Sxt  Ylnni.  Verf..» ounces  te 

If.    Big.— Teaspoonful  three  ttanes  daily,  In  water. 

BKUXF  OF  ASTHMA. 

Believing,  that  as  yet  the  physicians  of  this  section 
are  not  folly  acquainted  with  the  successfid  results  of 
the  cone,  tincture  of  passiflora  incarnate,  prepared  by 
Jno.  B.  Daniel,  of  this  city,  I  take  this  opportunity 
to  state  the  efff  cts  produced  by  this  valuable  prepara- 


tion in  one  instance  that  came  under  my  penon&l 
supervision. 

A  few  days  ago  I  was  hastily  summoned  to  t^  bed- 
side of  a  gentleman  who  was  suffering  with  a  severe 
attack  of  asthma.  After  examining  nis  condition  I 
gave  the  patient  a  teaspoonful  of  pasriiora  and  re- 
neated  the  amount  at  intervals  of  a  half  hoar.  The 
nrst  dose  caused  immediate  relief,  and  alter  the  third 
was  adminif  tered  the  natient  fell  into  a  quiet,  restful 
sleep,  entirely  relieved  of  the  violent  paroxjsm.  Hit 
slumber  was  not  broken  throughout  the  entire  night 
^  and  on  awakening  the  following  mornings  he  expressed 
himself  as  feeling  better  than  he  had  in  montlia.  1 10- 
fltructed  him  to  continue  the  use  of  the  medicine,  in  a 
little  water,  three  times  a  day.  The  gentleman  is  nov 
enjoying  splendid  health,  has  not  experienced  a  returo 
of  the  asthma,  and  feels  that  he  has  a  permanent  pre- 
ventive for  his  malady. 

Miss  Jennis  NxwicAir,  M.D. 

For  the  new  Mexican  remedy  for  rheumatasm,  ad- 
dress, the  Atlas  Chemical  Co.,  216  Blain  St,  Ciocin- 
nati,  Ohio. 

Havx  you  seen  a  sample  of  the  new  ointment  base 
— unguentine?  If  not.  send  for  it  to  the  Norwich 
Pharmacal  Ca,  Norwich,  N.  Y« 

Sks  the  liberal  ofier  of  the  Abbott  Alkaloidal  Co. , 
in  this  issue.  The  vest  pocket  case  of  nine  vials  is  a 
good  one,  and  the  granules  are  good. 

Sks  the  elmnt  24  vial  case  of  teblets  adTeitised  hj 
H.  K.  Mulfora  Co.,  in  this  issue.  If  you  carry  your 
own  drugs  you  will  find  it  desirable. 

Fob  a  fine  professional  suit  of  clothes,  send  your 
order  to  E.  O.  Thompson,  1888  Chestnut  St.,  Phila. 

For  a  handsome  pair  of  Saddle-Bags,  send  to  WUlis 
TL  Davis,  Keokuk,  Iowa. 

Fob  liberal  samples  of  Dyspepsia  Tablets,  send  your 
name  to  the  P.  J.  Noyes  Co.,  Lancaster,  N.  H. 

Trt  Aletris  Cordial  in  your  gvneoological  practice. 
Send  for  sample  to  Bio  Chemical  Co.,  St  Loen.  Tou 
pay  express  cnaiges. 

Your  dyn>eptic  patients  will  need  the  Pancreo-Bi»- 
muth  with  Pepsin,  made  by  George  C.  Frye,  Chemist, 
Portland,  Maine.    Sample  free. 

Strxtp  of  Figs  b  the  standatd  fiimily  laxative. 

SAifPLBB  of  Antikamnia  Tablets,  upon  request  to 
the  Antikamnia  Chemical  Co.,  St  Louis. 

For  Colden's  Liquid  Beef  Tonic  or  for  Svapnla,  tbe 
purified  opium,  apply  to  the  Charles  N.  Critteotoa 
Co.,  116  EHilton  St,  New  York,  N.  Y. 

WORLB  and  Times  and  EeffiMet  (weikly)  for  |1.75. 

Yes,  we  can  still  supply  World  and  I^tOadtipiM 
Medical  and  Surgical  Iteporierj  both  for  one  year, 
for  98.26. 

We  can  furnish  Peterson's  or  Arthur's  Home  Mag- 
aiine  to  our  subecribers  at  76  cents  eachner  year.  Be- 
member  this  when^yon  send  renewal.  Kemembsr  the 
wants  of  the  ladles  of  yeur  family.  Either  wcia^ 
make  a  nice  CSiristmas  present  for  a  nieoe  Or  couBifl. 
Both  of  the  above  Mamines,  Tbb  MrdioaIc  Woiti> 
and  the  Philadelphia  Med,  and  Surg.  lUpaiitr  (weskl?) 
aU  for  $4.76— worth  $6. 

World  and  Alkaloidal  Clink,  both  one  yesr  for 
»1.70. 

IxmieviUe  Medical  Monthly  and  Thb  MspicaI' 
World,  one  year  $1.76. 

(OMiMaifed  OR  fiea<  leVO 


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THE  MEDICAL  WORLD 


Substitution 

(the  substitutes  not 
containing  tlie  bromides 
of  tlie  metais,  and  l>eing 
colored  with  aniiine  dye) 
compeis  us  to  abandon 
the  2  oz.  and  adopt  for 
all  our  preparations  the 


Ten  drops  contain  of  Gold  Broco- 
Ide,  Arsenic  Bromide  and  Mercury 
Bromide  each  1/33  gr. 

Dispense  in  glass  only.  Do  hoc 
use  a  spoon. 

Should  be  used  only  upon  Phyiip- 
cian's  prescription. 

You  want  your 

patient  to  obtaiir 

that  which 

We  adopt  this 
means  to  prevent: 


Hot  the  ordinary  Litnns.  but  Obemioally  Fare  Litmae  pat  in  pencil  form.    One  half  of  the  PeneU  U  fwr- 
4§itm$img  AeldB,  ami  the  other  half  for  Alkaliee,  and  it  is  00  leniitiTe  to  the  action  of  aoide  and  alkalies  that  it 
vill  deteet  them  in  any  proportion  that  they  may  eziet ;  abont  fifty  times  more  Mnsitire  than  ordinary  Utmiifl 
XTee  on  nnglased  paper.    Price,  25  cents. 

The  next  case  of  Leaoorrhea  yoa  have— I  mean  a  ease  wlv»i« 
——other  treatments  have  fitiled.  Write  to  me  for  a  foor-os.  paea 
age  of  PUX.V.  Antisbptic  Oomp.,  FREE!  It  will  make  §mt 
gallons  of  the  best  wash  for  Leuoorrhea,  Oanorrhea,  etc.,  ever  introdnced  to  the  medical  profession,  and  will 
not  sost  yea  a  cent. 
FORMULA  r-Berato  «f  Sodium,  Alumen,  Carbolic  Acid,  Glycorino,  and  CrytUlizod  princlplot  of  Thymo,  Eucalyptus,  Gautthoria  and  Montlia. 

J.  S.  TYREEp  HaniifacUirlag  Pharmaclstp  Washington,  D.  C 


Mavufaotushb  of 

iOLDBIJB  MXDIOATKD  QKULTDI 

PBXPABATION& 


To  any  phyaidsn  menticniag 
MxDioAL  WoBij)  and  endosiag  Us 
bodneflfl  card  and  5  cents  in  atnip%  I 
will  send)  pos^Mud,  samples  of  Om 
Medicated  Boogies  sufficient  fcrtiiils 
together  with  a  copy  of  *TEUi 
RATIONAL  TREATMENT  OV 
URETHRITIS,''  (new  and  wlsigii 
edition),  a  pamphlet  containing  asaif 
valnable  hints  on  trestmsnt  sai  sf 
use  to  every  phvsiciaa. 

AddreM.  CHARLES  L.  MITCHELL.  M.  D., 

1016  Cherry  St.  Philadelphia.  Pia. 


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ilv 


THR  MBDICAI,  WORLD. 


PRACTICES 

*mnM  wEo  ue  not  M»nti  for  tlK 
"warn  WoBD.  Twenty-flye  woidg  i 
fovnlMKSilbaB.   For  addlttonal  ' 


WAMTBD    Ain>    FOB    BALB 

_    tdyertlfled  in  ttak  oolosin  ftnr 

iforthenraotioe,  forTHBu  Cxnti 

~  B  will  be  Inaerted  one  time  fi«e 

I  words  or  for  labeeqnent  in- 

,  three  oenti  per  word  required.    Adyertiaementi  of 
DitmmentB.  nrepanttions,  eto.,  or  regrolar  buainen  ad- 

I  in  this  oolmnn  for  lix  oents  per  word; 

BoJtoewoidg.  IfanswenaretobesentincareofoiirGfiloe, 
■acKtmfte  of  fifty  cent!  for  eeoh  insertion  is  chaiged.  An 
•drertfiement  intended  for  any  particolai  issoe  must  leaoh 
H  not  Iftter  than  the  12th  of  the  month  preceding.  Gssh 
Miat  aoocnnpany  all  orders.  In  estimatlnff,  the  name  an<; 
I  mnst  he  counted,  and  every  three  flisures,  or  ficaotion 
',  and  erery  letter  roprosonting  a  word  oounts  as  a 


"ITIOB  BALE:— Leading  druff  store  in  a  town  of  2500  inbabl- 
jj  tants;  60  miles  fipom  InmanapoUs.  On  account  of  death 
«f  proprietor  who  has  done  the  aristocratic  practice  of  the 
town  for  past  twenty  fi?e  years.  Address,  71  LumlMud  Build- 
ing, Indianapolis,  Ind. 

ANTED;— A  location  in  Texas.  Good  bladk  prairie 
ihrming  country  preferred.  Address,  TOMB,  Alikchi, 
Ty. 

TBTANTED;— A  physician  to  take  charge  of  a  laxse  practice. 
Tf     1400  InhAbitauts;  no  opposition.    J.  &  DODGE,  M.D., 

WANTED;— By  a  physician— a  pharmacist  with  S2500  to 
take  one-half  interest  in  a  drug  rtore  and  take  charge 
tif  the  same.    Address,  Box  63,  Opelousas,  La. 

fTlOB  BALE;— Eesl  estate  and  practice  at  value  of  former. 
JJ  Business  esublished  thirty  years  City  V0.000,  about  76 
BoBes  fhnn  Chicago.  Bare  chance  for  competent  physician 
smd  surgeon.  Owner  wishes  to  retire.  Address,  '^Badger,*' 
mte  of  WEIGHT  DRUG  CO.,  Milwaukee,  Wis. 

WTOR  BALE;— rractioe  two  thousand  yearly;  house  eight 
V    rooms;  wood  hou«e;  ice  house:granery  bam  8^x42  two- 

•  story;  all  new.  Fruit  orchard.   Wealthy  fkrmiDg  community. 

>JV>r  terms  address,  P.  UYNDMAN,  M.D.,  TompUnsi  Mich. 
See  page  xxoi  for  later  For  Sale  advi. 


This  Elixir  is  prepaied  from  the  chemically  pore 
Sells.  Reeulte  can  be  looked  for  from  its  adminis- 
tntioQ  that  could  not  poeaibly  be  expected  from  tfie 
Commercial  Salts. 

r  FORMULA. 

■sofa  fluid  drachm  oontaliis  Arsenkd  lodldam.  1-126  grain : 
Verrl  lodldam,  1-12  grain,  Hydrargyrl  lodldnm,  1-126  grain,  Ma»- 
fanssil  lodidam,  l-lO  grain ;  PotassU  lodldam,  one  grain;  ttodii 
iodldnm;  one  grun.  with  Aromatlos. 
^  -  ilEblCAL  PROPERTIES. 
The  greatest  valae  of  this  oomblnatlon  Is,  It  relieves  those  ob* 
and  chronic  obetractlons  to  gland  action— the  Kidney  Liver, 


fteMreas.  as  well  as  the  ivmpatoic  system,  which  may  exert  so 
great  an  mflaence  for  evil  on  the  economy.    It  enjoys  the  con- 


B  of  the  medical  profeaslon,  as  Its  use  Is  Indicated  in  a  wide 

lange  of  diseases,  paiilcalarly  so  In  Pemlcioos  Anemia,  Skin 
Diseases  both  scaly  and  papalar ;  has  remarkable  ciirative  efllMts 
In  Spedflc  Diseases  and  otner  manlf9Statlons  of  Systemic  Infso* 
Uon,  Chronic  Uterine  and  Pelvic  Diseases,  and  In  oomplainta 
ipsn  an  alterative  and  tonic  are  indicated. 

lUs  combination  proves  that  the  anited  action  of  remedies 
•re  often  zeqaialte  when  either,  alone.  Is  Insoffldent.  Physi- 
cians when  prescribing,  will  please  write :   Blixxb  Biz  Iodzdss 

^WAUCKB  GREBN'8--0kB  SOTTI.X. 

llie  drnnlst  will  please  write  directions  on  his  own  abeL 
r  SizTodides  Is  always  sold  In  eight  oa.  oval  bottles  and 
r  tad  balk. 

Wholesale  Price  $8.00  per  doz.  bottles. 
We  also  prepare  the  Elixir  six  Bromides—  Elixir  six  Hjrpop- 
fcesphltes  bach  at  |6  per  dozen  and  the  Elixir  six  Aperlens  at  |4 
Mr  doaen.  The  Elixirs  are  kept  In  stock  by  Wholesale  Draggista 
ttoooghoat  the  United  States.  Bxbtd  won  Oaaai^AM, 

n*  K^a/keP'Oneen  Miarmaoeuiioal  Co.   (Jnoo.) 

180  W.  Befent  8U  QUsffOW,  SeotUmd,  toA 
KaoMS  City,  U.  8.  A. 

■aasples  of  the  ftmr  Elixirs  wm  be  sent  prepaid  OB  receipt  of  ILOO 


Medical 


If  you  want  any  of  the   standard  or  late 
pubUcations   of    the  ECLECTIC  SCHOOL*   3 


send  to  us  for  complete  price  list 
We  also  publish  the 


Eclectic  MedicalJournal, 

and  sell  any  Medical  Book  Pablished 


JOHN  M.  SCUDOCR'S  SONS. 

. . .  Publishers,  . . . 
228  W.  Court  Street,        Cincinnati,  Ohio. 


IN  THE  SCLCCTION  OF 

A  CHOICE  CIFT 

or  of  an  addition  to  one*8  library,  eleganee  \ 
and  usefulness  will  be  found  combined  in 
WEBSTER'S  IHTERIf ATIOHAL  DICTiOHART 
8uooe$8or  qfthe 
**  Unabridged." 

Standard  of  Hm 
U.S.  GoT*t  Print- 
ing Office,  tbeU^S. 
Supreme  Court  and 
of  nearly  all  the 
Scboolbooks. 

Warmly  eom- 
mefnded  by  eTery 
State  Superintend- 
ent of  Schools,  and 
other  Educators  al- 
moet  without  num- 
ber. 

A.  College  President  irriteas  "For 
"ease  with  whlcli  the  eye  finds  the 
"  word  sought,  for  aoooracy  of  definl- 
"tion,  for  effectlTo  methods  in  indl- 
*' eating  pronunciation,  for  terse  yet 
"comprehensive  statements  of  facta, 
"  and  for  practical  use  as  a  working 
"dictionary,'  Webster's  International' 
"  excels  any  other  single  Tolnme.** 

The  One  Great  Standard  Authority, 

80  willes  Hon.  T>.  J.  Itrewcr,  JnsUce  U.  8. 
8apreoie  Oomrt. 

G,  A  C.  MnJtniAM  CO,,  PabUahera, 
SpringAeld,  Maaa.,U.S,A. 

S9*  Rend  to  the  pablMiera  for  free  pumphlet. 
S9*  I>o  not  boy  cheap  reprinUi  of  andent  edltiees. 


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THE  MEDICAL  WORLD. 


Farbenfabriken  vorm.  Friedr.  feayer  &  Co.'s 
Pharmaceutical  Specialties 


An  Albamose 

SOMATOSE 

Pood  Product 


SoMATOSE  is  a  new  food-product  consisting- 
of  the  Albumoses  and  nutrient  salts  of  meat, 
with  a  minimum  of  peptones.  It  is  a  powder 
readily  soluble  in  ordinary  fluids,  and  rapid- 
ly assimilated  in  the  organism.  Somatose  is 
useful  in  fevers,  gastric  affections,  phthisis, 
anaemia,  and  as  an  infant  food.  Supplied  in 
two  ounce,  quarter,  half  and  one  pound  tins. 


Trional  is  a  nerve  sedative  and  hypnotic 
which  has  given  satisfactory  results  in 
simple  agrypnia,  mental  excitement,  and 
delirium  accompanied  by  obstinate  insom- 
nia, and  in  narcotic  habitues.  It  acts 
promptly,  safely  and  effectively.  When  pain 
exists  Trional  may  be  combined  with  Phe- 
nacetine.     Supplied  in  ounces  and  tablets. 


Hypnotic 

Trional 

Neurotic 


Antiseptic 

Aristol 

Cicatrisant 


Aristol  is  a  convenient,  agreeable  and 
effective  dressing  in  major  and  minor  sur- 
gery, dentistry,  diseases  of  the  eye,  ear, 
nose,  and  in  bums.  Aristol  adheres  closely 
to  wounds  and  membranes,  and  may  be 
used  in  powder,  or  in  the  form  of  oint- 
ments, oils,  collodions  or  etherial  solu- 
tions.      It    is    supplied    in    ounces    only. 


LosoPHAN  or  Triiodocresol  has  given  ex- 
cellent results  in  the  treatment  of  mycotic 
diseases,  such  as  ringworm,  scabies,  pity- 
riasis versicolor,  the  chronic  forms  of  ec- 
zema, prurigo,  sycosis,  acne  and  pediculo- 
sis. Losophan  should  be  thoroughly  dis- 
solved in  oils,  and  not  simply  combined  with 
ointments.    It  is  supplied  in  ounces  only. 


Antlmycotic 

Losophan 

Dermic  Stimulant 


Antipyretic 


Phenacetine- Bayer    is    indicated    in    all 
acute,    inflammatory,    febrile    conditions. 


I3f-f  pjlVT  A/^pTIMP   and  all  forms  of  pain.      It  is  the  safest, 
Mr  1  Ii:;fil|r\V/i:;f  I  ll^IJr   ^jj^e  the  most  active  and  reliable  of  the 

-Bayer 


Analgesic   Anodyne 


antipyretics  and  analgesics.  Phenacetine- 
Bayer  is  supplied  in  ounces,  tablets  and 
pills ;  also  in  pills  and  tablets  combined  with 
Salophen,  Sulfonal,  quinine,  caffeine,  etc. 


Piperazine- Bayer  -  Europiien  -  Sulfonal-Bayer  -  Saloplien  -  Lycetol 
I  PAMPHLETS  PORWABBMB  ON  APPI^ICATION. 

W.  H.  5chieffelin  &  Co.,  New  Yorlc. 


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VI 


THB  MBDICAL  WORLD. 


Passiflora  Incarnata. 


In  the  December  number  of  the  News,  Dr.  J.  A. 
ouniog  iells  what  he  has  used  Passiflora  for 
(BleepleMiiess).  I  have  used  it  for  the  same  disease 
ivr  the  last  three  years  with  the  nrandest  success ; 
■l«o  for  oouTulsions  of  children  oue  to  any  cause ; 
wh»  for  all  complaints  arising  from  teething ;  even  to 
iiairlioea  is  benefitted  as  by  magic.  All  nerrous  dis- 
easen  of  the  bladder  in  adults,  frequency  of  urinating, 
•r  oonlnjs  away  drop  by  drop,  with  burning  or  any 
MMmodic  action  of  the  bladder  or  rectum,  where 
Bui  or  Kux  should  be  indicated.  I  found  one-half 
to  ene  teaspoonfU  of  Passiflora  O  given  every  thirty 
MfAutes,  for  a  few  doses,  and  then  once  in  two  hours 
•r  three  times  a  day,  acts  like  magic.  It  controls 
vaatlessiiees  of  nervous  people  better  than  anything 
lofperosed. 
LoSueor,  Minn.  W.  H.  FitHn. 


PattMora  in  Daiirimn  Tremant. 

**  In  delirium  tremens  and  in  the  insomnia  follow- 
tec  the  excessive  use  of  alcoholic  stimulents  it  (Pas- 
■ifiii  ■.)  acts  like  a  charm.    It  should  be  given  in  full 

s,  say  one  teaspoonful  every  two  hours,  until  the 
'.  result  is  oDtained.  It  is  valuable  in  fretftil, 
g  children,  use  it  both  intemallv  and  as  a 

[  application  to  the  swollen  gums.  My  colleague. 
Dr,  Brewer,  uses  it  in  spasmodic  incontinence  of 
■rtee,  especially  in  those  cases  where  the  patient  is 
v«tj  nervous  and  complains  of  a  burning  sensation 
when  the  urine  is  voided.  He  also  commends  it  very 
hi|Aly  in  the  treatment  of  cerebro-spinal  meningitis.'* 
— (Db.  H.  M.  Hbkkbl,  in  Be.  Medical  Journal. 


Fattiflora  Inoarnata  in  intomnla-Spatma. 

From  a  paper,  read  before  the  Ohicago  Academy 
•C  Medicine  and  published  in  the  Medical  Sra  of  De- 
Mmber,  1802,  we  extract  the  following  concerning 
FaMiflora: 

**  It  is  a  neurotic,  anti-spasmodic,  soporific,  ano- 
irae  and  sedative.  It  has  special  action  on  the  gan- 
l^ionic  cells  of  the  gray  matter  of  the  cord. 

*'  It  exerts  a  speeial  influence  over  the  ganglia  of 


the  thorax,  pelvis  and  abdominal  regions  and  genets 
ally  imiets  the  excitement  of  the  m^nlla  oblongata. 

<*  In  insomnia  it  acts  like  «  chann,  without  any 
unpleasant  after-effects.  It  is  valuable  in  neurosef, 
and  reliable  in  tonic  spasms  which  are  present  la  a 
great  number  of  cases  of  spinal  meningitis,  and  it  will 
prevent  chronic  spasms. 

<*  In  the  nervous  afl'ections  following  oongeation 
of  the  cord  and  ganglionic  centers,  it  produces  a 
iiuieting  eff'ect  not  produced  by  any  other  remedies, 
in  the  rapid,  irregular  respiration,  due  to  irritation  off 
the  medulla.  It  is  a  specific  in  pains  of  the  h— <» 
when  there  is  a  great  fear  of  immediate  dissolnlien 
and  constant  fear  of  death,  with  an  irregular  pnlaa. 

'*  In  the  irregular  pains  of  pregnancy  its  aotiea 
insure. 

"In  dismenorrhoea  its  action  is  decisive  aai 
pleasing,  tiding  the  patient  over  the  tiienstnial  i 
with  comfort. 

*'In  facial  neuralgia  and  neuralgia  of  tha 
pair  of  nerves,  it  is  very  useAil. 

*'  In  insomnia  from  over-indulgence  in  aloohrtlo 

beverages  it  acts  like  a  charm,  given  in  toll  ' 

every  hour  until  rest  is  produced.    It  relieves  f 
vation  of  the  nerve  centres— sympathetic  Ini. 
tion,  especially  so  in  epilepsy,  given  at  night 
nightly  attacks  occur. 

**  In  enlarged  prostate,  through  its  action  ^ 

the  ganglia  of  the  pelvis,  it  exerts  a  special  action. 

"  In  spasms  of  children  you  win  be  mora  than 
pleased  with  this  remedy. 

**  In  the  middle  stages  of  typhoid  fever,  in  tha 
initial  staires  of  scarlet  fever,  where  the  greaa  rest- 
lessness of  the  patient  is  so  trying  to  the  physidM 
and  friends. 

"  I  have  here  presented  quite  a  number  of  dURa- 
ent  manifestations  in  which  the  remedy  is  indloated, 
all  depending  in  a  greater  or  less  degree  upon  tha 
same  conditions.  Thev  are  only  given  as  pointeca. 
as  it  were,  showing  the  large  number  of  dlflSBnmt 
maniliBStations,  depending  upon  the  same  parta  at 
feult  in  which  it  is  adnussible  by  its  action  maoa 
these  certain  parts  of  the  nervous  system,  by  elMar 
not  performing  their  functions  or  from  an  eviar 
action." 


Concentratea  Tincture  Passiflora  Incarnata. 


Db.  F.  Q.  Wblch,  No.  77  W.  45th  St.. 

Nnw  YO&K  City,  Jan.  1, 1891 
Mb.  JNa  B.  Dakibl,  Atlanta.  Ga. 

Dear  Sir:  Enclosed  flnd  check  for  another  dosen 
Oanc.  Tr.  Passiflora  Incarnata.  Ship  at  once  and 
•bilge.  F.  G.  WKiiCH,  M.D. 

Db.  S.  Bbxtmbauoh,  421  S.  Jeffierson  St„ 

Dattok,  O.,  Dec.  29, 1898. 
Mb.  J.  B.  DAiriBL,  Atlanta.  Ga. 

Dear  Sir:  Passiflora  received  and  fully  tested,  and 
■^f  verdict  is  simply  this:  Passiflora  has  been  given 
a  place  on  my  office  medicine  shelf  to  stav.  I  care 
isr  nothing  more  effectual  in  all  conditions  indicating 
tta  ase.  Yours  gratefully, 

S.  Bbumbauoh,  M.D. 

OMce  of  J.  H.  EiMB.  M.D. .Physician  and  Surgeon. 

Bandon,  €k>os  Co.,  Obbqok,  Dec.  16, 1893. 
J.  B.  Davibl,  Atlanta,  Ga. 

Dear  Sir:  Please  send  me  by  express  flve  pounds 
OoBO.  Tr.  Passiflora.  The  pound  bottle  received  from 
foa  about  a  year  and  a  half  age  was  the  best  prepa- 
ratitrn  1,  have  used  from  this  plant.  I  liave  used  the 
Mnaedy  which  was  prepared  by  other  reliable  drug 
h«vaes,  but  the  result  was  not  satisfactory. 
Bespectfully  yours, 

J.  H.  KiMB,  M  J). 

Tkls 


E.  M.  G ABBBLL,  M.D  .^6  Braaelton  St.. 

Bostok,  May  98, 1808. 
Mb.  Dakibl,  Atlanta,  Ga. 

Dear  Sir:  Send  me  one  dosen  bottles  of  Oono.  Xr. 
Passiflora  Incarnata  as  soon  as  you  can.  lin<dosa4 
flnd  check.  Do  as  well  as  you  can ;  I  will  be  qnita  a 
customer.  Very  respectfUly, 

B.  M.  Oarbbij.,  MJ>. 


Office  of  Dr.  A.  E.  Kkumbu 
KAirsAs  Girr,  Mo,,  Jan.  10, 1 
Mb.  Jko.  B.  Dakibl,  Atlanta,  Ga. 

Dear  Sir:    I  used  up  the  last  bottle  of  the  i 

bottles  of  Passiflora  you  shipped  me  in  November* 
^93.    I  am  well  pleased  with  the  tincture.    I  flnd  it  ta 
be  A  No.  1  and  the  results  from  it  are  the  same,  whan 
the  remedy  is  indicated.    Please  ship  me  three  doaei 
bottles.  Very  truly  yours, 

A.  E.  NBUMBiaXB,  MJI. 

J.  L.  MoNbblt  &  Co.,  Druggists. 
GoviKOTOK,  Tbkv.,  Jan.  18, 1884. 
Jko.  B.  Dakibi^  Atlanta,  Ga. 

Dear  Sir:  You  will jplease  send  us  per  aspna 
lialf  dosen  bottles  Oona  Tr.  Passiflora.  wiU  mafca  i 
larger  order  next  time.  Very  trulv  yours, 

J.  L.  MoNbblt  9t  Oo» 


Pr^paraHofli    Is 

Whotesate  Drboglsty  34 


by    JOHN    B.  DJMIBLp 
Wall  Straat,  Attaatap  Sa. 


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SBNQ  inorea^M  the  secretion  of  the  digestive  fluid  by 
oauBing:  the  digestive  organs  to  perform  their  natural 
function.    It  is,  therefore,  the  best  remedy 


INDIGESTION, MALNUTRITION.muiWASTING  DISEASES 

DOSB:— Adults,  one  or  more  teaspoonfuls  three  times 
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repeated  every  half  hour  until  relieved. 


SULTAN  DRUG  CO., 


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Morphine 
Habit . 


•    t 

CON. 


CURED 


BY  THE  USE  OP 


TINO. 

(FBOM  OOMMOH  OAVf^ 


iRTIUTC 


KBITHS 

A  Powerful  Nerve  Stimulant.  Tonic,  etc. 

IS  AUBO  XMPLOTSD  ZV  THB  TBXATIOIVT  OF 

PtfftljBls,  EpnepBit  St.  YItu'  Duiee,  Chlonil  and  Tobaoeo  HaMtSt  Sleeplessnesst  Hcrre 

EzhaiisUoii,  Nearftl^a,  AloolHillnii,  Palnftil  and  Hefldeiit  Menstniatloii,  Head* 

ache}  Hysteria^  OonmUioBg*  and  ProRtratlini  from  ftJaUmg,  and  tho 

CoBTalesceiit  Stage  of  Aeate  DIseaMs. 

DOSB— From  ten  to  thirty  drops  or  more,  m  often  m  may  be  indioated  to  meet  the  nrgenoj 
of  the  cMe.    Adminiiter  in  hot  water  when  qniok  motion  if  desired. 

nninimnimniifiinnifi 

KX88B8.  B.  KSITH  A  Ck>.,  BABinWIULB,  OA. 

Gentlemen :— The  oon.  tine,  avena  satiya  has  been  more  snooessAil  in  the  treatment  of  the 
opinm  habit  than  anything  I  hare  erer  tried,  and  I  have  tried  yarions  other  remedies,  among 
them  (he  advertised  nostrums.  J.  O.  HALLOWAY,  M.  D. 

MB88B8.  B.  KaiTH  &  Ck>.,  AJDAMBYXXAB,  O. 

Gentlemen :— G.  M.,  aged  83  years,  Merchant,  had  oircnmscribed  peritonitis  and  thiokening 
Ibr  some  time.  On  aooonnt  of  pain  and  tenderness,  his  physician  prescribed  morphine  in  small 
doses,  bnt  he  nsed  it  afterwards,  of  his  own  accord,  until  the  habit  was  establisned.  He  tried 
hard  to  break  oiT,  but  he  would  always  be  taken  with  great  prostration  and  irritation  of  tha 
stomach,  yomit  everything  he  took  and  would  get  down,  and  finally  in  about  thirty-six  hours 
would  take  morphine  again,  and  in  a  short  time  feel  all  right.  While  under  its  influence  he  com- 
menced to  take  whisky  and  beer  to  keep  from  the  morphine.  He  also  tried  different  doctois.  but 
all  the  same.  When  i  was  consulted  he  would  take  stimulants  and  then  increase  the  morphine 
to  keep  off  big  head  (as  he  called  it),  taking  one  drachm  of  morphine  every  two  days.  He  wae 
miserable,  and  when  trying  to  quit  it  said  u  the  suffering  and  agony  of  hell  was  as  baa  he/ wanted 
to  steer  clear  of  the  place.  I  tried  valerian,  and  nearly  all  nerve  tonics  and  nerve  stimulantSt 
and  to  diminish  the  dose  of  morphine,  bnt  alL  did  no  good.    I  then  told  him  of  the  ( 


about  which  I  had  read,  and  he  said  if  he  could  quit  without  so  much  suffering  he  would,  if  not,  he 
could  not  bear  the  agony,  and  would  take  it  and  die  as  soon  as  possible,  lobtainedtiie  avena 
and  prescribed  it  in  fifteen  drop  doses  whenever  he  felt  the  need  of  morphine  which  was  four 
times  a  day ;  and  for  two  nights  Igftve  him  about  a  one-fourth  grain  of  morphia,  when  he  said  he 
could  do  without  it  he  did  not  sufier  any  more.  Thus  he  left  on  taking  morphine,  and  has  never 
taken  another  dose  of  it.  The  first  night  without  morphine  he  slept  reasonably  well,  and  eaidi 
succeeding  night  better,  until  five  nights,  when  he  slept  well ;  then  I  gave  him  only  three  dosea 
of  the  avena  for  three  days,  then  two  doses  for  three  days,  then  only  one  dose  in  the  evening  for 
one  week.  All  this  time  ne  rested  very  well,  said  his  suffering  was  nothing  to  what  he  haa  ex- 
pected, and  that  any  one  could  go  through  it  with  half  grit.  THis  oim  language.]  Since  then 
ne  has  taken  neither  avena  nor  morphine,  and  is  now  well  ana  has  no  desire  for  any  stimulantt 
and  says  that  "he  would  not  have  the  habit  for  the  world."  He  has  gained  thirty  pounds, 
namely,  he  has  now  his  original  weight.  He  never  was  an  intemperate  man  until  the  morphine 
was  prescribed  for  him  by  a  physician,  through  which  he  was  ruined,  losing  nearly  all  his  pro- 
perty and  agreat  deal  of  selr-respect.  He  had  never  been  without  morphine  for  more  than  thurty- 
six  to  forty  hours  since  he  had  contracted  the  habit,  namely,  during  three  years. 

A.  L.  JA0K8OK,  M.  D. 

C^Send  for  nrinted  matter  on  CON.  TIKO.  AVBNA  SATIYA  in  the  Morphia  or  Opinm 
Habit,  and  oertificates  from  different  members  of  the  Medical  Profession  citing  cases  under  their 
charge  treated  by  it,  also  BBVISBD  AND  BNLABGBD  MANUAL,  to 

B.  KEn^H"&"C0., 

•"cHi-i.T..  No.  75  William  Street,  NEW  YORK  CITY. 

ESTABLISHED   18S2. 


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Lamr  nuumftcinring  facilities  enable  job  to  reduce  the  price  of  the  Dr.  Melatoek 
Natural  Uterine  Supporter  £fom  |6.00  to  $2M  complete. 

Belt  only, each,  $2.00 

Cup  or  RinfT  onlr  solid  steo), "      1.00 

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Has  been  used  for  the  last  twenty  years  and  is  the  only  one 
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Instouments  sent  by  mail  at  our  ristL  on  leceipi  of  price, 
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Combined  it  tine  for  any 
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Utt 


prk«,  $35.00,  red 
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Ampatsdng  Case  No.  1,     ^ $14  00 

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*:  «*  "  Hick's  with  Certificate, • 1  40 

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^      Speculums  (Glass  Vaginal), 80 

<0       Fitch's  Pocket  Scale,  ....       76 

Uterine  Dilators, ~.   ...  1  76  to  7  60 

O      Uterine  Forceps, -..%.* 1  26  to  2  60 

D       Uterine  Sounds,  graduated, 60c  to  1  60 

bO     Obstetric  Forceps— Hala's,  Sawyer's  and  Hodge's, each»    8  26 

40      Obst.  Forceps,  Elliott's  or  Simpson's,  .  .   .  « .each,    8  76 

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Oni  70a  affiwd  to  nae  the  nnielkbl*  Oinical  ThemoiiMten  with  which  the  Coontcy  is  flooded  wkea  yoa 
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THE  STANDARD   HYPNOTIC, 

:Bfi.oi\j:iiDi.A..  ^ 

Dos«— One-half  to  one  fid.  draohm  In  water  or  syrup. 

TH^   STANDARD  ANODYNE, 


fid.  drachm,  represents  H  gr.  morphia  in  ano- 
dyne prindplOy  minus  Its  constipating  effect. 

THE  STANDARD  ALTERATIVE 


Pose   One  or  two  fid.  drachms  as  Indicated. 

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S.  H.  KENNEDY'S 
EXTRACT  OF. 
PINUS  CANADENSIS. 


I  have  used  S.  H.  KENNEDY'S  EXTRACT  PINUS  CANADENSIS 
in  some  affections  of  the  rectum,  vagina  and  cervix  uteri.  I  have  used  it 
considerably  diluted  as  a  vaginal  wash,  with  great  success ;  but  I  prefer  to 
Jtpply  it  to  the  os  tinc»  on  cotton  wool,  either  pure  or  mixed  with  glycerine 
and  rose  water.  Thus  applied,  it  should  remain*  intact  for  two  or  three,  or 
even  four  days,  and  then  be  renewed.  In  this  way  I  have  seen  chronic 
sranular  erosions,  with  leucorrhea,  disappear  very  rapidly  under  its  use. 
I  have  not  time  to  do  more  than  call  the  attention  of  my  professional 
brethren  to  this  new  extract,  which  I  am  sure  will  soon  be  recognized  as  a 
valuable  addition  to  our  Materia  Medica. 


Nb-w  York. ^ —  » 


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Qoo^^ 


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ziU 


Tonic  Stimulant.    ^ 


Each  fluid  ounce  rapresents  120  grains  or 
Kola  (Stercutia  Acuminata)  wlrate  agree- 
ablo  odor  and  cliaractarlttlc  tastt  (witliQut 
its  acrid  bitterness)  are  imparted  to  it  In  a 
marked  degree. 


KOLA  owes  its  thermpentic  yalne  to  Oaffeine,  Theobromine,  and  a  principle  pecoliar  to  itself,  called  Kolanlne. 
Its  stimolating  and  sustaining  effects  on  the  nervous  system  are  more  prompt,  powerfol  and  of  longer 
doration  than  that  of  Oafieine  alone.  It  is  also  superior  to  Coca  as  a  cerebro-tpinal  ttimulant,  with  nono 
of  the  objections  which  so  frequently  follow  the  continued  use  of  the  latter,  hence  this  Cordial  it  rooom« 
niondad  to  those  whose  werk  tubiecta  them  to  exoeetivo  mental  or  phyticai  exhauttion. 

Heretofore  all  preparations  of  Kola  have  been  more  or  less  objectionable  on  account  of  their  nnpalatabiliiy, 
owing  to  a  peculiar  bitter,  acrid  principle  which  it  possesses.  This  Cordial  oombinea  all  the  valuable  oonant- 
fienta  of  Kola,  without  anj  of  its  objectionable  features,  and  is  most  deiioious  to  the  taste,  and  efficient  ia 
action. 

Samples  and  literature  will  be  mail^  on  itiquiry,  and  we  will  forward  an  original  full  siaed  package  to 
euch  physicians  as  are  willing  to  assume  the  express  charges. 

We  have  prepared  an  Exhaustive  Treatise  on  KOLA,  its  History  and  Therapeutio  Range,  proftMsly 
tllostrated,  which  we  will  mail  to  any  physician  interested,  on  request 


Manufacturing  Pharmacista, 


Windsor,  Ont. 
London.  England 
New  York  City. 


''COON  HOLLOW  WHlSKieV 


The  finest  made  in  Kentncky.     A  pare,  nnadnlterated  unblended 
Whiskey,  especially  recommended  for  nse  in  tlie  family  and  aick  room. 

Fonr  Tears  Old $2.50  a  flrallon  |  Eiflrht  Tears  01d^....$lSO  a  gallon 

SixTearsOld 3.00       «*         |  (No  charge  for  packages.) 

Eight  Tears  Old  **Coott  Bellow**  in  cases,  $10iOO  per  case. 
Fifteen  Years  01d/*Coon  Hollow**  in  cases,  $15.00  per  case. 
Terms,  cash.    Correspoailbnce  solicited. 
S.  N.  JONC8.  Dauooiar  154and15SW.Htis8lnet  Loui8VIU.k  Kv. 


isso>iDioo<isospoooop<>ooo»osio>ooossosoopoPSOooooooooo»oeos>>sooioissstosoosiisstio<o<otooiiOi 


I   Bpecial  Dfier, 


confined  to  sections  where  no  dealer  lias  our  goods  in  stock,  26  per  oeot 
oft  NET  HERE,  or  15  pin  cent.  PRE-PAID  TO  ANY  EXPRESS  OFFICE' 
to  one  doctor  ONLY  in  each  town  or  localityp  WHO  first  .remits  lior  liis 


eboloe  sample,  thns  secniliig  agency  for  all  fatoie  sales  made  by  liiA,  who  agrees  to  show  **  Marshall's  Case-Bags  " 
to  brother  piactltionerB  with  whom  he  comes  in  ftiendly  oontaot,  BoUciting  and  transmitting  aecured  oiden  direct 


tons.   (See cuts, etc bek>w.) 


8ole  Manufacturer  of  Convertible  Caee-Bagt; 


FIC.  3. 

Ko.  M  or  57  (either)  have  botti  Square 
and  Bound  Bottles. 

imtt eieoo 

Blaok 15  50 


OUR  CUT  4. 

Blttk,  87  BottlM ei5  50 

"     83      "    11  50 


OUR  CUT  % 

N«  32  BOTTIL 

8bek 810  00 


C»o  be  flhanflid  initently  froin_perfeet  bngiy  eaie  to  eaddle  tege  or  riee  vena.    Two  Sandriee  ilPaoee  In  eaeh  beg.    No  tin  to 
rnat    Sayee  Men,  Time,  Money.    Toar  need.    Foil  eironUrs  of  Terione  aCylec  and  ilaee  mailed  if  aaked  for. 


rattle  nor  met. , , ,      -- 

ilret-olaM  in  efery  partioalar.   Sent  npfeM  pre-paid  on  receipt  of  reepeotiTe  prioe  (wUeh  here  eee.) 

W.  SCOTT  MARSHALL,  6020  Jackson  Av.,Chioafco 


Wamntad 

Order  now  direct  of 


tHitl»tmitll<OOOOHOPOO<OOIOOOtO<tOOOOO>IOO»>00>tlP»»00<OOOiHOt>>OIO<ttiO«>«Ot>MmtHtM 


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MXV 


THB  MBDICAL  WORLD. 


€€ 


MtepaH"  Breast  Rump 


Makes  a  Gontintiotu  Snction  for  anj  leDfth  of  time. 
Strength  of  siiction  easily  controlled  so  as  to  be  strong  whcB 
needed,  or  yerj  mild  and  easj  for  a  tender  nipple. 
Most  deanlj  of  any  Breast  Pomp.     Easily  detached,  and  entiiei^ 
j  without  pain.    Shape  of  the  glass  is  simply  perfect  for  the  purpose 

^    ^  needed.    Qoality  of  rubber  goaranteed. 

No  metal  to  corrode  and  oxidixe  the  mbber  and  caose  it  to  spoil.    Constructed  strictly  on  scientifie  prin- 
ciples and  the  only  perfect  Breast  Pump  on  the  market 

Physicians'  sample  by  mail  40  cents.    Descriptive  CSroular  mailed  if  requested. 


Walter  F.  Ware, 


^  YOU  p^cPibiiig  "The  Beii' 

SHOWN  AB  WCTJAUM  NXABLT  lIXrT   YMABB. 


H.  PLANTEN  *  SON,  New  York. 

EttaMblisd  1836.  The  ftosMr  Ansricas  CaptiU  Hsast 


•  Doctor,  if  you  are  called  upon  le  rejfdM 

or  emoellish   a   damaged  ooiBplfiTW» 

#      #      please  giro  our  preparation  a  chaBoe  to 

put  in  some  satisfactory  work  lor  joii» 

and  oblige, 

Tours  truly, 

NEW  JERSEY  MANUFG.  CO, 

JERSEY  CITY.  N.  Jl 

flmaU  saai]^  free  lij  man,  or  laiger  sample  ftee  lijenaMBB. 
If  yooaie  wining  to  pay  tbet 


HOLLOW  SUPPOSITORIES, 


i^i^A 


snwly  Physicians, 
id  others  with  Hoi#- 
iies  and  shapes,  to 
id  into  which  taey 
r  NuTBimvT,  thus 
r  Mbdioaxbb  Sup- 
more  reliable  than 

irith  oonoidal  stop- 
>  he  inserted,  when 
d  will  force  the  sup- 
ithout  the  use  ofa 
appliance  whatever, 
application,  and  msn- 


GLTCEBINE- 

MCmSnFiTBI. 

A  shell  ot  pure 
filled  wkh  pure 


Mn  Elegant  PreBcr^Hhit. 

Write  for  a  Free  Samfde,  antf 

convince  yourself  of  its  sopeii- 

ority. 

PATKirr  APPUKD  vox. 

Boxes  of  Twelve   .   50  Ct&i 

FhOLESALE  DrUQQISTS.  218  QrCCNWIOH  ST.t  New  YSBS. 


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THB  MBDICAL  WORLD. 


XV 


Poreiln  (^orfesjDonAence, 

I  have  found   Peacock's  Bromides   very 
Rtiflfacioiry. 

MYLE8  W.  O'REILLY,  M.  D.,  L.  M. 
Bootle,  Liverpool,  Eng. 


I  tried  Pbacock*s  Bromides  myself  when 
I  was  sofTering  from  sleeplessness  and  found 
it  Terj  efficacious. 

G.  DB  G.  GRIFFITH,  L.  R.  C.  P. 

S4  St  George's  8q.,  8.  W.  London. 


I  have  found  Peacock's  Bromides  valu- 
able in  neurotic  insomnia,  and  I  think  the 
•onbination  useful. 

F.  PITZHS^BBRT  JAY,  M.  D., 

Tenterden,  Kent  Eng.  L.  B.  a  P. 


I  hart  tried  Peacock's  Bromides  and  was 
▼ery  pleased  with  retoUs.  I  will  prescribe 
it  when  opportunity  occurs. 

K  NORTON,  M.  D.,  L.  R.  C.  P. 

Capel  Lodge,  Folkestone,  Eng. 


I  have  used  Peacock's  Bromides  and 
have  had  most  satisfactory  results,  espe- 
cially in  a  bad  neurotic  case. 

GEO.  T.  HINE8,  L.  R.  C  a 

St.  Oayth,  Essex,  Eng. 


I  have  pleasure  in  stating  that  I  tried 
Peacock's  Bromides  and  found  it  valuable 
in  hysterical  excitement 

D.  P.  TAYLOR,  M.  B.  &  C.  M. 
Raefirth  House,  Mid  Yell, 

Shetland,  Scotland. 


Peacock's  Bromides  combined  with  vale- 
rian have  proved  useful  in  cases  of  hysteria 
and  neurasthenia  under  my  care.  In  one 
case  of  hysteria  it  was  followed  by  marked 
relief.  J.  DAVIES,  M.  R.  C.  &, 

New  MillB,  Manafon,  Eng. 


I  found  Peacock^s  Bromides  of  great 
service  in  arresting  those  outbursts  of  heat 
experienced  by  persons  who  have  a  gouty 
tendency,  especially  after  a  relapse  from 
their  usual  abstinence.  I  will  continue  to 
use  it  in  my  practice. 

H.  A.  FENTON,  M.  B.  A  C.  L.  R.  C.  P. 

Hatfield,  Doncaster,  Eng. 


I  have  much  pleasure  in  stating  that  I  have 
had  most  satisfitctory  results  from  a  trial  of 
Peacock's  Bromides.  I  have  used  the  prep- ' 
aration  mostly  in  old  standing  epileptic 
cases,  and  since  doing  so  the  attacks  Imve 
been  lesa  frequent,  and  in  one  patient  have 
entirely  ifiaappeared. 

GEORGE  D.  WIIJ90N, 

L.  R.  C.  P.  4.L.  R.  C.  a 
481  Waodiworth  Road, 

Claphani^  a  W.  London. 


My  experience  with  Peacock's  Bromidbb 
leads  me  to  speak  favorably  of  the  preparik- 
tion.  I  think  the  effiet  <^  it  is  better  than 
one  gets  from  any  of  the  bromides  when 
given  singly.  I  can  thwefore  recommend  it 
in  those  cases  where  the  symptoms  of*  the 
patient  indicate  that  such  a  medicine  as 
Bromide  of  Potassium  (for  example)  should 
be  giwL  GEO.  HERRING, 

159  Cassland  Road,  L.  F.  P.  S.,  Glasg. 

Hackney,  London. 


I  beg  to  say  thai  P«A00C»*s  Bbomideb 
has  been  a  great  success ;  I,  myself,  tuflered 
from  sleeplessness,  and  after  using  the  Bro- 
mides for  two  or  three  nights  I  found  myself 
able  to  enjoy  a  quiet,  natural  sleep,  and  found 
myself  refreshed  and  vigorous  next  morning. 
I  also  used  it  in  two  cases  of  delirium  tre- 
mens, in  both  of  which  cases  it  answered 
most  satisfactorily.  I  have  since  used  it, 
and  intend  to  keep  on  using  it  when  required, 
as  I  find  no  better  preparation. 

H.  E.  EVANS,  L.  R.  C.  P.  A  L.  R.  C.  S. 

Eilkeel,  Co.  Down,  Ireland. 


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THB  MBDICAI*  WORLD. 


PHYTOLINE. 

A  POWERFUL  ANTI-FAT,  ABSOLUTELY  HARMLESS. 

Prepared  from  the  active  principle  of  the  berries  of  Phy- 
tolacca Decandra* 

Indicated  In  Obesity,  Patty  Degeneration  of  the  Heartt  Patty 


Tumors,  Rheumatism  and  allied  complaints. 
Prescribed  In  ten-drop  doses,  half  h        " " 
after  the  three  dally  meals- 


Prescribed  In  ten-drop  doses,  half  hour  before  and  one  hour 
)r  the  three  dally  meals- 
Only  advertised  to  the  Medical  Profession. 


PINEOLINE. 

FOR  SKIN  DISEASES. 


A  doUflrhtful  and  efncaclous  Ointment  prepared  from  the 
ethereal  extract  of  the  Needle  of  the  Pine  CPInus  Pumllio) 
growing  In  the  Black  Forest  of  Germany. 

Valuable  In  the  treatment  of  all  forms  of  diseases  of  the 
Skin:  Eczema»  Lichens,  Pruritus,  Scabies,  Acne,  etc. 

Plneollne  Is  applied  two  or  three  times  dally  on  linen  or  In 
any  other  desirable  way. 

A  small  sample  will  oe  sent  on  application. 
0  Dispensed  by  Druggists.   For  Literature,  address 


WALKER  PHARMACAL  CO., 


ST.  LOUIS,  MO. 


Profettional  Opiniont  on  the  Aotion  of  Phytoline. 

BEDUCED  THIRTY  POUNDS. 

The  bottle  of  Phytoline  I  prescribed  some- 
time ago  has  reduced  my  patient's  weight  thirty 
pounds.  I  am  more  than  pleased  with  it  My 
patient  suffered  with  Insomnia  before  taking  the 
Phytoline  and  sleeps  as  well  now  as  any  one 
eoidd.     The  family  of  the  patient  are  delighted . 

Oeet,  Ky.  C.  8.  Long,  M.D., 


THBEE  INCHES  IN  SIZE: 

*'  I  have  used  two  bottles  of  Phytoline  and 
have  reduced  my  weight  fifteen  pounds,  and 
three  inches  in  size  around  the  waist ;  breathe 
freely  and  can  walk  with  ease,  something  I 
haye  not  been  able  to  do  in  four  years.  I  can 
mow  walk  up  a  flight  of  stairs  without  stop- 
ping." H.  L.  Henslet,  M.D., 

Marion,  O. 


neyeb  felt  bbtteb. 

''  Not  long  since  I  ordered  a  bottle  of  Phyto- 
line, which  came  in  due  time,  and  I  put  it  to . 
work.    The  patient  Mrs.  B.  is  about  28  years  of 
age,  and  weighed  180  pounds.     She  has  lost 
during  seven  day's  treatment,  seven  poundi^  or 


a  pound  a  day,  and  never  felt  better  in  her 
lifa"  H.  H.  PoYNEER,  M.D., 

Pomeroy,  Wash. 


A  case   of   fatty  degeneration   of  ths 

HEART. 

**  I  have  two  patients  taking  Phytoline  and 
they  are  being  reduced  fiom  ten  to  twenty 
pounds  monthly.  They  are  much  pleased  with 
the  results.  One  weighed  240,  the  other  30O 
pounds.  The  latter  now  tips  the  beam  at  250. 
The  patient  had  fatty  degeneration  of  the  heart 
prior  to  taking  Phytoline ;  was  expected  to  die 
daily  from  heart  fiulure.  She  had  an  attack  of 
syncope  every  few  hours ;  would  become  unoon* 
sdous  for  an  hour  at  a  time ;  eztremitiea  cold, 
covered  with  clammy  sweat  After  the  first 
dose  of  Phytoline  she  had  no  more  attadoL  She 
has  lost  fifty  pounds  ;  is  stronger  cheerful  and 
goes  anywhere,  and  can  do  ccmsiderable  house- 
work, whereas  before,  she  was  perfectly  helpless, 
a  burden  to  her  family  and  not  expected  to  live 
from  one  day  to  another.  These  are  solid  facta 
and  can  be  fully  substantiated. 

D.  W.  Border,  M.D., 

KeameyviHe,  W.  Va. 


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THB  MBDICAI,  WORIJ). 


xvil 


FROM  214  POUKDe  TO  185. 

I  am  unng  Phytoline  on  a  ladj  who  nine 
^eekfl  ago  weighed  214  pounds ;  was  weighed 
last  wedc  and  had  lost  29  pounds,  weighing 
only  186.  She  is  much  pleaMd  with  the  medi- 
<nne,  and  will  continue  until  her  weight  is  less 
^han  160  pounds.        J.  H.  Wegksl,  BCD., 

Bieakabeen,  N.  Y.  . 


Remarks  on  Pineolint. 

m  MKVK  Aimcnom. 


OAimOT  DO  WITHOUT  IT. 

'*  I  haye  used  jour  Hneoline  in  aflfeotions  of 
the  skin  for  some  time,  and  find  it  so  e£Soaciou8 
in  eciema  that  I  cannot  do  irithout  it  A  case  of 
twenty  years'  standing  has  yielded  to  its  infln- 
'^ice  and  has  not  appeared  on  the  paitB  aflfeoted 
for  nearly  four  months.  I  now  haye  another  bad 
•caseinachild  whose  family  has  suffered  through 
fcur  generations.  It  is  a  typical  case  and  Ims 
baffled  the  skill  of  the  best  physicians.  Pineoline 
is  curing  it  W.  H.  Veatch,  M.D., 

Garthage,  His. 

A  CABB  OF  HEMOBBHOEDB. 

I  cured  a  yery  obstinate  case  of  hemorrhoids 
^th  Pineoline  a  few  weeks  ago.  The  ointment 
ivas  administered  by  means  of  Dr.  Seeley's  Beo- 
telTube,nightandmorning,  eyery  other  day  for  a 


week,  when  the  piles  had  completely  disappeared. 
It  not  only  acted  on  the  rectum  but  stimulated 
the  entire  alimentary  canal,  and  from  habitual 
constipation  the  patient  is  now  relieyed,  the  bow- 
els bemg  normal  and  regular. 

OEa  &  Pbice,  BCD. 

finest  eveb  seen. 
"I  am  prescribing  Pineoline,  and  must  say 
it  is  the  finest  preparation  I  haye  eyer  seen.'' 
Benungton,  Ind.    E.  B.  Shephbbd,  M.D., 

the  best  of  besultb. 

I  receiyed  the  package  of  Pineoline  and  haye 
giyen  it  a  thorough  trial  in  a  case  of  acne  that 
has  bothered  me  greatiy  for  a  longtime.  Afker 
the  second  application  the  benefits  were  percep- 
tible, and  it  has  giyen  me.  the  best  of  results.  I 
can  heartily  reiterate  the  Ofnnion  of  my  precep- 
tor, Dr.  A.  &  Oish,  of  Abilene,  Ean.  Shiol 
giye  the  remedy  further  use. 

Salem,  8.  D.    Ghas.  O.  Sbifebth,  M.D., 


DOES  EVEBYTHINO  EXPECTED  OF  IT. 

I  haye  used  a  great  deal  of  your  Pineoline  of 
late,  and  am  glad  to  say  with  the  greatest  satis- 
faction to  both  my  patients  and  myself.  It  fills 
the  bill  exactiy,  doing  eyerything  expected  of  it 

Chicago,  Ilk       £.  J.  Nickebson,  iLD^ 


IN  REFERENCE  TO 


A  8ULPHONIC  SALT  OF  ALUMINIUM 


ALUMNOL 


Cr  PRECIPITATES 


THE  NEW  ASTRINGENT. 


ALBUMEN  WHICH  BEOISSOLVES  IN  EXCESS 
IT  ACTS,  THEREFORE 


(  SUPERFICIALLY 


BOTH< 
SUPERFICIALLY 

AS  ASTRINGgNT  AND  ANTISEPTIC  IN 

«IHINO-LARYNQOLOQY 
«YNECOUIQY 
4IPNTHALMCUIQY 
^rrOLOSY 


AND 

DEEPLY 

DEEPLY 

AS  RESOLVENT  AND  RESGRBENT  IN 

CHRONIC  SKIN  AFFECTICNS 
INDOLENT  CALLOUS  ULCERS 
PLASTIC  EXUDATES 
LYMPHADENITIS 
EPIDIDYMITIS,  ETC. 

«TIS         ODORLESS— INNOCUOUS— UN-IRRITATING 


IPLOYED  IN 


POWDER— SOLUTION— OINTMENT 


FOR    FURTHER     INFORHATHIN    SEE    UTERATURB. 


MANUrACTURKO  SY 
FARDWERKE  VORM  MEISTER  LUCIUS  A  SRO NINO. 
HOECHST  O.  MAIN  (GERMANY.) 


SOLE  LICENSEES  FOR  U.S. 

SCHULZE-BERGE  A  KOECML 

79  MURRAY  ST..  N.Y. 

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zvm 


THB  MBDICAL  WORIJ). 


QLYCOZONE 


Both  Medal  and  Diploma 
Awarded  to  Charles  Sfarohand'g  Olycozone  by  World's  Fair  oi  Chicago,  1893,  fyr  ita 

Powerftil  Healingr  Properties, 
This  harmless  remedy  preYents  fermentation  of  food  in  the  stomach  and  it  cores  r 

DYSPEPSIA,  GASTRITIS,  ULCER  OF  THE  STOMACH,  HEART-BURN,  AND  ALL  INFECTIOUS 
DISEASES  OF  THE  ALIMENTARY  TRACT. 


HYDROZONE 


18    THB    STRONGEST   ANTISEPTIC    KNOWN. 

One  ounce  of  tliis  new  JSemedy  is,  for  its  Bactericide  Power,  equivalent  to  two  < 
of  Charles  Marchand's  Peroxide  of  Hydrogen  (medicinal),  which  obtains  the  HlA^st 
Award  at  the  World's  Fair  of  Chicago,  1893,  for  Stability,  Strength,  Purity 
Excellency.  cures  all  diseases  caused  by  oeiums. 

Statf  for  U—  t62»ptgo  book  giving  tall  Infomurtlon  wRh  tndofoomtntt  of  Modlng  phytlclant. 
f  liyticiaiis  romitling  oxproM  chargot  will  rocolvo  froo  tamplot. 


GIjTCOZONK  io  pat  mp  •mtj  !■  4««s.,  8-«s. 

VtmtMM  *^    r«ll«w  label, 

«rkil«  aa4  Mack  letten,  rMTaa^  Ma«  k«r4ar. 


aad    141-^a.  k«ttl«b. 


PSBPAKBO  ONLY  BY 


witii  filsaatavtt. 

HTDBOZOm  U  pat  ap  aalf  ia  oauiH. 
aMdlaaa  aa4  llftirge  »tee  b#ttleaL  Wariaa  a  r«4 
label,  wkiia  letten,  saM  aa4  blae  barker. 

17"  Mendoa  this  publicadoo.  Chemist  and  GrmdnmU  o/tJU  **Beok  CenirmU  tiesArUet  Manti/kcturgs  «U  Pmria 

t.«».J?'.°;^..«T«  Charles  Marchand 


C-^ 


28Friiioe8t,N«wTork. 


WHY 
TAKE 
CHANCES 

In  MiNting  Mttric  GniniilM  7  Thos<  prtparad  by  ut  hiv« 
b«m  tried  u4  pnmranced  absohtely  perfect   They  are 

Accurate.     Soluble.     Pemnaent. 

THEN 

WHY 

NOT 

Sond  US  a  trial  order?  Wo  guarantee  Mtitfactioa  or  re- 
Iliad  the  monoye  To  introdace  them  we  offer  the  following 
seasonable  assortment,  one  hundred  of  each. 

Anti-CoaetlpatloR  .12  Bronchial    .25 

Cough  .20  Coryza      .20 

Rheumatism         .25  Tonsilitis    .20 


Heart  Tonic 
Pertussis 


.15 
.12 


.25  Digitalln 

.20  Acooitlne 

Cystitis    .30 
The  regular  price  is  $2.24|  we  will  send  them  for  $1.00  cuh  with 
order. 


We  aro  ploMod  to  send  complete  Price  List  and  Samples  on  request, 
if  this  Journal  is  mentioned. 


Detroit  Metric  Qranule  Co., 

IWTR0IT*  MICH. 


Look  Here  I 
Doctor. 

1000  Note  HeBdB<6|z8i)Good  WUte  Paper,  f  3.00 
1000    *<  ««        «'     Cream  Linen    ^       8.75 

1000  Letter  **  (8zl0|)Good  White  "  4.00 
lUOO  «'  *'  **  OTeam  Linen  «  a75 
1000  EnTelope8,8iieKo.  6  xz  White  «  8.00 
1000  «*  ««         **    zx  Linen    "        3.89 

Pres.   BnTelopes   (8|z2|)  White  or  Ae- 

•orted  Colors.    Printed  any  desiarn  on 

one  side,  500— $1J»;  1000— &  00;  §000— $5.00 
1000  BUI  Heads,  (Special  Form  for  Phyei- 

oians) 2,75 

1000  Pres.  Blanks,  (S|z5i)   Good  Linen 

Paper 1.25 

1000  Powder  Papers,  (2|z8|)   25o.     5000 

for  $1.00. 
Bed  Pill  Boxes,  (4  sises  nested)  1  gross,  36 

eachsise  JBO 

Slide  Powder    Boxes,  Xo.  47,  2|  x  1|  x  | 

Per  Gross 75 

Slide  Powder  Boxes,  No.  48,  2^  x  li  x  i 

Per  Gross 90 

Slide  Powder   Boxes,  No.  48,  2]  x  1}  x  t 

Per  Gross IXXS 

N  OTK^When  oaah  aooompanies  order  we  pa j 
tzansportatlon  chaiges. 

,WM.  KOEiLt  CO.,  101H9  Peieh  SL,  Erie,  PL, 


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xiz 


CONTENTS. 


XnnouAt :  paob 

The  Typhoid  SUte «. AH 

Aoomac  J  Id  Dlieate  Nomenolatoie  429 
HydiopbobU  in  Alabama 429 

OBioniAL  ComcuincATxoNs : 

Aifectloni  of  the  Breat— RepUes 
to  Isaxiiilet.— Atrophj   of  the 

Pente  ?., 480 

Bangen  In  Milk  and  Its  Prodnots...  4S2 
CnlTenlty  of  Pennsylvania  Notes.  484 
Beplies  to  Some  NoTember  Queries  484 
•Gold  Water  Treatment  of  tfcarlet 

Fever.....««.„ ^... 435 

Death  from  SwallowiDg  a  Pleoe 
of  Glan  which  Lodged  in  the 

BMy|diagns............M «•»•  485 

Typhoid  I'erer ^ ^. ^.....  486 

Permanganate  of  Potissliim  Again 
as  an  antidote  to  Morphine.........  436 

iPnenmonia  and  its  Treatment— 

B%pld  RcooretT «..« 486 

Salol  Ts  Solpho-Carbolate  of  Zinc 
as  an  Intestinal  Antiseptic  in  En- 
teric FeTer...MMM....«»~.«.....M...»...  487 
-Conflimation  ot  Remedies.— Treat- 
ment of  Scarlet  Pever.......... 488 

Abase  of  Clothing.......^ 4ii8 

Intestinal  Obstraction.— Diet  in  In- 
testinal Diseases 489 

Teething.. 440 

Antisepsis  and  Poerpersl  Fever......  442 

Some  uses  forHyosoyamlne.....^.  442 

Heredltar/  Malformation.— A  Osse 

of  Atavftm. .. —  448 

JL  Osse  oTPost  Paitmn  Bdamrda..  448 
An  InterestfogCaseof  Bydratllbim 

Degenemtira  of  the  Chorion. 444 

of  the  Abdominal 


Aorta  in  Post-Partum  Hemor- 
rhage.—A  Safe  and  Ever  Ready 
Remedy 


444 
444 
445 
445 


ay 

Cord  the  Limbs  for  Hemorrhage.. ... 

Post-Partum  Hemorrhage 

Poet-Partnoi  Heanorrhaie....... 

Alkaloidal  Notes.  — Hemorrhage 
and  Oollapse  fh>m  Mlsoarrage.— 

Treatment. ., «..  446 

Give  Complete  Titles  to  Toor  Ar- 
ticles  ...» 446 

B'vyoott  Again... .....^  447 

Treatment  of  Paralysis  Agltank......  447 

A  Osse  of  Appendicitis  Cured  by 

Medical  Treatment 447 

The  Reason  Why  Peroxide  of  Hy- 
drogen Frequently  Bzplodrs.— 
Poisoned  Beef  as  a  Cause  of  Dr. 

Koon*8  Cases .^^.,  448 

Credentials  fior  Practice.— The  Im- 
portance of  the  Money  Question 

to  Physidan^.....^....; „«„  448 

Replies  to  November  Queries.........  449 

Other  Uses  of  the  Finger  Bandige..  449 
Correction .«...  449 

QunDBpjLBTMXzrr : 

ACaaeforDiagnodP 450 

To  Cause  Conception— Query  ......^.  452 

Formulas  Requested 452 

Correction  »..m— ^.....<^.......  458 

Diagnosis  Wanted...^..^ 458 

CuamaiT  Mbdical  Thouost  : 

Calcium  Chloride  for  Pneomooia...  454 
Apomorphine  for  Aspliyzia.-Abort 
ive  Treetment  for  Pneumonia.....  464 

Treatment  of  Aonte  Bronchitis 454 

Treatment  of  Tuberculosis  by  Suc- 
cinic Aold 454 


Points  to  be  Remembered  in  Rectal 

Surgery ., 466 

Treatment  f>r  Osteomalacia 456 

A  Promising  Treatment  for  Con- 
sumption   466 

Bisulphate  of  Sodiu  ca.  in  Acute  Ca- 
tarrhal Diseases. 466 

The  Surgery  of  the  QaU-Bladder  and 
BUel^cta  with  Brief  Notes  of 

Seventy-Bight  Cases 456 

Codeia  in  Diabetes  Mellitis ...  456 

MorbidConditiottsof  the  Heart  and 

How  to  Treat  Them 457 

Treatment  of  Crushing  Iqiuries  of 

the  Bxtrtmltiee. ..................  457 

Treatment  of  Varlz 4W 

ImmedSatf  Cure  of  Corneal  Ulcer...  457 
Special  Advantages  of  Acetanilid  in 
Surgery ..468 

FoufULAs: 

For  Toothache.  —  For  Bnmcfalal 
Colds.-ParFetidBreath  -Koch's 
Treatment  fbr  Erysipelas.— Gen- 
eral Debility.-SmoUimt  Oint- 
ment in  Measles  and  Boarlatina. 
—In  Sexual  Impotence  oTWomeo. 
—For  Pulmonary  Tuberculosis.- 
Pneumonia  Miztnre.— Acute  In- 
flammatcwy  Rheomatism.— Oold 
Powd«ir.-P^  MiM  Coqjunctivitls. 
—For  Conjunctival  Hyperemia.— 
For  Sobacnte  Oof]|jnnctivltis.— 
For  Biople  Blepharitis.  —  For 
AmenoRBea— For  FalnM  Fha- 
yngitis.— For  Pfeorlasls 466, 46a 

RlVmWl. r,tr,^r^M,tn;„M„„.^„    460 

Wr  ahd  Wbdom .....................  460 


Nuciein  Solution 

FROM   YEAST. 

Prepared  According  to  the  Formula  of 

iZiCTOR  C.  Vkughkn.  M.D.,  Ph.D.; 

Profe$$or  of  Hygiene  in  the  Univereity  of  Michigan. 


Naclein  is  a  non  poisonous  germicide,  found  in  various  v^j^etable  and  animal  cells,  also  in  blood- 
senim,  the  bactericidal  properties  of  which  are  dae  to  this  constitaent.  It  increases  the  namber  of 
white  blood-corpuscles  and  stimulates  the  activity  of  those  organs  whose  functions  it  is  to  protect  the 
body  against  infections  diseases.  It  has  been  used  with  benefit  in  indolent  oloers,  membranous  tonsillitis, 
ikrepCoooeoas  diphtheria,  and  in  initicd  cases  of  tnberoalosis. 

Dose— 20  to  60  minims  hjpodermaticallj. 

WBm  FOB  BBPUMT8  OF  PAPBB8  BT 

PROF.  VICTOR  0.  VAU6HAN/II.D.,  Pb.D.,  and  CHARLES  T.  McCUNTOCK,  Ph,  0. 

PARKE,  DAVIS  iL  COMPANY, 


DETROIT,         -         NEW  YORK,         -         KANSAS  CITY, 
LONDON,  ENG.,  and  WALKERVILLE,  ONT. 


U.S.A. 


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SEASONABLE    SUGGESTIONS. 

With  the  opeoing  of  the  winter  season,  and  its  attendant  bronchial  and  pulmonary  troubles,  we  are 
having  from  manj  sections,  reports  of  a  recorrenoe  of  the  La  Grippe  epidemic  which  for  the  past  six  or 
seven  years  has  afflicted  the  country. 

This  fact  makes  particularly  pertinent  a  recalling  of  Uie  salient  points  of  Dr.  V.  W.  Gayle*» 
paper  first  published  in  the  Medical  World  in  the  midst  of  La  Grippe's  most  malignant  visit  It  will 
be  well  to  note  closely  his  recommendations  and  experience  in  connection  with  the  recurrence  of  the 
epidemic  which  is  now  apparently  upon  us.  He  says:  *'This  disease  by  proper  treatment  of  an  attack, 
can  be  so  modified  as  to  be  almost  aborted.  If  not  properly  managed,  influenza  is  particularly  liable  vo 
grave  complications,  even  in  mild  cases  the  tendency  is  towards  prostration,  and  often  the  nervous  shock 
is  such  as  to  materially  debilitate  the  patient.  Where  there  is  much  angina  with  acute  bronchial  irrita- 
Iton,  the  following  is  indicated : 

K     Ammon.  Ghloridi •   •   •   •  5  ij 

Potassii  Chloras 3  j 

Tinct  Ferri  Ghloridi 5  ij 

Syr.  Simplex 3  'j 

Aqu« q.  8.  ft  5  !▼ 

M.  Sig. — ^Teaspoonful  in  sweetened  water  every  four  hours,  also  apply 
to  the  throat  with  probang  every  three  hours. 

Quinine  is  the  best  germ  destroyer  we  have  for  the  microbe  of  influenza.  During  the  reoeot  epi- 
4iemic  I  aborted  quite  a  number  of  cases  with  antikamnia  and  quinine  in  combination ;  also  with  antikanmiai. 
and  salol.  The  relief  obtained  by  the  administration  of  antikamnia  alone,  where  the  cephalalgia  was  severe 
as  in  the  minority  of  my  oases,  was  wonderfuL  When  the  pain  seemed  almost  intolerable  I  have  seen  % 
ten  grain  doee  banish  it 

Mustard  pediiavia  are  oi  great  advantage,  and  a  plaster  of  mustard  and  Lard,  one  part  of  the  fersier 
te  two  of  the  latter,  applied  directly  to  the  chest,  answered  admirably  as  a  mild  counter-irritant 

Expectorants  are  often  needed  and  antikamnia  should  be  administered  with  them,  thus : 

B     Antikamnia  (Genuine) 5  j 

Syr.  Senega |  j  ^ 

Vini  Ipecac 3  iij 

Syr.  Tolntan q.  s.  ft  g  iv 

Mix  and  let  stand  until  efierveecence  ceases. 

Sig. — Teaspoonfnl  every  two  hours. 

The  mild  chloride  of  mercury  in  minimum  doses  often  repeated  will  be  beneficial.  The  following 
preieription  is  a  favorite  of  mine: 

R     Hydrarg.Chlo.Mit gr.  j 

Sodii  Bicarb scrap  e  i 

Lactopeptine  (Gtouine) 3  as 

M.  ft  Chart  No.  X. 

Sig, — One  every  hour  until  all  are  taken,  followed  by  a  full  dose  of  hunyadi  janos  water." 

*'Antikamnia  and  Quinine  Tablets,"  containing  2J  grains  each  of  antikamnia  and  quinine,  also 
''Antikamnia  and  Salol  Tablets,"  containing  2}  grains  each  of  antikamnia  and  salol,  offer  the  best  vehicle 
for  exhibiting  theee  combinations,  giving  one  every  two  or  three  hours. 

Gkiyle  concludes  his  paper  as  follows :  *'  What  is  mostly  needed  is  an  antithermic  analgesic  to 
relieve  the  pain  and  reduce  the  fever.  These  properties  are  found  in  antikamnia.  This  with  the  genn 
destroyer  quinine  is  all  that  I  really  needed  in  the  treatment  of  this  disease.  I  advocate  the  use  of 
stimulants  in  nearly  every  case.  They  are  frequently  needed  in  the  onset  of  the  disease.  Sprays  of  carbolic 
add,  turpentine  or  resorcin  are  frequently  efficacious  in  >the  laryngeal  troubles.  The  diet  should  be  light 
and  easily  digestible.  By  careful  attention  and^'avoidance  of  exposure,  together  with  the  line  of  txeatment 
mapped  out,  the  vast  migority  of  cases  will  recover.  Of  course,  there  are  occasional  cases  which  pneent 
symptoms  which  require  other  remedial  agents,  but  these  of  necessity  must  be  left  to  the  discretion  of  the 
medical  attendant 


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zxi 


Noyes*  Dyspepsia  Tablets 


he  obtained  from  any  of  the 
flmi5  mentioned  below: . 


Ck>ok,  ETereit  &  PeDnell,  Portland,  Me. 
G^rge  O.  Goodwin  &  Co.,  Boston,  Mass. 
O.  N.  Orittenton,  Kew  York  City. 
Arthur  Peter  &  Co.,  LoaiiTiUe,  Kj. 
MoOlnre,  Walker  &  Gibson,  Albany,  N.  Y. 
Mansfield  Dmg  Co.,  Memphis,  Tenn. 
John' J.  Thomson's  Sons,  Baltimore,  Md. 
Strong,  Cobb  &  Go.,  Cleveland,  O. 
Mejer  Bros.  Drug  Co.,  St.  Louis,  Mo. 
Gwen  &  Minor  Drug  Go.,  Richmond,  Ya. 
Blanding  &  Blanding,  Proyldenoe,  B.  I. 
Lamar  &  Bankin  Drug  Co.,  Atlanta,  Ga. 
L  L,  Lyons  &  Co.,  New  Orleans,  La. 
Geo.  A.  Kelly  &  Ck>.,  Pittsburg,  Pa. 
8mlth,Kline  &  French  Go.,  Philadelphia,Pa 
Williams,DaTis,Brooks  &  Co.,  Detroit,Mich 
Fuller  &  Fuller  Co.,  Chicago,  111. 
Berry,  DemoTille  &  Co.,  Kashyille,  Tenn 

Mannfactured  ty 

The  P.  J.  NOYES  n'F'Q  CO., 

Of  Lancaster,  N.  H. 


DOCTOR 

your  Dyspeptic  patients  will 

BLESS  YOU 

if  you  will  afford  them  instant  relief 
by  prescribing  NOYES* 

Dyspepsia 

Tablets. 


We  have  Banufactared  these  Tablets  for 
Physicians  for  the  pest  20  years,  aad  are  aew 
probably  prescribed  by  neariy  every  physldaa 
In  New  Bngland. 

We  will  send  yea  fonaala  and  a  LARQB 
BOX  of  these  TableU  FREE  If  yea  wlU 
send  u*  year  aame  and  address  ea  a  postal  card. 

THE  P.  J.  NOYES  MF'Q  CO.,    , 
ChemistSt  Lancaster,  N.  H. 


The  Doctors'  Automatic  Driving  Lamp. 

MANUFACTURED  BY 

S.  L.  REEFY,  m.D.p  EMib«nh  ll>f  U.  S.  A. 


A  dark  night  trip  made  as  safe  and  pleasant  as  a  day  light 
Toyage. 


#tniMnto»o<iooosoiissooisnioistonosoosoionoso>miimo<mtMiHoimoi<o>iMimnNi'iH> 


VERY  PHYSICIAN  KNOWS  thb^ 


MERITS  OP  ^    BEST    • 

I  McARTHUR'S  syrup  preparation  f 

HYP0PH0SPHITE5 

:  EFFICIENT  and  RELIABLE 


IN  BLBOANCB  AND 
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(UnB  A  SODA)      COMP. 

IN  THNOAT  AND  LUNQ  ArFKCTIONB 

AND  QKNKNAL  DKBILITV. 


0    ; 


Funphlet  on  the  tuM  and  eflboli  of  (IM 
HypopboiphttM  lent  bee. 

KaMRTHUR  HYPOPHOSPHITE  CO.,  BOSTOM. 


CHEMICALLY 
PURE. 


13  OX.  for 
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»»<♦»»>»«♦<  >M  in  III  m»<iMiiii»MiiiMniiMiiiiii«M<MMiiiMiiiinmiMinmiiiinmii 


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[xu  THB  MBDICAI«  WORU>. 


Uervous  Exhaustion. 

HORSFORD'S  ACID   PHOSPHATE 

Recommended  as  a  restorative  in  all  cases  where  the  nervous  system  has 
been  reduced  below  the  normal  standard,  by  overwork,  as  found  in  brain-workeiSi 
professional  men,  teachers,  students,  etc. ;  in  debility  from  seminal  losses,  dyspepsia 
cf  nervous  origin,  insomnia  where  the  nervous  system  suffers. 

It  is  readily  assimilated  and  promotes  digestion. 

Dr.  Edwin  F.  Vose,  Portland,  Me.,  says:  "I  have  prescribed  it  tot 
many  of  the  various  forms  of  nervous  debility,  and  it  has  never  £sdled  to  do  good.'* 


Send  for  desoripCiTm  circakr.    Pbjruoimiis  who  wish  to  test  it  will  be  foiniihed,  upon  ^iplioitka,  wUk 
m  9fcri^i  bj  nudl,  or  a  fall  siie  bottle  witboat  expense,  except  express  obarges. 

Prepared  aooording  to  the  directions  of  Prot  E.  N.  Horsford,  by  the 

RUHFORD  CHEHICAL  WORKS, 
MMtTMS  OF  mmSTITOTEB  MMO  MtTJITWMS. 


HORUCICS  MALTED  MILK 

IS  PURE  NOURISHMENT. 

In  Horlick's  MALTED  MILK  the  physician  will  find  a  pleasant  and 
healthfhl  diet  for  his  infant  patients  ^  a  food  which  contains  all  the  nutritive 
elements  in  pure,  fresh,  sterilized  milk  and  malted  grain,  but  is  free  from 
starch,  cane  sugar,  or  other  indigestible  or  harmful  ingredients.  Its  form 
is  a  dry,  white  powder,  soluble  in  water  and  requiring  no  cooking  or  addi- 
tion of  milk  to  prepare  it  for  use.  Malted  Milk  will  not  curdle  in  the 
stomach  like  raw  milk  because  the  milk  it  contains  is  peptonized  by  a  nat- 
ural vegetable  ferment  plant  pepsin^  developed  from  the  grain  by  our 
special  process  of  malting,  originated  and  used  only  by  us. 

Kindly  consider  these  advantages*  We  invite  comparison  and  will 
gladly  send  you  liberal  samples  for  trial  free  of  expense  to  you. 

Horlick's    Food  Co., 

London,  Ensr.  Racine,  Wis. 


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XZIU 


'Mn  ■•dlclna  qualitas  prima  Brawls  est.'' 

Galenical    Preparations 

PREPARED    BY 

WILLIAn  R.  WARNER  <  CO., 

Standard    Remedies    ffer    Physicians    Oiily. 


WILLIAM   R.  WARNER  &  CO/S 

ORIGINAL 
For  Maklag  Udila  water  af  daflaHa  straagth. 

Diuretic  and  Antacid;   for   Gout,   Rheunnatismp  Gravels 
Stone  in  the  Bladder,  Bright's  Disease^  Etc. 


PIL.  SUMBUL  COMP.(w.<ioo.) 

(Dr.  Ooodell.) 

R  ~Bxt  BambiiL....^^.l  gr.      Fenl  Balph.  Sza............!  gr. 

AMfiBtMa.  ,..,...*,^,'2  gn.      Ao.  Anniitoii8............a-40  gr. 

*'I  me  this  pill  for  nflrvoos  ind  hyitaiiCAl  women  wbo 
need  bqikllxig  up."  This  pill  is  usea  witb  sdyantage  in  nea- 
1— thento  oondloons  in  oox^anctioo  with  Wan&n  A  Oo.'s 
Biomo  Soda,  one  or  two  pUla  t«ken  three  times  s  day. 


PIL:  DiOBSTlVA.  (wabiibbaoo.> 

A  VALUABLE  AID  TO  DiaBSTION. 

R-l^piin  Gone'...... 1  gr. 

^    Puif.NuxVom,....J<gr. 

Tldsoomhinfttianisveryiiseftain  reUeflng  TultaftftaBi 
a  DyipeiiBl*  and  Indigestion,  end  will  afltod  penumeni  ben- 
efit in  oases  of  enfoebled  digentiofn,  where  the  gastile  Joloei 
ai!^  not  prop^ly  Bporeted' 


Bolphnr. 
rnseftain  reUefing 


...1-li  gr. 


PIL:  LADY  WEBST&R.(w.aco.) 


R—PiiiT.Alses. 
PolT.MMtich 


....M..2  glB. 

.......Jftr. 


PnlTi  Beee  Leases. — ^H  gr , 
n^FU  one  pill. 


LadT  Weteter  Dinner  Pnis.  IliisisanezoeUentoomUna* 
tm  oiloially  designated  as  Aloes  and  Msstioh,  U.  &  P.  We 
take  yevy  great  messiire  in  ssking  physioians  to  preseilbe 
ttMm  more  UbetauT.  ss  they  are  very  excellent  as  an  aperleiit 
1  of  toll  habit  or  gouty  tendency  when  given  in 


PIL.  CASCARA  CATHARtICjCw.*oo.) 

Baoh  conts4ninr*  OMoazin,  }i  gz.  Sict  Belladop»  W  gr. 
Aloin,^gr.  Strychnin. l^Bp  gr.  ?oacphyllln,  1-6  gr.OQgSr* 
ii^Ksr.   Dose— 1  to 8  puis. 

ThiM  pill  aflbrds  a  brisk  and  eesjr  cathartic  effldent  In  ac- 


tion and  nsoally  not  attended  ' 


unpleasant  pains  In  tin 


doees  of  one  pill  after  dinner. 


bowela  It  acts  mUdly  upon  the  llyer  (Pwlephyllln).  tagWMM 
perlstalBis  (Belladonna),  while  the  carminaoye  elMt  of  the 
Gingerine  aids  in  pioduoing  the  desired  result  Pricey  60o. 


PIL:  CHALYBEATE,  (w.  a  00.) 

Proto.  Ctait.  of  Iron,  8  gndns. 

Dose  1  to  8  Pills. 

(WM.  R.  WARNER  A  CO. '8  PERRIKUNOUS  PILLS-) 

I Fenri  Carb.  Pe  00« 

/ Potaak  Sulph.  K.  SO* 


Ferrl  Sulph.  Fe  SO* 
~  -     .Oarb..K«00« 


PIL;  ANTISEPTIC  COMP.(w.aoo.> 

Saob  iM^^  fwntftfuit 

Sulphite  Soda ...........1  gr.      Powd  CapsJonin  .....JLIO  gr. 

Salfioyllo  Add 1  gr.      Oonoentrated  PeMln».„.l  gr. 

Bxt  Kuz  Vom. ^  gr.  Dose  1  to  8  JPfllii 


in 


PiL  Antlseptio  Oomp.  is  preecribed  with  great  advantsgee 
of  Dyspepsls,  Indigestion  and  Mslswlinllstlon  of  lbod> 


PIL.  CHALYBEATE  COMP.(w.aco.) 


Same  as  Pil.  CSialybeate,  with 
added  to  each  pill  toincresse  the 


Szt  Nux  Vomica 
efRMSt. 


Dose,!  to  8  Pills. 


PIL:  ALOIN,  BELLADONNA  AND 

STRYCHNINE.  (wiJunBaoo.) 

R— Aloln ...1-6  gr.      Bxt  Belladonna.. .........^g  gx. 

^    Stiychnlne i^gr.  Dose,  1  to  3  PHlg.     *^ 

Medieal  propertiea—  Tonic,  LsaatiTe. 
Try  this  piU  in  Habitual  Oonstipatlon. 


S^erior  to  Peptin  of  the  Hog.   A  powder  prescribed  In  the  same  manner,  dose  and  combinations  as  Ptpsin  with  better  retsltt. 

in  fitoses  of  lO  to  20  grains. 


Digitized  by 


Google 


XXIY 


THE  MEDICAL  WORLD. 


Is  the  profession  poor  f  Have  you  difficulty 
in  collecting  ?  If  so,  why  f  Is  it  on  account 
of  the  financial  inability  of  your  people ^  or 
your  own  deficient  business  methods  f  If  the 
latter,  have  you  studied  **  TJie  Physician  as  a 
Business  Man  "  {pjfered  this  month  at  whole- 
sale  price — js  cents — in  connection  with  your 
subscription  to  WORLD  for  18^5). 

If  it  is  because  your  people  are  unable  to 

pay,  why  are  they  so  f  Let  us  have  a   *  *  class 

meeting  "  upon  this  question.     If  necessary 

we  will  open  for  a  while  a  special  department 

in  these  pages  upon  this  subject^  and  it  can 

be  made  the  most  profitable  of  our  depart" 

ments.      We  wish  to  do  what  we  can  for  the 
{(XmtlnueA  <m  next  leaf.) 

PLEASE  SEND  ORDER  ON  THIS  BLANK. 


$2.02 

SAVED  TO  YOU. 


In  these  times  jon  wish  jonr  dollars  to  go  m  fiff  m 
possible.  /  We  have  Just  arranged  with  the  mannfto- 
torers  to  offer  yon  as  follows: 

A  handsome  24  vial  medicine  case  filled  with  th» 
most  practical  granules  as  follows: 


1  Aeonitine. 

2  AnenSoosadd. 
8  Atraplne  ralph. 

4  Bradne. 

5  Oalemel. 

6  Cloatlne  (from  oonivm). 


8  Oolohidne. 

9  Copper  Anenlte. 
10  Digitaline. 

U  XmeCine. 

13  Qlonoin  (Nitio^lroetine). 


18  Hjotoymmlne. 
UMereniylilniodldek 
16  Morphia  solph. 

16  PodophyUin. 

17  Strych.  enenlatet. 

18  StrydlL  solph. 

19  Tutar  emetic. 
20Veiatilne. 

21  Zlno  snlpbo^arbolalBL 

22  Trinity  (for  ftorreo). 

28  Anodyne  (for  Infoali). 
24  Anttoonstlpatlon. 


^^.^..^^^.....^^..n.^^'^  This  case,  withylals,  etc  complete,  filled  as 

«HBMBDICAI.W««|W,i^CtaM»atSl...l.  '^iXIS^Sf^^;^^^^:^^^^^^^^ 

ywiadipiiUi»  Fa.  from  %y^  mannfoctaren. 

a»M»T.«^y  y iKiM^ina^  find  th«  iiim  of        ^®  Mbdioai.  Would  for  one  year IM 

^.„   -,  DoUan,  Total.  SSJtt 

Aw  wIiIaIi  -^ Mid  mA  "Wo  wttl  send  all  for  only  $8.00  making  a  saTiag  tm 

S»  lumHfTar    i»oDr  ri  A«.  .a^                 a.  ^  to  yon  of  $2.03.    We  cannot  Tarj  abore  list.    It  If  the 

Sf  *^i?^?^?SJ5^/"  x»«5   .  .  .  .Si-oo  awit  practical  all  aronnd  lilt  that  can  be  ohoeea.  and 

MDder  for  the  Medical  Wofld, 35  if  TMtetion  were  pennitted  the  ftill  price  woiOdliaTe 

Or  Thiee  Binders  for i.oo  to  be  asked.    These  grannies  are  guaranteed  ia  every 

AwliDrpQnohingWoBLDsi9rBlnder6oti,ea(ii,or  FBO  possible  way  to  be  exactly  as  represented.    If  yea 

^.         .^.   ...  witiittireeblndsa.  have  noTor  used  granules  of  the  actiTeprlnciplee»eead 

Chanof  SkfaiDiaeaaea* 50  for  this  case,  and  you  will  soon  bless  the  dajj^  70a 

Ito  Pfajtidan  as  a  BaaiiieM  if  an« 1.00  began  their  use,  and  so  will  your  patients.    wetUak 

1  of  Tieatment  by  Active  Mndplss  and  8ome  dosimetrists  go  to  an  extreme,  and  are  a  little 

Mew  Remediea                                           1.00  Tisionary  about  the  action  of  some  jgraanlea,  as  fsr 

.  %MmA\^^\^a^MirM^^  f  1^  'imLm  'wlvC»\  •  "-^  oxample.  citrate  of  caffein,  1-«T  gr.    In  the  abere  Hat 

*  ■■•TSi  ilSl/^SLzf  ^       ^••^t)  1.5a  ^e  have  been  carefW  to  Include  only  such  drugs  ae 

llM^^t^tmm^jm  comi^, i.oo  are  in  constant  use  by  every  phyiidan  and  ia  such 

of  Monthly  Balances,  as  per  nodes  quantities  as  are  of  positiTe  value.    So  tlds  does  not 

below, ts  mean  a  change  in  method  of  practice;  but  an  inereaee 

.......  in  convenience,  economy  and  accuracy  of  practice. 

XoiaL  ^^  ^  ^^«  ^^^"^  opportunity  that  has  ever  occurred  te 

^^^ enable  you  to  begin  their  use.    Literature  will  ae- 

company  case.  If  your  subscription  is  already  paid 
for  the  coming  year  we  will  credit  you  with  aaother. 
Send  8  cents  registration  foe  if  you  wish  safo  delivery 

AdHrras. „.„.,. , ............„.„,„.„,  of  case  guaranteed. 

In  connection  with  above  we  will  nj  that  we  par- 

1-..^                   .^    .^           «...•           „,^  chased  a  liberal  supply  of  Dr.  Wangh^  "  Manual  of 

........f  ..^.....w......     «..     •••••-•  •      •"•    "        "          •  Treatment  by  Active  Frindples  and  iTew  Bemediee,'' 

B^  ^^^i^S!!i[SSiS£l?2Sii^2n"^  at  a  low  cash  price.    We  felUhat  this  in  vestment  wi^ 

S?!lTyjJgl°S.gSS?*""  "*  "*"*^  ■""  ^  P0*««08  8nfe  for  the  demand  for  Dr.  Waugh's  books  is  always 

isnas mSo^teMlstiatkm  of  e^ih  artlde  (except  S^^.  ^® ^^^ ^^® ^^^ ^^ ^^'^Sl^ ^' ^^^^ ??^ 

jll^^SjSLl^S\^m^^SiS^  ""^  ^""^  Soned  advantageous  purchase.    The  regular  whele- 

Thb  M«mnAT.  WOBLD  Visitlnff  lift  oonistBcIa  sale  price  is  75  cents  each,  and  retaU  price 9LO0.    We 

hsadwmelestherosaeaodtweiveiemoTaUese^^  canoffsrt^mTOOumsc^^ 

Wenowtopiehoornew  sections  for  lii^;  tWy  sn  ^£2rNW,55rtWso«brwillnotbe  continued  after 

iMHOved  over  oar  former  ones  inseveialdeta^^  the  present  iupply  is  exhausted.    Remember  it  Is  aa 

as  luger  naee  for  credits,  etc    But  we  still  have  no  elegantly  bound  book  of  9i7  pages. 

Lsdgers  cfMontfJy  Bslimces  except  ihoss  dated  188.  .  Many  were  di»appointed  in  not  getting  the  "Of- 

totesd  of  189 .  •  To  dose  ool  these  Ledgeis  (which  are  f^£^l  Formula)  of ^Americui  Hospitals*  ^^^  'P^?*^ 

psrfootly  good  except  for  the  triflingjuSrence  in  date)  "*  "  " 
and  to  get  yon  started  with  oar  Bvstem  of  book-keM^ng, 
IPS  wflf  giTO  a  Ledger  /^  to  aU  who  order  the  Yisit- 
Ing list  ssabove.  If  bought  separately  the  Ledger 
ml  cost  26  cents.  The  xegolarprice  is  60  cents,  bat 
am  aoooont  of  the  trifling  diflnrsnoe  ia  date  we  are 
«Ding  them  at  half  price. 


offering  last  month,  as  our  supply  was  soon  exhaustedt 
and  orders  are  still  coming.  i>ont  miss  the  above  by 
being  too  late. 

The  Medical  World, 

WM  OhMtnot  St., 


Digitized  by 


Qoo^^ 


THB  MEDICAL  WORLD. 


XXV. 


FRELICH'S  TABLETS 

(COUGH  AND  CONSTITUENT) 


WGR  THB 


[jPBEYENTION  AND  CURE  OF  PULMONARY  PHTHISIS^ 


FORHnXI^JBt 


COUGH  TABLETS. 


Each  Tablet  Gortaihs: 

Morph.  Solph.  (^  gr.)»  Atropue 
Solph.  (jJv  «r.),  Codeia  (^  gr.), 
Antimony  Tftrt.  (^  gr.),  Ipecac, 
Aconite^  Palniilla,  Dalcamara,  Oauf- 
ticnm.  Graphite,  Bhos-tox.,  and 
LachwiB,  fractionallj  so  arranged  as 
to  aooomplith  erery  indication  in  anj 
form  of  cough. 


COISTITUEIT  TABLETS. 


Each  Tablet  Oontaims: 

Arsenicum  (^  gr.),  Precipitate 
Oarb.  of  Iron,  Phos.  Lime,  Garb. 
Lime,  Silica,  and  the  other  ultimate 
constituents,  according  to  physiologi- 
cal chemistry  (normally),  in  the  hu- 
man organism,  together  with  Caraocas 
Cocoa  and  Sugar. 


PRIOE,  THREE  DOLLARS  PEk  DOUBLE  BOX. 


i 


letent  Tablets  of  eaeh 


kind  to  last  from  One  to  Threo  Months,  aooordlni^  to 

ofthoFattoBt.  \ 

•A  OnMieetioot  Physician  writes : — "  I  am  now  nsing  your  Tablets  on  a  patient  (yonog  lady)  who  had  three  qahti 
MT«re  hemorrhaaies  the  week  preyious  to  the  beginning  of  the  same.     She  has  taken  one  box  only.  hasbiJ. 
■a  letnm  of  l^e  hemorrhage,  and  has  gained  four  (4)  pounds  since  b^inninff  treatment,  besides  all  latfonaL 
symptoms  have  improved  wonderfully.    I  will  add  tnat  I  had  tried  OL  Morrh.,  Syr.  Hypophoe.  Ooc,  t/to^ 
4        wUh  no  apparent  ben^t"  Y 

\A  Tiiginia  Physician  writes  >-**  Enclosed  find  Postal  Note  for  another  double  box  Fbxlxoh's  TkUets^  Insad* 
tlie  sample  box  in  three  cases,  with  decided  benefit  in  one,  slight  improvement  in  second,  and  while  they 
M  not  unproTe  the  third  case,  it  being  in  Teiy  advanced  stage,  there  was  an  amelioration  of  the  distnssii^ 
symptoms.'' 

▲  MMMchnsetts  Physician,  in  practice  twenty-five  years,  writes:— "Send  me  two  double  boxes  Fbbu0hH^ 

Tablets.    I  have  tried  the  sample  box  with  most  exdellent  results." 

▲  MUbigan  Physician  writes.*—"  I  am  more  than  pleased  with  them.    They  have  not  disappointed  me  onoe/ 

Br.  &,  for  whom  I  ordered  a  box,  writes  me  that  he  is  much  improved,  and  speaks  in  praise  of  them.  K* 
hm  genuine  Tuberculoiis,  and  while  I  do  not  think  he  can  recover,  yet  I  firmly  believe  the  Tkiblets  will 
prolong  his  life." 

SPBCIAI^  OFFBR  i 

While  the  above  formula  have  been  in  uscl  in  private  practice,  over  thirty  years,  and  we  coold  give  tesH 
'-''-  from  well-known  clergymen,  lawyers  and  business  mtti,  we  prefer  to  leave  them  to  Uie  unbiased  judf- 


ikiae  months  (in  the  nu^oritv  of  oases)  in  some  one  case.  Card,  letter>head  or  some  proof  that  the  ai^dicanl  Is 
ft  pliysioian  in.  active  practice^  imis<  accompany  each  application.  Pamphlet,  with  full  particulais,  pricchlisli^ 
tiai  on  request 

LA  GRIPPE. 

Our  Phosphorised  Gerdbro^inant,  Freligh's  Tonic,  is  being  largely  used,  withhnost  gratifying  xesults,  by 
tfM  physicians  of  Boston,  New  York  and  Philadelphia,  to  overcome  the  debilitating  aAer-eflecIs  of  the  BussiiA 
Tmwma  Our  Special  Ofifer  is  still  open,  to  send  to  any  ph^dan,  on  receipt  of  twenty-five  cents,  and  his  cari 
m  lettcr^iead,  half-a-dosen  samples,  delivered,  diazges  prepaid.    Each  sample  is  sufficient  to  test  it  for  a  week  Im 


As  we  ftimish  no  samples  through  the  trade,  wholesale  or  retail,  for  samples,  directions^  price-lists^  ela 


iL  0.  WOODRUFF  &  CO.,  ininetinn  or  Physician's  Specialtiet»i 

100-08  ITulton  /St..     .        New  York  Cltj. 


Digitized  by 


Google 


XXVl 


THE  MEDICAL  WORLD. 


financial  betterment  of  the  profession.  Do 
you  wish  to  kelp, and  be  helped?  Are  you 
poor,  and  are  your  people  poor?  If  so, 
why? 

(Read  again  editorial,  **Our  Profeuaion  and  the 
People/'  in  Norember  World). 

EXGBLLBNT  practice  In  R.  R.  ▼lUage,  Eastern  Pa.. /or 
noCMno.  to  Doctor  baying  my  property.   Addieaa  **  K," 
eare  Mxdicjll  Wobld. 

A  B AROikIN— Drug  store  and  baiUUnicB ;  practice  12000  to 
A,  12600  yearly,  central  Pennsylvania— raiizoad  town  of 
6a>--connty  seat  No  opposition :  good  climate.  Fine  village 
and  oonntnr  location.   Address  "A,"  ci^ie  of  Mbdical  World. 

No.  6,  XXX  white  envelopes  printed  to  order  and 
po«t-paid  fifty  cents.  Note  heads  ditto.  WiluamJ. 
:,  printer,  Talmage,  Pa. 


KAntOTH, 


200' 


.  MEDICAL  piacttoes  fbr  sale.  Lists  mailed  free. 
'  Practices  and  droR  stores  hoo^t  and  sold.  Assist- 
ants and  partners  provided.  Address,  The  mb>icjll  Echo, 
Lyni\,Mass. 

ITOR  SALB.-$5000  practice.  Chicago  sabnrfo.  OoUectloiis 
1?  over  96  per  cent.  Excellent  chance  for  right  man.  Will 
intiodaoe  buyer.  Addma  PHTMOAif,  49  Metropolitan  Block, 
Chicago,  ni. 

ER  R  ALB.— €ood  practice;  dwelling-flve  rooms:  hnildinn; 
office;  nine  acres  land.  Qood  location.  For  9500.  Q.W. 
a.  ILD.,  Swannville,  Ban  Auguvtine  Co.,  Texas. 

/VN  ACXX)UNT  of  my  wifle's  health,  I  desire  to  locate  fiarther 
\  /  north.  I  am  sole  owner  of  the  Imperial  Hernia  Cure 
and  Imperial  Tro<iar  Needle,  and  am  an  expert  in  the  treat- 
ment of  hernia  itodrthe  fitting  of  trusses;  also  a  specialist  in 
diseases  of  the  nose  and  throat  I  wifh  to  sell  my  practice 
here^  and  want  a  partnership  in  a  good  piactioe  elwwhere. 
My  heniia  cote  Is  a  winner  and  wUl  make  money  in  any 
lootflty.   Address  8.  T.  Viwcent,  M.D.,  EyansvUle,  Ind. 

See  back   of  Yearly 

Index    for   Ther- 

mometors  and 

Hypodermic  Syringes 

SENT  FREE  TO  PHYSICIANS 


Sun^e  of  aiMjali's  ■•MMtotf  Ul 

Imts  will  be  nudled  free  to  any  phTddan  who  it 
not  altMtdljr  aoquainted  with  thdr  moita.  See  adTer- 
UaaoMnt  in  another  oolnmn.    AddiMi, 

MIOAJAH  &  OO,  Wamn,  Pa. 

OPIUM^MORPHINE 

HABIT  CURED 

IN  FROM  10  TO  20  DAYS. 
TWaij  TkowHMid  cases  cared.   Thousands  of 
reference  and  testimonials  famished  on  applica- 
tion.    Business  established  1875.   Bfe  Pimj  from 
resm>nalble_person8  reqalred  until  oared. 


Colleire  of  Pbyslcians  and  Sarreons* 

BOSTON,  MASS. 
Equal  prlTllegf 8  for  both  sexes.    Hospitals  and  Dis- 

Einsarles  directly  connected.  Fifteenth  year  opens 
tpt.  19.  AUOUSTUS  P.  GLABKE,  A.  M.,  M.  n.,  DiBan, 
(^Send/or  Catalogue.)  bit  Shawmut  Airenoo. 


'^'^r^r^ 


Chicago  Summer . . . 
School  of  Medicine. 

Term  begins  March  6,  1895,  and 
oontinues  six  montha 

ADOIICSS, 

William  F.  Wauoh,  M.D.,  Dean, 

.  .  .  OB  .  .  . 

John  B.  PANinNOTOV,  M.D.,  Secretary, 
103  State  Street,  Chicago,  111. 


B 
A 
B 
Y 


I'st^ChUdNB's 


PerflBCtflttlne  hygienic  ootflts.  No  Bands.  Na 
Pins.  Oomblning  health,  comfbrt  and  beauty. 
I>ress  and  undergarments  placed  together  and 
putonasonegannenu  Approved  by  physldans 
and  appredaCed  by  thouglitltil  parents. 
MATtRIALS.  PREPARED  WORK.  LAYEHES. 
10  Dorothy  Bsby  Patterns,  longorsbort,  $1.00 
Send  stamp  Ibr  circular  and  samples.   Mentton 

MBS.  B.  J.  GDNrs^Hlu^iTe.,  Net  Tort 


w 

E 
A 
R 


» 


Piysi 
Cnred.  Honu 


MOBPHINE 
WHXSKTHaWt 


Home  or  Sanitarium 


Treatment.  Trial  FREE,  For  f  nil  pap» 
I  ticnlare  address  the€0MP0€HB0xS 
flEy  A880CtATI0y,  Fort  Way#i,  lad. 


Stnouid  Buy 


Which  Is  BSASOVABLV  at  first  cost,  and  aooNomoAL  lo  i 

tain,  which  Is  Drt,  Pobtabxji,  Oucavlt,  Oomsvamt  la  aottoa 
and  ALWAYS  bbaot  fbr  use.  ^ 

Bend  ftmr  cents  In  stamps  (actual  cost  of  malUnc),  and  we  wffll 
forward  our  Catalogue,  showlnc  that  we  are  the  manoihclareB 
of  such  Batteries,  as  have  jost  been  described. 

The  Chloride  of  Silver  Dry  Cell  Battery  Ce. 

OP    BALTIMORE    CITY.    MD. 

Please  mention  this  joamal  when  correspondlnf  with  as. 


Digitized  by  V^OOQlC 


THB  MBDICAL  WORU). 


XXVll 


THE     BEST    ANTISEPTIC 
POR    BOTH    INTBRNnU    RND    BXTBRNnU    USI 


ANTIMPTK), 

PWO^HVLAOTIO, 

DCOOOKANT. 


USTERINE 


NON-TO^OO. 
NOM-INRITANT, 

NoN-EaoHANonou 


USTERINE  i8  a  weU-pToren  antiBeptio  agent— an  aotisymotio— especially  naeftil  in  the  manage- 
ment of  catarrhal  conditions  of  the  mucous  membrane ;  adapted  to  internal  use,  and  to  make  and 
maintain  Buigical  cleanlineas— asepalB— Ui  the  treatment  of  all  parts  of  the  human  body,  whether 
by  spray,  irrigation,  atomlzation.  or  simple  local  application,  and  therefore  charactemed  by  it» 
particular  adaptability  to  the  field  of 

PREVENTIVE  MEDICINE-INDIVIDUAL  PROPHYLAXIS. 


LISTERINE  destroys  promptly  aM  odors  emanatingr  from  diseased  ffums  and  teeth,  ar>d  wi(T 
be  found  of  great  value  when  taken  internally,  in  te^^jpoODtu)  doses,  to  control  the 
fermentative  eructations  of  dyspepsia,  and  to  disinfect  irie  mouth,  throat,  and  stomach. 
It  ts  a  perfect  tooth  and  mouth  wash,  INDISPENSABLE.*OR  THE  DENTAL  TOILET. 


Lambert's  Lithiated  Mfdrangea. 

FORMULA.— Each  fluid  drachm  of  '^Lithiated  Hydrancea"  represents  thirty  grains  of  pribh 
Hydbanoba  and  three  grains  of  chemically  pube  Benzo-Salicylate  of  LIthia.  Prepared  by 
our  improved  process  of  osmoeis,  it  is  iKyAXiABLY  of  dbfinitb  and  vnifobx  therapeutio 
strength,  and  hence  can  be  depended  upon  in  clinical  practice. 

DOSE.— One  or  two  teaspoonftils  four  times  a  day  (preferably  between  meals). 


i^ea  to  b€ 
\tve  and 


regarded  fty 


CloM  cUnieal  obwervoHon   ha§   eauged  Lambert'i  Lithiated  Hydn 
phyHcia/n*  generally  as  a  very  valuable  Benal  Alter 
Anti'lAthie  Agent  in  ttte  treatment  of 
URINARY  CALCULUS,  aOUT.  RHEUMATISM,  CYSTITIS,  DUBETES,  H4EMATURIA.  BRI6HT*S  DISEASE. 
ALBUMINURIA  AND  VESICAL  IRRITATIONS  GENERALLY. 
^e  have  much  valuable  literature  upon  Gbnbbal  Antxsxftic  Tbbatmxkt,  LiTHsaiiA,  Diabbtbb, 
Ctritib,  Era,  to  forward  to  physicians  upon  request. 

LAMBERT  PHARMACAL  COMPANY,  St.  Louis.  Mo. 


$4.50 


POUCH 
SADDLE 
BAGS 


For  an  Doctors  who  want 
tbMB.  Better  than  like  ktad 
or  similar  bags,  that  other 
maJcers  brag  on  and  seU  as 
IbeyoAnorwhen  they  can  at 

WeU  Baaie  of  Bnaiet-Uui-aole- 
leather,  honest  trimmings,  etc 
DlBMiMlODB  of  each  bag  or 
pooch  TxftxS,  Sundry  Box  on 
fSther  aide  «B23(zik.  Total 
round  annealed  bottles  hi  ad- 

ylB  4. 8«k;n,lo«.;  M,  8  dr.— 

WrSs  £r "^dMcrlptlve  drcu- 
laxa  of  oiler  Bags,  Gsaea  and 

^'"'^^^SOUTH  BRANCH  M'F'C.  CO. 

.CENTRALIA,  ILL. 


Mouth    Breath  ins   Prevented    Durtnfir 
Sleep  by  the  Use  of  the 


TRAOK  MARR.       PAT.  •«  FtB.  «••«. 


''Perfect  in  Operation,  Comfortable  to  Wear.' 
Sent  by  mall  OB  reoeipt  of  prioe,  flXO,  by 
The  SplrodoM  Co., 


MetcalPs  Throat  Speclflc. 

▲  tasteless  powder,  has  been  naed  fbr  the  past  20  yean, 
with  the  utmoat  auoooaa«  In  the  praetloe  of  aa  old  phy- 
dolan,  for  all  disoaaes,  and  abnormal  conditions  of  the  throat, 
as  Fharymdtis,  Ohxonlo  VoUenlar  or  Aente  Tomillttfak  Uioer- 
ated.  Diphtheritic,  etc  Oontaina  No  Poiaon  or  Potash.  Bef • 
evenoea  and  Itemnla,  inpon  apnlloation.  Piioe  ledneed  to 
IB.0O  per  ounce,  postpala;  one  dram  or  leas  generally  sofh- 
olent  to  cnre  ordinary  oases.  Address, 

J.IV.  METCALF,  II.D,,  l248HsrfcInisr8t.,BraoklyivN.Y. 


HENRY'S  TRI-ianiliEB 

Is  approved  by  eminent  clinicians  as  a  most  reliable  fohnnla  in  goaty 
rheumatic  and  lithemic  conditions. 

CHLDRIIIEB  R.  ft  H. 

This  formula  suggests  itself  as  an  ideal  alterative  tonic.    Is  compat- 
able  with  the  soluble  iodides.    It  will  not  derange  the  stomach,  nor  coast* 
pate.    Send  for  literature. 

RENZ  &  HENRY  PHARIVIACAL  CO., 

LOViaiflLLB;   KVi 


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THB  MBDICAI,  WORLD. 


Pra-S^nility.— Uterine  TrouMet. 

I  used  Sanmetto  with  the  beet  of  reeulte.  Its 
mctixm  was  so  perfect  that  I  have  einoe  used  it 
^th  BuooesB  on  some  fifteen  different  patients, 
%a  all  are  reooyering  from  old  chronic  troubles. 
In  fact  I  cannot  say  one-half  that  is  due  San- 
metto. I  shall,  in  the  future,  in  i^  cases  of 
lost  manhood,  and  in  all  uterme  troubles  think 
first  of  Sanmetto  as  the  drug. 

Louisville,  Kj.      H.  W.  Hendbiokb,  M.D.. 


A  Good  Word  for  Sanmetto. 

I  have  a  good  word  for  Sanmetto.r  Am  using 
it  in  the  third  case.  I  haye  unde^  my  charge 
m  gentleman,  sixty  years  of  age,  #ho  has  had 
<7Btitis  for  some  ten  years,  and  has  been  gradu- 
ally growing  worse,  until  I  prescribed  Sanmetto 
lor  him.  He  is  now  on  his  third  bottle-ndeeps 
«11  mght,  has  no  extra  calls  through  the  night 
to  urinate,  feels  good,  says  he  is  well  and  has  a 
.good  word  for  Sanmetto.  I  have  a  case  of  a 
young  lady  who  has  had  chronic  cystids  for 
three  years  from  the  effects  of  la  grippe.  A 
abort  time  ago  she  came  to  me  for  adyice,  and  I 
prescribed  Sanmetto  for  her,  with  happiest  re- 
sults. '  She  says  she  is  now  quite  as  well  as  ever, 
and  passes  her  time  in  helping  perform  house- 
liold  labor,  and  says  that  being  on  her  feet  gives 
her  no  uneamness.  I  am  prescribing  Sanmetto 
in  a  third  case  for  a  gentleman  suffering  from 
ishronic  catarrh  of  the  bladder.  He  is  now  on 
the  fourth  bottle,  and  claims  that  he  can  per- 
form manual  labor  all  right,  sleeps  all  night, 
euflbrs  no  pain  or  soreness  about  the  region  of 
Che  bladder,  and  speaks  in  the  highest  terms  of 
Sanmetto.  G.  M.  Lindlet,  M.D., 

Brooklyn,  Ind. 


Inflammation  of  Bladder  and  Prostate, 
I  gave  Sanmetto  a  fair  test  in  my  own  case. 
I  had  been  confined  to  my  bed  for  four  weeks 
with  inflammation  of  the  bladder  and  prostate 
gland,  causing  my  testicle  to  swell  to  an  enor- 
mous 9106.  I  began  cm  Sanmetto^  and  can 
heartily  say  that  it  did  fi)r  me  all  that  is  claimed 
totiL  I  expect  to  use  it  in  my  practice  so  long 
as  it  proves  as  e£Soient  as  it  hm. 
Cameron,  L  T.  IL  F.  Qbat,  M.  D., 


No  Failures. 

I  put  Sanmetto  to  a  severe  test  in  three  dif- 
ferent cases,  that  had  defied  all  the  treatment  I 
could  think  of,  and  it  has  given  me  the  most 
remarkably  good  effects  of  any  medicine  I  have 
ever  tested — no  /oi/ures.  I  have  been  active  in 
the  practice  for  thirty  years,  and  have  used  a 
great  many  if  not  the  most  of  the  special  prepar- 
ations, but  Sanmetto  has  given  me  uniform  good 
results  in  every  one  of  the  several  cases  m 
which  I  have  tried  it,  after  having  tried  maoy 
other  medidnes  without  success. 

Greston,  la.  8.8.  Whiie,  M.D., 


Now  Tliey  All  Keep  Stocked  Wtth  Saamitto; 

In  this  ''supply  city,"  with rixteen phynam 
and  eight  splendid  drug  stores,  Sanmetto  was  ta 
all  a  stranger  a  month  ago.  Now  they  all  keep 
stocked  up  irith  it  from  wholesale  firms.  I  aas 
greatly  pleased  irith  its  curative  properties  i 
diseased  kidneys  and  inflammation  and 
nesB  of  the  sexual  organs.  I  have  used  the 
best  kinds  of  fluid  extracts  these  twenty  years^ 
and  Sanmetto  I  will  use  in  all  the  future. 

Bockland,  Me.       Oeoboe  Clark,  ILD., 


Frequent  Micturition-— Nervous  Debility. 

I  have  used  two  bottles  of  Sanmettow  One 
for  too  frequent  micturition,  in  wiiioh  caae  San- 
metto filled  the  bill.  The  second  was  used  em 
an  old  lady  about  sixty  years  of  age  for  nervoua 
debility  and  pain  after  vending  urine,  and  it  had 
the  desired  ^ect,  as  the  patient  recovered. 

D.  Au  HUKOEBFOBD^  M.D., 

Julesburg,  GoL 


Cystitis  wKii    Enlarged    Proetate.— Veetoal 
Uretliral  lrritation.-Qleet 

I  have  used  Sanmetto  in  cases  of  oystitia  i 
enlarged  prostate,  in  veacal  and  urethnd 
tion,  and  in  gleet,  and  am  thoroughly 
with  the  excellent  results  in  alL    I 
Sanmetto  a  therapeutical  agent  well  worth  Aa 
trial  of  the  medical  profession. 

H.  R  LoxAz,  1LD.» 

New  Baltimore,  N.  T. 


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THB  MBDICAL  WORU). 


50,000  Doctors 

know  all  about  us— know  that  what  we  say  is  so— and  they're  better  dressed 
for  knowing  it.  We  have  made  a  special  department  for  the  making  of 
clothes  for  physicians  who  send  their  orders  by  mail.  Our  Professional 
Garments  are  in  use  in  every  part  of  the  United  States,  and  are  eminently 
satisfactory.  We  are  making  them  better  and  better  every  year ;  we  find 
it  pays— so  do  the  physicians  who  deal  with  us. 

We've  secured  a  special  material— Llama  Thibet  Cloth— the  only  real 
black.  Any  other  black  is  artificial.  Made  from  the  black  wool  of  the 
black  Llama,  it  can't  be  anything  else  but  black.  This  material  is  soft, 
•liable  and  sanitary.  It  wears  better  than  other  materials,  because  the  wool 
kas  lost  none  of  its  natural  strength,  and  because  it's  all  wool  and  nothing 
kut  wool.     Looks  neat  and  dressy. 

A  Walking-Coat  Suit  costs  $20.50,  a  Sack-Coat  Suit  $18.00,  an  Over* 
Mat  1 16.00,  and  so  on.  Nobody  ever  complained  of  these  prices  after  the 
result  was  shown.   Cut  out  this  advertisement,  and  send  it  to  us  with  your 


Nafne,,. 


.  Post  Office, 


C0uniyr. 


,~- SUUe, and  we  ivill  send  you  a  sample  free^ 

wUh full  particulars finsiruciions  for  self-measurement,  fashion- 
plate,  eU. 

E.  O.  Thompson, 

IMPORTBIt.  TAILOR,  CLOTHIER. 

1338  Chestnut  St.,  Philadelphia. 

Alao,  145  Broadway,  New  York. 


•abinat  ■•dicin*  Bag,  No.  1808.      Satchel  Buggy  Case,  Na.  740. 


D|]|1011gIOI18^ 

5K  in.  wide,  6 
in.  high,  and 
lllocheslong. 
Made  of  beit 
Black  Grain 
Bftgitock,  lea- 
ther covered 
iteel  frame, 
with   nickel 


OPBN. 


Contains  22 
oneonnoeand 
23  three-dram 
▼lals,  pocket 
for  powder  pa- 
cers and  space 
2  X  6  X  11  in. 
for  sundries. 
The  adyanta- 
ges  of  this  bag 
are,  that  the 
partitions 
holding  the 
J  are  entirely  remorable,  thus  allowing  the  bag  to  be 
I  tat  traTeling.  or  for  carrying  instmments,  when  so  de- 
~    It  is  also  the  most  centeel  looking  Physicians'  Case, 

:  deroid  of  all  nicxel  trimmings,  such  as  comers,  etc, 

•tdtnaiHy  found  on  Medicine  Cases.  Above  all,  it  is  rabstan- 
llaBf  made,  and  with  ordinary  eare  wlU  last  a  good  many 
jmn,  answering,  as  before  stated,  for  several  purposes  a 
iaatsre  to  be  highly  appreciated  by  the  physician. 

Tbtd  bottles  are  held  ^vith  the  latest  Improved  Western  Com- 
HOtk  Patent  One-Plece  Silver-Plated  Spring  BotUe  Holder. 
Price,  each,  $9.00. 


Made  of  beet  black  grained  Leather,  steel  ooverad  tnsn.% 
nickel  spring  look,  with  key,  name-plate,  etc 

Dimensions— 10  inches  long,  7  inches  high,  4  inches  wMci 
Contains  20  oneK>unce,  11  four  dram  and  20  three-dram  vials. 

Has  center  partition,  protected  axonnd  the  comers  of  each 
by  nickel-edge  trimmings ;  pockets  for  papers,  etc,  on  one 
sldeof  flap,  loops  for  instraments  on  the  other  side ;  also  boa 
on  one  putition  for  sundries,  hypodermic  syringe,  etc 

Price,  each,  $9.00. 


Satchel  Buggy  CasOp  He.  745. 

TUs  is  a  smaU,  compact  case.   As  a  hand-satohel  it  is  not  excelled  by  any  on  the  market.   For  constractUm  and  appear^ 
see  cot  of  No.  740. 

Dfaienslons— A  inches  long,  6  Inches  high,  4  Inches  wide.    Contains  14  six-dram,  9  four- dram,  and  8  three-dram  viala^ 
am  bas  for  hypodermic  syringe,  etc  Prlce^  •ach,  98.00. 

19ie  bottles  in  both  No.  74o  and  No.  746  are  held  with  the  OomstookSllver-Plated  Springs.    Send  for  Catalogue     ' 

"^C^eeterzi  Ijeatlier  IwllQgr.  OO.,  125-137  Ret  street,  Chicege. 


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XXX 


THB  MBDICAL  WORLD. 


gftSfflftailDWflM^^ 


.FOR  FEMALE  DISEASES.. 


MlCAJAH'5 


MEDICATED 
UTERINE  WAFERS 


▲  BUCIDT  fOm  THI  LOCJlL  TKAATMKMT  OF 


VSOULIABTO 


Cbrooic  Inflammatioii  and  Bngorgement  of  the  Womb,  Ulcentioii,  LeaoanfaoBa,  Irregolar,  Bi^* 

proned,  and  Painful  Menstmatioii,  Pkolapana,  and  tba  Irrai^iilaritiea  Ind- 

dflBtal  to  Cbanga  of  Ufc. 


Applied  in  tiie  manner  directed :— The  lemadj  ia  qidcUj  absorbed  and  acts  bj  atimnlatfng 
the  Hypogastric  Plexus  of  nerrei.  and  hj  this  means  rssloies  and  maintains  the  healthj  fonctiona  of 
die  organs  to  whidi  this  plexus  of  nerres  is  <fistribated. 


Climacteric    ^ 
Metrorrhagia 


BOWI.ING  Grbbn,  Kv. 
Dbc.  27, 1890. 


On  September  2ist/I  was  called 

to  meet  a  brother  M.   D.   in  the 

7^\  case    of  Mrs.   R.     Diagnosed    the 

case  Climacteric  Metrorrhagia. 

Had   been  wasting  the  three  preceding  weeks,   without  even   temporaiy 

cessation ;  during  each  of  the  three  last   nights   had   saturated  the   bed.     The 

Doctor  had  used  all  of  the  usual  remedies,  including  ergot  and  astringents. 

Prescribed    Micajah's    Medicated    Uterine  Wafers  to  be  introduced    evaty 
third  day,  aided  by  ergot  and  acetic  acid  equal  part^ — F^ss  every  three  iKmm 
By  Tuesday  evening  the  flow  was  under  complete  control,  and  the  patient  haa* 
done  well  since  that  time.  W.  H.  DICKERSON,  M.  D. 


The  price  of  a  box,  sufficient  for  3  months*  treatment  Is  $i.oo« 

To  phygieians  not  aequainUd  wUk  iKe  merita  ufike  Wafertf  a  wmpU  will  be  mailed  free 
en  appUeatiion,  memUanmg  thUjoumoL 


airstiWICAJAH  &  CO.,  Warren,  Pa. 


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xxxl 


•haply   •    toltebto    Truss    st    •    Soitakly 


a.  p.  o. 

'  OR  UII6  PETROSELIMUi  SATIVUM 

H^morrhonlM  SucoeMsMff  TnaM. 

Thif  ointment  i«  rapidl j  Msaming  the  lead  of  Pile 
Bamedioi.  A  sample  box  often  onrea  aoTeral  oaaea. 
Phjiioiana  who  Iuito  ordered  theb*  trial  order,  Iuit* 
ordered  again  and  again,  and  praise  it  for  its  tnUj 


Bt 


IblloiHng  ezlraols 


marreloas  qualities,  wli&ob 
show  plalnl  J. 

Mi.  Pblul,  Tbitn^  Oot.  I,  Xtt6. 

Fbux  "W.  SvnwAfl,  Oswego,  K.  Y. 

Dear  8lr^-Yba  will  find  esolosed  one  dollar  for 
which  yon  will  please  send  to  mj  address  fonr  boxes 
of  Gypsy  Pile  Ointment,  and  obl^  I>r.  Ohilwood 
recommended  it  as  the  surest  and  most  sneedy  cure 
known  to  him.  S.  O.  Jackbov. 

Bbhtok,  Mo.,  June  17, 1808. 
Fbbz».  W.  Btswabt,  Oswego,  N.  Y. 

BeceiTed  my  last  order  about  fifteen  days  ago  all 
O.  K.  I  hare  need  np  all  the  suppositories  (one  doa. 
box).  I  haye  been  in  the  praotioe  twen^  y^^**  Imt 
noTor  found  any  eye  ointment  or  any  recipe  equal  to 
your  Pile  Ointment  when  used  ror  eye  ointment. 

Please  send  me  half  pound  box  of  the  pile  ointment 
by  mail  to  M.  A.  Oubtis,  M.  D. 

BvaHVXLL,  TTiTi.,  Not.  9, 1866. 
Fbkd.  W.  SnwABT,  Oswego,  »,  Y. 

Dear  Sir:— I  find  your  Oypsy  Pile  Ointment  all 
that  is  claimed  for  ii  I  have  been  using  it  in  my 
practice  fbr  oyer  fbur  years,  I  cannot  cmI  to  mind 
a  single  instance  wherein  it  has  disappointed  one. 
You  will  find  enclosed  one  dollar,  please  send  me  tibs 
amount  in  your  Pile  Ointment,  and  oblige, 

B.  A.  Pi]rKi.BT,  M.  D. 

Gtxthiaka,  Ijnx,  Oct.  80, 1803. 
Mb.  BrnwAjrr. 

Dear  Sir:— Find  enclosed  money  order  for  serenty- 
flye  cents,  for  which  please  send  me  tkatmuoh  of  you 
celebrated  Pile  Ointment,  thaye  used  three  or  four 
boxes  of  it.  and  it  does  as  much,  and  more  thsA  tob 
recommend.  I  haye  cured  two  or  three  cases  of  pUee 
of  long  standing,  which  had  been  doctored  for  years 
with  no  success.    Please  send  at  once. 

Bespectfkiny,  L.  B.  AiiUr,  M.  D. 

SDnrBUBO,  Miae. ,  Jan.  9, 18BS. 
Fbbd.  W.  Stbwabi,  Oswego,  N.  Y. 

Dear  Sir>-Bnclosed  ted  poital  note  forgone  doUaf 
for  whichyou  will  please  send  me  the  worf' 
TaluablePUe Ointment.  Ifindfttbebestt      , 
oyer  tried,  and  good  for  more  thii|gs  than 
rhoids.    Send  by  mail  at  your  yery  MrliM  conteBi- 
,  and  oblige. 


bUge, 

YC 


ours  truly,  W.  T.  HuTonnrs,  M.  D. 

East  JAmsT,  K.  H»  March  »,  18Ba 
Fbbd.  W.  8«bwabt,  Oswego,  K.  Y. 

Dear  Sir:— Some  half  doaen  years  age.  more  oi^eas,  I 
bought  quite  a  lot  of  Stewartfs  Oypsy  Pile  OintmcBt  of 

r»u;  if  you  still  prepare  it,  please  sepd  me  four  bosns. 
haye  retired  fh>m  practice,  but  occasionally  want  to 
use  some.  I  regard  ft  as  the  hmi  Pile  Ointment  I  hay« 
oyer  used,  in  a  practice  of  more  than  forty  years. 

Yours  truly,  O.  H.  Bbadi.bt,  M.  D. 

KonoB.— I  will  send  a  sample  box  of  the  oiBtment 
free,  to  any  physician  writing  for  same  and  mention- 
ing MBDIOAL  WQBLD. 

I  haye  Imndreds  of  letters  from  physiciaas,  besides 
the  aboye,  speaking  Just  as  highly  in  its  praise.  Post- 
ace  or  express  cha^cea  always  prepaid  by  me.  Pli^- 
sioians  not  wishing  to  send  for  it  themselyes  shouid 
insist  on  their  druggist  sending  for  it  Tell  them  I 
prepay  all  charges. 

Thtn  is  no  advertising  on  letter  or  package, 

AddrcH,  FRED;  W.  STEWART,  ItowHt.  ■•  V* 


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Kxxn 


TBB  MBDICAI,  WORLD. 


A  aUUIOK  AT|THK 

COMPOSITION 


CELEBlim 

VIZ: 

TMK  AOnVE  PmNCIPLCS  OF 

CELERY, 
COCA, 


AND 


viBURmnM, 


sksptlMl  physl- 
•ff  Ms  valM  la  ALL  LANSUID  OR 
DKBILITATED  CONDITIOIIS  OF  THK  SYS- 
m,  SUGA  AS  LOSS  OF  NERVE  POWER* 
NERVOUS  HEADACHE,  NEURALOIA,  PAR- 
ALYSISp  IHPOTENCY,  HYSTERlAp  OPIUM 
HABIT,  INEBRIETYp  DYSHENORRHCEAp 
PROSTATIS.  DYSPEPSIA,  Eto. 


Aatflto  TMUamiy  •<  ^m^IMIm 


J. 

After  1 

0teteth»t] 

Unt. 


f.  Ohablxs,  M.  D^KaniM  City,  Kaa.,  im: 
thoroiif bly  testing  Cvlemim±  I  «m  pleM>t  l> 
bluit  I  mid  U  ft  splendid  nerre  tonio  Mid  iliHa- 


W.  B.  Dots,  M.  D.,  Berne,  K.  Y..  em:  I 
pleenre  in  informing  yonof  theyery  Tilnable  ■ 
of  Oblxexha.    It  if  nnmirpAMed  as  %  nenre  tonin 


A.  H.  YouKOj.  M.  D.,  Percy,  In.,  mts 
QBLBBXirA  and  nnd  it  nnforpaMed  in 
brought  on  b j  oyer-work  and  fatigue. 

A.  M.  Datis,  M.  D.,  Oenda  Spring!,  Kaa., 
OBLnnrA  gaye  me  great  satiafMtlon  ai  a 
neryont  proatation. 

J.  D.  L.  BAiiL,  M.  D.,  Tyler's  Greek,  W.  Va..  siva : 
OsLSBiHA  is  the  best  remedy  in  neorasthenia  I  iMVi 
oyer  seen. 


8.  BABXXB,  If .  D.,  3i  Oaton  Plaoe.  Brigbton,  k^^ 
says :  Oblbbioa  gaye  prompt  relief  in  fimgiior,  m^ 
yons  beadaobe  and  dyspepsia. 


Thos.  8.  Bui«iiXB,  M .  D.,  O.  M.  Oanadat  L.  8.  A., 
L.  M.,  B.  O.  8.  Bng.,  late  Qaarantine!8npi.  tor  ?!»> 
toria,  Australia,  says:  Haying  ezperimoDted  wtfk 
OxLBBiHA,  on  botb  myself  and  otbers,  I  am  of  upia 
ion  tbat  it^is  an  exoelient  article,  wben  adndnlrtewi 
Judiciously.  It  relieyes  teuslon  after  exoitsmert» 
giyes  relief  in  distressing  beadacbe,  and  remo>yea  tka 
oraying  for  strong  stimulants. 

J.  OozLTT.  M«  D.,  Betired  Surgeon-General  Aiay 
Bournemouth,  Bug.,  says :  I  think  Oblbbiva  ia  bb 
excellent  and  powerfbl  stimulant,  and  likely  tp  bt 
uselbl  in  cases  of  mental  depression  and  btalB  wony. 

W.  B.  BYAirs,  M.  D.,  L.  B.  O.  a  !«.,  19  If < 
Square,  Dublin,  Ireland,  says :  I  baye  large!; 
scribed  OBUtBiVA  in  the  debility  following  epf 
influensa,  and  baye  found  it  mosi  usefUL 

W.  M.  CummroKAM,  M.  D.,  Oorona,  AU.,  eafi; 
I  baye  used  your  preparation,  OmiMmntJu  wmk 
marked  success  and  I  am  highly  pleased  with  ft. 

Alfbbd  Bakbb.  M.  D.,  Aysgarthf  Bedale.  Yotk- 
shire,  Eng.,  says :  I  think  Oblbbiha  is  certaliily  of 
seryice  in  neryous  ezhastion. 

Db.  Mabohand  Libob,  Belffium,  sa|s : 
is  unsurpassed  in  neryous  debility. 

Db.  Bbbliozb,  Brussels,  Belgium,  says :  We 
in  Oblbbiha  a  magnifident  combination  for  all  ^ 
of  neurosis. 


Db.  W.  Bbbthxlot,  Santander,  SpaiiL 
baye  found  a  combination  of  Oblbbota  and 
OOBDIAL  yery  useftU  in  dysmenorrbeiL 


Mja:  I 


Eio  Chemical  Company 


A  firfl  Blm  li«tlto>f  ZCELERINA  will  i 
mSB  !•  miy^^Plijrsiolsn  whs  wishes  to 
N  hm  will  p«y  llMi  mumrmmm  eharf  ••. 


tMl  N 


i 


St.  Louis.  Mo> 


Digitized  by 


Google    / 


/ 


THB  IIBDICAL  WORU).  xxxiii 


Which  every  physician  kno ws,  that  nearly 
every  woman  has  some  trouble  with  her 
menstrual  functions  at  some  period  in  her 
lif  e,  such  as 

MENORRHAGIA, 
LEUCORRHEA, 
AMENORRHEA, 

DYSMENORRHEA,  Etc. 

In  these  cases  ALETRIS  CORDIAL  is 
peculiarly  indicated,  and  by  its  use  all 
menstrual  derangements  are  speedily 
overcome  and  the  uterine  system  restored 
to  its  normal  condition* 

Rio  Chemical  Co., 

AMm^oboldo  of  ALETRIB  CORDIAL  will  be)  ^^      ■  •  ■■ 

MSiFKEBtoaiijFhTiioianwhowldiM  to  tort  it,ifV  Sfa    LOUISa    InOl 

%•  wfll  pft7  BzpTCM  Oliars«f  •  )  ' 

Digitized  by  VjOOQIC 


^xxiv  THfi  MBDICAL  WORLD. 


Tlif  Clwwical  Twatmiit  im  Cmtwytiti, 

A«tln«i«,  Ohmiiio  Konchitb,  Tnbeieiilar  LuTiigitif  and  Ortairii 

JittHirtti  fcy  W.  It  Awlcfc,  A.  M.,  M.  P.,  of  Ctiicliiiiiti» 

is  mpplied,  to  PhTndaas  Only,  bj  the  aieliiaiTe  Oimipoiiiidaa, 

The  Awtck  ChewJcal  Co.,  166  W.  8«¥«iitli  Street, 

(S)U9imad,OItio,U.  &  A.    It  hM  bMB  Taitod,  EbdoiMd  and 

lUlepted  hy  tlw  Wedlcii  PnHutlm  d  All  Sdwoli 

as  the  onljSaooeiBfnl  TrMtmcni  ftir  Polmoiuuy  DiseaMs. 

Ttit  PackagM  ol  the  Aiilclc  lle<idiwt  Sent  Trte 

of  oost  to  Phjaioiant  Srcrywhave  for  each  new  Patienl. 

Or.  Anicfc't  Vmn  m  WMch  Mw  TrMtwent  It  Bawii^ 

'     OoitiDftlieMdUdiiei  and  other  neosMaiyliifoniiation  on  Beq^ 

THE  AMICK  CHBMICAL  tO., 


iM  WMt  5#veiiCh  mnatt, 

» O.,  U.  S.  A. 


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THB  MBDIGAI«  WORLD. 


XXXV 


immeimmpmm^mp&mmsmi 


Pa  great  opportunity^I 


Two  Dollars    * 
Given  Away. 


!» 


Por  a  Short  time  we  will  send  this  elegant  pocket  OMe 
filled  with  any  nine  of  the  following  partial  list  of  onr  al- 
kaloidal  granules  aoo  of  a  kind)  as  a  premiom  to  eyOry  Nbw 
SUBSOBIBBB  sending^  $1.00  for  a  year's  subscription  to  Thk 
Alkaix>idai.  Clinic,  a  monthly  Journal  devoted  to  the  therapentioe  of  the  active  prineiplee. . 


SlLKCT 

1  Aoonitfoegr.  1-184 
2I>igitaUngr.l.67 
t  Hyoioyamine  gr.  1<260 
4  Oodeine  gr.  1-67 
6  PodophylUn  gr.  1-6 

6  8ti9cfarAa«3ale  gr.  1-tM 

7  Omer  Anenlte  gr.  l-lOOO 

8  Quinine  Arpeniate  gr.  1-87 

9  Okmoln  (Nitro^ljro.)  gr.  l-OBO 
MAk]lngr.M2 


BY   NuiiaKR  AND   MfNTION  TnIS 

11  Add  AnenJmis  gr.  1-87 

12  AJUodtneB^Md gr.  1«800 

•^'inhidei 


18 


14  Oaloiumaalphidegr.1-8 

15  Calomel  gr.lT 
18  OunlHr  Mono-bras  gr.  1-8 

17  Oolcfi5ne  gr.  1-184 

18  ftMttne  gr.  1-87 


19  XEBOttn  cr.  1-8 
28  UOdum  Benaoate 


gr.1-8 


^  Three  Dollars 

We  will  send  this  case  filled  with  any  twenty-fjor  of 
the  aboYe  and  the  Journal.  If  yon  can't  satisfy  your- 
self lh>m  this  list  send  for  onr  complete  prioes  current 
and  select  granules  of  the  same  average  price  or  if  you 
want  higher  priced  ones  add  the  difierence  to  your  re- 
mittance. This  OrFss  is  to  Kew  Subscribbbs  and 
Nbw  Customebs  Onlt.    We  are  pleatiing  others  and 

WB    KNOW    WE   -CAN    F1.EA8E    YOU    If    yOuTl    giVC    US  a 

chance  to  try. 


Fair  Samples  of  Our  Letters. 


Tear  sample  case  received.   It  is  a  beau<y  fbr  the 
pilee  and  the  choice  of  medicine  is  ilnt  dais. 
Crockett,  TiKas.  R.  Bsldssi,  M.D. 


Goods  received, 
pleased 
Trement^Pa. 


I  received  the  pocket  oa«e  a  iisw  days  ago  and  *be 
ir»t  copy  of  the  Alkaloibal  Clinic,  to-day.  Am 
wdlpUgfced with b,>UL       L  S.  HoixowauL,  M.D. 


I  have  received  O.  K.  the  copy  of  the  Alkaloidal 
Cuvic  and  the  filled  case.   Am  pleaed  with  both. 
Saginaw.  Bilch.  O.  M.  Belfry,  M.D. 


.find 

usedthe 

and  find  toubs  tbb  vbby  bsst. 

eacepted.   Keep  them  to  their 


ed  please  find  order  for  granul._.    

vanoos  granules  made  at  none  and_abroad« 


Ihave 


**ChantandVf 


The  case  is  a  «*  daisy,"  I  am  well 
Jos.  W.  Bxao,  M.D.     ' 


Kceptb^Tffl  to  their  pieeent  itandard,  and 
if  once  usedTotfieri  will  never  be  substituted. 
Brownsville,  Md.  J.  T.  Yocbtbx,  BLD. 

Within  find  ofder  for  granule  <.  I  have  tried 
gsanules  of  the  other  compaoies,  but  youis  give  me 
oetter  latisflMStion  than  any  of  the  oUiera  Tri 
Alkaloidal  Clinic  is  brief,  practical  and  to  the 
point.   LoDcmay  "itwa?e!'^     J.  H.  Fool,  1I.D., 

Sooth  If  ills,  n;c. 

The  pocket  cace  and  journal  received,  both  of 
which  I  am  well  pleased  to  have  in  my  office. 
AdalTifille,  Oa.  John  H.  Kino,  M.D. 

Don't  waiti  fbr  this  offer  will  net  be  open  always.  Our  complete  net  price  list  will  be  sent  with  each  case.  Don't  ask 
for  sampjes—thoy  dont  pay  either  of  us.    Accept  one  or  both  of  the  above  propositions  and  see  how  well  pleased  you'll  be. 

I P  YOU  ARE  NOT  SATISFIED  on  receipt  of  the  case  and  one  copy  of  the  Journal,  send  it  bacK  and  we 
wHI  refund  your  money.  No  better  value  was  ever  offered.  Send  for  price  list  and  literature.  Buy  direct  and 
pay  one  moderate  profit.  Wo  supp'y  all  a  dispensing  physician  usually  needs.  If  you  don't  see  what  you 
want  in  our  list  asi(  for  it.  . 

The  Abbott  Alkaloiml  Co.  f 

Ravenswood,  Chlcagro,  III  ^      ii  e 


OI8TANCK  18  NO  088TACLK.     WC  CAN 
SKRVC    YOU    WHKRCVKfl    MAIL    Q3K8. 


Digitized  by  V^OOQlC  ■ 


MMXvi  THB  MBDICAI*  WORLD. 


PEACOCK'S  BBOHIDES 

(SYRi   BROMi   OOMPt  PKAOOOKJ 

laoh  fluM  draohm  rmpmBmntm  1 6  sraln^  of  thm  Oombln^d  0«  P.  Br^nMmm  of 
Potassium,  •odium,  Oalolum,  Ammonium  and  Lithium* 

Uses:  Epilepsy,  Uterine  Congestion,  Headache,  and  aK 
Congestive,  Convulsive  and  Reflex  Neuroses. 

^Thls  preparation  produces  results  wMch  can  not  be  obtataMtf 
•rom  the  use  of  commercial  Bromide  substitutes. 

MMB.-Ono  to  two  FLUID  draohmo.  In  WATER,  throo  or  moro  ttmoo  a  dayw 

C  H  I  O  N  I A     CHlONAIiTHUS. 

Uses:  BiliODsnoss,  Jaoodlco,  Dispipsla,  GoosHpatloD,  ad  iB 
Diseases  Caused  by  Hepatic  Terpor. 

CHIONIA  stimulates  the  Liver  and  restores  It  to  a 
healthy  condition,   without  debilitating  the  system  by 

Catharsis;  does  not  pursre,  per  se,  but  under  Its  use  th* 
Liver  and  Bowels  gradually  resume  their  normal  functions. 

0OSE.<-On«  nuld  Dnurtwn  three  times  a  day. 

SAKPLES  SUIT  TO  ANT  TEWSUXt  VBO  WLL  PAT  IZFB188  0BABSI8. 

PEACOCK  CHEMICAL  CO.,     -     ST.  lOUiS. 

Cacti N A  Fillets. 

Indicated  In  abnormal  heart  action,  mental 
depression,  and  general  debility. 

Cactlna  Is  the  best  cardiac  and  general  tonic  In 

the  materia  medlca,  and,  therefore.  Indispensable 

I  In  the  treatment  of  every  form  of  weakness. 

'  SBrKach  Pfllet  repretentfl  one  one-hnndredth  of  »  gndin  of 

tottve  prozlxnate  principle  of  Caotos  Mexioana. 

IKMf.— Om  Pllitt  mmry  hour,  or  Iu9  tfttm,  m  Mhat$i. 


PRICE.   PER   BOTTLC  (100   PlLLCTS).   26    GKNTS 

Samples  Mailed  Free  to  any  PhysteUui  Seadlsg  fils 


SULTAN  DRUG  CO.,  St.  Louis  and  Londoife 

/Google 


Digitized  by ' 


THB  MEDICAL  WORLD. 


zzxvu 


Without  a  ScarT 


Jl    REMARKABLE   SURSICAL   CASE   OF  A  SEVERE   BURN   TREATED 

WITH    UNSUENTINE. 


OFnCS  OF 

H.  XNTOK,  M.  B., 
MB  Clinton  St. 

Bbookltv,  K.  T.,  Jannsry  28,  18M. 
MomwxoH  Phabmacal  Oo.,  Norwicli,  N.  T. 

GBMTLncxN:— I  really  owe  yon  an  aoology  ftir  not  Booner 
flfflnmnwi^i^tinff  to  you  the  reault  aohteTed  by  me  with  Uagaea- 
tteo.  IwasoDllgedtoiuetbeentireboxinthecaMcrfalady 
who  hadly  bnmed  one  hand  and  arm,  the  Inlnry  extending 
ahoTS  the  elbow.  I  saw  the  caae  three  days  after  the  wounds 
liadbeenignorantly  dieeBed,andtheentireBuperfloialaieaof 
tasnd  and  ann  was  one  foul  smellinc  aggregation  of  discrete 
ftDd  concrete  ulcers,  foetid  in  the  ertreme  and  beginning  to 
■tough.  After  oarefal  washing  with  wann^ater.UagaeoiliM 
WM  apDlied  on  sections  of  old  linen,  each  section  about  six 
tnohfls  long  and  two  inches  wide,  strips  of  this  oonlbrmation 
enabling  me  to  secure  contact  at  all  points  for  the  Uagnentlne. 
Then  a  Broad  roller  bandage  was  used  to  enyelop  the  smeared 
■eotioos.  This  operation  was  repeated  erery  third  day,  and 
In  twelTe  days  the  arm  was  well,  without  a  slough,  without 
■car  tissue,  without  contraction,  and  presenting  a  new  pink 
■Idn  that  I  regarded  as  a  surgical  triumph.  The  fbeCor  dlsap- 
pmrfMl  after  the  second  application  and  the  pain  also. 

This  is  my  ezperience  with  Uagaentliie,  and  you  are  wel- 
gonaiouaeltaayonpleue.  H.  SNTON,  M.  D. 

Nkw  York  OrriCK, 
140  William  8t. 


Unguentine. 


an  alum  ointment  with  the  irritating  proper- 
tiea  of  the  drag  eliminated,  with  carbolio 
add  and  ichthyol  added,  combined  with  Pei- 
rolatnm  base.  Modified  formula  of  Sir  Astlej 
Cooper.  Used  in  the  leading  hospitals  and 
dispensaries  of  New  York  City. 


Samples  and  literature  sent  upon  request.        ^ 
Sold  only  in  one  pomid  boxes,  One  Dollar  'p«r 
poond.    Made  onlj  bj 


The  Norwich  Pharmacal  Co., 

NORWICH,    N.   Y. 


J.  FEHR'S 

Componnd  Talcnm  Baby  Poider 

.  "HYGIENIC  DERMAL  POWDER" 


INFANTS  AND  ADULTS. 

Originallj  inTestisated  and  its  therapeutic  properties  disooyered 
in  the  year  1868,  by  Dr.  Fehr,  and  introduced  to  the  medical 
and  Uie  pharmaceutical  professions  in  the  year  1878. 

OOMFOSmON:     Silicate  of  Maf^esia   with   Carbolic  and 
Salicylic  Acids. 


PBOPEBTIES:    Antiseptic,   Antisymotic,   and   Disinfectant 


GENERAL  SPRINKLING  POWDER. 

WItlCpoattiTe  Hygienic,  Prophylaotio,  and  Tlieiapentio  properties. 


•sod  la  aiPaf  Mtteiit  of  the  tkin.      Sold  by  the  drug  trade  generally. 

Per  Box,  plain,  26c.;  peiftuned,  60c. 

Per  DoMu,  plain,  11.75 ;  perftuned,  9U/k 


THB  MANUFAOrU&BB : 

JULIUS  FEHR,  II.  D., 

ANCIENT  PHARMACIST,  HOBOKEN.  N.  *. 

Only  Adv«ftiMd  in  Medical  and  Phannacentical  prints. 


Digitized  by 


Google 


ZKXXVlll 


THB  MEDICAL  WORU). 


|p%/%^%/%/%/%^%/%^%^ 


)^%/%^} 


1^%/%^%^^^%^%^%^%/%^%^%/%/%^ 


of  the  total  number  of  American  Physicians  are  using  and  have  con- 
fidence in  Mulford  Go's  Tablets.     Such  popularity  does  not  come  by 
chance.    We  have  merited  confidence  by  exercising 
^t1^^^  t^c    °io8t  scrupulous  care  in  selecting  and  manu-  Regular 

\         ^^  facturing  every  article  bearing  our  name.  Price,  $3.35. 

^   ^^..-'''^^^^  J^'To  get  all  in  line  we  make  this  *•  SPECIAL      r~] 
^C^^-^I^S)  Introductory  OFFER"    of  Seasonable  Fall  and     ^1     QQ 


Winter  Remedies,  in  Tablet  form,  for 


Cash  with  order.     Duplicate  orders  filled  only  at  regular  list  prices.   We  pre-pay  charges. 


COCAINE,   CUBEBS  COMP. 


Ibbitat 
OaMlMMariait... 
PMMs.  Chtor..».. 
Ammaa.  Marl  ate.., 
In.  OljcTiThiss.., 
OUB«h  Cubeb... 


1-U  gr. 

«««• 

'}V' 

t  tn. 

!-«  r- 


Dosa.— Allow  1 10  dlMOlf*  itowly  U 
ihroM  •mey  two  hoan. 

roo,  ^Riom  000. 


CORYZA  (IMPROVED). 

OuBBhor 1-4  fr. 

QaialMSalpk 1-4  gr 

IforpUlM  Salph 1-Mfr. 

AtroplM  Solph MOOOgr. 

IxC  OlyeyrrhlM Mgr. 

OotB— i  10 1  OTory  holf-hoor  or  m. 

too,  i^miom  900. 


HYDR.  ACID,    HYPOPHOS, 
COMP.  and  CRE050TE. 

A  MOOT  TALOAOLB     BSMBBT    Uf   ftnumu 
AirO  BOB  TUB     Pb«Oa1.AB  OB  ObIT, 

BBraoiAiJ.r    wmsB  ma«ibbbtb» 

BT  0BTBBB     KbBTOVB  DbTBBB- 

■MB  AMB    ExBAOonoa. 

■yr.  Bjdrlodlo  Aeid M«r. 

S5ferf;:':r-.°.»:r;:iij;;: 

Orwooto,  Mooehwood l*Sfr. 

•OOB.— 1  to  3  Oflor  BOOlB. 

roo»  iFmtom  0Oo. 


EXPECTORANT  (TONIC). 

■  •PBeiAIJ.T    TALOABLB   IB   "  WlBTBa 


Mtiyoh.  Salpk l«gr. 

Tr.  DlgftiUls SbJb. 

Tor^B  Hjdrota Sgro. 

Pow«.Of««B I-S4gr. 

Bn.  Hyo««y»mBo l*«gr. 

Dots.— 1  to  3  toMcts  S  or  4  tiaiot  doilT. 

too,  iFRIOm  0Oo. 


KBRMBS*  MINERAL  COMP. 

(Cro«».) 

IBTAI^ABLB    111    CftOOP     ABO    CArUXABT 


ABtlBMaT  Solpbarot. 1-4  gr. 

Powdorad   <p«coe 1-11  gr 

OooB.— Ai  OKpootorBOt,  1  ovovy  bolf 
ft*  1  how;  ••  omooe,  S  to  i. 

roo.  iFm9om  aoo. 


AMMONIUM   CHLOR.  COM- 
POUND WITH   COOBINB. 

(ABodyno  Expoetoroat.} 

AMBoa.  CUer Mgr. 

Kit  OlreTrrbica. l-l»gr. 

Powd.  Cobob  l-«gr. 

Aodiom  Cbloralo. Mgr. 

Ood^oo l-»gr. 

OoiB — 1  to  1  oTory  S  or  S  boars. 

too,  iFmiom  2Bo. 


H.  K.  MULFORD  COMPANY, 


CHICAGO  OFFICE, 
iia  and  114  Dearborn  St. 

wmirm  fojv  ooMi»L«r«  umr  amo  mmmuMm  of  wiMrmm  mmMmoimm, 


Factors  of  Rcllabio  Tablets, 
PHILADELPHIA. 


N.  Y.  OFFICE, 
la  Gold  St. 


r'%^%/%^%^%/%%/%^%^%^%^%^%^%^%^%%%^vW'%^%/%^%^%^%^%^%^%^ 


k%%V 


▼al«abl«  R«m«d7  for  D7»p«p»lao^>* 

CONTAINING  THE  DIGESTIVE  PRINCIPLES 

COMBINED  WITH  THE  CORRECTIVES 
Bismuth  and  Bi-CarhonaU  afSoda,  and  the  Carminative  Stimulant  Singer, 

Ykii  prepsration  is  a  yaloable  remedy  in  the  different  forms  of  Dyspepsia.    The  Pepsin  which  is  nsed  infttil 

preparation  is  of  the  highest  digestive  power;  its  combination  with  Panoreatin  increases 

its  valne  as  a  synergist  in  meeting  the  varied  requirements  of  a  diges- 

tant  in  disordered  states  of  the  digestive  functions. 

THE  GREAT  FAVOR  IT  HAS  GAINED  IN  THE  PROFESSION  ONLY  GIVES  EVIDENCE  OF  SAT- 
ISFACTORY RESULTS  OBTAINED  FROM  ITS  USE. 

In  fermentative  Dyspepsia  and  Diarrhea  it  will  be  found  an  invaluable  remedy. 
DO0B^-ao  grains  or  >f{  tesspoonftii,  mixed  with  a  Uttle  water,  before  or  after  niea]s,ss  directed  by  the  physician.  In 
'"*^' '"■  ^ — ^ — *-         1  may  be  increased  to  1  teaspoonAil.  WewillsendaiampletoanyaddrMiupoo       * 

ky  CEORSE  C.  FRYE, 


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THB  MEDICAL  WORLD.  xxux 


S7E.  E7F0PE0S.  CO.,  FELLOWS 

OHiitolM  the  Essential  Eiementg  of  the  Animal  Organimtinii — ^Poteh  and  I  iwm ; 

The  Oxidizing  Agents— Iron  and  Manganeee ; 

The  Iconics— Quinine  and  Btrychnine ; 

And  the  Yitalizing  Constttnent — ^PhogphoruB;  tlie  whole  combined  in  the  £im  ef  • 

Syrnp  with  a  Slightly  Alkaline  Beactiom 
It  IMflbrs  in  its  Effects  from  ril  Analogons  Freparattons;  and  it  poMesses  the  jai- 

portant  properties  of  being  pleasant  to  the  taste,  easily  borne  by  the  stomacht  aad 

harmless  under  prolonged  use. 
H  has  Gained  a  Wide  Bepntatton,  particularly  in  the  treatment  of  Pulmonary  Tnber* 

culosb,  Chronic  Bronchitis,  and  other  affections  of  the  respiratory  organs.    It  has 
also  been  employed  with  much  success  in  various  nerrous  and  debilitating  diseases. 

Ha  Cnrative  Power  is  largely  attributable  to  its  stimulant,  tonic,  and  nutritiYe  pvop- 
erties,  by  means  of  which  the  energy  of  the  system  is  recruited. 

Its  Action  is  Prompt;  it  stimulates  the  appetite  and  the  digestion,  it  promotes  i 
lation,  and  it  enters  directly  into  the  drculatbn  with  the  food  products, 
prescribed  dose  produces  a  feeling  of  buoyancy,  and  remoyes  depression  and  i 
oholy ;  hence  the  preparation  is  of  greai  value  in  the  treatment  of  mental  and  i 
4iffeetion$.    From  the  &ct,  also,  that  it  exerts  a  double  tonic  influence,  and  indnoas  a 
healthy  flow  of  the  secretions,  its  use  is  indicated  in  a  wide  range  of  < 


NOTICE-CAUTION. 

The  success  of  Fellows'  Syrup  of  Hypophosphites  has  tempted  certain  ; 
to  offer  imitations  of  it  for  sale.    Mr.  Fellows,  who  has  examined  samples  of  ser- 

«ai  of  Hieae,  finds  tlhot  no  tWG  of  them  are  idemUcat^  ^aA 

that  all  of  them  differ  from  the  original  in  composition^  in  freedom  from  acid  reao* 
tion,  in  susceptibility  to  the  effects  of  oxygen  when  exposed  to  light  or  hea^ 

in  the  property  of  retaining  the  strychnine  in  solu- 

HOflf  And  in  the  medicinal  effects. 

As  these  cheap  and  inefficient  snbsdtutes  are  frequently  dispensed  instead  otiSkm 
genuine  preparation^  physicians  are  earnestly  requested^  when  prescribing  the  Syraf^ 
to  write  *^  Syr.  Hypophos.  FellOWS.^ 

As  a  further  precaution,  it  is  advisable  that  the  Syrup  should  be  ordered  in  the 
original  bottles ;  the  distinguishing  marks  which  the  bottles  (and  the  wrappers  sor- 
voanding  them)  bear,  can  then  be  examined,  and  the  genuineness— or  otherwise  oi 
the  oontents  thereby  im>ved. 

JHodJooZ  Letters  may  be  addressed  to: 

Mr.  FELLOWS,  48  Veaey  Street,  Mow  Toitt. 


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The  Demand  For 

a  pheasant  and  effective  liquid  laxative  has  long  existed— « 
laxative  that  would  be  entirely  safe  for  physicians  to  piesaflM 
for  patients  of  all  ages — even  the  very  young,  the  very  old,  tb# 
pr^Tiant  woman,  and  the  invalid — such  a  laxative  asthephyn- 
cian  could  sanction  for  £unily  use  because  its  constituents  .werr 
known  to  the  profession  and  the  remedy  itself  had  been  proves 
to  be  proiupt  and  reliable  in  its  action,  as  well  as  pleasant  tr 
administer  and  never  followed  by  the  slightest  ddi>i1itatioA. 
After  a  careful  study  of  the  means  to  be  employed  to  prodoes 
such 

A  Perfect  fedxative 

the  California  Fig  Syrup  Company  manuiactiired,  from  the  jvlcs^ 
of  True  Alexandria  Senna  and  an  excellent  combination  of  car- 
[▼e  aromatics  with  pure  white  sugar,  the  laxative  which  is  now  so  well  and  fistvorably  known  mder  ^bm-> 
name  of  **  Syrup  of  Figs."    With  the  exceptional  facilities,  resulting  from  long  experience  and  tatkm- 
to  the  one  purpose  of  making  our  product  unequalled,  this  demand  for  the  perfect  lazatiye 

is  met  bj?  Our  jVlethod 

•f  txtracthig  the  laxadve  properties  of  Senna  witbont  retainii^  the  griping  principle  frond  in  all  otb«- 
irapaiations  or  combinations  of  this  drug.  This  method  is  known  only  to  ns,  and  all  eflforts  to  produce  cheap 
Imitations  or  substitutes  may  result  in  injury  to  a  physician's  reputation,  and  will  give  diasatisfrctioii  to  ibm* 
patient ;  hence,  we  trust  that  when  physicians  recommend  or  prescribe  "  Symp  of  Figs  "  (Syr.  Fid  CaL)  thef* 
will  not  permit  any  substitiitioiL  The  name  ^'Syrup  of  Figs''  was  given  to  this  laxative,  not  because  im 
Iht  process 


of  jVlanuf acturitig 


A  fpir  figs  are  used,  but  to  distinguish  it  from  all  other  laxatives,  and  the  United  Sutes  Coorts  have 
MMt  wa  have  the  exclusive  right  to  apply  this  name  to  a  laxative  medicine.    The  dose  of 

"SVRUP  OF  PIGS" 

«■  •  laxative  is  one  or  two  teaspoonfnls  given  preferably  before  breakfast  or  at  bed  time.    Fh>m  one-luif  l» 
•AC  tablespoonful  acts  as  a  purgative,  and  may  be  repeated  in  six  hours  if  necessary. 

**  Syrup  of  Figs  "  is  never  sold  in  bulk.     It  is  put  up  in  two  sizes  to  retail  at  fifty  cents  and  $ljOO  par 
liet^  and  the  name  *'  Syrup  of  Figs  "  as  well  as  the  name  of  the  California  Fig  Symp  Company  is  pciafeiA  mm.- 
ab#  wnqypen  and  labels  of  every  botde. 

CALIFORNIA  FIG  SYRUP  COMPANY    . 
SAN  FRANCISCO,  CAL 
LOUISVILLE,  KY.  NEW  YORK.  N.  Y. 


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zli 


Worn  Day  and  Niffht  with  Comfort.   No  DIapIaoament. 
PRIOBS  TO   RHVSIOIKNS. 


Stnffle  Truaaea 

Adiilti  Toathi  caindi 
Siiet  28  to  42  22  to  28 12  to  21 

A.  Plain,  each,  fiJbO  $1.25  fl.OO 
B.F1iie,  "  2.00  1.76  IM 
CSilk,      **       2M     .  .      . 


DoublaTrua'a 

Adul'iythiChndi 
28to42  22to28  12tcm 

92JM)  $2.00 11.50 
8.00  2.60  2,00 
4j00    .  .     .  . 


Fie.  16. 


DIIECTI0N8  FOR  0RDERIN6.-6lvf  clrcumftrwicf  ofabdomMOiilntofniptur*.   Stattlffortliiglf  or  doubit,  right  •ritit 
CkMda  not  b7  Mall  upon  raoalpt  of  inloe,  or  IbLpnm  O.  O.  D.,  ohaige  fixr  xetomiiig  addod. 

a.  W.  FLAVEU.  a  BROo        No.  1005  Spring  Garden  Strert,        Ptailadelpbia,  Pa. 


Syropos  RoboraQS. 

lyr.  Ni^liot.  Comp.  wHh  Quiii.  Mtngin.  and  Strych.  1-128  gr. 

Strychnino  to  toaspoonful 
Mywtfm  Roborant  at  a  Tonic  during  Convalotconco  hat  no  oqiial. 

Jka  a  nerre  itimalaiit  and  reatoiatlTe  in  wasting  and  debiU- 
ialflf  diaoaaea.  as  a  conatraotlTe  agent  in  Tnaomnla,  Pneu- 
WMttBML,  Tnbercoloala.  Bronchial  a**^**"**^,  Mfummn'i,  Btnunoaa 
mwaaoa  and  Genml  Debility,  this  oomponnd  baa  noaoperior. 

gimjFUH  BOBOBAN8  la  in  peitect  lolntton  and  wfflkaep 


\  O.  BoBBBTB  saT8 :— In  caaea  oonTaleaeing  tnm  *1a 
8yrupua  Rooorana  baa  no  equal 


Peter's  Peptic  Essence. 


A  Powerftil  DIgattive  Fluid  In  Palatabia  Fo 

PtoaM  note  that  Esionco  and  Elixir  Poptin  contain  oalv  PtNli 

white  In  Potor't  Poptic  Emooco  Wo  have  i3l  the       ^^ 

digettlvo  Formonti. 

It  ii  a  Stomaoblo  Tonic,  and  lellerea  IndlgeitlDO,  ] 

id  baa  the  zemarkable  property  of  aneitu«  tobuI 

cenianoy.   It  ia  a  remedy  of  great  Tahie  In  Gaat 


piegnanoyi 

tanugia,  Obolem  Infimtdm,  ud  inteatlnal  Deiani 
eapeoaUy  thoae  of  an  Inflammatoiy  ohancter.  Ite 
mothen,  and  teething  children  it  baa  no  anperior. 


ttBplot  ooat  upon  application. 


Exarooi  Chargot  at 


your  Expente.  For  Sale  by  all  Wholooala  DraggMi. 


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MEXICAN 
REAR'S  niAW  BERRY  I  OTION 

rEFARED  from  Bear's  Claw  Berries,  Sulphuric  Ether  and 
Oils  of  Turpetine,  Orisanum  and  Citronella.  aooording  to 
the  forxnnla  of  Dr.  W.  R.^ILLESPIE.  See  MEDICAL  BRIEF,  Jime, 
page  680.  This  is  a  recent  discovery  and  in  every  case  in 
which  it  has  been  employed  the  results  have  been  marve- 
lous. The  only  local  application  which  instantly  relieves  ail 
forms  of  Rheumatism  and  Neuralgia.  Its  effects  are  perma- 
nent and  will  warrant  every  physician  in  giving  this  B;eniedy  a  triaL 

READ  WHAT  THE  FOLLOWINQ  PHYSICIANS  HAVE  TO  SAY  OF  IT:      ^ 


Davis,  W.  Va.,  July  17,  1894. 
Dear  Doctor: — ^The  Liniment  was  re- 
ceived and  I  have  used  it  in  six  cases;  five 
of  them  it  did  well,  the  other  had  no  re- 
sults from  it.  My  belief  is  due  to  the  fact, 
that  the  man  would  not  use  it  as  directed 
and  wanted  me  to  prescribe  for  him  for 
nothing,  while  he  could  raise  money  for 
latent  medicines.         Yours  etc., 

B.  M.  Smith,  M.  D. 

Bemus  Point,  N.  Y.,  Aug.  23,  1894. 
W.  R.  Gillespie,  M.  D. 

Dear  Doc/or  :^l  can  truly  say  the  Lini- 
ment is  all  you  recommended,  and  is  do- 
ing what  many  different  doctors  did  not 
do  in  the  case.  The  patient  was  almost 
helpless,  unable  to  walk  except  being 
carried  on  the  shoulders  of  some  one  as 
support.  Leg  and  shoulder  drawn  up.  She 
Ittaii  now  straighten  out  leg  and  is  getting 
nN|ch  better  use  of  shoulder ;  is  in  good 
spirits,  says  she  is  going  to  get  well ;  is 
taking  on  flesh  and  has  only  used  half  a 
bottle.  Want  more  when  you  are  able  to 
furnish  it.  Will  inform  you  as  the  case 
proceeds.  Hoping  you  success, 
I  remain  yours, 

E.  A.  SCOFIELD,  M.  D. 


Columbus,  Miss.,  Aug.  24,  1894. 
W.  R.  Gillespie,  M.  D., 

Covington,  Ky. 

Dear  Doctor : — Your  favor  of  August 
2 1  St  received,  will  state  in  reply  that  my 
patient  used  the  last  of  the  Mexican 
Liniment  the  other  day,  and  will  atate 
further  that  since  she  commenced  the 
use  of  the  Liniment  she  has  steadily  im- 
proved. Now  she  is  free  from  pain,  but 
still  has  some  swelling  of  the  wrist  and 
knee  joints.  She  has  but  little  use  of 
the  lower  extrenieties,  but  I  think  this 
trouble  will  be  gradually  overcome.  She 
went  visiting  the  other  day,  something 
that  she  has  not  done  for  twelve  or  four- 
teen months.  You  should  by  all  means 
prosecute  the  study  of  the  plant  If  the 
plant  has  ever  been  described  by  procur- 
ing a  dried  specimen  of  the  plant,  you 
could  readily  find  out  the  botanical  name. 
I  am  satisfied  from  the  effects  of  the 
Remedy  on  my  patient  that  it  possesses 
valuable  curative  properties  for  Rheuma- 
tism. 

Should    vou  write  an   article  on  this 
Remedy,  please  forward  me  a  copy. 
Yours  truly  and  fraternally, 

J.  W.  Spillmakx. 


*See  Miso  M  letter  from  Dr.  W.  R.  CLEMENT,  September  BRIEF, 


W7U 


Put  up  in  pints  only,  at  $8.00  per  pint,  net.  One  pint  is  sufficient 
for  the  treatment  of  one  chronic,  or  from  three  to  five  acute  oases,  as 
but  very  little  is  required  for  each  application. 

ATLAS  CHEMICAL  CO. 

216  Main  Street,  Cincinnati, Ohio,  U.S.A. 

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