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11.00  PER  YEAR. 


15c   PER  COP> 


DeCROIS 

meDiQMir 
^oumjus 


DETROIT,  MICH 

ORIGINAL: 

Tuberculosis:   Glbbi 
Epoch  Making  In  l^fedlclne' 

CORRESPONDEN 

Journal  of  a  Naval  S«r«eon: 
EDITORIAL: 
Demise  of  President  McKlnley:..  175 

Cajuput  Oil: 176 

Two    Novel    Claims: 177 

FlghtinK  Nile  Sudd: 177 

EDITORIAL  NOTES: 
ITEMS  AND  NEWS: 
BOOK  REVIEWS: 


NEW    INSTRUMENTS   AND 
DEVICES: 

THERAPEUTIC  BREVITIES 

MEDICAL   PROGRESS: 


tH^J.F.HARTZ  CO., 
DETROIT,     MICH. 

PcNiNSULAK  En*.  OerRoiT 


publishers: 

&  BOOK-SE.LLERS 


tNTERED  AT  THE  POST  OFFICE  AT  DETROIT,  MICH.,  AS  SECOND  CLASS  MATTER   MAY  aTH.  1901. 

THE  ONLY  STRICTLY  ETHICAL  MEDICAL    JOURNAL     IN     AMERICA. 


DETROIT    MEDICAL 
JOURNAL 


An  independent  Medical  Montlily  conducted  solely  in  the  interests 
of  the  medical  profession. 

The  reading  columns  present  a  monthly  epitome  of  practical 
medicine  and  therapeutics. 

No  Dead  AVood. 

No  Abstruse  Theories. 

••FAKE"  Advertising  Tabooed. 

No  Long->vinded  and   Impradiical  Disctis- 

sions. 
Alw^ays  Reliable  and  Trtitbful. 
Fearless,   Fair  and  Judicial. 
Tbe    Only    Purely    Medical     Magazine    in 

Nortti  America. 


F.AT£St 

SIZE  OF  PAGES  5  J-2  x8  1-2. 


SPACE 

Three  Months 

SU  Months 

Twelve  Moodu 

One  Pac^t . 
One-Hall  Page, . 
Ooe-Ouartcr  Page, 

$75^ 
J8.75 

$150U)0 
75.dQ 
37^ 

$300U)0 

J50.00 

75.00 

PREFERRED  SPACE  AT  THE  RATE  OF  $400.00  PER  YEAR. 

(Coven  and  »<]joinlng  pages,  and  pages  next  to  Uterary  matter.) 

Single  insertions  in  proportion,  plus  the  expense  of  coQxposition. 


THE   J.    F.    HARTZ    COMPANY, 

Medical  Pul>liaK«ra,   I'mport*r* 
^       and    BooKs«ll«rB,       .^ 


270  Woood-ward  Ave. 


DETROIT,   MICH. 


DETROIT  MEDICAL  JOURNAL. 


Mcintosh  No.  6  Table  or  Wall  Plate 


Arranged  for  use  with  110  vo't 
direct  current,  or  with  battery  « 
43  Ammonium  Chloride  Cells 

All  needed  accessories  of  ;i 
tirst-class  oflice  battery,  mounted 
on  Tennessee  Marble  Plate  h'> 
inches  square. 

Don't  be  content  with  a  cheap 
substitute. 

BUY  THE    BEST 
We  lead  the  world  in 

STATIC  MACHINES, 
MOTORS  and 

TRANSFORMERS 

RHEOSTATS  and  METERS 
OFFICE  CABINETS 
ELECTRODES 
PORTABLE  BATTERIES. 


WRITE  FOR  OUR  REVISED  21st  EDITION  CATALOGUE 

PRICE,  $50.00,    EXPRESS   CHARGES    PREPAID  TO   ANY 
CITY    IN    THE    UNITED   STATES. 

MclNTOSH   BATTERY  and  OPTICAL  CO., 

92  to   98   STATE    5TREET,    CHICAGO,    ILL,,    U.  S.  A. 


Make  Your  Office  lip-To-Date 


f_,mi-^ 


\^ 


OFFICE  TREATMENT  TABLE. 

Table,  only $18.50 

Twelve    Fine    Bottles,    as- 
sorted Crystal  and  Blue.    2.75 


A  convenient,  white  enameled  Table,  with  plate  glass 
shelves  and  nickel-plated  trimmings. 

THE  WOCHER  N0.2  OPERATING  TABLE  has  been 
conceded  as  the  best.    Send  for  description. 

OUR  COMBINATION  STERILIZERS  for  Gauze, 
Water  and  Instruments  have  no  superior.  Send  for  de- 
scription. 

COMPRESSED  AIR  SPRAY  APPARATUS.  We 
make  the  largest  line  of  these;  also.  Office  Nebulizers, 
Vaporizers,  Cautery  Transformers,  Batteries,  Electric 
Head  Illuminators,  etc.,  and  solicit  correspondence. 

We  are  one  of  the  most  extensive  manufacturers 
of  Surgical  Goods,  and  guarantee  prices  to  be  as  low  as 
any,  considering  quality.  Remember  that  many  reduc- 
tions have  been  made. 

Max  Wocher  &  Son, 

Surgical  Instrument  Makers, 

21-23  W.  Sixth  St.  CINCINNATI,  OHIO. 

Office  and  Hospital  Tables  and  Chairs. 


11. 


DETROIT  MEDICAL  JOURNAL. 


V 


GREATEST  SUCCESS  IN 
AURAL  MASSAGE 


W.H.WIGMORE 


Inventor  and 
Manufacturer  of 


Surgical 
instruments 


Specialties 

of  Gold,  Silver,  Aluminum, 
Silver  and  Nickel-plated 


Patented  June  27. 1859.  Philadelphia 


Price,  $10.00  i;X^.  Pa. 


LATEST  INVENTION  IN 
STETHOSCOPES 


KCNLKH'S    STCTHOSCOP* 

PRICE,  t2.00.    Pest  Prepaid 


..ESTABLISHED  1857. 


THE  FULLER  **WALKEASY" 

ARTIFICIAL  LEG 


HAS  A  FOOT  WITH  SPONGE  RUBBER  SOLE  AND 
REPRESENTS  THE  LATEST  PROGRESS  IN  MOD- 
ERN     ARTIFICIAL    LIIVIB    CONSTRUCTION. 

Various  other  styles — Legs  and  Arms — and  at 
various  prices. 

Since  1880  we  have  made  one-fourth  of  all  artifi- 
cial limbs  furnished  Pensioners  by  the  U.  S.  Govern- 
ment. 


SEND  FOR  BOOK 

GEO.  R.  FULLER  &  CO. 

Rochester,  N.  Y. 


branches:     23  W.  SWAN  ST.,  BUFFALO.'N.  Y.k.50  N.   1  3TH  ST.,  PHILADELPHIA,  PA. 


DETROIT  MEDICAL  JOURNAL.  Ill 


i 


TO  PHYSICIANS 


We  carry  a  full  line  of  Physicians' 
and  Surgeons' 


Pills,      Tablets,      Tinctures, 

Fluid  and  Solid  Extracts, 
Reagents,      Hypodermatics, 

Chemicals, 

...Surgical  Appliances  and... 

Dressings. 

WRITE  FOR  QUOTATIONS. 

THE  J.  F.  HARTZ  CO., 

268  Woodward  Avenue,  No.  2  Richmond  Street, 

DETROIT,  MICH.  TORONTO,  ONT. 


ly 


DETROIT  MEDICAL  JOURNAL. 


If  your  drug- 
gists don't 
handle  them, 
write  to  us  di- 
rect, or  to  The 
J.  F.  HART': 
CO.,  Detroit, 
Mich. 


No  Pain  from  your  Rupture  if  you  wear 

THE 

Champion 
Truss. 


ALSO  MAKERS  OF  THE 


Celebrated  Blanck  Artificial  Limbs, 

Elastic  Stockings  and  Belts, 
Crutches,  Shoulder  Braces, 
Suspensory  Bandages,  and 
Genuine  Hard  Rubber  Trusses.^ 

THtpHILADELPHIATRlSSCO. 


Catalogue  and  Price  List  on  Application. 


MANUFACTURERS, 

P.  0.  Box  1207.  60  Locust  St.,  PHIULELPHIA., 


Columbus  Aseptic  Operating  Table  and  Chair  Combined. 

PRICE  $25.00. 


Height  of  seat^  31  inches.    By  letting  the  back  down  any  desired  angle 
may  be  obtained. 
No  physician  can  afford  to  be  without  a  Modern  C(\\  IIIURliS  PHARIVIAfAl    PO 

COLIMBIS,  OHIO. 


Aseptic  and  Up-to-date  Operating  Table  and  Chair. 


DETROIT  MEDICAL  JOURNAL. 


THE 

RNY-^CHEERER  CO 


Manufa«f%urers  and  Dealers'in 


High-Grade 
Surgical 

Instruments 


Hospital 

and  Office 

Supplies 


225  to  233  Fourth  Avenue,  NEW  YORK  CITY. 


The    largest    establishment    of   the    kind    in    the    United 
States.     Carrying  the  most  entensive  and  complet  line  of 


SURGICAL  INSTRUMENTS, 
MODERN  ASEPTIC  HOSPITAL 

SUPPLIES, 
ASEPTIC  OPERATING,  WARD 

and  OFFICE  FURNITURE, 
STERILIZERS  and  DISINFEC- 

TORS, 
NURSES'  REQUISITES, 
SICK-ROOM  UTENSILS, 
RUBBER  SURGICAL  GOODS, 
SANITARY  APPLIANCES, 
DEFORMITY  APPARTUS, 
TRUSSES, 

ABDOMINAL  SUPPORTERS, 
SHOULDER  BRACES, 


ELASTIC  HOSIERY, 
CRUTCHES,  SPLINTS, 
[NVALID  CHAIRS, 
ASEPTIC  SURGICAL  DRESSINGS, 
BANDAGES  and  PLASTERS, 
ELECTRIC  BATTERIES  and 

APPLIANCES, 
MASSAGE  INSTRUMENTS, 
ANATOMICAL  MODELS, 
OSTEOLOGICAL  PREPARA- 
TIONS, 

LABORATORY  SUPPLIES, 
NATURALISTS'  INSTRUMENTS, 
MICROSCOPES  and  ACCES- 
SORIES, ETC.,  ETC. 


Correspondence  Invited. 
Inspection  of  PREMISES  and   STOCK  SOLICITED. 

Catalogues  Mailed  FR£E1  on  Application. 


VI 


DETROIT  MEDICAL  JOURNAL. 


The  "Olym|)ia"   the  "western"! 


I^edicine  Case     j0     Tor  Hand  and  Bug^y  Lse. 


Price,  $7.00 


DIMBNSIONS-12y2  in.  long,  614  In.  high,  and 
wide  mouth  screw  cap  jars,  for  salts,  etc.,  and  4 
6V6  in.  wide.  Contains  14  1-oz.,  28  3-dr.,  4  2-oz.. 
2-oz.  G.  S.  &  M.  C.  bottles  for  acids,  etc.  ALSO  A 
LARGE  SUPPLY  SPACE,  11^x5^4x2%  in.  deep.  It 
Is  fitted  with  the  "Western"  silver-plated  springs 
for  holding  the  bottles,  metal  covered  flanges  at 
head  of  corks,  preventing  same  from  coming  out 
and  spilling  contents;  nickel  spring-lock  and  key 
ahd  extra  strong  handle  with  metal  reinforcement 
on  inside. 

It  is  made  of  heavy  black-grained  waterproof 
leather  (cowhide),  hand  stitched  around  the  edges, 
and  lined  with  thoroughly  durable  material.  The 
sides  and  bottom  of  case  are  protected  with 
leather  buttons. 


Mii.le 


GLASS  STOPPER 
AND  METAL  CAP 


Safety  Bottle 

For  Medicine  Cases  and  Bags.  A  Rellali 
Container  for  Carbolic  Acid,  Tr.  Ira 
Iodine,  Ergot,  Chloroform  and  simil 
fluids. 

It  i.s  made  of  the  very  best  heavy 
iint  glass  with  an  emery  ground 
-class  stopper  fitted  accurately  to  the 
opening,  and  the  same  is  absolutely 
k.ept  in  place  with  a  metal  cap  which 
rirmly  screws  over  the  stopper  and 
iround  the  neck  of  the  bottle,  thus 
preventing  any  possible  chance  of 
the  stopper  becoming  loose,  and  re- 
lucing  the  liability  of  leakage,  if  any. 

o  virtually  nothing,  as  this  is  not 
in  ordinary  sand  ground  stopper,  but 

lie    especially    ground    for    us    with 

mery,  making  the  same  fit  very  snug- 
ly in  the  neck  of  the  bottle.  The 
'herlts  of  this  device  are  easily  appre- 
ciated, as  nearly  every  doctor  has  had 
trouble  and  inconvenience  by  not  hav- 
ing a  reliable  container  for  such  and 
similar  fluids  as  named  above, 
m  six  sizes— %,  1%,  2,  4,  6  and  8  ounces. 


Western  Leather  Mf<^.  Co. 
48  Wabash  Ave.,  Chicago. 

Send  for  Catalogue. 


THIS  :C\JT  S-O-O-WS  A  200   GAI^I^ON  TANK   RE^ADY 
FOR    USE,    OF 


OXYG  EN 


If  you  are  interested,  we  will  appreciate  receiving  your  name.     We  can  tell  you  who  dispenses  it 
in  your  vicinity  and  give  information  regarding  its  use.     Please  drop  us  a  line. 

"We  are  MaKers  of 

Oxygen  (Pure)  Nitrous  Oxide 

Carbonic  A.cicl  Oas  Retorts 


Oxygen  (compound) 
Ktc.,  £tc. 


TKe  Lennox  CHeinical  Co., 


41  to  49  "Wilison  Ave. 


CLEVELAND.  O.    : 


DETROIT  MEDICAL  JOURNAL. 


VII 


•'••'»-•">"»"»"••'>"•••••••-•-•"»"»•'•-•"•-»■■»■■»••♦-«•■•"»"•■•—•••"••• 


5ILR  WORM  GLANDS 


(Commonlx  called  SilK  'Worm  Gut.) 


di 


o  o 
o  o 


<U  0}  0) 

o,  o<  o< 

«  o  <v 

CJ  CJ  t) 

*p  "C  "E 

PU  CU  Ph 


Silk  Worm  Glands,  especially  made  for  surgical  use,  and  sterilized  by  the  most 
modern  aseptic  methods,  have  attained  the  foremost  rank  as  suturing  material. 

Our  Silk  Worm  Glands  are  removed  from  the  silkworm  and  subjected  to  the  action 
of  a  strong  solution  of  Corrosive  Sublimate  prior  to  being  drawn  out  to  proper 
length  and  thickness.  Note — the  ordinary  solution  employed  in  the  process  of  making 
Silk  Worm  Gut  (so-called)  is  vinegar,  which  is  always  full  of  bacteria 

Sutures  made  from  Silk  Worm  Glands  are  indestructible  when  imbedded  in  human 
tissue.  They  do  not  absorb  and  are  not  absorbed,  therefore  remain  in  perfect  condition 
until  removed.  They  do  not  oxidize  as  is  the  case  with  metallic  sutures.  They  do  not 
absorb  and  retain  pus  in  suppurating  wounds,  thus  producing  stitch  abcesses. 

Use  Silk  Worm  Sutures  once,  and  you  will  not  employ  any  other  ligature  material. 


THEJ.     F.     HARTZ     CO., 


268  'W^ood'wirard  A.ventiet 
2  RicHmond  Street,  £., 


DETROIT,  MICH. 
TORONTO,  ONT. 


.••"•"••••••••••••••••"••••"••••' 


•®®C«)®®®®®®®®® 


VIII  DETROIT  MEDICAL  JOURNAL. 


NEARLY  READY 


Our  New  Catalogue  of  Physicians  Supplies  which  will 
be  available  for  distribution  about  October  First. 


For    Physicians    ONLY! 


Place  your  request  for  the  same  at  once  in  order  to 
avoid  delay:     "First  Come,  First  Served!" 

This  work  is  the  most  complete  of  its  kind  ever  issued 
from  the  press.  It  embraces  all  the  essentials,  in- 
cluding the  Newer  Remedies,  both  singly  and  in  com- 
binations, that  are  sanctioned  by  Modern  and  Ethical 
Therapeutics. 

We  offer  a  complete  line  of  Tablets, — Triturate,  Com- 
pressed, Coated  and  Hypodermatic;  Pills,  Pellets  and 
Alkoloidal  Granules — all  representing  the  Acme  [of 
excellence  as  regards  ingredients,  the  perfection  ^of 
manufacture  and  palalability. 

— Our  Hypodermatic  Tablets  are  the  most  freely  soluble, 
and  exact  as  to  Division  and  Dosage,  of  any  in  the 
market. 

We  also  offer  many  Specialties  and  Novelties,  based 
upon  Physiological  Therapeutics 

Likewise  a  full  line  of  Solid,   Fluid  and  Powdered  Ex- 
tracts:     Concentrations    and     Resinoids:      Homoeo- 
pathic and  Eclectic  (green-drug)  Tinctures:     Syrups, 
Wines.  Elixirs,  etc, — all  our  own  manufacture. 
Our  motto  is: 


ACCURACY  AND  EXCELLENCE  ABOVE  ALL! 


THE    F.    J.    HARTZ    COMPANY, 

No.  2  RicHmond  Street,  E,.,  2G8    IVood^vard    A'venue, 

TORONTO,  ONT.  DETROIT,   MICH. 


DETROIT  MEDICAL  JOURNAL. 


IX 


S>6c  Faultless 

Rubber  Glove 


Is  the  best  Glove  your  money  can 
buy.  Made  in  four  weights  and  in 
sizes  and  half  sizes  from  6  to  1 1 
inclusive.  Can  be  sterilized 
re|)eatedly«  For  rough  usage, 
dishwashing,  etc., 


Non-Pa-Reil   Gloves 

have  no  equal.     For  sale  by  all  jobbers.     Booklet  free. 


THE  FAILTLESS  RIBBER  CO.,  Mnfgs., 

AKRON  ^  OHIO 


.SURGEONS  ^rPECIFY 

LEE'S    SUTURES 

and   LI  GATURES 

Because  they  have  been  convinced  by  experience 
of  their  unvarying  excellence. 

We  manufacture  and  prepare  over  forty  different  styles. 


Est.  1883 


Trade  Mark. 


J.  ELLWOOD  LEE 
COMPANY. 

"THE  HOME  OF  ASEPSIS" 
CONSHOHOCKEN,  PA. 


Special  Rates 

given  physicians  desiring  to 
purchase,  sell  or  exchange 
practices     ::::::: 

Detroit  Medical  Journal. 


DETROIT  MEDICAL  JOURNAL. 


Grand   Clubbing  Offer  for   1901=1902. 


WE  OFFER  THE 


Detroit  Medical  Journal 


(Wholly  in  the  physician's  interests;  purely  ethical  in  character.) 

For  One  Year  in  connection  with  the  following: 

1  Success:   Current  Literature:  McClure's:   Home  Magazine:  Review 

of  Reviews — the  latter  to  new  subscribers  only,     (Publish- 
ers'   price,   $9.50)    for $5.00 

2  Ditto,  substituting  Cosmopolitan  for  Home     Magazine.      (Publishers' 

price,    $9.50) 5.00 

3  "      without  Review  of  Reviews.     (Publishers'  price,  $7.00) 4.25 

^   4        "      substituting   Home   Magazine   for  Cosmopolitan.     (Publishers' 

price,  $7.00) 4.25 

5  "      substituting    Pearson's   for   Cosmopolitan.     (Publishers'   price, 

$7-0o) 4.25 

6  Success,  Current  Literature,  Cosmopolitan     and     Home     Magazine, 

(Publishers'  price,  $7.00)    .•     4,00 

7  Success, Current  Literature,  Pearson's  and   Home   Magazine.      (Pub- 

lishers' price,  $7.00) 4.00 

8  Success,    Current    Literature,    Pearson's   and   Cosmopolitan.     (Pub- 

lishers' price,  $7.00) 4.00 

9  Success,  Current  Literature  and  McClure's    Magazine.      (Publishers' 

price,  $6.00) 3.75 

10  Success,  Current  Literature,  and  Home  Magazine.    (Publishers'  price, 

$6.00) 3.50 

11  Current  Literature,  Cosmopolitan  and  Pearson's  Magazine.    (Publish- 

ers'   price,   $6.00) 3.50 

Note. — In  any  of  the  foregoing,  Nos.  i  and  2  excepted,  the  Review  of  Re- 
views may  be  substituted  for  Current  Literattire. 

12  Success,  McClure's  and  Home  Magazine.     (Publishers'  price,  $4.00)  3.25 

13  Success,  McClure's  and  Cosmopolitan,     (Publishers'   price,   $4.00)..  3.25 

14  Success,  McClure's  and  Pearson's.     (Publishers'  price,  $4.00) 3.25 

15  Success  and  McClure's.     (Publishers'  price,  $3.00) 2,75 

16  Success  and  Home  Magazine.     (Publishers'  price,  $3.00) 2.50 

17  Success  and  Cosmopolitan.     (Publishers'  price,  $3.00) 2.50 

18  Success  and  Pearson's.     (Publishers'  price,  $3.00) 2.50 

Subscriptions  may  begin  any  time. 

Cash  subscriptions  prior  to  January    first     will    secure     the    remaining 
issues  of  the  Detroit  Medical  Journal  for  1901,  gratis. 

THE  J.  F.  HARTZ  COMPANY, 

PUBLISHERS,    BOOK  -  SELLERS 
AND   IMPORTERS . 

No.  3  Richmond  Street,  East,  370  Woodward  Avenue, 

TORONTO,  ONT.  DETROIT,  MICH. 

♦♦♦♦♦♦♦♦ »»♦#»♦»»" 


DETROIT  MEDICAL  JOURNAL. 


ZI 


KellyS 
lm[)roved  | 
Surgical 
Cushion. 


The  feature  of  this  new 
cushion  Is  the  covered  apron 
for  conducting:  the  fluids  to 
the  receptacle 

It  has  a  stout  spring  at  the 
mouth  of  the  apron  which 
Insures  an  unobstructed  flow. 

At  the  lower  end  there  is  a 
hook  which  can  be  snapped 
over  the  spring  by  folding 
back  the  apron. 

This  forms  a  pocket  for 
receiving  the  fluid,  and  is 
very  convenient  in  many 
operations. 


— MADB    BY— 


Tm  B.  F.  OOODRICn  COMP% 

AKRON  RLBBER  WORKS,      AKRON,  OHIO. 


DRUGGISTS'     AND     SUR- 
GEONS' RUBBER   GOODS 


^|MW 


SEEM  HIGH 


CX^  AND  <j^     ^ 

c^  Superior  ^  \ 
Qualities 

ARE  THE  FUNDAMENTAL  REASONS  FOR  THE 
UNPRECEDENTED  POPULARITY  OF 


[I 


THE 


(DRY  CELL) 


OVER  103.000  NOW  IN  USE, GIVING  COMPLETE 

^  SATISFACTION.  ^.  i 

■^     ^  WE  GUARANTEE  THIS  TO    <»     Si 

^       <^     ALL  OUR  PATRONS.  «^   ^ 


ii^'/AfORE.WO.Vii 


DORO^IIIIIIl  MM  I 

(Kach  gallon  contalningr  IB  Kr.  o£  r.li  .- 
lum  Carbonate  and  7%  gr.  Boric  Acid- 
Made  from  the  famous  Hygela  Spring 
Water  of  Waukesha.) 

Is  commended  by  more  prominent 
Physicians  tiian  any  other  water. 

Is  put  up  under  the  direction  of  a 
graduate  in  medicine. 

Contains  more  lithia  and  less  or- 
ganic matter  than  any  water  on  earth. 

Send  for  Doctor's  pamphlet — sam- 
ples free  to  Physicians  who  will  pay 
express  charges. 

"Boro-Lithla  water  has  demonstrated 
its  value  in  two  classes  of  disorders— 
the  inflammatory  aflHictlons  of  the  urin- 
ary tract,  kidneys  and  bladder  In  particu- 
lar; and  in  those  numerous  conditions 
due  to  imperfect  elimination  of  uric  acid 
compounds.— To  the  first  class  belongs 
Brlgnt's  Disease  and  Cystitis.— To  the 
second  class  dyspepsia,  constipation,  per- 
sistent headache,  rheumatic  pains,  gouty 
swellings,  irritation  of  the  bladder."  Wm. 
T.  Belfield,  M.  D.,  of  Rush  Medical  Col- 
lege. 

THE  WAIKESHA  WATERJCO., 

WAUKESHA,   WISCONSIN,  U.  S.  A. 


o:o:o:ox3:o:o:o:o:o:o:o:o:o:o:o:o:o:o:o:o:o:ao:o:oxx^^^ 


The  Hastings  &  Mcintosh  Truss  Go. 

Manufacturers  of  all  kinds 
of 

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XIV  DETROIT  MEDICAL  JOURNAL. 


FEEDING  AND 
NURSING  THE 
BABY 


By 

CKas.  Douglas,  M.  D., 

Professor   of  Children's  Diseases  and  Clinical  Medicine   in   the    Detroit   College   of  Medicine;    Consuliing 
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XV 


JtdT  XS  OOOD  is  not  THE  BE^T 


High  Tension  Apparatus. 
Coil  nearly  8000  feet  long. 
Gear  for  moving  coil. 
Rheostat,  Slow  and  Rapid 
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it  is  of  service,  A  faradic  coil  when  properly 
constructed  has  definite  polar  direction.  In  the 
glowing  of  a  vacuum  tube,  the  positive  is  deter- 
mined by  the  discharge  from  the  wire  inside  the 
tube.     The  full  bulbus  glow  represents  the  negative. 

We  have  illustrated  one  type  of  medical  bat- 
tery. Let  us  suggest  that  if  you  will  spare  the 
time  to  write  to  us  we  will  cheerfully  spare  the  time 
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best. 

Jerome  Kidder  Hf<^«  Co., 


Manufacturers  to  the  Medical 
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New  York,  N.  Y. 


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KALAMAZOO,  MICH.,  L.  S.  A. 


RETICULAR  TUBERCLE  CENTRE  IS 
JU5T  BEGINNING  TO  NECROSE 


-S  ''•'^• 


INfLAMMATORY    TUBERCLE 
CGMMENClNGr-LUNG  OF  CEIILD. 
CASE    DIAGNOSED      AS  ACUTE 
MILIARY    TUBERCULOSIS 
LUNG    INJECTED  WITH  BERLIN 
BLUE. 


RETICULAR    TUBERCLE- 
COMMENCING:  FROM  A  CASE  OF 
ACUTE  MILIARY    TUBERCULOSIS. 


T  -^ 


^^^> 


CASEOUS  TUBERCLE  IN  LUNG 
or  CHILD   IN  CASE  OF  ACUTE 
MILIARY  TUBERCULOSIS  SO  CALLED. 
CENTRE  OF  MASS  CONTAIN5  A 
LARGE  NUMBER  OF  TUBERCLE 
LACILLi. 


(Photo-micrographs  made  on  Cramer  iso-chromatic  plates.) 


>-Os. 


'dyO^ 


DETROIT 
MEDICAL  JOURNAL 


"SMjP — ~^i:li£^- 


Original  Articles. 


TUBERCULOSIS. 

i;V  HENEAGE  GIBBES,  M.  D.,    C.   M.,    L.  R.   C.  P. 
(LONDON.) 

Koch's  statement  concerning  human  and 
bovine  tuberculosis,  at  the  British  Congress 
recently  held  in  London,  has  caused  a  sen- 
sation throughout  the  world  from  which 
nothing  but  good  can  arise,  inasmuch  as 
numerous  investigations  will  be  made  that 
will  embrace  all  sides  of  the  question ;  and 
the  statement  of  Professor  Virchow,  in  re- 
gard to  the  German  Commission  (of  which 
he  is  a  member)  that  "henceforth  the  ana- 
tomical tubercle  shall  be  fully  considered," 
is  most  important. 

I  should  not  be  surprised  if  Koch  has  a 
still  more  startling  statement  to  make  pub- 
lic, for  which  that  regarding  human  and 
bovine  tuberculosis  is  a  sort  of  pilot  bal- 
loon. It  must  be  remembered  that  he  has 
never  gone  so  far  as  some  of  his  disciples, 
and  that  years  ago  he  admitted  having  seen 
ises  wherein  no  tubercle  bacilli  could  be 

lund,  a  truism  that  has  been  abundantly 
Dufirmed  by  others;  and  yet  there  are 
many  who  still  deny  this  well-proven  fact. 
It  is  to  be  hoped  that  clinicians  will  now 
come  to  the  front  and  let  us  have  the  result 
of  their  years  of  experience,  gathered  from 


careful  painstaking  observation  of  cases 
seen  throughout  their  whole  course. 

And  here  I  wish  to  point  out  where  I 
think  the  view  that  the  tubercle  bacillus  is 
ever  present,  and  a  cause  of  all  disease  end- 
ing in  destruction  of  the  lung  substances, 
has  worked  positive  harm.  We  are  famil- 
iar with  the  condition  of  the  lungs  when 
a  consolidation  is  formed  which,  after  a 
time,  softens  and  breaks  down,  is  thrown 
off,  and  a  cavity  left.  This  result,  I  con- 
tend, is  brought  about  by  two  distinct  dis- 
eases-processes, which  should  have  en- 
tirely different  treatment  before  this  condi- 
tion is  arrived  at. 

The  first  is  a  purely  inflammatory  one, 
beginning  as  bronchitis,  extending  into  the 
lungs  as  broncho-pneumonia,  forming  a 
consolidation  varying  in  size  according  to 
the  intensity  of  the  inflammation  and  the 
number  of  bronchioles  affected.  Should 
the  vitality  of  the  patient  be  so  low,  or  the 
intensity  of  the  inflammatory  process  so 
great  that  the  affected  portion  of  the  lung 
is  unable  to  resist  it,  death  of  the  part  re- 
sults and  then,  after  a  time,  a  cavity  is 
formed. 

Careful  study  of  a  large  number  of  these 
cases  has  proved  that  the  disease-process  is 
a  purely  inflammatory  one  from  first  to  last ; 


Detroit,  Mich.,  September  25th,  1901' 


Vol.  1,  No.  6. 


162 


DETROIT  MEDICAL  JOURNAL. 


and  in  cases  of  capillary  bronchitis  where 
death  took  place  before  the  inflammatory 
process  had  extended  into  the  lungs,  the 
morbid  changes  were  identical.  Bacterio- 
logical examination  of  these  cases  fails  to 
reveal  the  tubercle  bacillus  in  the  secretions 
of  the  bronchi,  or  in  the  consolidation  in  the 
lungs,  until  these  organs  begin  to  break 
down,  and  then  they  are  generally  present 
in  large  numbers. 

I  am  told  by  men  who  hold  the  general 
view  that  the  tubercle  bacilli  are  pathogno- 
monic, that  these  are  cases  of  tuberculosis. 
I  now  desire  to  know  when  they  became 
tubercular?  From  the  number  of  cases  ex- 
amined and  the  uniformity  of  the  results 
obtained,  I  feel  sure  of  the  stage  when  the 
tubercle  bacillus  appeared  on  the  scene. 
Was  this  the  time  when  the  broncho-pneu- 
monia became  luberculosis,  because  this 
was  when  the  disease-process  had  destroyed 
so  much  lung  tissue  that  the  patients  would 
have, died  anyway? 

I  will  venture  to  say  that  over  fifty  per 
cent,  of  cases  with  cavities  in  the  kmgs  are 
produced  by  broncho-pneumonia.  Is  it  not 
then  of  the  utmost  importance  that  the  num- 
ber of  men  who  are  trying  to  cure  these 
pulmonary  conditions  should  know  which 
disease-process  they  are  handling,  since  the 
same  treatment  can  not  apply  equally  to 
both  ? 

The  other  form  of  lung  disease  resulting 
in  the  formation  of  a  cavity  is  an  entirely 
different  disease-process.  Take  a  typical 
case :  Here  we  have  a  patient  complaining  of 
lassitude  and  fatigue  easily  induced;  we 
notice  a  commencing  stoop  and  rounding  of 
the  shoulders ;  there  may  be  no  cough  at 
this  early  stage,  but  a  careful  examination 
of  the  chest  reveals  dullness  at  one  apex, 
generally  the  left.  As  we  watch  the  case 
from  day  to  day,  it  it  is  found  the  dullness 
is  constantly  extending  below  the  clavicle, 
and  thus,  gradually,  all  the  symptoms  de- 
velop with  which  we  are  so  familiar.  There 
is  no  expectoration  in  the  early  stages ;  there 


can  not  be  as  the  bronchi  are  not  affected 
and  the  consolidation  has  not  yet  broken 
down. 

This  condition  differs  in  loto  from  that 
first  described :  There  is  no  acute  inflam- 
matory process  extending  into  the  lungs, 
on  the  contrary  the  disease-process  is  going 
on  in  the  lung  itself;  and  this  process  con- 
sists of  a  new  growth  which,  starting  in 
one  apex,  gradually  substitutes  itself  for 
the  normal  lung-tissues;  as  it  grows  new 
blood  vessels  are  formed  for  its  nourish- 
ment, and  the  growth  slowly  progresses 
until  a  large  portion  of  the  lung  is  involved ; 
the  other  lung  becomes  affected  after  a  time, 
and  we  have  all  the  signs  and  symptoms 
of  pulmonary  tuberculosis.  This  new  tissue 
is  of  an  unstable  character,  and  in  some 
manner  cuts  off  the  blood-supply  from  the 
central  portion  of  the  oldest  tubercles, 
which  becoine  necrosed,  then  break  down, 
and  thus  form  cavities. 

I  have  made  a  long  and  careful  study  of 
these  two  disease-processes,  which  although 
entirely  different,  end  in  the  formation  of 
cavities  in  the  lungs. — The  accompanying 
illustrations,  from  micro-photographs,  show 
the  initial  stage  and  full  development  of 
each  form. 

The  lower  left-hand  illustration  is  taken 
from  a  lung  injected  with  Berlin  blue,  and 
the  injected  vessels  are  seen  in  the  nodule; 
the  whole  is  composed  of  cells,  i.  e.,  leucocy- 
tes, which  have  passed  from  the  adjacent 
blood  vessels  by  diapedesis  in  response  to 
some  irritation.  This  does  not  differ  in  any 
way  from  inflammatory  exudation  in  any 
other  organ  or  part  of  the  body  where  sqj 
irritation  exists,  causing,  immediately  at 
spot,  a  massing  of  leucocytes,  that  is,  infl£ 
mation,  which  increases  until  a  consolida- 
tion is  formed  large  enough  to  be  recog- 
nized. At  no  period  in  this  disease-proc( 
is  there  any  new  tissue  formed. 

Taking  the  initial  stage  of  this  conditi^ 
as  set  forth  in  the  left-upper  illustrati 
we  find  a  totally  different  process  going 


>om^ 


DETROIT  MEDICAL  JOURNAL. 


163 


there  is  no  inflammatory  exudation ;  there 
is  nothing  acute  about  it,  in  the  sense  of  an 
inflammatory  re-action  to  an  irritant.  The 
first  appearance  of  the  lesion  consists  of  one 
or  more  giant  cells  surrounded  by  a  fibroid 
tissue,  consisting-  of  fusiform  cells  arranged 
in  a  kind  of  network ;  the  giant  cells  vary 
-reatly  in  point  of  size,  but  all  are  multi- 
nucleated. When  this  small  tubercle  has 
grown  to  some  extent,  other  small  tubercles 
are  formed  in  its  periphery  until  the  con- 
solidation reaches  a  considerable  size ;  at 
the  same  time  it  is  only  an  aggregation*  of 
tubercles. 

We  have,  then,  a  portion  of  the  lung 
that  has  become  a  mass  of  consolidation 
from  the  growth  in  it  of  an  alien  tissue 
which  has  entirely  replaced  that  of  the  lung. 
This  new  tissue  being  of  low  vitality  easily 
l)ecomes  necrosed,  breaks  down  and  is 
thrown  off,  leaving  a  cavity. 

I  have  made  a  very  large  number  of  ex- 
aminations of  both  these  initial  stages  and 
liave  never  been  able  to  find  the  tubercle 
bacillus  in  either.  Surely,  if  the  tubercle 
1)acillus  is  the  cause  of  either  of  these  les- 
ions in  the  lung,  it  ought  to  be  found  at  the 
commencement  of  the  morbid  process ! 
Contrasting  this  with  leprosy :  In  the  latter 
malady  I  have  made  many  examinations  of 
the  liver,  where  the  disease  is  never  so  far 
advanced  as  in  other  parts,  and  wherever 
there  were  two  or  three  new  cells  formed 
from  the  connective  tissue  of  the  organ, 
there  I  invariably  found  the  leprosy  bacil- 
lus. 

Here  then  are  two  disease  processes 
that  are  absolutely  different  in  everything 
but  their  results,  viz.,  cavitation  of  the 
lungs.  The  two  upper  illustrations  exhibit 
the  adult  conditions. 

I  have  already  stated  that  tubercle 
bacilli  are  found  in  the  inflammatory  pro- 
cess after  the  lung  breaks  down.  They 
are,  in  some  instances,  but  not  in  all, 
found  in  a  similar  manner  in  the  other 
process.  Many  cases  are  on  record  where 


no  bacilli  could  be  found  during  life,  or 
even  after  death  and,  as  far  as  I  have 
been  able  to  ascertain,  these  cases  all  be- 
long to  the  second  of  these  disease-pro- 
cesses. 

It  must  be  plain  to  any  thinking  physi- 
cian that  these  two  conditions  can  not 
be  approached  and  treated  in  the  same 
manner,  and  I  .think  that  it  is  of  the  ut- 
most importance  that  the  difference 
should  be  recognized  at  once  on  examin- 
ing a  case.  I  saw  this  well  exemplified 
recently,  when  called  in  consultation  to 
a  child  twelve  years  of  age :  A  small 
consolidation  existed  on  one  side,  about 
the  level  of  the  third  rib ;  dullness  was 
well  marked,  but  moist  rales  were  found 
round  the  edge ;  auscultation  and  percus- 
sion above  the  consolidation  showed  that 
the  lung  was  performing  its  functions 
and  that  the  consolidation  did  not  ex- 
tend to  the  apex.  This  at  once  removed 
any  idea  of  the  case  being  one  of  tubercu- 
losis, but,  on  the  other  hand,  showed  it  to 
be  a  patch  of  broncho-pneumonia,  clearing 
up;  and  subsequent  events  proved  this 
opinion  to  be  correct. 

I  wish  to  point  out  that  this  new  tissue 
which  is  formed  in  the  lungs  under  the 
influence  of  the  tubercular  virus,  differs 
entirely  from  that  produced  as  a  re- 
action to  a  chronic  irritation ;  this  is  well 
shown  by  Doctor  W.  F.  Metcalf,  in  his 
paper  on  "Pseudo-Tuberculosis,"  publish- 
ed in  the  May  number  of  this  Journal: 
There  he  shows  that  the  prolonged  irri- 
tation produced  by  the  presence  of  the 
chitinous  chelicerse  of  an  Ixode  in  the 
cutis  vera,  caused  the  formation  of  a 
nodule,  the  cells  of  which  were  entirely 
unlike  any  of  the  normal  cells  of  the 
part;  but  these  cells  were  also  quite  dif- 
ferent from  those  of  a  tubercle  such  as 
I  have  described. 

Pfeifer  has  lately  described  a  pseudo- 
tuberculosis and  Klein  has  confirmed  his 
results ;  their  deductions  seem  rather 
contradictory,  but  further  work  on  this 


164 


DETROIT  MEDICAL  JOURNAL. 


subject  may  have  an  important  bearing 
on  tuberculosis.  One  thing  seems  cer- 
tain :  Many  workers  will  now  take  up 
the  pathological  side  of  the  question, 
when  there  will  be  a  great  deal  of  light 
thrown  on  these  conditions;  and  I  very 
much  fear  the  child-like  faith  of  the  bac- 
teriologists will  be  rudely  disturbed. 
92  Edmund  Place, 

Detroit,  Michigan. 


*RECENT  EPOCH  MAKING  IN  MEDICINE. 

BY    SAMUEL   BELL,    M.    D. 

At  a  meeting  of  the  British  Pathological 
Society,  of  London,  April  6th,  1875,  the 
"Germ  Theory"  of  disease  was  first  formally 
introduced,  the  discussions  being  very  ani- 
mated and  earnest, — which  also  obtained 
at  subsequent  meetings.  This  conference 
was  attended  by  distinguished  medical  men, 
some  of  whom  were  profoundly  impressed 
by  the  arguments  brought  forward.  The 
co-existence  of  bacteria  and  contagious  dis- 
ease was  admitted,  but  Doctor  Bastian,  one 
of  the  most  prominent  speakers,  contended 
that  they  are  pathological  products  spon- 
taneously generated  in  the  body  after  it  has 
been  rendered  diseased  by  real  contagion. 
The  grouping  of  the  ultimate  particles  of 
matter  to  form  living  organisms,  was  con- 
sidered, by  the  speaker,  to  be  an  operation 
as  little  requiring  the  action  of  antecedent 
life,  as  their  grouping  to  form  any  of  the 
less  complex  chemical  compounds. 

Prior  to  this,  Henle  (in  1840)  after  ma- 
ture deliberation,  collating  and  weighing  of 
evidence,  had  arrived  at  the  conclusion 
that  the  causes  of  infectious  maladies  are 
to  be  found  in  minute  living  organisms  or 
fungi ;  hence  he  may  be  regarded  as  the 
true  and  original  author  of  the  "Germ 
Theory." — He  formulated  opinions  and  in- 
vestigated the  subject  with  such  thorough- 
ness and  ability  that,  in  after  years,  Koch 
adopted  precisely  the  same  views.  In  1862, 
Pasteur  published  a  paper  on  the  "Organ- 


♦Annual    Oration,    Michigan    State    Medical 
Society,  Battle  Creek,  May,  1901. 


ized  Corpuscle  existing  in  the  Atmosphere," 
in  which  was  demonstrated  that  many  of 
the  floating  particles  are  organized  bod- 
ies, and  that  these,  when  planted  in 
sterile  infusions,  yield  abundant  crops  of 
micro-organisms,  evidencing  that  the  source 
of  life  in  the  infusions  was  derived  from  the 
air.  Listerism  originated  in  1875,  and  when 
Koch  published  his  famous  work  on  the 
Wundinfectionskrankheiten  (traumatic  in- 
fectious diseases),  three  years  later,  the 
Listerian  theory  took  firm  root,  spreading 
slo'wly  but  surely  to  all  departments  of 
medicine  and  surgery. 

From  time  to  time,  as  the  need  was  real- 
ized, men  of  genius  have  provided  devices 
and  instruments  with  a  view  to  aiding  in  this 
work,  and  some  of  these  have  made  pos- 
sible subsequent  discoveries. — Among  these 
may  be  mentioned  the  use  of  sterilized  cul- 
ture fluids  as  formulated  by  Pasteur;  the 
introduction  of  solid  culture  media  and  the 
isolation  methods  of  Koch;  the  use  of  the 
cotton  plug  by  Schroeder  and  Van  Dusch; 
the  introduction  of  the  anilin  dyes  by  Weig- 
ert  and,  finally;  the  improvements  made  in 
the  compound  microscope. 

It  is  interesting  to  note  that  after  the 
discovery  of  the  anthrax  bacillus  by  PoUen- 
der  and  Davaine,  in  1849,  there  was  a  pro- 
longed period,  during  which  no  important 
discoveries  of  pathological  organisms  were 
made,  but  during  this  period  important 
methods  of  technique  were  elaborated.  This 
was  again  followed  by  a  period  during 
which  important  additions  followed  each 
other  in  rapid  succession:  In  1873,  Ober- 
meier  discovered  the  spirillum  that  bears 
his  name  and  is  deemed  the  source  of  re- 
lapsing fever;  Hansen,  in  1879,  announced 
the  discovery  of  a  bacillus  in  the  cells  of 
leperous  nodules;  and  Neisser  during  the 
same  year  demonstrated  tlie  gonococcus; 
in  1880  the  typhoid  bacillus  was  first  ob- 
served by  Eberth,  and  subsequently  and  in- 
dependently by  Koch ;  the  same  year  Past- 
eur published  his  work  on  "Chicken -chol- 
era," and  the  pneumococcus  was  descrilx'l 


■ 


DETROIT    MEDICAL    JOURNAL. 


165 


by  Sternhcr- ;  in  1882.  Koch  announced 
the  Bacillus  luhrrciilosis.  \vhich  was  soon 
followed  hy  rasleur's  work  on  "Rouget 
du  Pore,"  while  Loeffler  and  Schiitz 
reported  the  isolation  of  the  bacillus  of 
glanders;  in  1884  the  "comma  bacillus"  was 
announced  by  Koch  as  the  probable  source 
of  cholera,  about  the  same  time  Loeffler 
discovered  the  germ  bearing  his  name  con- 
jointly with  that  of  Klebs,  and  believed  to 
be  that  of  diphtheria,  and  before  the  end 
of  the  year  the  tetanus  bacillus  was  demon- 
strated by  Nicolaier;  in  1892  Canon  and 
Pfeififer  announced  the  bacillus  of  influ- 
enza;  in  1894,  Yersin  and  Kitasato  inde- 
pendently isolated  the  germ  of  the  bubonic 
])lague,  and  Sanarelli  discovered  the  Bacil- 
lus ictcroidcs,  supposed  to  be  the  source  of 
yellow  fever. 

During  the  last  quarter  of  a  century  the 
science  of  bacteriology  has  made  triumph- 
ant strides,  revolutionizing  all  preconceived 
ideas  and  theories  respecting  the  aetiology, 
diagnosis  and  even  the  treatment  of  infec- 
tious diseases ;  among  those  upon  which  in- 
formation has  been  of  greatest  value  are, 
tuberculosis,  diphtheria,  tetanus,  bubonic 
plague,  etc. 

Up  to  1875  there  were  few  scientific  men 
who  accepted  the  germ  theory,  the  great 
majority  adhering  to  the  doctrine  of  spon- 
taneous generation,  believing,  with  Billroth, 
that  the  presence  of  fungi,  where  decom- 
position was  in  progress,  was  an  accidental 
result  of  universal  distribution  or  (more 
conservatively)  that  their  presence  in  pu- 
tpid  wounds  was  either  due  to  spontaneous 
development  or  accidental  and  artificial  in- 
troduction. 

McFarlane  was  among  the  first  of  any 
promiri'.nce  to  accept  the  germ  theory  as 
applied  to  diphtheria :  He  says  that  all  pos- 
siljle  skepticism  as  to  the  specificity  of  bacil- 
li was  dispelled  by  an  accidental  infection 
that  confined  him  to  the  house  for  three 
weeks  during  the  busiest  season  of  the 
>ear.  A\'ithout  having  been  exposed  to 
any  known    contagion,  and  while    experi- 


menting in  the  laboratory  with  a  virulent 
culture,  the  diphtheria  l)acilhis  was  drawn 
into  a  pipette  and  accidenially  entered  his 
throat.  As  the  result  of  this  accident,  two 
days  later  his  throat  was  full  of  typical 
pseudo-membrane  which  contained  Klebs- 
Loeffler  bacilli. 

Welsh,  of  Johns  Hopkins,  has  perhaps 
furnished  the  most  reliable  as  well  as  the 
most  complete  statistics  of  the  results  ac- 
complished by  the  antitoxin  treatment  of 
diphtheria  :  Excluding  every  possible  error 
of  calculation,  his  report  shows  an  apparent 
reduction  of  55.8  per  cent,  in  mortality. 
Another  very  important  point  made  by  this 
author  illustrates  the  importance  of  early 
treatment,  viz. :  The  fatality  in  1,115  cases  of 
diphtheria,  treated  in  the  first  three  days 
of  the  disease,  was  about  8.5  per  cent.,  as 
against  546  cases  injected  with  antitoxin 
after  the  third  day,  with  a  death  rate  of  27.8 
per  cent. — Thus  was  established  the  fact 
that  early  treatment  is  essential,  and  that 
after  the  toxin  has  set  up  destructive  or- 
ganic lesions  in  the  various  organs  of  the 
body,  no  amount  of  neutralization  will  re- 
store the  integrity  of  the  parts ;  consequent- 
ly, antitoxin  fails  to  be  of  material  benefit 
in  the  latter  class  of  cases. 

In  1884,  Lusgarten  devised  a  methcnl  for 
staining  bacilli  found  in  syphilitic  tissue, 
which  germs  he  assumed  to  be  the  cause  of 
the  disease.  The  most  recent  research  on 
bacterium  of  syphilis  is  that  of  Van  Xies- 
sen,  w^ho  claims  to  have  cultivated  from  the 
blood  of  a  few  cases,  and  by  inoculation 
experiments  obtained  evidences  of  the  speci- 
ficity of  the  organism,  by  the  production  of 
abortion  in  pregnant  rabbits ;  by  the  de- 
velopment of  extra-genital  primary  lesions 
on  the  ears  of  the  same  in  the  form  of 
nodes ;  and  by  the  production  of  secondary 
ulcers,  tumor-formations  and  irregular 
lesions.  However  the  researches  of  others, 
up  to  the  present  time,  have  not  been  satis- 
factorily confirmative,  and  consequently  the 
specificity  of  this  germ  is  not  established. 

Considering  our  increased  possessions  in 


166 


DETROIT  MEDICAL  JOURNAL. 


the  Far  East,  the  importance  of  early  rec- 
ognition of  the  bubonic  plague  can  be  ap- 
preciated, especially  when  the  United  States 
Marine  Hospital  Service  reports  the  intro- 
duction of  this  fell  malady  to  the  Western 
Hemisphere.  Its  appearance  in  Santos, 
Brazil,  in  October,  1899,  marks  an  epoch  in 
plague  literature,  as  furnishing  the  very 
first  recorded  instance  of  the  disease  in  the 
New  World.  During  November  of  the 
same  year  the  malady  was  brought  to  New 
York  by  a  British  steam-ship,  and  late  in 
December,  1899,  it  made  its  appearance  in 
Honolulu;  its  advent  in  California  is  so 
recent,  that  mere  mention  is  sufficient. 

This  disease  furnishes  a  striking  illus- 
tration of  the  scientific  advance  of  mod- 
ern medicine,  for  it  was  not  until   1894 
that    its   true    nature   became   positively 
known.     All    through    the    centuries,    in 
all   the  countries,   the   subject  had  been 
enveloped   in    darkness,   and   there   was   a 
blind  groping  after  facts,  an  unsuccess- 
ful search  for  cause,  and  the  same  igno- 
rant struggle  against  its  ravages,  on  the 
~  part  of  physicians,  sanitarians  and  pub- 
lic officials  alike,  such  as  obtains  to  the 
history  of  cholera,  a  malady  that  now, 
fortunately,  by  the  efiforts  of  science,  is 
robbed  of  its  terrors.     So,  too,  the  cause 
of  the  plague,  the  mode  of  propagation 
and  the  measures  essential  to  prevent  its 
spread,    are    to-day    matters    of    general 
scientific    information.     To   Pasteur   and 
Koch  is  indirectly  due  the  credit  of  this 
discovery    by    establishing    bacteriology 
as  a  science,  though  to  a  Japanese  physi- 
cian, Kitasato,  and  the  French  observer, 
Yersin,  we  are  indebted  for  the  discov- 
ery itself.     The  fact  is  now  established 
that  the  plague  is  an  infectious  malady 
caused   by    a   specific   bacillus;    and    the 
anti-pest  serum  of  Yersin  and  Roux,  and 
the    Haf^kine    prophylactic,    have    been 
tested  with  most  gratifying  results,  the 
latter  for  the  prevention  of  the  plague, 
the  former  for  its  effects  upon  the  bu- 
bonic  poison   whereby   it   is   neutralized 


n 


within  the  system.  The  French  Com- 
mission that  recently  investigated  the 
efficacy  of  the  anti-pest  serum  in  Portu- 
gal, report  that  the  mortality  was  but 
fourteen  per  cent,  against  seventy  per 
cent,  of  fatalities  where  the  serum  was 
not  employed. 

In  a  recent  lecture  by  Roux,  a  striking 
illustration  was  given  of  the  efficacy  of 
the  Yersin  serum: 

The  Bombay  manager  of  the  local  branch  of 
the  Credit  Lyonnaise  resided  with  his  wife, 
children,  and  a  numerous  retinue  of  native  ser- 
vants, in  a  dwelling  in  an  infected  portion  of 
the  city.  His  little  daughter  was  stricken 
with  the  pest  in  a  virulent  form;  was  treated 
with  the  serum  and  made  a  rapid  and  unevent- 
ful recovery.  As  a  precautionary  measure  the 
whole  family  were  subjected  to  inoculation  and 
the  same  measure  of  treatment  was  oiTered  to 
the  native  domestics.  Those  who  accepted  es- 
caped infection,  while  all  of  the  six  who  declin- 
ed were  striken,  five  fatally.  It  seems  that  a 
more  crucial  test  could  not  have  been  devised 
or  a  more  triumphant  vindication  obtained. 

The  British  Medical  Journal  gives  the 
results  accruing  to  the  employment  of 
Hafifkine  prophylactic  in  Bombay,  which 
show  a  reduction  in  mortality  of  eighty 
to  ninety  per  cent. 

The  work  of  the  late  Federal  Commis- 
sion in  establishing  the  disputed  fact  that 
the  plague  existed  in  California,  was  a 
signal  triumph  for  science  and  marks  an 
epoch  worthy  of  a  place  in  the  archives 
of  modern  achievement. 

In  1896,  Widal  and  Griinbaum,  working 
independently,  discovered  that  when  blood- 
serum  from  typhoid  fever  patients  is  added 
to  cultures  of  the  typhoid  bacillus,  a  definite 
reactive  phenomenon  occurs;  this  is  known 
as  the  "Widal  reaction,"  and  consists  in 
complete  cessation  of  the  characteristic 
movement,  and  subsequent  agglutination, 
of  the  typhoid  bacilli.  The  test  was  applied 
to  two  hundred  and  thirty  cases  of  typhoid, 
among  troops  engaged  in  the  Spanish-Am- 
erican War,  treated  in  the  Medico-Chir- 
urgical  Hospital,  and  of  this  number  two 
hundred  and  nineteen  reacted  positively,  or 
95.64  per  cent.  The  statistics  derived  from 
Osier's  wards  in  the  Johns  Hopkins  Hos- 
pital, by  Block  and  Gwyn,  up  to  November, 


DETROIT   MEDICAL   JOURNAL. 


167 


1898,  evidence  that  the  reaction  was  present 
gin  one  hundred  forty-four  of  a  total  of  one 
lundred  fifty-one  cases.     Statistics  further 
ieveloped  the  fact  that  the  reaction  failed 
in  only  4.5  per  cent  of  cases  out  of  a  total 
\pi  2,393 ;  ^"d  ^t  is  probable  that  even  this 
small  percentage  would  have  been  further 
reduced  if  the  test,  when  negative  at  the 
irst  examination,  had  been  repeated  every 
[day  or  two  until  convalescence  was  fully  es- 
ttablished.     Without  granting  the  precision 
lof  the  method,  it  nevertheless  may  be  as- 
[sumed  to  be  of  great  diagnostic  importance. 
Bacteriology  is  the  outgrowth  of  the  med- 
icine and  surgery  of  the  past;  and  from 
[being    looked    upon    as    nierely    incidental 
Ithereto  it  has  become  the  dictator  of  the 
medicine  of  the  present  and  future.     Much 
valuable  work  has  been  done  on  the  acute 
and  chronic  inflammatory  diseases,  also  on 
the  toxemias  and  bactericides. 

Hematology,  a  comparatively  new  study, 
has  become  an  adjunct  to  clinical  diagnosis, 
but  sufficient  time  not  having  supervened, 
the  limits  of  its  usefulness  have  not  been 
fully  determined;  the  evidences  afforded, 
thus  far,  have  been  very  disappointing  some- 
times— results  accruing  that  were  wholly 
unexpected,  perhaps  opposed  to  those 
sought, — while  again,  on  the  other  hand, 
shedding  far  more  light  than  could  have 
been  anticipated.  The  number  of  mala- 
dies in  which  its  value  is  apparent  are 
less  than  a  half-score,  but  that  it  proves 
a  decided  aid  in  many  more  is  not  to  be 
gainsaid ;  it  may  provide  the  missing  link 
in  a  chain  of  otherwise  incomplete  evi- 
dence. On  the  whole,  hsematology  in  its 
results  is  not  inferior  to  examination  of 
urine ;  both  give  definite  results  in  a  few 
diseases,  and  side  lights  in  many  obscure 
conditions,  even  if  the  process  itself  is 
negative ;  and  the  former  has  one  very 
decided  advantage :  It  can  be  employed 
during  the  life  of  the  patient,  and  like 
all  methods  of  purely  physical  character, 
in  all  febrile  maladies,  and  where  there 
is  any  cause  (such  as  insanity,  stupidity 


or  unconsciousness)  preventing  intelli- 
gent communication  with  patient,  much 
light  can  thereby  be  obtained. 

It  is  now  conceded  that  Anopheles,  a 
form  of  mosquito,  may  convey  the  para- 
site of  malaria  from  man  to  man ;  even 
a  resume  of  the  literature  of  the  subject 
would  consume  so  much  time  and  space,  I 
must,  per  force,  be  content  with  mentioning 
that,  important  observations  by  original 
workers  are  now  being  made  in  the  trop- 
ics that  promise  more  practical  informa- 
tion. 

The  most  striking  feature  in  this  con- 
nection, however,  is  the  (apparently)  defi- 
nite establishment  that  the  cause  of  yel- 
low fever  is  present  in  the  blood  of  those 
attacked  thereby,  and  that  certain  mos- 
quitoes can  inoculate  healthy  individuals; 
also  that  the  disease  is  not  transferrable 
by  fomites.  This  is  regarded  as  a  very 
important  medical  discovery,  removing  in 
large  part  the  mystery  obtaining  to  the 
aetiology  of  a  malady  that  is,  not  alone 
the  scourge  of  some  of  the  fairest  portions 
of  the  globe,  but  renders  certain  districts 
thereof  prac-tically  uninhabitable  to  civil- 
ized man. 

Relative  to  the  cause  of  cancer.  Max 
Schuller,  of  Berlin,  and  Roswell  Park,  of 
Buffalo,  (and  the  co-laborators  of  the  lat- 
ter at  the  State  Hospital),  have  accomp- 
lished some  excellent  work ;  Park  reports 
having  been  able,  in  some  of  the  lower 
animals,  to  produce  true  adeno-carcino- 
nias  by  inoculation  with  fluid  from  the 
peritoneal  cavity  of  a  man  suffering  with 
colloid  cancer  of  the  omentum.  Schul- 
ler reports*  having  found  in  both  carcin- 
oma and  sarcoma  a  golden-yellow  body,  a 
protozoon,  that  he  presumes  to  be  the 
primary  cause  of  these  growths ;  and  a 
culture  thereof,  when  injected  into  a  rab- 
bit, produced  cancerous  tumors,  while 
other  cultures  revealed  the  organism  in 
different  stages  of  development.  The  re- 
sults of  experiments  now  in  progress,  are 

*Centralblatt  fuer  Bakteriologie,  1900. 


168 


DETROIT  MEDICAL  JOURNAL. 


awaited,  both  in  Europe  and  America,  witli 
great  interest. 

Since  the  discovery  of  the  Roentgen 
rays,  great  advances  have  been  made  in 
the  practical  appHcation  of  this  myster- 
ious form  of  energy.  Somewhat  reckless 
predictions,  born  of  enthusiasm,  have 
been  indulged  in,  nevertheless  they  have 
proved  of  great  diagnostic  and  therapeu- 
•  tic  value,  and  time  may  be  expected  to 
establish  more  fully  their  scope  and  util- 
ity. At  one  time  it  was  seriously  feared 
that  the  prolonged  exposure,  deemed  es- 
sential to  successful  observations,  would 
limit  their  usefulness,  but  the  improve- 
ments in  technique  that  have  recently  ac- 
crued, permit  of  excellent  results  being 
secured  with  more  brief  exposures.  Now% 
with  our  improved  methods,  a  diagnosis 
is  often  possible,  and  with  a  precision  that 
can  not  be  obtained  in  any  other  way.  By 
means  of  the  radiograph,  foci  of  tubercular 
infection  can  be  made  manifest  to  the  eye 
much  earlier  than  to  the  ear;  a  unilateral 
or  bi-lateral  enlargement  of  the  heart,  or 
any  form  of  cardiac  displacement,  is  read- 
ily discovered  by  the  same  means;  em- 
physema, asthma,  pleurisy,  hydro-pneu- 
mothorax,  pyo-pneumothorax,  hydrothorax 
and  pneumonia,  are  easily  recognized 
and  their  limits  defined;  thoracic  aneu- 
rysms are  recognizaI-)le  in  their  early 
stages;  cavities  which  escaped  detection 
by  ausculation  or  percussion  are  revealed; 
and  the  presence  of  fluid  within  the 
pleura  may  be  positively  determined.  Senn 
declared  the  X-rays  as  employed  during 
the  late  war,  "fully  answered  all  expecta- 
tions," and  added:  ■ 

During  the  Spanish-American  War  the  skia- 
graph enabled  us  to  diagnose  the  existence  or 
absence  of  fracture  in  a  large  number  of  doubt- 
ful cases  in  which  we  had  to  depend  exclusive- 
ly on  this  diagnostic  resource.  In  fractures  in 
close  proximities  to  joints,  it  has  been  of  the 
greatest  value  in  ascertaining  whether  or  not 
the  gun-shot  fracture  extended  into  the  joint. 
In  the  light  of  recent  experience  the  X-ray  has 
become  an  indispensable  diagnostic  resource  to 
the  military  surgeon  in  active  practice,  and  the 
suggestion  that  every  chief  surgeon  of  every 
Army  Corps  should  be  supplied  with  a  portable 


apparatus,  and  an  expert  to  use  it,  must  be  con- 
sidered a  timely  and  urgent  one. 

Manifestly  the  limit  of  usefulness  of  this 
aid  has  not  yet  been  determined.  It  may  be 
noted,  however,  that  the  rays  have  rendered 
valuable  aid  in  tlie  treatment  of  diseases  of 
the  skin,  more  especially  lupus  vulgaris,  lup- 
us erythematosus,  chronic  eczema,  vas- 
cular naevi,  hyper-trichosis,  favus,  and 
sycosis ;  also  in  other  pathological  condi- 
tions of  internal  organs. 

During  the  past  ten  years,  phenomenal 
advancement  has  been  made  in  the  diag- 
nosis and  treatment  of  diseases  of  the 
stomach ;  the  cyromele  has  been  invent- 
ed ;  the  gastro-diaphane  perfected ;  a  per- 
fect gastric  electrode  introduced,  likewise 
the  gastric  bucket ;  X-ray  pictures  of 
stomach  have  been  taken ;  a  large  number 
of  lavage  apparatus  devised ;  the  gastro- 
scope  made  fairly  practicable ;  and  a 
number  of  operative  procedures  devised. 

In  considering  the  burning  questions 
of  the  day  it  is  ^-equisite  to  include  the 
bacterial  toxins,  sero-therapy,  organo- 
therapy, auto-intoxication,  and  the  rela- 
tions of  internal  secretions  to  problems 
connected  with  the  nervous  system, — 
that  part  of  the  human  organism  which, 
in  the  main,  is  responsible  for  the  lofty 
position  which  man  holds  among  ani- 
mals. The  last  decade  has  given  birth 
to  unprecedented  activity  in  connection 
with  the  progress  in  neurology.  The  re- 
sults obtained  have  led  to  complete  revo- 
lution in  ideas  concerning  the  elements 
of  the  nervous  organs  and  their  mechani- 
cal relations,  and  supplied  a  host  of  new 
methods  of  investigation  in  the  prosecu- 
tion of  the  study  of  the  nervous  system 
in  health  and  disease.  Entirely  new  ave- 
nues of  research  have  been  opened  up, 
and  problems  heretofore  thought  beyonrl 
the  reach  of  scientific  inquiry  seem  now 
within  human  grasp.  So  numerous  haw 
been  the  methods  of  original  research 
pursued,  that  space  and  time  forbid  their 
review;    I   shall   merely   mention   briefly 


DETROIT  MEDICAL  JOURNAL. 


169 


a  few  of  the  main  achievements :  Among 
the  names  which  have  shed  new  lustre 
on  the  subject  of  neurology  is  that  of 
Ramon  y  Cajal,  whose  connection  with 
original  work  has  been  both  brilliant  and 
fruitful.  If  popular  history  can  be  relied 
upon,  the  story  of  this  young  scion  of 
Spain  is  remarkable,  especially  from  a 
medical  standpoint:  Developing  in  a 
country  not  remarkable  for  original  re- 
search, he  applied  for  a  position  as  teach- 
er of  the  microscope,  and  was  refused; 
whereat,  being  ambitious,  industrious 
and  proud  he  was  keenly  wounded.  He 
then  purchased  a  small  library  devoted 
to  histology  and  microscopy,  practically 
ostracised  himself  from  society,  and  be- 
gan his  original  work,  paying  special 
attention  to  technique,  and  as  a  result  found 
himself,  a  decade  later,  famous.  A  brief  in- 
quiry into  the  contributions  of  Cajal  can  not 
fail  to  reveal  why,  since  1888— and  in  all 
parts  of  the  scientific  world, — his  produc- 
tions have  attracted  attention,  and  ultimate- 
ly gained  for  him  a  professorship  at  Madrid, 
as  well  as  notice  and  appreciation  by  in- 
ternational audiences.  Among  his  origi- 
nal contributions  are:  "Demonstration 
of  the  Complete  Independence  of  at  least 
the  Majority  of  Nerve  Elements" :  "Ap- 
preciation of  the  Wide-spread  Occur- 
rence and  Significance  of  the  Lateral 
Branches  of  the  Axis-Cylinder  Process- 
es," and :  "Demonstration  of  the  Strik- 
ing Uniformity  in  General  Structure  of 
the  Majority  of  Nerve  Elements  in  all 
parts.  Despite  Minor  Morphological  Ele- 
ments." 

Since  1880,  investigations  of  Golgi,  His, 
Kolliker,  Cajal  and  others,  have  produced 
a  complete  revolution  in  ideas  relative  to 
the  elements  of  which  the  nervous  sys- 
tem is  constructed,  and  also  of  the  mode 
in  which  these  elements  are  architectur- 
ally put  together.  The  Golgi  method  of 
staining  tissue  is  now  recognized  by  the 
whole  scientific  world,  and  the  pictures 
of  nerve  cells  and  their  processes  secured 


thereby  (incomparably  superior  to  any- 
thing hitherto  obtained)  are  regarded 
in  the  light  of  a  new  discovery.  Cajal 
with  his  incomparable  genius  made  new 
applications  of  the  Golgi  method,  which 
have  attracted  wide-spread  attention,  and 
anatomists  everywhere  (von  Kolliker 
and  others  in  Germany,  van  Gehuchten 
in  Belgium,  Retzius  in  Sweden,  Schafer 
and  Andriezzen  in  Great  Britain,  Berkeley 
and  Strong  in  America,  and  a  host  of 
others)  set  to  work  with  the  osmo- 
bichromate  mixture  and  silver  nitrate, 
and  in  a  short  time  a  new  era  was  opened 
up,  and  information  supplied  regarding- 
the  reciprocal  relations  of  nerve  units  in 
the  various  parts  of  the  cerebro-spinal 
and  sympathetic  nervous  systems.  The 
connection  of  the  axis-cylinder  processes 
of  the  cells  of  the  neutral  horns  with  the 
axis-cylinder  of  the  fibres  of  the  motor 
roots  of  the  spinal  nerves,  were  first  ab- 
solutely established  by  Weigert's  meth- 
ods coupled  with  the  method  of  Gerloch. 
— This,  in  conjunction  with  improved 
technique  in  sectioning,  has  contributed 
greatly  towards  the  investigations  in 
neurology. 

In  1891,  Waldeyer  brought  out  the 
doctrine  of  individuality  of  the  nerve  ele- 
ments, or  the  "Neuron  Concept,"  which 
may  be  briefly  condensed  as  follows : 

The  nervous  system,  aside  from  its 
neurolgia,  ependymal  cells,  blood  vessels 
and  lymphatics,  consists  of  an  enormous 
number  of  individual  elements  of  neurons, 
each  neuron  in  its  entirety  representing  a 
single  body  or  cell.  The  foundation  for  the 
neuron  doctrine  rests  upon  these  facts: 

The  nervous  system  agrees  with  other 
parts  of  the  body  in  being  cellular: 

The  proof  that  in  the  embryo  the  nerve 
cells  exist  as  independent  units,  many  of 
which  are  capable  of  wandering  for  con- 
siderable distance  from  the  origin : 

The  fact  that  the  nutrition  of  the  nerve 
cells  is  most  easily  explained  from  the  stand- 
point of  a  doctrine  which  looks  upon  the 
nervous  system  as  made  up  of  units,  which 
are  not  only  anatomical  but  physiological. 

Since   this   doctrine   was   advocated   a 


170 


DETROIT  MEDICAL  JOURNAL. 


large  amount  of  work  upon  degeneration 
of  nerve-fibre  and  cells  has  been  done, 
especially  by  Marchi,  which  confirms  the 
validity  of  the  neuron  doctrine,  the  latter 
being  of  value  in  enabling  the  histologist 
to  follow  the  diseased  nerve-fibre  to  its 
termination.  The  conception  of  the  neu- 
ron has  helped  to  facilitate  the  under- 
standing of  some  diseases,  in  showing 
that  there  is  no  cardinal  distinction  be- 
tween gray  and  white  matter ;  and  it  like- 
wise served  to  unravel,  in  part  at  least, 
the  mystery  which  formerly  surrounded 
those  diseases  that  involve,  almost  sim- 
ultaneously, the  various  systems  of  white 
fibres  and  the  gray  matter.  Proportion- 
ately with  the  growth  of  the  neuron  con- 
cept the  value  of  systemic  diseases  is 
lessened. 

Do  what  we  may,  we  can  not  separate 
mental  diseases  from  organic  affections  of 
the  spinal  cord  and,  indeed,  of  many  other 
organs  of  the  body.  The  line  of  demarca- 
tion between  the  mental  and  physical  con- 
ditions is  so  indistinct  that,  in  many  in- 
stances, one  merges  into  the  other.  One  of 
the  foremost  alienists  of  Europe  latterly  de- 
clared that  psychiatry  is  on  a  level  with  the 
medical  sciences  of  a  hundred  years  ago, 
being  based  wholly  upon  clinical  studies 
and  not  upon  pathological  anatomy.  A  few 
years  since.  Doctor  Weir  Mitchell,  during 
his  annual  address  to  the  American  Medico- 
Psychological  Association,  indulged  in  se- 
vere criticism  upon  the  lack  of  scientific 
work  in  hospitals  for  the  insane,  which 
aroused  no  trifling  indignation.  That 
abundant  material  for  scientific  work 
exists,  both  clinical  and  pathological,  is 
undeniable,  and  that  there  has  been 
marked  advance,  both  in  the  character  of 
the  clinical  work  and  in  honest  endeavor 
along  setiological  lines,  is  conceded.  That 
greater  advancement  has  not  been  made 
can  not  be  attributed  wholly  to  inertia  on 
the  part  of  those  in  charge,  but  is  largely 
due  (especially  in  relation  to  causation)  to 
the  well  known  fact  that  the  morbid  path- 


ology of  the  brain  is  more  complex  than  any 
other  part  of  the  human  organism.  The 
asylum  reports  instead  of  being  given  over 
to  stereotyped  data,  as  formerly  was  the 
case,  to-day  are  fast  becoming  store-housi. 
of  useful  information  regarding  all  that  per- 
tains to  the  care,  cause,  and  treatment  of 
the  insane.  To  the  practical  psychiatrist  the 
question  of  domiciliation  does  not  over- 
shadow every  other  desideratum,  as  in  the 
past,  and  during  the  last  decade  the  im- 
portance of  early  diagnosis,  the  accompany- 
ing pathological  conditions,  prompt  separa- 
tion from  domestic  surroundings,  and  skill- 
ful treatment  (mental,  moral  and  physical) 
have  become  questions  of  paramount  in- 
terest. Closely  trained  observers,  records 
of  clinical  facts,  also  systematic  laborator 
work,  are  now  the  rule  rather  than  the  ex 
ception  in  many  institutions :  Pleasant, 
cheerful  rooms  have  taken  the  place  of  dark- 
ened cells ;  airy  courts  are  provided,  along 
with  beautiful  grounds  and  attractive  archi- 
tecture ;  the  Kirkbride  system  has  replaced 
the  old  quadrangular  buildings,  and  the 
cottage  pavilion,  in  some  form,  is  fast  super- 
seding all  others ;  finally,  the  specially  train- 
ed, and  skilled  nurse  has  been  substituted 
for  the  ignorant  (and  sometimes  careless) 
attendant. 

The  work  of  Meynert  on  the  cerebral 
cortex,  and  the  researches  and  experimental 
labors  of  Charcot,  Flechsig,  Wernicke,  et 
al,  have  done  much  to  illumine  conditions 
hitherto  obscure  and  considered  impervious ; 
the  labors  of  the  New  York  Pathological 
Institute,  under  the  leadership  of  van 
Gieson,  have  received  the  recognition  and 
commendation  of  many  of  the  original  in- 
vestigators of  Europe  as  well  as  Amer- 
ica, and  the  original  contributions  of 
Berkeley  to  the  pathology  of  brain  les- 
ions,  have  stimulated  the  study  of  p^Hj 
chiatry  in  insane  hospitals  everywheflS 
It  is  the  spirit  and  honest  endeavor  on  the 
part  of  those  interested  in  the  science  of 
psychiatry  (together  with  the  increase  of 
insanity   over  and   above   the   increase    in 


i 


DETROIT  MEDICAL  JOURNAL. 


171 


population)  which  makes  possible  a  psy- 
chopathic hospital  in  Michigan  in  connec- 
tion with  institutions  of  learning,  exactly  as 
such  are  now  established  in  connection  with 
the  older  universities  of  Europe.  At  the 
present  time  there  is  no  branch  of  medical 
science  which  offers  so  many  interesting 
problems  for  solution ;  and  though  the  past 
has  been  full  of  disappointments,  the  future 
is  full  of  hope. 

We  begin  a  new  century  under  most  en- 
couraging auspices.  That  just  closed  will 
go  down  into  history  as  one  marvellous  in 
scientific  achievement,  especially  in  many 
departments  of  medicine  and  surgery,  and 
as  marking  the  close  of  the  career  of  dog- 
matic medicine ;  but  there  are  still  many  im- 
portant subjects  that  require  careful  and 
profound  consideration.  Fortunately,  sci- 
ence recognizes  no  nationality;  from  Ger- 
many, Belgium,  Sweden,  Russia,  Italy, 
I'Vance,  Spain,  Japan,  South  America, 
England,  Canada  and  the  United  States, 
come  reports  of  work  that  embody  the 
spirit  of  scientific  research  to  an  eminent 
degree.  What  of  the  future?  That  more 
brilliant  achievements  are  soon  to  follow, 
few  can  doubt.  Serum  therapy  is  yet  in  its 
infancy,  and  although  one  of  the  crown- 
ing triumphs  of  the  Nineteenth  Century, 
there  are  certainly  great  possibilities  as 
regards  its  future  scope  and  employment. 

35  Bagley  Ave., 
Detroit,  Mich. 

Correspondence. 

EXTRACTS  FROM  THE  JOURNAL  OF  A 
NAVAL  MEDICAL  OFFICER. 

(Continued.) 

December  2d. — The  weather  has  been  un- 
usually tempestuous  for  the  last  week  or 
so,  and  high  winds  and  frequent  showers  of 
rain  have  been  the  rule,  so  that,  though  the 
anchor  was  once  hoisted  to  go  outside  for 
target  practice,  we  returned  the  same  day 
without  doing  anything.  Fortunately  the 
inside  anchorage  is  so  protected  by  a  reef, 
that  there  is  never  any  sea  no  matter  how 
higli  the  wind,  and  there  are  never  any  hur- 


ricanes here.  Our  ship  is  anchored  very 
close  to  the  shore,  that  is  to  the  reef — nbt 
the  landing  in  the  town, — and  like  all  craft 
in  the  harbor  that  desire  it,  we  have  a  tele- 
phone while  in  port.  The  reef  is  the  in- 
evitable coral  formation  found  generally 
throughout  the  Pacific,  and  with  its  crest- 
line  of  white  breakers,  dividing  the  apple- 
green  or  amethyst  shoals  from  the  blue  of 
the  ocean,  under  a  bright  afternoon  sun 
only  now  and  then  obscured  by  a  swift 
passing  cloud  bringing  with  it  a  spoonful  of 
rain,  is  beautiful  with  a  beauty  unequalled. 

Yesterday  I  went  ashore,  and  there  being 
less  wind  and  rain  than  usual,  made  an- 
other trip  out  the  Nuuanu  road.  On  the 
way  up  I  observed  a  sight  that  was  very 
amusing:  A  white  house  with  large,  well- 
kept  grounds,  numerous  trees,  shrubber>- 
and  flowers,  presented  quite  a  menagerie. 
If  of  nervous  disposition,  one  is  apt  to  be 
alarmed  by  seeing  a  full  sized  lion,  ap- 
parently stalking  across  the  grass  toward 
him,  with  only  a  low  fence  intervening  and 
offering  protection.  The  animal's  eyes  are 
large  and  the  whites  very  prominent,  which 
give  him  an  expression  of  mingled  pain  and 
ferocity  that  becomes  ludicrous  when  it  is 
discovered  the  creature  is  of  cast  metal._ 
There  are  at  least  half  dozen  of  these  form- 
idable brutes,-  all  loose,  without  even  collar 
or  chain,  standing  in  the  rank  grass  with- 
out a  pedestal  or  platform  for  their  poor 
feet,  and  their  bronze  or  cast  iron  fur  is 
quite  mouldy  with  damp.  These  are  not  the 
only  sham  animals  on  the  premises ;  there 
is  at  least  one  deer,  the  most  wildly  impos- 
sible quadruped  imaginable;  also  certain 
white  statues  of  young  women,  presumably 
marble,  but  which  I  suspect  are  after  all  but 
ordinary  cast  iron,  whitewashed.  The  lions 
are  full  grown,  and  rather  much  for  one's 
nerves,  inasmuch  as  they  are  artfully  ar- 
ranged, apparently  lurking  in  the  recesses 
of  the  shrubbery,  yet  visible  to  the  wary 
traveller,  and  besides  very  white  eyes,  are 
well  toothed  in  deeply  lurid  jaws. 

I  paused  half  way  up  the  Nuuanu  road, 
mauka  side  (that  is  seaward  side)  to  take 
in  the  view,  upon  which  I  have  expatiated 
before.  I  may  as  well  say,  right  here,  that 
mauka  is  a  word  of  great  resource  among 
the  natives,  and  in  this  instance  means  the 
side  furthest  away  from  Honolulu. 

I  have  before  spoken  of  the  little  spring 
a  few  hundred  yards  down  the  cliff  towards 
the  valley  beyond  the  pali;  also  that  both 


172 


DETROIT   MEDICAL  JOURNAL. 


men  and  women  here  ride  boldly.  While 
lingering  at  the  spring  I  heard  a  clatter, 
and  up  came  a  cavalcade  of  some  sixty  or 
seventy  ponies  and  mules,  all  with  little 
packs  on  their  backs,  driven  by  Chinamen, 
who  all  dismounted  at  the  top  of  the  pali, 
which  natives  would  never  have  thought 
of  doing.  These  islands  are  a  perfect 
paradise  to  the  Celestials,  and  they  travel 
about  a  great  deal ;  and  although  cutting 
most  awkward  figures,  they  can  ride,  or  at 
least  stick  on,  or  do  anything  else  necessary 
to  their  business ;  and  they  go  fast  and 
slow  according  to  the  needs  of  the  time  or 
place  with  the  same  stolid  indifference  they 
show  in  the  laundry.  They  frequently  in- 
termarry with  the  natives,  and  the  type  re- 
sulting is  rather  peculiar  and  not  unpleas- 
ing.  The  remarkable  thing  about  the  Ce- 
lestial is  his  ability  to  adapt  himself,  in  his 
peculiar  way,  to  anything  and  everything, 
^consequently  he  is  found  in  every  form  of 
business  where  money  is  to  be  made.  Some- 
how there  always  seems  to  me  something 
strange  and  almost  uncanny  about  these 
guttural  jabbering  people,  though  why,  I 
cannot  say. 

The  walk  up  and  down  the  Nuuanu  road 
was  more  interesting  than  it  would  other- 
wise have  been  on  account  of  the  great  num- 
ber of  roadside  flowers  and  weeds  which, 
though  seldom  of  any  size,  were  so  plentiful 
as  to  give  decided  color  Cm  patches),  to  the 
landscape.  A  purple  flower  of  the  mint 
family  was  about  the  only  one  that  re- 
minded me  of  our  vegetation  at  home,  ex- 
cept some  convolvuli  -which  were  every- 
where apparent.  There  was  also  a  very 
bright  yellow  fluffy  ball  of  a  species  of 
mimosa ;  a  pure  blue  but  very  delicate 
flower  like  a  forget-me-not ;  and  variegated 
clusters  of  a  blossom  which  I  thought  I 
ought  to  know  but  could  not  place — all  so 
thick  as  to  make  the  outer  edges  of  the  road, 
and  banks  of  the  ditches  and  taro-patches 
bear  resemblance  to  the  borders  of  a  flower 
garden,  and  withal  it  must  be  remembered 
this  is  in  mid-winter.  I  think  there  is  rather 
a  large  variety  of  plants  indigenous  to 
these  islands,  but  hundreds  more  have  been 
introduced  as  ornaments,  or  for  utility, 
from  all  parts  of  the  world.  The  other  day 
Mrs.  Afong  (of  whom  more  anon)  gave  me 
a  blossom  of  the  ylang-ylang  from  a  tree 
in  her  garden,  the  odor  of  which  was  won- 
derfully penetrating.  All  classes  of  Hawa- 
iians,  as  well  as  the  South  Sea  Islanders, 
are  passionately  fond  of  flowers  and  bright 


colors,   especially   red ;   even   the   cannibals 
of  the  Solomon  Islands  have  this  taste. 

Walking  into  town  on  my  way  back  I 
observed  many  fine  places,  though  perhaps 
not  very  carefully  kept,  but  with  plenty  of 
trees,  royal  palms,  date  palms,  algarobas, 
bread-fruit,  etc.  The  Afongs  possess  a 
noble  banyan,  the  only  one  I  know  of  in 
the  city ;  and  cocoa-nuts  are  only  too  com- 
mon. 

December  5th. — The  weather  here  can 
hardly  be  fancied  for  this  time  of  year.  It 
is  not  really  hot,  neither  is  it  always  cool 
or  comfortable  ;  though  bright  this  morning, 
in  -the  afternoon  it  turned  out  showery,  as  is 
usual  at  this  season.  In  the  main,  blue  uni- 
forms are  more  suitable  than  the  white  ones. 
The  rain,  however,  has  brought  out  a 
wealth  of  flowers,  especially  roses,  very 
fine  ones  being  visible  on  every  hand. 

I  just  broke  off  to  bum  a  piece  of  cam- 
phor on  account  of  the  mosquitoes  that  ap- 
pear unusually  ravenous  and  blood-thirsty — 
this  procedure,  which  has  the  sanction  of 
"authority,"  never  proves  very  efficacious. 
On  shore  the  Chinese  have  curious  orna- 
mental furnaces,  made  from  some  sort  of 
white  metal,  in  which  they  burn  a  powder, 
sometimes  of  sandalwood,  sometimes  Pyrc- 
thum  rosiim,  better  known  perhaps  under 
its  pseudonym  of  "Persian  Insect  Powder;" 
the  art  of  the  thing  is,  that  the  powder  is 
poured  over  a  little  iron  mould,  which  is 
then  withdrawn  leaving  the  contents  di- 
vided into  continuous  ridges,  so  that  when 
a  match  is  touched  to  one  end  the  fire  creeps 
and  smoulders  along  evolving  smoke  for  a 
couple  of  hours  or  so — if  the  powder  was 
simply  piled  up  it  would  all  be  consumed 
at  once. 

Off  Lahaina,  December  loth. — We  ar- 
rived her  yesterday  for  target  practice  and 
are  bound  for  Hilo,  on  the  island  of  Hawaii. 
The  ship  is  under  weigh,  with  her  great 
guns  going,  and  while  I  am  writing,  every 
now  and  then,  if  one  of  the  after  battery 
is  fired,  my  ink-stand  fairly  jumps  from  the; 
table.  •    i 

I  presume  there  will  be  no  opportunity 
to  visit  the  shore  here,  hence  my  descrip- 
tion is  merely  of  what  can  be  seen  from  the 
deck  or  from  a  port.  There  is  a  strip  of 
low  green  land,  apparently  level  and  fringed, 
with  cocoa-nut  trees,  just  inside  the  shore- 
reef.  The  slopes  beyond,  and  towards  thej 
mountain  ridges  that  form  the  background, 
are  green  with  sugar-cane  and  other  crops; 
then  there  are  rifts  or  deep  ravines  intersect- 


DETROIT  MEDICAL  JOURNAL. 


173 


ing  the  ridge  ;  and  finally  a  pali  that  appears 
inaccessible.  From  the  ship — we  are  twelve 
or  fifteen  miles  oflf  Maui — we  can  see  the 
islands  of  Molokai,  Lani,  Kahoolawe  and 
Hawaii,  including  the  famous  extinct  vol- 
cano of  Haleakala,  with  the  largest  crater 
known,  which  rises  on  our  port  beam  nearly 
1 1, GOO  feet,  and  so  huge  as  to  appear  dome- 
shaped.  This  volcano  is  separated  from  the 
Lahaina  district  by  a  low  sandy  ridge.  As 
we  coast  along,  with  the  aid  of  glasses  I  am 
able  to  detect  quite  a  number  of  little  sec- 
ondary craters  that  rise  out  of  the  bulk  of 
the  mountain  ;  and  I  am  told  there  are  scores 
of  cones  within  the  main  crater,  which  is 
twenty-eight  miles  in  circumference.  One 
very  perfect  cone  appears  to  rise  from  the 
sea-bottom,  as  it  is  entirely  surrounded  by 
water.  It  is  a  long  time  since  this  volcano 
has  exhibited  evidences  of  activity,  and  on 
the  last  occasion  its  force  appears  to  have 
been  exerted  from  northwest  to  southeast 
and  all  along  the  chain  from  Kauai  to 
Hawaii. 

Hilo,  December  27th. — This  is  a  most  en- 
chanting little  settlement  half  hidden  be- 
neath a  wealth  of  flowers  and  a  forest  of 
bananas,  bread-fruit  and  cofifee  trees,  with 
here  and  there  thick  clusters  of  cocoa-nuts 
shooting  high  in  air  waving  their  leaves 
and  rattling  trunks  in  a  very  indolent  and 
graceful  style  peculiarly  their  own.  Then 
the  deep,  velvety  verdure  around  gradually 
rises  in  green  slopes  and  recedes  far  away 
in  the  distance,  until  the  scene  is  closed  by 
the  "twin  giants  of  the  Pacific,"  Mauna 
Kea  and  Mauna  Loa.  Nearer,  along  the 
shore,  are  silvery  rills  leaping  into  the  sea; 
and  the  bay  is  constantly  alive  with  canoes 
and  boats,  with  their  broad  paddles  flash- 
ing in  the  sun,  each  holding  two  or  more 
chattering,  gesticulating  natives,  offering 
for  sale  tempting  tropical  fruits  reposing 
dewily  in  leafy  baskets. 

Neither  is  the  town  disappointing  on 
closer  view.  The  richest  and  most  dense 
of  tropical  foliage  shades  and  almost  ob- 
structs the  pathways ;  pretty  huts  of  thatch- 
ed straw,  cottages,  and  even  more  preten- 
tious dwellings  are  embowered  in  groves 
and  shrubbery,  while  flowers  abound  in  pro- 
fusion on  every  hand ;  streams  of  limpid 
water  murmur  in  every  direction,  and  the 
cool  trade-winds  blow  breezily  through  the 
foilage — alltogether  the  effect  is  most  Arca- 
dian and  quite  exhilarating.  Then,  always 
when  we  go  ashore,  there  are  la'rge  numbers 
of  copper-hued  natives,  rigged  out  in  the 


gayest  colors,  waiting  to  receive  us,  includ- 
ing a  stout  individual  with  a  most  import- 
ant air,  and  a  crown  embroidered  on  the 
sleeve  of  his  coat  which,  along  with  a  short 
baton,  conveys  the  information  he  is  a 
Kaiko  or  "king's  man,"  in  other  words  an 
authorized  guardian  of  the  peace. 

On  Sunday  I  happened  in  front  of  the 
native  church  just  as  the  congregation — 
something  like  eight  or  nine  hundred  peo- 
ple— was  coming  out.  There  were  ancient 
matrons  in  dazzling  print  frocks,  cut  very 
high  in  the  neck  and  very  low  at  the  heels, 
but  unconfined  by  either  belt  or  bodice,  each 
with  one  or  more  pieces  of  ancient  millinery 
appertaining  to  a  long  forgotten  era,  gaud- 
ily decorated  and  perched  high  upon  their 
sinciputs  and  conveying  the  idea  they  had 
been  put  on  wrong  end  foremost, — as  was 
the  actual  fact  in  many  instances;  young 
damsels  attired  in  gaily  colored  shawls  and 
ribbands,  their  nether  limbs  encased  in  a 
superabundance  of  hose  and  strong  brogan 
shoes ;  venerable,  gentlemanly  Kanakas  in 
tightly  fitting  trousers  and  swallow-tail- 
ed coats  unconscionably  short  in  the  waist, 
and  ditto  long  in  the  skirts,  while  others 
were  only  saved  from  appearing  in  pur  is 
naturalihus  by  a  flimsy  shirt,  or  fold  of 
tappa  wound  about  the  loins,  breech-clout 
fashion. 

Hawaii,  or  properly,  Owyhee,  affords  a 
fair  glimpse  of  primitive  island  life,  being 
less  visited  than  other  portions  of  the 
group ;  but  the  natives  have,  apparently, 
lost  little  by  this  fact.  They  still  preserve, 
in  some  degree,  their  old  habits  and  heathen- 
ish customs,  and  many  deep-rooted  and  im- 
moral practices  still  obtain.  Nevertheless, 
it  strikes  a  stranger  with  surprise  to  find 
these  demi-barbarians  can  all  read  and 
write,  and  that  the  well-defined  caligraphy 
of  the  Hilo  nymphs  will  compare  favorably 
with  that  of  the  most  fashionable  style  of 
the  art  in  young  ladies'  seminaries  and 
"finishing  schools"  at  home;  they  also  pay 
strict  observance  to  the  "Sabbath"  (out- 
wardly at  least),  have  a  general,  even 
though  slip-shod,  knowledge  of  the  Scrip- 
tures, and  many  possess  a  tolerable  educa- 
tion. The  natives,  moreover,  are  amiable, 
good  natured,  though  indolent  beings,  and 
approach  nearer  to  the  toxijours  gai  than 
any  people  in  existence ;  nevertheless,  let 
no  one  imagine  from  their  simplicity  of 
manners,  he  can  win  their  hearts  wath  gim- 
crack  jewelry,  glass  beads,  and  baubles  of 
that   ilk !      Peradventure    he   will   discover 


174 


DETROIT  MEDICAL  JOURNAL.    . 


they  have  as  correct  an  appreciation  of 
silver,  and  can  drive  as  sharp  a  bargain  as 
ever  the  Jew  out  of  Jerusalem.  Still  they 
are  obliging  and  will  attend  you  all  day 
in  tramps  and  excursions,  apparently  well 
satisfied  with  a  trifling  present  of  cigar- 
stumps. 

Among  the  favorite  dishes  is  that  of 
raw    fish,    and    as    a    great    rarity    a    hian 
dog.     Under  the  most  solemn  pledges  of 
secrecy,  I  was  permitted  to  witness  the 
exhuming  of  one  of  these  animals,  with 
the  privilege  of  dining  therefrom  in  case, 
he  was  fovmd  palatable.    These  solecisms 
on  modern  cookery  and  viands  are  severe- 
ly frowned  upon  by  their  white  teachers 
and   pastors,    consequently   it   was   with 
much  caution  I  was  taken  to  a  small  hut 
in  the  outskirts,  where,  when  a  venerable 
Kanaka  had  been  placed  on  guard  to  pre- 
vent surprise  from  Kaikos,  the  entertain- 
ment began.     First,  a  huge  calabash  was 
pla^ced  on  the  ground  filled  with  the  Na- 
tional   preparation    of     poi-poi — a    white 
mixture   made   of   mashed   and    fermented 
taro,  of    the    consistency    of    paste    and    a 
flavor  of  sour  starch;  and  it  is  not  con- 
sidered the  mode  to  eat  it  with  aught  else 
but  the  fingers — one,    two,   three,    or  the 
whole  hand,  according  to  its  liquidity.    The 
Hawaiians  beat  the  Neapolitan  lazzaroni  in 
dextrous  use  of  their  digits  and  digestions, 
for  whereas  the  latter  can  only  suck  down 
several    continuous    leagues    of    macaroni 
without  a  bite,  and  be  satisfied,  the  Kanaka 
will  make  a  cone  of  hand  and  fingers,  and 
•  with  the  whirling  velocity  of  a  water-spout, 
takes  up  enough  of  the  plaster-of-Paris-like 
liquid  to  make  a  thorough  cast  of  mouth 
and  jaws,  with  the  energy  to  repeat  the  im- 
pression   every   minute!      No   wonder   the 
natives,    for    most    part,    are    pot-bellied! 
Where  all  the  stuff  goes  too  is  a  mystery. 
It  has  been   suggested  that  they  are  hol- 
low, like  bamboos,  down  to  their  heels ;  but 
it  is  a  mooted  point.    I  tasted  the  poi-poi  by 
way  of  an  appetizer,  and  felt  no  further 
indication  to  make  a  hearty  meal,  especially 
as  I  knew  it  had  all  been  chewed  at  least 
once  in  the  making,  and  the  fact  the  opera- 
tion is  generally  performed  by  white  tooth- 
ed maidens,  and  that  success  depends  upon 
the  thorough  admixture  of  saliva,  did  not 
tend  to  render  the  dish  any  more  palatable. 
By  the  time  the  poi-poi  had  disappeared, 
the  stones  and  leaves  were  taken  from  a 
sunken  oven  in  the  corner  of  the  hut  ex- 


posing the  bouf-zvow  to  view.  The  warn- 
ing of  cave  canem  which  I  had  seen  in 
former  years  at  Pompeii  never  struck  me 
forcibly  till  now !  I  had  heard,  too,  a  meta- 
phor to  the  effect  that  the  "hair  of  a  dog 
is  good  for  the  bite,"  but  the  moment  I 
beheld  the  entire  animal  with  his  white  jaws 
and  tongue  lolling,  I  felt  no  indication  for 
even  the  bite — lost  my  appetite  and  came 
quickly  away,  with  the  intention  of  turn- 
ing informer,  and  sending  the  Kaikos  in 
among  the  party. 

While  dealing  with  Hawaiian  cuisine  I 
may  as  well  speak  of  some  other  matters 
pertaining  thereto :  The  manner  of  fatten- 
ing these  interesting  and  delicate  animals 
is  not  dissimilar  to  the  process  of  cram- 
ming turkeys  with  walnuts,  or  geese  pre- 
paratory to  having  their  livers  turned  into 
pate  de  fois  gras.  These  animals  are  of  a 
peculiar  kind — short-legged  and  domestic. 
The  feeder  takes  a  mouthful  of  poi-poi,  and 
after  masticating  it  to  proper  consistency 
and  shape,  seizes  his  victim  by  the  throat, 
chokes  the  jaws  wide  open,  and  drops  the 
contents  of  his  own  oral-cavity  into  that 
of  the  brute — it  is  said  violence  is  only 
necessary  with  puppies,  for  on  becoming 
older  and  docile  they  take  to  this  diet  more 
kindly.  I  have  twice  partaken  of  liiart 
turkey — fattened  by  the  same  process,  and 
considered  by  the  natives  as  only  inferior 
to  luau  dog, — but  it  proved  on  both  oc- 
casions to  be  a  most  insipid  dish.  The  gob- 
bler is  stripped  of  his  plumes,  cleaned, 
dressed,  stuffed  with  a  green  cabbage-look- 
ing vegetable  known  as  Inaii  (hence  the 
peculiar  title),  carefully  swathed  like  a 
mummy  in  damp  banana  leaves,  and  laid  on 
a  native  oven  of  red  hot  stones,  all  covered 
thickly  over  with  more  leaves  until  not  a 
chink  or  cranny  is  left  for  the  escape  of 
heat  or  steam.  How  long  the  bird  is  com- 
pelled to  undergo  this  operation,  I  do  not 
exactly  remember,  but  on  sitting  down  to 
the  table,  he  was  ushered  in  on  a  huge 
platter  in  his  green  winding-sheets,  and 
after  removing  the  outer  coatings  presented 
a  whitish  par-boiled  appearance,  half- 
drowned  in  a  pulpy  mass  of  liiaii,  and  fell 
to  pieces  at  the  first  touch ;  he  was  steamed 
to  death.  There  was  not  a  trace  of  turkey 
flavor  left,  and  I  thought  it  the  worst  pos- 
sible use  he  could  have  been  put  to ;  albeit 
the  vegetable  was  delicious  and  in  the  main 
made  amends  for  tasteless  fowl. 

(Continued.) 


DETROIT  MEDICAL  JOURNAL. 


-Detroit  Hedical  Journal 

A  CONCISE  nONTHLY 
EPITOnE  OF  PRACTICE  AND  THERAPEUTICS. 

DR.  G.   ARCHIE  STOCKWELL,    Editor. 

— ISSUED     BY — 

THE  J.    F.    HARTZ   CO., 
Publishers,  Booksellers  and  Importers. 


Note.— The  management  cannot  undertake  to  return  rejected 
manuscript  unless  sufficient  postage  is  provided  to  cover  the 
expense  thereof. 

Address  all  communications,  of  whatever  nature,  at  270 
Woodward  Avenue,  Detroit.  Michigan.  U.  S.  A. 

DETROIT,  MICH.,  SEPTEMBER,    1901. 


DEJIISE  OF  PRESIDENT  MCKINLEY. 

We  stop  the  press  to  announce  this  de- 
plorable and  sorrowful  event  which,  though 
sudden,  was  not  altogether  unexpected  by 
medical  men  who  had  carefully  followed 
the  results  accruing  to  the  assassin's  bullet. 

"In  multiple  counsel  there  is  safety"  is 
an  ancient  and  threadbare  aphorism  that, 
however  true  in  its  application  to  ordinary 
affairs,  in  conditions  like  those  surrounding 
the  bedside  of  the  martyred  Chief-Execu- 
tive is  apt  to  prove  delusive.  We  have  no 
wish  or  purpose  to  criticise  adversely  the 
medical  gentlemen  in  attendance;  admitted- 
ly each,  individually,  is  a  man  more  than 
ordinarily  professionally  endowed,  and  pos- 
sessed of  considerable  more  than  a  mere 
local  reputation ;  but  on  the  other  hand  we 
c^n  not  but  feel  the  sufferer  and  his  medical 
advisors  alike  were  sadly  handicapped  by 
the  results  accruing  to  popular  clamour,  and 
the  demand  that  no  measures,  however  ex- 
traordinary, be  left  undone — such  generally 
results  in  overdoing,  especially  when  the 
patient  is  possessed  of  great  prominence, 
and  the  facts  are  taken  into  consideration 
that,  amid  a  multitude  of  counsel,  clashes  of 
opinion  are  possible,  and  no  medical  man, 
except  one  possessed  of  unusually  strong 
personality,  would,  in  the  face  of  the  ad- 
verse opinions  of  colleagues,  (and  the  cer- 
tainty of  mis  judgment  on  the  part  of  the 
public  and  professional  press),  dare  to  act 
in  any  way  independently,  or  to  overstep 
in  any  particular  the  boundaries  of  accus- 


tomed routine.  We  certainly  would  have 
had  more  hope,  from  the  first,  if  the  Presi- 
dent had  been  relegated  to  the  exclusive 
care  of  one  or  two  individuals. 

Also,  we  can  not  but  deprecate  the  un- 
seemly attempts  to  secure  advertising  for 
self  and  friends  on  the  part  of  individuals, 
which  led  to  the  importation  of  an  alien 
nurse,  and  (at  the  last  moment,  when  the 
fatal  termination  had  become  inevitable) 
of  physicians  from  far  away  cities ;  both 
acts  appear  to  reflect  upon  the  ability  of 
those  in  attendance,  and  particularly  upon 
nurses  and  medical  fraternity  of  Buffalo. 

Again,  the  excluding  of  Mrs.  McKinley 
from  her  husband's  bedside,  and  the  denial 
of  the  accustomed  cigar — which  was  crav- 
ed, and  asked  for,  and  could  have  work- 
ed no  possible  harm,  while  it  might  have 
obviated  certain  adverse  phenomena — 
smack  of  the  torture-chamber  and  mediae- 
val superstition  more  than  anything  else : 
— Does  not  one  suppose,  if  Mrs.  McKinley 
is  the  woman  we  take  her  to  be,  that  these 
procedures  had  her  sanction,  though  ex- 
clusion was  made  to  appear  solely  in  her 
interest !  Here  we  have  two  factors  that, 
seemingly,  in  the  minds  of  most,  of  little 
importance,  may  have  had  direct  influ- 
in  securing  the  untoward  result.  "Noth- 
ing is  more  depressing  to  an  invalid  than 
an  enforced  quiet  without  any  form  of 
physical  or  mental  occupation,  especially 
when  surrounded  by  strange  attendants. 
Apparently,  not  only  was  Mrs.  McKinley 
very  carefully  excluded,  but  her  spouse 
was  left  to  the  "rule-of-thumb"  care  of 
an  alien  "trained"  attendant. 

We  learn  the  immediate  cause  of  death 
was  "gangrene  of  both  walls  of  the 
stomach  and  pancreas."  It  seems  passing 
strange,  in  the  face  of  previous  reports 
(emanating  apparently  from  authority) 
that  such  condition  could  have  existed 
without  being  suspected;  the  character 
of  the  pulse,  to  say  the  least,  was  such  as 
to  lead  to  a  surmise  that  some  untoward 
event  w^as  threatening. 


176 


DETROIT  MEDICAL  JOURNAL. 


One  of  the  theories  propounded  is,  that 
the  bullet  of  the  assassin,  with  a  devilish- 
ness  almost  unprecedented  in  modern 
times,  was  deliberately  poisoned,  for  the 
purpose  of  making  the  fate  of  the  victim 
doubly  certain.  This,  however,  seems  high- 
ly improbable. 

Undoubtedly,  there  yet  remain  many 
facts  to  be  made  public  that  are  of  inter- 
est to  the  medical  profession,  and  accord- 
ingly we  await  the  official  and  authorita- 
tive report.  Such  data  as  are  at  hand,  com- 
ing as  they  do  through  the  Associated  Press 
and  filtered  through  the  hands  of  non- 
professional editors,  are  altogether  mea- 
gre and  unsatisfactory. 

The  political  lessons  of  the  tragedy  are 
many;  it  is  hoped  they  will  be  taken  full 
advantage  of  as  regards  the  future.  It  is 
possible  that  the  "grief  of  the  Nation  may 
ultimately  prove  the  Nation's  salvation" 
in  the  matter  of  eradicating  the  anarchistic 
and  other  obnoxious  socialistic  elements. 

Fortunately  the  executive  chair  will 
now  be  succeeded  to  by  a  gentleman  pos- 
sessed of  no  less  great  personality  than 
Mr.  McKinley,  one  moreover  whom  the 
breath  of  scandal  has  not  been  able  to 
touch,  and  whose  high  rectitude  and  hon- 
esty of  purpose  is  unchallengeable. 


Cajuput  Oil. 

The  advent  of  oil  of  Melaleuca  Leuca- 
dendron  dates  back  to  171 5  when  it  was  in- 
troduced to  Europe  via  Amsterdam.  An 
apothecary  very  properly  was  responsible 
for  the  introduction,  but  it  appears  to  have 
languished  a  century  after  this  before  Lon 
don  took  it  seriously  under  consideration. 
During  the  cholera  epidemic  of  1830  it  came 
into  wide  repute,  which  has  since  been 
sustained,  more  or  less,  as  a  valuable  dif- 
fusible stimulant,  antispasmodic  and  dia- 
phoretic. Unfortunately,  owing  to  its  high 
price,  oil  of  cajuput  {Oleum  W ittnehianum) 
is  subject  to  adulteration,  and  the  vast  mst- 
jority    of    that    offered  in  the    market   is 


nothing  but  a  mixture  of  turpentine,  oil  o( 
rosemary,  camphor  and  bruised  cardamor 
seeds,  treated  with  a  little  milfoil  to  giv< 
the  requisite  color.  Oils  of  camphor,  lavi 
ender,  origanum  and  rosemary  frequently 
serve  for  adulteration. 

The    true    oil,    when    taken    internallyJ 
causes  a  sensation  of  warmth  in  the  stom-i 
ach.   excites   the   action   of  the   heart   anc 
arterial   system,   and   subsequently   inducesi 
copious  diaphoresis. 

In  gout  and  rheumatism  much  benefit 
follows  both  the  internal  and  external  use 
of  this  agent ;  in  retrocedent  gout  it  is  par- 
ticularly serviceable  in  doses  of  from  live 
to  six  drops,  frequently  repeated.  It  is 
occasionally  of  great  service,  employed  both 
internally  and  externally,  in  neuralgic  af- 
fections, but  is  inadmissible  if  the  malady 
is  connected  with  inflammatory  conditions. 

Immediate  relief  attends  its  exhibition  in 
flatulence  and  flatulent  colic,  maladies  in 
which  it  has  never  been  known  to  fail.  In 
typhoid  and  other  low  forms  of  fever  it 
may  be  judiciously  prescribed  as  a  stimu- 
lant ;  so  too,  as  an  antispasmodic,  it  proves 
valuable  in  convulsions  attended  by  debility 
or  anaemia. 

It  has  been  recommended  in  epilepsy,  but 
its  value  is  somewhat  problematical  except 
when  the  disease  is  associated  with  hysteria 
or  with  great  nervous  depression ;  but  in 
hysteria,  even  in  considerable  doses  it  ap- 
pears to  be  inferior  in  action  to  either  asa- 
foetida  or  valerian. 

In  spasmodic  cholera  the  oil  has  been 
highly  lauded,  and  in  some  instances  its  ac- 
tion has  appeared  to  be  almost  magical ;  on 
the  other  hand  it  has  frequently  failed  to 
be  of  any  real  benefit,  which  possibly  may 
be  due  to  the  fact  that  an  impure  product 
was  employed. 

All  in  all,  cajuput  oil  is  a  remedy  of 
great  power  and  value,  one  too  much  neg- 
lected in  general  practice ;  but  it  is  demand- 
ed when  this  drug  is  employed  that  its  pur- 
ity be  definitely  assured. 


DETROIT  MEDICAL  JOURNAL. 


177 


Two  Novel  Claims. 

In  the  Medical  Record  for  July  13th.,  ap- 
pears two  novel  communications  which, 
undoubtedly,  will  attract  considerable  at- 
tention : 

One,  on  the  "Etiology  of  Alopecia,"  by 
Doctor  Delos  L.  Parker,  of  Detroit,  ad- 
vances the  theory  that  this  malady  is  due  to 
auto-intoxication  through  absorption  of  de- 
composed organic  matter  present  in  the 
residual  air  of  the  lungs,  and  upon  which 
the  author  bestows  the  title  Trichotoxicon. 
Experiments  upon  pigeons,  that  were  in- 
oculated with  a  solution  of  respired  air  in 
water,  seems  to  confirm  the  claim,  but  lack 
satisfactory  negative  and  control  evidence. 
This  is  a  very  interesting  communication, 
whatever  the  verdict  of  the  profession  may 
be. 

The  second  is  the  claim  of  one  Doctor 
H.  Holbrook  Curtis,  that  he  immunizes 
hay-fever  sufferers  by  administering  a  prep- 
aration purporting  to  be  made  from  the 
pollen  of  certain  plants,  more  particularly 
^'ragweed"  {Ambrosia  triUda),  golden-rod 
(Solidago  odora),  etc.  What  is  more  re- 
markable is  the  fact  that  this  paper,  though 
read  before  the  American  Laryngological, 
Rhinological  and  Otological  Society,  prior 
to  its  appearance  in  the  Record  had  been 
distributed  broadcast  as  a  part  of  the  ad- 
vertising literature  of  a  well  known  phar- 
maceutical house ;  also  the  unsigned  "tes- 
timonials" read  very  like  those  that  obtain 
to  patent  medicine  almanacs.  Hence  it 
is  a  matter  of  considerable  surprise  to  us 
that  this  paper  obtained  place  in  a  publica- 
tion of  the  standing  of  the  Record.  The 
"ear-marks"  to  say  the  least,  are  those  of  a 
proprietary  product,  and  the  text  affords 
no  ])ositive  or  conclusive  information  as 
to  the  character  of  the  compound,  while  the 
title,  is  manifestly  intended  to  be  "catchy." 
We  opine  the  concern  that  has  under- 
taken to  market  this  preparation,  will  find 
it  has  committed  a  grievous  error,  particu- 
larly as  it  has  hitherto  been  held  to  be  im- 
maculate in  the  matter  of  foisting  upon  the 
profession  products  of  doubtful  character. 


Fighting  the  Nile  Sudd. 

The  difficulties  and  dangers  of  tearing 
a  passage  through  the  dense  masses  of 
floating  vegetation  which  periodically  ob- 
struct the  Nile,  making  navigation  im- 
possible, are  well  described  in  an  article 
which  appears  in  the  August  number  of 
Pearson's  Magazine.  A  free  waterway  has 
now  has  been  opened  up  the  river  as  far 
as  Uganda.  In  all  fourteen  blocks  of  the 
sudd,  as  the  drifting  marshes  are  called, 
have  been  removed,  the  total  length  of  the 
river  cleared  being  eighty-three  miles.  The 
actual  work  was  done  by  some  750  .Soudanese 
prisoners  under  the  direct  orders  of  two 
young  officers  of  the  British  Royal  Navy. 
The  following  is  an  extract  from  a  journal 
kept  by  one  of  them : 

Now,  as  to  how  we  do  it.  On  arriving  at  a 
block  we  tie  up  the  steamer,  and  set  every- 
thing on  fire,  then  cut  down  all  the  dead 
papyrus,  which  is  on  the  sudd,  until  it  soon 
looks  like  a  very  rough  field.  Then  this  field  is 
dug  into  small  sections  four  or  five  yards 
square;  the  trenches  are  dug  to  about  two  feet 
under  water,  the  sudd  itself  being  one,  two, 
or  three  feet  above  water,  and  from  six  to  ten 
underneath.  Next  we  put  pieces  of  wood  round 
our  section  (cut  up  telegraph  poles),  fix  a  wire 
hawser  round-  the  section,  shoved  well  down  in 
the  trenches  and  behind  the  posts,  and  bring 
the  two  ends  on  the  steamer.  The  steamer 
then  backs  astern,  and  eventually  pulls  out  the 
section,  which  fioats  away  down-stream.  The 
wire  is  got  on  board  again,  the  poles  are  re- 
covered, and  the  steamer  proceeds  for  another 
section.  The  force  anl  jerk  which  the  steamer 
brings  on  the  wire  severs  the  roots  of  the  sec- 
tion underneath  from  the  others — or  at  least 
something  does!     That's  the  idea. 

It  is  expected  this  work  will  have  a  ma- 
terial bearing  on  the  fevers,  especially  those 
of  malarious  character,  peculiar  to  the  up- 
per Nile  region. 

EDITORIAL  NOTES. 


Epilepsy  and  the  Bromides. — 

The  bromides,  unfortunately,  have  been 
widely  heralded  as  specifics  for  epilepsy; 
yet  no  claim  can  be  farther  from  the  truth. 
They  may  temporarily  suppress  epileptic 
attacks,  but  only  during  the  period  in  which 
they  are  exhibited  to  the  point  of  saturation  ; 
they  are  in  no  sense  remedial. 

Again,  a  great  deal  of  the  trouble  ac- 


178 


DETROIT  MEDICAL  JOURNAL. 


cruing  to  the  administration  of  this  class  of 
agents  is  due  to  the  selection  of  a  poor  and 
cheap  salt.  Bromides  of  potassium,  of  am- 
monium, of  lithium,  etc.,  are  unpalatable 
and  in  the  main  unsatisfactory,  the  stomach 
quickly  rebelling  against  their  administra- 
tion. If  one  must  have  a  bromide,  select 
one  that  will  not  upset  the  stomach  and  in- 
terfere with  digestion  and  assimilation. 
The  sodium  salt  is  the  only  one  that  fulfills 
this  demand ;  if  dissolved  in  water  it  affords 
a  fairly  palatable,  even  refreshing  drauglrt ; 
it  may,  moreover,  be  employed  for  a  long 
time,  in  maximum  doses,  without  any  un- 
toward results  and  carries  with  it  a  larger 
percentage  of  bromine  than  most  other  salts. 


Epithelioma. — 

A  writer  in  the  Chicago  Medical  Times, 
asserts  as  the  result  of  "forty  years  ex- 
perience" that  extirpation  by  the  knife  is 
much  less  efficacious  than  the  employment 
of  a  paste  of  zinc  chloride — "for  some  rea- 
son the  same  amount  of  tissue  sacrificed 
by  the  knife  will  give  far  better  results  if 
destroyed  with  the  caustic ;  with  the  former 
recurrence  is  the  rule,  by  the  latter,  the  ex- 
ception." The  claim  is  likewise  made  that 
"chloride  of  zinc  has  as  great  efficacy  and 
is  as  certain  death  to  cancer  cells  as  is 
quinine  to  malaria." — The  latter  part  of 
this  quotation  is  certainly  a  trifle  foggy. 

How  about  lactic  acid  which  is  practically 
harmless  to  healthy  tissue,  but  inimical  to 
the  adventitious  or  neoplastic  form?  The 
latter  has  been  successfully  employed  to 
destroy  growths  that  recurred  within  three 
weeks  after  expiration,  and  at  the  cicatrix. 


Oleum  Jecoris  Aselli. — 

Doctor  Jones  Greer  of  Newport,  Eng- 
land,* takes  exception  to  this  authorized  and 
official  synonym  of  cod-liver  oil.  He  re- 
marks : 

"Asellus  signifies  a  little  or  young  ass.  This 
word  has  also  been  extended  to  fishes,  as  the 
cod  {Morrhua  vulgaris),  which  have  the  color 
of    the  ass;     at  least,    Varro,  in    speaking    of 


fishes  named  from  their  color,  mentions  the 
asellus,  or  cod,  as  deriving  its  name  from  this 
circumstance.  Those  therefore  who  trust  to 
a  dictionary  might  not  be  able  to  tell  whether 
oleum  jecoris  aselli  meant  the  oil  of  a  cod's 
liver  or  the  oil  of  the  liver  of  an  ass.  In  1839 
the  latter  translation  was  actually  adopted  by 
a  writer  in  a  medical  journal,  who  gravely  told 
his  readers  that  the  Germans  had  been  using 
oil  of  asses'  livers  for  fifteen  years!" 

Doctor  Greer's  quotation,  derived  from 
a  foot  note  on  "Lac  Asellae"  in  Selecta  e 
Prcscriptis,  is  interesting  as  exhibiting  the 
uncertainties   of  philological  derivation. 


Preservation  of  Anatomical  Specimens. — 

Pathological  specimens  are  best  preserved  by 
the  aid  of  formalin,  which  has  the  effect  of  re- 
taining the  natural  colors  of  the  preparation. 
Judging  from  the  specimens  shown,  the  result, 
so  far  as  preservation  of  color  is  concerned,  is 
everything  that  can  be  desired.  The  process 
requires  both  patience  and  experience  to  ob- 
tain the  best  results,  but  its  introduction  marks 
a  new  era  in  the  preservation  of  museum  speci- 
mens, the  decoloration  of  which,  under  the 
methods  hitherto  resorted  to,  constitues  such  a 
serious  drawback  to  their  educational  value.    . 

— Medical  Press  and  Circular. 
Equally  as  valuable,  and  perhaps  even 
more  effective,  is  a  mixture  of  methyl 
alcohol,  sulphurous  acid  and  glycerin,  equal 
parts.  Morbid  specimens  placed  in  this 
fluid,  after  proper  preparation  and  cleans- 
ing, may  be  kept  almost  indefinitely  without 
either  shrinkage  or  loss  of  color. 


Brucine  for  Children. — 

It  seems  not  to  be  known  that  for  patients 
under  ten  years  of  age  brucine  is  a  much 
better,  and  every  way  more  effective  stim- 
ulant (though  milder)  than  strychnine. 

A  solution  of  brucine,  newly  made,  more- 
over, is  a  very  satisfactory  topical  analgesic : 
the  "earaches"  of  children  may  often  be  ef- 
fectually relieved  by  inserting  in  the  audi- 
tory meatus  a  pledget  of  cotton  saturated 
with  this  fluid. 


*The  Lancet,  London. 


Colds.— 

For  the  relief  of  coryzas  vegetable  char- 
coal is  suggested  by  Doctor  T.  M.  Stewart, 
of  Cincinnati.  He  states  the  remedy  is  par- 
ticularly indicated  if  there  is  irritation  of 
the  trachea  and  bronchi  with  mucous  expec- 
toration, chilliness  and  light  colored  urine. 


DETROIT  MEDICAL  JOURNAL. 


IT 


Jystitis  and  Urethritis. — 

One  of  the  most  valuable  agents  for  the 
relief  of  either  of  both  these  conditions  is 
corn  silk,  and  to  secure  its  best  effect  the 
ledicament  should  be  exhibited  in  the  form 
)f  an  infusion  made  from  the  freshly  gath- 
ered drug,  and  newly  prepared  every  couple 
|days  or  so.     When  the  Stigmata  niaydis  is 
)ut  of  season,  a  "German  tincture"  will  do 
^ery  well  from  which  to  make  the  infusion. 
The   dose   should  not  be   less   than   one 
irachm,  and  gradually  pushed  to  one  ounce, 
[or  a  half  wine-glassful.     That  this  drug  is 
|a  valuable  adjunct  in  the  management  of 
ronorrhoeic  cases  is  self  evident. 


of  the  medicaments  recommended  for  the 
topical  treatment  of  this  malady  are  ef- 
fectual. 


[Leucorrhcea  and  American  Women. — 
Not  only  do  our  women  have  leucorrhcea 

[to  an  unprecedented  extent,  but  they  suffer 
from  many  other  forms  of  disease  of  the 

^sexual  apparatus,  more  than  women  of 
other  countries.  Certainly  something  is 
wrong  to  produce  this  condition  so  univer- 
sally, and  one  can  not  but  believe  our  social 
laws  need  radical  revision.  The  corset  is 
accused  of  being  the  chief  factor,  but  this 
is  doubtful,  for  French  women,  even  more 
than  Americans,  are  addicted  to  the  mon- 
strosity, which  has  survived,  in  some  form, 
several  centuries.  The  artificial  conditions 
of  life ;  the  improper  foods  commonly  in- 
gested ;  habits  that  inhibit  proper  tissue  toni- 
city ;  and  the  freedom  with  which  the  sexes 
commingle,  even  at  a  very  early  age,  are 
undoubtedly  more  at  fault  than  any  article 
of  feminine  apparel. 


Gonorrhoea. — 

The  latest  fad  in  the  treatment  of  this 
form  of  the  venereal  is  a  solution  of  zinc 
acetate  and  albumen  naphtho-sulphonate. 
It  is  however,  no  way  superior  to  dozens 
of  other  remedies  possessed  of  astringent 
and  aseptic  tonic  properties^  and  vastly  in- 
ferior to  the  hot-water  douche.  The  error 
universally  made,  is  neglect  to  order  the 
patient  to  bed,  and"  keep  him  there  until 
cured !     If  this  rule  is  followed  almost  any 


Chinese  Yeast. — 

The  substance  known  as  Chinese  or  Jav- 
anese yeast  is  largely  used  in  Eastern  Asia 
for  the  fermentation  of  rice.  This  fungus, 
which  has  the  power  of  exciting  fermenta- 
tion, has  been  made  the  type  of  an  inde- 
pedent  genus,  Amylomyces ;  but  Wehmer, 
in  The  Pharmaceutical  Journal  and  Tran- 
sactions, shows  it  is  a  true  Mucor,  and 
hence  gives  it  the  specific  title  of  M.  rouxii. 
It  ferments  levulose,  dextrose,  galactose, 
sucrose,  lactose,  maltose,  and  inulin,  with 
the  production  of  alcohol.  It  is  accom- 
panied by  another  undescribed  species  of 
Mucor,  which  also  takes  part  in  the  fer- 
mentation of  "ragi,"  and  is  named  M.  jav- 
aniciis. 


Alopecia. — 

For  some  years  the  item  has  gone  the 
rounds  that  pilocarpine  was  an  effective 
remedy  for  alopecia.  The  fact  is,  however, 
it  has  never' been  observed  to  have  any  ef- 
fect upon  the  disorder,  whether  adminis- 
tered internally  or  applied  topically. 

Each  case  .of  alopecia  demands  to  be 
studied  by  itself  and  prescribed  for  accord- 
ing to  its  nature.  Disinfecting  and  stimu- 
lating remedies  are  most  in  demand,  yet  it 
must  be  acknowledged  that  our  therapeutics 
are  for  the  most  part  powerless,  and  that 
the  rare  cures  which  result  are  not  so  much 
due  to  medication  as  to  spontaneity. 


Diabetes  Mellitus,  Potatoes  in. — 

It  has  long  been  a  moot  question  as  to 
whether  potatoes  may  have  a  place  in  the 
dietary  of  diabetics.  Recently  this  has  been 
decided  by  Mosse*,  at  least  to  his  own  satis- 
faction :  He  declares  the  tubers  may  be 
given  to  the  amount  of  two  to  three  pounds 
daily,  and  as  a  substitute  for  the  whole 
(or  part)   of  the  bread  allowed,  and  that 


*Klinische  Therapeutische  Wochenschrift. 


180 


DETROIT  MEDICAL  JOURNAL. 


the  cases  which  respond  best  to  such  man- 
agement are  those  of  medium  intensity  and 
of  the  arthritic  type.  Two  cases  are  cited  in 
evidence  of  the  wisdom  of  this  decision  in 
which  "there  was  prompt  decrease  in  the 
amount  of  sugar  excreted  in  the  urine." 


Milk,  Artificial  Coloring  In. — 

A  simple  method  to  detect  artificial  tint- 
ing of  milk,  is  to  precipitate  the  coloring 
matter  on  fibre.  If  anatto,  for  instance,  is 
suspected,  render  the  sample  of  milk  alka- 
line with  sodium  bicarbonate  and  then  partly 
immerse  it  in  a  strip  of  white  filtering 
paper,  allowing  to  remain  several  hours, 
— x^natto  imparts  to  the  immersed  paper 
a  yellow  tint.  The  same  method  may  be 
employed  to  detect  methyl-orange,  except- 
ing that  ammonium  carbonate  must  sub- 
stitute the  sodium  salt,  and  clean  white  (ab- 
sorbent)  wool  employed  instead  of  paper. 

Curangine. — 

This  alkaloid,  according  to  Boorsma,  is 
possessed  of  marked  febrifuge  properties 
and  derived  from  Curanga  amara,  a  mem- 
ber of  the  family  Scrophularacce,  having 
the  formula  a8Hi7O20.  it  is  easily  soluble 
in  ethylic  and  methylic  alcohols,  aqueous 
acetone,  and  acetic  ether ;  less  so  in  ether, 
petroleum  ether,  carbon  disulphide ;  and  but 
partly  soluble  in  chloroform  and  pure  acet- 
tone.  In  water  it  is  soluble  to  the  ex- 
tent of  6.18  per  cent. 


Important  if  True. — 

The  Dominion  Medical  Monthly  declares 
that  "Pressure  over  the  supra-orbital  foram- 
en in  alcoholic  coma  will  cause  a  man  to 
come  to  immediately,"  and  that  this  method 
may  be  employed  to  diflferentiate  between 
alcoholic  coma,  diabetic  coma,  hysterical 
coma  and  apoplexy. 

We  should  like  to  have  this  statement 
more  fully  verified,  especially  as  it  is  not 
an  editorial  utterance. 

Will  not  some  of  our  readers,  when  the 
opportunity  oflfers,  experiment  and  report? 


Tuberculosis. — 

An  exchange  declares  that  this  disease 
is  very  common  among  pets — dogs,  cats 
and  parrots. 

This  is  in  a  measure  true,  as  parrots  and 
monkeys  are  specially  prone  thereto,  proba- 
bly because  they  are  kept  in  too  confined 
space  without  a  proper  supply  of  fresh  air. 

The  great  trouble  with  pets  is,  that  the 
average  woman  insists  upon  keeping  them 
too  warm,  particularly  if  their  natural 
habitat  is  the  tropics  or  sub-tropics,  under 
the  supposition  that  equatorial  regions 
yield  a  uniform  heat.  One  of  the  most 
delicate  of  the  Simian  tribe,  that  escaped 
from  its  master,  was  known  to  have  sur- 
vived for  several  years  in  a  mountain  forest 
in  northern  Georgia,  where  ice  in  midwinter 
is  no  uncommon  feature;  and  presumably 
it  would  have  lived  much  longer  but  for  the 
interference  of  the  man  with  a  gun. 


Scanty  Menstruation. — 

Aside  from  the  ordinary  domestic  reme- 
dies and  the  employment  of  apiol  (true) 
and  cannabis  Indica,  there  is  probably  no 
agent  superior  to  black  cohosh,  which  should 
be  administered  in  doses  of  fifteen  to  thirty 
minims  at  least  four  or  six  times  daily.  It 
is  most  eflfective  with  women  living  quiet 
sedentary  lives,  and  that  are  closely  ap- 
proaching the  menopause. 


Use  of  Laryngoscope. — 

Drop  a  minim  of  glycerin  upon  the  mir- 
ror, warm  slightly  over  an  alcohol  flame, 
then  wipe  oflf  quickly.  This  will  prevent 
the  blurring  of  the  image  from  condensation 
of  respiratory  vapors. 


Heart  Maladies. — 

Potassium  iodide  is  a  valuable  remedy 
where  fatty  degeneration  exists  as  the  re- 
sult of  debility  or  overwork;  it  is  equally 
effective  in  both  true  and  false  angina. 


But  Most  People  Do. — 

It  is  folly  to  expect  the  stomach  to  do  the 
work  of  the  teeth. 


DETROIT  MEDICAL  JOURNAL. 


181 


Items  and  News. 


An  Ascetic's  Lament. — 

Audi,  doctor,  me  clamantem, 
Trista  voce  lamentantem ! 
Aqua  horrida  interna 
Ventris  plena  est  cavernal 
Diaphragma,  in  thoracem 
Aquae  vi   Impressum,   pacem 
Rapit  jam   pulmoni,  omnes 
Fere  noctes  sunt  insomnes, 
Nunquam  autem  tulit  venter 
Mens  aquam-phy!  libenter! 
Ergo  doctor  fac  me  salvum, 
Aqua  liberando  alvum, 
Ne  sis  Fabius  Cuncator, 
Veni  Medicus  Punctator. 

— Deutsche  Medisinal  Zeitung. 


The   Tuberculin    Cattle   Test.— It   has 

been  declared  that  "if  anything  has  been 
demonstrated  to  a  mathematical  cer- 
tainty in  experimental  pathological  medi- 
cine and  anatomy,  it  is  the  fact  that  tu- 
berculin is  a  sure  test  of  masked  or, un- 
recognized tuberculosis  in  cattle." 

This  is  the  dogmatic,  assertive  side  of 
the  question.  Practically,  it  is  found  the 
British  Royal  Commission  on  Tubercu- 
losis, after  a  lengthy,  careful  and  pains- 
taking investigation,  reported  that  the 
tuberculin  test  on  cattle  was  untrust- 
worthy. 

There  are  some  people  in  this  world 
who  would  continue  to  assert  that  night 
was  day  if  they  stumbled  at  every  step 
for  want  of  light. — Lawrence. 


The  Practitioner  and  His  Finances. — 

The  man  who  neglects  to  secure  his 
financial  position  by  careful  investments, 
insurance,  and  prompt  collection  of  bills, 
may  arrive  at  the  age  when  he  ought  to 
cease  active  practice,  and  yet  be  obliged 
to  continue  to  make  his  daily  living.  Too 
often  keen,  able  practitioners  develop 
into  querulous,  jealous,  disappointed  old 
men,  because  they  are  obliged  to  compete 
with  the  younger  men  when  they  ought 
to  have  retired  with  honors. — Medical 
A^ezvs. 


The  Photo-Bacterium. — 

Pure  cultures  of  the  photo-bacterium — 
which  is  the  cause  of  the  phosphorescence 
of  the  sea, — can  be  obtained  by  placing  a 
fresh  haddock,  or  herring,  in  a  two  per  cent. 
salt  solution  and  keeping  it  at  about  seven 
degrees  above  freezing.     In  a  few  days  the 


fish  and  all  the  fluid  give  off  a  pale  greenish 
light,  made  more  brilliant  by  adding  a  little 
sugar.  The  cultures  can  even  be  photo- 
graphed by  their  own  light. — The  Lancet 

(London.) 


Ozone,  Uses  of. — 

This  agent  is  coming  into  use  for  many 
purposes.  While  it  artificially  ages  liquor, 
and  spirits  generally,  it  improves  coffee, 
and  is  of  advantage  in  the  treatment  of 
tobacco,  of  which  it  improves  the  aroma. 
It  seasons  wood  for  sounding-boards  of 
musical  instruments,  and  also  has  the  ef- 
fect of  protecting  it  from  the  ravages  of 
moisture  and  temperature.  It  is  used  for 
thickening  oil  in  the  manufacture  of  lino- 
leum, and  its  action  in  bleaching  linen  is 
familiar  to  most  of  us. — Western  Drug- 
gist. 


The  Country  Physician. — 

While  there  is  much  truth  in  the  state- 
ment that,  "Where  there  is  nothing  great 
to  be  done,  a  great  man  is  impossible" — 
when  it  comes  to  medicine^  to  be  a  modest 
country  doctor,  surrounded  by  a  confiding 
constituency,  is  no  mean  position  to  oc- 
cupy, and  might  well  fill  the  cup  of  ambi- 
tion for  the  best  equipped  man. — Clinical 
Rcvieiv. 


Night  Work. — 

This  is  a  much  exaggerated  evil  of  the 
physician's  life.  In  the  first  few  years  of 
city  practice  there  is  not  a  superabundance 
of  either  day  or  night  calls,  and  to  one  who 
falls  asleep  full  .of  apprehensions  as  to  the 
success  of  the  future,  the  jingle  of  the  tele- 
phone breaks  in  upon  his  troubled  dreams 
like  sweet  music. — Benedict  (Lippincott's 
Magazine. ) 


Practice  of  Medicine  in  Iowa. — 

The  State  Board  of  "Medical  Examiners 
has  refused  to  recognize  diplomas  from 
Barnes  Medical  College,  of  St.  Louis,  as 
entitling  their  holders  to  enter  the  examina- 
tions of  Iowa. — Northwestern  Lancet. 


Pomegranate,  New  Alkaloid  of. — 

Piccinni  has  isolated  from  the  bark  of 
pomegranate  root,  a  new  alkaloid  that  is  a 
liquid  and  likewise  miscible  with  water. — 
Chemische  Centralhlatte. 


182 


DETROIT  MEDICAL  JOURNAL. 


I 


Book  Reviews. 


King's  American  Dispensatory.  Edited  by  Har- 
vey Wifckes  Felter,  M.  D.,  and  John  Uri 
Lloyd,  Phr.  M.,  Ph.  D.:  Eighteenth  Edition 
and  third  revision.  Cloth,  royal  8  vo.;  pp. 
2291;  Two  volumes.  Price,  $9.00.  The  Ohio 
Valley  Co.,  Cincinnati. 

This  is,  by  long  odds,  the  most  complete 
epitome  of  materia  medica  and  pharmacology 
ever  issued  from  the  press:  Its  scope  is  such 
as  to  dwarf  all  other  dispensatories,  and  the  in- 
formation conveyed  (notably),  has  been  edited 
with  a  care  that  seldom  accrues  to  any  work 
of  this  class.  It  practically  puts  to  shame  the 
National  and  the  United  States  Dispensatories 
with  which,  revision,  for  years,  has  meant  lit- 
tle but  the  embodying  of  a  few  new  prepara- 
tions, often  of  no  merit. 

The  original  King's  Dispensatory  was  narrow, 
empirical,  and  uncertain  in  scope  and  adjuncts, 
and  morever  strongly  tinctured  with  the  tenets 
of  Thomsonianism  and  the  so-called  "botanical 
practice;"  and  this  has  obtained  in  some 
degree  to  all  subsequent  editions  up  to  the  one 
now  under  consideration — "Eclectic"  in  name, 
for  the  first  time  only  has  this  work  reached 
the  high  plane  indicated  by  its  title. 

The  new  volumes  are  broad,  scientific,  and 
in  every  way  reliable.  Professor  Felter  is  well 
known  as  an  authority  on  therapeutics,  espec- 
ially the  branch  that  more  particularly  comes 
within  the  scope  of  his  school,  and  that  he  has 
not  slighted  his  subjects  the  text  bears  ample 
evidence.  Professor  Lloyd,  too,  stands  in  the 
front  rank  of  American  chemists,  botanists  and 
pharmacologists,  and  moreover  has  justly  earn- 
ed a  reputation  for  scientific  ability  and  ex- 
actitude such  as  accrues  to  but  few.  Hence 
these  volumes  represent  the  acme  of  pharma- 
ceutical, botanical,  chemical  and  therapeutic 
accuracy  and  advancement. 

The  work  as  a  whole  is  a  worthy  one,  and  no 
professional  man  who  has  accurate  therapeu- 
tics at  heart  can  afford  to  be  "Without  it. 

Professor  Lloyd  makes  the  explanation  that 
in  1880  he  promised  Doctor  King  to  revise  the 
pharmaceutical  and  chemical  sections  of  the 
American  Dispensatory  if  such  became  neces- 
sary; that  he  did  not  understand  the  magnitude 
of  the  undertaking  which  constituted  practical 
rewriting.  He  adds  that  monetary  considera- 
tions could  not  have  induced  him  to  undertake 
this  enterprise  and,  that  the  exacting  researches 
necessary  have  been  altogether  a  work  of  love. 
We  have  only  one  adverse  criticism,  namely: 
A  number  of  drug  preparations  are  spoken  of 
as  "specific;"  this  word  is  nowhere  explained 
and  apparently  finds  place  solely  with  the  view 


of  advertising  the  preparations  of  one  house, 
and  the  work  thus,  practically,  becomes  an  ad- 
junct of  an  individual  Eclectic  school;  we  un- 
derstand these  "specific"  drugs  to  be  of  the 
same  precise  standard  as  Pharmacopceal  fluid 
extracts  except,  perhaps,  that  in  some  special 
instances  they  are  derived  from  the  green, 
crude  product. 

This  fact,  however,  does  not  in  any  sense 
militate  against  the  actual  value  of  the  work, 
as  before  mentioned,  though  it  certainly  is  the 
reverse  of  good  taste. 


New  Instruments  and   Devices. 

COMBINATION  SELF-RETAINING  CATHE- 
TER AND  DRAINAGE  TUBE. 

This  illustrates  an  instrument  that,  though 
not  entirely  nev/,  is  a  modification  of  an  exist- 
ing form  that  cannot  fail  to  secure  the  full 
appreciation  of  the  medical  fraternity. 


It  is  a  Lliiii,  llexible  vclvet-fiuislied  rubber 
catheter,  with  an  elastic  button  at  the  end  so 
that  it  may  be  drawn  over  a  stylet  for  the  pur- 
pose of  facilitating  introduction  into  the  blad- 
der. The  button  or  bulging  portion  enaoles 
it,  likewise,  to  be  employed  with  certainty  as  a 
self-retaining  catheter  for  either  sex.  It  is  also 
uqually  useful  as  a  drainage  tube,  not  alone 
for  the  bladder  but  for  the  chest  cavity  after 
the  operation  for  pyo-  or  hydrothorax, — it  is 
valuable  in  any  cavity  where  compression  is 
not  so  great  as  to  interfere  with  its  lumen. 

The  value  of  this  device  can  hardly  be  over- 
rated in  cases  of  cystitis  and  urethritis  with 
enlarged  prostate,  or  where,  through  sensi- 
tiveness, constant  catheterization  becomes  un- 
bearable and  the  employment  of  cocaine  (as 
it  almost  always  is  in  the  urethra)   a  menace. 


This  is  a  soft  rubber  catheter  made  in  two 
parts;  or  in  other  words  is  composed  of  two 
distinct  tubes  joined  together  in  such  a  way 
that  introduction  is  not  only  simple  but  facili- 
tated. 

The  advantages  of  the  design  are,  it  is  thoro- 
ughly aseptic  and  furnishes  a  large  and  con- 
tinuous lumen  for  the  efferent  tube  carrying 
off  the  urine. — This  is  especially  valuable  when 
the  urine  is  very  dense  or  heavily  laden  with 
pus. 

It  is  also  available  for  irrigating  the  bladder 
in  cystitis  with  solution  of  potassium  perman- 
ganate, as  recommended  by  Doctor  Valentin'^ 
of  New  York. 


DETROIT  MEDICAL  JOURNAL. 


lo3 


Therapeutic  Brevities. 

Indication  for  Venesection. — Bleeding 
[may  be  employed  to  good  advantage  in : 

Diseases  of  the  nervous  system,  menin- 
[geal  inflammations,  cerebral  congestion,  and 
fapoplex}  : 

Diseases  of  the  kidneys,  where  there  is 
.generalized  cedema  with  un-emic  symptoma 
[ — here  venesection  acts  both  as  a  depleting 
tprocess  and  as  a  sudorific : 

In  circulatory  troubles  consecutive  to 
'cardiopathies, — it  unloads  the  venous  sys- 
tem and  augments  arterial  tension : 

In  pneumonia  its  efficacy  is  remarkable 
and  recourse  should  be  had  thereto  at  the 
; outset;  it  eases  the  patient  by  suppressing 
:pain  in  the  side  and  rendering  the  respira- 
rtion  and  circulation  freer ;  likewise  dimin- 
iishes  the  engorgement  and  pneumonic  exu- 
date.— If  the  heart  should  ultimately  flag, 
there  need  be  no  hesitation  in  repeating  the 
operation. 

In  chlorosis: — One  or  more  bleedings  at 
from  four  to  five  weeks'  interval  constitute 
a  sovereign  remedy,  and  the  more  the  blood 
is  altered,  the  more  the  operation  is  indi- 
cated.— Note :  A  simple  method,  little 
known,  of  appreciating  the  alteration  of  the 
blood  without  the  hicmatoscope  and  the 
haematometer  is,  collect  a  few  cubic-centi- 
metres of  blood  in  a  straight  tube  and  al- 
low to  remain  for  twenty-four  hours; 
two-thirds  should  then  be  occupied  by  the 
clot,  above  which  should  be  seen  a  fine  red 
layer  composed  of  leucocytes,  while  the  up- 
per third  is  occupied  by  serum  of  a  straw- 
yellow  color;  the  more  the  appearance  dif- 
fers from  this,  the  more  the  blood  is  altered, 
and  the  more  is  bleeding  indicated. — Kac- 
ZER  {Wiener  Klinische  Rundschau.) 


Glaucoma. — This  condition  is  frequent- 
ly relieved  by  improved  nutrition,  with 
correction  of  any  existing  errors  of  re- 
fraction ;  also,  sometimes,  by  iodide  potas- 
sium, associated  with  the  topical  employ- 
ment of  eserine  drops. 

Mild  and  insidious  cases  of  inflammatory 
character,  between  paroxysms,  may  exhibit 
but  little  tension ;  such  require  iridectomy 
for  the  drainage  of  the  engorged  vessel? 
during  the  paroxysm,  and  constitutional 
treatment  to  aid  in  the  elimination  of  ac- 
cumulated debris  in  the  tissues. 

Inflammatory  glaucoma,  excluding  trau- 


matic cases,  should  be  accepted  as  a  mani- 
festation of  many  diatheses ;  and  while  iri- 
dectomy may  be  necessary,  it  should  not  bii 
performed  to  the  exclusion  of  the  al'.-i;; 
portant  constitutional  measures.    Moreovci 
as  the  operation  can  accomplish  nothing  bo 
yond  the  establishment  of  drainage-  of  thu 
vessels  of  the  iris  and  contiguous  slructurel 
into  the  aqueous  chamber,  the  amount  of 
iris  removed  should  be  small.     The  opera- 
tion should  not  be  repeated,  and  in  any  ca.'50 
is  only  supplemental  to  constitutional  meas- 
ures. 

In  all  cases  of  increased  tension  of  the 
eye,  with  peripheral  contraction  of  the  field 
and  engorgement  of  the  retinal  veins  with 
or  without  cupping  of  the  disc,  constitution- 
al treatment  is  essential;  and,  above  all, 
strict  attention  to  general  nutrition  and 
habits  of  life. — Reynolds  {Ophthalmic 
Record.) 


Dysentery. — This  is  an  acute  infectious 
disease,  and  like  most  of  its  class  has  a 
tendency  to  get  well  in  time ;  still  is 
of  sufficiently  serious  nature  to  demand 
treatment.  It  is  hardly  necessary  to  re- 
view the  many  drugs  which  have  been 
recommended ;  the  majority  are  useless, 
in  many  cases  pernicious.  Large  doses  of 
ipecac  werjs  very  popular  at  one  time, 
and,  doubtless,  efficacious  in  many  in- 
stances. 

The  cause  must  first  of  all  be  eliminat- 
ed :  Next  disinfect  the  mucous  mem- 
brane and  restore  the  normal  glandular 
secretion,  which  is  best  done  by  admin- 
istering magnesium  sulphate  in  drachm 
doses,  every  three  hours,  combined  with 
ten  drops  of  dilute  or  aromatic  sulphuric 
acid.  The  beneficial'  effect  is  shown  in 
a  few  hours :  The  pain  becomes  less ;  the 
tormina  and  tenesmus  rapidly  subside; 
the  pulse  rate  diminishes,  and  the  tem- 
perature is  lowered.  When  these  effects 
are  apparent,  the  Epsom  salt  may  be 
gradually  withdrawn. — Cruikshank  {New 
York  Medical  Journal.) 


Uterine  Deviations. — The  use  of  gly- 
cerin and  ichthyol  tampons  in  the  treat- 
ment of  retro-displacements,  and  particu- 
larly in  those  complicated  with  the  perimet- 
ric inflammation,  where  it  can  be  persist- 
ently and  thoroughly  carried  out,  is  of  great 
value.  Glycerin,  by  its  affinity  for  water, 
depletes  the  tissue ;  ichthyol,  five  or  ten  per 


184 


DETROIT  MEDICAL  JOURNAL. 


cent,  (in  glycerin)  will  alleviate  pain  and 
hasten  absorption.  Replace  the  uterus  and 
introduce  one  tampon  into  the  posterior 
vaginal  fornix,  packing  quite  firmly; — this 
will  press  the  uterus  anteriorly ;  then  intro- 
duce another  (larger,)  straight  into  the 
vagina  against  the  anterior  lip  of  the  cervix, 
to  hold  the  first  in  place,  and  to  raise  the 
uterus,  thereby  increasing  the  ante-position 
and  also  improving  the  circulation  by 
straightening  the  pampiniform  plexus  of 
veins.  Finally,  in  treatment  of  uncompli 
cated  retro-deviation  by  a  simple  operation, 
advance  the  anterior  vaginal  wall  higher 
upon  the  uterus. — Shimonek  {Mihvaukee 
Medical  Journal.) 


Laryngeal  Tuberculosis. — Congestion 
of  one  vocal  cord  is  very  suspicious  of  tu- 
berculosis, and  a  week's  treatment  by  potas- 
sium iodide  will  exclude  syphilis. 

The  prognosis  is  not  so  grave  as  was 
formerly  supposed ;  the  laryngeal  process 
may  heal  even  with  progressing  pulmonary 
tuberculosis.  No  sharp,  irritating  foods  or 
drinks  should  be  allowed,  and  the  patient 
should  be  forbidden  to  use  the  voice,  even 
in  a  whisper,  communicating  entirely  in 
writing  until  cicatrization  has  progressed 
for  a  few  weeks  or  months.  When  it  is 
found  that  the'  parts  do  not  become  congest- 
ed or  swollen  from  whispering,  then  the 
use  of  the  voice  can  be  gradually  resumed. 
Treatment  may  be  by  means  of  solution  of 
lactic  acid,  not  oftener  than  every  one  or 
two  weeks.  If  possible  remove  all  the 
diseased  tissue  by  an  endo-laryngeal  opera- 
tion. In  advanced  cases  with  much  stenosis, 
tracheotomy  is  preferable  to  laryngo-fissure. 
— Schmidt  {Thcrapie  der  Gegemvart,  Ber- 
lin.) 


Giaourdi. — Boil  milk  for  one  hour,  con- 
stantly stirring.  When  it  has  reached  the 
desired  consistence,  add  a  fig  ferment  and 
reduce  the  temperature  to  113°  Farh.  The 
result  is  a  smooth,  semi-solid,  easily  digest- 
ible milk-food,  which  while  not  materially 
different  from  "bonny-clabber,"  possesses 
many  advantages  over  the  latter — the  fig 
ferment  produces  a  soft,  smooth  coagulum 
that  is  the  more  digestible  because  of  the 
lack  of  lactic  acid.  This  preparation  has 
proved  very  satisfactory  in  gastric  ulcer, 
pyloric  stenosis  and  neurasthenia. 

The   ferment  may  be  made  by  soaking 


a  dry  fig  over  night  in  three  ounces  of  wate 
next    morning    adding  a  trace    of    renn^ 
along    with  a  few    drops  of    lemon  juic 
Many  Swiss  cheese-makers  employ  the  ii| 
ferment  as  an  addition  to  rennet,  since  ther< 
Ijy  a  much  finer  flavored  and  more  home 
geneous  product  is  obtained. 

Giaourdi  is  in  general  used  in  Greece  an| 
the  Levant. — Achilles  Rose. 


Gleet  and  Gonorrhea. — Triturate  fi^ 
drachms  of  acetanilid  and  120  grains  goldc 
seal  with  three  ounces  of  glycerin  and 
water  sufficient  to  bring  the  finished  pro- 
duct up  to  one  pint.  This  should  be  em- 
ployed as  an  injection,  after  shaking  well, 
at  least  three  times  daily,  following  immedi- 
ately upon  micturition,  the  fluid  being  re- 
tained in  the  urethra  for  at  least  four  or 
five  minutes.  Under  ordinary  conditions  a 
cure  may  be  expected  in  from  fourteen  to 
ninety  days. 

If  the  patient  is  emaciated,  the  bowels 
should  have  due  attention ;  also  a  tonic  may 
be  administered,  something  of  the  character 
of  the  following: 

Strychinine  sulph...     2  grains 
Hydrastis,  powd....     3  drachms 

Glycerin     3  ounces 

Ginger,  ext.  fid 3  ounces 

Alcohol    5  ounces 

Water  to   make....   16  ounces 
A  teaspoonful   every  three  hours   or   as   de- 
manded. 

— Washburn. 


Bees  for  Rheumatism. — Some  years 
ago  an  Austrian  physician  advanced  the 
theory  that  the  virus  of  the  bee  sting  is  an 
infallible  remedy  for  acute  rheumatism,  a 
fact  that  receives  unquestionable  confirma- 
tion from  a  custom  of  the  country  people 
in  Malta.  Bees  are  plenty  in  this  island,  and 
their  stings  in  such  repute  that  resort  to  this 
primitive  method  of  inoculation  has  been 
a  common  practice,  in  severe  cases  of  rheu- 
matism, for  generations,  with  most  satisfac- 
torv  results. — Mediterranean  Naturalist. 


Hydrogen  Peroxide. — The  activity  of 
this  chemical  is  promoted,  when  employed 
externally  or  internally,  by  the  addition  of 
hot  water.  A  teaspoonful  added  to  a  half 
glass  of  the  latter  and  ingested  just  prior  to 
meals,  exerts  a  powerful  remedial  influ- 
ence    upon     catarrhal     gastritis. — Elling- 

WOOD. 


DETROIT  MEDICAL  JOURNAL. 


18:' 


Chorea'  Complicating  Pregnancy. — 

Chorea  is  not  an  accidental  complica- 
tion due  to  the  occurrence  of  a  previous 
infantile  chorea,  but  in  the  majority  of 
ases  appears  for  the  first  time,  and  to  a 
L;reat  extent  is  induced  by  this  condition, 
although  pregnancy  alone  can  not  be  re- 
garded as  the  direct  cause ;"  various  con- 
ditions such  as  heredity,  previous  infec- 
tive diseases,  etc.,  are  predisposing  fac- 
tors, and  some  nervous  shock  is  usually 
the  starting  point. 

The  prognosis  is  more  grave  than  in 
early  life.  In  severe  cases  ether  and 
chloroform  may  be  given,  as  in  eclamp- 
sia :  Pinard  suggests  producing  almost 
continual  sleep  (waking  the  patient  only 
to  administer  food),  by  means  of  chloral 
h3'^drate ;  when  improvement  appears,  the 
(loses  can  be  diminished,  but  should  be 
continued  until  this  desideratum  obtains. 
— Newell  (Medical  and  Surgical  Journal, 
Boston.) 


Indolent  and   Stubborn   Ulcerations. — 

After  an  ulceration  has  partially  healed, 
it  is  often  found,  when  a  certain  stage  is 
reached,  that  it  no  longer  improves.  One 
of  the  best  applications  for  this  condition 
'^f  affairs  is  oxyde  of  zinc  ointment  every 
unce  of  which  is  fortified  with  ten  grains 
chloral  hydrate — the  chloral  seems  to 
stimulate  and  promote  the  granulating  pro- 
cess.— Medical  Summary. 

[In  many  instances  the  delay  in  healing 
is  due  to  the  tension  of  the  parts.  Here 
strapping  with  adhesive  strips,  in  a  way 
to  secure  relaxation  of  the  tissues  in  the 
immediate  neighborhood  of  the  ulcera- 
tion, secure  results  that  are  almost  magi- 
cal.— Ed.] 


Asthma, — This  condition,  regardless  of 
cause,  may  sometimes  be  relieved  by  apply- 
ing a  bag  of  ice  to  the  neck  over  the  pneu- 
mogastric. — Sanger. 

[It  might  be  well  to  try  also  the  appli- 
cation of  cantharidal  collodion  in  the  same 
locality. — Ed.] 


Trachoma. — Excision  of  the  retrotarsal 
fold  is  the  best  method  of  treatment,  an 
operation  that  always  proves  successful  and 
can  be  performed  without  difficulty. — Kan 
(  Vratch. ) 


Uterus,    Influence   of   on    Bladder. — In 

view  of  the  intimate  vascular  and  nervous,  as 
well  as  mechanical  and  topographical,  rela- 
tions of  the  uterus  to  the  bladder,  it  is  ad- 
vised that  in  all  cases  of  vesical  trouble  in 
women,  the  uterus  should  first  be  examined, 
and  existing  lesions  corrected.  Relief  of 
the  bladder  symptoms  may  be  obtained  in 
this  way  by  curettage,  uterine  dressings,  or 
pessaries,  or  at  the  time  of  menstruation  by 
relieving  pelvic  congestion  by  diuretics, 
laxatives,  hot  baths,  or  even  local  bleeding. 
— Vergely  {Medical  and  Surgical  Moni- 
tor.) 


Sodium  Chloride,  Lack  of  in  the  Econ- 
omy.— When  the  system  is  deprived  of 
its  normal  supply  of  salt  the  nervous  tissue 
becomes  more  susceptible  to  medicinal  salts, 
in  consequence  of  which  extremely  small 
doses  becomes  efifective.  In  this  manner, 
for  instance,  thirty  grains  of  -odium  brom- 
ide given  during  twenty-four  hours  proves 
remarkably  helpful  in  severe  cases  of  epi- 
lepsy. Probably  this  is  also  true  of  the- 
alkaloidal  salts. — Richet  {U  Union  Medi- 
cale. ) 


Urinous  Odor,  Correction  of. — Essence 
of  turpentine  taken  internally  in  ten-drop 
doses,  three  times  daily,  by  persons  afflicted 
with  urinary  incontinence,  in  a  short  time 
does  away  with  the  disagreeable  ammonia- 
cal  odor,  replacing  it  with  the  flavor  of 
violets.  This  treatment  can  be  continued' 
without  inconvenience  for  several  weeks,, 
and  is  only  contra-indicated  in  gastric  ca- 
tarrh and  nephritis. — Kansas  Medical  Jour- 
nal. 


Influenza  of  Childhood. — 

Sodium  benzoate.   30  grains 

Phenazone    30  grains 

Sparteine   sulph..     2  grains 

Paregoric 4  drachms 

Liquorice    extract     1  drachm 
Tolu  syrup  to  maite     2  ounces 
Shake  well:     A  teaspoonful  four  times  daily 
for  a  child  of  six  to  eight  years  of  age. 

— Merck's  Archives. 


Furuncles. — Salicylic  acid  in  the  form 
of  ointment  or  paste,  constantly  applied,, 
will  relieve  the  pain  and  tumefaction.  Early 
resort  thereto  will  usually  secure  abortion 
of  the  initial  purulent  accumulation ;  applied 
later,  it  will  at  least  hasten  and  promote 
resolution, — Hartzmann. 


186 


DETROIT  MEDICAL  JOURNAL. 


Cocaine  Muriate. — In  small  doses  this 
drug  slows  the  pulse  rate,  but  this  effect 
persists  only  for  a  brief  period ;  is  in  fact 
ephemeral.  Larger  quantities,  as  might 
be  expected,  intensify  this  action,  and  if 
the  toxic  effect  is  produced,  arrest  of  the 
heart  in  diastole  results ;  trigeminal  paraly- 
sis is  also  induced.  The  slowing  of  the 
pulse  depends  on  irritation  of  the  vagi, 
since  it  can  be  inhibited  by  the  simultane- 
ous  employment   of  atropine. 

Large  doses  induce  speedy  paralysis  of 
the  cardiac  ganglia,  preceded  by  elevation 
of  blood-pressure,  induced  by  the  stimu- 
lation of  the  vaso-motor  centres  as  well 
as  by  a  direct  action  upon  the  organ 
itself. — Wasserzug. 


Pilocarpine  in  Eye  Maladies. — Grati- 
fying results  are  obtained  in  the  treatment 
of  interstitial  keratitis,  traumatic  purulent- 
iritis,  vitreous  opacities,  and  retino-choro- 
iditis.  Some  place  great  reliance  upon  the 
drug  in  toxic  insanity  supervening  upon 
influenza,  auto-intoxication,  and  similar 
processes,  the  brain  rapidly  clearing  after 
two  or  three  free  perspirations.  Apart  from 
its  action  hypodermatically,  pilocarpine  (or 
the  fluid  extract  of  jaborandi)  in  small 
doses  by  the  mouth,  has  been  found  of  value 
in  degeneration  of  the  vitreous.  The  per- 
sistent nausea  so  common  after  the  use  of 
the  drug  is  usually  relieved  by  small  dos- 
es of  chlorodyne. — Hansell  (Philadelphia 
Medical  Journal.) 


Rectal  Prolapse  in  Children. — A  taper- 
ing piece  of  ice,  about  three  inches  long 
and  one  inch  in  diameter  (at  the  largest 
end),  is  wrapped  with  iodoform  gauze,  and 
its  point  pressed  gently  against  the  center 
of  the  prolapsed  mass  until  it  is  replaced ; 
the  ice  tampon  remains  in  the  rectum  with- 
out the  use  of  any  retentive  bandage,  pro- 
vided it  is  pushed  in  far  enough.  A  fresh 
piece  of  ice  is  employed  in  this  way  after 
each  act  of  defaecation.  This  treatment 
soon  cures  the  prolapse,  and  seems  to  act 
by  emptying  the  blood-vessels  and  hight- 
ening  the  contractihty  of  the  rectum. — 
Hajech  (Detitsche  A'crtse-Zcitung.) 


Varicose  Veins. — Inject  Squibb's  ergot 
by  the  side  of  the  vessels,  then  give  by  the 
mouth  one-eighth  to  one-half  of  a  grain  of 
barium  chloride  to  contract  the  arterioles. — 
Bartholow. 


I 


Dropsy. — Apocynuvi  Cannabinum  is  ai 
old  remedy  possessed  of  immense  value, 
and  when  given  for  certain  direct  indica- 
tions proves  unfailing.  (Edema  of  super- 
ficial cellular  tissue,  wherever  found  and 
however  extensive,  is  a  condition  in  which 
it  will  not  fail 

Personal  observation  proves  it  to  be  a 
heart  tonic  of  considerable  value  where  there 
is  flaccidity  of  cardiac  muscle  coupled  with 
an  atonic  and  relaxed  condition  of  the  gen- 
eral system ;  with  a  tendency  to  adiposity 
and  plethora,  especially  when  effusion  ap- 
pears, it  will  produce  excellent  results  in 
small  doses,  say  from  one  to  three  drops. 
In  others,  particularly  if  relief  from  the 
dropsical  effusion  is  imperative,  large  and 
hydragogue  doses  may  be  given. — Elling- 

WOOD. 


Constipation  in  the  Young. — Constipa- 
tion is  invariably  due  to  errors  in  diet,  either 
through  the  mother's  milk  or  from  im- 
proper artificial  food.  Massage  the  abdo- 
men gently  with  inunctions  of  cod-liver  or 
of  castor  oil.  Study  the  diet  and  regulate 
it  according  to  the  modified  teachings  of 
Rotch.  Use  glycerin  injections  or  sup- 
positories, as  necessary.  In  older  children, 
feed  prune  juice,  stewed  dried  peaches, 
dates,  orange  juice,  and  other  laxative 
foods,  and  practice  the  same  massage  and 
inunctions.  Give  less  drugs  and  practice 
more  mechanical  and  dietetic  hygiene,  and 
you  will  have  more  satisfaction. — Medical 
Suininary. 


Hay  Fever. — Where  no  hypertrophy  or 
permanent  obstruction  is  present,  but  simpb' 
a  turgescence  of  the  mucous  membrane,  u 
the  following : 

Arsenous    acid 1  grain 

Strychnine  sulph.  ...  2  to  3  grains 

Belladonna,    ext 4  grains 

Zinc    phosphide 4  grains 

Gentian,    ext 20  grains 

Make  twenty  pills  and  give  one  three  times 
daily. 

In  conjunction  employ  a  menthol  prepara- 
tion locally.  This  is  effective  in  any  form 
of  nasal  neurosis. — Dabney  {Northwestern 
Lancet.) 


New  Use  for  Black  Cohosh. — In  pain- 
ful conditions  existing  in  or  around  the  eye 
or  ear,  the  external  application  of  the  cimi- 
cifuga  tincture  will  often  give  immediate 
relief. — Homoeopathic  Recorder. 


DETROIT  MEDICAL  JOURNAL. 


187 


Gymnemic  Acid. — This  is  the  active 
principle  of  Cymncma  sylvestris,  and  is  a 
greenish-white  powder  with  pungent,  sour 
taste,  only  slightly  soluble  in  water.  If  a 
small  quantity  of  the  tincture,  made  by  dis- 
solving the  drug  in  alcohol,  be  placed  upon 
the  tongue,  the  taste  of  sweet  things  and 
of  bitter  things  is  entirely  destroyed;  no 
other  effect  is  produced,  for  taste  is  as  sen- 
sitive as  ever  to  'other  substances.  If  the 
mouth  is  rinsed  with  a  twelve  per  cent,  solu- 
lion  of  the  acid  before  taking  any  bitter 
nbstance,  the  latter  will  not  be  tasted. — 
i  hicago  Medical  Times. 


Solidago  Virgaurea. — This  is  a  foreign 
species  of  golden  rod,  one  used  as  a  domes- 
tic remedy,  for  backache  and  diseases  of  the 
kidneys  generally,  in  Germany,  for  centuries. 
Homoeopathic  physicians  prescribe  for  renal 
pain,  or  pain  in  circumscribed  spots  in  the 
region  of  the  kidneys ;  for  pains  in  back, 
extending  forward  to  the  abdomen;  in 
dysuria,  difficult  and  scanty  urination,  dark 
urine  with  sediment  (either  of  the  phos- 
phates or  blood  or  pus)  ;  useful  also  in  pro- 
nounced nephritis. — Rademacher. 


Ergot  and  Uterine  Inertia. — An  excel- 
lent way  to  give  the  medicament  is,  to  di- 
lute a  teaspoonful  of  the  fluid  extract  iti 
fifteen  teaspoonfulls  of  water,  in  a  glass, 
and  give  a  drachm  every  ten  minutes  until 
improvement  occurs.  The  treatment  should 
be  ])egun  early  to  secure  the  best  results ; 
and  even  then  the  remedy  is  inferior  to  can- 
nabis Indica,  providing  a  reliable  prepara- 
tion of  the  latter  can  be  obtained. — Medi- 
cal Rczieiu  (Birmingham). 


Bilious  Colic. — Dioscorea  villosa  is  un- 
doubtedly as  much  a  specific  in  bilious  colic 
as  is  quinine  in  intermittent  fevers.  The 
dose  of  fluid  extract  is  from  five  to  thirty 
minims — which  may  be  doubled  in  emer- 
gency ;  of  the  solid  extract,  one  to  four 
i^Tains  every  one  to  four  hours,  according 
to  urgency.  The  remedy  is  useful  in  flatu- 
lence of  the  bowels. — Bacon. 


Uterine  Fluxes. — Hydrastine  is  the 
most  valuable  of  all  remedies.  Use  hypo- 
dermatic injections  of  five  to  ten  drops  of 
the  hydrochlorate  in  ten  per  cent,  solution. 
There  is  no  pain  or  discomfort  from  the 
operation . — Falk. 


Tonic,  a  Valuable. — Phosphate  of  soda 
combined  with  ergot  affords  favorable  re- 
sults in  melancholia,  hysteria,  adynamia, 
and  chlorosis ;  it  overcomes  the  great  con- 
stitutional depression  of  the  algid  stage  of 
certain  fevers.  Sodium  phosphate  alone 
has  been  employed  in  the  cerebral  torpor  of 
senility,  but  the  combination  with  ergot 
increases  its  efficacy.  The  general  indica- 
tion for  the  administration  of  the  mixture 
is  functional  debility  of  nervous  origin. — 
Luton   {Journal  de  Medicine  de  Paris.) 


Haemorrhoids. — More  than  once  I  have 
found  great  relief  or  temporary  cure  to 
speedily  follow  upon  the  free  use  of  dis- 
tilled extract  of  hamamelis  as  a  rectal  in- 
jection. The  quantity  used  is  from  two 
to  four  drachms,  frequently,  during  the  day 
and  evening.  No  unpleasant  results  accrue. 
It  may  be  that  those  who  have  been  disap- 
pointed trusted  to  internal  administration 
or  too  scanty  local  application  of  the  drug. 
— De  Waterville. 


Warts  and  Moles. — Twice  daily  touch 
each  with  enough  glacial  acetic  acid  to 
saturate  without  allowing  to  touch  the 
healthy  skin.  If  this  results  in  soreness, 
too  much  acid  has  been  employed ;  sus- 
pend for  forty-eight  hours,  and  again 
resume.  The 'warts  and  moles  turn  brown, 
rapidly  disappear  and  leave  no  scar.  There 
is  no  danger.  Do  not  tell  the  patient  what 
is  being  used,  though  it  may  safely  be  placed 
in  his  or  her  hands,  with  cautions. — Tay- 
lor. 


Cranberries. — The  pure,  fresh  juice  of 
raw  cranberries,  given  freely,  either  undi 
luted  or  with  an  equal  part  of  water,  is  an 
excellent  means  of  relieving  the  thirst  in 
fever  and  moreover  is  markedly  antipyretic. 
In  the  thirst  and  vomiting  pecidiar  to 
cholera  it  is  even  more  eft'ective.  In  fifty 
cases  in  which  ice  and  narcotics  failed  to 
make  the  slightest  impression,  cranberry- 
juice,  in  small  but  repeated  doses,  rapidly 
checked  both  vomiting  and  nausea. — GoRi- 

ANSKV. 


Nasal  Catarrh. — Most  ozaenas  and  ca- 
tarrhal discharges  are  readily  relieved  by 
the  exhibition  of  berberis.  If  the  High- 
morean  antrum  is  implicated,  relief  is 
prompt  if  the  remedy  is  administered  in 
full  doses. — Heitzman. 


188 


DETROIT  MEDICAL  JOURNAL. 


Nitrous  Oxyde  and  Ether. — The  ad- 
vantages of  the  combined  method  of  using 
nitrous  oxyde  with  the  Bennett  inhaler,  fol- 
lowed by  ether,  have  been  shown  it  in  all 
cases  operated  on  during-  the  last  eight 
months  in  Doctor  Kelly's  private  hospital. 
It  seems  to  possess  so  many  advantages  to 
the  patient,  operator  and  anaesthetizer,  and 
so  few  disadvantages,  that  it  has  become  a 
distinct  part  of  the  operative  technique. — 
Philadelphia  Medical  Journal. 


Iodoform  in  Lupus. — Excellent  results 
can  be  obtained  by  the  hypodermatic  injec- 
tion, at  a  distance  from  the  seat  of  disease, 
of  iodoform  dissolved  in  a  neutral  petrol- 
eum. Improvement  generally  appears  after 
twenty-four  or  forty-eight  hours,  and  is 
well  marked  at  the  expiration  of  five  or  six 
days. — Lavalier  (Journal  des  Maladies 
Cutanccs  ct  Syphilitiques.) 


Heart    Maladies    and    Alkaloids. — The 

best  authorities  are  united  in  discouraging 
the  use  of  the  active  principles  of  digitalis, 
strophanthus  and  convallaria.  in  the  treat- 
ment of  cardiac  disease.  The  best  effects  are 
obtained  by  employing  the  tinctures,  prefer- 
ably the  "mother  tinctures"  so-called,  of  the 
Homoeopath. — Medical  Gazette   (Bombay). 


Influenza. — Infusion  of  boneset  is  one 
of  the  best  remedies  for  the  treatment  of 
la  grippe,  inasmuch  as  it  reduces  temper- 
perature.  acts  as  a  sedative  and  alterative, 
and  appears  to  be  grateful  to  the  patients. 
— Brodnax. 

[The  foregoing  has  our  hearty  endorse- 
ment.— Ed.] 


Stomach  Anodynes. — Atropine  checks 
the  gastric  juice  almost  completely,  but 
morphine  increases  it.  When  secretion 
is  excessive,  as  in  ulcer,  morphine  is  con- 
traindicated,  and  one  of  the  belladonna 
preparations  will  act  better. — Biegel  ( Thcr- 
apic  dcr  Gegenzvart.) 


Cystitis,  Chronic. — Rhus  aromatica, 
ammonium  muriate,  potassium  citrate,  com- 
bined, do  well,  but  the  dose  of  the  ammon- 
ium salt  must  be  large  to  be  of  real  or  lasting 
benefit. 

r  aUvays  advise  the  urine  be  rendered 
alkaline  by  some  potassium  salt  combined 
with  a  vegetable  acid. — ^Joseph  Ai)OLPHUS. 


m 

eve^H 
nosl^l 


Scarlatina, — Few  cases  of  scarlet  f 
are  not  benefited  by  the  constant,  almos 
continuous,  exhibition  of  small  doses  of 
tincture  of  aconite  and  belladonna — say 
one-fourth  or  one-half  minim  of  the  form- 
er, and  one-sixth  minim  of  the  latter.^ 
Potassium  bichromate  is  very  satisfactory! 
for  the  angina,  and  daily  inunction  by 
means  of  cacao  Initter  should  not  be  neglect- 
ed— this  latter  aflfords  nourishment,  favors 
desquamation,  and  reduces  the  fever. — 
Stock  WELL. 


Hydrastis. — This  is  a  very  good  rem- 
edy in  constipation.  Hughes,  in  his  "Phar- 
macodynamics," recommends  a  drop  of  the 
mother  tincture  in  water  before  breakfast. 
A  globule  of  the  first  attenuation,  once  or 
twice  daily,  has  been  given  by  me  on  many 
occasions  and  I  can  recall  no  failure. — 
CiiorDiUMn'. 


"Bone"  Felons. — To  abort  before  sup- 
puration has  set  in,  cover  the  swelling  to 
the  thickness  of  an  eighth  of  an  inch,  with 
citrine  ointment.  This  must  be  kept  in 
place  by  a  non-absorbent  bandage,  and  put 
on  fresh  every  eight  hours,  until  all  signs  of 
inflammation  have  disappeared.  —  Lum- 
MiNS  (Medical  Suntnwry.) 


Gonorrhoea!  Buboes. — Apply,  thrice 
daily,  with  friction,  one  part  each  of  oil  of 
sassafras  and  oil  of  peppermint,  dissolved 
in  sixteen  parts  strong  tincture  of  capsi- 
cum.— Washburn. 


Albuminuria. — Try  one  drop  of  a  one 
per  cent,  solution  of  nitro-glycerin.  three 
times  daily.  This  often  will  relieve  the  pa- 
tient in  a  few  days. — Northivcstern  I^ancet. 


Mosquito  Bites. — Naphthalan  is  an  ef- 
fective remedy  for  mosquito  l)ites.  Its  ac- 
tion on  the  ])oison  is  effective  and  specific. 

— VOGKS. 


Uterine  Inertia. — Strong  hot  coffee, 
drunk  without  seasoning,  will  usually  prove 
effective. — Joseph  Adolphus. 


Diphtheria. — Local  treatment  is  cruel 
and  brutal  whenever  and  wherever  applied. 
— Jacobl 


DETROIT  MEDICAL  JOURNAL. 


189 


Medical  Progress. 


Disease  Odors. — 

Of  the  specific  odors  of  disease  two  very 
marked  cases  come  to  mind :  One,  a  young, 
Inixom,  red-cheeked  woman,  whose  men- 
strual discharge  was  accompanied  by  such 
a  pervasive  odor  that  few  could  stay  in  the 
same  room  with  her ;  the  other,  a  man  who 
sutTered  from  profuse  foetid  perspiration 
confined  to  the  axillary  regions — the  fluid 
could  be  seen  constantly  exuding,  of  a  con- 
sistence a  little  heavier  than  normal  perspir- 
ation, the  disagreeable  odor  it  yielded  being 
very  penetrating,  so  much  so  as  to  pervade 
the' whole  room  and  adhere  to  the  furniture 
for  hours  after  his  departure. 

The  ammoniacal  smell  common  to  the 
aged,  and  due  to  retained  or  dribbling  urine 
is  well  known.  Berard  says  that,  apart 
from  the  excretions,  an  abnormal  odor  of 
the  skin  tends  to  draw  flies,  and  that  how- 
ever little  noticeable  it  may  be  it  denotes 
death  is  near;  and  Boerhaave  held  that  a 
cadaveric  odor  always  presages  death. — 
Althaus  tells  us  that  Skoda  was  hardly 
ever  led  into  error  by  this  indication,* 
and  Compton  also  laid  great  stress  upon 
this  as  a  clinical  symptom ;  but  the  smell 
given  off  during  the  "death-agony"  is 
totally  different  from  the  death  odor  (that 
of  putridity)  and  is  universally  admitted 
to  be  specific. 

The.  odors  obtaining  to  sex  are  vastly 
dififerent,  thus  in  man  it  suggests  mush- 
rooms, in  woman  codfish.  * 

In  gout  the  skin  secretions  take  a  special 
odor  which  Sydenham  compared  to  whey ;  it 
is  sour,  or  at  least  sourish,  as  there  is  an 
excess  of  ammonia.  In  rheumatism  it  is 
acetoformic,  particularly  in  the  regions  of 
engorged  articulations  (Monin)  ;  it  is  a 
sour-smelling,  acid  perspiration. 

In    diabetes    the    smell    is-  sweetish    and 


*[An  odor  of  semen  persisting  about  the  body 
and  apartment  of  an  old  man,  even  if  he  does 
not  appear  seriously  ill,  appears  to  be  indicative 
of  speedy  dissolution.  This  is  invariable, 
though  why,  except  it  is  in  a  sense  cadaveric, 
we  are  unable  to  explain.  It  most  frequently 
obtains  in  connection  with  suppression  of  urine, 
and  in  the  majority  of  cases  points  to  pros- 
tatic disease  of  long  standing. — Ed.  I 

t  [The  odor  of  a  perfectly  heaitoy,  cleanly 
woman  should  be  that  of  thyme;  the  codfish 
odor  is  evidence  of  lack  of  personal  cleanli- 
ness as  regards  the  sexual  organs,  or  of  a 
diseased  condition. — Ed.] 


mawkish,  as  of  hay,  according  to  Latham, 
"acetone"  says  Picot,  and  "midway  between 
aldehyde  and  acetone,  being  due  to  a  mix- 
tiu-e  in  variable  proportions  of  the  two 
bodies,"  according  to  Bouchardat. 

A  musky  odor  obtains  to  several  maladies, 
notably  peritonitis,  jaundice  and  icterus; 
and  a  stale,  sour-beer  odor  to  scrofulosis. 

The  pysemic  person  has  a  sweet,  nauseat- 
ing breath,  with  perhaps  a  flavor  of  new- 
mown  hay. 

In  milk  fever  the  smell  is  distinctly  acid ; 
in  typhoid,  musty,  often  with  the  odor  of 
blood;  in  typhus,  ammoniacal  and  mouse- 
like, which  latter  also  obtains  to  favus ;  in 
intermittent  the  odor  is  that  of  fresh-baked 
Ijrown  bread;  yellow  fever  has  a  cadaveric 
smell,  or  like  the  washings  of  a  dirty  gun- 
Ijarrel. 

In  measles  it  closely  resembles  fresh-pick- 
ed feathers ;  in  diphtheria,  is  sickening  and 
gangrenous — an  odor  that  is  absolutely 
pathognomonic;  in  smallpox,  according  to 
severity  and  stage,  it  ranges  from  that  of 
the  fallow  deer  to  the  dreadful  one  of  the 
whole  menagerie,  or  it  may  be  that  of  burn- 
ing horn  or  bones. 

Hysteria  usually  develops  an  odor  of  vio- 
lets or  pine-apples  ;  sudamina,  that  of  putrid 
straw ;  scabies,  mouldy ;  anaemia  and  chol- 
era, ammoniacal  (Drasch,  Parker)  and  the 
discharges  have  either  a  semen  or  mush- 
room flavor. 

Otorrhoea  has  a  peculiar,  clinging,  long- 
lasting  odor  that  once  observed  will  never 
be  forgotten ;  so,  too,  is  the  odor  of  a  hen- 
roost that  obtains  to  ozsenas  and  bad  chronic 
catarrhs.  Gangrene  has  an  old,  dead-meat 
smell,  as  have  some  cancers  at  certain  stages, 
— if  there  is  much  pus  from  an  actively 
breaking-down,  malignant  growth,  and  es- 
pecially in  sarcomas,  it  is  more  like  decaying 
fish. 

At  the  onset  of  the  plague  the  odor  is 
sweet  (Diemerboeck)  or  honey-like  accord- 
ing to  Doppner. 

The  atmosphere  surrounding  the  chronic 
onanist  will  have  a  rotten  mushroom-like 
odor,  and  an  ill-kept  libertine  will  combine 
this  with  a  cod-fish  smell. — Clarke  {Horn- 
oeopathic  Medical  Recorder.) 

Value  of  Meat  Extracts. — 

Doctor  A.  McGill,  in  a  report  to  the  In- 
land Revenue  Department,  Ottawa,  Can- 
ada, observes  that  much  has  to  be  done 
by  experimental  physiologists  before  final 


190 


DETROIT  MEDICAL  JOURNAL. 


pronouncements  can  be  made  upon  the 
food  value  (if  any)  of  the  flesh  bases, 
which,  in  most  instances,  form  the  chief 
portion  of  the  nitrogenous  material  in 
meat  extracts.  The  bases  certainly  dif- 
fer among  themselves  in  food  value,  and, 
.  of  course,  if  this  is  true  of  the  flesh  bases, 
it  is,  a  fortiori,  true  of  the  various  forms  in 
which  proteid  matter  occurs  in  these 
preparations,  viz.,  as  peptones,  proteoses, 
acid  albumens  and  so  forth.  Doctor  Mc- 
Gill's  experiments  suggest  that  a  part  of 
the  nitrogen  in  some  meat  preparations 
exists  as  urea.  Urea  certainly  can  have 
no  food  value,  nor  can  one  really  under- 
stand how  the  allegation  that  it  is  of  use 
as  a  stimulant  can  be  justified.  Nature 
seems  to  have  provided  for  its  prompt 
elimination  from  the  system,  and  it  is 
certain  that  any  failure  to  get  rid  of  it  by 
way  of  the  kidneys  results  in  serious  dis- 
turbance of  the  vital  functions,  and  may 
end  in  death  by  uraemia.  No  practical 
method  has  been  discovered  by  which  a 
sharp  analytical  line  can  be  drawn  be- 
tween the  nitrogen  present  as  urea  and 
that  present  as  creatin,  creatinin  and 
xanthin.  It  is  evident  that  the  flesh  bas- 
es cannot  be  called  food  stufT  in  the  prop- 
er sense  of  that  term.  They  represent  a 
stage  of  the  process  by  which  complex 
nitrogen  compounds  are  changed  to  sim- 
ple ones,  supplying  the  energy  so  set  free 
to  the  animal  organism  in  the  form  of 
vital  force.  They  may  still  have  some  food 
value,  since  they  are  not  excreted  as  such, 
but  undergo  further  simplification,  till 
they  appear  as  urea.  It  is  certain  that 
their  food  value  is  very  much  less  than 
that  of  proteids  proper.  When  once  the 
urea  stage  is  reached,  the  urea  must  be 
promptly  got  rid  of.  The  blood  is  the 
vehicle  by  which  nutritive  matter  that 
has  been  digested  and  made  soluble  is 
conveyed  to  all  parts  of  the  body;  and  it 
is  also  the  vehicle  by  which  waste  mat- 
ter is  conveyed  to  the  lungs  and  other 
excretory  organs  to  be  eliminated.  Flesh 
bases  are  always  present  in  the  blood, 
though  in  small  amounts.  They  are 
much  more  largely  present  in  muscle  tis- 
sue, and  when  fresh  lean  beef  is  treated 
with  hot  water,  these  flesh  bases  are  the 
chief  material  taken  into  solution.  Apart 
from  any  possible  nutritive  value  which 
they  have,  these  flesh  bases  undoubtedly 
possess  a  stimulant  action  on  the  system 
analogous  to  that  exhibited  by  the  alka- 


loids of  tea,  cofifee  and  cocoa,  and  it  i 
beyond  question  that  to  this  stimulating 
effect,  rather  than  to  any  true  nutritive 
power,  they  owe  such  value  as  they  pos 
sess. — British  Food  Journal. 


1 


Bacteria  a  Vital  Necessity. — 

The  presence  of  certain  bacteria  in  the 
air  is  as  necessary  as  oxygen  for  the  con- 
tinuance of  vital  processes  in  animals.  When 
animals  are  confined  for  some  days  in  a 
chamber  of  sterilized  air,  some  die,  and 
those  taken  out  alive  expire  shortly  after- 
wards or,  if  they  survive,  show  symptoms  of 
extreme  lassitude  and  weakness.  These  re- 
sults are  due  neither  to  starvation,  nor  to 
toxic  exhalations,  nor  to  the  presence  of  CO^ 
in  the  sterilized  air.  The  urine  excreted  by 
the  subjects  is  found  to  be  abnormally  rich 
in  leucomaines,  while  the  quantity  of  urea 
present  is  very  low,  showing  that  the  pro- 
cesses of  oxydation,  which  normally  go  on 
in  the  tissues,  were  materially  retarded.  The 
oxydizing  ferments  which  have  been  shown 
to  be  normally  present  in  the  tissues  are 
supplied  by  bacteria,  which  gain  access  to 
the  blood  and.  probably,  to  the  leucocytes 
in  the  lungs.  The  actual  cause  of  the  debil- 
ity and  death  in  the  animals  experimented 
on  may  be  considered  to  be  the  enormous 
accumulation  of  insufficiently  oxydized  pro- 
ducts which  exercise  a  toxic  influence.  Bac- 
teria are,  therefore,  considered  to  be  essen- 
tial to  the  maintenance  of  animal  life. — 
KijNiziN  {Pharmaceutical  Journal  and 
Transactions.) 


I 


The  Earliest  Human  Ovum. — 

Leopold  recently  exhibited  microscopic 
sections  of  the  youngest  human  ovum  ever 
detected.  The  uterus  of  a  woman,  aged 
thirty,  was  removed  for  cancer  of  the 
cervix,  the  interior  carefully  examined,  and 
an  undoubted  ovum  the  size  of  a  lentil 
found  making  a  prominence  on  the  surface 
of  the  uterine  mucous  membrane,  which  was 
hypertrophied  in  its  neighborhood.  The 
periphery  of  the  ovum  was  bounded  by  a 
deep  groove  devoid  of  mucous  membrane. 
After  careful  inquiries  it  was  concluded  that 
the  ovum  had  reached  the  eighth  day  after 
conception.  Great  pains  was  taken  to 
secure  successful  sections.  The  arrange- 
ment of  the  villi,  and  the  opening  of  the 
arterioles  of  the  endometrium  into  the  in- 
tervillous spaces,  came  out  very  clearly. 

Kanthack    has    recently    added    to     the 


DETROIT  MEDICAL  JOURNAL. 


191 


museum  of  St.  Bartholomew's  an  instructive 
specimen  of  a  very  early  human  ovum  in  its 
membranes. 

Histological  study  of  the  human  embryo 
and  its  envelopes  during  the  first  few  weeks 
of  development  is  much  needed.  We  must 
not  rely  too  far  on  homologous  structures 
in  the  lower  mammals,  where  the  anatomy 
and  physiology  of  the  genital  tract  differ  in 
important  details. — British  Medical  Journal. 

Voluminous   Retro-Pharyngeal 
Abscess. — 

A  boy  of  eleven  months  began  to  suft'er 
•  from  cervical  adenitis  with  suppurating 
glands,  and  incision  liberated  a  large  quan- 
tity of  pus.  Later  it  wag  noticed  the 
child  had  trouble  in  swallowing,  which 
steadily  increased  until  brought  for  examin- 
ation. A  visible  bulging  of  the  posterior 
pharyngeal  wall  was  discovered,  almost 
touching  the  base  of  the  tongue  and  filling 
the  bucco-pharyngeal  cavity,  causing  diffi- 
culty in  swallowing  and  respiration.  This 
was  a  voluminous  retro-pharyngeal  abscess 
consecutive  upon  suppurating  cervical 
glands,  which  was  immediately  incised,  the 
child  being  held  on  the  knees  of  an  as- 
sistant, and  immediately  bent  forward. 
Notwithstanding  these  precautions,  the 
pus  was  so  considerable  that  it  caused 
asphyxia.  The  pharynx  and  larynx  were 
well  mopped  out,  and  the  child  being  laid 
flat  on  a  table,  rhythmical  tractions  of 
the  tongue  and  artificial  respiration  were 
practiced,  along  with  flagellation  of  the 
cardiac  region.  In  fifteen  minutes  respira- 
tory movements  began.  Complete  recovery 
in  six  days. — Traver  (Revue  Hehdome- 
daire  de  Laryngologie.) 

The  Twentieth  Century  Baby. — 

The  baby  of  to-day,  as  a  matter  of  sober 
fact,  is  threatened  with  manifold  drawbacks 
to  development  short  of  actual  extinction, 
by  the  wholesale  substitution  of  the  artifi- 
cial for  the  natural.  Instead  of  the  most 
perfect  food  in  Nature,  mother's  milk,  we 
find  a  host  of  artificial  substitutes,  each  one 
of  them,  calculated  to  rear  an  infant  with 
the  brains  of  a  Newton  combined  with  the 
frame  of  a  Sampson.  How  often,  alas !  the 
outcome  of  all  these  costly  cares  is  a  being 
of  stinted  body  and  limited  intellect,  unfitted 
to  play  a  soldier's  part  in  the  battle  of  life. 
This  question  of  food  strikes  deep  into  the 
physical  welfare  of  a  race,  and  there  can 


hardly  be  a  more  serious  National  problem 
than  how  to  rear  this  Twentieth  Century 
baby  of*  ours  in  strength  and  happiness. 
There  is  a  vast  deal  of  nonsense  written  and 
taught  about  the  proper  way -to  clothe,  nur- 
ture, and  tend  babies  generally.  The  best 
basis  is  that  of  plain  milk  diet,  either  from 
the  breast  or  from  modified  cow's  milk :  For 
the  rest,  those  ills  that  are  preventable 
should  be  prevented.  Most  of  the  mischief 
done  in  the  nursery  is  the  result  of  attempt- 
ing to  do  too  much!  It  would  be  an  impor- 
tant step  toward  the  stabiUty  and  future 
of  our  race  were  the  laws  of  health  to 
be  taught  in  our  schools,  with  a  special 
class  on  nursery  management  for  the  girls' 
classes. — Medical  Press  and  Circular. 


Urine,  Oxalates  In. — 

Calcic  or  calcium  oxalate  is  rather  a  com- 
mon sediment,  often  mistaken  microscopi- 
cally for  a  cloud  of  mucus;  it  is  found  in 
both  acid  and  alkaline  urine,  especially  after 
the  patient  has  eaten  freely  of  rhubarb,  to- 
matoes and  other  vegetables  rich  in  oxalic 
acid.  The  crystals  are  usually  octahedral 
in  shape,  giving  the  appearance  of  a  square 
crossed  by  two  diagonal  bright  lines,  like 
the  back  of  a  square  envelope;  they  are 
much  smaller  than  those  of  the  triple  phos- 
phate, from  which  they  are  further  distin- 
guished by  their  insolubility  in  acetic  acid. 
A  much  more  rare  form  of  calcium-oxalate 
crystal  is  that  resembling  a  dumb-bell. 

Hippuric  acid  is  occasionally  met  with  as 
a  urinary  sediment,  in  the  form,  microscopic- 
ally, of  fine  needles  or  of  four-sided  rhombic 
prisms  with  beveled  ends  and  edges.  A  de- 
posit of  hippuric  acid  is  met  with  most  fre- 
quently after  the  ingestion  of  benzoic  acid  or 
of  certain  aromatic  vegetables — cranberries, 
for  instance. — Hill. 


Differential  Diagnosis. — 

Acute  general  miliary  tuberculosis  and 
basilar  cerebro-meningitis  at  times  simulate 
typhoid.  In  the  former,  attention  and 
minute  examination  of  the  patient,  and  the 
course  of  the  morbid  phenomena,  quickly 
dissipate  any  doubts ;  in  the  second,  the  pre- 
vious history  of  the  disease,  the  mode  in 
which  it  commenced,  the  course  of  the  tem- 
perature, the  absence  of  abdominal  symp- 
toms, and  the  early  appearance  of  delirium 
or  coma,  do  not  long  allow  hesita,tion  in  the 
diagnosis. — Homem. 


19:; 


DETROIT  MEDICAL  JOURNAL. 


Fresh  Air  for  Infants. — 

The  most  saHent  point  made  by.  Doctor 
Holt  in  his  able  address  before  the  Cleve- 
land Medical  Society,  recently,  was  the  im- 
portance of  fresh  air  for  infants.  It  is  a 
striking  fact  that  this  one  thing  makes  not 
only  a  perceptible  but  an  enormous  differ- 
ence in  the  mortality  statistics  of  hospitals. 
Of  the  essentials,  good  food,  and  fresh  air, 
the  latter  is  by  no  means  the  least  important, 
and  the  lack  of  this  often  determines  the 
death-rate  of  seventy-five  to  ninety-five  per 
cent,  in  foundling  asylums.  It  is  not  reas- 
suring to  note  the  fact  that  the  wealthiest 
as  well  as  the  most  intelligent  people  are 
taking  the  greatest  pains  to  exclude  fresh 
air  from  their  houses.  The  modern  house 
is  furnished  with  weather-strips  to  prevent 
draughts,  and  with  either  steam  or  hot-water 
heaters  which  provide  no  ventilation  at  all, 
or  a  furnace  with  an  air-shaft  that  draws  its 
supply  from  the  hall,  thus  preventing  an  in- 
flux of  pure  air  from  without, — all  of  which 
is  well  calculated  to  conduce  to  infant  mor- 
tality.— Cleveland  Medical  Journal. 


Alopecia. — 

The  most  unpleasant  and  unsightly  cases 
are  the  atrophic  forms,  in  which  coarse 
thick  hairs  are  found  on  a  dry  scalp  without 
baldness — cases  that  are  practically  hope- 
less. Nor  is  there  much  hope  where  young 
men  become  prematurely  bald  at  the  same 
age  as  when  this  condition  overtook  their 
fathers, — which  would  seem  to  indicate 
that  the  malady  is  of  an  inherited  rather 
than  an  infectious  nature,  though  it  rarely 
attacks  girls.  Perhaps  the  reason  why  the 
female  sex  suffer  less  from  alopecia  is  the 
fact  they  give  more  attention  to  their  hair, 
and  wear  more  suitable  and  better  venti- 
lated headgear. — La  Semaine  Medicate. 


Typho-Malarial  Fever. — 

In  spite  of  "eminent"  authority  to  the 
contrary,  this  term  is  the  proper  designa- 
tion for  those  asthenic  forms  of  remittent 
fever  with  typhoid  symptoms  in  which  the 
typhoid  bacillus  is  not  present  in  the  blood. 
It  is  a  typhoid  fever  complicated  by  pre-ex- 
isting malarial  infection  or  a  malarial  fever 
complicated  by  a  typhoid. — Lillie. 


Gelatine  Suppositories,  Base  for. — 

Gelatine  forty  parts ;  glycerin,  twenty-^ 
five  parts  ;  water  to  make  lOO  parts, or, if  a 
softer  mass  is  required,  120  to  130  parts. 
The  product  is  said  to  be  well  adapted  for 
use  with  alum  and  other  salts.  The  addi- 
tion of  twenty-five  parts  of  powdered  acacia 
or  dextrin  in  place  of  an  equivalent  amount 
of  water  renders  the  mass  more  suitable  for 
use  in  summer  or  in  a  warm  or  moist  atmos- 
phere. In  either  case  the  gelatine  should 
be  soaked  in  200  parts  of  water  until  soft, 
the  glycerin  (and  gum  if  required)  added, 
and  the  whole  heated  on  a  water  bath  un- 
til complete  solution  is  effected  and  the 
excess  of  water  evaporated.  Stir  gently 
while  heating,'  and  keep  the  temperature 
well  below  boiling-point.  If  air-holes  ap- 
pear in  the  mass  on  cooling,  it  must  be  re- 
heated with  100  parts  of  water  and  the 
whole  again  evaporated  to  the  required 
bulk.  The  moulds  should  be  oiled  before 
filling,  and  if  made  of  metal,  should  pre- 
viously be  heated  to  about  122°  Fahr. — 
The  Chemist  and  Druggist. 


Foreign  Body  in  Maxillary  Sinus. — 

Mignon,  of  Nice,  reports  an  interesting 
case  in  which  a  young  man,  with  suicidal  in- 
tent, discharged  a  revolver  against  his  tem- 
ple. A  few  days  after  the  incident,  as  no 
symptoms  of  reaction  occurred,  an  examin- 
ation by  the  radioscope  was  attempted,  and 
it  was  found  that  the  bullet  was  lying  loose 
within  the  left  maxillary  sinus. — Archives 
dc  Laryngologie. 


Invertin  in  Grapes. — 

There  is  present  in  the  juice  of  all  kinds 
of  grape  a  sucrase,  in  quantities  sufficient  to 
invert  the  entire  amount  of  saccharose  pres- 
ent, without  the  assistance  of  any  organic 
acid.  The  "invertin"  is  not  present  in  wines 
attacked  by  bacterial  diseases,  and  disap- 
pears entirely  in  wines  which  have  been 
strongly  oxydized. — Martinaud  {Pharma- 
ceutical Journal  and  Transactions.) 


Pneumonia. — The  appearance  of  labial 
herpes  is  a  favorable  sign  in  congestion  of 
the  lungs. — Denver  Medical  Times. 


Chorea. — 

This  is  a  form  of  rheumatism — cerebral 
rheumatism,  in  fact — as  is  well  borne  out 
by  evidence. — Dyce  Duckworth. 

Osteomyelitis. — The  chief  diagnostic 
point  is  the  acutely  sensitive  spot  near  the 
junction  of  the  epiphyses. — Funkhauser. 


DETROIT  MEDICAL  JOURNAL. 


XVII 


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DETROIT  MEDICAL  JOURNAL. 


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XXII 


DETROIT  MEDICAL  JOURNAL. 


You    May- 
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respondence on  the  subject  of  artificial  foods  solicited, 
which  will  receive  prompt  and  courteous  attention. 

Made  by 

Henrx  K.  IVampole  (Si  Co., 

Specialists  in  Progressive  Pharmacy, 

Ori^nators  and  Sole  Manufacturers  of  Wampole's  Perfected 
and  Tasteless  Preparation  of  Cod  Liver  Oil. 

Main  Office  and  Lalwratories.  PHILADELPHIA,  U.S.A. 


NESTLES  FOOD 


A    PARALLEL 


What  Dr.  Jacob!  says  a  TRIE  Infants'  Food 
should  be: 

1.  "Without  CCW'S  MII^K,  no  substi- 
tute Infant  Food  can  be  thought  of." 

2.  "At  present  it  begins  to  be  considered  fair 
to  accept  that  milk  becomes  more  digestible 
by  the  addition  of  FLOUR  decoctions." 

3.  "The  identity  of  Milk  Sugar  in  woman's 
and  cow's  milk  is  very  doubtful,  and  the 
Milk  Sugar  of  the  market  is  quite  often 
impure.  That  alone  makes  it  desirable  or 
advisable  to  substitute  C  A.  N  £ 
SUGAR.' 

^.  "Babies  should  frequently  be  offered 
WAXCR  in  some  shape  or  other,  and 
it  is  easiest  to  add  it  to  their  food." 


What  NESTLE'S  FOOD  is: 


1.  Pure  CO"W'S  MILK  is  the  basis  of 

NESTLES  FOOD. 

2.  Baked   FLOUR,  from  selected  wheat, 

with  the  starch  converted  into  dextrim. 

3.  Refined  CANE  SUGAR,  sufficient 

to  render  it  palatable. 


4.  Prepared  by  the  addition  of  "WATER 
only. 

HENRI  NESTLE, 

73  WARREN  STREET,        -        NEW  YORK  CITY. 


DETROIT  MEDICAL  JOURNAL. 


XXIII 


Goodrich  Sop  Rubber  Catheters 


)f)f)f)f)f)f3f>f)f>f>f)fj 

• 
• 
• 

• 

• 

• 


A  distinctive  line  of  New  Am- 
erican Soft  Rubber  Urethral 
Instruments,  made  of  the  best 
compound  red  rubber,  with  "that 
desirably  soft  velvety  surface," 
and  in  accordance  with  the  ad- 
vanced ideas  of  the  surgical  pro- 
profession. 

Please  ask  for  these  goods. 


MADE     BY 


The  B.  f.  Goodrich  Coml^dDy, 


AKRON  RtBBER  W0RM8.        ^____  AKRON,  OHIO.     I 

NEW  YORK,  CHICAGO,  BOSTON,  4 

66-68  Reade  St.  141    Lake  Street.  67  Chauncey  St.      • 

SAN  FRANCISCO,  308  Mission  Street.  • 

I 

___  * 


!2i:^='Send  for  our  booklet  on  Soft  Rubber  Catheters. 


.^^>f  >f)f  )f  )f  3f  )4-jf)f  Jf  Jf)f  . 


■ 

THE  LARNED-DAVIS 

HYGIENIC  JACKET 

LIGHT,  DURABLE,  VENTILATED 

RAW-  HIDE 

PERFECT   SUBSTITUTE 
FOR   PLASTER  JACKET 

CAN  BE  PUT  ON  AND  TAKEN 
OF  WITH   PERFECT    EASE 

COMBINES    ALL     THE    Es- 
sential   FEATURES    OF    A    PERFECT 
SUPPORT    WITH     THE      MINIMUM      OF 
WEIGHT     AND     MAXIMUM     OF     VENTI- 
LATION   ::::::::::::: 

Write  for  Descriptive  Circular  and  Price. 

Can    be   Readily  Softened   and 
Fitted    to    tHe    Form    writH    tHe 
Utmost    A.ccuracy-.       yf        yf        if 

LARNED-DAVIS  JACKET  COMPANY 

141  ^VOODIVARD  ifVVENUE.    ^   ^    1^    DETROIT,  MICHIGA.N 


XXIV DETROIT  MEDICAL  JOURNAL. 

I  Perfect  Asepsis  and 
I  Antisepsis 


Something:  New! 


SIMPLE      INEXPENSIVE 
PRACTICAL 


Price  25c  each;    $2.00  per  dozen.     (One-Third  Size.) 


Price  25c  each;    $2.50  per  dozen.    (One-Third  Size.) 


Price  3SC  each;    $3.00  per  dozen.    (One-Third  5ize.) 

The  first  illustration  represents  our  New  Aseptic  Dressing 
Syringe,  provided  with  extra  long  nozzle,  whereby  it  is  possible 
to  reach  deep  into  wounds  and  abcesses  for  the  purpose  of  cleansing 
and  sterilizing  the  most  remote  parts  thereof. 

Next  follows  an  Aseptic,  Cone-Pointed  Gonorrhoea  Syringe,  the 
advantages  of  which  are  self- apparent. 

Lastly  we  call  attention  to  the  new,  Aseptic  Intra-Uterine 
Syringe. 

Being  of  glass,  with  detachable  rubber  bulb,  these  syringes  can 
be  readily  and  thoroughly  cleansed  and  disinfected:  May  be  boiled  if 
desired. 

NOTE — The  capacity  of  each  syringe,  from  point  to  neck,  is  exactly  that 
of  the  air  capacity  of  the  bulb,  thereby  preventing  contact  of  the  syringe-con- 
tents with  the  rubbers. 

The  Only  Instrument  Suitable  for  Employment  of 

Hydrogen  Peroxide;        Bicloride;  Permanganate,  Etc. 


THE  J.  F.  HARTZ  COMPANY,  1 

No.  2  Richmond  Street,  East,  a68  Woodward  Avenue,  * 

TORONTO,  ONTARIO.  DETROIT,  MICHIGAN.       ^ 

i 


DETROIT  MEDICAL  JOURNAL. 


XXV 


♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦»♦»♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦»♦♦»♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦ 

BAZZI-BIANCHI 

PHONENDOSCOPE 


Metal  Cases $3'7S 

Velvet  Lined  Cases 4 .00 

BE'W^ARE    OF    INFRINGE:M£NT.S. 

All  GENUINE  have  our  name  on  instrument.    Buy  from  your  dealer,  or,  if  not  in 
stock,  from  as  direct 


GEO.  P.  PILLING  (SL  SON, 

Sole  Agents  for  \J.  S.  A.,  PKiladelpHia. 


SLOAN'S  TONSIL  ^NARE. 

(Superior  to  the  Xonsilotome. 


One  end  of  the  wire  is  anchored  at  "A"  and  the  other  wire  fastened  at  "B."  whereby  the  tonsil  is  made  to  rotate,  inducing 
torsion  of  the  vessels  and  practically  no  haemorrhage. 

Manufactured  exclusively  by 

Hand  made,  of  tKe  very  best   Steel.  THE  J.   F.   HARTZ   CO., 

Price  $0.00.  net.  268  Woodward  Ave.,  Detroit,  mich. 

^  2  Richmond  St.,  East,  TORONTO,  ONT. 


VAN  HORN  &  CO.'S 
STERILIZED 
CATGIT  AND 
KANGAROO- 
TENDON  -^ 

In  Hermetically  Sealed  Glass  Tubes 

The  price  is  25cts.  per  tube,  or  $2.00 
per  dozen,  of  any  desired  assortment. 

Mailed  to  any  <uldress  upon  receipt  of 
price. 


Our  Sterilized  Catgut  and  Kangaroo-Tendon  are  absolutely  aseptic.  This  is  assured  by  direct  test 
of  the  bacteriological  laboratory,  and  the  strict  adherence  to  bacteriological  principles  whichjprevail  in 
our  sterilizing  laboratory. 

Kangaroo-Tendon  and  Catgut,  plain  and  chromicized,  in  these  glass  tubes  will  always  remain 
aseptic,  and  they  are  always  ready  for  use. 

"Van  Horn    &  Co.'s  tendon  and  catgut  sutures  have  been    used    by    Dr.    Bull    and    myself   for 
nearly  ten  years,  and  frequent  bacteriologrical  tests  have  always  shown  them   sterile." 

DR.  W.  B.  COLEY,  Annals  of  Surgery,  Dec,   1900. 
1729  Chestnut  St.,  Philadelphia. 
"I  find  your  Kangaroo-Tendon  the  best  on  the  market,  and  I  now  always  use  It." 

W.  W.  KEEN,  Prof.  Surgery,  Jefferson  Medical  College. 


THE  J.  F.  HARTZ  COMPANY, 

Sole  Agents  for  Michigan  and  Ontario. 
268  Woodward  Ave.,  DETROIT,  MICH. 

2  Richmond  St.,  TORONTO,  ONT. 


VAN  HORN  &  CO., 

Surgical   Dressings, 

307  Madison  Ave.,  NEW  YORK. 


XXVI 


DETROIT  MEDICAL  JOURNAL. 


UlSn'KOlT  MEDICAL  JOURNAL. 


XXVII 


A  Sanitary  Necessity 
THE  PRI=MO 

LADIES'  SYRINGE. 


The  Only  One 
in  its  class: 


Nothing  Else 
Like  It. 


NOZZLE  AND  SHIELD. 

ONE-HALF   SIZE. 


Nozzle  made  in  one  piece— hard  rubber,  highly  polished.  The  detachable  pneumatic 
cushion,  of  soft  rubber,  is  a  non-conductor  of  heat.  Anatomically  correct  in  design :  Fits 
perfectly  without  undue  pressure,  and  isn't  a  wedge. 

Dispenses  with  the  inconvenient  and  troublesome  bed-pan  and  rubber  sheet. 

Not  necessary  to  disrobe  when  douche  is  taken. 

Only  syringe  that  can  be  employed  in  any  position,  without  accessories,  or  an  attendant. 

E.  J.  HUSSEY  &  CO., 

80  John  Street,  NEW  YORK. 


The  E.  &  G.  Improved  Atomizers. 

The  B.T.  H.  No.  456  Physicians'  Atomizers. 


Jfll  Jill  Jill 

^1 

ft  1 

Bi  1 

]> 

f 

0 

These  Physicians'  Sets  are  made  with  the  greatest  care  in  every  detail,  and  finished  in  the 
best  possible  manner.  The  tips  are  our  well  known  B.  T.  H.  style  and  are  platinum  lined. 

For  Sale  by  all  Surgical  Instrument  Dealers  and  Physicians'  Supply  Houses. 

5®®®®®®®®®®C 


XXVIII  DETROIT  MEDICAL  JOURNAL. 


BAUER 

&  BLACK 

MANUFACTURFRS  OF 

Medical  and  Surgical  Plasters 

•    Absorbent  Cottons 

Surgical  Dressings,  Suspensories 

Chest  Protectors 

g^flPi^Etc,  Etc, 

283  25th  St.,  Chicago. 

DETROIT  MEDICAL  JOURNAL.  XXIX 


^: 


Pink  Cathartic 

Granules 


Are  most  popular  with  the  medical  profession. 

Act  physiologically  by  increasing  Peristalsis,  stimulating  se- 
cretions of  Liver,  and  Pancreas,  as  well  as  the  glands  generally 
throughout  the  Intestinal  tract ! 

Each  Granule  contains : — 

Aloin,  C.  P.,    -        -        -  1-6  grain. 

Podophyllin   resin,    -        -  Va  grain. 

Extract  Nux  Vomica,  -        -  %  grain. 

Extract  Belladonna  Lvs.,     -  %  grain. 

Dose. — One  to  Two  or  Three  as  re- 
quired. 

Are  available  whenever  an  Aperient,  Laxative  or  Cathartic, 
pure  and  simple,  is  indicated; 

Are  adapted  to  the  needs  of  the  young  or  the  old  ;  for  the  most 
delicate  and  the  most  robust  alike. 

When  discontinued  do  not  leave  the  patient  in  a  more  consti- 
pated condition  than  when  begun. 

Put  up  in  bottles  of  1,000  and  5,000  each. 

Price,         .50       per  1,000 
Price,  $2.25       per  5.000 

Note. — We  are  the  sole  authorized  purveyors  of  the  Milbum 
Specialties. 


THE    J.     F.     HARTZ    COMPANY, 

2O8  ■WToodwara  Avenue,  DETROIT,  MICH.  . 

No.  2  R.icHinond   Street,  TOR.ONTO,    ONT.  i 


XXX 


DETROIT  MEDICAL  JOURNAL. 


The  Lakeland  Hospital 


...A  PRIVATE  HOSPITAL  FOR... 

MENTAL  AND  -^  ^ 
NERVOIS  DISEASES. 


CROSSE  POINT, 
MICHIGAN. 


I^     O     C     A    T     E     D 

OverlooKis\|f  t  H  e 
beautiful  sceners' 
of    I^aKe    St.     Clair. 


P.   O.   ADDRESS: 


DR.  SAMUEL  BELL, 

Detroit,  Mich. 


In  Charge  of  Dr.  Samuel  Bell,  formerly 
Medical  Superintendent  of  the  Upper 
Peninsula  Hospital  for  Ihe  Insane. 


POLK'S  MEDICAL 
REGISTER 

(Seventh  Revised  Edition) 


Will  appear  in  due  time.  Send 
for  descriptive  circulars.  Physi- 
cians  who  have  moved  since 
1898  should  notify  the  publish- 
ers promptly. 

Polk's  Medical  Directory  has 
been  established  15  years.  Do 
not  be  deceived  by  untried  and 
unknown  Imitations. 


I     R.  L.  POLK  &  CO.,  Publishers, 
I  DETROIT,  men. 

I 


I  •«•"•"...•-•...- 


~....~.«....»«-.-.~."....~«~.~»~»~« I 


An  Even 

Hundred 
Dollars 

will  buy  a 

BBS 

Micro= 


scope 

The  most  reliable,  accurately  built,  complete, 
and  desirable  microscope  ever  oflfered  for  $100.00. 
Meets  every  requirement  for  Bacteriology,  His- 
tology, Pathology,  Biology,  Urinary  'Work,  Etc. 
Two  eyepieces  ij  and  J  dry  and  j".  Oil  Immersion 
Lenses,  Abbe  Condenser  and  Iris  Diaphragm, 
and  Triple  Revolving  Nosepiece.  Usecl  at  Cor- 
nell, Harvard,  Yale,  University  of  Chicago,  Col- 
lege of  P.  and  S.,  and  scores  of  other  prominent 
iBboratories. 

CATALOGUE  FREE. 

MfrHe  for  Cub  Dlnronnt. 

BAUSCH  &  LOMB  OPTICAL  CO. 

New  York.        ROCHESTER,  N.  Y.       Chicago. 


DETROIT  MEDICAL  JOURNAL. 


xxxr 


Tablets  and  Pills 

Tablet  Trittirates 
Tablets  Compressed 
Tablets  and  Pills,  *«%Sated 
Tablets  and  Pills,  ^'^^fo^ifeS 


Full  lines  of  all  standard  formulas  in  packages  of  1 00 ; 
500;  1000,  or  in  bulk.  Our  own  production — "Made  on 
Honor  !  " 

Special  formulas  to  order — Our  Specialty! 


If  Honest    Goods, 

TKe  Best  Quality  in  Drti^s, 

A.ncl    the   A,cnie    in    FinisK. 


is  desired,  it  will  pay  you  to  seek  prices  at  our  hands. 

If  cheap  goods,  unreliable    drugs,  and   fake  formulas  are 
demanded,  do  not  apply  to  us. 


Ftill    lii>e   of  FRAZER**   PREPARATIONS 
carried    in    stocK.         j^         j0         j0        j0        jE/ 


the:  j.  f.  hartz  company, 

268  -Woodward  A.-venue,  DETROIT,   MICH. 

No.  2  R.icHmond  Street,    TOR.ONTO,    ONT. 


XXXII 


DETROIT  MEDICAL  JOURNAL. 


•  ••  x^HE^*** 


No.  I. 


SpHnt  Qate 

AND 

Bandage. 


No.  a. 


A  PERFECT  BANDAGE  AND  CAP  FOR  WOUNDS, 
CARBUNCLES,    ETC. 

These  are  so  obviously  SUPERIOR  and  SENSIBLE,  they  can  not  but  ap- 
peal to  every  progressive  practitioner  at  a  glance. 

Made  of  aluminum,  they  may  be  rendered    sterile    and    will    not    rust;    are 
moreover  light  and  inexpensive. 

They  enclose  but  do  not  touch  the  wound;   dressing  can  thus  be   attended 
AD  LIBITUM  and  without  pain. 


A  wound  covered  by  the  gate 
(which  being  concave-convex, 
has  great  strength)  has  a  positive 
protection  from  chafing  or  injury. 
Opened  with  ease,  it  permits  of 
instant  examination. 


No.  3- 


No.  4. 


Figure  i  and  2  represents  our  Vaccine  and  Boil  Cap:      Made   in   three 
sizes. 

Figure  3  and  4  reveal  our  Splint  Gate :     Made  in  two  sizes,  and  may  be 
easily  and  quickly  attached  to  any  splint,  or  plaster  cast. 

Figure  5  and  6  show  our  Finger  Splint  Cot,  equally  applicable  to  hands 
or  feet:     Made  in  three  sizes. 

FOR  SALE  BY  ALL  SURGICAL  HOUSES. 


Splint  Qate  & 
Bandage  Co., 

LAKOTA,  NORTH  DAKOTA. 


No.  5- 


No.  6. 


r^     Mi,    ■ 


o 


The  only  reliable  lotion  for  the  prompt  and 
effectual  eradication  of  Acne  in  all 
its   protean  forms— Guaranteed  I 

(formula  of  g.  r,  shimmbl.) 

This  preparation  represents  the  greatest  possible  therapeutic 
activity,  along  with  the  perfection  of  pharmaceutical  art  and  chemical 
skiir    In  pint  bottles  only. 

EACH  PINT  SUFFICES  FOR  FOUR  PRESCRIPTIONS. 

Price:    75  Cents  per  Bottlb,  Net. 


HARTZ  ACNE  LANCE  AND  COMEDO  EXTRACTOR. 


Price:    50  Cents  Each. 


A  Hartz  combined  Acne  Lance  and  Comedo  Extractor  will  be  presented  to 
every  physician  with  his  first  order  for  Albasulphidi,  thus  making  his  equipment 
complete  as  regards  the  management  of  this  most  stubborn  of  skin  maladies 

N.  B.     As  this  offer  is  made  only  to  introduce  Albasulphidi,  the  instrument 
cannot  be  supplied  gratis  to  more  than  one  individual,  and  only  to  a  physician. 


THE  J.  F.  HARTZ  CO. 


268  Woodward  Ave.,  Detroit,  Mich. 
No.  2,  East  Richmond  St.,  Toronto,  Ont. 


Price,  $1.50  per  i.uoo. 


75c  per  500. 


J 


t 


ANNABIN 
TABLETS 


(Formula.) 

Cannabln   1-10  grain 

Zinc  Pliospliide   1-10  grain 

Strych.  Phos 1-40  grain 

Avenine 1-200  grain 


Anodyne,  Antispasmodic,  Aphrodisiac, 
Hypnotic,  Nervine,  Reconstructive,  Roborant, 
Sedative. 

A  true  Anodyne  and  Sedative  to  the 
stomach  without  any  of  the  inconveniences 
attending  the  uses  of  Chloral,  Bromides  or 
Opiates. 

Promotes  assimilation,  msiead  of  retarding. 

Unequalled  in  the  management  of  funct- 
ional dyspepsias. 

Acts  like  magic  in  relieving  the  pains  of 
Rheumatism  and  Gout,  is  an  almost  specific  in 
most  forms  of  Neuralgi?. 


Confederation  Life  Building. 
Toronto,  Ontario. 


268  Woodward  Ave., 
Detroit,  Mich. 


I 


The  J.  F.  Hartz  Co.,     |